A Health Department action Thursday afternoon appears to have resolved a situation that shut down even emergency dental procedures across the state this week.
Thursday’s action relaxes guidelines instituted Monday to control the risk of spreading coronavirus.
Johnstown dental surgeon Michael Gress contacted The Tribune-Democrat on Wednesday morning to share the plight of dentists and their patients.
When the state told hospitals to stop elective procedures, it meant dentists could only do emergency procedures, such as treating a severe toothache or infected abscess.
But the rules, which were based on Centers for Disease Control and Prevention guidelines, required all procedures to be done in “negative pressure” rooms with air filters. The set-up draws the air out of the procedure room and captures airborne microorganisms.
All those in the room would be required to wear high-tech N95 masks, which are in short supply across the nation.
“There is no dentist in the state with a negative pressure room,” Gress said.
His attempts to get the N95 masks were not successful. One company predicted delivery in mid-May at the earliest.
The state policy was approved Sunday.
Gress began calling patients Monday to cancel procedures.
That meant people with severe toothaches were continuing to wait for relief.
Gress is a member of the Pennsylvania Dental Association, which contacted the Health Department and Gov. Tom Wolf to negotiate a less restrictive policy.
“We have confirmed that even the dental schools don’t have negative pressure engineering controls,” the association wrote to the state.
“This guidance will effectively shut down most, if not all, dental facilities and offices. Patients needing emergency care will flood hospitals’ emergency rooms, the very place we do not want them to go.”
Gress said that had not happened yet in Johnstown, but expected the hospital would call him to do the emergency procedure, anyway.
Health Secretary Dr. Rachel Levine was asked about the situation during Thursday’s press briefing.
“We’ve come up with some new draft policies that I’ll be discussing with the dental experts this afternoon,” Levine said. “We’ll have a report that, hopefully, we can release tomorrow.”
Responding to the newspaper’s request, her office emailed the new policy document to The Tribune-Democrat just after 4:30 p.m. Thursday. Gress was provided a copy.
The revised policy requires the N95 mask only for patients with COVID-19 diagnosis or symptoms.
All other procedures are permitted with the standard personal protection equipment used by dentists.
“It seems to be common sense,” Gress said. “If a patient is not suspected of having coronavirus, then it’s appropriate to treat them on an emergency basis.”
The dental association president responded on its Facebook page.
“Now dentists in Pennsylvania can provide emergency dental care to patients who have been suffering with severe pain and swelling, or who have had traumatic injuries to their teeth as a result of accidents, without the requirement to use negative pressure rooms which are not available in dental offices, hospitals, public health facilities or dental schools,” association President Charles Incalcaterra said.
“We look forward to communicating regularly with the Department of Health as this crisis unfolds.”
Gress said he expected to resume work immediately.
“This is good news,” he said. “Now I can see the pile of patients that has backed up.”