May 14, 2020

OSHA Highlights Protective Measures for Dental Practitioners During COVID-19 Pandemic

A new alert (PDF) published by OSHA lists measures that employers can take to help protect dental practitioners from occupational exposure to SARS-CoV-2, the virus that causes COVID-19. The agency urges employers to maximize the use of telemedicine for non-emergency consultations; prioritize urgent and emergency procedures; and install physical barriers or partitions between patient treatment areas. According to OSHA, employers should also ensure that ventilation and airflow in treatment areas adequately moves air away from staff work areas. Other preventative measures include minimizing the number of staff present when aerosol-generating procedures are performed and providing appropriate personal protective equipment, including eye goggles, face shields, and N95 respirators, to protect dental practitioners and support staff. Workers should also be encouraged to stay home if they are sick and to report any health and safety concerns.

More detailed guidance for dental industry workers and employers published previously by OSHA describes dentistry work tasks associated with the four exposure risk levels in the agency’s occupational risk pyramid. Tasks in the lower exposure risk category include administrative duties in non-public areas of dentistry facilities. Providing urgent or emergency dental care that does not involve aerosol-generating procedures to well patients is an example of a task that falls into the medium risk category. High-risk tasks include providing emergency dental care (not involving aerosol-generating procedures) to a known or suspected COVID-19 patient, and performing aerosol-generating procedures on well patients. Tasks that put dentistry workers at very high risk include performing aerosol-generating procedures on and collecting or handling specimens from known or suspected COVID-19 patients. Examples of tasks that can generate aerosols in dentistry include the use of dental turbines, micro-motor handpieces, ultrasonic scalers, and air-water syringes.

On March 16, the American Dental Association (ADA) recommended that dentists restrict their practices to all but urgent and emergency procedures during the COVID-19 outbreak. ADA’s latest statement, dated April 18, urges dentists in states that are reopening to “exercise professional judgment and carefully consider the availability of appropriate PPE to minimize risk of virus transmission.” The association also published interim guidance (PDF) related to masks and face shields.