Dentistry in the News
Interesting news articles at a national level and regional level across the country...
BDA mentions in the news
Opening the [dental] floodgates risks raising false expectations unless the government is willing to step up and help
The BDA said millions of patients will welcome the news, but not all practices will be able to get up and running straight away. The BDA also said that while dentists would be relieved by the announcement, the ability of practices to reopen would depend on the availability of personal protective equipment (PPE). "It is right to allow practices to decide themselves when they are ready to open. Dentists will be keen to start providing care as soon as is safely possible, but we will need everyone to be patient as practices get up and running," said BDA Chair Mick Armstrong. "Dentists can open their doors but won't be able to provide a full range of care without the necessary kit. Longer-term, practices can only stay afloat with ongoing support, while social distancing continues and the costs of providing care are sky-high." He added "Opening the floodgates risks raising false expectations unless the government is willing to step up and help."
PPE needed to open practices is 'either non-existent or prohibitively expensive'
BDA spokesperson, Paul Woodhouse was interviewed this morning on BBC Radio Tees in response to the announcement that dental practices in England can re-open in 10 days' time. Paul said that this was as much a surprise to him [and dentists], as he heard the news at the same time that the public were informed of this at around 5pm yesterday. When asked whether practices were ready to open, Paul said that while dentists are very resourceful, he didn't think so because the challenges persist in getting the appropriate level of PPE, which he said is either non-existent or prohibitively expensive. A box of faces masks that used to cost £1.50 now costs £25, Paul said, adding that if you're a private dentist, the cost will be passed on to patients but not under the NHS, and dentists have heard nothing yet on how this will be funded. Commenting more generally on how urgent care centres were functioning, Paul said these varied, those in his patch (Stockton on Tees, North East) were well stocked and staffed but not in other parts of the country.
https://www.bbc.co.uk/sounds/play/live:bbc_tees; listen from around 9.20
Getting 10,000 practices back online from 8 June is an 'absolute impossibility'
Dave Cottam Chair of BDA GDPC, spoke to Lisa Aziz on LBC News this morning about the reopening of dental practices on 8 June. When talking about preparations needed, he said: 'This is going to be a huge problem. Our first main concern is all the patients who we've tried to triage in the last 10 weeks probably over 750,000 cases now, that patients who have had problems during this period of time and been holding back until we can open again. The other huge problem is the availability of equipment, to get 10,000 practices back online from 8 June, fully equipped, is an absolute impossibility. There are huge problems moving forward with PPE supply, and for most procedures where we need to get the drill out, we are going to need the top level of equipment and that involves testing and training, and that is a huge barrier for our return to work." The presenter said Government says it is working around the clock to ensure dental centres do have PPE, but Dave said there was a problem with supply due to the demand and the jump to 10,000 practices will not work - he said many dentists were still waiting for PPE, and would only be able to see emergency and do limited care. He said, 'I estimate that it is going to be at least three to six months before we can get back into full operational order, to see patients on a routine basis...instead of seeing patients perhaps every 30 mins in the past.... the minimum time will be an hour, as we have to have the downtime for safety purposes, and that is key...to have surgery well prepared and safe for the next patient". He said that the stories about DIY dentistry were an appalling situation, and added: "....we have to...have an absolutely safe environment, and we need to protect ourselves, our staff and the patients...and until we can, then we can't be seeing patients on a regular basis as we have before."
LBC News: Not available online
'Raring to go, but not ready. PPE is the problem'
Adrian Chiles on BBC Radio 5 discussed dentists seeing patients from 8 June, highlighting that the BDA welcomed the announcement but has concerns about the availability of PPE. In an interview, Hannah Woolnough, an Ipswich dentist and Chair of BDA's English Council, said 'We are raring to go, but we are not ready. And I think we are not in a dissimilar position from the majority of dental practices in the country. PPE is the problem. We had a letter yesterday morning from the CDO England going through some measures we needed to think about with regards to reopening but without a date." When asked whose fault the lack of PPE is, Hannah explained '...we have to source and pay for our own PPE, and this is going to be one of the issues because it's so hard to come by, and costs have skyrocketed..." She added: "When we say we are re-opening on the 8th, it's not going to be business as usual, there will be very restricted services. We've got to keep the number of patients coming through the building [low] to keep people safe...and unfortunately, that does mean we are not going to be seeing a huge amount of people and we are only going to see the worst affected, until we've got access to PPE, so we can operate more normally. This is going to be the gradual reopening of services". Chiles said he had many dentist friends and aired the frustrations he's been hearing, the lack of communication from the CDO and Government, and the huge issue of availability of PPE and profiteering over getting hold of equipment.
Hannah said: "It's not possible in a week to get everything ready for the majority of people...there are all sorts of implications, time, and the cost is a significant one. We haven't had the same level of support with things like business rates as shops, private dental practices have had no government support whatsoever. Bookmakers have had more government support than private dental practices and these are practices that are providing frontline care for 50% of the population." She said she has real concerns that a number of practices won't be able to reopen. They discussed the fit testing for FFP3 masks that are needed for AGPs, she said the fit testing is a real concern, there is a lack of kit and the need for people to be trained to do fit testing. They also discussed the UDC centres and amount of time it took to get them set up to see emergency patients, and the ongoing struggle to get PPE. Hannah said: we can offer limited services, and there will be a 'blended' approach with UDC and dental practice until the amount of PPE is available. She said: "I think the key thing for patients to know is dental care is available if you are in agony, call your dentists first and they can direct you to most appropriate place...but we are not going back to normal on the 8th and this is what patients need to appreciate, you cannot phone up and book a scale and polish on [then]." Chiles asked how long before a regular check-up is anything but a distant fancy, she said his guess was a good as hers, due to the ongoing likelihood of the coronavirus threat.
https://www.bbc.co.uk/sounds/play/live:bbc_radio_five_live (listen at 11:10)
Profession only found out news from seeing ticker tape running during PM briefing on BBC last night
Mike Ehrlich, a dentist from Leeds gave his response to the news that dental practices are opening in a week's time, while patient, Carol, awaiting root canal treatment for the past two months' She spoke about the pain she suffered from an abscess in her tooth since April. She'd been given antibiotics and advised to take painkillers, which helped in the short term, but is still in pain. She said that when dentists do open, she is worried how long she will have to wait, as they are likely to be inundated with patients. Mike was asked what will happen next for dentists opening, he said: "The scenario is, that we found out from the tape running from Boris' commentary yesterday, that was the first the profession knew about it...we had been told that it would be a staged return and anything using the drill, creating aerosol, which can spread the virus, will be the last thing to happen. To do that safely we need PPE of the highest-level. Weeks ago they announced that all dental surgeries had PPE from the NHS. Rubbish. I cannot get PPE, the NHS supply chain contacted me after I emailed them telling me to contact the suppliers I've been using for the last 30 years, none of whom have any PPE." He said he plans to open his surgery in a week or so, but as he only has basic PPE will only be doing basic emergency treatment, such as temporary fillings and extractions, but explained they can't do root treatment due to the lack of appropriate PPE. He said they only have the basic masks which are 'useless' against the virus, and that to get the correct PPE for AGP treatments, they need FFP3 masks, which needs to be professionally fitted and tested, to ensure the safety of dentist, staff and patients. When asked about Carol's case, he said, "I would be saying sorry I can't treat you. It would break my heart, I've got patients who are in the same position that I can't treat." He said that of his three surgeries, only one is likely to be open, as they can't do all three due to social distancing guidance. He said: "I don't get how this works, because we can't social distance at all."
https://www.bbc.co.uk/iplayer/live/bbcone?rewindTo=current Watch at 08:47
Dentists wearing WW2 gas masks
BBC Three Counties Radio discussed dentists being allowed to go back to work from 8 June, and said practices are being told to prioritise patients from vulnerable groups or those who need urgent treatment. It says the BDA has welcomed the announcement but says key questions remain, and that while dentists would be relieved by the announcement, the ability of practices to reopen would depend on the availability of PPE. The presenter relayed a story she had heard that it has been so difficult to get hold of equipment that they were going to wear a WW2 gas mask. They spoke to Dan Shaffer, a dentist in Harpenden who said he was involved in 3D printing of masks and PPE, but said there were problems with certification and making it fit tested for use, and the MHRA said that nothing 3D printed could be approved. He said: 'That we will be sticking to established supply chains of PPE, and that is probably a good thing because it ensures that everything is certified and up to a good standard...but the trouble is, the supply chain...has been prioritised to frontline health, which is excellent, but there will be shortages when we reopen." He said there will be a lot of challenges for practice going forward, especially around social distancing and sourcing PPE.
https://www.bbc.co.uk/sounds/play/live:bbc_three_counties_radio (listen at 12:08)
'I can have a plumber to fix my waste disposal, but can't get my son to a dentist'
BBC news this morning highlighted the growing number of stories they've featured of dental patients in pain and resorting doing DIY dentistry, as they have been unable to get treatment, with patients saying they are 'outraged' and frustrated by being 'ignored'. It included the story of 11-year old Charlie whose baby tooth came out, but was still attached to his braces. Their dentist Yasmin George said: "I've been a dentist for 31 years and this has shocked me to the core. I had to ask Charlie's Mum and Dad, if they'd got any pliers, and they had to take these pliers to their child's mouth. I'm embarrassed that as a profession we can't look after our patients." The Mum said: 'I think it's crazy that I can have a plumber to fix the waste disposal, but I can't get my son to a dentist'. The report notes that some dentists say they are ready to reopen in a few weeks, but not everyone can get the right PPE, and fears that higher costs and limited patient numbers because of social distancing will make it difficult to see the backlog and hard to see a viable future for every practice, the reporter concluded: "Getting face to face with the dentist won't be easy."
Not available online
Dentists have been working on the science available to mitigate the risks
Eddie Crouch Vice-Chair of BDA was interviewed by Vanessa Feltz this morning on her BBC London Breakfast programme about the risks associated with reopening dental practices, in light of the precautions required for aerosols containment and 'spray' where the coronavirus can spread. Eddie said: "Obviously we've been closed for nearly 10 weeks, the potential risks are as you've described, we've been trying to work on the science to mitigate the risks, so hopefully in the next few weeks, dental practices will be getting back to seeing patients. The issues are having enough PPE, we've had 500 UDC hubs opened in the last 4/5 weeks and many of those have struggled to get the right PPE, and now we are talking about opening 10,000 high street practices: it doesn't fill you with confidence that we are going to have the PPE to deliver an effective service."
https://www.bbc.co.uk/programmes/p02nrwb6 listen from 9.23
Dentists to re-open for routine checks
The Times reports that relief is in sight for the thousands of patients who have been in dental pain but have not been able to see a dentist during the covid crisis. The article notes the cases of DIY dentistry that have occurred due to the lack of access to routine dentistry. In a departure from previous advice the Chief Dental Officer in England has advised dentists that dental surgeries can re-open from the 8th June. The British Dental Association has warned that a sudden re-opening of dental surgeries could lead to a 'postcode lottery' of care. The Chair of the British Dental Association, Mick Armstrong, is quoted as saying that he welcomes the return to high street dentistry, but that patients will need to be patient as the dental surgeries get up and running again. He noted that dentists will not be able to offer the full range of treatment immediately and that the use of PPE may limit the number of patients who can be seen. The article notes that before the announcement on re-opening there were warning of the severe financial impact that the lockdown was causing to dentists.
'Practices may not be going up to full capacity immediately'
On BBC Radio Shropshire mid-morning today, a reporter talked about the lockdown rules easing in England, including dentistry. She said all routine dental care in England was suspended on 25 March, and that there have been some 'horrific tales' of people with emergency dental problems who couldn't get treatment from UDC hubs. She said: "....there are some horrifying things being done in the name of DIY dentistry, and people in an awful lot of pain. So it's welcome news. The BDA is really pleased, but there is a lot of safety to consider and the right protective equipment has to be available. Of course, with so many people wanting special masks and gloves...it's difficult to get hold of that still. I think you may not see practices going back up to full capacity immediately. There will be a backlog of treatment required and all the routine appointments and the check-ups."
https://www.bbc.co.uk/sounds/play/live:bbc_radio_shropshire - listen at 11:26
Scotland: gap in treatment amidst lockdown leads patients online for fillings
Dentists in a Highland practice are directing patients online to seek temporary DIY fillings, while routine dental care is suspended. The article explains that the practice in Fort William has been turned into an urgent dental care hub and can only see a limited number of emergency patients. For all other patients, the practice has been providing phone advice, one option for patients is temporary filling kits, that can be obtained from Amazon or pharmacists. It was emphasised that any steps should be taken under advice from a dentist. A British Dental Association spokeswoman is quoted as saying that patients who use temporary filling kits should only do so after having contacting their dentist and following the dentists advice.
Also in the news
Test and trace system kicks off in England and Scotland
Downing Street said the test and trace system would "improve" over time but rejected suggestions the scheme had been launched early. But Chris Hopson, chief executive of NHS Providers, said hospital trust leaders were questioning the risk being run by easing the lockdown without having local systems in place. He also said it was "never going to be the case" that the UK would have a "world-class" test and trace system in place by June - in reference to a previous pledge made by Prime Minister Boris Johnson. Mr Hopson said while work was progressing "at pace", the UK was "weeks behind where we really ought to be".