Pandemic-driven changes in the scope of dental practice: Ethical implications

Many states have called on dentists to volunteer alongside other health care professionals (OHCPs) during the COVID-19 pandemic, introducing the question of when it is ethical for a dentist to broaden their scope of practice. Although a dentist’s obligatory role during spikes in infection should be emergency oral health care and public health awareness, OHCPs have other supererogatory skills, beyond the call of duty, that could help alleviate demand on hospitals, testing, and vaccination centers. Within the United States, cases of COVID-19 have been diagnosed across all areas and demographic groups.1 Infections in health care providers and caregivers have led to staff shortages.2,3 Physicians across specialties have volunteered for, and been required to take on, additional responsibilities and have even come out of retirement to join the cause.2 A need has also arisen for additional providers, which creates validity for OHCPs to be beneficent and broaden their scope of practice.4 Dentists are valuable members of the health care team, specialists in the head and neck, and well trained in medicine, pharmacology, patient management, and sterile surgical techniques.5 They possess emergency management skills, which may include airway management, code protocol, and pharmacologic response, and are prepared for emergencies during routine provision of care. As one of few professions that perform conscious surgery, dentists are consistently exposed to stressful situations that require careful patient care management. OHCPs credentialed in minimal and moderate sedation require in-depth knowledge of advanced life support, airway management, and pharmacology.6 Training of oral surgeons and dental anesthesiologists explicitly allows these professionals to induce all levels of sedation. Furthermore, dentists are highly versed in proper use and disposal of personal protective equipment and are able to take the steps necessary to protect themselves while serving a highly contagious population. Because COVID-19 is a respiratory ...