Point-of-care testing to screen patients for chronic diseases and other medical conditions such as COVID-19 that could complicate dental care or put the patient and dental staff at risk is within a dentist’s scope of practice, according to a new policy from the ADA.
“Yet currently, rapid and reliable COVID-19 tests are not available to dentists for in-office use, which makes no sense,” said ADA president Daniel Klemmedson, DDS, MD, who noted 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,” Klemmedson said.
“Patients with abnormal tests results would be referred to a physician, other qualified medical professional, or medical facility for diagnosis and follow-up care,” said Klemmedson.
“With strengthened infection prevention protocols and personal protective equipment (PPE), dental offices have reopened safely around the country. Millions of patients have returned for oral healthcare, which is an essential health service,” he said.
“Dentists should be given access to FDA-authorized point-of-care testing for COVID-19 infection to add to their ability to screen patients and help to identify those infected with the virus,” Klemmedson said.
Dentists’ areas of care include the teeth, gums, and supporting bone as well as the muscles of the head, neck, and jaw, the tongue, salivary glands, and the nervous system of the head, neck, and other areas, Klemmedson said.
When appropriate, he continued, dentists perform procedures such as biopsies and screen for chronic or infectious diseases, salivary gland function, and oral cancer.
In addition, the ADA said, according to 2013-2016 data from the US Centers for Disease Control and Prevention (CDC), 7.7% of people (10.2 million) reported having seen a dentist in the previous 12 months but had not seen any other medical professional.
“It makes practical sense for COVID-19 point-of-care testing to be included in screening procedures dentists perform,” Klemmedson said.
The US Food and Drug Administration includes dentists among those professionals who can test for COVID-19. Also, the CDC recommends that dental facilities consider implementing pre-procedure testing for COVID-19, particularly during PPE shortages.
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 and 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,” 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,” he said.
Since patients receiving dental treatment may be pre-symptomatic or asymptomatic, Klemmedson said it is critical to identify those individuals carrying the virus to minimize their contacting and potentially infecting others.