Key Guidelines and Restrictions

During the COVID-19 pandemic additional guidelines have been designed to keep yourself, your team and your patients safe. These include looking at the whole practice and implementing measures to minimise the risk of spreading COVID-19. In addition to the Guidelines, the levels of restriction on dental practice will change according to the current environmental risk assessment and it's important to understand what each of these levels mean for you and your practice. 

Are the level 1 restrictions mandated by the regulator?

Yes the Dental Board of Australia has published the restrictions.
 

How do I know if a patient who has previously been COVID-19 positive (confirmed case) has recovered from COVID-19?

When patients recover from COVID-19, they stop shedding the SARS-CoV-2 virus and no longer pose a risk of infecting others. This means they can safely be treated in office based practice, following the same precautions used for all low risk patients as described in level 1 restrictions.
 
Some patients may be given a letter of clearance from the state or territory health authority stating that they are no longer required to be in isolation and can return to normal life in the community. This letter is confirmation that the patient is no longer infectious. 
 
CDNA recommendations dated 12 June 2020 state that COVID-19 confirmed cases can be released from isolation (and therefore seek necessary dental treatment) if they meet criteria outlined in either point 1, 2, or 3 below – whichever is applicable. Significantly immunocompromised cases can be released from isolation if they meet the appropriate criteria in point 1, 2, or 3 and an additional criterion.
 
1. Confirmed cases who are asymptomatic are recovered If at least 10 days have passed since the first respiratory specimen positive for SARS-CoV-2 by PCR was taken, and no symptoms have developed during this period.
 
2. Confirmed or probable cases with mild illness who did not require hospitalisation are recovered
if they meet all of the following criteria:
• at least 10 days have passed since the onset of symptoms; and
• there has been resolution of all symptoms of the acute illness for the previous 72 hours.
 
3. Confirmed or probable cases with more severe illness who have been in hospital are recovered:
  1. For cases released from hospital, if they meet all of the following criteria:
• at least 10 days have passed since hospital discharge; and
• there has been resolution of all symptoms of the acute illness for the previous 72 hours.
 
  1. For cases who will be remaining in hospital, if they meet all the following criteria:
• at least 10 days have passed since the onset of symptoms; and
• there has been resolution of all symptoms of the acute illness for the previous 72 hours; and
• the case has had two consecutive respiratory specimens negative for SARS-CoV-2 by PCR taken at least 24 hours apart at least 7 days from symptom onset.
 
For significantly immunocompromised persons, in addition to meeting criteria described in points 1, 2, or 3 above, they can be released from isolation (and therefore access non-urgent dental treatment) when they are PCR negative on at least two consecutive respiratory specimens collected at least 24 hours apart at least 7 days after symptom onset.
 
For further guidance on current CDNA recommendations, see: https://www1.health.gov.au/internet/main/publishing.nsf/Content/cdna-song-novel-coronavirus.htm
 
 A dental practice that refuses dental care to a patient solely on the basis of previously having had COVID-19 infection, and who has now been cleared of COVID-19 and released from isolation, would likely to be found to be in breach of national and jurisdictional anti-discrimination legislation.​
 

Why aren’t standard precautions sufficient for aerosol producing procedures in COVID-19?

The use of standard precautions (including hand hygiene, PPE, safe use and disposal of sharps, routine environmental cleaning, reprocessing of instruments and equipment, respiratory hygiene and cough etiquette, aseptic technique, and waste management) is the principal way we minimise the transmission of infections in any healthcare setting, including dental practice, and are applied to everyone, regardless of their perceived or confirmed infectious status.  They ensure a basic level of infection prevention and control.  Standard precautions are used when undertaking treatments or procedures where there is handling of blood, body fluids (e.g. saliva), non-intact skin, and mucous membranes. 
 
Transmission based precautions (contact, droplet or airborne) are used in addition to standard precautions when there is suspected or confirmed presence of infectious agents that are not effectively contained by standard precautions alone.  The type of transmission based precaution required is dependent on the route of transmission of  the infectious agent:
  • Contact precautions
    • are used when there is a risk of direct/indirect transmission of infectious agents e.g. highly contagious skin infections/infestations such as methicillin-resistant staphylococcus aureus (MRSA) and vancomycin resistant enterococcus (VRE)
    • Direct transmission occurs when infectious agents are transferred from one person to another, without a contaminated intermediate object or person.
    • Indirect transmission involves the transfer of an infectious agent through a contaminated intermediate object (fomite) or person.
  • Droplet precautions
    • are used when there is a risk of transmission through large respiratory droplets (>5 microns) or mucous membrane contact with respiratory secretions, generated by a patient who is coughing, sneezing, or talking. e.g. influenza, norovirus, pertussis, meningococcus.
    • Transmission via large droplets requires close contact as the droplets do not remain suspended in the air and generally only travel short distances. As the droplets do not travel over long distances, special air handling and ventilation are not required.
    • The droplets can contaminate horizontal surfaces close to the patient, and the hands of healthcare workers can become contaminated through contact with these surfaces.
  • Airborne precautions
    • are used when there is risk of transmission through small respiratory droplets (<5 microns) that remain infective over time and distance when suspended in air. e.g. measles, chickenpox, tuberculosis
    • Transmission via small droplets can result due to inhalation by susceptible individuals who have not had face-to-face contact with (or been in the same room as) the infected individual.
 
The WHO has confirmed that coronavirus responsible for SARSCoV2 or COVID-19 is spread primarily through droplets generated when an infected person coughs, sneezes or speaks, however transmission can also occur by touching a contaminated surface and then touching the eyes, nose or mouth before washing your hands. While this would suggest that droplet precautions are required for patients identified as positive to COVID-19, most dental treatments are identified as aerosol generating procedures, and therefore the Australian Guidelines for the Prevention and Control of Infection in Healthcare (2019)[1], states that “if a patient requires care under droplet precautions but an aerosol generating procedure is undertaken, then droplet precautions should be increased to airborne precautions for at least the duration of the procedure.”
 
The Center for Disease Control and Prevention advice for Dental Settings[2] states that there is currently no data available to assess the risk of SARS-CoV-2 transmission during dental treatments, or to determine whether dental healthcare professionals are adequately protected when providing dental treatment when using Standard Precautions, however they have referenced the Occupational Safety and Health Administration’s Guidance on Preparing Workplaces for COVID-19[3] which places dental practitioners in the very high exposure risk category, as their jobs are those with high potential for exposure to known or suspected sources of the virus that causes COVID-19. 

The CDC concluded that when practicing dentistry in the absence of Airborne Precautions, the risk of SARS-CoV-2 transmission during aerosol generating dental procedures cannot be eliminated, and provided the following recommendation:
  • Avoid aerosol generating procedures whenever possible. Avoid the use of dental handpieces and the air-water syringe. Use of ultrasonic scalers is not recommended during this time. Prioritize minimally invasive/atraumatic restorative techniques (with hand instruments only).
  • If aerosol generating procedures are necessary for emergency care, use four-handed dentistry, high evacuation suction and dental dams to minimize droplet spatter and aerosols. 

This is not the first coronavirus pandemic this century. In 2003 we had Sudden Acute Respiratory Syndrome caused by SARSCoV1. A retrospective review[4], outlined measures to reduce the risk of cross infection with coronavirus in the dental setting, including the identification of patients with SARS through targeted screening questions, pre-procedural rinsing, hand hygiene, PPE, rubber dam isolation and recommended that “aerosol-generating procedures should be avoided as much as possible if rubber dam isolation is not feasible. Some of these procedures include ultrasonic scaling, root-surface debridement, and high- or low-speed drilling with water spray.” These measures were adopted in both the ADA Managing COVID-19 Guidelines and ADA Dental Service Restrictions documents. A conclusion of this article was that while no dental healthcare worker was affected in either a nosocomial or dental setting, this was thought to be due to the use of universal infection control measures and/or the low degree of viral shedding in the prodromal phase of SARSCoV1.

While both SARSCoV2 and SARSCoV1 demonstrate high viral loads in posterior oropharyngeal saliva samples, SARSCoV1 viral load was found to peak at 10 days after symptom onset.  In comparison, SARS CoV2 has the highest viral load on presentation, suggesting that SARS-CoV-2 can be transmitted easily, even when symptoms are relatively mild. This finding could account for the fast spreading nature of this pandemic, with efficient person-to-person transmission noted in community and health-care settings.[5]
 
[4] Samaranayake L, Peiris M
Severe acute respiratory syndrome and dentistry. A retrospective review
JADA 2004; 135: 1929-1302.
 
[5] To KK-W, Tsang O T-K et al
Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARSCoV2: an observational cohort study
The Lancet Infec Dis 2020; 20: 565-74
  Level 1 Decision Tree

A decision tree for patient management during COVID-19 Level 1 restricitons.

  Level 2 Decision Tree

A decision tree for patient management during COVID-19 Level 2 restricitons. Version 3.

  Managing COVID-19 Guidelines

A guide to managing COVID-19 in your practice

  Practice Start Up

A checklist to assist you if starting up practice following hibernation due to the Covid-19 pandemic.

  Activities During Downtime

A guide to activities that can be undertaken by the practice team during periods of downtime.

  ADA Dental Service Restrictions in COVID-19

A framework outlining the ADA's recommendations in relation to the continuation of dental services.

Practice Policies

In order to implement the newly established guidelines, practice policies should be developed so that staff and clinicians understand how to practically implement these changes. These policies look at how staff and clinicians can determine the COVID-19 risk of each patient, the other risk factors that should be considered and the ways to operate in a consistently safe manner. Each practice should also have an exposure response plan so that all team members know how to behave and react in the situation where there is a COVID-19 exposure. 

Should I be changing how I manage appointments?

Yes. If a patient requires treatment that can be performed under current restrictions you should call prior to the appointment and ask if they have:

 - returned from overseas travel in the past 14 days
 - felt unwell, including but not limited to symptoms of COVID-19 such as fever, cough, sore throat or shortness of breath
 - had any contact with a confirmed or suspected case of COVID-19 in the past 14 days

If the patient answers YES to any of these questions, advise them that you cannot provide treatment and reschedule the dental appointment for 14 days after their return from overseas or contact with a COVID-19 case, or when their symptoms have resolved and they are no longer considered a risk.

Upon confirming appointments recommend that:

1) patients over the age of 70 years old, or those with chronic disease in particular, cardiovascular or respiratory disease; those who are immunocompromised e.g. currently under cancer treatments or insulin dependent diabetics, defer all non-urgent dental treatments.

2) patients attend alone or only bring minimal additional accompanying persons being mindful of consent requirements and family commitments. 

Consider longer appointments to allow enough time between treatments to enable additional infection control measures including environmental cleaning.

Consider staggering patient appointments to minimise patient contact in the waiting room, or if there is a car park on site, ask patients to wait in their cars and call the practice upon arrival.

Further advice can be found in the Managing COVID-19 Guidelines.

Do I have to use a rubber dam?

A rubber dam substantially decreases the risk of producing dangerous aerosols, particularly for procedures where aerosol producing instruments are necessary e.g. endodontic access.

Can I charge an item number for consulting over the phone?

The ADA has recently issued a new item number for teleconsultations.  Please refer to the Guidelines for Teledentistry for further details on the use of this item number.

919 Teleconsultation
The remote provision of a consultation to a patient in exceptional circumstances which prevent face to face consultation. It may include the provision of oral health or treatment information and referral.

Should I purchase one of the machines that claim they extract aerosols out of the clinical environment and ensure non-recirculation due to the presence of HEPA [special filters] and UV destruction?

Most domestic air purifiers are not effective at removing viruses.  Available studies on these show no difference in aerosols (for bacteria) when they are used.

High-quality air purifiers designed for allergy sufferers that have medical HEPA filters built-in, will remove viruses from the air. The filters do need periodic replacement and there are normally three different filers of which the last one is the HEPA filter.

There has not been any research undertaken in using these units in healthcare facilities, so it is unknown how well they work and how long they would need to run to give a meaningful reduction in airborne particles.

 

Should I turn off the air-conditioner while undertaking aerosol generating procedures?

There is no need to turn off the air-conditioning. No additional precautions with respect to air-conditioning or air filtration need to be taken if treating a low risk patient.
 

I am building a new dental surgery. Should I make the treatment room negative pressure?

The use of a negative pressure room is just one part of a suite of measures for treating patients under full airborne precautions. Other parts of airborne transmission based precautions include:
  • Annual fit-testing of P2/N95 respirator masks which is undertaken by a trained and validated fit-tester
  • Specific processes for patient entry and exit from the surgery e.g. appointment time, entering and exiting the building, restriction contact with other patients and staff.   
  • Specific donning and doffing protocols of PPE
  • Environmental cleaning
The design of a negative pressure room is also important such as including bulkheads to eliminate areas where things can settle on and build upon, making surfaces much easier to clean, designing the room's airflow patterns correctly.  Expert advice should be sought to ensure all issues have been considered.
 
  ADA Guidelines for Teledentistry

A guide on the appropriate use of teledentistry to provide urgent dental consultation. 

  COVID Safe Plan - MEMBER RESOURCE

A template COVID-19 safe plan to assist with returning to work and preventing the further spread of COVID-19.

  Dental Practice Treatment Guidelines

A template set of treatment guidelines for your dental practice during the COVID-19 pandemic.

  Triaging and Care Prioritisation

A quick-guide for practices to assist triaging and care prioritisation.

  Rubber Dam for Restorative Dentistry

A guide to the use of rubber dams in restorative dentistry.

  COVID-19 Risk Factors

Additional information for dental practitioners when considering risk factors for the contraction and severity of COVID-19 and infection.

  Exposure Response Plan

A template Exposure Response Plan for your dental practice.

  Practice Hibernation and Mothballing Checklist

If you have decided to put the practice into hibernation for the time being then this checklist should help ensure everything is mothballed and ready for your return.

Posters for your Practice

Below are some posters to place in your waiting room and in other publicly visible areas in your practice so that patients and staff are aware of what behaviour and symptoms to be mindful of. 

Should I be asking my patients to complete hand hygiene when entering the practice?

Yes, you should be directing patients to use alcohol-based hand rub, or washing their hands with soap and water when they enter the practice.
  Identifying the Symptoms Poster

A poster you can display in your waiting area and/or the door of your practice directing patients to notify staff if they may be at risk of carrying COVID-19.

  Cough Etiquette Poster

A poster you can display in your waiting area to inform patients and staff of correct cough etiquette.

  Hand Hygiene Poster Suite

A collection of posters demonstrating approved procedure to ensure hand hygiene, including how to hand wash or hand rub and the five moments of hand hygiene, as well as how to set up your work area.

...

Infection Control

Infection control in dental practice has always been a cornerstone of ensuring your practice is safe. This is the responsibility of the treating practitioner. Below are some general infection control resources as well as some additional measures to be mindful of during the COVID-19 pandemic. 

What additional measures are required that may not have been implemented before COVID-19 pandemic?

All aspects of patient interaction within the practice should be considered including alcohol-based hand-rub or hand-washing for patients when they enter the practice, wiping down of door handles and benches that the patients touch, and the inclusion of a pre-operative patient mouth rinse such as 1% hydrogen peroxide. Additional precautions will also be required depending on the COVID-19 risk of the patient and the dental procedure being performed.
  Guidelines for Infection Control

This essential publication, which it is mandatory for every practice to have onsite, describes the infection control processes that dental practitioners and clinical support staff are obliged to implement.

...
  Maintaining the Environment

Promoting and practising respiratory hygiene and cough etiquette and observing high standards of surface hygiene remain critically important.

  Infection Control Manual Template

The Infection control manual template takes all the hard work out of documenting your infection control processes and procedures.

  Practical Guide to Infection Control

This publication outlines the most effective practical procedures for implementing the ADA’s Infection Control Guidelines in a dental practice.

  Self Assessment Tool for Infection Control

This practical tool, which is best used in conjunction with ADA’s Guidelines for Infection Control, is designed to help dental practitioners identify issues around infection control within their practice.

...
  Transmission Based Precautions

A guide to standard precautions and transmission based precautions, to be implemented where standard precautions alone may be insufficient to prevent infection.

  Hand Hygiene Audit

Hand Hygiene Audit template to assist you in becoming fully compliant with hand hygiene procedures.

  Faecal-Oral Transmission of COVID-19

Information regarding potential faecal-oral transmission of COVID-19 and its impact on environmental cleaning.

PPE and Stock

There's some confusion surrounding the requirements of PPE during the COVID-19 pandemic. Understanding the precautions and whether you need to consider droplet or aerosol-based precautions will depend on the patients COVID-19 risk and the type of procedure being performed. Worldwide, PPE supply is diminished due to an unprecedented demand. It's important to be mindful of the PPE you require in the context of your practice and in the wider environment.

What role do masks have in COVID-19?

COVID-19 is spread via respiratory droplets when an infected person sneezes or coughs, (within 1m) of another or via contact routes, where the droplets land on a surface and are transferred by touch. There's a risk that airborne transmission may occur if the droplets are aerosolised when certain procedures are performed, such as the use of high-speed drills, ultrasonic scalers, triplex syringes, particle beams and hard tissue lasers.
 
A Level 2 or 3 Surgical Mask, or P2/N95 respirator may be worn when caring for patients on droplet precautions (for example, undertaking urgent procedures on medium risk patients with no aerosols being generated).
 

What PPE is required during the COVID-19 pandemic?

This depends on the COVID-19 risk of the patient and the prescribed treatment. If the patient has a low risk of having COVID-19, and the procedure does not involve aerosol or aerosol is minimised with the use of rubber dam and high volume suction, then standard universal precautions plus the additional COVID-19 measures (pre-operative rinse and additional environmental cleaning) are sufficient. 

Can I re-use or sterilise masks?

While it might seem like the obvious solution, according to the Dental Board of Australia and manufacturers of these products, masks are typically labelled as a single-use item and cannot be reprocessed.

The filtration abilities of a surgical mask start to deteriorate after around 20 minutes of continuous use as a result of moisture on the inner and outer surfaces of the mask. It is not necessary to change it after this time if you are in the middle of a procedure which goes for a longer period. However, masks should be changed between patients.

Steam sterilising renders the mask ineffective by altering the charge on the microfibers that are responsible for particle filtration, causes degradation of the mask straps, renders the splash protection useless, and causes parts of the mask to disintegrate or melt, and release some toxic vapours.

Can I use a P2/N95 respirator?

Yes, but you must check that they are suitable for health care use and they must be fitted correctly. You will find information on how to fit check a P2/N95 mask here. P2/N95 masks will not seal effectively unless you are clean shaven.

What is the difference between P2 and N95 Respirators?

The terms P2/N95 respirator are used interchangeably to cover both US and European standards. They have the same level of protection for particles in the same size range as most viruses (0-.1-0.3 microns). N95 respirators are used for oil free aerosols where P2 respirators are tested with paraffin oil. European standards refer to filtering face piece (FFP) masks and in that scheme, FFP2 matches with N95.

How well do P2/N95 respirators work, and what is fit-checking and fit-testing?

A correctly fitted P2/N95 respirator will block 99% of total viral influenza particles, but effectiveness drops to 66% if poorly fitted (e.g. not matched to the size and shape of the face). A poorly fitted P2/N95 mask performs little better than a poor fitting surgical mask.

Fit checking is the appropriate minimum standard at the point of use for healthcare workers using P2/N95 respirators. Fit checking is required when using a P2/N95 respirator to treat low risk and medium risk patients. Fit checking is performed by the practitioner every time they put on a P2/N95 respirator to ensure it is fitted correctly, and air is not leaking around the perimeter of the mask. A good seal must be achieved over the bridge of the nose and mouth, with no gaps between the respirator and face. Facial hair (beards and stubble) prevent an air-tight seal being obtained. No clinical activity should be commenced until a satisfactory fit has been achieved with the respirator.
 
The following Queensland Health PowerPoint presentation describes a fit-check procedure for a P2/N95 respirator:
https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/infection-prevention/transmission-precautions/p2n95-mask
 
Fit-testing is carried out to select the ideal respirator for each individual. A risk-management approach should be applied to ensure that staff working in areas with a significant risk of exposure are professionally fit -tested and are trained in how to correctly use the respirator including performing a fit-check at the time of use. Fit testing is conducted by an appropriately trained technician, using a qualitative or quantitative method to evaluate the fit of a specific make, model and size of respirator on an individual. The test verifies that the mask has achieved an adequate seal and that this seal is being maintained in reasonable challenge conditions such as when deep breathing, talking, when the head moves or when exertion occurs. No high-risk patient in the context of COVID-19 should be treated without a properly fit-tested respirator.
 

Can I re-use a P2/N95 respirator?

The answer is NO. P2/N95 surgical respirators are a one-time-use item. There is no acceptable or effective way to reprocesses these. The manufacturers do not recommend or support attempts to sanitize, disinfect, or sterilize them.

All methods that have been tried suffer from at least one of the following four problems: 
  • they are not effective against the COVID-19 virus;
  • they damage the respirator’s filtration;
  • They affect the respirator’s fit to the face; 
  • they create safety problems for the person wearing the respirator (e.g. off-gassing of chemicals into the breathing zone). 

Can I wear a visor or face shield?

Face shields and visors do not protect against aerosols as they have no filtration and do not meet the Standard required by the regulator, so they are not a suitable replacement for a surgical mask.

What should I do if I run out of hand sanitiser?

For routine dentistry it's completely appropriate to use 2% or 4% chlorhexidine hand wash (if you can source it) as a good alternative to ABHR, but washing effectively with soap and water is also completely appropriate.

There are other Antibacterial TGA approved handwash products also available including Povidone Iodine products (such as Betadine) which may be used with appropriate caution. For surgical procedures the ADA Infection Control Guidelines provide guidance on appropriate hand hygiene.

Can you clarify the use of gowns during COVID-19 level 2 service restrictions?

The use and type of PPE is determined by whether you are using standard precautions only or with transmission based precautions. This is outlined in the NHMRC guidelines.

In the context of COVID-19 you may wish to consider using a disposable gown for over street clothes, together with PPE for standard precautions (disposable gloves, level 2 surgical mask, eye protection), where you determine that there is a risk of contamination of your clothes with bodily fluid. “Bare below the elbow” principles should still apply for non-surgical treatment indications in low risk patients.

Impervious gowns are required for droplet/airborne transmission based precautions, as per the NHMRC guidelines. Droplet precautions, with the use of impervious gowns, are only expressly required for patients who are identified as moderate (suspect case) or high risk (probable case) of COVID-19, as per CDNA guidelines. Treatment of patients confirmed with COVID-19 would also require impervious gowns as part of the PPE due to airborne precautions, which is beyond that expected to be provided in an office based dental setting due to the need for dedicated airborne transmission based precautions including a negative pressure room.
 

What do I do if I have completely run out of masks or other PPE?

If you’re unable to practice due to insufficient PPE, contact the ADA team on 02 8815 3333 or send an email to [email protected] and we’ll do everything we can to help you.

Can't the ADA relax the standards?

The ADA is not the regulator.  The Dental Board of Australia is the regulator and sets out the infection control requirements for registered dental practitioners. They require dentists practice in accordance with a range of standards and guidelines, including;

1. NHMRC Australian Guidelines for the Prevention and Control of Infection in Healthcare
2. AS/NZS 4815/4187
3. CDNA Guidelines
4. The ADA's Guidelines for Infection Control

The Dental Board has stipulated there will be no flexibility to the standard in relation to PPE and the ADA has requested the Board identify what their plan is to ensure dental practitioners can continue to treat patients through the shortage of masks.

In short, the ADA does not set the rules we help dental practitioners interpret and apply them.
  Where to find PPE

Information regarding which suppliers stock each item of PPE.

  Putting on and Removing PPE

A poster from the National Health and Medical Research Council (NHMRC) demonstrating the correct sequence for putting on and removing PPE.

  Conserving Mask Stock

A range of ADA-recommended measures that can be used to conserve your remaining masks you have left while ensuring that you, your staff, and your patients are kept safe.

  Which Mask and When

An outline of the regulatory requirements around mask use and guideance on which mask to use, and when.

Marketing and Patient Communication

These Resources are available to ADA Members Only.

The Covid-19 pandemic has been an unprecedented situation for dental practices and our patients. With most of the restrictions on dental practices now lifted, it's important to let patients know that practice doors are open and they can safely return to see their dentist.
  Reopening the Books Webinar

Our panel of dental pratice marketing experts, share with you effective marketing strategies and practical business tips to help you rebuild your book as restrictions ease.

  COVID-19 Recovery Plan

A Covid-19 recovery plan for dental practice owners.
 

  Members Media Release

A media release and supporting document to assist members in communicating to patients that they can now safely return to see their dentist.

  Media Assets - Level 1

A range of assets for your practice to assist you in communicating the move to Level 1 and what it means for patients.

Financial Support

Changes to working arrangements will directly affect your finances. The ADA have included links below to a range of resources to help manage your finances for the weeks and months ahead. We also advise that you contact your accountant and financial adviser so that you can have direct advice during this time.  Additionally, the government is releasing different packages to support members of the community and we will update you as they become available 

How am I going to make ends meet while I don’t have an income?

The government, lenders and some landlords have introduced provisions to protect those that are vulnerable during the COVID-19 pandemic. Please look at the resources below to see what is currently available.
  COVID-19 Government Assistance Guide

A business guide from Australian Chamber of Commerce and Industry to financial and regulatory assistance from government during the COVID-19 pandemic. 

  Choosing a Financial Adviser

Guides to help you to find a financial adviser to assist you in managing your finances appropriate to your requirements.

  Jobkeeper Payment Guide

A brief employer guide to the new JobKeeper wage subsidy from the Australian Chamber of Commerce and Industry.

  JobKeeper and Government Support

Information on government support for individuals including the JobKeeper scheme.

  Commercial Leasing During COVID-19

Information regarding the National Cabinets mandatory code of conduct on commercial leasing during COVID-19.

  Small Business Loans and Repayments

Information for practice owners regarding business loan repayment support.

  Managing Individual Financial Obligations

Information to guide individual practitioners in managing their financial obligations.

  Cashflow and Debt Management for Practice Owners

Information to guide practice owners in assessing cashflow and managing debt.

HR Support

HR Resources are available to ADA Members Only.

We understand that restrictions on the services you can provide will profoundly affect your cash-flow and the staffing requirements of your practice, and may result in the practice temporarily closing. It is a difficult and uncertain time for everybody and ensuring that the practice team are treated fairly and with respect is important and will aid in our efforts to return to business as the restriction levels lower. 

The ADA's HR Advisory Service is available to members and provides individual advice to guide you through any changes you need to make.
  HR FAQs

Answers to some of your most frequently asked questions.

  JobKeeper Wage Subsidy

Information sheet and guide to the governements JobKeeper scheme encouraging employers to keep Australian employees in jobs.

  COVID-19 - Amendments to the Fair Work Act

A guide to the amendments made to the Fair Work Act 2009 (Act) in response to the COVID-19 pandemic.

  JobKeeper FAQs for Employers and Practice Owners

Answers to the most frequently asked questions on the governments new JobKeeper scheme

  JobKeeper 'One in, all in' rule

Further clarification around the JobKeeper scheme and the question of 'One in, all in'.

  Information for Practice Owners

Information provided by the ADA HR Advisory Service team to assist practice owners in responding to potential changes in practice operations due to the COVID-19 health crisis.

  Information for Employees

Information provided by the ADA HR Advisory Service team to assist employees in responding to potential changes in practice operations due to the COVID-19 health crisis.

  HR - WA State System

Relevant HR advice for Western Australia State System employers and employees regarding COVID-19.

  Government Assistance

Information and links to government assistance available through Centrelink and Services Australia.

  Redundancy Fact Sheet

Information on dismissals for reasons of redundancy under the Fair Work Act 2009.

  COVID-19 Jobs - Expressions of Interest

Information on state health departments seeking expressions of interest from dental practitioners to assist with their response to COVID-19.

HR Template Letters

A series of template letters for practices not qualified for the JobKeeper scheme to use when communicating with the Dental Team regarding working arrangements during the COVID-19 pandemic.

HR Template Letters - JobKeeper Qualified

A series of template letters for practices qualified to the JobKeepers scheme to use when communicating with the Dental Team regarding working arrangements during the COVID-19 pandemic.

Mental Health Support

The COVID-19 pandemic affects everybody and their ability to earn an income, have security and socialise. As a result, there are many members of our community who are struggling with their mental health. Below is a link to resources and advice that are available. The ADA understands that we are all part of a wider community and now more than ever it is important to reach out to your colleagues, check-in and stay connected.

Since COVID-19 I’m experiencing anxiety and loneliness. Are there some things that I can do?

We definitely encourage you to reach out to your community and the ADA. We would also recommend: 

1. Managing your exposure to media and social media; ensure your information comes from trusted sources, like the ADA and Department of Health.

2. Being physically active, eating nutritious foods and creating routines the best you can.

3. Being socially active with friends and family by phone or video through newer tools like Skype.

4. Remaining "calm yet cautious" and seeking support if you need it.

5. Being kind to others, and yourself.

Is there someone I can talk to straight away?

If you would like to speak to someone immediately, you can call Lifeline on 13 11 14 or BeyondBlue on 1300 224 636.

Are there support services for Dentists?

Each state has different support services avaiable. You can find yours HERE.
  Mental Health Support

Information on mental health support and advice available in each state or terrritory.

  Online Assessment

Online assessments to help you to understand any mental health symptoms you may have and direct you to appropriate support.

COVID.TV

Access to episodes of COVID.TV: a series of short and to the point updates on the latest news and issues arising from the COVID-19 pandemic.
  Episode 1 - Introduction

An introduction to COVID.TV from ADA CEO Damian Mitsch.

  Episode 2 - Patient Management and Decision Making Under Level 3 Restrictions

Dr Dominic Aouad talks us through the ADA's decision tree and some of the implications of Covid-19 and Level 3 restrictions.

  Episode 3 - Dental Service Restrictions

Dr Sharon Liberali discusses restrictions in light of the Covid-19 pandemic.

  Episode 4 - Transmission Based Precautions

Dr Sharon Liberali provides additional information regarding standard based precautions and additional transmission based precautions in light of Covid-19.

  Episode 5 - Safety and Quality

An introduction to the ADA's new online safety and quality program.

Receive more information