Defining Emergent, Essential (Urgent), and Non-Essential (Elective) Care in Dentistry

Dental healthcare providers rely on their professional judgment and clinical expertise to make decisions in the best interests of their patients. As a regulator, CDSBC normally avoids providing prescriptive, clinical advice because we recognize that professionals have the training and the expertise to make decisions and provide care based on the unique needs of each individual patient.

However, under the lens and pressure of a pandemic, we recognize dental healthcare providers and patients will sometimes want and require more detailed guidance.

Much concern has been expressed about determining and defining the differences between emergent, essential (urgent) and non-essential (elective) care.

As professionals, we need to make decisions and provide care in ways that will decrease the burden on hospital departments, allowing them to focus on the critical support of patients affected directly by viral infection.

By limiting the types of care provided and respecting the need for social distancing and subsequent transmission, we can help flatten the curve of transmissibility and prevent overwhelming these facilities. As well, by triaging, managing and providing emergent and essential care, dentists can help solve patient concerns before they reach the level of hospitalized care.

CDSBC has not asked you to close your offices. But we are strongly recommending that provision of all non-essential (elective) care be suspended immediately. To help practitioners better interpret this recommendation, we provide the following definitions of emergent, essential (urgent) and non-essential care.

EMERGENT CARE
Emergency dental care is defined as potentially life-threatening conditions requiring immediate management or treatment to stop ongoing tissue bleeding, alleviate severe pain or infection and include:  

• Cellulitis as a result of an uncontrolled infection compromising the airway  

• Severe uncontrolled hemorrhage (bleeding)  

• Trauma to the orofacial complex especially to facial bones that potentially compromise the patient’s airway  

• Uncontrolled severe pain  

• Uncontrolled infection  

ESSENTIAL (URGENT) CARE
Essential care is separate from emergency care and focuses on the management and treatment of conditions that require immediate attention to relieve pain and/or risk of infection. These should be treated as minimally invasively as possible. These conditions would include (but not limited to):  

• Pericoronitis or third molar pain  

• Post-operative osteitis (dry socket dressing changes)  

• Abscess with localized pain and swelling  

• Treatment required before critical medical procedures can be provided  

• Dental trauma involving avulsion or luxation of a tooth  

• Tooth fracture resulting in pain or causing soft tissue trauma  

NON-ESSENTIAL (ELECTIVE) CARE
Non-essential care is routine or non-urgent procedures and would include (but not limited to):  

• Recall examinations including routine radiographs  

• Routine debridement and preventive therapies  

• Orthodontic procedures other than those to address acute issues (e.g. pain, infection, trauma)  

• Restorative dentistry (including treatment of asymptomatic carious lesions)  

• Aesthetic dental procedures.

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