'It’s completely illogical': Quebec dentists decry lack of access to PCR tests

But the province's Health Ministry says it has no intention of changing the directive.

The Montreal Gazette 4 minute read May 4, 2022

Some dentists in Quebec are only now discovering they’re not eligible for PCR testing for COVID-19 — resulting in shock, confusion and occasionally hundreds of dollars worth of private testing.

The province limited PCR testing to priority groups in January during the Omicron wave, when the virus began spreading at an alarming rate and public health couldn’t keep up with demand. Dentists practising in private clinics aren’t among prioritized groups, but given the nature of their work, some assumed they were — only to realize that’s not the case upon showing up to testing sites.

“It’s completely illogical,” said Dr. Josée Landry, whose dental clinic is in St-Jean-sur-Richelieu. She became aware of the rule when her daughter, who works at the clinic, was recently denied a test. “We’re playing in people’s mouths.”

The same happened to Dr. Natalie Socqué in Châteauguay. After developing symptoms and testing negative twice using rapid tests, she decided to go to a nearby testing centre — with ample availability listed online — to be more sure of the result. She was shocked when she was turned away at the door.

“We’re in aerosols,” Socqué said. “We work in that all day.”

Not all dentists have had the same experience, according to Socqué. Some centres have been accepting them under the health-care worker umbrella, but others have stood firm on the guideline. Socqué said she understands restricting testing to doctors, nurses and CHSLD staff when centres are overrun, but not the logic behind turning away dentists when they’re not.

“After that, it should be our turn — we see tons of people in the population and we also see elderly people,” she said. “Can we protect those people? Can we protect our personnel? It makes no sense.”

Quebec’s Health Ministry said the guidelines aren’t flexible depending on traffic and that if dentists have been given PCR tests, it’s because of local decisions likely based on a wider interpretation of the “health-care worker” category.

“This does not change the guidelines in place and it is not our intention to modify them,” said spokesperson Marie-Claude Lacasse. “Public health consultants determine screening priorities.”

The objective behind restricting PCR tests to workers in certain sectors, Lacasse said, is “for optimizing and assessing the risk of disruption of services offered to the population and especially to the most vulnerable people.”

Dentists who work in health-care establishments have access to PCR tests, the Health Ministry said.

But for private dental clinics, the ministry judged that guidelines in place to limit the spread of COVID-19 are sufficient to avoid disruptions, according to the Ordre des dentistes du Québec (ODQ). It clarified the government directives surrounding priority groups — and how dentists fit into them — have existed since the start of the pandemic, and not just for PCR testing.

“We made sure to have protocols that are well established in dental clinics,” an ODQ spokesperson said, adding that the group accepts the ministry directives.

Having symptoms consistent with COVID-19 but no access to PCR tests to be more certain of results, Socqué said, can lead to service disruptions when dentists have to isolate and postpone appointments that patients have organized their lives around. That’s why she decided to pay hundreds of dollars for a PCR test.

“I just want to know, do I have COVID? Because should I work, or should I not?” she said.

While Socqué admitted dentists are able to screen patients to limit the spread of the virus in a way that might not be possible for other health professionals, she said there’s still room for human error.

“I have a person who is immunocompromised at the office; I have another who is pregnant,” she said. “So I want to be sure there’s no COVID.”

Dr. Vesna Repac, a dentist in Montreal, said she was able to get a PCR test on the South Shore in February but was denied one at a different location, also on the South Shore, in March. In both cases, Repac was asymptomatic but wanted to be safe after encountering situations in which she could have been exposed to COVID-19.

“You go and see what happens,” Repac said of testing sites. “I would assume that we’d be included because we treat elderly people, and our patients can’t wear masks when we treat them, so they’re automatically at a medium risk level. … Our contact lasts for more than 15 minutes and we’re less than two metres away from them.”

Landry expressed similar concerns, saying the average age of her patients is between 70 and 75.

“If I have it, I want to know,” she said. “I’ll stay home.”