“Each Dentist Must Use His or Her Own Expertise and Judgment to Review Each Situation on a Case-by-Case Basis”

TDMR has received the following advice for Texas dentists from Dr. Carlos Cruz, former president of the Rio Grande Valley Dental Society.  He has given his permission to publish.


While all routine and elective dental care has been suspended due to COVID-19, the need for organized emergency care performed by dental providers while using appropriate personal protective equipment takes priority.

The TSBDE nor the Governor has recommended that offices be completely closed.  The TSBDE has stated that they are working in conjunction with the Texas Governor’s office to help us navigate through this difficult time. The mandate is to defer elective and non-urgent procedures until after May 8th, unless other mandates come into effect prior.

There is a lot of inconsistency and debate as to what emergency/urgent care is and what is an elective procedure. Each dentist must use his or her own expertise and judgment to review each situation on a case-by-case basis. After evaluating the relevant clinical information, considering the health history, history of present illness, etc., the dentist should apply the Principles of Ethics and Code of Professional Conduct to arrive at a decision that is in the best interest of the patient and the community as a whole.

The dentist also has the obligation to protect the welfare of the staff and ensure that appropriate PPE is used and infection control measures are strictly followed. Each dentist has a legal and ethical obligation to see a patient of record in an emergency. Dentists should not refer their patients to the local emergency room or urgent care facility. Not responding to a patient of record could be interpreted as patient abandonment.

Concentrating on emergency dental care only during this time period will allow dentists and their teams to care for emergency patients and alleviate the burden that dental emergencies would place on hospital emergency departments.  Practices are strongly recommended to provide a phone number for patients to call into to assess their situation and develop a treatment plan accordingly.

The coronavirus is currently a very fluid situation with new developments occurring daily. The current recommendations of the TSBDE, TDA, ADA and AAOMS are to postpone non-emergency procedures until mandated by our state, May 8th at 11:59 pm.

However, there is no way to know when this will end.

All practices should consider contingency plans if this lasts longer. Dentists and hygienists are a vital part of the healthcare community and have an obligation to protect the safety of patients and staff during this outbreak. Adhering to current and future national and state recommendations will reduce the spread of COVID-19 in the dental setting and help maintain the oral health of our patients.

This is a rapidly changing situation and the information continues to evolve.

Sincerely yours,

Dr. Carlos Cruz
Oral & Maxillofacial Surgeon

Former president of Rio Grande Dental Society

3 Responses

  • I hope that people will read this article and understand that this is how it is in dental offices in most states because of COVID 19. It is very important that dentists only see emergency patients right now. This will help to limit exposure for everyone. Dentists are hoping that by allowing patients to come to them for their dental emergencies, it will keep these people from going to the hospital. https://MVDMaine.com/

  • Thank you Dr Carlos Cruz!

    You are a voice of reason!

    I am not a dentist, orthodontist, or employed to promote any dental technology company. I have observed dentistry for many years and I know the lack of acceptance in this state of adopting new dental technology which is very frustrating to many dentists.

    There are dentists in this state and around the world who have adopted these new technologies and HAVE the treatment records to back up that these procedures work! These technologies would work very well in a COVID-19 reality. You should seek them out and understand their work.

    They fear retribution from this board and their peers who refuse to learn or adopt new technology. This is what this board stated they would encourage.

    Dentistry in Texas needs to move forward and take advantage of these new technologies!

  • Here! Here! Dr. Carlos Cruz. You are the voice of reason! Why can’t Dave Tillmen and the rest of the TxDental Board of Examiners listen and consult with you before agreeing the ridiculous/laughable language that was in the current Executive Order.

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