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American Dental Education Association
Volume 2, No. 75, November 8, 2022
CDC Issues Health Advisory to the Dental Community
Last week, the Centers for Disease Control and Prevention (CDC) issued a Health Alert Network (HAN) Health Advisory [ [link removed] ] to the dental community following outbreaks of nontuberculous Mycobacteria (NTM) infections in children.
In March 2022, the CDC was notified of a new cluster of suspected NTM infections in children following dental procedures at a pediatric dental clinic. Investigation into this cluster is currently ongoing, and preliminary site visit data report that dental unit waterline testing results showed microbial counts much higher than the level recommended by CDC.
The CDC recommends that all dental unit waterlines be treated regularly with disinfectants to meet the Environmental Protection Agency (EPA) regulatory standards for drinking water (i.e., ≤500 colony forming units (CFU)/mL of heterotrophic water bacteria). Dental providers should also consult with their dental equipment manufacturer for appropriate methods and equipment necessary to both maintain and monitor the quality of dental water. The CDC also provided the Food and Drug Administration’s recommendations [ [link removed] ] for infection control procedures for dental unit waterlines for both dental practitioners and dental equipment manufacturers.
The CDC went on to provide additional recommendations geared towards dental providers, dental facilities and medical providers.
CDC Issues New Guidance for Opioid Prescribing
The Centers for Disease Control and Prevention (CDC) has issued new guidance [ [link removed] ] for clinicians on how and when to prescribe opioids for pain. The 100-page document serves as a roadmap for prescribers who are navigating the issue of treating pain, including advice on handling pain relief after surgery and managing chronic pain conditions while reducing risks associated with opioid pain therapy, including opioid use disorder, overdose and death. The guidance was issued in response to complaints and concerns raised by patients living with chronic pain and their doctors.
The guideline addresses the following four areas:
1. Determining whether to initiate opioids for pain,
2. Selecting opioids and determining opioid dosages,
3. Deciding duration of initial opioid prescription and conducting follow-up and
4. Assessing risk and addressing potential harms of opioid use.
CDC developed the guideline using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.
CDC officials say that doctors, insurers, pharmacies and regulators sometimes misapplied the older guidelines, causing some patients significant harm. These patients reported they were being denied medication that allowed them to function, though they were not addicted to the medication. Doctors have also described battles to secure pain medication for patients with cancer and other painful diseases, such as sickle cell anemia.
In an effort to prevent this, the CDC lists specific diseases, conditions or situations that the recommendations do not apply to, such as “pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care.” Further underscoring the need for flexibility when prescribing, the CDC goes on to note that “recommendations should not be applied as inflexible standards of care across patient populations.”
Kentucky to Expand Dental Benefits for Adult Medicaid Populations
Beginning Jan. 1, 2023, Kentucky adults enrolled in Medicaid will have access to expanded dental benefits. Gov. Steve Beshear (D) recently announced [ [link removed] ] the plans, framing improved health as a way to get more people involved in the state’s workforce. Kentucky currently offers limited dental benefits [ [link removed] ] for adults enrolled in Medicaid, but according to a spokeswoman for the Cabinet for Health and Family Services, the expanded benefits will add coverage for fillings, dentures, implants, root canals, extractions, restorations, periodontics and an additional cleaning each year. The expanded benefits will also include increased coverage for vision and hearing.
ADEA AGR will provide additional updates as more details of the plan emerge.
Louisiana Proposes Several Changes to Licensure Rules, Finalizes Rule to Allow Dental Hygiene Practice in Nursing Homes
The Louisiana State Board of Dentistry has proposed several changes [ [link removed] ] to licensure rules. If adopted, the following changes would be made:
• Current regulations require an applicant for a dental license who did not attend an accredited dental school or dental college to successfully complete a postgraduate, Commission on Dental Accreditation-approved program in either general dentistry or one of the specified Board-approved specialties. The proposed regulation would allow the Board to waive this requirement if the applicant meets with the board and is determined by the Board to be qualified by other means to practice dentistry in this state.
• Applicants for dental and dental hygiene licensure by credentials would be permitted to successfully complete an initial licensure examination in a U.S. jurisdiction that includes a hand-skills assessment rather than a procedure on a live patient.
• A dental hygienist who has been licensed and trained to administer local anesthesia in another state may qualify, at the discretion of the board, to be permitted to administer local anesthesia in Louisiana by presenting written documentation of such licensure and training to the Board and documentation of experience.
Additionally, the Board adopted a rule [ [link removed] ] that would allow dental hygienists to perform dental hygiene in a licensed nursing home under general supervision. To qualify to practice under the rule, a dental hygienist will:
• Have to have at least five years of full-time practice of dental hygiene,
• Be employed by a Louisiana licensed dentist,
• Have completed six hours of continuing education on medical emergencies within the last two years or during the hygienist’s last preceding licensure cycle,
• Have current CPR certification and
• Complied with the established protocols for emergencies which the supervising dentist has established.
ADEA Advocacy in Action
This appears weekly in the ADEA Advocate to summarize and provide direct links to recent advocacy actions taken by ADEA. Please let us know what you think and how we might improve its usefulness.
Issues and Resources
• Applications open [ [link removed] ] for HRSA Dental Public Health Research Fellowship
• ADEA report [ [link removed] ] on teledentistry
• ADEA report [ [link removed] ] on the Impact of the COVID-19 Pandemic on U.S. Dental Schools
• ADEA policy brief [ [link removed] ] regarding overprescription of antibiotics
• For a full list of ADEA memos, briefs and letters click here [ [link removed] ] .
Key Federal Issues [ [link removed] ]
ADEA U.S. Interactive Legislative and Regulatory Tracking Map [ [link removed] ]
Key State Issues [ [link removed] ]
The ADEA Advocate [ [link removed] ] is published weekly. Its purpose is to keep ADEA members abreast of federal and state issues and events of interest to the academic dentistry and the dental and research communities.
©2022
American Dental Education Association
655 K Street, NW, Suite 800
Washington, DC 20001
Tel: 202-289-7201
Website: www.adea.org [ [link removed] ]
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B. Timothy Leeth, CPA
ADEA Chief Advocacy Officer
Bridgette DeHart, J.D.
ADEA Director of Federal Relations and Advocacy
Phillip Mauller, M.P.S.
ADEA Director of State Relations and Advocacy
Brian Robinson
ADEA Program Manager for Advocacy and Government Relations
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