Friday 10 July 2020
Radio 4 consumer programme warns that post COVID costs could “decimate private dentistry”
Today’s edition of "You and yours" on BBC Radio 4 programme, You and Yours issued a warning that the extra costs incurred of being a dentist in the post COVID era ‘will decimate private dentistry’ and this isn’t good news for NHS dentistry either. The segment included interviews with BDA vice chair, Eddie Crouch, and BDA chair of English Council, Hannah Woolnough.
Hannah spoke about the social distancing measures taken at the practice where she is based, including the closure of the waiting room and toilets to minimise patient contact with surfaces and to reduce the number of people in the practice at any one time. Commenting on the decontamination required post COVID, Hannah said dentists stick to the letter of the guidance but they would like to see a significant evidence base for these rules, considering the huge impact this is having on the viability dental practices.
Eddie pointed out that many practices provide both NHS and private dentistry and the latter often subsidises NHS running costs. He highlighted that even before COVID 4 million people were struggling to access NHS dentistry and warned that if private practices go bust this would exacerbate these problems. Eddie also explained that if dentists were unable to provide aerosol generating procedures for any length of time this would make private dentistry uneconomic, and some dentists were now looking outside the profession to boost their income.
We need proper science: dentists in Europe can carry out AGPs, the situation here is bizarre
Last night BBC’s Reporting Scotland featured interviews with BDA chair of SDPC, David McColl and SDPC member, John Davidson about the next phase in dental practices opening in Scotland. From Monday, it was announced that dentists would be able to do oral cancer checks and people could have dentures and braces fitted, but they would not be able to do aerosol generating procedures (AGPs).
Speaking from his practice, John said we need proper science and pointed out that in most countries in Europe, dentists are able to carry out AGPs, describing the situation here as 'bizarre'.
However, the presenter noted that if patients could afford it and dentists can provide the appropriate PPE, there were no restrictions on doing AGPs. David expressed concern that dentists could go bust unless they
get a better sustainability package.
BDA Radio Merseyside - capacity to see dental patients reduced to 25%
This morning, BBC Radio Merseyside’s presenter, Tony Snell, spoke about his recent visit to the dentist, which he said was much better than he had anticipated. This segment also included an interview with Mark Woodger, BDA spokesperson and also local hon LDC secretary. Mark explained that since the pandemic dentistry is no longer ‘business as usual’ and that his capacity to see patients has been reduced to about 25%, but he assured listeners that it was very safe to see your dentist. He was unable to say when the backlog of patients could be seen, but for now, he said, urgent cases were prioritised. He also expressed concern over the fact that patients are missing out on oral cancer checks and he urged any listeners with such concerns to see their dentist who could refer them to a specialist if required.
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30 articulated lorries of PPE to be distributed to dentists and Stormont health committee raises query about fallow time
The acting chief dental officer told Stormont's Health Committee that the health service is “fighting a short-term and a long-term battle”, BBC NI reports. Michael Donaldson said oral health groups, concentrating on children and older people, (that were being created at the start of the year), will be revived as quickly as possible. He said the challenges posed by Covid-19 were considerable, and it was just a question of how quickly those groups could be put together. The BBC referenced the BDA as stating that dentists in Northern Ireland have been able to provide non-urgent care to the public since 29 June; they are expecting to be allowed to carry out AGPs from 20 July.
Mr Donaldson also said that level one personal protective equipment (PPE) for dental services, announced by Health Minister Robin Swann last week, should start to be delivered from next week. Mr Donaldson said dentists had asked the Business Services Organisation (BSO) if level two PPE would be available at the same time. He said that supply could not be provided without “possibly affecting the ability to provide to trusts and the wider health service". It was also noted that dentists usually pay for their own PPE, but the health minister has announced that 3m items of PPE would be provided free of charge. Mr Donaldson said the amount of PPE to be distributed to dentists was "colossal" - requiring 30 articulated lorries and more than 700 pallets to be transported. He said the delivery of PPE next week should enable an estimated 38,000 patients to be seen each week, which was a "very significant advance" on the 4,000 emergency patients seen weekly during the pandemic.
During the discussion, Alliance MLA for South Belfast, Paula Bradshaw, asked where the evidence was for the requirement for the fallow time between AGPs. Mr Donaldson said the advice had come from Public Health England (PHE), and that he had not reviewed the evidence on which PHE had come to that position. He said NI had altered the approach to what dental practitioners could do, so it had been tweaked for the local situation. "Nobody in the UK at this time challenges the AGP advice from PHE, but that report is under review." The committee's chairman Colm Gildernew said that was "extremely worrying".
Coronavirus: Both 'short-term and long-term battle' being fought, says dental chiefPPE delivery for dentists is 'colossal'
Wednesday 8 July
The Huffington Post: Why we are having avoidable tooth extractions
The Huffington Post reports on people who have been suffering toothache during the COVID-19 pandemic. It reports that while high street dental practices in England have been able to re-open since 8 June, dentists are only able to offer a limited range of treatments. This is largely due to the restrictions on the types of treatments, which are termed aerosol generating procedures, that can be offered and require hospital level personal protective equipment (PPE). The article quotes BDA chair, Mick Armstrong, explaining that many practices have been left with the only option of extraction of teeth that could have been saved, to deal with dental pain. He noted that as long as current government guidance and PPE shortages continued then procedures that could have saved a patient's tooth would not be able to take place. He went on to point out that with a collapse in patient numbers and the huge increase in PPE costs that many high street dentists may not be able to survive the 'new normal' and may close. The Huffington Post pointed out that it had contacted the Department of Health over the cost and shortage of PPE in dentistry and was awaiting a response.
Tuesday 7 July
Metro: Social distancing measures are leading to extra costs for dentists and other ‘close contact’ businesses
Businesses that have to be in close contact with their customers, such as hairdressers and dental practices, are having to adapt to the new rules of social distancing and COVID safety measures, the Metro reports. The article points out that while many close contact businesses are now open in England, they are having to follow government guidance, which calls for mitigating actions to reduce the risk of contracting covid-19. It also notes that that these measures cause businesses extra expense, such as the provision of personal protective equipment (PPE). The article quotes Mick Armstrong, the chair of the British Dental Association, who explained that dentists can only operate at a quarter capacity and are facing PPE costs that have increased by 6000%, due to the pandemic. He notes that without government support many dental practices may close. The article profiles Harley Street dentist Patrick Tarrant, who is glad to be able to re-open but has had to spend £15,000 on adapting to social distancing and is having to charge his patients a surcharge of £45 for the cost of PPE.
Monday 6 July
Mail on Sunday: Dentists: We need to fill cash hole
The Mail on Sunday featured an interview with chair of BDA Dental Practice Committee, David McColl as Scotland enters phase three of the route out of lockdown, when 'routine' treatments can be carried out again from July 13. The article points out that dentists fear social distancing and other restrictions will mean they can treat only a fraction of the patients they did previously, massively reducing their income. But – as the article notes – they still face the same costs for staff, equipment, cleaning and bills – as well as increased bills for PPE in the private sector, and infection control measures. The Scottish Government provides PPE for NHS dental practices but David pointed out that other costs have to be considered and talking about 'routine' care from the 13th sends out the wrong message. He explained that most practices provide a mixture of NHS and private with treatments, such as white fillings, subsidising the underfunded service. He added: 'Without that activity going on a lot of practices would go under, [as] NHS dentistry is chronically underfunded. We've had a financial stability package but as practices start opening again this needs to start going up.' Dentist Andrew Scott in Aberdeen said: 'Private practices have had no support and have been under great financial pressure. It is causing a lot of stress and mental health problems. We need more financial help.'
A Scottish Government spokesman said: 'We have provided additional funding to NHS dental services during the period of lockdown and will be maintaining this as dental practices begin to open. 'We will keep this funding under review to protect NHS dental services. We would also encourage private practices to take advantage of the range of business support initiatives available from the Scottish Government and UK Government.'
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The Shetland Times: Extra protection for dentists visits
The Shetland Times reports that some dental visits have resumed in Shetland, but with a host of new measures in place to prevent patients spreading the virus. Patients need to contact their dental practice, phoning first to see if they are able to have a face to face appointment. When they visit a dental practice a patient will need to observe social distancing guidelines and will notice that dentists are wearing personal protective equipment. NHS Shetland has acknowledged that these conditions are not ideal, but they must follow national guidelines. David McColl of the British Dental Association said the resumption of appointments would come as a great relief. He noted that it came after dentists had been waiting a number of weeks for clear guidance and a firm response. He also noted that the fragmented response to re-opening dental clinics had led to widespread confusion.
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LawPod: Challenges for Dentistry during Pandemic
Our Head of Indemnity, Len D'Cruz, has done a LawPod podcast on dentistry and the pandemic.