US Dentists Seeking to Conduct Coronavirus Testing Face Regulatory, Supply Hurdles

By Carl O'Donnell

April 23, 2020

(Reuters) - U.S. dental care providers are pushing for permission to test patients for the coronavirus, both to help augment a nationwide effort to combat its spread and shore up their own dwindling business, with most of the country still under stay-at-home orders.

North American Dental Group (NADG), a Pittsburgh-based dental services organization, wants to provide diagnostic testing in all of its approximately 250 facilities across 15 states, the company told Reuters. This week, it launched a small pilot program in New York state, epicenter of the U.S. epidemic.

Other dental groups are considering following suit. The Association of Dental Support Organizations trade group has formed a committee of around 20 members to discuss how to begin coronavirus testing on their premises.

Most testing by dentists is likely to initially focus on screening patients and staff to help minimize the risk of infection from the highly contagious pathogen at their practices. But some want to eventually provide tests more broadly to the general public, NADG executives said in an interview.

Those ambitions are hampered for now by shortages of testing supplies that have constrained local public health departments and hospitals, as well as by individual state rules that could bar dental practices from administering diagnostic tests.

The American Dental Association (ADA), which represents 163,000 dentists nationwide, is asking the U.S. Department of Health and Human Services (HHS) to permit dentists to conduct coronavirus tests at their practices on an emergency basis.

"Approving dentists to administer these tests now will expand the nation's medical surge capacity ... and create a safer environment for treating dental patients," the ADA said in a letter to HHS.

HHS did not immediately respond to a request for comment.

Coronavirus testing could also provide a source of revenue for dentists whose practices have been limited to only the most urgent cases by social distancing measures during the outbreak that has infected more than 800,000 Americans and killed over 45,000, according to a Reuters tally.

Around 85% of dental practices say that they are seeing fewer than 5% of their normal volume of patients, according to an ADA survey conducted earlier this month.

LOBBYING CAMPAIGN

Trade groups and dental care providers are lobbying state dental boards for a clearance to test for COVID-19, the respiratory illness caused by the virus.

However, dental boards generally cannot override state statutes that set what procedures dentists are allowed to conduct, and would likely need to solicit waivers from governors to do so, said Robert Zena, president of the American Association of Dental Boards, a nonprofit advocacy group.

Governors around the country have said far more testing is needed to safely begin to reopen the nation's battered economy, so they may be open to such waivers.

"I don't think the current regulations and oversights were built for this kind of environment," said NADG Chief Executive Kenneth Cooper.

More than 2 million COVID-19 tests have been conducted in the United States so far, but they are still not available to many who need them, Dr. Stephen Hahn, commissioner of the U.S. Food and Drug Administration, said last week.

Mitchell Goldman, chief executive of Mid-Atlantic Dental Group, a dental services organization based near Philadelphia, said he reached out to vendors about acquiring tests, only to be told it could take several weeks to receive a supply. Executives at NADG said that they received a similar response from suppliers.

In the interim, NADG began its pilot program with a few dozen tests this week in Westchester County, New York, where the state's first COVID-19 cluster appeared.

It hopes to be able to scale up to as many as 150,000 coronavirus tests across its facilities in May and more in June, the organization said, provided the equipment is available.

For the pilot phase, NADG partnered with a physician to avoid violating state restrictions on dentists performing such tests, the executives said.

The initial tests conducted on patients and employees will be shipped to major laboratories like Quest Diagnostics Inc for analysis, they said.

They hope success with the pilot will help them win over state regulators who can authorize expansion of the program.

"We seek first and foremost to address the lack of testing in the communities we serve and take some pressure off of primary care providers," NADG's Cooper said.

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