Please refer to this post by the RCDSO (Royal College of Dental Surgeons of Ontario)
COVID-19 (Novel Coronavirus) - Patients
The College has recommended that all non-emergency dental services should be postponed to help prevent the spread of COVID-19.
If you think you have an emergency case, call your dentist. They will ask you for information about your situation and give you advice about next steps. If you need to visit the office, they will let you know if they can help or will direct you to another dentist.
Do not go to a hospital emergency room for a dental problem at this time.
If you don’t have a dentist, see our list of emergency clinics.
Telehealth Ontario is also a key hub for advising the public on options for in-person assessment (if deemed necessary). The Telehealth number is 1-866-797-0000. Stay in self-isolation until you receive instructions otherwise from one of the above sources.
Click here for the Ministry self-assessment link.
The College has developed a Standard on Infection Prevention and Control that is in effect.
If you have a dental emergency, your dentist will ask you questions over the telephone and determine if you need to be seen.
If you need to be seen in the office, there are strict Infection Prevention and Control Standards that they must comply with.
Your dentist or oral health care worker should wear personal protective equipment such as gloves, protective eyewear, masks and protective clothing. Protective equipment should be used consistently during the treatment of patients.
Your dentist or oral health care worker should ensure that their hands are washed with plain or antimicrobial soap and running water or, if hands are NOT visibly soiled (i.e. in the majority of instances), the use of a 70-90% alcohol-based hand rub is the preferred method of hand hygiene.
All critical and semi-critical instruments used in dentistry, including handpieces, are available in heat-tolerant and/or single-use (disposable) forms. All heat-tolerant critical and semi-critical instruments must be heat-sterilized between uses. All single-use items must be disposed following use.
With this information, the dentist will evaluate your emergency and determine if it is a true emergency. In dentistry, a “true emergency situation” includes oral-facial trauma, significant infection, prolonged bleeding or pain which cannot be managed by over-the-counter medications.
Your dentist will then determine if over-the-counter medications (e.g. Advil, Tylenol) are recommended, if prescription medications are necessary, and/or if you need to be seen at the office.
If a prescription is indicated, your dentist can provide either a verbal or a faxed prescription to the pharmacy directly.
During this pandemic, dentists must continue to practice within the College's Guidelines with respect to writing prescriptions for narcotics and/or opioids
See guidance regarding the management of emergencies.
As a result, the College will not revisit its strong recommendation that all non-essential and elective dental services should be suspended until the State of Emergency has been lifted by the Government of Ontario.
As the situation continues to evolve very rapidly, visit the College’s website and follow us on Twitter on a regular basis for updates.
Non-emergency dental procedures include but are not limited to:
In dentistry, a “true emergency situation” includes oral-facial trauma, significant infection, prolonged bleeding or pain which cannot be managed by over-the-counter medications. Refer to the above questions and answer and our guidance on true emergencies.
If you believe you have a unique clinical situation and would like to discuss further, please reach out by email to the Practice Advisory Service to seek guidance.
If you don’t have a dentist, see our list of emergency clinics. This list has been organized alphabetically by city and the names of the office identify if it is a specialty office.
Not all dentists have the safety equipment needed to guard against COVID-19. Dentists that are equipped to treat emergency cases are required to maintain all standards of infection, prevention and control set by the College and Public Health.
Do not go to a hospital emergency room for a dental problem at this time.
Ontario’s Chief Medical Officer of Health and Canadian health authorities have asked that dentists remain open to ONLY provide emergency services and ONLY when they have the PPE and facilities to do that safely.
Dentists are expected to consider the best interests of their patients and communities at all times. Ontario has declared a state of emergency, and the Canadian government is strongly urging all Canadians to practice social distancing.
We continue to raise these issues with the relevant authorities. In the meantime, be aware that if a clinic remains open other than for emergency care, Public Health could be notified to take strong action.
Finally, stay isolated and stay healthy and we will be on the other side of this shortly.
Sincerely,
Dr. Jordan Pettigrew
If you think you have an emergency case, call your dentist. They will ask you for information about your situation and give you advice about next steps. If you need to visit the office, they will let you know if they can help or will direct you to another dentist.
Do not go to a hospital emergency room for a dental problem at this time.
If you don’t have a dentist, see our list of emergency clinics.
Where do I go if I am experiencing symptoms of COVID-19?
Contact your doctor if you’re experiencing symptoms of the COVID-19 novel coronavirus.Telehealth Ontario is also a key hub for advising the public on options for in-person assessment (if deemed necessary). The Telehealth number is 1-866-797-0000. Stay in self-isolation until you receive instructions otherwise from one of the above sources.
Click here for the Ministry self-assessment link.
Is it safe to visit my dentist?
Infection prevention and control in dentistry is vital for safe patient care.The College has developed a Standard on Infection Prevention and Control that is in effect.
If you have a dental emergency, your dentist will ask you questions over the telephone and determine if you need to be seen.
If you need to be seen in the office, there are strict Infection Prevention and Control Standards that they must comply with.
Your dentist or oral health care worker should wear personal protective equipment such as gloves, protective eyewear, masks and protective clothing. Protective equipment should be used consistently during the treatment of patients.
Your dentist or oral health care worker should ensure that their hands are washed with plain or antimicrobial soap and running water or, if hands are NOT visibly soiled (i.e. in the majority of instances), the use of a 70-90% alcohol-based hand rub is the preferred method of hand hygiene.
All critical and semi-critical instruments used in dentistry, including handpieces, are available in heat-tolerant and/or single-use (disposable) forms. All heat-tolerant critical and semi-critical instruments must be heat-sterilized between uses. All single-use items must be disposed following use.
I don’t want to go to my dentist’s office. Can my dentist just prescribe medications for me over the phone?
If you have a dental emergency, your dentist should ask you questions over the telephone regarding your symptoms and their level of severity, your current medications, allergies, history of trauma, sleeplessness, etc.With this information, the dentist will evaluate your emergency and determine if it is a true emergency. In dentistry, a “true emergency situation” includes oral-facial trauma, significant infection, prolonged bleeding or pain which cannot be managed by over-the-counter medications.
Your dentist will then determine if over-the-counter medications (e.g. Advil, Tylenol) are recommended, if prescription medications are necessary, and/or if you need to be seen at the office.
If a prescription is indicated, your dentist can provide either a verbal or a faxed prescription to the pharmacy directly.
During this pandemic, dentists must continue to practice within the College's Guidelines with respect to writing prescriptions for narcotics and/or opioids
See guidance regarding the management of emergencies.
Will the College continue to recommend that dental offices treat emergencies only?
Since our advice to dentists released March 15, the Government of Ontario has declared a State of Emergency. The government has also clarified that only “health care professionals providing emergency care including dentists” are considered to be in the category of ‘essential services’.As a result, the College will not revisit its strong recommendation that all non-essential and elective dental services should be suspended until the State of Emergency has been lifted by the Government of Ontario.
As the situation continues to evolve very rapidly, visit the College’s website and follow us on Twitter on a regular basis for updates.
What is a patient dental emergency during the pandemic?
In dentistry, an emergency could include an injury to the mouth and face, severe infection (such as an abscess or swelling), bleeding that continues for a long time or pain which cannot be managed by over-the-counter medication like Advil or Tylenol.Non-emergency dental procedures include but are not limited to:
- initial or periodic oral examinations and recall visits, including routine dental radiographs
- routine dental cleaning (scaling, polishing) and other preventive therapies such as fluoride applications
- orthodontic procedures other than those to address acute issues (e.g., pain, infection, trauma, wire cutting into the gum/cheek)
- removal of asymptomatic (non-pain/no swelling/no discomfort) teeth
- restorative dentistry (e.g. dental fillings, including treatment non-painful carious lesions).
- replacement of teeth with implants or bridges
- aesthetic dental procedures such as teeth whitening, veneers.
Can dentists cement a permanent or temporary crown/bridge or deliver a denture to a patient?
The Acting Chief Medical Officer of Health has advised that all non-essential and elective services should be ceased or reduced to minimal levels, subject to allowable exceptions, until further notice. Allowable exceptions can be made for time sensitive circumstances to avert or avoid negative patient outcomes or to avert or avoid a situation that would have a direct impact on the safety of patients.In dentistry, a “true emergency situation” includes oral-facial trauma, significant infection, prolonged bleeding or pain which cannot be managed by over-the-counter medications. Refer to the above questions and answer and our guidance on true emergencies.
If you believe you have a unique clinical situation and would like to discuss further, please reach out by email to the Practice Advisory Service to seek guidance.
I think I have an emergency dental situation. What do I do?
If you think you have an emergency case, call your dentist. They will ask you for information about your situation and give you advice about next steps. If you need to visit the office, they will let you know if they can help or will direct you to another dentist.If you don’t have a dentist, see our list of emergency clinics. This list has been organized alphabetically by city and the names of the office identify if it is a specialty office.
Not all dentists have the safety equipment needed to guard against COVID-19. Dentists that are equipped to treat emergency cases are required to maintain all standards of infection, prevention and control set by the College and Public Health.
Do not go to a hospital emergency room for a dental problem at this time.
Many dentists apparently are not heeding the College’s recommendation and are continuing with non-emergency treatment in their office. What will the College do about this?
The College sought legal advice and confirmed that we do not have the legal authority to close dental offices. Our approach and advice is similar to most health care regulators under Ontario’s Regulated Health Professions Act (RHPA), and by regulators in many other provinces; we are limited to “strongly recommending” that all dental offices close.Ontario’s Chief Medical Officer of Health and Canadian health authorities have asked that dentists remain open to ONLY provide emergency services and ONLY when they have the PPE and facilities to do that safely.
Dentists are expected to consider the best interests of their patients and communities at all times. Ontario has declared a state of emergency, and the Canadian government is strongly urging all Canadians to practice social distancing.
We continue to raise these issues with the relevant authorities. In the meantime, be aware that if a clinic remains open other than for emergency care, Public Health could be notified to take strong action.
Where to find up-to-date information
Follow us on Twitter @rcdso_org for regular updates.Finally, stay isolated and stay healthy and we will be on the other side of this shortly.
Sincerely,
Dr. Jordan Pettigrew
