Patient in facemask and Dentist in full PPE

Eastern Dentists Insurance Company (EDIC) recognizes the importance of providing our clients with trustworthy information that will protect both patients and dental health care personnel during this pandemic.

We encourage our clients to check the Centers for Disease Control and Prevention (CDC), the American Dental Association (ADA), state and local health departments, state dental societies, and other reputable sources for the most up-to-date information as well. Please continue to exercise your best professional judgment.

EDIC FREE Webinars*

*FREE Webinars are only available as an exclusive member benefit for EDIC insureds.

EDIC Archived Webinar Library: You will have to log in (either existing account or create a new account) to access the webinars. After logging in, click on the Webinars tab.

Recent webinar now available in the library

June 9, 2021

Infection Control and Guidance in the Aerosolized Pandemic

Participants will learn about

  1. Federal infection control guidelines
  2. CDC guidance and changes
  3. State of Massachusetts requirements
  4. Implementation of the compliance program
  5. Consequences of non-compliance

Presented by Howard J. Pactovis, DMD

Billing Questions

If you are experiencing financial hardship, please contact your EDIC Account Manager during normal business hours for further information. 800-898-3342

ADA Announcement from Small Business Administration:

How Dentists Can Apply for Economic Injury Disaster Loans and Paycheck Protection Program 7(a) loans

Coverage and Risk Management Questions

The decision to reopen a dental office or remain closed, absent an overriding state or federal mandate, is a decision to be made by each individual dental practice. The following FAQs were developed to assist dentists in making that decision, as well as to encourage a concerted effort in making the reopening of dental offices the safest environment possible for patients, staff, and dentists.

The safety of patients, dentists, and dental team members is EDIC’s utmost concern.

Do Dentists Have to Treat Unvaccinated Patients?

Dentists are generally not legally obligated to accept unvaccinated patients into their care, nor are they required to retain them. Unvaccinated individuals are currently not a protected class under federal or state law, nor is being unvaccinated a recognized religious tenant, so practitioners are not prohibited from dismissing them.

The rules of patient abandonment still apply, however. Patients in active treatment or not medically stable may not be dismissed. Dentists must provide adequate notice and follow a formal dismissal protocol when dismissing unvaccinated patients from their practices. Dentists must also remain available for emergency treatment for a minimum of 30 days.

Additionally, remember that dentists have a legal and ethical obligation to treat patients who may have a disability, which may include those unable to be vaccinated. Consultation with the patient’s physician may be necessary. If the patient’s vaccination status hinges on a disability or because they belong to a protected class, it may be against the law to dismiss the patient.

Remember, legal considerations regarding vaccine status vary by jurisdiction and are evolving. If you have questions about what is legally permissible in your jurisdiction, please consult local counsel.

Can I administer the COVID-19 vaccine?

The administration of the COVID-19 vaccination by dentists is being approved by State Governors and State Boards of Dentistry in some states. If your state has added the administration of COVID-19 vaccinations to the definition of the practice of dentistry, then your EDIC malpractice policy will cover the vaccine administration that conforms to the regulations of your state.

You must follow the CDC’s Vaccine Administration protocols, including certain information recorded in the patient’s record. Additionally, other provisions of your malpractice policy still apply. Remember that you may not give medical advice to your patients.

For each COVID-19 vaccine authorized under the Emergency Use Authorization (EUA), the FDA requires that vaccine recipients or their caregivers are provided with certain vaccine-specific EUA information to help make an informed decision about vaccination. Please document in your treatment notes that you have given the patient a copy of the official EUA Fact Sheet, as well as information on scheduling a second vaccination appointment.

This information does not apply to dental hygienists.

Can I mandate that my dental team get the COVID-19 vaccine?

This is a question for an employment attorney. EDIC cannot comment on employment liability or workers compensation questions.

We expect our dentists to practice to the standard of care and follow all infection control protocols. The immune system status of dentists and dental team members is outside of the standard of care. Dentists should follow Federal, state, and local guidelines for appropriate COVID guidance, such as appropriate PPE, when personnel and patients should quarantine at home, how to screen patients, new infection protocols, etc.

The ADA has posted COVID-19 Vaccination Employer FAQs, which may be helpful in answering this question.

Can I administer the COVID-19 test before treatment to check the status of a patient?

Your policy provides coverage for dental health care services performed on a patient in your profession. It is not in EDIC’s purview to determine what is involved in your scope of practice – that’s set forth by your state Board of Registration, or the similar body that governs the practice of dentistry in your state. Your policy does not cover nondental procedures as described in your state’s dental practice act.

COVID-19 testing by dentists is being approved by State Boards of Dentistry in some states (e.g., North Carolina). If your state legislature or state board has added the administration of COVID-19 testing to the definition of the practice of dentistry, then your EDIC malpractice policy will cover COVID-19 testing that conforms to the regulations of your state. EDIC recommends using this Informed Consent and Release when administering the testing.

Is there a screening form I can ask my patients to sign?

You should telephone screen all patients for signs or symptoms of respiratory illness (fever, cough, or shortness of breath). If the patient reports signs or symptoms of a respiratory illness, avoid dental care. If possible, delay emergency dental care until the patient has recovered from the respiratory infection.

You should confirm patients have not, within the past 14 days, traveled by airplane, been in close proximity (less than 6 feet proximity) at a gathering of 10 or more persons, or had close contact with a person who has been confirmed positive or suspected to be positive for COVID-19.

What if I treat a patient and a couple of days later, I find out they tested positive?

Even when you screen patients for respiratory infections, you may treat a dental patient who is later confirmed to have COVID-19.

It may be a good idea to institute a policy to contact all patients who received dental care 48 hours after care. You should ask patients if they are exhibiting any signs or symptoms of COVID-19. If a patient reports signs or symptoms of COVID-19, refer the patient to their medical provider for assessment and follow CDC’s Healthcare Personnel with Potential Exposure Guidance.

Additionally, the ADA has offered these Steps to Take if a Patient Reports COVID-19 Exposure After Treatment.

Is there a consent form I can ask my employees to sign?

Dental professionals and staff experiencing fever with either cough or sore throat or muscle aches should not report to work. All personnel and dentists should self-monitor and remain alert to any respiratory symptoms (e.g., cough, shortness of breath, sore throat) and check and record their temperature before beginning work every day, regardless of the presence of other symptoms consistent with a COVID-19 infection. Personnel and dentists with temperatures over 100.4º should return home.

Check your state dental society for any forms that may be available for employees. Remember that you may not ask your employees to sign a form that waives their workers compensation rights.

Can I be sued by patients or employees if they get COVID-19 from my office?

Unfortunately, you can be sued for anything. Policy coverage determinations are individualized. You could also potentially have coverage under your commercial general liability, business owners package, and workers compensation policies when there are disease exposure claims, depending on the claim circumstances. The claim circumstances will determine which of your policies might apply. If you do receive notice of a claim, please contact the EDIC Claims Management team immediately. Doctors should make sure they are heeding federal and state guidelines, posting appropriate signage, communicating with patients and staff, and following the standard of care. If you are taking extra steps to clean your office, train staff, post signs, etc., then make sure you document those steps.

Do you have a sample informed consent form available for patients that come in for care during the pandemic?

We recommend alerting your patients to the risk of coming in for treatment during the pandemic before they set foot in your office. You can put a sign at the front door, send out an email, and make it part of your voicemail greeting. You can also print it out and ask your patients to sign it before treatment.
“You are receiving dental care during the events of a COVID-19 National Emergency. Please be advised that there may be risks in being in the proximity of dentists, patients, or staff. We are taking precautions to limit the spread of disease, yet there is still a possibility of transmission.”

Remember that an informed consent form, by itself, is insufficient to shield you from liability for negligence or violating the standard of care. An informed consent form is designed to be a part of a process of obtaining a patient’s agreement, following an explanation and discussion of why treatment is needed, as well as the risks of and alternatives to a procedure. The risk discussion would be where you would highlight the COVID-19 exposure risks, along with other infection risks.

Final Note

As always, we encourage our clients to check the CDC, the ADA, state and local health departments, state dental societies, and other reputable sources for the most up-to-date information as well.

Please continue to exercise your best professional judgment and stay safe out there.

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