Friday 14 August 2020
BBC Radio Foyle: Routine care is no longer very routine
During an interview on this morning’s Breakfast Show, BBC Radio Foyle, BDA Northern Ireland president, Paul Brennan said that most dental practices’ capacity to treat patients was vastly diminished, by at least 50% compared to pre-Covid. He referenced recent WHO guidance on treating dental patients and said this was how most people are being treated in Northern Ireland. It has created a very safe environment for patients, he said, but it was very slow, as dentists are struggling with months of backlog, and also an hour’s fallow time.
Most practices are seeing their own patients, he said, and carrying out what treatment they can but it is extremely difficult, and in some cases, patients would be referred to the urgent dental care centres. He said that routine care is no longer very routine any more, and the whole experience for patients is very different and the environment for the dental team had changed too, with PPE, taking temperatures and managing people in and out of the practice.
He also drew attention to the BDA’s concerns about the viability of practices in the long-term. He said the NHS element of practices had got support from the Department of Health but he was concerned about the viability of mixed practices, as most are in NI, and health service practices too if the support mechanisms weren’t kept in place. We’re not coming out of [this pandemic] any time soon, he said, and this will probably continue well into next year.
Listen from around 7.56.
Wednesday 12 August 2020
BBC Radio 4: Dr Mark Porter in discussion with Eddie Crouch on the challenges faced by dentists
Last night’s episode of Inside Health on BBC Radio 4 explored the impact of covid on dentistry in a wide ranging interview with BDA’s vice chair Eddie Crouch. The presenter, Dr Mark Porter (MP), introduced the dental segment by pointing out that because of the high risk of cross infection in many dental procedures high street dentistry had all but disappeared during lockdown and while practices are now open, the service in this new covid era is anything but normal. Eddie explained that since 8th June when practices reopened in England that Public Health England dictates that once dentists have done a treatment that involves a spray or an aerosol the surgery has to be remain completely unused for an hour afterwards, while any potential spray or aerosol settles on the surface so that surgeries can be cleaned appropriately for the next patient. He added that we are one of the few countries in the world operating at an hour’s lag from seeing a patient to when we can get the next patient in; many countries are operating with far lower fallow time than we are using in the UK, and many of those counties are using absolutely no fallow time at all. Eddie emphasised that we need to be sure the science is right, and certainly we wouldn’t want to operate in an unsafe environment for our patients but whether an hour is really justified is what the profession is asking and the sooner we have that answer the better.
MP said: “The implications for the surgery are that you could have an empty room for 4/ 5 hours a day when you’re not seeing patients; what sort of knock on has this had on the number of patients that each dentist can see a day?” Eddie replied that it has had a massive effect, as you can imagine. “Pre-Covid an average dental surgery would see about 30 patients a day, now they would see between 25% and 50% of those numbers and that’s having a terrible effect on patient care and it’s a stressful time on the viability of dental practices.”
MP asks: A typical dentist might only see fewer than 10 patients a day? Eddie agreed, adding that virtually everything a dentist does involves a spray or an aerosol, even check- ups, he said, where a spray of water has been used could be classified as an aerosol generating procedure. There is a theoretical risk that these carry viral particles into the atmosphere, Eddie said. He went on to say that sometimes patients opt to have a tooth out instead of waiting even longer for an AGP, such as a root canal treatment, that might save the tooth. Sadly, he said, many patients have had teeth taken out because they have got completely frustrated with the pain they have been in and having to wait so long to have an AGP. MP – Just to be clear, the tooth might be able to be saved if they have an AGP, it was easier and simpler to remove a tooth?
Eddie explained that this isn’t what dentists want, adding that the difficulty we have is the lack of science. He said there is a review of the standard operating procedures that we are carrying out, PHE said this review would be there for the profession to see about two or three weeks ago but sadly that hasn’t come out yet. We are dealing with a theoretical threat of the virus particles in the aerosol and there were a huge number of papers that have been generated across the world that PHE are looking at to see whether we can modify what we are doing at the moment and to make it easier for patients to get into practices and for dentists to see more patients. Eddie then went on to discuss the longstanding access problem to NHS dental care, and highlighted the BBC survey from last autumn which showed that nearly 4 million people were struggling to access care. He also warned that if many of these practices go to the wall it will have a huge impact on access dental surgery.
MP said that if he were a florist, he could have got help, and wondered why dental practices have fallen through the cracks. Do they not qualify for help? He asked. Eddie said that dentists virtually qualified for nothing, and one colleague did a freedom of information request to his local council and found that every single premise on the high street had had some business rebate, and he had absolutely nothing because the dentist was earning more than £50,000. The outgoing for dental practices are incredibly high, most of the equipment we buy is on monthly repayment schemes.
Listen from 21.09.
Mail says avoid non-urgent treatment
article in the Mail mistakenly claims that guidance from the World Health (issued on 3 August) Organization means that people “should not attend dentist appointments unless they are urgent until the risk factor from coronavirus is better understood.” This misinterpretation of the guidance, also states that patients and dentists should avoid non-urgent appointments until research on this is completed.
The article goes on to say that many surgeries faced a dramatic change to normality when they reopened on June 8th, with commentary from England’s chief dental officer, Sara Hurley. It said the BDA welcomed reopening plans at the time but warned that expectations need to be managed, and infection control and social distancing measures could reduce their capacity to see patients by up to two-thirds.
Northern Ireland: Dentists 'little option' but to pass on 'sky-rocketing' cost of PPE
Several news outlets in NI report that dentists have begun charging patients for PPE – claiming the cost of treatment has “sky rocketed”. It quotes the BDA as saying our members had “little option” but to pass on the increase, which has jumped as much as 6,000% for a single procedure. The number of people dentists can see has also dropped – to a quarter of pre-coronavirus levels because of new rules requiring a one hour gap between some patients, they said. On social media patients have reported an extra charge from £8 to £40 for protective gear. Stormont has kicked in £3.8million to cover the cost of high-grade equipment, which wasn’t included in a shipment of equipment supplied by the government last month.
NI dentists 'little option' but to pass on 'sky-rocketing' cost of PPE with reports of £40 charge - Belfast Telegraph
NI Dentists charging patients for PPE as treatment costs soar - Belfast Live
Tuesday 11 August 2020
Dental care exempt from charges plummets by a third, NHS Digital figures reveal
The British Dental Association says the system for claiming free care is a “nightmare by design”, and has led to thousands of fines and a huge drop in attendance – which will be made worse by the Covid-19 pandemic. Adult patients in Blackburn with Darwen received 14,265 courses of treatment exempt from charges in the first six months of 2019-20, a new NHS Digital biannual report shows. This was 1,708 fewer than during the same period a year earlier – an 11% drop in treatments. And it represented a 32% fall from the first half of 2013-14, the earliest year with comparable data. Compared to 2013-14, dental care exempt from charges plummeted by almost a third.
Charlotte Waite, chair of the BDA's community dental services committee, said NHS dentistry will see a huge drop during the pandemic, but added that the fall in free care was “entirely man-made”. She added: “The system by which many often vulnerable patients claim is a nightmare by design, where mistakes come with a £100 penalty charge. It’s left hundreds of thousands of innocent people facing fines and encouraged millions more to miss out on care. Parliament instructed government to change tack, but sadly patients who tick the wrong box on a form are still being treated like fraudsters."
The NHS launched a video campaign warning that “not all benefits entitle you to free treatment”, and that false claims – even those done by mistake – could result in a £100 fine.
1,500 fewer free dental treatments given to adults and children in Blackburn - The Lancaster and Morecambe Citizen