On February 19, 2021, the Texas State Board of Dental Examiners (TSBDE) voted unanimously to adopt a new COVID-19 emergency rule—22 Texas Administrative Code §108.7(16). It will remain in effect until June 18th, 2021.
Several previous requirements were removed, including:
- The removal of magazines, reading materials, toys, and other objects that may be touched by others;
- COVID-19 patient screening by phone during scheduling. Patients must still be screened during patient confirmation prior to appointment;
- Prohibition of patient companions. Companions should continue to be screened for COVID-19 during patient check-in;
Additionally, a pre-procedure rinse is no longer recommended.
The most important requirement was left intact: N95, KN95 masks, or their substantial equivalent are still required for all dental health care personnel (DHCP) who will be within six feet of any and all procedures likely to involve aerosols.
I can’t say often enough that dental practices using N95 and/or KN95s are required to have a written respiratory protection program (RPP) in place. The program must include a designated plan administrator, a written plan document, documented training, medical evaluations, and fit testing. None of these are optional.
The reason I’ve been a broken record regarding the use of respirators is we’re seeing a less than 50% compliance rate in Texas, to the detriment of a dental practice’s employees, patients, and the practice. Dental practices are being heavily fined for ignoring these requirements; including a single-location practice fined over $24,000.
Misinformation surrounding the requirement is robust. Dental Facebook groups are awash with comments from clinicians who work in offices not using respirators, much less that are concerned with having an RPP in place. If you think your staff or patients don’t notice, think again. In January and February, OSHA opened 15 investigations of dental practices. 12 (80%) of those investigations were the result of complaints, which typically come from employees or ex-employees but also come from patients.
Pleading ignorance when a TSBDE or OSHA investigator calls or shows up at your door is not a viable option.