IDPH, IDB Statement on Postponement of Elective Procedures


Covid-19 Update

IDPH, IDB Statement on Postponement of Elective Procedures

The Iowa Department of Public Health, in collaboration with the Iowa Dental Board, has been closely monitoring the spread of the coronavirus. Dentists, hygienists and staff are part of the healthcare community and have a responsibility in the prevention and mitigation efforts of the administration during this outbreak. Dentists are also in the highest risk categories for both transmission and contraction of the Coronavirus, as a majority of the procedures performed creates significant aerosols in the operatories. As a part of the healthcare community and the community at large, there is an obligation to protect the safety of patients and staff.

For these reasons we are recommending, in alignment with the recommendations from the ADA and IDA, that elective care be postponed for a period of three weeks. 

These recommendations to the dental profession are intended to reduce the risk of patients’ exposure to COVID-19 and to preserve PPE and supplies, while still allowing access to necessary and emergency dental services.  This will maintain the oral health of Iowa citizens and keep them out of the hospital ER.  

Please reschedule elective procedures, which may include but are not limited to: 

  • Any cosmetic or aesthetic procedures, such as veneers, teeth bleaching, or cosmetic bonding.
  • All routine hygiene appointments.
  • Any orthodontic procedures, not including those that relieve pain and infection or restore oral function or are trauma-related.
  • Initiation of any crowns, bridges, or dentures that do not address or prevent pain or restore normal oral functioning.
  • Any periodontal plastic surgery.
  • Extraction of asymptomatic non-carious teeth.
  • Recall visits for periodontally-healthy patients.
  • Delay all appointments for high risk patients, including ASA 2 and 3 patients, unless it is an emergency.

Additionally, we urge you to consider the following measures: 

  • Use cell phone or teledental triage: take a picture of the area and text it to the dentist.
  • Have a detailed questionnaire and conversation with the patient before scheduling appointments. Prior to any procedure, ask the patient about flu-like symptoms, travel abroad for self, family, friends, and co-workers to permit a thorough evaluation of the patient.
  • Consider taking the temperature of the patient at the outset.
  • Reconsider scheduling high risk patients unless they need emergency treatment.
  • Careful evaluation of the need for scheduling of ASA 2 & 3 patients.
  • Use of 1% hydrogen peroxide rinse prior to examination of the oral cavity by the patient to reduce microbial load.
  • Use of rubber dam for isolation and high volume suction to limit aerosol in treatment procedures.
  • Proper disinfection protocol between patients with a possible repeat of the protocol for a second time.

To prevent overcrowding of waiting areas or the possible spread of infection:

  • Consider having patients wait in their cars instead of the waiting areas to prevent inadvertent spread of the virus. Call patient when surgical area is ready for treatment.
  • Consider staggering appointment times to reduce waiting room exposure.
  • Consider rescheduling elective procedures on ASA 2 & 3 patients. https://www.asahq.org/standards-and-guidelines/asa-physical-status-classification-system
  • Have front desk staff take measures to prevent exposure.
  • Have sterilization staff, lab technicians and auxiliary staff take adequate measures to prevent exposure.
  • Limit access to waiting room use to only patients. Accompanying individuals have to wait in their respective transportation. 
  • Remove all magazines, toys, etc. from waiting area to prevent contamination. 

Thank you for your understanding and cooperation as we work through these very difficult and unprecedented times.

Please forward your questions via email to Jill.Stuecker@iowa.gov.