Next Steps

We recognize you have many questions regarding your practice right now and how to best contend with the impacts of COVID-19.

Please review your state-specific recommendations, public health department recommendations, and dental association websites for the most current updates on the suspension of non-essential treatment. This request comes as an effort to preserve limited supplies of PPE for emergency dental treatment and frontline healthcare personnel dealing with COVID-19. We’ve put together a resource to help you make informed decisions.

Recommendations and regulations regarding the safe practice of dentistry during the COVID-19 outbreak vary by state and are actively changing as well.

Please continue to check the ADA’s site, the CDC site, and your local health authority’s site for updates as well.



American Rescue Plan Act (ARPA)

Congress Passes $1.9 Trillion COVID-19 Bill

The relief package signed March 11th includes:

  • $15 billion for targeted Economic Injury Disaster Loans and designates an additional $7.25 billion for forgivable loans in the Paycheck Protection Program.
  • $10 billion for manufacturing and procuring medical supplies and equipment, including PPE, diagnostic products, and medical devices.
  • Provides paid-leave benefits and tax credits for employers with fewer than 500 employees who voluntarily participate, reimbursing them for the cost of the sick time.
  • Provides $5 million for enhanced Occupational Safety and Health Administration enforcement activities at high-risk workplaces, including health care facilities.
  • Makes all COVID-19 student loan relief tax-free.
  • Covers 100% of the costs of continuing health insurance through September for workers who have been laid off.
  • $1400 stimulus checks for qualified individuals based on income.

Last Updated 3/19/21


COBRA Provision Impacting Employers

  • An employer is to pay 100% of the COBRA premiums for medical coverage during April 2021 through September 2021 for an employee (spouse and dependents) who elect COBRA during this time if the employee lost health coverage due to involuntary termination or a reduction in hours (during this time period or earlier).
  • The employer is to notify eligible individuals of this (DOL to have model notices by April 10th) and the employer is able to claim a payroll tax credit for the COBRA premiums.

A few examples of situations where this will have an impact:

  • Separations
  • Reductions in force
  • Asset acquisitions (where employees are terminated and hired by buyers)

Last Updated 3/19/21


Consolidated Appropriations Act of 2021

Last Updated 1/11/21

The $900 billion economic relief package offers additional support for dental practices. The SBA and Treasury Department announced last Friday that the new PPP would re-open this week (January 11-15, 2021). Community financial institutions will be exclusively allowed to make first-draw PPP loans starting on January 11th and second-draw PPP loans on January 13th. The PPP will open to all participating lenders shortly after and remain open through March 31st. The SBA guidance includes a commitment from the SBA to make at least the first two days of the PPP application window open exclusively to applications from community financial institutions that serve minority- and women-owned businesses. Apply for the PPP2 through the SBA. The ADA has created a helpful fact sheet to support dentists as they apply for this funding. This document should answer most questions regarding the PPP2 grant and the EIDL loan. 

Highlights include:

  • An additional $284 billion was released to the SBA for more PPP forgivable loans.
  • Eligible businesses with less than 300 employees, who posted a 25% loss in any quarter of 2020 compared to the same quarter in 2019, will qualify. Additional funds are set aside for businesses with 10 or fewer employees.
  • Additional expenses eligible include PPE and modification expenses related to COVID-19.
  • Practices must spend at least 60% of PPP2 funds on payroll costs over the covered period.
  • One caveat for practices who participated in the first round of PPP grants – they need to have used the full amount of their first PPP loan on or before the expected date for the second PPP loan to be disbursed. The Interim Final Rule also clarifies that the borrower must have spent the full amount of the first PPP loan on eligible expenses.
  • The “PPP2” loan is calculated at 2.5 times average payroll costs in the year before the loan or for 2019, capped at $2M.
  • An additional $20 billion in EIDL (Economic Injury Disaster Loan) grants will be allotted. The EIDL grant will no longer reduce the amount of PPP2 funds eligible for forgiveness. Apply for the EIDL grant.
  • An additional $3 billion in Provider Relief Funds will be allotted. Directing HHS to distribute funds to healthcare providers who were under-represented in previous allocations.
  • Additional details from the Treasury Department offer guidance.
  • As always, dentists should consult their tax professional for guidance on their specific situation.


Last Updated 12/28/20

On Sunday, December 27, 2020, the $2.3 trillion spending bill was signed into law. Containing $900 billion in stimulus relief for the COVID-19 pandemic, the package is aimed at helping people and businesses nationwide. The ADA released an announcement highlighting the provisions they believe will most impact dentists “White House signs $900 billion coronavirus relief package.”

The Dental Trade Alliance also outlined how the dental industry can benefit – “COVID-19 Relief and Omnibus Appropriations Legislation.”



Below are some top highlights from the ADA we believe will be most useful to dentists, dental students, and dental team members in light of the Phase 3 legislation passed March 27, 2020. Read the Act in its entirety on the Congress website.

(Please make sure to contact your accountant or other tax or legal professional when looking at these important business decisions.) The IRS has established a special section of their website focused on steps to help taxpayers, businesses, and others affected by the coronavirus.


CARES Act – Provider Relief Fund

Last Updated 10/8/20

On October 1, 2020, the U.S Department of Health and Human Services (HHS) announced Phase 3 of the Provider Relief Fund. They are allocating an additional $20 billion in new funding for health care providers, including dentists. In Phase 3, eligible dentists can apply for funding through November 6, 2020. According to HHS, eligible dentists include those who missed the original September 13th application deadline and dentists who began practicing January 1, 2020-March 31, 2020 (who were not previously eligible).

All dentists who previously applied, accepted, or rejected payments from the Provider Relief Fund will now be eligible to provide additional information to HHS. HHS will review this information to determine if they received a Provider Relief Fund payment equal to 2% of patient care revenue from prior distributions. If not, they will be eligible for additional funding to reach this level. If you previously submitted an application and feel you’ve received an incorrect payment or made a mistake on your previous application – act now.

Most importantly, even if your practice has already applied for and received Provider Relief Fund payments of 2% of your 2019 collections, you can now apply for additional funding, known as an “equitable add-on payment.” HHS will calculate this equitable add-on payment based on your decline in operating revenues and/or increase in operating expenses attributable to the COVID-19 pandemic.

Since funding is on a first-come, first-serve basis, you should apply now through the Provider Relief Fund Portal. For questions, contact the DHHS Provider Support Line at 1.866.569.3522 from 7:00AM-10:00PM (Central Time), Monday-Friday. 


Last Updated 9/28/20

Health & Human Services has released guidance outlining reporting requirements for those receiving funding from the Provider Relief Fund. According to HHS, recipients who received one or more payments over $10,000 will be required to comply with the requirements when the reporting system opens in early 2021. The ADA has recapped some of the highlights from the new HHS guidance.


Last Updated 8/26/20

The Department of Health and Human Services has $175 billion in relief funds for health care providers to cover healthcare-related expenses or lost revenue due to COVID-19. These funds are now available to all dentists (originally they were intended only for dentists participating in CHIPs and Medicaid). The deadline has been extended, you had until September 13, 2020 to apply.

Eligible dentists can receive reimbursement amounts equal to 2% of their reported annual patient revenue. For example, if your practice collected $2,000,000, you would be eligible for payments of $40,000 through the Provider Relief Fund. These payments aren’t loans, they do not have to be repaid.

Have more questions? The ADA has put together a list of FAQs just for you.


Economic Injury Disaster Loan (EIDL)

Last Updated 6/18/20

As of June 15th, EIDL funding is open to all qualified small businesses and non-profits, including dental practices. (In early May, the SBA restricted these loans and emergency grants to agricultural businesses only, as those businesses were not eligible to apply for the first round of EIDL funding.)

Dentists can apply for an EIDL, request the EIDL advance, and find additional guidance for small businesses on the SBA website.

Last Updated 5/6/20

The Economic Injury Disaster Loan (EIDL) established an emergency grant allowing a dental practice to receive a grant of no more than $10,000. The grants were awarded on a first-come, first-served basis until the $10 billion fund was exhausted. Additional funds were allocated April 27th specifically to agricultural businesses.


SBA Express Bridge Loan

Last Updated 3/31/20

This pilot program allows SBA Express Lenders authority to deliver expedited SBA-guaranteed financing on an emergency basis for disaster-related purposes to eligible small businesses, while the small businesses apply for and await long-term financing. The maximum loan amount is $25,000 with a maximum term of 7 years.


Small Business Interruption Loans

Last Updated 3/30/20

The Small Business Administration will pay the principal, interest and any associated fees that are currently owed on 7(a) loans, 504 loans, and microloans. This would be for a six-month period starting on the next payment due date. Loans already on deferment would include an additional six months of payment by the Small Business Administration beginning with the next payment. Read more from the ADA.

Loan Forgiveness for Certain Small Business Loans

Employers may be eligible for a portion of their federal small business loans to be forgiven (tax-free) for amounts spent for certain payroll, sick leave, family leave, and other overhead expenses between February 15th and June 6th, as well as certain other debt obligations incurred prior to February 15, 2020.

Retirement Account Withdrawals

The bill allows for a withdrawal of money from retirement funds (i.e., 401K, etc.) of up to $100,000 in 2020 without paying a tax penalty if the dentist, their spouse, or dependent are diagnosed with SARS-CoV-2 or COVID-19, or experience adverse financial consequences as a result of being quarantined, furloughed, laid off, or having work hours reduced due to the viruses.

Student Loan Interest Deferral

Federal student loan borrowers would not be required to make a payment through September 30, 2020. During this time, no interest would accumulate on those federal loans (payment suspension applies only to loans held by the Department of Education, not private loans). Loan borrowers should call their lender to verify eligibility.

Defer Social Security Tax

Employers and self-employed individuals can defer payment of the employer share of the Social Security tax until December 31, 2020. The deferred amounts would be paid over the following two years, with half of the amount required to be paid by December 31, 2021 and the other half by December 31, 2022.


ADA Lobbies Congress on the CARES Act

Last Updated 3/20/20

On March 20th, the ADA sent out an alert to dentists, assuring them that they continue to lobby on their behalf in response to the Coronavirus Aid, Relief and Economic Security Act (CARES). Read more from the ADA…


Paycheck Protection Program (PPP)

Last Updated 3/26/21

Biden Signs Law Extending PPP for Small Businesses Until May 31st

On March 30th, President Biden “signed legislation extending a loan program designed to help small businesses adversely impacted by the coronavirus pandemic.” The bill “extends the deadline for businesses to apply for assistance through the Paycheck Protection Program (PPP) by two months, from March 31st to May 31st.” In addition, the Small Business Administration now has “until June 30 to process loan applications.” Learn more on The Hill.


Last Updated 3/26/21

The Paycheck Protection Program (PPP) application period deadline was to close on March 31st. Congress recently approved a 60-day extension to May 31st, with President Biden expected to sign the change into law. In addition to extending the application deadline, the bill will provide the Small Business Administration (SBA) with an additional 30 days to process pending applications. The SBA recently updated application forms for borrowers and lenders. The Small Business Association also published an interim final rule in The Federal Register on March 22nd, incorporating the American Rescue Plan Act’s changes to the PPP, which apply to loans that are approved and loan forgiveness applications that are submitted on or after March 11th.


Paycheck Protection Program (PPP)

Last Updated 7/8/20

Small businesses affected by the COVID-19 pandemic now have until Aug. 8 to apply for the Paycheck Protection Program. Read the latest update from the California Dental Association.


Paycheck Protection Program Flexibility Act (PPPFA)

Last Updated 6/8/20

The Paycheck Protection Program Flexibility Act provides employers greater flexibility on how they use PPP funds while remaining eligible for loan forgiveness.

  • The PPPFA creates flexibility in the amount of loan money that must be used for payroll purposes. Employers have to spend 60%, rather than the previous 75%, of PPP funds on payroll costs.

Payroll costs include:

    • Salary, wages, commissions, and tips—up to $100,000 annualized for each employee.
    • Employee benefits, including paid leave, severance pay, insurance premiums, and retirement benefits.
    • State and local taxes assessed on pay.
    • Payroll costs for sole proprietors and independent contractors include wages, commissions, income, or net earnings from self-employment (up to $100,000 annualized).

The additional 40% can be spent on mortgage interest, rent, utilities, and other costs.

  • Borrowers will now have 24 weeks from the disbursement of their loan to use the PPP funds, or until December 31, 2020, when the program is now set to end. Borrowers can still opt, however, to use funds in the original eight-week period.
  • The Act also extends the time period for rehiring all staff, to avoid a reduction in loan forgiveness from June 30th to December 31, 2020.
  • Employers will not be penalized for any reduction in staff, if they can document either of the following as of December 31, 2020: (1) the employer was unable to rehire staff previously employed on February 15, 2020, but were later laid off or furloughed, or hire similarly qualified workers as replacements; or (2) the employer was unable to return to the same level of business activity (compared to February 15, 2020) due to compliance with governmental requirements or guidance related to social distancing, sanitation standards, or any other COVID-19 related worker or customer safety requirements.
  • While any amounts not forgiven will still have to be repaid, the new law extends the time period before repayments have to begin from 6 months to 1 year. Furthermore, the time period over which any PPP loan amount must be repaid in full is extended from 2 years to at least 5 years for new PPP loans taken out after the date the law goes into effect.
  • Under the PPPFA, borrowers will also able to defer payroll taxes, even if they receive loan forgiveness.



Senate Approves Bill to Ease Restrictions on Paycheck Protection Program

Last Updated 6/3/20

The Paycheck Protection Program Flexibility Act would provide employers greater flexibility on how they use PPP funds, while remaining eligible for loan forgiveness.

  • Employers would have to spend 60%, rather than 75%, of PPP funds on payroll costs. The additional 40% could be spent on mortgage interest, rent, utilities, and other costs.
  • Employers would also have 24 weeks, instead of 8 weeks, to spend the loan dollars.
  • The Act also extends the time period for rehiring all staff, to avoid a reduction in loan forgiveness from June 30 to December 31, 2020.
  • Employers will not be penalized for any reduction in staff, if they can document either of the following as of December 31, 2020: (1) the employer was unable to rehire staff previously employed on February 15, 2020, but were later laid off or furloughed, or hire similarly qualified workers as replacements; or (2) the employer was unable to return to the same level of business activity (compared to February 15, 2020) due to compliance with governmental requirements or guidance related to social distancing, sanitation standards, or any other COVID-19 related worker or customer safety requirements.
  • While any amounts not forgiven will still have to be repaid, the new law extends the time period before repayments have to begin from 6 months to 1 year. Furthermore, the time period over which any PPP loan amount must be repaid in full is extended from 2 years to at least 5 years for new PPP loans taken out after the date the law goes into effect.


Last Updated 5/26/20

The SBA has created an application form for PPP Loan borrowers. Download the Paycheck Protection Program Loan Forgiveness Application PDF with instructions and calculation form for borrowers.

Last Updated 5/6/20

The SBA resumed accepting applications on April 27th for the $310 billion additional allocations of funds restricted to agricultural businesses only.

Last Updated 4/16/20

These loans were only available through preferred lenders; approved lenders have an icon on their website. Small businesses and sole proprietorships affected by the coronavirus pandemic were able to apply for loans under the federal Paycheck Protection Program (PPP) beginning April 3rd. We continue to recommend you consult with a financial advisor to determine what loans are a good fit for your practice’s needs.

The Treasury urged those in need of funding to apply quickly; the program had a cap and demand was high.

Loan Forgiveness 

Last Updated 5/6/20

As of May 1st, PPP recipients, and the CPAs who advise them, are waiting for guidance on specific documents required and calculations to use in determining their loan forgiveness amount under the PPP.  The Treasury department and the SBA have shared that guidance is “forthcoming.”  In the meantime, the American Institute of CPAs has developed a resource which outlines the steps to take for PPP loan forgiveness (as of 4/24/2020).

For additional information on PPP loan forgiveness, review the information on these sites:

PPP Loans FAQs

Last Updated 5/13/20

The SBA and Treasury Department recently released detailed rules dentists need to follow, so the team members who refuse to return to work in the practice are not held against you for purposes of calculating the practice’s PPP loan forgiveness (FAQ #40). Under Section 1105(d)(2) of the CARES Act, your PPP loan forgiveness amount is reduced if your number of FTE staff is otherwise reduced below pre-pandemic levels.

It’s recommended you provide a notice to each staff member, in writing (by email or regular mail), as soon as possible, in order to comply with this new rule. Your notice should include:

  • Notice of reopening date and time
  • Offer of rehire at same wage and same number of hours as prior to closure
  • Request for a response, in writing, of rehire offer with a response deadline
  • Notice that if they should not accept re-employment, they may forfeit eligibility for unemployment compensation

For documentation purposes, place a copy of this notice, and all responses received, in each employee’s personnel file, as well as your PPP loan forgiveness file.

Additional Guidance from the Treasury Department

Last Updated 4/6/20

April 6th the Treasury Department responded to several FAQs, resolving many questions and conflicting information about the Paycheck Protection Program (PPP).

Originally, the law stated payroll data from the 12-month period immediately prior to the loan application date should be used. However, payroll tax returns for the 1st quarter of 2020 have not been filed yet (due April 30th). The new Treasury Department clarification stated calculations had to be based on your financial information for the 2019 tax (calendar) year (Q&A #14), so all amounts were tied to the W-2s your practice issued, payroll tax returns your practice filed, and practice retirement plan reports received for that time period.


Understanding Available Loans – CARES Act

Last Updated 4/9/20

Recent updates and fact sheets from the ADA and Academy of Dental CPAs to help you better understand the loans and grants available.

ADA Recap of Economic Injury Disaster Loan (EIDL) and Paycheck Protection Program (PPP)

ADA Small Business Interruption Loans

Treasury Department Paycheck Protection Program Loans Summary and Answers to FAQs

Need additional information to understand your options? Small Business Administration Loans: Understanding the Options for Dentist Owners A 50-minute video from the SBA, Academy of Dental CPAs, and the ADA.


Families First Coronavirus Response Act (FFCRA)

Last Updated 1/6/21
FFCRA Extension

Paid leave under the Families First Coronavirus Response Act (FFCRA) was scheduled to expire on December 31, 2020. The FFCRA benefit will not be renewed, meaning employers do not have to provide additional FFCRA paid leave to employees in 2021. However, if an employee did not use up all of their FFCRA time, employers can voluntarily choose to provide paid leave and receive the tax credit through March 31, 2021. As a reminder, employees who meet FFCRA eligibility requirements can take a total of two weeks paid emergency sick leave and an additional 10 weeks for childcare related needs.


Last Updated 9/11/20

The Department of Labor has issued revised regulations on paid-sick-leave and paid-family-leave clarifying when leave is available and when employees need the approval to take leave. The definition of a healthcare provider has been clarified to more clearly include dental teams and dentists. SHRM covers the revisions in their article “DOL Issues Revised FFCRA Leave Rules.”


Last Updated 9/9/20

ADA Associate General Counsel Cathryn E. Albrecht discusses COVID-related leave in dental offices in this webinar.


Last Updated 9/4/20

The Department of Labor has provided additional guidance on parents staying home with school-age kids during school closures.

They have also released a letter clarifying unemployment eligibility in light of these new definitions.


Last Updated 8/12/20

Federal Court Invalidates Portions of the DOL’s FFCRA Rule

On August 3, 2020, a federal court in New York issued a decision on several of the DOL’s FFCRA rules. The DOL has posted FAQs on its website, along with a Final Rule interpreting the FFCRA, which was issued on April 10, 2020. Employers have relied on the FAQs and the Final Rule to help implement the employee leave benefits set forth in the FFCRA. The court decision invalidates or modifies four provisions of the Final Rule, along with the corresponding FAQs, which addressed:

  • The work availability requirement to take leave
  • The definition of health care provider as it relates to employees who are excluded from FFCRA benefits
  • The employer’s consent before an employee can take intermittent leave
  • The documentation requirements to support an employee’s request for leave


Last Updated 7/8/20

The DOL has developed a handy tool for employees to determine if they are eligible for the FFRCA – an employer tool is coming soon!


Last Updated 4/3/20

On April 1st, the Labor Department shared Dental Offices may be exempt from FFCRA (read more from the ADA). We will update this site as soon as the Department of Labor publishes the criteria small businesses with fewer than 50 employees will need to meet to qualify for the exemption as well as potential exemptions for certain health care personnel, which may include dental staff. Watch for updates on the DOL site.

Additionally, the DOL Released FFCRA Regulations establishing reasonable notice procedures:

The U.S. Department of Labor (DOL) issued temporary regulations for the Families First Coronavirus Response Act (FFCRA), which confirmed employees must give notice to their employers of the need to take leave and provide documentation to support paid sick leave and emergency family and medical leave. The IRS also provided guidance on needed documentation.

As of April 1st, each covered employer must have posted a notice of the Department of Labor’s poster detailing employees’ rights under the Families First Coronavirus Response Act’s requirements in a conspicuous place on its premises. OR, an employer could have satisfied the posting requirement by emailing or direct mailing the notice to employees or posting the notice on an employee information internal or external website. The poster covers paid-leave entitlements, employee eligibility, and qualifying reasons for leave related to COVID-19 and enforcement. (Download a PDF of the DOL Required Posting of Notice of FFCR Act poster.)

We will update this site as soon as the Department of Labor publishes the criteria that small businesses with fewer than 50 employees will need to meet to qualify for the exemption as well as potential exemptions for certain health care personnel, which may include dental staff. Watch for updates on the ADA site.

Additional Links

EmployeesDOL Fact sheet on FFCR Act

EmployersDOL Fact sheet on FFCR Act

FAQs from DOL on FFCR Act


New Paid Sick Leave and Expanded Family and Medical – Updated Implementation Guidelines

Last Updated 4/1/20

As a part of the Families First Coronavirus Response Act (FFCRA), the U.S. Department of Labor announced new action regarding how American workers and employers will benefit from the protections and relief offered by the Emergency Paid Sick Leave Act and Emergency Family and Medical Leave Expansion Act. Read more from the Department of Labor.

On April 1st, the Labor Department shared Dental Offices may be exempt from FFCR act (read more from the ADA). We will update this site as soon as the Department of Labor publishes the criteria small businesses with fewer than 50 employees will need to meet to qualify for the exemption as well as potential exemptions for certain health care personnel, which may include dental staff. Watch for updates on the DOL site.

Additionally, the DOL Released FFCRA Regulations establishing reasonable notice procedures:

The U.S. Department of Labor (DOL) issued temporary regulations for the Families First Coronavirus Response Act (FFCRA), which confirmed employees must give notice to their employers of the need to take leave and provide documentation to support paid sick leave and emergency family and medical leave. The IRS also provided guidance on needed documentation.

Read the full Paid Leave under the Family First Coronavirus Response Act from the Department of Labor. 


Tax Credits

Last Updated 4/1/20

The Families First Coronavirus Response Act (FFCRA), signed by President Trump on March 18, 2020, provides small and midsize employers refundable tax credits that reimburse them, dollar-for-dollar, for the cost of providing paid sick and family leave wages to their employees for leave related to COVID-19. Find more information on the IRS website.


Senate Passes and Trump Signs Families First Coronavirus Response Act on March 18th

Last Updated 3/26/20

The Families First Coronavirus Response Act aims to provide relief to workers and families during the COVID-19 outbreak. This Act includes a number of provisions directly affecting employers and the enacted version contains a number of changes from the bill first passed by the House of Representatives on March 14, 2020. Read more from the Department of Labor…


The House passed the Coronavirus Bill on March 14th

Last Updated 3/14/20

The House passed the Coronavirus Bill March 14th. Senate lawmakers are reviewing the Families First Coronavirus Response Act, which would provide free screening, paid leave, and enhanced unemployment insurance benefits for people affected by COVID-19. This current version provides for an effective date of 15 days following enactment.

  • Part of this Act includes an Emergency Family and Medical Leave component. Although FMLA leave normally applies only to employers with 50 or more employees, this public health emergency leave would be available to ALL employers with fewer than 500 employees.*
  • Employers would receive a payroll tax credit to cover 100% of paid sick leave and paid FMLA leave, up to $200 per employee per day.*

*Not included in the final bill signed on March 18th.


Economic Relief

Relief packages are currently in process through the federal government, check with your CPA and attorney for the latest offerings to take advantage of the programs available to you. In the meantime, many banks are offering 6-month deferments for loan payments without penalty or interest. (Additional information can be found under Economic Support.)

  1. U.S. Small Business Administration is offering relief to businesses impacted by COVID-19.
  2. The IRS has provided guidance regarding the Families First Coronavirus Relief Act.
  3. Tax Assistance: Employers experiencing a hardship as a result of COVID-19 may defer Federal tax payments until July 16, 2020.
  4. Many states, counties, and cities are offering additional relief. (See partial listing below.*)
  5. Federal and state tax assistance may be available; check your local sites.


*Emergency Business Assistance Programs






ADA Releases COVID-19 Vaccine: Key Facts

The ADA has released some key facts surrounding COVID-19 vaccinations in the US. Their goal is to keep dentists informed of details surrounding evidence-based information so practices can help educate their patients and cohorts. Read More.


Dental Offices Can Test for COVID-19

The American Dental Association, in consultation with the ADA’s Advisory Task Force on Dental Practice Recovery, has developed a suite of resources to help guide dentists interested in offering their patients rapid response, point-of-care COVID-19 testing within the practice.

The ADA also released information regarding the FDA list of approved test kits. Learn More.


ADA Urges CDC to Include Dentists in the COVID-19 Vaccine Plan

The ADA is asking the Centers for Disease Control and Prevention to incorporate dentists into its framework for distributing the COVID-19 vaccine. Read more from the ADA website.


AGD Requests OSHA Remove Recommendation

Last Updated 5/4/20

AGD President Dr. Connie L. WHite, DDS, FAGD submitted a request that OSHA substantially amend or remove Guidance for Dentistry Workers and Employers. She specifically addresses the recommendation for N95 be replaced with Level 3 surgical mask and face shield. Read her full letter.


Interim Infection Control Guidance

CDC Interim Infection Control Guidelines

Last Updated 4/7/20

The CDC has addressed key concepts around dental settings Guidance for Dental Settings During COVID-19.

Additional CDC Resources

Hand Hygiene in Healthcare Settings

Strategies for Optimizing the Supply of Isolation Gowns

Strategies to Optimize the Supply of PPE and Equipment


ADA Interim Guidance for Minimizing Risk of COVID-19 Transmission

Last Updated 6/1/20

The ADA has provided a Return to Work Interim Guidance Toolkit with advice from beginning to end of a patient visit for all involved from the Dentist and team to the patient before dental care starts, during dental care, and after dental care has been provided.


Webinar – COVID-19 Infection Control Protocols & Procedures Webinar – 1 CE Credit

Last Updated 3/20/20

On March 20, 2020, the ADA teamed up with leading infection control experts from OSAP to provide the dental community with practical guidance and education as we navigate the challenges associated with COVID-19.

The complete webinar is available to watch and earn 1 free CE credit.


ADA Interim Mask & Face Shield Guidance

Last Updated 4/20/20

The ADA has released interim guidance on appropriate face masks and shields or goggles. Read the corresponding press release as some states consider reopening.

“Understanding Face Masks” from the ADA

Last Updated 4/20/20

The ADA provides guidance on type, use, and fit, for surgical masks, N95 masks, and N95 equivalent mask KN/KP95, PFF2, P2, DS/DL2, Korean Special 1st.


OSHA Respiratory Protection Fit Test

Last Updated 4/22/20

In this video and transcript, OSHA covers Respirator Fit Testing. Learn what it is and why it’s necessary to protect your health and safety.


Pandemic Recovery Guide

We are here to support you, to listen to you, to stand beside you as we all learn to navigate a new normal with COVID-19. We have created and gathered a number of resources –  with an emphasis on infection control and PPE, team communication and training, patient communication, scheduling, teledentistry, office management, and FAQs – from leading industry and healthcare professionals to help along your journey. Read more…

Phase 1: Soft Re-Opening of Your Dental Practice

As you prepare to re-open your practice, we’re here to help. We’ve compiled critical recommendations for success including: how to reassure your team and your patients of their safety in your practice, PPE updates, scheduling suggestions, and enhanced protocols for patient confirmation, arrival, and check-out. Read more…


Temporary Closure

The temporary closure of your dental practice was likely a stress-inducing event for the owner, staff, and patients. In a time of crisis, it can be helpful to focus on the next step forward, which includes the steps you are taking today to ensure a smooth return when the spread of COVID-19 is controlled.

Current Workflow

Many states have mandated the ongoing care of patients for emergency treatment during your temporary closure to reduce pressure on local emergency rooms. You will need to connect with previously scheduled patients to reschedule their appointments. You will likely field more calls than normal from anxious patients. You need to collect as much as possible, which requires the filing of claims, tracking down unpaid claims, and sending narratives or requests for reviews to insurance companies. You will also need to provide limited care during this time. The steps outlined below will provide needed support for ongoing workflow as well as a smooth transition back to full operations.

  1. Keep a part-time front office team member on the payroll for as long as the budget will allow. Ideally, this person is cross-trained to assist with emergency care. If the budget will not allow, you will need to take on the responsibilities outlined.
  2. Be sensitive to unemployment laws and offer hours to allow your staff to take advantage of federal and state programs.
  3. Maintain reduced phone hours (4 hours per day) to answer phones and return messages. Direct patients to the doctor’s emergency line for after-hours calls.
  4. Work on collections and reducing your aging AR. Review denied claims, file review requests and collect monies owed. It is critical to infuse as much cash flow into the practice as possible.
  5. Reschedule patients into the future to make sure you come back to a full schedule. You may not know the exact return date as information is changing quickly, but it will be easier to move an appointment a second time than it will be to come back to an empty schedule. Push patients out to the most recent return-to-work date you have from the authority in your state.
  6. For patients who are not comfortable rescheduling at this time, track them on a short call list. That will be your immediate go-to scheduling list when you return.
  7. Identify patients who need treatment right away to prevent an emergency. The ADA has provided guidance on the definition of emergency care. Find additional guidance under Emergency Care Protocols.
Patient Communication

Most everyone in our country has read about the COVID-19 pandemic and are adjusting to changes in their daily lives. However, many do not consider dentistry to be elective, and learning their trusted practice and provider is temporarily closed will cause anxiety and stress. That is especially true for patients who have an existing treatment plan. A needed filling may feel like an emergency to them. Calm their fears with good verbal skills when rescheduling patients and communicate frequently with patients through social media during your closure. Find more guidance in the Communication & Reassurance section.

  1. Do not send a letter to the entire patient base to announce the temporary closure, as this may create unnecessary fear for patients who will not experience an impact during this time.
  2. Call each patient on the schedule to reschedule their appointment; reassure them they will have priority scheduling and select a date. Remind them of your availability if they have an emergency and to not hesitate to call.
  3. Communicate daily via social media channels or your website. Post something fun, perhaps of staff weeding their yard or doing a puzzle – anything that reflects life as normal with a daily reminder you are still there, can see emergencies, and hope everyone is staying safe and healthy.


Maintaining strong relationships with your patients, even when you’re not seeing them actively for appointments, is helpful to support their overall patient experience. It enhances patient connections to your practice, demonstrates your care for them, and can even boost their – and your – mental health. A connection call can help you do just that.

Here’s a PDF with recommendations on who to target, what to say, and additional resources to help you get started.


Staff Communication
  1. Communicate frequently, even if you do not have all the answers! Your staff is looking to you for leadership and direction. The communication you provide now will have a lingering impact on how supported they feel during this time.
  2. Set up a group text so everyone can continue to connect. Share budgeting tips, pictures, news, and create a forum to ask questions of each other. A few budgeting tips you can share:
    • Spouses/partners of displaced staff can temporarily stop all 401K contributions to increase cash flow
    • Some banks are allowing a deferment of mortgage payments; it does not hurt to call and ask. This may be true for utility companies as well.
    • Check with state and federal programs for unemployment or other packages that may be available to them.
  3. Send detailed updates via email to the staff. Send a text in the group text to ask everyone to check his or her email when an update is available. Text messages tend to be checked more frequently than email, but messages can be lost and it’s difficult to send detailed information in that format.

Find additional guidance in the Communication & Reassurance section.


Equipment & Technology Considerations

In the event you plan to temporarily close your office, or if you have already closed your office, here are some things to consider if you’re going to be closed for an extended period – these will help make returning to business easier.

  1. Has your Mechanical Room equipment been shut down properly?
  2. Have you flushed each of your delivery systems?

During this challenging time, we remain committed to being a resource for you and your practice. We can schedule a Service Technician to help you through the process. Call your local branch or customer service to set up an appointment. We’ll cover the trip charge.

*Note: The above recommendations are intended to support and protect your practices’ equipment during temporary closure, but do not guarantee the elimination of equipment failures.


Marketing Your Practice

Maintaining strong relationships with your patients, even when you’re not seeing them actively for appointments, is helpful to support their overall patient experience. It enhances patient connections to your practice, demonstrates your care for them, and can even boost their – and your – mental health. A connection call can help you do just that.

Here’s a PDF with recommendations on who to target, what to say, and additional resources to help you get started.


Returning to Work
  1. Consider adding additional days or hours to your schedule when you return. You should have a higher demand on your return with many overdue patients. Additional availability will help meet patient demand, allow opportunities for staff to make up for lost wages, and increase collections more rapidly. Touch-base with your staff as your return date gets closer to check availability.
  2. Know your equipment and follow guidelines to restart and recalibrate. Plan to run test strips in sterilization equipment on your return. Run waterlines using appropriate disinfectants.
  3. Take steps to ensure a sterile environment on your return for the safety and peace of mind for patients, staff, and yourself. Find interim guidance from the CDC and ADA under Emergency Care Protocols.
  4. This crisis likely increased sterilization efforts and techniques; determine which of those will continue indefinitely as part of your new protocol. For example, if you started wiping down door handles, front desk counters, and reception areas as a new protocol, communicate which of those you expect to become part of the new norm moving forward.
  5. The EPA recently released a list of approved disinfectants that are effective against COVID-19.



A crisis creates an opportunity to re-evaluate your goals, your practice systems, and allows time to reflect on changes you would like to make in the future. This is an ideal time to determine growth opportunities for the practice that can be put into place on your return. It will also provide hope and synergy for your team.

Burkhart offers several no-cost analyses to provide insight into areas where you are succeeding as well as identifying growth opportunities.

  • Practice Analysis. With two easy-to-print reports, we can provide an analysis that reviews 8 key areas of the practice and compares your data to healthy benchmarks. We set up a time for you to speak with one of our consultants to help you strategize for improvements.
  • PPO Analysis. Let us help you by calculating the average adjustment per plan and provide recommendations for re-negotiating contracts or limiting exposure to high write-off contracts.
  • Coding Analysis. We can help you maximize your insurance reimbursement through proper coding strategies.
  • Associate Readiness Assessment. We would be happy to evaluate your practice to see if it’s a good time to add an Associate.
  • Overhead Analysis. We can compare your overhead numbers to healthy benchmarks in the dental industry and strategize with you to reduce your overhead.

Please let us know how Burkhart can come along beside you during this time to ensure you come back to a stronger, healthier practice in the future.


Communication & Reassurance

You’ve made the tough decision to temporarily close the practice, some of your team members may have been furloughed or placed on standby and one or two others may be working a reduced schedule to check mail, post payments, and assist with emergency patients. Even if you’re still trying to understand the situation you’re in, it is a critical time to stay engaged with your team members and your patients.

When dealing with uncertainty, it’s probably not possible to over-communicate. Remember your goal of helping your team and your patients feel safe in order to help your practice rebound back when the pandemic subsides. Now is your time to shine as a leader; your staff and patients are counting on you.

Your Dental Team

In fast-moving and uncertain situations, leaders face questions they may not have the answers to. In these situations, communication is key. Your team wants to know they’ll have a practice to come back to and life will return to normal. They are looking for emotional safety and they are counting on you as their leader to support them. So, what do you do?


  • The unknown is scary. What is your plan to get through this tough time? Share as much as you know.

Continue to share with your team

  • Set up a group text for the team to communicate in fun ways and stay connected.
  • Set up a group email for the team. If you are sharing important information, that would be cumbersome to include in a text, send it in an email. Text the group to expect an email as many people check their texts more frequently than their email. Select a format that is dated and easy to follow as you will likely send frequent email updates. Plan to update the team at least every other day so they feel they are in the loop regarding rapidly changing recommendations that may impact the practice.
  • Empathy is key right now; make a goal to reduce the stress of uncertainty.
  • Be the leader of the practice and the main source of information; don’t delegate this.
  • Text the group every day – A quick update on the practice and something that helps the team members connect. What did they binge-watch last night? What local take-out place is still open? Have they read a great book? Encourage the team to post pictures of what they are up to.
  • Explain what you know, what you don’t know yet, and your sources of information.
  • Connect via FaceTime with each team member so you can “see” each other.
  • Are you using the time to get better at something? Share this with your team.
  • Your team will be impacted by the tightening economy, ask for tips on what everyone is doing to budget right now. Share helpful budgeting resources or tips you’re using to save money.
  • Don’t forget birthdays and practice anniversaries – you can still celebrate them remotely.
  • Your team members are ambassadors for your practice in the larger community; put their minds at ease.
  • Try to provide timely information rather than waiting until you have all the answers.
  • Connect for virtual meetings, if appropriate, as a team even if it is for a few minutes each week. Zoom and Skype are two free options.

All of these efforts will help reassure your team and make it easier to pull the team back together when the practice opens again.


Your Patients

Focus on what’s important to your patients. Your patients want to know they’ll have a practice to come back to as well. They are also looking for emotional safety and they are counting on you as a medical professional to reassure them.

Share regular updates with your patients

  • Pick a social media channel that is strong for your practice and post something on the practice feed daily.
  • Be the voice of your practice, don’t delegate this.
  • A short, sweet message is fine.
  • Authentically, try to reduce the stress of uncertainty and demonstrate empathy.
  • Remind patients best ways to connect with the practice if they have an emergency.
  • Share photos or videos of the Doctor(s) or team along with your post (everyone is tired of seeing the Coronavirus germ now).
  • Keep valuable patient relationships growing. Ask patients what they are doing – hiking, kayaking, walking their dog, hanging with their kids, reading a great book?
  • Say thank you to local businesses and caregivers in your community.
  • Post about the dentistry you want to be doing more of.
  • Post pictures of offices you refer to and champion their practice as well.
  • Got a new song you’re washing your hands to? Post a video.
  • Your patients will be impacted by the tightening economy; share budgeting resources or tips on saving money.
  • Many of your patients are working from home; share tips on productivity and balance.
  • Share ways in which you’re helping local, national, or global communities in crisis.



Emergency Care Protocols

The CDC and the ADA released interim guidance for managing dental care.

For help defining what constitutes a dental emergency, seek advice from your local dental association and the ADA. (Download an explanatory PDF from the ADA.) To help your patients better understand what a dental emergency is, share this ADA resource on your social media pages.

Teledentistry Screening

Last Updated 4/20/20

Teledentistry is a safe option to screen patients for emergency care while reducing the spread of COVID-19. Offering teledentistry also supports the federal objective of limiting the use of emergency rooms for dental-related issues.

Teledentistry services, when coded properly, are billable events. Download the list of proper codes and frequently asked questions from the ADA.

Watch the webinar from the ADA – Teledentistry & Virtual Evaluations During COVID-19 – 1 CE Credit.

Many managed care groups are making changes to their protocols during the pandemic. Evaluations should be conducted using video or photographs. (No special equipment is needed during the pandemic). Most are also requesting this procedure be submitted as procedure code 0140. Frequency limitations will be reviewed on a case-by-case basis. Check in with each of your contracted providers to see how they are handling these claims. The ADA provides guidelines referring to individual plans.

If your practice is in-network, refer to your plan documents to determine if D9995 and D9996 are considered inclusive. If they are not inclusive and no coverage exists, or if you are out-of-network, you can bill the patient.

Please note, no special technology is needed to deliver teledentistry services during the pandemic. Since healthcare systems are facing uncharted territory in managing the COVID-19 outbreak, concessions have been made to assist healthcare providers in delivering this service. The Department of Health and Human Services announced that “Providers will be allowed to use everyday technologies to talk to telehealth patients.” The HHS Office of Civil Rights has also stated it will waive any potential HIPAA penalties for use of telehealth during the COVID-19 emergency. If a practice needs help with setting fees for this service, they can reach out to Practice Support Team for guidance.


In-Person Patient Screening – ADA Recommendations

The ADA recommends that patients be screened for active disease prior to providing dental care in the office. Take note of:

  • Patients who exhibit or report signs of respiratory illness such as coughing, fever, and shortness of breath. Include temperature readings.
  • Recent travel to locations designated by the CDC to have a Level 3 Travel Health Notice for COVID-19. Verify when the patient returned to the United States.
  • Close contact with an individual, such as a family member or co-worker, diagnosed with COVID-19 within the last two weeks.
  • Encourage patients who respond “yes” to these questions to contact their primary physician or public health department as soon as possible to determine if they should be seen or tested.


Once Appointed – ADA Recommendations

Once appointed, the ADA recommends:

  • In small waiting rooms, offering less than six feet of distance between patients, request patients wait in their cars and receive a phone call or text message when it is their turn for treatment.
  • Patient and dental healthcare workers should perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water, alcohol-based hand rub, or antiseptic handwash) after possible contact with respiratory secretions and contaminated objects/materials.
  • Include temperature readings as part of your routine assessment of the patient prior to performing dental procedures.
  • Avoid or minimize operations that can produce droplets or aerosols.
  • Use rubber dams whenever possible.
  • Rinse the oral cavity slowly, avoiding unnecessary splatter.
  • Use high-speed evacuation for all dental procedures producing an aerosol.
  • Autoclave handpieces after each patient.
  • Have the patient use an antimicrobial rinse before appointment; ADA suggests using 1% hydrogen peroxide.
  • Avoid or minimize procedures that may induce coughing, such as taking routine intraoral X-rays.


What You Can Do Now to be Proactive

Team Communication
  • Be the voice of your practice and lead your team. Consistency in communication is key in uncertain times. Having one voice lead that effort and responding to questions is critical.
  • Employees should be made aware some of the preventive measures recommended by the CDC might result in a loss of income if an employee has exhausted paid sick time or other paid time off.
  • Ensure you have updated contact information for all of your employees to include home addresses, phone numbers, and updated emergency contact information.
  • Establish a staff phone tree or group text to keep each other up-to-date on possible exposure or office closure.
  • Advise each team member of their accrued PTO and PSL.
  • Consider who your “skeleton team” could be so you can continue to meet emergency patient needs while being prudent with your staff overhead.
  • Bear in mind school closures and illness may affect some of your team members’ availability.
  • Staff experiencing illness (fever with or without cough) should not report to work.
  • If the practice closes or operates at a reduced staff level, set up a regular cycle of communication to check in with your team members and keep them informed of developments/changes over the weeks you are closed/operating with reduced staffing.

Find additional guidance in the Communication & Reassurance section.


Patient Communication
  • Develop a communication plan for how to reach patients in the event the office is closed. Use phone calls, texts, emails, and the practice’s social media pages to get the message out. Offices also need to keep track of area school closings and health department updates.
  • Use the resources available under Practice Resources at the top of the page as a template for your communication with patients.
  • If you are still able to see patients other than emergencies, continue your practice marketing efforts and focus attention on recare calls.
  • Many students are home currently for several weeks. Now may be an ideal time to reach out to these patients and schedule appointments.
  • Consider using text messaging to promote social distancing; encourage patients to wait in their cars until their operatory is ready, text them to come right back to the clinic area. Additional recommendations for safety can be found under Emergency Care Protocols.

Find additional guidance in the Communication & Reassurance section.


Remote Work Abilities

Set expectations for your team members working from home regarding what work they will do, the quality expected, and set deadlines for completion of tasks. Working remotely can be a huge change for people and clear expectations are necessary and helpful!

  • Out of sight, should not be out of mind. Set up a cycle of communication with any team members working remotely on behalf of the practice.
  • Can your Practice Management System be accessed off-site? Do you and your Office Manager have the ability to access from off-site should your office manager work remotely? If this has not been set up previously, consider doing so now.
  • Is your payroll system accessible off-site? If this has not been set up previously, consider doing so now.
  • Review your cybersecurity policy with your team. Ensure patient data and practice data is protected when accessed off-site by a strong firewall, appropriate encryption and strong, secure passwords.


Staffing Plans

In the event of a potential staff shortage, employers should prepare alternative staffing plans.

  • Proactively reach out to local dental staffing services.
  • Plan for if you should fall ill; reach out to your coverage network to ensure ER patients can be seen.
  • Compute your staff overhead to better understand the minimum you need to produce to maintain your current staffing levels. (Staff overhead includes wages, payroll taxes, health insurance and additional benefits, other than retirement benefits. A healthy staff overhead is in the range of 20-30% of collections).


Review Your Sick Leave Policy
  • Ensure policies follow state-mandated paid sick leave policies and employees are aware of these policies.
  • The CDC has encouraged employers to maintain flexible policies allowing employees to stay home to care for sick family members and be aware more employees than usual may need to stay home.
  • The CDC advises employers not to require a healthcare provider’s note to validate an employee’s illness since healthcare facilities may be extremely busy and unable to provide documentation in a timely way.


Resources for Downtime

Uncertainty remains a stressor as dental employers and their teams deal with the impact from COVID-19.  There are things you can do, even while at home, to keep the focus on a successful return to operations.


Free/Reduced Cost Online CE Options

ADA CE Courses

Dental Care CE Courses – Crest & Oral-B

Colgate Oral Health Network CE Courses

Proctor & Gamble CE Courses – Dental Network of America

Hu-Friedy CE Courses

Glidewell Dental CE Courses

ADHA CE Courses


Burkhart Support

Practice owners and managers will benefit from taking advantage of Burkhart’s no-cost analyses to review a variety of business aspects. Burkhart’s Practice Support Team is standing by to provide analytical data and phone support to help during this critical time. Prepare now for stronger systems to get you up and moving quicker on your return.

  • Practice Analysis
    Gain an overview as we compare 8 critical areas of your practice to healthy benchmarks. With just two reports from your practice, we can analyze your data, provide kudos, and strategize via phone with you for identified growth opportunities.
  • PPO Analysis
    Receive a detailed analysis of the plans you are in contract with and recommendations to reduce your exposure, or re-negotiate your fee schedules.
  • Coding Analysis
    Get back to work knowing you are utilizing coding strategies to maximize your reimbursement.
  • Overhead Analysis
    Know how you compare, in each overhead category, to healthy benchmarks. We can help you right the ship.
  • Facilitated Team Meetings
    Schedule a time to have one of our consultants join your staff meeting to review analyzed reports or best practices to improve the patient experience, staff communication, and business systems.
  • Other questions?
    We are here for you; give us a call 1.800.665.5323, or shoot us an email


Economic Support

Financial Next Steps
The coronavirus pandemic quickly altered your dental practice business. Many of you have already had to make tough financial decisions. In a time of crisis, it can be helpful to focus on the next step forward, which includes the steps you are taking today to ensure a smooth return when the spread of COVID-19 is controlled. Your goal is to emerge from this crisis as “whole” as possible. While there are no easy answers right now, assessing where you are currently and tackling what you can now, will be helpful financially and mentally moving forward.


Determine Your Baseline Before the Crisis

Once you determine your baseline, make the applicable adjustments for any expenses you can temporarily reduce. The net result after adjusting your monthly collections and expenses is your net cash flow per month.

Practice Costs Breakdown during COVID-19


Forecast Your Revenue for Next Two Months as Best You Can

A practice with managed care contracts will continue to receive income as claims and accounts receivables are paid. This also applies to Fee-for-Service practices that have not yet collected older AR and claims they have submitted on behalf of their patients. There could be potential revenue generated from ER dental care as well as any tele-dentistry fees collected. Download this resource to help forecast your revenue.


Identify Opportunities to Generate Revenue

Some practices remain open for a limited number of hours to provide emergency dental services or are open as-needed to provide urgent dental care. Some practices are also offering tele-dentistry as a tool to identify and support patients who need urgent dental care.


Consider Ways to Decrease Payroll Expenses

You are not alone in having to make some tough decisions about your team. Congress is addressing this need; we should know soon what the new bill will offer businesses and employees to help weather this crisis.

Options for You to Consider:

  • Reduce Hours: Hourly, nonexempt team members are paid only for the hours they work. Exempt employees are on salary, which means they are entitled to their entire salary, even if they work a reduced schedule.
  • Furloughs: A furlough is a temporary layoff from work. Team members are not paid during furloughs, but they do keep employment benefits such as health insurance. Employees are not allowed to do any work for you while they are on furlough.
  • Layoffs/Terminations: A layoff can be either temporary or permanent; the employee is dismissed from their job. The person would need to be rehired to come back on payroll.
  • Standby: Some states are offering a standby designation during this time. The employee collects unemployment, if qualified, and has an anticipated rehire date with their employer. In most states, the employee must have been full-time.
  • Discontinue Doctor’s Payroll: Consult your accountant to see if you can take distributions in lieu of payroll.

Bear in Mind:

  • Dental practices that offer paid sick time and/or vacation time typically need to pay any accrued hours to terminated employees (check your specific state regulations).
  • Double-check your current employee manual to confirm how your PTO policy is structured.


Reduce and/or Defer Rent

If you haven’t already, call your landlord to ask if you can lower or even defer your rent for April and May. This is a situation you hopefully have never been in before. Make them aware you have very limited income coming in and once restrictions are lifted, you can resume business and your (full) payments.


Reduce, Defer, Eliminate Costs

You should immediately decrease dental and office supply orders to only what is needed in the immediate future. If you pay for a service you will not be using while you are closed, ask about pausing services. If you are making monthly payments to a marketing firm to boost posts, etc., consider stopping those payments and efforts for the next few months. Create a listing of all vendors, what your current monthly payments are, what reduced fee they have agreed to, and a column for notes. This will be helpful to reference once your practice is fully open again.


Reduce or Refinance Debt Payments

You should call your lender to ask about reducing or refinancing debt payments; making interest-only payments on your business loan; decreasing any excess principal payments; or lengthening the term of the loan. The federal government has allowed federal student loan borrowers to pause their payments for 2 months (this may change), at which time interest is being waived. Some of the larger financial institutions have paused payments on loan obligations for 3-6 months to assist in the recovery effort.

Contact your bank to apply for a line of credit, if you do not already have one. There may be an opportunity to draw against available lines of credit on the business or personal property, if needed.

Now’s a good time to contact your credit card company to see if there is a penalty for missing a payment, or if they will allow you to skip a payment without penalty.


Additional Options

Dentists who need access to cash resources during the next few weeks should also talk to their accountant/financial planner for additional options. These could include temporarily stopping automatic contributions to your retirement plans or taking a loan against your 401K.

Managing Cash Flow – Recommendations from Cain Watters & Associates

With recent announcements that effectively close dental practices temporarily for the next several weeks (or months in some states), we are all uneasy about the coming weeks. Cain Watters Associates recently shared some suggestions for Dentists regarding managing cash flow during the COVID-19 pandemic.

Additional Financial Resource Links: 

State Labor Offices

Find Your State’s COVID-19 Employer Resource Website

ADP Employment Tax Guide: State Agency Status in Response to COVID-19

SBA Disaster Relief Loan

Disaster Relief in Response to the Coronavirus

IRS Guidance on Families First Coronavirus Relief Act


Business Interruption Insurance

Be sure to check your business owner’s policy or property insurance policy. Business interruption is commonly made part of a property insurance or business owner’s policy (BOP) and if included in your policy, it pays out if the cause of loss is covered by the overarching or primary policy. Business interruption is intended to help cover a business’ lost income or revenues resulting from a disaster which causes physical damage to your insured property and loss of occupancy as a result of a civil authority mandate. It is important to note however that most property insurance policies contain a specific exclusion for disease or a virus causing agent in the policy. The ADA is advising members “to consult with their personal insurance agent representative and/or legal counsel to carefully review their insurance policies and assess what coverage, if any, may exist for potential claims arising out of the coronavirus risk environment.”


Delta Dental Member Support

DDWA is launching two programs aimed to support Member Dentists during this time – the Delta Dental of Washington (DDWA) Independent Dental Practice Reimbursement Advance Program and the DDWA Independent Dental Practice Assistance Fund.

Arizona Dental offices can receive an advance of up to $50,000 from Delta Dental of AZ as part of their new “Advance Claims” program. Dentists can apply for funds from the Advance Claim Payment Program by completing the online application by April 10.

The ADA has created a PDF detailing additional states offering support.


Premera Blue Cross Provider Support

Premera created a program to offer advance payments to eligible providers to help provide financial support during this period of revenue shortfall related to reductions in services. The program allocates up to $100M in advance payments to Washington and Alaska providers caring for members every day with the services they use most. Applications are available beginning Monday, April 13th, at 10 a.m. on the Premera provider website.


Helpful Resources


Most Recent Updates

NIH Study shows Coronavirus stable as aerosol and on surfaces Visit Article (3/17)

ADA congressional lobby for relief package Visit Article (3/17)

ADA’s Statement on postponing elective dental procedures Visit Article (3/16)



Based on recommendations and guidance from the CDC and the ADA, dental practices are being asked to limit patient treatment due to the COVID-19 pandemic. It is recommended dentists practicing in many states voluntarily suspend nonessential or non-urgent dental care, depending on the state. (See your state specific association or public health site for recommendations).

Why close your dental practice?

In short, to help “flatten the curve” and ensure the continued health of your patients, your staff and you. The COVID-19 pandemic is putting a strain on all health care facilities and resources locally and nationally due to the increasing number of affected individuals.


What do I tell my team?

We’d suggest verbiage similar to this: We need to do our part to help our community during this historic time. In order to ensure the continued health of ourselves and our patients, we are suspending nonessential or non-urgent dental care as recommended by the ADA, your local Public Health Authority, or Dental Association. The health and welfare of our patients, our staff, all of our families, and extended community, is our top priority and we want to do our part to limit the spread of COVID-19 and lessen the strain on resources needed to treat patients who are suffering with the virus. I value your assistance in making this a smooth transition. I appreciate your commitment to working together to get through this difficult and, hopefully, brief time.  We may be closed temporarily, but we are going to stay in close contact with each other throughout this pandemic and we will all emerge stronger because of this experience.


How long will the practice remain closed?

If public health officials see positive indications of slow disease spread and possible containment, the recommendations for social distancing may ease. Currently the shortage of PPE’s are placing a strain on the healthcare community. Oral health is important, as those pressures ease and the supply chain returns to normal, recommendations for dental practices may change. As time goes on and more is understood about the virus, such as how long it remains infectious in the air and on different surfaces, the CDC can make informed recommendations on how individuals can protect themselves from the virus. We will continue to monitor and follow recommendations and guidance offered from the ADA and our local public health departments.


Employment Questions

We continue to monitor pending federal legislation to address family and sick leave due to COVID-19 and will update this site accordingly.  The information below is based on federal laws, not your individual state laws.


Can I require employees to use accrued paid sick leave?

An employer cannot require an employee to use paid sick leave, that is the employee’s choice.  If an employee does not qualify for paid sick leave or has exhausted their paid sick leave, other leave may be available to them in the form of paid time off or vacation.


What resources are available for our employees if I can’t pay them while the practice is closed?

Partial wage replacement may be available to those employees through unemployment benefits. Additional benefits may be available through the Families First Coronavirus Response Act that was signed into law on March 18th. Access to unemployment benefits and federal relief aid are rapidly changing. Check frequently for these updates.


Can I lay off my employees so they can get unemployment and then rehire them?

If you’ve reduced your schedule or closed the practice temporarily, you are not required to lay off or terminate employees you intend to continue to employ. Partial unemployment claims are available in many states. The employer must often certify that the employee is expected to return to work. Several states offer a variety of options for temporary closures, standby and reduced work hours. Select options carefully as many have strict stipulations.











New Mexico







Contact your State Labor Office


Where Can I Find My State’s COVID-19 Employer Resource Website?

Make sure you know the latest coronavirus-related guidance issued by your state, including public safety mandates, agency closures, and the latest local labor legislation. Here’s a table to reference for guidance by state.


ADP Employment Tax Guide

State Agency Status in Response to COVID-19


How do I notify my appointed patients of the office closure?

Contact patients via phone, email and text and reschedule their appointments for a later date. Explain the reason for the change. Here is a sample closure announcement and message for your confirmation system. Make sure your patients know that you will be available for dental emergencies throughout the temporary closure.  It is important your patients know you will be there if they need you while reducing the potential strain on emergency rooms.