CORONA VIRUS AFFECTING DENTISTRY IN NEVADA

UPDATED: October  7, 2022

UPDATED: September 16, 2022:

UPDATED: May 20, 2022:

UPDATED: March 23, 2022:

UPDATED: February 11, 2022:

UPDATED: February 10, 2022:

UPDATED: June 1, 2021: 

On June 1, 2021, Board President Kevin Moore, DDS circulated a email blast to inform licensees of updates regarding the following:  

(1) Recent CDC mask guidance and impact upon Nevada dental settings;  
(2) CDC interim dental settings; and  
(3) Reminder regarding dental license renewal 

The emailed memorandum can be found here.

UPDATED: February 10, 2021:

NEW COVID GUIDANCE FROM January 5, 2021 BOARD MEETING

The Nevada State Board of Dental Examiners (“NSBDE”), at its January 5, 2021 board telephone conference meeting, voted to approve the CDC’s interim dental settings guidelines (updated December 4, 2020) pursuant to NAC 631.178, with the modification that where the guidelines recommend use of N95 respirators, licensees can, instead, use the combination of a level 3 surgical mask, face-shield and eye protection.
The modification acknowledges that N95 respirators should be used when readily available, but also takes into account ongoing issues with sourcing N95 respirators by offering licensees the option to use a more readily available alternative combination of PPE that has been used in dental settings for several months (in tandem with other aerosol mitigating technology such as rubber dams, high-speed suction, and four-handed/tool assisted dentistry) with acceptable results.

URL LINK TO CDC GUIDANCE

The full text of the original CDC interim dental settings guidelines (updated December 4, 2020) can be found at:
CDC Guidelines - Updated December 4, 2020  

UPDATED: November 30, 2020:

NEW COVID GUIDANCE FROM October 8, 2020 BOARD MEETING 

The Nevada State Board of Dental Examiners (“NSBDE”), at its October 8, 2020 board telephone conference meeting, voted to:

1. approve the CDC’s interim dental settings guidelines (updated August 28, 2020) pursuant to NAC 631.178 with modifications to allow for the use of N95 or equivalent, namely a level 3 surgical mask, faceshield and eye protection;  and to
2. not approve the CDC’s interim dental settings guidelines (updated August 4, 2020).    

This means that, per NAC 631.178, licensed dentists and dental hygienists in Nevada “shall comply” with the CDC’s guidance for dental settings, which now include the CDC’s August 28, 2020 interim dental settings guidelines with modifications that allow the use of N95 or equivalent.  

URL LINK TO CDC GUIDANCE

The full text of the original CDC interim dental settings guidelines (updated August 28, 2020) can be found at:

   CDC Guidelines - Updated August 28, 2020    

UPDATED: September 16, 2020:

QUESTIONS FOR CDC CLARIFICATION?

At the June 3, 2020, the CDC COCA (Clinician Outreach and Communication Activity) call regarding "Guidance for Dental Setting During the COVID-19 Response", COCA advised that you may email your questions to COCA@CDC.gov .   You may also wish to visit CDC's COVID-19 website at www. CDC. gov/COVID-19 for more information.

You can also find the CDC Releases Interim Reopening Guidance for Dental Settings updated on August 28, 2020, at https://www.cdc.gov/oralhealth/infectioncontrol/statement-COVID.html

UPDATED: July 16, 2020:

NEW COVID GUIDANCE FROM JULY 14 BOARD MEETING

The NSBDE, at its July 14, 2020 board telephone conference meeting, voted in favor of motions to

1. approve the CDC’s interim dental settings guidelines (updated June 17, 2020) pursuant to NAC 631.178; and 
2. to no longer follow the “Guidance for Dental Services in Nevada” DHHS memorandum that it had previously adopted at the April 30, 2020 board meeting.  

This means that, per NAC 631.178, licensed dentists and dental hygienists in Nevada “shall comply” with the CDC’s guidance for dental settings, which now include the CDC’s June 17, 2020 interim dental settings guidelines.

URL LINK TO CDC GUIDANCE

The full text of the CDC interim dental settings guidelines (updated June 17, 2020) can be found at:https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html

LOCATION OF POPULAR TOPICS IN CDC GUIDANCE

While all of the CDC interim dental settings guidelines are important, the board’s staff has fielded repeated questions on particular topics, including:

• considerations for the use of aerosol generating procedures,
• use of personal protective equipment (PPE), and
• the monitoring and management of dental healthcare personnel.

The following PDF of the full text of the CDC guidelines (updated June 17,2020) includes highlighted text that addresses these three popular topics: LINK TO CDC GUIDELINES W/ HIGHLIGHTED TOPICS

UPDATED: April 30, 2020:

At the Thursday, April 30, 2020 NSBDE Telephone Conference Meeting, the NSBDE voted to adopt certain portions of the “Guidance for Dental Services in Nevada” memorandum issued by the Nevada Department of Health and Human Services. These new regulations will take effect on Monday, May 4, 2020, and can be found at the link below:

**Please direct questions concerning the DHHS Memo to Dr. Antonina Capurro, DMD, M.P.H, MBA Nevada State Dental Health Officer**

Department of Human Health Services
4150 Technology Way, Suite 300
Carson City, NV 89706
(775) 684-4200 Fax (775) 687-7570

• Link: DHHS Memorandum

UPDATED: April 29, 2020:

Update to Dental Licensees:

There is conflicting information being disseminated to licensees from various entities and organizations.  The mission of the NSBDE is to safeguard the health, safety and welfare of the citizens of Nevada by regulating the practice of dentistry in the State of Nevada.  Please be advised that the NSBDE is the only entity in the State regulating the practice of dentistry, dental hygiene and dental therapy.   The practice of dentistry is regulated by Nevada Revised Statutes and Nevada Administrative Code 631.  NAC 631.178 states dentists “shall comply” with CDC guidelines.  The current CDC guideline issued on April 27, 2020 is available at the following link and states:

Recommendation

Postpone Elective Procedures, Surgeries, and Non-urgent Dental Visits

Services should be limited to emergency visits only during this period of the pandemic. These actions help staff and patients stay safe, preserve personal protective equipment and patient care supplies, and expand available health system capacity.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html

Based on the current guidelines dated April 27, 2020 please postpone elective procedures, surgeries and non-urgent dental visits.  As this situation is fluid, we anticipate the CDC guidelines to be revised in the near future to incorporate recommendations for resuming non-emergency dental services.

UPDATED: April 13, 2020:

For Your Information:

1. Interim infection prevention and control guidance for dental settings during the COVID-19 response as recommended by the Centers for Disease Control and Prevention
   https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html
2. If emergency dental treatment is medically needed for a patient with known or suspected COVID-19, airborne infection precautions and parameters should be strongly considered
3. If offering treatment for dental emergencies, customary infection control protocols should continue to be followed (i.e., weekly biological spore testing of sterilizers, updating sterilization logs with tests dates & results, etc)

UPDATED: April 08, 2020:

The NDA has organized a response team to help equip our hospitals and urgent care facilities with PPE's.  If you have a surplus that you could spare please contact them using the form attached.  Thank you all for helping us care for Nevadans!

PPE Surplus Form

UPDATED: April 02, 2020:

Dear Nevada Dental Practitioners:

As an update to our most recent statement concerning the practice of dentistry in the State of Nevada during the Coronavirus pandemic, we direct all practitioners to the Declaration of Emergency Directive 010 Stay at Home Order (“Directive 010”) issued by The State of Nevada, Executive Department (which includes Governor Sisolak) on March 31, 2020.

Directive 010 extends Governor Sisolak’s March 12, 2020 Declaration of Emergency from April 16, 2020 to April 30, 2020. Therefore, in continued alignment with Governor Sisolak’s direction as set forth in Directive 010, the Board supports the postponement of elective dental procedures until at least April 30, 2020 per the prior mandate given to all essential businesses in Directive 003 that they “must adopt COVID-19 risk mitigation measures that reduce the risk of community disease spread” in order to continue operating during the Coronavirus pandemic.

Additionally, many of you have inquired about the ability to practice teledentistry during this time. Please note that at the Board’s July 19, 2019 public meeting, the Board passed a motion finding that telehealth is within the scope of NRS 631.215, which defines the practice of dentistry in the State of Nevada. The Board also voted to create a regulation to address and define telehealth as it relates to the practice of dentistry in the State of Nevada. While such a regulation has yet to be created and adopted, the Board has already concluded that practitioners may practice in teledentistry. Therefore, pending the creation and adoption of such a regulation, practitioners would be subject to at least the same substantive measures and practices required of them as though they were treating a patient in person.

Thank you for your time and attention to these important matters. We remain committed to weathering this storm with you and hope the best for your practices as you follow the Board’s recommendations, as well as any guidelines, recommendations, and any mandates from national, state, and local governments.

For those who may require Continuing Education extensions we have provided a link below:

Continuing Education Extension Form

Please fill out and return to the Board for review.

UPDATED: March 27, 2020:

Dear Nevada State Dental Practitioners:

Please accept our sincerest apologies for having to cancel the meeting scheduled for March 26, 2020. We are working diligently to resolve the teleconferencing issues experienced and appreciate your patience as we try to effectively conduct business during this difficult time. We know you are frustrated and anxious about how to maintain your practices and assure you  that we are committed to providing you with information to guide you  in doing so. In this regard, and knowing that you are awaiting direction from the Board, we direct all practitioners to the Declaration of Emergency for COVID-19 Directive 003 (“Directive 003”) issued by The State of Nevada, Executive Department (which includes Governor Sisolak), a copy of which can be found here:

Practitioners should note the following important provisions of Directive 003:

Section 4: An Essential Licensed Business [which includes a dental office per Governor Sisolak] . . . is encouraged to continue operation, but must adopt COVID-19 risk mitigation measures that reduce the risk of community disease spread . . . [;] and . . .

Section 11: This Directive [shall] remain in effect until April 16, 2020, unless renewed by a [subsequent] Directive promulgated pursuant to the March 12, 2020 Declaration of Emergency to facilitate the State’s response to the COVID-19 pandemic.

In alignment with Governor Sisolak’s direction as set forth in Directive 003, the Board supports the postponement of elective dental procedures until at least April 16, 2020 per the mandate given to all essential businesses that they “must adopt COVID-19 risk mitigation measures that reduce the risk of community disease spread” in order to continue operating during the Coronavirus pandemic.

In addition to the foregoing, the Board further reminds practitioners that the State of Nevada, Department of Health and Human Services, issued a Memorandum on March 24, 2020, a copy of which is attached, which states, in relevant part:

While the practice of dentistry is considered an essential service in the State of Nevada, all routine, non-essential dental procedures/surgeries in Nevada should be postponed for public health and safety from the date of this Notice. The situation is evolving and is subject to change at the discretion of the Governor and Nevada Chief Medical Officer. Non-compliance may be viewed as unprofessional conduct which is subject to disciplinary action by the Nevada State Board of Dental Examiners.

Finally, to any of you who would like to make public comment at an upcoming public meeting regarding issues relating to the current Coronavirus pandemic, we encourage you to submit such public comment in writing. Doing so will help ensure order at the meeting and allow everyone’s voice to be heard.  Note that we will not schedule a public meeting until we are certain that the technology available can accommodate everyone’s participation.

The Board thanks each of you who has diligently and thoughtfully followed our recommendations and those of other national, state, and local governments. We are concerned for you and your practices but believe that, together, we can play an important part in stopping the spread of COVID-19 and get back to work!   

Posted March 16, 2020:

The Board recognizes that Governor Sisolak recently issued a state of emergency regarding COVID-19 for Nevada.  The Board is committed to protecting consumers, applicants and licensees regarding the spread of the Coronavirus.  We are working closely with state and federal agencies and monitoring the Governor's office to determine the best course of action.

In the current national emergency regarding the COVID-19 disease and its causative agent, SARS-CoV-2, the Board would like to remind the public that all Nevada dental offices are required by law to follow the latest CDC recommendations for cross contamination and infection control which are the most stringent of recommendations.  These rules, regulations, and guidelines specifically define the "Universal or Standard Precautions" which make the dental offices in Nevada among the safest medical facilities anywhere.  The Board wishes to assure the public that we have the utmost concern for our collective patients and fellow Nevadans. We want the public to know that we as a profession will continue to monitor this pandemic and make specific recommendations as necessary to ensure the continued safety of our patients, assuring the public health of our population and maintaining the public trust.

The Board will continue to monitor and make recommendations as new information and regulatory changes are made.  Please use the following links to ensure the most up to date information.   

Office Closures:

The Nevada State Board of Dental Examiners concurs with ADA (American Dental Association) that our healthcare practitioners do their part to mitigate the spread of Covid-19 by recommending that our dental healthcare providers postpone elective procedures for the next two weeks.

Universal Precautions and Measures:

Face masks and appropriate PPEs are required.  As a reminder face masks are single use and disposable and should be changed between patients or when soiled during a procedure.  Current recommendations for certain procedures do not require a Level 3 mask.  Keeping in consideration the supply and demand of PPEs, the ADA website has suggested the following concerning masks:    

Level 1 mask recommended where there may be low exposure to fluid, spray and/or aerosol is produced such as exams, evaluations, orthodontic visits, operators cleaning or similar procedures.*

Level 2 mask recommended  where there may be low to moderate  exposure to fluid, spray and/or aerosols are produced such as sealant placement, simple restorative or composite procedures, endodontics or similar procedures.*  

Level 3 mask recommended  where there may be exposure to moderate to heavy exposure amounts of fluid, spray and/or aerosols are produced such as ultrasonic scalers and similar equipment, crown and bridge preparation, complex oral surgery, implant placement and similar procedures.*

* recommendations taken from the ADA’s website. Please visit their website

The Board would like to recommend that all manufacturers' use recommendations are followed to prevent off-label usage of their products. 

Further Recommendations:

If you have recently returned from a country which is under a travel restriction, the CDC recommends you self-quarantine for 14 days immediately upon returning home from the affected area.

We have official recommendations that groupings  should not be more than 10 people.  Consider staggering appointments to reduce the groupings.

SELF-QUARANTINE RECOMMENDATIONS

If you have recently returned from a country with a Level 3 travel health notice, the Centers for Disease Control and Prevention (CDC) recommend that you stay at home for a period of 14 days.  The start of the self-quarantine should begin on the date that you returned from an affected area.  

Additional information regarding the recommendations to self-quarantine is available at the websites of the  CDC.  

Continuing Education:

The Board is aware of numerous cancellations of continuing education events and meetings.  The Board accepts live  webinars as alternative  sources for in-person meetings.  Live webinars that are AGD PACE, ADA CERP, ADHA and any national recognized associations of dental or medical specialist are accepted.   Live webinars that do not have such certification must be approved prior to their broadcast.  If you need more time to complete your continuing education requirements, a waiver form will be available.  Details of the form will be available in the next few weeks.   

The Board will be ready to mobilize dental offices in Nevada to serve as screening/testing centers if they should be called upon to do so by the Governor given that dental offices in Nevada are already at or above national recommendations for infection control.

The Board is aware of temporary suspension of licensure examinations due to COVID-19.  The Board will be continuing all current licensure requirements at this time.

Additional Information concerning the COVID virus may be found at:

• Interim Guidance for Healthcare Facilities: Preparing for Community Transmission of COVID-19 in the US | CDC
• CDC WEBSITES:
• https://www.cdc.gov/coronavirus/2019-ncov/index.html
• https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/steps-to-prepare.html
• https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html
• https://www.cdc.gov/coronavirus/2019-ncov/summary.html.
• https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html--
• World Health Organization
• Department of Health and Human Services
• Southern Nevada Health District
• Washoe County Health District
• ADA Center for Professional Success
• Environmental Protection Agency