SCREENING patients for chronic diseases and other medical conditions, including COVID-19, is within a dentist’s scope of practice.
The new policy on ‘’point-of-care testing’’ was issued by the American Dental Association (ADA) on Nov. 4.
Point-of-care testing is essential because diseases could complicate dental care or put the patient and dental staff at risk, the ADA observed.
“Yet currently, rapid and reliable COVID-19 tests are not available to dentists for in-office use, which makes no sense,” states ADA President Daniel Klemmedson who holds degrees in both dentistry and medicine.
He points out that dentists are doctors of oral health.
“It is well within dentists’ scope of practice to screen not just for COVID-19 infection but also other medical conditions that may affect dental care such as glucose levels, which help screen for diabetes, and blood pressure, which help screen for hypertension.
“Patients with abnormal test results would be referred to a physician, other qualified medical professional or medical facility for diagnosis and follow-up care.”
Dentists’ areas of care include not only their patients’ teeth, gums and supporting bone but also the muscles of the head, neck and jaw, the tongue, salivary glands, the nervous system of the head and neck and other areas.
When appropriate, dentists perform procedures such as biopsies, and screen for chronic or infectious diseases, salivary gland function and oral cancer.
“It makes practical sense for COVID-19 point-of -care testing to be included in screening procedures dentists perform,” Dr. Klemmedson said.
Nearly eight in 10 or 7.7 percent of Americans (10.2 million) reported having seen a dentist in the previous 12 months but no other medical professional. The numbers come from 2013-2016 data of the U.S. Centers for Disease Control and Prevention (CDC).
In fact, the U.S. Food and Drug Administration (US FDA) includes dentists among the professionals who can test for COVID-19.
The CDC recommends dental facilities consider implementing pre-procedure testing for COVID-19, particularly during shortages of Personal Protective Equipment (PPE).
With strengthened infection prevention protocols and PPE, dental offices have re-opened safely around the country, Dr. Klemmedson said.
“Millions of patients have returned for oral health care, which is an essential health service,” he said.
Dentists should be given access to point-of-care testing for COVID-19 infection authorized by the US FDA, he said, pointing out that it adds to their ability to screen patients and help to identify those infected with the virus.
The ADA and state dental societies are actively advocating state and federal regulatory authorities to publicly recognize that point-of-care testing for COVID-19 is within dentists’ existing scope of practice. That is, health authorities should make COVID-19 tests available for use in dental practices.
“With dental practices reopened across the country, dentists are already screening patients for signs and symptoms of COVID-19, and referring patients for appropriate medical follow-up when indicated,” Dr. Klemmedson said.
“Unfortunately, such screening alone will not identify all individuals who are infected. Identifying infected patients is key to being able to protect both patients and dental team members from exposure to the virus.”
Given that patients receiving dental treatment may be pre-symptomatic (infected but will develop symptoms in the next 14 days) or asymptomatic (infected but will never exhibit signs or symptoms of disease), Dr. Klemmedson said it is critical to identify those individuals carrying the virus so that it is possible to minimize their contacting and potentially infecting others.
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Dr. Joseph D. Lim is the former Associate Dean of the UE College of Dentistry, former Dean of the College of Dentistry, National University, past president and honorary fellow of the Asian Oral Implant Academy, and honorary fellow of the Japan College of Oral Implantologists. Honorary Life Member of Thai Association of Dental Implantology. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515./PN
