Do vaccinated patients have to wear masks while in the practice?

Yes. While recent CDC guidance no longer recommends universal masking in health care settings, as noted above, the stricter requirement by the state or local agencies prevail. The California Department of Public Health September 20, 2022 guidance clearly states that masks must continue to be worn in health care facilities, long-term care facilities and other specific settings. As a best practice, refresh patient communications and signage.

Must we continue to screen patients and take temperatures?

Yes. Patient screening is an essential part of COVID-19 infection prevention and is also required by Cal/OSHA aerosol transmissible disease regulation. Temperature taking is at the discretion of the dental practice. A screening form is not required but record in the patient’s chart that they were screened. See the updated screening protocol.

Do staff have to wear masks while at work?

Yes. The California Department of Public Health September 20, 2022 guidance states that masks must continue to be worn by visitors, patients and employees in healthcare settings. Masking may be optional only when all three of the following are true: in non-clinical (no patients) areas, where there have been no outbreaks in the facility and where COVID-19 Community Level is low. An employer must provide properly fitted respirators to staff involved with aerosol-generating procedures. Cal/OSHA requires the use of respirators during such procedures in both dental and medical settings. Staff may voluntarily choose to wear a respirator while at work and for non-aerosol generating procedures, and the employer must provide it if requested, per Cal/OSHA. Voluntary use of a respirator does not require the employer to provide a medical evaluation or fit-testing but the employer must ensure the employee is trained on how to put it on and how to perform a seal check each time the respirator is worn.

Are respirators still required to be used in the practice?

Yes, for aerosol-generating procedures according to the Cal/OSHA emergency temporary standard. Cal/OSHA requires respirators used in the practice to be approved by NIOSH.

How often must an employer provide an employee with a new respirator?

Filtering facepiece respirators, such as the N95, are disposable respirators that cannot be cleaned or disinfected. They must be replaced if they get damaged, deformed, dirty, or difficult to breathe through. A best practice is to replace filtering facepiece respirators at the beginning of each shift. Employers should follow the manufacturer’s instructions. CDC recommends replacing a disposable filtering facepiece respirator after it has been taken on and off five times. Filtering facepiece respirators may not fit correctly after repeated use. For voluntary use, the need to replace a respirator varies with use and environment.

Is physical distancing still required?

Cal/OSHA no longer requires physical distancing at the workplace. CDC recommends individuals who are sick or unvaccinated stay 6 feet away from others. For dental facilities with open floor plans, CDC recommends at least 6 feet of space between patient chairs and other strategies to prevent the spread of pathogens.

Are barriers still required?

Barriers are no longer required by Cal/OSHA. CDC does recommend physical barriers between patient chairs and other strategies to prevent the spread of pathogens.

What should my practice’s mask policy state?

The dental practice’s mask policy should clearly state that all patients and visitors must wear a face-covering in the dental office regardless of their vaccination status, according to CDPH guidance. Practice owners can find sample messaging in the Patient Communication and Management section.

If a patient refuses to wear a mask in my dental practice, can I deny them service?

In limited circumstances, there could be a situation in which a patient cannot wear a mask due to a legitimate health reason. In this case, the practice may consider a special accommodation, such as scheduling the patient when other patients are not present. The goal of the practice should be to clearly communicate the policy to patients prior to their appointment and answer any questions they may have. If the patient expresses concern prior to the appointment and refuses to wear a mask, develop messaging for your dental team to use to reschedule the patient for a later date prior to their arrival for their appointment. CDA has developed sample messaging for rescheduling patients.

What if a patient gets upset about the mask policy?

If a patient refuses to wear a mask while in the dental office and becomes confrontational, it may be necessary to call security or law enforcement to help de-escalate the situation. Practice owners are responsible for keeping employees safe while they are at work. Physical and verbal violence should never be tolerated in the dental office.