Yasmin George, a general dental practitioner, on the frustrations of not being able to treat patients during the lockdown and the challenges of returning to work from 8 June.
With the news, yesterday, that
dentists can finally reopen in England to see patients face to face - patients, dentists, and their staff will be breathing some sighs of relief.
However, as a dentist of 30 years, with a passion for ensuring all patients are assessed and treated promptly, I don’t think we are going to be able to meet the expectations of all of those who are going to need to see us, just yet.
There are still going to be problems in being able to treat patients the way we would prior to lockdown. Coronavirus has not gone away, and the risks associated with doing AGP treatments in dentistry, the confusion around cross-infection protocols, and the shortages of PPE (and the sky-rocketing costs), have also not gone away - which means we are not out of the woods yet.
The pitfalls of looking after patients remotely
Prior to the lockdown if a patient rang my practice with a serious concern or problem, my team and I would always do our best to see the patient the same day.
The lockdown and the immediate shut down of dentistry meant that dentists had no opportunity to see their patients who were at critical stages of treatment, or - relevant to my area of dentistry - make safe or deactivate orthodontic appliances which would normally be supervised by me on a 3-4 weekly basis.
Instead, I was forced to look after my patients remotely by telephone, Zoom and Facetime.
I’ve been providing orthodontic care for more than 27 years, and never in that time have I had to deal with quite as upsetting and difficult a case, like the one I experienced last week.
Charlie’s mother emailed me the two photos above and rang to ask for my help. The pictures are of 11-year old Charlie, who was just about finished with a short course of orthodontics and who was supposed to get his braces removed, but couldn’t due to the then lockdown restrictions on dentistry.
Losing hope: resorting to DIY dentistry
His parents tried their best to keep his teeth and braces clean, whilst they waited to hear news of when they could get to see me, but they were fast losing hope.
The braces were meant to ensure that his mouth had enough room for all of his adult teeth and they did exactly what they were supposed to do; but because they couldn’t be removed at the right time, one of his baby teeth fell out with the braces still attached.
This child was left in a very uncomfortable situation, unable to eat or close his mouth. Talking and drinking were incredibly difficult for him as well. His parents were beside themselves with worry and frustration and they contacted me immediately.
As soon as I saw the photos, I knew this was going to be difficult to resolve remotely. I was very upset to have to reluctantly advise them to try to remove the tooth from the brace using pliers. This is not something I would ever have imagined myself saying to a patient’s parents and was a strategy fraught with potential complications and the risk of making the problem worse.
The fact that we have come to the point of having to suggest DIY dentistry to patients because they are in such dire straits, is like a bad dream.
The parents managed to remove part of the tooth to make their child more comfortable. However, there is still a chunk of the tooth left on the bracket, that they couldn’t remove. This child needs to be seen as soon as possible before things get worse.
At the time this happened, dentists had no idea when they would be able to see their patients. For 9-10 weeks we had no idea of the way forward or any clarity on what the next steps were so that families weren’t continuing to be left in such awful circumstances.
Getting face to face with the dentist won’t be easy
I am now doing my best to get my practice up and running, but shortages of PPE will hamper us, the restrictions around what we need to do to ensure we keep ourselves, and our patients, safe, will mean we are going to have to make some tough decisions on who to prioritise first and how we are going to make the financial side work.
As a BBC reporter said during an interview I recently gave highlighting Charlie’s plight, "Getting face to face with the dentist won’t be easy".
Dentists shouldn’t have been left in limbo in these awful times. As an experienced private practitioner, but not a business owner, I and many others have been left without any support during this crisis.
I could not access any of the Government’s financial support packages, and this has caused me a great deal of concern and worry.
Charlie’s mother said: "It’s crazy that I can get a plumber, but I can’t get a dentist to see my son. Dentists need to be able to help their patients during this time."
I couldn’t agree more. We all want to get back to treating our patients, but our new normal is going to look quite a bit different from the way we used to work. We need some clarity on how this 'new normal' is going to work for all spheres of dentistry in practice.