It is crazy to think that less than one week ago, lives were still normal for most Americans. However, in just under one week, many U.S. cities have gone into lockdowns. Americans everywhere are laid off from work. And businesses are grasping for their chance of survival. It is impossible to say which way the disease will go. But on its current trajectory, it is likely to spread more, affecting many more people and businesses.
The dental industry has been one of the sectors most affected by the pandemic. At pH Dental, more than half of our dental office clients have temporarily closed over the last week. On the other hand, other offices now only treat emergency cases, as suggested by healthcare organizations.
What does the current situation mean for dental offices that remain open?
For the dental offices that remain open, dentists should try to detect potential cases of coronavirus before setting up an appointment for a patient. The CDA recommended that dentists should implement patient screening about their travel history and overall health condition.
Initial patient screening via telephone should be initiated remotely at the time of scheduling appointment. We have created a sample screening script for dental offices to follow. The script should be provided to all doctors and staff. It will cover questions to gain information regarding whether a patient has been to COVID-19 affected areas, or whether he or she has shown any signs of respiratory illness symptoms.
Sample COVID-19 Patient Screening Phone Script
Greetings and identify the problem
Receptionist: Thanks for calling pH Dental. This is Chris speaking. How can I help you?
Patient: Hi, Chris. My name is John Nguyen. I want to set up an appointment. My tooth really hurts. Is it possible to set up an appointment immediately?
Receptionist: I am sorry to hear that, John. Have you ever been to our office before?
Patient: No, I haven’t.
Receptionist: Could you tell me which area is causing you pain? And how long have you had this toothache?
Patient: Yes, it’s really hurt in the back of my mouth, upper right corner. And it has lasted for more than 2 days.
Receptionist: Do you have any swelling or bleeding?
Patient: No, it’s only the pain.
Receptionist: Okay, John. Our dentist can definitely take a look at your teeth. We want to help you with your problem as soon as possible so you can be relieved from the pain. However, as you may already know about the situation with coronavirus, we need to ask you a few screening questions before setting an appointment. We know you are experiencing severe pain right now, but we hope that you could understand and comply with our precautionary measures.
Patient: No problem.
What if the patient’s case is not an emergency?
According to the ADA, dentists should only treat patients who are in pain, have an infection, or non-treatment will negatively impact their health in the next three to six months. Additionally, patients who have new treatments requiring the removal of sutures would also be considered appropriate for treatment.
Receptionist: Thank you for calling our office, John. However, due to the current situation regarding the coronavirus pandemic. Our office has decided only to treat emergency cases. We sincerely apologize and hope for your understanding.
Coronavirus patient screening questions
Receptionist: In the past 14 days, have you or any family member traveled to New York, other countries (China, Iran, Italy, Spain, Germany), or anywhere else?
Patient: No. We haven’t traveled outside the city in the past 2 weeks.
If the patient answers yes to the question, please take note of all locations. Dentists should keep track of global tracking for COVID-19 to stay informed about the areas with a high number of confirmed cases.
Receptionist: Okay. In the past 14 days, have you or any family member come in contact with someone who has been tested positive for COVID-19 or shown symptoms relating to the virus?
Patient: No. We haven’t.
Receptionist: Okay. Have you had any fever, coughing, or difficulty breathing in the last 14 days?
Patient: No. There’s just this toothache.
Receptionist: Okay, John. Thank you very much for your understanding and cooperation. We can move forward and set up an appointment with you. Would today at 3:00 work?
Receptionist: Okay. I have put you in our appointment calendar. Is there anything else I can help you with?
Patient: That’s all. Thank you.
Receptionist: We will see you soon. Again, thank you for your cooperation.
Even if the patient answers no to all of the above questions, practices should still apply precautionary measures when that patient comes to the office. For example, dentists should measure the patient’s temperature.
If the patient answers yes to any of the COVID-19 screening questions, dental offices should turn down the appointment and defer it to at least 14 days.
Receptionist: Okay, John. Thank you very much for your cooperation. Unfortunately, we cannot move forward and set up an appointment with you. We understand that you are experiencing pain and discomfort. However, since coronavirus could quickly spread in the dental setting, we have to make sure that there’s a low risk of infection to protect our dentists and staff. We could try setting up an appointment with you again in 2 weeks. We sincerely apologize and hope for your understanding.
Additionally, consider implementing teledentistry. According to the ADA, teledentistry is providing dental care for patients remotely. In this setting, dentists use telecommunication technologies, such as live video, to convey health information and monitor the patient’s condition. Utilizing teledentistry is not a bad idea during the coronavirus outbreak. Through it, dentists could still give dental care to patients, and at the same time, mitigate the spread of coronavirus.
Read the full guide about teledentistry from the ADA.
Pharmacological management, such as oral analgesics, could be a possible solution to help patients who are experiencing pain or swelling.
The two above solutions could be implemented to help patients during the 2 weeks self-quarantine period.
What to do if the patient is in a “life-threatening” condition?
Yes, we recommend that dental offices shouldn’t treat patients who answer yes to any of the COVID-19 screening questions. However, what to do if the patient is experiencing bleeding or trauma, and requires dental care immediately?
Dentists should evaluate the severity of the situation and decide using their professional judgment whether or not they should provide dental care to the patient. In this case, dentists should follow strict guidelines by the CDC to mitigate infections (How to put on and remove protective equipment when treating COVID-19 patients (CDC)).
Additionally, we recommend dental offices to build their own “Emergency Case Assessment” questionnaire and make treatment decisions based on this questionnaire. For example, dentists could ask the patient about their level of pain on a 10 point scale, or ask if the patient is having difficulty in eating and chewing.
We know that it is very difficult, both morally and ethically, for a healthcare professional to turn down a treatment. However, with the current situation, implementing patient screening is one way that healthcare professionals could protect public health.
It is crucial that dentists apply the above-mentions guideline and make informed decisions regarding giving out dental care treatments. We know that the upcoming weeks will be tough, so please read our article about strategies for dentists to survive through this pandemic.
We summarize our suggested COVID-19 patient screening questions below. Please save and teach them to all staff so that together we could control the spread of coronavirus.
- In the past 14 days, have you or any family member travelled to New York, other countries (China, Iran, Italy, Spain, Germany), or anywhere else?
- In the past 14 days, have you or any family member come in contact with someone who has been tested positive for COVID-19 or shown symptoms relating to the virus?
- Have you had any fever, coughing, or difficulty breathing in the last 14 days?
Now, have your practices implemented all precautionary measures? Follow us on social media to keep up-to-date with everything-dental.