October 2021
We are still in the thick of the situation that has been created by the Pandemic and although there has been some move in the direction of normality, we still need to be vigilant to protect our colleagues and our patients as well as delivering our services.
You will all be aware of the recent publications that have been sent out by NHSE&I and the Office of the Chief Dental Officer.
The NHS letter dated 19th July 2021, 4th Edition of Delivering Better Oral Health dated 21st September 2021 and The IPC Dental Appendix dated 29th September 2021.
I don’t intend to dissect these documents minutely, however in the Next Steps to Recovery practices are reminded that they should not prioritise patients of lower clinical need over those in higher clinical need, such as urgent care or a member of a priority group such as children. As there is no patient registration within dentistry patients must be prioritised against clinical need and priority groups regardless of whether the member of public is on a practice’s business list or not, this is a condition of ongoing financial support.
It also states that frontline workers are eligible for a free Flu vaccination this season and I would advise that all healthcare workers strongly consider taking the offer up, unless there is a medical reason not to. I would also remind colleagues that have not been vaccinated against COVID to consider their own protection as well as others. Those who have been doubly vaccinated should be eligible for a booster vaccination and again I would encourage all to take it up. I recently had mine and apart from feeling a bit rough for 24 hours no other symptoms.
In terms of access and activity careful reading of the Dental Appendix treatment pathways highlights the continued need for assessment of your patient, however in the Low Risk
Pathway it states:-
‘Currently, and until ‘point of care’ testing is available, patients requiring routine dental care will predominantly fall into the medium risk pathway. If a patient has evidence of a recent (72 hours) negative SARS-CoV-2 PCR test and no screening or triaging risks are identified, then the low risk pathway can be followed.’
I would add to that statement that the patient has been vaccinated unless medically exempt. We have had a few patients, at the Blackpool Training Practice, that have met those criteria and assessed that they could be treated in the low risk pathway. This simplified the appointment and the patient was able to have a scale and polish or a filling that appointment without the need for level 3 PPE. We did, however, allow the minimum fallow time.
In terms of PPE, visors worn during an AGP should extend far enough to cover the filters on your mask or the exhale valves of an FFP3 surgical mask.
It should be noted that when undertaking ‘sterile’ treatments such as implants or flap surgery a Type 11R surgical mask can be worn for non AGP interventions, however for an AGP intervention a fit tested mask, without an exhale valve, or a respirator should be worn.
Finally, the recent edition of Delivering Better Oral Health is available on line, however it has been published in chapters rather than as a complete document. Chapter 2 has the guidance tables and in my opinion is the most useful section to open. By all means read the rest of the chapters but Chapter 2 summarises it all.
If anyone wants to contact me about any matter my email is:
David Bradley BDS, Dental Adviser NHSE&I Lancs and South Cumbria