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|Your Weekly COVID-19 Wrap-UpFriday, May 1, 2020|
Getting Dentists Ready to Get Back to Work
This week, the Ontario government released A Framework for Reopening our Province. The document makes clear that, when implemented, “public health and safety will be the number one concern, while balancing the needs of people and businesses.” The new normal for dentistry will be very different than pre-COVID-19 dental office routines – the need for enhanced PPE, requirements for physical distancing and varied workflow are expected.
The ODA Return-to-Practice Working Group has begun its work to create viable solutions to dentistry’s challenges with information, protocols and resources based on the best evidence available. We’re closely examining Manitoba and Saskatchewan, as dentists in those provinces start to reopen their practices in the coming weeks, for a glimpse into what we can expect and plan for.
The Working Group has launched new resources to assist members as they start bringing staff back to work – a Q&A document and a notice-to-recall template. These were developed in collaboration with the labour and employment law firm Emond Harnden. You can find them on our member website. In the coming days, additional resources and requests for information will be coming from the Working Group.
The Working Group is also working hard to investigate all the conflicting information around retrofitting open-concept offices, including air-purification. As in previous member updates, we strongly recommend that members resist jumping into expensive renovations or product purchases, as many options being promoted are not evidence-based nor have been properly analyzed. We know the frustration about the lack of clear answers, and the urgency we all feel to use the time now to prepare. But it would be even worse to incur significant costs that may be unnecessary or ineffective in meeting immediate, short and medium-range guidance for safety in Ontario dental offices.
Rapid or Point-of-Care COVID-19 Testing
Despite claims and assurances by some companies that their tests are ready to be used and have approvals, the Ministry of Health has not yet determined the reliability of point-of-care testing and its effectiveness in a clinical setting for screening purposes. The Return to Practice Working Group is also reviewing all the information available to better understand the potential for COVID-19 point-of-care testing so we can be prepared. However, we don’t expect any immediate progress on this. Here’s why:
There are primarily two types of tests, each with its own strengths and limitations.Tests that attempt to detect the presence of the virus. These are a greater predictor of the infectivity of the patient. However, these tests are sensitive to the technique used for collection since the virus is not evenly distributed through the body, which could potentially lead to false negatives.Tests that attempt to detect the body’s immune reaction to the virus. These can confirm whether an individual has had COVID-19 and if immunity has been developed, but it will not confirm if the person is still infectious.Because inherent problems still exist in terms of the accuracy of the tests, dentists should be cautious of buying into tests now when health officials are still assessing their options. It would have tremendous implications for dentistry and public health if we rush to get these tests out. What if patients were told that they are negative for COVID-19 when they are still infectious? Would insurers or the Ministry of Health even consider covering costs for tests that end up not being supported?
We must take every precaution to ensure, as much as we can, the safety of patients, dentists and staff when practices re-open. We just can’t take any risks on this front and jeopardize the opening of dentists’ livelihoods and the reputation of our profession.
Clarification on Teledentistry Codes
We’ve received many calls from members asking for clarification between the procedure code 01205 (emergency examination and diagnosis) and 05201 (consultation with a patient).01205 has always been used to describe an intraoral exam which is performed with a patient in the office. If an office is open to see emergency patients and an in-person clinical examination is performed, this code should be used.05201-05209 are the codes used for teledentistry assessments during the province’s State of Emergency, based on the RCDSO’s direction. Teledentistry is the provision of patient dental care at a distance using information and communication technologies and is to be used to assist with the provision of emergency care – specifically, to assess and triage patients’ oral health care needs and to determine next steps. A full emergency examination and diagnosis is not possible using teledentistry alone.More information is on our COVID-19 page on the member website. With regards to adjudicating claims, insurance companies have begun adding 05200 to plans, or are mapping it to codes that are already covered. The Canadian Dental Association is receiving an increase in reports across Canada confirming that claims are being reimbursed. This is directly due to the CDA and ODA’s work to raise awareness among the insurance industry of the importance of teledentistry right now. While this is promising news, it is important to remember that not all insurance companies or plans are covering this code in the same way, and every benefits plan is different. As always, please remind your patients to check with their employer or plan sponsor about their specific coverage.
Federal Funding Information for Dental Practices
The Canadian Dental Association (CDA), the national voice of ODA members, has changed its downloadable Business Roadmap document into an online resource to ensure it can continue to be quickly updated with the latest information. It has partnered with MNP and the Canadian Medical Association to share and personalize federal funding program information that is more specific to certain business models, including: dental professional corporations or self-employed dentists; cost-sharing arrangements (unincorporated association); and partnerships.
ODA in the Media
The ODA is your voice to the public. We have been featured in more than 100 local, provincial and national media stories about COVID-19 and its impact on dentists, patients and the profession. Our President, Dr. Kim Hansen, spoke to CTV News and Global News about why routine care is not available, why home oral hygiene is more important than ever, how to access emergency care and how dentists are working on the front lines in response to the pandemic.
Dr. Hansen has also brought attention to the need for dentists to access adequate PPE as dental offices are expected to be one of the first line of businesses to reopen. He appeared on CBC’s The National evening television newscast last night as part of a report on Premier Doug Ford’s plan to reopen businesses and, just recently, a CityNews story on the impact the pandemic will have on patients and why dentists need support.
|Ontario Dental Association|
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