Updated at 5:44 p.m., March 22, 2020: to include Abbott’s one-month ban on elective dental procedures.
AUSTIN — Gov. Greg Abbott on Sunday ordered dentists, as well as other health care professionals in Texas, to postpone for one month all elective surgeries and non-emergency procedures.
Abbott’s new executive order directs dentists as well as doctors to delay until 11:59 p.m. on April 21 “all surgeries and procedures that are not immediately medically necessary” to preserve a patient’s life or avoid “adverse medical consequences.”
Abbott’s order applies to all licensed health care professionals and all licensed health care facilities.
The main impetus for it was to free up hospital beds for Texans who have contracted the novel coronavirus. However, many workers in the dental profession believed keeping dentists’ offices open posed a hazard to their and patients’ health – by increasing community spread of the virus. It also depletes scarce masks, gloves and shields, they said.
Last week, Abbott and the state board that regulates dentists resisted entreaties that they tell Texas dentists to shutter their practices to stop spread of COVID-19.
Instead, as directed by Abbott’s aides, the Texas State Board of Dental Examiners on its website Friday morning told dentists to “use their professional judgment” on whether to obey federal health officials’ strong advice that all elective procedures be postponed.
Dentists are business owners and conditions around the state may vary, so “there’s no way we can do a blanket statement that covers all,” Boyd Bush, the board’s executive director, said Friday afternoon.
During an electronic town hall that was televised statewide late Thursday by Irving-based Nexstar Media Group, Abbott fielded a question from a prerecorded video submitted by Savanah Hearnsberger, a Hallsville dental assistant concerned about catching the virus and squandering protective equipment needed at the front lines.
“Will there be any mandates for dental offices to close,” asked Hearnsberger, who said the dentist she works for had voluntarily reduced hours of operation, performing emergency procedures only.
Abbott replied, “There is no intent right now to shut down any health care provider. It would be up to her employer — that particular health care provider — to make sure that they are living up to the standards of care.”
Reached by phone Friday, Hearnsberger said she was “a little disappointed” by Abbott’s answer.
“It just made it seem even more like it was just a suggestion, like something that you didn’t necessarily have to abide by and that wasn’t really being enforced as strictly as it needed to be,” she said.
However, Hearnsberger, 33, who has worked for East Texas dentists for 13 years, said she and other dental workers commenting on Facebook pages were pleased the state dental board posted the online message Friday morning.
It was at least a gentle prod to consider following the federal Centers for Disease Control and Prevention’s guidance to dentists that they delay elective work, she noted.
The message read, “With guidance from the Governor, the Texas State Board of Dental Examiners is directing all licensees to follow CDC guidelines regarding elective dental procedures. Please note, a strict interpretation may not necessarily be the best interpretation, and each licensee should use their professional judgement when making these decisions.”
Bush, the board’s executive director, said he and his staff worked with members of Abbott’s staff “in crafting and pulling that together.”
Bush was asked why, when both the CDC and the American Dental Association have recommended that dentists halt routine and elective procedures, the Texas board isn’t telling them to shut their practices.
“The way things are set up in the state of Texas is each one of the dentists is the basic owner of their business,” he said. “And it’s their decision on following these guidelines, how they’re going to be practicing.
“The thing is, one dentist in one area sees things different from other dentists in other areas, and there’s no way we can do a blanket statement that covers all of that. That’s why we’ve appealed to their professional judgment.”
To help reduce spread of the virus, all week, governors elsewhere — of both parties — have ordered dentists in their states to stop performing all but emergency procedures.
On Tuesday, through his health department, Louisiana Gov. John Bel Edwards, a Democrat, prohibited routine visits and elective surgery in dental offices for 30 days.
Hearnsberger, who lives less than an hour west of Shreveport, called Louisiana’s move disheartening.
“It’s like well, our neighbors are really cracking down and getting serious about this. So why aren’t we doing something that’s a little more,” she said.
In Texas, she said, “Some offices are conducting business as usual.”
Late Friday, Abbott spokesman John Wittman, asked to comment, said, “Dentists must join all Texans in doing everything we can to reduce COVID-19.”
State dental board member David Yu acknowledged Friday morning, “There is some confusion here.”
Yu, an Austin periodontist, said, “In the end, CDC is where dentists should reference. It’s how dentists should do best practices now.”
On Wednesday, the federal agency announced that all elective and nonessential medical, surgical and dental procedures — including routine dental visits — should be delayed during the COVID-19 outbreak. On Monday, the American Dental Association recommended postponing elective procedures for three weeks.
At a Tuesday news conference, Deborah Birx, a physician and diplomat who serves as the response coordinator for the White House Coronavirus Task Force, echoed the call for postponing elective procedures.
“If I could just say one other thing to the hospitals and dentists out there: Things that don’t need to be done over the next two weeks, don’t get it done,” Birx said.
On Thursday, Birx kept at it.
In a call President Donald Trump and Vice President Mike Pence had with governors, including Abbott, she said, “Critically, you need to make sure that all elective medical and surgical procedures and dental procedures have been canceled,” according to a White House transcript.
Republican Govs. Jim Justice of West Virginia and Kay Ivey of Alabama have ordered a halt to all elective dental procedures, as have Democratic Govs. Gavin Newsom of California, Jay Inslee of Washington, Kate Brown of Oregon, Jared Polis of Colorado and Tim Walz of Minnesota.
Asked whether the danger of virus spread from dental patients and employees who don’t show symptoms isn’t enough of a danger to shut down elective procedures in Texas, Bush, the dental board director, replied, “That will be a mandate that needs to come from the governor, not the TSBDE.”