What Can Dentists Do during the Covid-19 Pandemic?

By: Chase Howard

Like most medical practices and businesses in Florida, dental practices have been deemed non-essential except for emergency type services. For good reason, non-life threatening care, surgeries and services are put on hold to help curb the spread of COVID-19, which has left providers with the question of what they can do to maintain and treat patients remotely.

Recently, the American Dental Association (ADA) provided helpful guidance on the difference between emergency and nonemergency care, as well as the use of teledentistry.

Teledentistry is the use of a telehealth system through a variety of different technologies to deliver virtual health services, including dentistry.

Telehealth includes live video (synchronous), store and forward (asynchronous), remote monitoring, and mobile health. Live video is a live, two-way transmission of audiovisual telecommunications. Store and forward is a recorded file of the patient’s health information. Remote monitoring allows a provider to track patient health data through the use of devices which transmit data to a portal which the provider can securely access. Mobile health is the use of personal devices to share health information and education.

The ADA has echoed local governments calls to alleviate the pressure on emergency services by having healthcare professionals postpone all elective services and non-emergency care. The ADA put forth guidance to help individuals and dentists determine what constitutes a dental emergency, which includes issues that are potentially life threatening and require immediate treatment. Immediate treatment would include stopping bleeding or treating severe pain, infections, or conditions. A more complete guide can be found here.

In light of these changes, many dentists have sought creative ways to manage patient care while avoiding risk of further spread of COVID-19. The ADA has also provided billing guidance for dentists who aim to provide telehealth services to their patients during this time.

The ADA advises providers to consider that services must still be properly documented and conducted in accordance with established protocols. Providers must also advise the patient that the patient has the right to expect:

1. That any dentist delivering services using teledentistry technologies will be licensed in the state where the patient receives services, or be providing these services as otherwise authorized by that state’s dental board.
2. Access to the licensure and board certification qualifications of the oral health care practitioner who is providing the care in advance of the visit.
3. That the delivery of services through teledentistry technologies will follow evidence- based practice guidelines, to the degree they are available, as a means of ensuring patient safety, quality of care and positive health outcomes.
4. That they will be informed about the identity of the providers collecting or evaluating their information or providing treatment, and of any costs they will be responsible for in advance of the delivery of services.
5. That relevant patient information will be collected prior to performing services using teledentistry technologies and methods including medical, dental, and social history, and other relevant demographic and personal information.
6. That the provision of services using teledentistry technologies will be properly documented and the records and documentation collected will be provided to the patient upon their request.
7. That services provided using teledentistry technologies and methods include care coordination as a part of a dental home and that the patient’s records be made available to any entity that is serving as the patient’s dental home.
8. That the patient will be actively involved in treatment decisions, will be able to choose how they receive a covered service, including considerations for urgency, convenience and satisfaction and without such penalties as higher deductibles, co-payments or coinsurance relative to that of in-person services.
9. That the delivery of services using teledentistry technologies are performed in accordance with applicable laws and regulations addressing the privacy and security of patients’ private health information.

Dentists must also continue to provide care that is consistent with in-person care as well as ensure compliance with scope of practice laws, regulations and rules as well as billing practices.

For a broader review of regulatory changes to telehealth regulations during this time, take a look at our other blog posts on this topic.