Last week, Governor Inslee released an Interpretive Statement related to Proclamation 20-24 and announced “Safe Start Washington,” a phased approach to reopening many Washington businesses. Following these announcements, WSDA has received many inquiries from members seeking further clarification on dental care that can currently be provided in our state, the date upon which elective care may resume, and whether the Governor’s extended stay-at-home order and “Safe Start” plan announcement impact dentistry.

Please see responses to such inquiries below. WSDA will continue to provide updates as possible.

---

Are dental offices considered “Essential Businesses” in the Governor’s “Safe Start” Phase 1?

Yes. Dental offices have been considered an Essential Business (restricted to urgent care) since the initial Stay Home, Stay Healthy order and are still considered an Essential Business in Phase 1 of our state’s “Safe Start” plan.

---

How do the Governor’s Proclamation 20-24 and April 29 Interpretive Statement impact dentistry in Phase 1?

While we are in Phase 1 of the “Safe Start” plan, Proclamation 20-24, issued on March 19, still supersedes the plan. The proclamation prohibits “all hospitals, ambulatory surgical facilities, dental, orthodontic and endodontic offices in Washington State from providing health care services, procedures, and surgeries that, if delayed, are not anticipated to cause harm to the patient within the next three months.”

In response to the advocacy efforts of WSDA and other stakeholders, the Governor issued “Interpretive Statement Related to Proclamation 20-24, Restrictions on Non-Urgent Medical Procedures” on April 29, setting forth additional guidance for providers to determine whether to provide or delay care prior to the expiration of the proclamation. WSDA released guidance to help dental offices understand the Governor’s Interpretive Statement. We strongly encourage you to read the complete guidance.

Important points from the guidance include the following:

• Decisions about increasing care during the COVID-19 pandemic should be made by each dentist using their best clinical judgment.
• Dentists may now perform timely dental treatment that would reduce the risk of harmful dental or medical consequences, as determined by the patient’s dentist, as outlined in the Interpretive Statement. 
• To help guide your decision-making process, WSDA strongly encourages you to include a diagnosis in your treatment notes for every patient visit performed. The diagnosis should be consistent with other documentation in your chart and reasonably demonstrate why a delay in treatment would cause harm to the patient. Meaning, that the care provided prevents a worsening condition that would have caused additional or more complicated care in the near future.

---

What care can a dental office provide now, and, should Proclamation 20-24 expire with no additional orders or restrictions issued, what care can a dental office provide on Tuesday, May 19?

Now: Decisions about increasing care during the COVID-19 pandemic should be made by each dentist using their best clinical judgment. A dental office may now perform timely dental treatment that would reduce the risk of harmful dental or medical consequences, as determined by the patient’s dentist, as outlined in the  “Interpretive Statement Related to Proclamation 20-24, Restrictions on Non-Urgent Medical Procedures”. Dental offices should follow the appropriate infection control and PPE protocols as outlined in the ADA’s Return to Work Interim Guidance Toolkit.

Tuesday, May 19: Unless an additional proclamation or restriction is issued by the Governor, dental offices should be able to resume their full scope of care and should follow the appropriate infection control and PPE protocols as outlined in the ADA’s Return to Work Interim Guidance Toolkit.

---

WSDA continues to be in active dialogue with state authorities and will advocate for fully reopening dental practices. We will keep members apprised of any developments.

Sincerely,

Dr. Dennis Bradshaw
WSDA President