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Access TDA’s COVID-19 news and updates as new COVID-19 information and updated regulations become available.

Updated 3/2/21

Gov. Abbott Reopens Texas; TSBDE Emergency Rule Still in Effect
On March 2, 2021, Governor Greg Abbott issued a new executive order (GA-34) reopening Texas. According to the executive order, “COVID-19 hospitalizations and the rate of new COVID cases have steadily declined…”.

Effective 12:01 AM on March 10, 2021, counties located in an “area without high hospitalizations” have no state-imposed COVID-19 related operating limits for any business or other establishments. Although face coverings will no longer be required in public after the order’s effective date, individuals are still strongly encouraged to wear face coverings when unable to maintain 6 feet of social distance from other persons not in the same household.

TDA talked with the Texas State Board of Dental Examiners (TSBDE) this afternoon and the agency is still reviewing and discussing Governor Abbott’s new order and how it will impact the dental board’s COVID-19 emergency rule. Until notified otherwise, all dentists must practice in accordance with the TSBDE’s COVID-19 emergency rule—22 Texas Administrative Code §108.7(16) that went into effect on February 19, 2021.

The order defines areas with high-hospitalizations as a Trauma Service Area (TSA) with 7 consecutive days in which the number of COVID-19 hospitalized patients exceeds 15% of overall hospital capacity. The designation is lifted when the TSA has 7 consecutive days in which the number of COVID-19 hospitalized patients is 15%  or less of overall hospital capacity. The Department of State Health Services will maintain a current list of areas with high hospitalizations. In areas of the state defined as high hospitalization for 7 straight days, a county judge “may use COVID mitigation strategies” provided that local restrictions allow businesses and other establishments to continue operating at 50% minimum capacity.

TSBDE Adopts New COVID-19 Emergency Rule
On February 19, 2021, the Texas State Board of Dental Examiners (TSBDE) voted unanimously (2 absentees) to adopt a new COVID-19 emergency rule22 Texas Administrative Code §108.7(16). The new emergency rule is in keeping with Governor Greg Abbott’s Executive Order (GA-19) dictating the minimum standards for safe dental practice during the COVID-19 pandemic. Unless Governor Abbott lifts the COVID-19 disaster declaration, the final new COVID-19 emergency rule will be in effect for 120 days. At that time, the dental board will reconvene and decide whether to extend the rule for an additional 60 days.

Highlights of the new emergency rule include:

  • No longer prioritizing that patient care be performed by dental health care personnel not at high risk for contracting COVID-19;
  • No longer requiring the removal of magazines, reading materials, toys, and other objects that may be touched by others;
  • No longer requiring COVID-19 patient screening by phone during scheduling. Patients must still be screened during patient confirmation prior to appointment;
  • No longer prohibiting patient companions. Companions should continue to be screened for COVID-19 during patient check-in;
  • No longer recommending a pre-procedure rinse; and
  • Changing the time for a patient to contact the dental office if they experience COVID-19 symptoms from 10 days to 7 days after the dental appointment. 

Governor Abbott Renews COVID-19 Disaster Declaration

On February 4, 2021, Governor Greg Abbott renewed the state disaster declaration for COVID-19 for 30-days.

TDA is Advocating for Dentists and Dental Teams to Get COVID-19 Vaccine
TDA is currently working with the Texas Department of State Health Services (DSHS) and its Expert Vaccine Allocation Panel (EVAP) to encourage the panel to recommend dental health care personnel be given access to COVID-19 vaccines in the next distribution phase.

The state based recent vaccine distribution guidelines on protecting COVID-19 frontline health care personnel and vulnerable populations, to preserve vital state health care resources. In our discussions with DSHS, TDA is emphasizing that oral health is integral to overall health, and Texans’ continued access to dental care must be preserved. This includes maintaining a strong dental workforce. TDA will update members as those discussions continue.

In the meantime, we want to remind dentists to continue following the Texas State Board of Dental Examiners’ (TSBDE) COVID-19 emergency rule dictating the standards for safe dental practice during the COVID-19 pandemic so that dentists and their teams can continue safely treating patients. This rule remains in place until Governor Abbott’s COVID-19 disaster declaration is terminated.


FDA Issues Warning Letter to Battelle

The TDA shared information with its members about a free decontamination service from the Battelle Company to reuse N95 and N95-equivalent respirators. The Food and Drug Administration (FDA) authorized the emergency use of the Battelle Decontamination System. On October, 7, 2020, the FDA issued a warning letter to Battelle for failure to comply with regulatory requirements for medical device reporting as specified in the Emergency Use Authorization (EUA) for the Battelle Critical Care Decontamination System. You may also read the FDA’s press release.

Governor Abbott Issues Proclamation Suspending Elective Surgeries in More Texas Counties
On July 9, 2020, Governor Abbott issued a proclamation prohibiting elective surgeries in hospitals in all counties located within Texas’ 11 Trauma Service Areas. Texas is divided into 22 regions called trauma service areas (TSAs). The proclamation goes into effect 11:59 PM on Friday, July 10, 2020.

Counties included in the July 9, 2020 proclamation include:
  • All counties within TSA J—Andrews, Brewster, Crane, Ector, Glasscock, Howard, Jeff Davis, Loving, Martin, Midland, Pecos, Presidio, Reeves, Terrell, Upton, Ward, and Winkler counties;
    All counties within TSA K—Coke, Concho, Crockett, Irion, Kimble, Mason, McCulloch, Menard, Reagan, Runnels, Schleicher, Sterling, Sutton, and Tom Green counties;
  • All counties within TSA M—Bosque, Falls, Hill, Limestone, and McLennan counties;
  • All counties within TSA O that are not already covered by Executive Order GA-27—Bastrop, Blanco, Burnet, Caldwell, Fayette, Hays, Lee, Llano, San Saba, and Williamson counties;
  •  All counties within TSA P that are not already covered by Executive Order GA-27—Atascosa, Bandera, Comal, Dimmit, Edwards, Frio, Gillespie, Gonzales, Guadalupe, Karnes, Kendall, Kerr, Kinney, La Salle, Maverick, Medina, Real, Uvalde, Val Verde, Wilson, and Zavala counties;
  • All counties within TSA Q that are not already covered by Executive Order GA-27—Austin, Colorado, Fort Bend, Matagorda, Montgomery, Walker, Waller, and Wharton counties;
  • All counties within TSA R—Brazoria, Chambers, Galveston, Hardin, Jasper, Jefferson, Liberty, Newton, and Orange counties;All counties within TSA S—Calhoun, DeWitt, Goliad, Jackson, Lavaca, and Victoria counties;
  • All counties within TSA T that are not already covered by Executive Order GA-27—Jim Hogg and Zapata counties;
  • All counties within TSA U that are not already covered by Executive Order GA-27—Aransas, Bee, Brooks, Duval, Jim Wells, Kenedy, Kleberg, Live Oak, McMullen, Refugio, and San Patricio counties; and
  • All counties within TSA V that are not already covered by Executive Order GA-27—Starr and Willacy counties.

Previously, the governor suspended elective surgeries in hospitals in Bexar, Cameron, Dallas, Harris (Executive Order GA-27), Hidalgo, Nueces, Travis, and Webb counties. The goal is to preserve hospital beds for coronavirus patients.

Dentists in the affected counties will be required to demonstrate to the hospitals that patients needing surgical dental treatment in the hospital must be treated in a “timely” manner, or be at risk for serious medical consequences or death, or be able to demonstrate that performing the dental procedure(s) within the accepted clinical standards of care will not deplete the hospital’s capacity needed to cope with the COVID-19 disaster.

Amended GA-27 remains in effect until it is further amended, rescinded, or superseded by the Governor. Governor Abbott and his team are continuously monitoring local COVID-19 data and “will continue to take precautionary action where it is necessary.” Through proclamation, the Governor can add or subtract from the list of counties included in GA-27 due to COVID-19 hospital surges that may occur in other parts of the state.

However, none of the proclamations nor GA-27 impact the ability of dentists to continue practicing in their dental offices. Dentists are reminded to adhere strictly to the dental board’s COVID-19 emergency rule including the of personal protective equipment and infection control protocols.

TDA Helps Keep City of Brownsville Dental Practices Open
On July 2, 2020, City of Brownsville Mayor Juan “Trey” Mendez III released a clarification of his eighth amended COVID-19 disaster declaration, ensuring that dental practices in Brownsville are able to continue treating patients as long as they abide by already established rules and guidelines published by the Texas State Board of Dental Examiners and Centers for Disease Control and Prevention.

In response to serious concerns about ongoing COVID-19 transmission and increasing COVID-19 hospitalization rates in the city of Brownsville, Mayor Mendez previously released an amended disaster declaration prohibiting all “elective medical, surgical, and dental procedures in the City.”

TDA was able to successfully work with concerned Valley dentists, the Texas Academy of Pediatric Dentistry, the Texas State Board of Dental Examiners, Governor Abbott’s office, and Mayor Mendez on the clarification to keep dental practices in the city fully open for all residents’ dental needs.

Governor Abbott Establishes Statewide Face Covering Requirement, Issues Proclamation To Limit Gatherings
On July 2, 2020, Governor Abbott issued an GA-29 requiring all Texans to wear a face covering over the nose and mouth in public in counties with 20 or more positive COVID-19 cases. This takes effect statewide on 12:01 PM on July 3, 2020. Face coverings must be worn inside commercial spaces open to the public, or when outdoors and it is not feasible to maintain 6ft of social distance from persons not in the same household. Refer to the order for a list of face mask exceptions based on age, certain medical conditions or disabilities, and certain activities. Violations are punishable by fines.

Governor Abbott also issued a proclamation authorizing localities to limit the size of outdoor gatherings. With certain exceptions, it is mandatory that people cannot gather in groups larger than 10 and must maintain 6 feet of social distancing for others. The governor cautioned that large gatherings are a “clear contributor to the rise in COVID-19 cases.” 

Governor Abbott continued that, “If Texans commit to wearing face coverings in public spaces and follow the best health and safety practices, we can both slow the spread of COVID-19 and keep Texas open for business. I urge all Texans to wear a face covering in public, not just for their own health, but for the health of their families, friends, and for all our fellow Texans.”

CDC: Updates Guidance for Dental Settings Interim Infection Prevention and Control Guidance for Dental Settings During the COVID-19 Response
On June 17, 2020, the Centers for Disease Control and Prevention updated its guidance for dental care during COVID-19. The updates include removing the recommendation to wait 15 minutes after completing a patient’s clinical care to clean and disinfect room surfaces and patients have 2 days to inform a dental practice if they develop COVID-19 symptoms or are diagnosed with COVID-19 following a dental appointment. To read the updated guidelines in their entirety click HERE.

**Please remember that CDC guidelines are simply recommendations. Dentists must adhere to the Texas State Board of Dental Examiners’ COVID-19 emergency rule which requires dentists to instruct patients to contact the dentist’s office if they experience COVID-19 symptoms or a COVID-19 diagnosis within 14 days after the dental appointment.

Governor Greg Abbott: COVID-19 Mandate Regulating Dentists (Executive Order GA—19)
After TDA’s round-the-clock advocacy, fueled by your input, Governor Abbott issued executive order (GA-19) allowing dentists to return to full practice on May 1, 2020. The order requires dentists to comply with any emergency rule promulgated by the TSBDE during the COVID-19 disaster. Again, it was TDA’s advocacy that secured Governor Abbott’s approval of the dental board’s emergency rule allowing dentists to safely reopen their dental practices on May 1, 2020, at 12:01 AM.

It is important for dentists to know and share with their dental teams that neither Governor Abbott’s GA-19 order nor the TSBDE’s emergency rule require dentists to fully reopen. Dentists must use their independent professional judgement to determine if they can comply with the TSBDE’s COVID-19 emergency rule. Dentists should balance the need to provide dental care wile minimizing risk to patients and dental healthcare personnel. 

Governor Abbott’s executive orders are statewide mandates. His executive orders have the force and effect of law. A violations of the Governor’s executive order is punishable by fines and/or jail time— fines are not to exceed $1000 and jail confinement not to exceed 180 days. Violations of the Governor’s order may be reported to Texas Attorney General Ken Paxton and/or the Texas State Board of Dental Examiners (TSBDE).