Thursday 28 May
The Daily Telegraph: Will dentists re-open on 15th June?
The Daily Telegraph notes that dentists will not be re-opening on the 15th June, when non-essential shops are scheduled to re-open in England. The Telegraph quotes the Chelsea Dental Clinic as saying they are aiming for a mid-June or early July re-opening. At a meeting with the chief dental officer in England last week, Sara Hurley, the British Dental Association repeatedly emphasised the need for dental care to be expanded. A number of dentists are quoted and discuss the fact that they are sourcing their own PPE in preparation of re-opening their practice. The dentists also express a general disquiet over what they see as a lack of guidance from the government over the timetable of returning to seeing patients.
BBC in Northern Ireland: BDA calls on Department of Health to produce roadmap to recovery
Northern Ireland has been taking the first steps in easing restrictions imposed when the coronavirus lockdown was enforced in March, the BBC reports, as outlined in the first stage of the executive's five-stepPathway to Recovery. The BBC explores a range of services that may be available again soon, though this will not include getting a dental appointment, “unless you are in serious pain.” However, the BBC points out that while there are no firm dates yet, the picture of when changes to this are likely to happen should become clearer in the coming weeks. The article states that the “Northern Ireland Dental Practice Committee, which represents about 90% of dentists in the region and is part of the British Dental Association, will be meeting on Tuesday 2 June to discuss a reopening schedule for general dental practices”. It also cites the BDA as calling on the Department of Health to produce at roadmap to recovery, which lays out what dental services can return in general practice, depending on the level of public health risk, and whether or not these generate aerosols. Readers are advised to call their dentist have a dental problem, call your dentist.
The Scotsman: Three-phased return for NHS services on government route map
The Scottish Government’s phased return of NHS dental services in Scotland was outlined in a letter to the British Dental Association from Scotland’s Chief Dental Officer (CDO) Tom Ferris on 20 May. 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. Mr Ferris goes on to outline the government’s phased plan for reopening NHS dental services in Scotland, although no specific dates have been confirmed as of yet. Of the three-phased return, the first will be to increase capacity of the urgent dental care centres, which are already up and running during the covid crisis. The second will involve re-opening high street dental practices, to provide routine examinations and any procedures that do not involve aerosol generating procedures (AGPs). The third phase is the re-introduction of dental treatments that will produce AGPs. The article noted that there is no definite timetables in relation to the three phases and the BDA is continuing to seek clarity on the details of the plan for dentistry and private practices in particular.
BBC Radio 2: Hannah the dentist discusses urgent care on Jeremy Vine’s show
The Jeremy Vine programme on BBC Radio 2 devoted a section of the programme today to dentistry and DIY measures during lockdown, with Hannah Woolnough in the chair. She outlined why routine dental care has been suspended, the risks associated with dentistry without the right level of PPE, and the limited treatments that are available as a consequence at the urgent care centres. Hannah, who is the chair of the BDA’s English Council, highlighted the ongoing challenges for UDCs to get this PPE, which she said was similar to that used in intensive care units. She explained that aerosol generating procedures cannot be provided without this PPE, and this means that more extractions were being done than before the pandemic. She empathised with people who experienced toothache. It is torture, she said, though rarely life-threatening, and would have been resolved easily before the pandemic. Hannah also warned that when dental practices re-open, treatments will take longer because of PPE requirements and the need to let any aerosols settle in between treating patients. Commenting on one caller’s efforts to replace a filling, Hannah said one of the hardest things to do is dentistry on yourself doing it back to front with a mirror. She advised listeners on how they might temporarily deal with a broken brace, a loose crown, until services return to normal.
BBC Radio 2, Jeremy Vine, today at circa 12.40am, not available online
LBC Radio: The frustration of dental profession over DIY dentistry
Eddie Crouch, our vice-chair, spoke to LBC Radio’s Tom Swarbrick yesterday on the problem of patient access during the pandemic crisis. When asked what dentists can do during lockdown, Eddie said: “In most cases very little, I’m afraid, apart from giving advice, some analgesics, or some antibiotics, by remote triage with patients phone their dental practice. Some have been doing video conferencing, asking patients to send in pictures of what’s happening in their mouths, others have been operating in UDCs, that dentists can refer onto… but the bar has been set very high for those patients waiting to be seen, so many of those patients are sadly 10 weeks on still suffering.” He also highlighted the lack of PPE which is dictating the type of treatment that can be provided, and that ‘…many of those patients sadly are having the option of only having teeth removed, which would not be the case had we been able to offer a full complement of services like we were back in February.” He noted that the BDA has been contacted by a huge amount of patients in pain. He concluded: “We need to get back to providing a much better service, over a wider footprint, it’s not going to be like it was back in February, but it’s going to be a darn sight better than 500 UDC centres.”
LBC: not available online
BBC Radio Devon: Covid-19 is ‘devasting for both patients and the dentists’
BBC Radio Devon highlighted our warning that the repercussions of the COVID-19 crisis could devastate the UK’s dental service. The programme noted that high street dentists have been closed and patients can only get treatment in an emergency; it also quoted the BDA as saying that access to emergency treatment is patchy. Speaking to their reporter, Tim Hodges, dentist and secretary of local dental committee, said that their LDC has calculated that: “The current hubs can unfortunately only see approximately 7% of the patients who actually call up in pain.” He remarked that it was devastating for both patients and dentists, because we desperately want to help our patients.” His said his practice had opened as an urgent dental care hub and has had to buy thousands of pounds worth of personal protective kit, to ensure staff and patients are safe, and had to put in place a host of new procedures. He said his main worry is the number of patients they will be able to see in the new ‘system’, as they usually see 30 patients a day, but this will change to seven or eight patients a day, and will only be for urgent care at the moment. He also answered questions from listeners on their dental problems. When asked when practices will reopen, he said there was nothing concrete at the moment, “One thing we are really struggling with the ‘powers that be’, the CDO, who is not being forthcoming with information, and we just don’t know where we are.”
Listen at 07:05
The Irish News: Could Corona Virus crisis cause some dentists to close down for good?
The Irish News reports that according to the British Dental Association dentists are one of the few high street businesses that are not being offered full relief from having to pay business rates. The article quotes Ashley Dé of the British Dental Association, who explained that private dentistry accounted for more than half of the £7.8 billion spent on dentistry in the UK, dentists often use their private income to subsidise NHS work and if private dentistry is left to collapse it will have a knock on effect on all dentistry. The article notes that high street dentists are not likely to be able to open until early July.
Wednesday 27 May
ITV’s Good Morning Britain: Dentistry “isn’t in the queue, not even the back of the queue”
Mark Porter, a GP and medical journalist, told ITV’s Good Morning Britain
, that dentistry is a huge issue and hasn’t been given the prominence that it should be getting. He referenced a BDA spokesperson as saying that dentistry “isn’t in the queue, not even the back of the queue.” Mark spoke about the limited treatments available at urgent dental care centres, and the advice that dentists or even GPs would give over the phone would be the same, the 3As. However, he warned that these may only be a stop-gap before requiring further treatment.
The Metro: Lorraine Kelly really misses dentists
picked up on ITV’s Good Morning Britain feature, focusing on an interview between Lorraine Kelly and dentist Amarinder Sehda. One of the GMB banners in front of the dentist headlined the BDA's concern that DIY dentistry would increase during lockdown. Amarinder urged viewers not to try any DIY dentistry without speaking to their dentist first and two of the strangest DIY measures that he had encountered involved whitening teeth with nail varnish and using a toy gun to help shoot out a tooth! Lorraine said that “we really miss you guys and gals and when this is all over you will be rushed off your feet.”
BBC Radio Devon: DIY dentistry
Breakfast on BBC Radio Devon
interviewed our vice chair Eddie Crouch on the challenges facing dentistry when it resumes, along with local resident Sarah Hurley who discussed how she did a DIY filling after being advised to get a kit by her dentist. Although shops are opening soon, Eddie pointed out that there is no date set for dentistry yet. He warned that there would be a huge backlog of patients requiring treatment before ‘routine’ dentistry would be re-established which he thought might not be until the end of the year. He pointed out that prior to lockdown dentists would have seen up to 30 patients a day but afterwards it would be more likely to be around seven a day.
Commenting on the same theme of when dentistry might resume, Eddie also provided interviews this morning for several BBC Radio outlets, including Shropshire Live at 7.52 am, Cambridge Live at 8.22 am and Somerset Live at 8.30 am.
I News: When will dentists re-open?
While the PM has announced the re-opening of non-essential shops, bars and schools, there has been no mention of dental practices, the inews reports today. The office of the Chief Dental Officer for England has restated that there is no change yet in relation to dentistry. The article
pointed out that this was different in Scotland, where a phased return to normal dental treatment was being discussed, while in Wales adjustments are being made in response to easing the lockdown. Our chair, Mick Armstrong, and the Chief Executive, Martin Woodrow, have met with the minister, Jo Churchill, and Sara Hurley, the Chief Dental Officer for England, to discuss the general approach in England for both NHS and private practices.
The Telegraph: Dentists to re-open in stages
The Telegraph is reporting that dentists will re-open in phases in an attempt to reduce the backlog of dental treatment due to the crisis. The article quotes Sir Desmond Swayne, a senior Conservative backbencher, as saying that patients had been left ‘high and dry’ due to the closure of dental practices. He stated that there were urgent dental care centres, but they offered limited access and only for extractions. The article notes that the proposals to re-open dental practices follows a sustained campaign by MPs, who have highlighted the problems that their constituents are facing in getting treatment as well as the devastating impact of the lockdown on most dental practices, which – the article explains – are commercial operations and therefore face possible bankruptcy. Mick Armstrong, is quoted as saying that while a phased return is one thing, there needs to be a timetable. He noted that many practices are facing severe financial strain due to the lockdown and that the limits on dental treatment going forward, due to the crisis, could have a real impact on service availability to members of the public.
The Daily Telegraph, 26/5/20, available online but behind a paywall
Tuesday 26 May
BBC You and Yours: DIY efforts to save a tooth and avoid antibiotics
Yesterday’s edition of BBC Radio 4’s consumer programme You and Yours featured an item on dentistry which included interviews with BDA’s vice chair, Eddie Crouch, and board member Paul Woodhouse. The programme highlighted that it has been two months since dentists closed their doors to routine treatments, and there was still no sign of them returning any time soon and that dentists were calling on the Government to clarify when and how they might return to work.
It included an interview with Maude, who experienced such intense toothache that she had pain in her jaw and headaches. She didn’t want to have her tooth extracted at an urgent dental centre nor take antibiotics so she spent five hours with some makeshift dental tools, sterilised the area as best she could and removed what she thought was the root, along with the broken filling and decay in her tooth. Paul listened in horror to Maude's experience, saying how he empathised with her problem and that it could have been dealt with by dentist in 20/30 minutes before lockdown. Commenting on the limited treatments available at some urgent care centres, Paul said that of the 14 in his patch, the north east, only two had the appropriate PPE to do aerosol generating procedures. Eddie Crouch pointed out that the provision of urgent care varied, and this was a post code lottery. In his patch, the West Midlands, Eddie said these were functioning well, but in Gloucestershire the centres only had facilities that were capable of seeing seven patients a day for the whole of the county, that’s obviously wasn't enough, he said.
Listen from 28 mins 35 sec.
Government Update: Downing Street features question on dentistry
One of the questions raised during last Friday’s Downing Street daily briefing is when dentists will open and how will patients be treated safely. Sir Patrick Vallance, the government’s chief scientific adviser, responded by saying that the chief medical officer (CMO) is looking into seeing what can be done to reduce risks from ‘aerosolisation in dentistry’, and what the guidance should be to permit dental practices to open. He also acknowledged that dentists are used to working in an environment where there is an infection risk.
The i: Dental practices facing ‘financial meltdown’ under lockdown restrictions
The i reports that the government order to shut down most dentistry is not only impacting patients but also on the future of dentistry in the UK. The article notes that in England, in place of normal dental treatment, the government has established 400 urgent care centres; however, these sites are only treating emergencies and some were struggling from a shortage of the PPE they need to function. The lack of routine dental care is leading to a rise of patients performing DIY dentistry. The article explains that most dental practices provide a mix of both NHS and private care and while dentists are receiving some financial support in relation to their NHS work, there is no such support for private work. Mick Armstrong, the BDA’s Chair, is quoted as calling for a national plan from the government to ensure that patients can return to a dental service in a form they recognise. He notes that betting shops are receiving more financial support than private dentists and warns that Britain is waking up to a world without regular dentistry and the awful consequences that are resulting.
Mail on Sunday: Five-year-old with dental pain told to use Babybel cheesewax
Kate Mansey, writing in the Mail on Sunday, describes her experience of telephone triage with a dentist about her son’s dental pain. She was told that the urgent dental care centres were only seeing emergencies and in most cases they were only able to do extractions to avoid aerosol generating procedures, which could help spread the covid-19 virus. The consultation ended with the dentist saying she could use the wax from a Babybel to temporarily apply to the child’s molar. The article describes the problems with the current situation where routine dental care is suspended. The article highlights that people are missing out on mouth cancer diagnosis, which could result in more cancer cases in the future. Eddie Crouch, Vice-Chair, pointed out that in England dental provision during the covid crisis is a lottery and that the Chief Dental Officer for England did not have the autonomy of her colleagues in other UK nations and that the response in setting up urgent dental care centres in England had been much slower than in other UK nations. He went on to argue that there needs to be an inquest into why decision making in England had been so slow. The article also highlights the dire financial situation that dentists find themselves in, private dentists in particular.
Harpers Bazaar: When will dentists reopen in the UK?
There is no date set for the return to normal dental appointments, several news outlets report, including Yahoo and Harpers Bazaar. They report Sara Hurley, the Chief Dental Officer for England, as saying that there is no change yet in relation to dentistry, after the Prime Minister spoke of measures to reduce lockdown. The article quotes Martin Woodrow, Chief Executive of the British Dental Association, as saying that talks were taking place across the UK about how dentistry can emerge from the lockdown. Harpers Bazaar spoke to London dentist Richard Marques for advice about oral health during the crisis. He advised regular brushing of the teeth, the use of mouthwash and avoiding sugary foods. The article noted that some dentists may have a telephone triage service where they are giving advice over the phone to deal with as many problems as they can.