Q: Is COVID-19 testing within a dentist’s scope of practice?
A: The California Dental Practice Act states that the scope of practice of a dentist includes all necessary related procedures needed to provide dental treatment. Testing prior to proceeding with care falls within this definition, and test results should be noted in the patient’s dental record.
Dentists may also conduct COVID-19 tests on dental team members that are not patients of record.
Q: Because there are different types of tests, what considerations are there for dentistry?
A: When thinking about the benefit of testing and the types of tests available, it is important to focus on the primary purpose of the test. Public health and physicians are primarily testing for viral particles or antigens to identify people who are infected with SARS-CoV-2. This allows them to ensure individuals get the care they need early on, isolate themselves from others, and allow tracking of transmission and disease rates. For this purpose, the best test is one that produces low false positives. Every false positive in medicine sets additional, potentially resource-intensive actions into motion, so a low false-positive rate is essential.
In dentistry, however, it is important to know if the patient needing dental treatment is COVID-19 negative so treatment can proceed; dentistry is trying to detect those who are not infected with the SARS-CoV-2 virus. This means that dentistry needs to avoid using a test that has a high false-negative rate. Every false negative in dentistry potentially increases the risk of disease transmission to others, so a low false-negative rate is essential.
When choosing a COVID-19 test, it is important to make sure it is FDA-approved or has an FDA emergency use authorization.
Q: How much does it cost to get a test?
A: Public health testing, conducted through local health departments, has been occurring in San Francisco, Sacramento, and several other communities and is provided at no cost to the individual being tested. This is, in part, due to the Families First Coronavirus Response Act (FFCRA), which is federal legislation that was signed into law on March 18, 2020. This law mandates that anyone can receive free COVID-19 tests for the duration of the public health emergency, regardless of insurance plan type or lack of insurance.
Q: Because rapid tests are already on the market, how do I determine which tests are reliable?
A: You can check which antigen tests have an emergency-use authorization by the FDA here. The FDA list includes each test instructions for use and fact sheets for healthcare providers and patients, respectively.