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A COVID-19 Q&A With ADA President Dr. Chad P. Gehani

We took some time to ask the ADA’s President, endodontist Dr. Chad P. Gehani, to elaborate on the ADA’s latest efforts around COVID-19, as well as the role endodontists and dentists play on the front lines of this global pandemic.

AAE: In addition to its website and putting out emails to its membership and interested constituencies, what is the ADA doing about the COVID-19 pandemic?
Dr. Gehani: We want all dentists to know that the ADA is hard at work to support them during this difficult time. It’s an all-hands effort, and the entire ADA staff—along with the Board of Trustees and a host of volunteer leaders—are working around-the-clock to provide meaningful guidance to help dentists face this difficult new reality.

As you mentioned, we’ve dedicated all of our communications efforts to bringing dentists the latest on this rapidly evolving situation. Every morning, ADA members receive the Morning Huddle, which aggregates news stories from various sources and delivers them to member’s e-mail inboxes.

In the last few weeks, we’ve launched a series of relevant digital events and webinars on clinical topics (such as infection control) and practice management. We’ve also created two online resources—one, ADA.org/virus, is the hub for ongoing COVID-19 updates from the ADA and CDC. The site links to our ADA.org/virusresources page, which features the on-demand webinars and other items.

There has also been vigorous legislative advocacy on Capitol Hill on behalf of the dental community. The last several weeks has seen the passage of three COVID relief packages such as the CARES Act, which includes provisions that benefit dentists, practice owners, dental students, and dental office employees. The ADA stood up for the profession on this legislation, and there was a tremendous grassroots effort to secure its passage.

On the leadership front, our Board of Trustees are in touch on a daily basis to determine how we can continue to meet dentists’ needs at this time. The COVID landscape is continually changing, so our leaders are always assessing how the ADA can best advocate for dentistry. Leaders and staff are also in touch with state and local dental societies with a live, interactive update webinar every week.

AAE: Are there any organizations, medical groups, government agencies the ADA is partnering with?
Dr. Gehani: The ADA is in regular contact with the U.S. Centers for Disease Control and Prevention, the Small Business Administration, the Department of Treasury, the Department of Labor and members of Congress.  We recently joined together with other health care organizations and signed a public statement March 27 saying we strongly support emergency efforts at the federal level to dramatically increase the production and distribution of personal protective equipment (PPE) and other necessary medical equipment and supplies during the COVID-19 pandemic.

AAE: What should endodontists know about COVID-19?
Dr. Gehani: The emerging science tells us a few things. For one, it is easier for a person to be infected with COVID-19 than with other viruses. Transmission may be airborne through droplets, and COVID-19 may spread through aerosols produced by various dental tools and even when intra-oral x-rays are being taken, especially if the patient coughs during this procedure. A person may be infected with COVID-19, show no symptoms, and yet may still be shedding the virus. So in all types of dental practice, there are major implications for the welfare of patients and the entire dental team. COVID-19 may require different precautions than those we’ve been taking over the last few decades.

AAE: Likewise, what can they do differently? In their practices? Communities?
Dr. Gehani: The ADA is urging all dental practices to close to all except urgent or emergency procedures until April 30th at the earliest. We know that this is disappointing news for dentists who would like to get back to work. As a practicing endodontist, I feel the same way. But we have to do our part to help mitigate the spread of COVID-19 in our communities. We made the recommendation, in part, to alleviate the additional burden that dental emergencies could place on hospitals, which are under enormous strain right now. The ADA has developed materials to help dentists and patients understand what constitute a dental emergency.

Our recommendation aligns with that of the CDC. However, mandates and recommendations for dental practice vary from state to state, and mandates take precedence over the ADA’s recommendation. Dental societies, which have a better understanding of the situation in their cities and states, may issue recommendations as well.

AAE: What role do dentists and endodontists play on the front lines of COVID-19?
Dr. Gehani: Dentists are essential to the welfare of our communities, and play a vital role in getting our nation through this pandemic. In addition to seeing only urgent and emergency cases, some dentists are stepping up to volunteer locally in the event of hospital surges. There are dentists who are donating any surplus PPE they have on hand to nearby hospitals. Dentists are very much on the front lines of this crisis, both as health care professionals and compassionate citizens.

AAE: As endodontists and dentists continue to treat patients in times of dental emergency, what can they do to make sure their patients, themselves and staff are safe?
Dr. Gehani: On April 1st, we released interim guidance for managing emergency and urgent dental procedures. These materials include flowcharts for triaging emergency and urgent patients, screening for COVID-19 infection, and minimizing the risk for COVID-19 transmission. The guidance is based on the best available scientific evidence.  We encourage dentists to review these materials and use their professional judgment.

AAE: Post-COVID-19, how do you think the dental landscape will have changed?
Dr. Gehani: Public health crises of this magnitude, thankfully, do not come along often. But even through influenza pandemics, like that of 1918, and the HIV/AIDS crisis decades ago, dentistry has adapted and remained resilient. With time, experiences like these are what inform the development of new technologies and help us enhance our infection prevention protocols. So while I can’t say for sure what impact the COVID-19 pandemic will have on the dental landscape, I am confident that we will come out of this a stronger, more unified profession.