Thursday 18 June 2020
BBC: NI practices ready to provide AGPs to resume these on July 1
Last night’s evening news bulletin from
BBC Newsline highlighted that dental practices in Northern Ireland would re-open on June 29th for routine, non urgent care, such as check-ups, with aerosol generating procedures being available from 20th July. The BBC also announced that dental practices that can show they are ready could be fast-tracked to provide AGPs from July 1. Commenting on the massive spike in PPE prices, BDA chair of NI Dental Practice Committee, Richard Graham, told viewers this has gone up 6000%, and could be even more when phase 3 is in place, the APGs.
Watch from 19.28
BBC: Alarm over drop in oral cancer detection rates
Our Northern Ireland team has warned that lives may be lost because of a lack of people being able to access dental treatment during the pandemic. Paul Brennan, the president of the BDA NI branch told BBC Radio Foyle this morning that there are major concerns that oral cancer is not being detected. He said: "Oral cancer detection rates are down by two thirds in NI and oral cancer, like all cancers, is a very serious issue. That will have major life-changing effects on people and maybe even cost lives.” Northern Ireland will now be able to provide non-urgent dental care from the end of this month and procedures involving drills, like fillings, will be back on the treatment list from July 20. However, BDA warned that a lack of PPE, and escalating prices could jeopardise a return to routine care. Paul said: "Practices have been able to access PPE, but it has got a lot more expensive, significantly more expensive than it was before." The acting chief dental officer, Michael Donaldson, was also interviewed on
Radio Foyle, listen from 1:19:28.
BBC News Northern Ireland - Live Reporting (page 2, 08:22am)
BBC Radio Ulster: Timetable for reopening of dental practices in Northern Ireland
BBC Radio Ulster report yesterday on the news that dentists in NI will be able to provide non-urgent care from 29 June. Aerosol generating procedures including fillings are scheduled to start from 20 July. It points out that the BDA says the timetable has been agreed by DH but ongoing PPE shortages could hinder progress. Q Radio yesterday also spoke to BDA NI chair, Richard Graham, who said: “We do know that there is a backlog of things, people have broken teeth, fillings that have come out, infections.” Their report also noted that costs for PPE has risen by up to 6000% due to a spike in demand.
Not available online
The Herald: Scotland dentists launch funding call as they prepare to receive patients
Dentists have called for additional funds from the Scottish Government as they face challenges to reopen, the Herald reports. It says the BDA has welcomed the announcement yesterday that they can start to see patients with urgent care needs from Monday, but fear increased costs and PPE shortages may prove ‘fatal’ for practices. It quotes the BDA’s survey which said fewer than 8% of practices say they can maintain financial sustainability. David McColl, chair of the Scottish Dental Practice Committee, said: “Dentists have been looking forward to welcoming our patients back into our practices but already we are hearing from colleagues who simply can’t afford to re-open, given the limits of the current Government support package.” Prime Minister Nicola Sturgeon said Scotland’s chief dental officer, Tom Ferris, has been “working very closely with the dental profession”. She said: “Dentists have been considered to be high risk of transmission in the last few weeks but we are now able to move forward thanks in large part to the work the chief dental officer and the profession have been doing, re-opening on Monday initially for urgent care but hopefully quickly after that to get back to normal.”
Not available online.
The Times: Coronavirus in Scotland - dentists open but fear worst
The Times in Scotland reports this morning that dentists have warned of “financial oblivion” without support from the Scottish government after practices reopen on Monday. It says the BDA has warned that lower patient numbers and increased costs could prove fatal for the industry. Three million items personal protective equipment to Scotland’s 1,000 practices would only allow for ten patients to be seen a day. The article quotes Scotland Dental Practice Committee Chair, David McColl, who said: “We finally have a date for the return of face-to-face care, but it arrives after weeks of waiting for clear guidance. Dentists have been looking forward to welcoming our patients back but already we are hearing from colleagues who simply can’t afford to reopen, given the limits of the government support package.”
The Scotsman: When will dentists open in Scotland? Date confirmed for practices to reopen
The Scotsman yesterday reported on the news that the Scottish Government has announced the reopening of dentists under phase 2 of the easing of lockdown restrictions from Monday 22 June, but initially only for urgent care. It reports that Scotland’s Chief Dental Officer, Tom Ferris, alerted the BDA on 20 May outlining the phased return proposals. He stated: “As you will be aware this is an extremely complex process. We need to be mindful of the oral health needs of patients balanced against the wider situation with Covid-19, and the essential requirements that we reduce the risk of community transmission and protect both patients and dental teams.” The letter goes on to explain that aerosol-generating procedures, which produce airborne material during dentistry procedures, carry an extra risk of transmission. Another “major consideration” for reopening dental practices is the availability of PPE, according to the CDO’s letter. The BDA said, “The Scottish Government has issued some further details on the plans to reopen practices to NHS patients later this month. This follows the CDO’s letter of 8 June. The date for reopening will be confirmed following the Scottish Government’s next 3-weekly lockdown review on 18 June.” The article explains the detail of the three phases, with phase two involving opening up NHS dental practices in Scotland, but that this will only be for non-AGPs.
The Irish News: Dentists 'need government help' over PPE costs and social distancing measures
The Irish News this morning reported that dentists have warned that the spiralling cost of PPE and social distancing requirements will make dental practices "financially unsustainable" without government help, after being given the go-ahead to reopen. It said that BDA Northern Ireland sounded the alarm as the Department of Health confirmed Phase 2 for recovery of general dental services - non-urgent care - will begin on June 29 and Phase 3 - aerosol-generating procedures (AGPs) - will start from July 20. Phase 2 will increase the dental patients from around 2,200 patients to an estimated 38,000 a week for extractions, removing dental decay and placing temporary fillings and making dentures. The Health and Social Care Board said practices will also be able to "fast track" a full return to routine care by the beginning of July "providing key conditions around infection and prevention control are met". Acting Chief Dental Officer Michael Donaldson praised "all dentists and staff who, throughout the pandemic, have gone the extra mile to ensure that patients in urgent need were able to receive the care that they required in very challenging circumstances". The BDA warned that AGPs, "represent the majority of dental treatments" and "dentists performing these procedures are expected to use full PPE, similar to those used in hospital ICUs". It estimated shortages - "and the need for kit never previously required" - mean "the cost of PPE alone, ignoring other treatment costs, for treating a single patient has increased by up to 6,000 per cent". The BDA said dentists are "reliant on commercial wholesalers and have experienced severe and ongoing PPE shortages" and called for "the integration of dental services into the wider government supply chain", if routine dental care is to be restored. Richard Graham of the Northern Ireland Dental Practice Committee said "dentists need time to prepare, but PPE remains the elephant in the room. Practices face not only shortages but crippling increases in costs for vital protective kit," he said. Mr Donaldson said "the nature of dental treatment... brings a heightened risk of virus transmission" and insisted the department "will support dentists in restoring services by providing help with PPE supplies". However, the BDA has also highlighted how the return of routine dental care in England "has seen a majority of practices operating at less than a quarter of their former capacity, to ensure social distancing and infection control protocols are met" This has led just eight per cent of practices able to "maintain their financial sustainability", with dentists calling for "long term support" to "keep the service in Northern Ireland viable".
The Derry Daily: Non-urgent dental care to resume on 29 June in Northern Ireland
The Derry Daily and
BBC News Northern Ireland also reported yesterday that non-urgent dental care can resume in Northern Ireland would resume from 29 June. It features the BDA’s data highlighting that the cost of PPE has increased by 6000 per cent: “Costs for kit were around 35-45 pence pre-pandemic, and could now stand at £20-30 depending on exact PPE requirements and usage.” It reports that no decision has yet been taken on whether dentists will have access to the central government supply of PPE, and Richard Graham, chair of the BDA’s Northern Ireland Dental Practice Committee said: “We finally have a timetable. Dentists need time to prepare, but PPE remains the elephant in the room. Practices face not only shortages but crippling increases in costs for vital protective kit.” The BDA said it believes the integration of dental services into the wider government supply chain will be a pre-requisite to any plan to restore routine care. Richard added: “We can put out the welcome mat, but without access to government supply chains, we will be in no position to treat patients. But we will need help to survive the new normal. Without long term support, sky-high overheads and fewer patients could be the final nail in the coffin for the service in NI. We trust the department will step up to the plate.”
Wednesday 17 June
BBC Radio Foyle: Dentistry in Northern Ireland 'heading into the abyss'
BBC Radio Foyle Talkback yesterday spoke to Paul Brennan, President of the BDA in Northern Ireland, on the situation of Health Service dentistry. Paul said he is deeply concerned there is a lack of political will and planning around the post-COVID-19 future of dental services and that the Health Minister needs to give reassurances that Health Service dental care has a place in the NHS or dentistry will be heading into an abyss, he said: “He needs to engage properly with the dental profession, and his officials need to engage properly, they need dental representation. If dentistry is there it shows a lack of priority, and we are really concerned that we are going to end up with Health Service dentistry in such a state, that’s it either by design or neglect, it’s going to end up non-existent, and people will not be able to access health service care, and we are going to end up by privatisation by the back door. The Department of Health said there has been regular engagement with the BDA and financial support scheme has been established, allowing funding for local dentists.
Not available online
HealthWatch: How to get an NHS dentist appointment during COVID-19
HealthWatch reported on 16 June on how routine dental care has changed because of COVID-19, and social distancing rules. It says the BDA advises that patients will be asked screening questions via the telephone, they may be asked to wash hands on arriving and leaving surgery, that social distancing measures will be in place in waiting rooms and appointment times offered may be fewer.
Netdoctor: When will dentists reopen in the UK?
Netdoctor yesterday reported on dental practices reopening in England and what has changed if you need an appointment. It quotes the BDA's survey figures saying that only 36 per cent in England felt ready to open due to a lack of PPE available. The article quotes BDA chair Mick Amstrong, saying that dentistry currently has a 'skeleton service', he said: 'Those practices reopening now face fewer patients and higher costs and will struggle to meet demand.' The article also covers what dental appointments will look like, how patients can make an appointment and how to look after your oral health with tips from dentist Richard Marques.
BBC1 Look East: ‘There are limits to what we can achieve if the restrictions continue to apply’
BBC1 Look East reported yesterday evening that the BDA has said dentistry is facing a crisis, due to the Government’s strict safety measures which is making it hard for dentists to stay open. The programme visited a surgery in Saffron Waldon and highlighted that dentists aren’t open to doing routine treatments, and still tackling the backlog of emergencies patients, seeing only 10 patients a day instead of the usual 75. Commenting on the situation, dentist Carla Jones, said: “If it went on like this for a long period of time, absolutely catastrophic. Short-term, I think we can cope and deal with the emergencies, but if it went on and on, no. We are doing all these things and making our lives difficult, and also for patients, is it really necessary? We need some proper science just to try to get back to some kind of normality”. A patient said: “There’s no way that you can manage without the professional help they give.” BDA Chair Mick Armstrong was interviewed and said “It is a crisis. The dental profession are incredibly adaptable, but there are limits to what we can achieve if the restrictions continue to apply.” The programme highlighted the need for full PPE for AGPS, and then the hour needed for deep cleaning afterwards, and an hour before can use the room again, saying it makes dentistry economically unviable. It said dentists concerns have been put to Government, which is undergoing a dentistry inquiry, and admits the current situation makes it more urgent.
Watch at 15:50
BBC1 South East Today: Dentistry could become unaffordable
BBC1 South East Today evening news reported on the BDA’s concerns that the new measures for dentists have dramatically increased costs, and unless the Government steps in, dentistry could become unaffordable. It quoted BDA figures saying around 60 per cent of dental practices in the South East are now thought to have reopened, but some are running at only 1/5 of former capacity and the extra guidelines mean the cost of PPE can increase by around 6000 per cent. They said the new normal means staff have to change PPE after every appointment at a cost of £50 as well as rotating and deep cleaning surgery. Dentist Aniko Lazar said: “We have to swap surgeries between patients, we have to let the air settle down, we have got a cleaning time which is much increased, we have to socially distance, we have to make sure our staff and patients are safe, so we can only book one patient per hour.” Dentist Amanda Riley said: “There is a crisis in dentistry. I think the number of urgent cases that have happened during lockdown, every practice must have their list of them and every practice is keen to get back and get working on their patients, so we can get them out of pain.” They report the practice can only schedule 8 patients a day and will be another week before all patients requiring emergency treatment can be seen.
Watch at 17:38
BBC Radio Tees: Fake PPE and lack of access to NHS supply chain hindering dentistry
BBC Radio Tees Drive programme yesterday evening featured a piece on the situation of dentists reopening, and said that with social distancing in place and shortages of PPE, there is a backlog of patients. They spoke to BDA North Yorkshire representative Mark Green, who said dentists are struggling to find ways to treat more people, he said: “The one thing that’s been suggested, more remote triaging by technology firms, using phones and visual aids, to do a pre-check up check, to avoid wasting the time of a patient by coming in and travelling back and forth.” He also appeared on the BBC Radio York Drive programme, highlighting the problem of fake PPE being sold, and the issue of dentists not being part of the NHS supply chain. Mark said: “Every situation there’s always a bottleneck, and it was, first of all, appropriate PPE, then it was being charged for overpriced counterfeit PPE, then we had to get PPE that has to be fit tested. At every stage, there has been a hindrance to allowing us to operate at normal.” Mark also made a guest appearance yesterday on Jonathan Cowap’s programme, BBC Radio York for 45 minutes. He discussed all the issues above, in addition to raising awareness of how NHS dentistry relies on the private sector to fill in the shortfall and emphasised the need to make NHS dentistry more attractive for dentists by getting rid of the UDA system.
Listen from 11 mins
HSJ: A&E leader: All departments should be call before you walk?
A ‘call before you walk’ system to prevent overcrowding and the spread of COVID-19 in emergency departments should be implemented alongside a ‘beefed up’ NHS 111 service, reported the
HSJ on 16 June. Katherine Henderson, president of the Royal College of Emergency Medicine, told MPs a “triage point” such as NHS 111 should be available for patients needing urgent treatment and be able to book access to primary care, urgent treatment centres or same-day emergency “hot clinics” staffed by specialists. She told the Commons health and social care committee she did not envisage A&Es would turn away people in desperate need of care, but said before the pandemic they were being used as a “safety net for the system” and becoming “very overcrowded”. Dr Henderson said technology should also be used to “track” whether patients have followed the advice of 111, such as whether they turn up to appointments and said trusts should consider alternative ways in which patients can access same-day emergency care. She told the committee today that the “call before you walk” model for emergency care, which is used by some Scandinavian countries, should be adopted by the NHS in the long term. “[Emergency departments] were able to have an infinite number of patients, we were never able to say ‘we’re full, we’re at capacity,’” she said. “We now need to recognise we can’t do that in an era where we need to keep patients safe, and the patients that need to be able to come to an emergency department […] are some are some of our most vulnerable, and are most at risk if they do pick up COVID. So if we cannot have space to put those patients, we’re going to cause enormous problems and harm to patients. “[We need to have] some way of knowing who’s coming, and making sure that the right patients are coming to the emergency department and there are other routes of access to care for urgent patients but maybe patients who are not needing emergency care.” The article reports that MPs were also told dental surgery is facing a “probably existential” threat due to the pandemic, by BDA Chair Mick Armstrong. He said it would be “very difficult” for dentists to increase the number of aerosol-generating procedures, from 10-15 per cent now, under current guidelines, while only 8 per cent of practices believe they are financially viable.
Tuesday 16 June
BBC Radio Wales: Teeth and eyes - expert panel answer callers’ questions
This morning, Jason Mohammad on BBC Radio Wales was joined by Lauren Harrhy, vice chair of the BDA’s Welsh General Dental Practice Committee and Sali Davis, chief executive of Optomet ry Wales, answering listeners’ dental and optical questions. One man called to ask when his daughter was likely to get an appointment to see her orthodontist after explaining that a month into lockdown the wires of her brace became ‘loose’ and a ‘spring’ broke which he used a wire cutters to remove, as advised by the orthodontist. Lauren explained that she would probably get this within the next few weeks and to use wax sparingly to prevent the remaining wire rubbing against the gum in the interim. She told listeners that every practice was open in Wales for emergency treatment and explained that dentists would assess cases over the phone first. If they were unable to treat a patient they could be referred to an urgent care centre. Lauren also spoke about the importance of preventing dental problems.
Phone in starting around 9am.
Herald Scotland: Could virtual dentistry be the way ahead?
Andrew Culbard writes in Herald Scotland that for the dental profession the covid-19 crisis is not just a threat to people’s lives, with dentists in a high risk group, due to exposure to people’s mouths, but also a threat to the future of the dental profession, with the financial losses of closed dental practices mounting. He notes that online video consultations have become the new normal and he believes that this combined with other online technology could be the future for dentistry as it helps to reduce clinical time and remove an element of non-essential contact which in turn reduces risk. For patients, this could mean reduced travel to their dental practice for issues easily resolved over the phone and decreased waiting times for appointments. However, he warns that the need for dental services will not disappear and the current inability to access care is likely to create an urgent demand. Pre–pandemic access to NHS dentistry was difficult enough, he says and cites the BDA as reporting that last year 4 million people, across the UK, had an unmet dental need. The dentist suggests the use of technology, begun in response to the COVID-19 crisis, could be a way to meet this unmet need in the future.
Lovemoney: Coronavirus: new rules for dentists
Lovemoney reports that dentists have begun opening again, from the 8th June, but that there are limited appointments and these will be for mainly emergencies. The British Dental Association advises wearing a face mask when you go to the dentist or be prepared to wear one when you get there. When phoning for an appointment you are likely to be asked screening questions by the receptionist. At the surgery you will be advised to use hand sanitiser and magazines and children’s toys will no longer be available. The advice is that if you arrive early for an appointment you should wait outside the surgery, and if possible, you should pay by contactless card.
Monday 15 June
Sunday Mirror: Dental practices face financial ruin
The Sunday Mirror on 14 June highlighted that more than nine in 10 dental practices are facing collapse, with the BDA's figures showing only eight per cent believing they can stay in business under government corona rules which mean they are treating fewer patients while weathering the burden of extra costs. It says that dentists are being sold fake PPE and paying exorbitant prices for genuine kit. BDA chair, Mick Armstrong, said: "No health professional should be reliant on Google to secure PPE. Fake masks are a threat to both patients and staff. And prices for kit have hit the roof." A dentist from North London, Kevin Silver said that kit was also difficult to source and fit.
People: Dentists in cash crisis
The People report that more than nine in 10 dental practices face financial collapse. The British Dental Association report that only eight percent of dentists think they can stay in business under new government rules for treating patients. Dentists have to vacate their surgeries for an hour after each patient and this has to followed by 20 minutes of deep cleaning. Dentists are also having to pay high prices for PPE and are concerned that they might be buying fake supplies from unscrupulous suppliers.
14/6/20, not available online
iNews: We're used to seeing 600 patients a week, last week it was down to 26.
Dentistry has changed massively since practices reopened in England on June 8. iNews has reported on this by following Stockton-on-Tees dentist and BDA board member, Paul Woodhouse, for the week. This documents the challenges he faced from PPE shortages to childcare issues and the frustration he felt over the limited treatments he could provide for his patients. On Monday last Paul was preparing his surgery to see patients again and having to navigate all the new procedures required to stop the spread of coronavirus. On Tuesday he records seeing five patients between two dentists, when in pre-covid times two dentists could have seen up to 60 patients a day. On Wednesday a patient was overjoyed to have a tooth removed, due to the pain, though Paul feels that he was letting the patient down because in normal times he would have offered procedures to extend the life of the tooth, but being unable to access the appropriate PPE, meant that aerosol generating procedures 'were off the menu'. On Thursday Paul explains that childcare is a big problem for his nurses and other team members, as the government has not added them to its list of key workers. On Friday he records that his practice has seen 26 patients over the week, whereas in March it would normally see 600 and his frustration at only being able to offer extraction, as a form of treatment. He feels relatively lucky because around 75 per cent of his work is NHS, so" I'm getting some support, but the private part of my business has disappeared. Top priority is keeping staff and patients safe, but we also need to keep the wolf from the door."
BBC Radio Manchester: Reopening dental practice 'a struggle'
BBC Radio Manchester on 14 June discussed the reopening of dental practices and highlighted our survey findings saying only a third of practices would open from 8 June and asked how prepared dentists are. The presenter spoke to Bilal Sheikh at the Roe Street Dental Practice in Macclesfield who reduced service down from 60 patients to eight. He said reopening was quite a struggle, as they weren't given much notice and said the guidelines from the Chief Dental Officer came quite late. He discussed both the reduction in footfall and in services, explaining most dentists are not doing the drilling, or any AGPs, due to the lack of PPE and kits, and that these procedures are still being referred to the UDC centres.
Not available online
Daily Mirror: Six small changes you can make right now to improve your health and wellbeing
The Daily Mirror on Saturday featured experts giving top tips on improving oral health, posture, sleep patterns and digestion. BDA spokesperson Philip Stemmer gave advice on good oral hygiene, he said: "Leave the sink the moment you've applied toothpaste to your brush – rinsing washes away the protective fluoride coating, which adds hours of protection. Avoid drinking any fluids for at least half an hour after. I dry my toothbrush before applying paste – there's plenty of moisture in your mouth already."
Also in The People (Ulster) edition - not available online