Royal College of
Dental Surgeons of Ontario
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COVID-19 Frequently Asked Questions

Our Practice Advisory Service receives many emails and phone calls daily from dentists and the public about COVID-19. Below is a list of FAQs compiled by the Practice Advisory team to assist you in getting up-to-date information in a timely manner.

Do I have to close my office? 

The College does not have the authority to order all dental offices closed. Only the Ministry can do this. The furthest that we can go is to strongly recommend all non-essential and elective dental services are suspended immediately. In the meantime, both the College and the ODA are making efforts with the Ministry on this issue.

You are required to limit your services to emergency treatment only, provided you can do so safely. Refer to this article in Dispatch for our latest guidance. Since clinical advice is rapidly evolving, we ask that you check this page frequently.

You are expected to put your patients’ interests and the safety of the community first. Ontario has declared a state of emergency, and the Canadian government is strongly urging all Canadians to practice social distancing.

What is the definition of an essential-dental treatment or a dental emergency? 

In dentistry, a “true emergency situation” includes oral-facial trauma, significant infection, prolonged bleeding or pain which cannot be managed by over-the-counter medications. 

Read our guidance on true emergency situations.

If you believe you have a unique clinical situation, please reach out by email to the College to seek specific guidance.

What are considered emergencies / true emergencies? 

Please refer to our latest guidance with respect to emergencies.  

How should dentists manage emergencies during this pandemic? 

Refer to this article in Dispatch for our latest guidance. Check this frequently as clinical advice is rapidly evolving. 

Avoid referring to a hospital dental department at this time.

If your dental practice is unable to meet required safety precautions or has closed, you can still help. Ontario has also launched a website to act as a central point for businesses and organizations who can supply emergency products and innovative solutions to support the province's response to COVID-19.

During this pandemic can we prescribe outside of the College’s recommendations for the management of dental pain for our patients? 

Dentists must continue to practice within the College's Guidelines with respect to writing of narcotics and opioids.

The Guidelines provide guidance regarding the suggested maximum number of tablets for a single opioid prescription. However, it also states that in some situations, practitioners may consider exceeding the suggested maximum number of tablets. Practitioners are expected to exercise reasonable professional judgment in determining when this is justified, which should be documented.

If you feel that the patient requires more than the Guidelines recommend, please screen the patient and evaluate their emergency over the telephone and determine if it is a true emergency.  You can then determine if pharmacotherapy (including the prescription of opioid) is indicated and how to proceed. If it is determined that treatment is required, with or without generating any aerosols, proceed with the appropriate PPEs.   

Please refer to our latest guidance with respect to emergencies.  

Please ensure that you keep a record of any patients that you speak with over the phone so that you can provide documentation in the patient record once you return to the office.

Can I use teledentistry for remote screening of emergency patients?

See our guidance on teledentistry here

If we do not have N-95 respirators, what do we do if we are treating emergencies? 

Refer to this article in Dispatch for our latest guidance. Check this frequently as clinical advice is rapidly evolving. 

I have run out of surgical masks and N-95s, what do I do? 

Refer to this article in Dispatch for our latest guidance. Check this frequently as clinical advice is rapidly evolving. 

Do N-95 masks require fitting?

N-95 masks require proper fitting in order to provide optimal protection for the dentist and the patient. If you don’t have the right size, protection could be compromised.

How do I get them fitted?

Manufacturer’s instructions must be followed. We suggest that you and your team contact the suppliers/manufacturers for more information on proper fitting and usage. 

The occupational health department of your local hospital may be able assist. Also, some colleagues (dentists/specialists) in your community may have the training, resources and staff to conduct proper N95 mask testing. You can reach out to them.

There is a shortage of N-95 masks, can we use KN-95 or other “equivalent” masks instead?

Dentists should be very cautious about replacing the use of an N-95 mask with any other mask/respirator. The College is not able to verify if these masks would be a suitable substitution. You should contact the manufacturers for more information about these masks.

Are N-95 masks required for all treatment?

If a patient presents with an emergency that CANNOT be managed without generating an aerosol (i.e. high-speed handpiece or air-water syringe MUST be used), then care MUST be provided using enhanced precautions (i.e. fit-tested N-95 mask, gloves, eye protection, face shield and protective gown).

  • If possible, use a rubber dam to decrease possible exposure to infectious agents.
  • If possible, use high-speed evacuation to minimize aerosols.

If a patient presents with an emergency that CAN be managed without generating an aerosol (i.e. high-speed handpiece and air-water syringe will NOT be used), care can be provided using routine practices and contact/droplet precautions (i.e. procedure/surgical mask, gloves and eye protection).

Refer to this article in Dispatch for our latest guidance.

What questions should we ask our patients over the phone in order to identify their symptoms if we need to see them for an emergency? 

Follow a similar line of questioning you would use for an emergency if a patient were present. Ask about symptoms, severity of issue, medications, review the patient’s medical history, allergies, case history, trauma, sleeplessness, etc.  

Further information may also be obtained from the Ministry of Health's website regarding questions about travel and other circumstances that may lead to self-isolation and the inability to treat an emergency: https://www.ontario.ca/page/2019-novel-coronavirus   

In addition to the above, please check the College website for regular updates with specific reference to clinical dental practice.  

We already adhere to standard precautions. Can dentists do anything else to prevent transmission in our offices while we treat emergencies? 

  • Practice safe social distancing. Do not keep many people in your waiting room.
  • Screen patients
  • Make sure PPE you are using is appropriate for the procedure performed
  • Use high speed evacuation for all dental procedures
  • Clean and disinfect public areas frequently, including door handles, chairs and bathrooms.

What do we tell a patient if they screen positive for COVID-19? 

The patient must self-isolate immediately. You are responsible for reporting this to Public Health as a reportable disease. You can contact Public Health directly.

How do I manage a staff member’s illness and return to work? 

If you or a member of your staff is ill please refer to this memo from the Ministry of Health for guidance.

Where do I go if I am experiencing symptoms of COVID-19? 

Contact your doctor if you’re experiencing symptoms of the COVID-19 novel coronavirus. Telehealth Ontario is also a key hub for advising the public or HCP re: online assessment and options for live assessment (if deemed necessary). Telehealth No. 1 866-797-0000. Stay in self-isolation until you receive instructions otherwise from one of the above sources. 

Click here for the Ministry self-assessment link. 

My practice is unable to meet the required safety precautions in place to manage emergency cases in person, including access to and ability to safely use fit-tested N-95 masks, gloves, eye protection, face shield and protective gown, or I am closed.  Is there any way I can help? 

Ontario has launched a website to act as a central point for businesses and organizations who can supply emergency products and innovative solutions to support the province's response to COVID-19.

During this pandemic, all PPEs are valuable and make a difference. Your generosity can go a long way.

Is the College providing a support fund or any financial relief for dentists experiencing loss of income and business during the pandemic? 

The College does not provide employment advice or related financial advice. We suggest you seek legal advice from an employment lawyer.

You can obtain additional information by logging into your ODA member’s account

You may wish to review the financial assistance packages announced by both the Ontario and Canadian Governments, as well as seek professional advice on your obligations. 

Also review, the Federal COVID-19 Economic Response Plan: Support for Canadians and Businesses to check if you or your staff are eligible: https://www.canada.ca/en/department-finance/economic-response-plan.html  

Will the College continue to recommend that dental offices treat emergencies only

Since our advice to dentists released March 15, the Government of Ontario has declared a State of Emergency. The government has also clarified that only “health care professionals providing emergency care including dentists” are considered to be in the category of ‘essential services’.

As a result, the College will not revisit its strong recommendation that all non-essential and elective dental services should be suspended until the State of Emergency has been lifted by the Government of Ontario.

Keep your office open if you can ensure emergency dental care can safely be provided to patients both in the short and long term. 

The College continues to closely monitor the situation. We constantly consult with the Ministry of Health and Public Health.

As the situation continues to evolve very rapidly, visit the College’s website and follow us on Twitter on a regular basis for updates.

Many dentists apparently are not heeding the College’s recommendation and are continuing with non-emergency treatment in their office. What will the College do about this?  

The College sought legal advice and confirmed that we do not have the legal authority to close dental offices. Our approach and advice is similar to most health care regulators under Ontario’s Regulated Health Professions Act (RHPA), and by regulators in many other provinces; we are limited to “strongly recommending” that all dental offices close.

Ontario’s Chief Medical Officer of Health and Canadian health authorities have asked that dentists only remain open to ONLY provide emergency services and ONLY when you have the PPE and facilities to do that safely.

Dentists are expected to consider the best interests of their patients and communities at all times. Ontario has declared a state of emergency, and the Canadian government is strongly urging all Canadians to practice social distancing.

We continue to raise these issues with the relevant authorities. In the meantime, dentists should be aware that if their clinic remains open other than for emergency care, Public Health could be notified to take strong action.