Arkansas Report – May 2020

The Arkansas State Board of Dental Examiners understands the uncertainty, confusion and anxiety produced by the return to work in the era of COVID-19. The officers of the Board have attempted to produce a thought process on procedures and scheduling that we feel would fit into the early phases of the return. This is not intended to be comprehensive but rather examples for the individual dentists to use along with both professional judgment and frankly good common sense.

In Phase 1, we would interpret “reduce scheduling” to mean one patient seated per provider at a time. In other words, for a multi-chair office there will be idle operatories that are “resting” after disinfection. Phase 2 will allow for a more typical volume, with some continued restrictions on procedures.

Also note well the definition of acceptable PPE if aerosol producing procedures are performed, along with the lack of ultrasonic/piezo units during Phases 1 and 2. If the described PPE is not available, the procedure should not be performed.

Diagnostic procedures Phases 1, 2, &3: All examinations, and radiographs.

Restorative dentistry Phases 1&2: Amalgam and composite restorations, single unit crown preparations, impressions for fixed, removable and implant restorations, dental appliances including but not limited to occlusal splints, bleaching trays, orthodontic retainers. Phase 3: Situations such as multiple unit cosmetic veneer/crown cases and multi-unit fixed edentulous space restorations involving natural teeth.

Endodontic therapy Phases 1&2: Routine and typical nonsurgical endodontic care is consistent with the spirit of the resumption. Phase 3: Surgical endodontics (apical surgery and root amputations)

Periodontal therapy Phase 1&2: Absent the use of ultrasonics/piezos scalers, ScRP and periodontal surgery for the control of periodontitis. Mucogingival surgery without an aerosol. Again, absent the use of ultrasonics maintenance therapy is necessary. Phase 3: Utilization of ultrasonics/piezos

Implant therapy Phases 1&2: Immediate implant placement, implant exposure/healing cap placement, restorative procedures. Phase 3: Long-standing edentulous areas needing implant placement

Oral surgery Phases 1&2: Dentoalveolar procedures Phase 3: Implant site development

Orthodontics Phases 1&2: Routine adjustments, new patient activities should be acceptable with care. Case finish-out requires slow speed handpieces and hand instruments to obtain a smooth surface, even if that means a future visit for final finishing.

All of this remains very fluid. Federal agencies are frequently issuing new guidance and how much these will influence Arkansas decisions, if any, could alter all the planning that has gone into this document. Please watch the Arkansas Department of Health website and the ASBDE website for updates.