Covid 19 - What does it mean for your dental care?
As we move through the recovery phases of lockdown and begin to transition back to normal life, you may be wondering what will happen for your dental care going forward?
What happened?
Phase 1 of the Scottish government's plan for easing lockdown. By now we’re sure you’re aware that all dental practices in Scotland were ordered to close on the 25th of March, stopping face to face interactions, leaving us with limited options for treatment. During this time we were limited to triaging patients over the telephone and were only able to provide advice, prescriptions or to refer urgent cases to the Urgent Dental Care Centres (UDCC’s) for treatment.
Phase 2 of the Scottish government’s plan allowed dental practices across Scotland to reopen for emergency appointments only. Given that COVID-19 is a respiratory virus that can spread from coughing or sneezing, we had to introduce new, enhanced infection control measures and adhere to strict social distancing measures. We were (and still are) also prohibited from providing Aerosol Generating Procedures (AGP’s) on the NHS patients. This means that we were unable to carry out treatment that requires the use of water spray (from a drill) or the ultrasonic scaler - patients requiring such treatment must be referred to the UDCC’s.
Where are we now?
As we enter Phase 3, we have been advised by the Scottish Government and the Chief Dental Officer that we can start to see patients for more routine dental treatments, whilst still maintaining our strict infection control policy. Unfortunately, we are still prevented from performing AGPs in this phase, which rules out a great deal of our “routine dentistry”. Furthermore the restrictions also present a number of challenges to our normal way of working:
Constraints of Time: Due to the fact that we must follow social distancing measures we are only able to treat a limited number of patients in a day in order to prevent an overlap of patients at reception areas;
Restrictions Placed by the NHS: We have a large mix of NHS and private patients registered at our practice. All of our patients are equally important to us, however, restrictions have been set by the NHS which means that we cannot carry out the same treatment on NHS patients that we can on private patients;
Cost and Availability of Personal Protective Equipment (PPE): Currently the cost of PPE has skyrocketed due to a global increase in demand and we face obstacles in acquiring enough stock. This obviously has an impact on the cost and availability of treatments;
Lack of UDCC’s: The NHS option for patients requiring treatment with the use of aerosols and drills is a referral to the UDCC’s. There is limited capacity at the UDCC’s and treatment is only for emergencies with restrictions in what treatment they can provide.
We also face difficulty given the fact that we have a large mix of NHS and private patients at the practice. At Borland and Morton we equally value all of our patients and want to be clear that it is the restrictions that have been put in place by the Scottish Government that limit our treatments on the NHS - this may be due to the prohibitive costs of PPE as mentioned above. These same restrictions are not in place for private dental practice meaning that we can now provide AGP treatments on a private basis. NHS patients do have the option to pay privately to obtain treatment in the current climate whilst remaining NHS patients.
What safety measures are required for AGPs?
“Your safety and the safety of our staff is our top priority”
We will be wearing:
FFP3 respirator masks (the highest level of protection offered by any mask);
surgical caps, full gowns, gloves and full face visors;
Dental scrubs ( to be changed after each session);
We will use a rubber dam (a rubber sheet which isolates the teeth being worked on) on patients wherever possible.
After treating each patient we will allow the surgery to be left empty for a period of 1 hour in order to clear any potential aerosols left in the air before fully wiping down and disinfecting the surgery.
We are also aware that the NHS Scottish Dental system in general is under review with potential plans to change what treatment is offered and how. Given the above there is an option for NHS patients to become private patients. For more information on private options please click here.
We appreciate that this is a confusing time and appreciate your patience. As with all forms of industry that have faced restrictions during COVID-19 we continue to await further information and clarity in order that we can fully inform our patients and return to normality. We hope to provide more information in due course.
Take care and stay safe.
Martin Allan and Paul Allan
Borland and Morton Dental Care