One of the most pressing issues in dentistry at the moment is when will we be able to re-open for emergency dental appointments. It is has been nearly 2 months since we were forced to close our doors. Despite what the Government may say, on the 25th March the Chief Dental Officer stated:
1. All routine, non-urgent dental care including orthodontics should be stopped and deferred until advised otherwise.
2. All practices should establish (independently or by collaboration with others) a remote urgent care service, providing telephone triage for their patients with urgent needs during usual working hours, and whenever possible treating with:
a. Advice
b. Analgesia
c. Antimicrobial means where appropriate
3. If the patient’s condition cannot be managed by these means, then they will need to be referred to the appropriate part of their Local Urgent Dental Care system. These new arrangements will involve providers working with defined groups of patients to manage urgent dental care needs only, with appropriate separation arrangements in place to manage patient status and professional safety
By all accounts, this ordered an immediate halt to all dental services within primary care. In my local area, Fulham, SW6 London, I have not been informed of a local urgent dental care centre that I am able to refer extreme emergency cases to. The advice given by various bodies ( I shall not name them) was to call 111. Frankly, this may have been almost acceptable in the early stages of the pandemic but NOT 7 weeks after the statement. Thousands of patients across the country have been left in pain and distress with the advice to take pain killers and anti biotics, which as we all know, are only effective when infection is present.
In this respect, I spent many hours reviewing the literature to provide some evidence-based analysis on how we can protect ourselves, our patients and get back to work after lockdown. If you are interested in reading this article, it was published by Dentistry and the link is here.
The summary involves 10 key points which are easy to implement and allow us to get back to work as soon as possible. These include:
1. Careful screening of patients pre treatment
2. Alteration of patient appointment times/ flexible time frames
3. Reception screening, social distancing measures.
4. Consider clean air systems within reception areas and surgeries such as those involving air suctioning pre filters, HEPA filters, carbon filters and UV lamps
5. Reducing aerosol
6. Always use high volume suction or HVA
7. Use rubber dam or consider additional isolation systems such as Isovac/Isolite
8. Provide assistants to hygiene/therapists for HVA
9. Enhanced PPE especially for those at greater risk of Covid 19
10. Extra time for cleaning and disinfecting surfaces including areas not previously cleaned
These are measured points that will go a large way to help our profession back to work and re-start the process of opening our dental clinics in London and across the UK.
Should you have a dental emergency, please do not hesitate to contact me. Although we cannot see you right now, I can try to help as best as I can remotely and arrange an appointment as soon as we can re-open.
www.progressivedentistry.co.uk
t 0207 7311162
e info@progressivedentistry.co.uk
Article written by Dr Nissit Patel
