Pa. adjusts restrictions on dentists to handle emergency situations

Pennsylvania adjusted its restrictions on dental work after dentists said too-strict rules prevented them from performing even emergency procedures.

Now, patients experiencing an emergency, such as an abscess or infection, can call their dentist for a phone evaluation and can come in for treatment if necessary.

Routine cleanings and non-emergency procedures are still banned in Pennsylvania under U.S. Centers for Disease Control and Prevention guidelines to limit the spread of the coronavirus.

Dentistry has a high risk of spreading the virus because saliva particles can become airborne and “aerosolized,” meaning they become very fine and can hang in the air much longer than normal, making them easy to inhale. But dentists said certain emergency procedures, such as extracting an infected tooth or recementing a crown, can be done safely with proper protection and would reduce the risk of patients in distress turning to already busy hospital emergency departments or self-medicating with painkillers.

The new rules reverse a March 22 order from the Pennsylvania Health Department ordering dentists to stop performing even emergency dental procedures unless using personal protective equipment, including N95 respirators, and working in a negativepressure room — a resource the vast majority of private practices and school clinics do not have.

Even hospital-based dental clinics were unable to meet the state’s guidelines.

Michael Barnes, a private practice dentist in South Philadelphia, said he is pleased the state reversed its emergency restriction because he worried how patients would respond when unable to get treatment.

Without a negative-pressure room, Mr. Barnes was limited to seeing patients through virtual visits and prescribing antibiotics or pain medication. Tooth problems can escalate quickly from minor discomfort to major pain. Antibiotics can sometimes help relieve pain from a tooth infection temporarily, but often the way to fix the problem is to remove the infection.

“We’re not ready to go back to full-on working. That’s not what anyone wants right now,” he said. “But at the minimum, it would help very much to be able to bring a patient in, look in their mouth, see what’s bothering them and if we can do anything to help them.”