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In the news week commencing 2 November 2020

National and local media coverage we've received week commencing 2 November.

Friday 6 November

Charities and unions urge Gavin Williamson to fund free school meals over Christmas
Britain's leading food charities have joined education unions, doctors and dentists to call on education secretary Gavin Williamson to guarantee poor children don't go hungry over Christmas. In a letter to the cabinet minister, shared with HuffPost UK, groups including FareShare, the Women's Institute and the Food Foundation said that the government should back footballer Marcus Rashford's plea to ensure extra support over the festive period and beyond. Williamson is asked to "commit to funding benefits-related free school meals during the Christmas holiday period and through to Easter 2021, including children from households with no recourse to public funds". The letter calls on him to urgently provide funding to councils to allow them to step up and set up emergency food provision in their local communities via grants, food banks or local voucher schemes. The news coverage in HuffPost and MSN includes the letter and lists the 30 signatories to it, including BDA Chair, Eddie Crouch, as well as the National Education Union and Unison, charities Save the Children, School Food Matters and the Children's Food Campaign, and council chiefs. The letter highlights that more than a million people have now signed the parliamentary petition promoted by Rashford, which urges ministers to implement key recommendations from the independent National Food Strategy. This includes expanding access to free school meals, providing meals and activities during holidays to stop holiday hunger and increasing the value of and expanding the Healthy Start scheme for pregnant mothers.

The articles claim that Government insiders have hinted that Johnson is planning a comprehensive package that would mean help being given through the welfare system rather than through free school meal vouchers, but to date no details have been given.

Thursday 5 November 

How can I maintain good oral hygiene without flossing?
This was the topic covered in the Times today, in a new series on health which invites experts to offer their recommendations that is underpinned by science. There were contributions from the BDAs scientific adviser. Professor Damien Walmsley, as well as Ian Needleman, professor of periodontology and evidence-informed health from the Eastman Dental Institute, and Ruth Freeman, co-director of the dental health services research unit at the University of Dundee. The article drew attention to the limitations of flossing over interdental brushes as per the Cochrane review of flossing, and the benefits from cutting down on our sugar intake, quitting smoking and seeing the dentist regularly. Damien emphasised the importance of getting the basics right because, he said, that too many surveys show that people are either not cleaning their teeth twice a day or skimp on the time spent on brushing. He advises people to brush your teeth twice a day with a fluoride toothpaste for at least two minutes before you go to bed and one other time. He says the reality is that we spend a dismal average of 45 seconds, with 48 per cent of people in a survey failing to meet the two-minute mark. Another tip he offered readers was to spit, don’t rinse, after brushing to keep the fluoride in contact with your teeth for longer; this makes your teeth more resistant to tooth decay.”

Nine rules you may have missed as England is plunged into second lockdown –  as dental practices remain open

The Mirror highlights that people will be able to see their dentist during the second lockdown in England which started today. It lists dental visits among nine of the lesser-known lockdown rules, which the Mirror gleaned from the government’s ‘huge 32-page document’ on the dos and don’ts of what you can and can't do this time. The Independent also noted that the dental practices would be open by contrast to the situation during the first lockdown. The news outlet repeated its earlier assertion that the BDA tweeted [ie prior to the government’s announcement on the state of play for dentistry) that, “we are supporting the NHS to safely carry out urgent and non-urgent services and it is vital anyone who thinks they need any kind of medical care comes forward and seeks help".

Tuesday 3 November

BDA seeking urgent clarification on the status of dental services
ITV Lunchtime News yesterday reported that the BDA told the programme they were seeking urgent clarification on the status of dental services over the next month, but that clarification had just come through and that if you do require dental services you will be able to access them. In March 12,000 dental practices were shut and 100s of UDC centres were set up with varying degrees of success.

Not available online.

Various national and local outlets also reported on the story:
The Daily Express - Dentist in lockdown: Are dentists open during lockdown? Can I see a dentist?
The Metro - Will dentists be open during lockdown in England?



Staying healthy in lockdown: How to look after your body while at home
The Daily Telegraph reports on what next month will mean for our physical health with gyms closing and the weather worsening. Professional bodies such as The College of Optometrists, British Dental Association and the Chartered Society of Physiotherapists are advising members to stay open and continue taking appointment bookings as normal. However, the Government has suggested that key workers get priority during the upcoming lockdown, so booking an appointment might prove harder than usual. If that’s the case, don’t panic. “We will get patients in,” assures Dr David Cottam, chair of the BDA’s General Dental Practice Committee and a practising dentist. “If patients are in trouble or it’s an emergency, we get them in. If you have a problem, call your dentist. Don’t think they won’t be able to see you or give advice over the phone. Emergencies are being looked after and looked after well.”

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Patient expectations need managing as ‘full service’ resumes in Renfrewshire  
Renfrewshire News report that BDA Scotland has warned that the reintroduction of the ‘full range’ of NHS treatments will not signal a return to routine care, as a new poll reveals the limited capacity in the service.  Quoting BDA data from practices across Scotland the article highlights that two-thirds are operating at less than a quarter of their pre-COVID capacity, 80% report less focus on routine NHS dentistry, 53% are reporting more focus on urgent cases, and 63% stating less focus on cosmetic dentistry. The greatest levels of concern with the Scottish Government’s performance has been on managing patient expectations, where 84% of practices expressed dissatisfaction with the government’s record. This compares to 43% dissatisfied with access to PPE, 58% on financial support. 82% were dissatisfied with the government’s overall performance during the pandemic in relation to the service. The BDA has welcomed positive signals that the Scottish Government is developing communications to provide a needed ‘reality-check’ to patients. It has said clear and consistent messages from government and all NHS Boards are now essential to reduce patient frustration and prevent practices and their staff from being overwhelmed. While the BDA has recognised growing anxiety about an increasingly ‘two-tier’ system in Scotland it has questioned the timing of reintroduction of a full range of NHS dental services when COVID transmission rates are increasing significantly, and a huge swathe of the country is already facing Level 3-type restrictions. David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said: “November will not mark a return to ‘normal’ dental services in Scotland. Since the return to a ‘full range’ of services was announced the phones at many practices have been ringing off the hook. Dentists may be able to offer a wider range of treatment but now face demand that simply cannot be met.”

Daily Record - NHS dental treatment resumes in Scotland but priority given to 'emergency care'

Monday 2 November

Can I see the dentist in lockdown 2?

Following the Prime Minister’s announcement on Saturday evening to England that a second lockdown would be implemented from Thursday, several news outlets have been speculating - in the absence of government confirmation - whether dental practices will be open or closed during this period. The Manchester Evening News said the British Dental Association expects the situation to be different this time round - though the government has yet to officially confirm this. It quotes from the BDA’s website: "Based on the Government guidance so far published our interpretation is that dental practices will continue to operate as at present. The guidance says that individuals can be outside of their homes for specific purposes, which include ‘for any medical concerns, reasons, appointments and emergencies'. The guidance also says that: ‘A number of public services will also stay open and you will be able to leave home to visit them. These include... the NHS and medical services like GPs. We are supporting the NHS to safely carry out urgent and non-urgent services and it is vital anyone who thinks they need any kind of medical care comes forward and seeks help.” BBC Radio 5 Live Breakfast programme cited the BDA’s twitter account at 6.59 this morning as stating that the Association sees no reason why practices should shut. The presenter said the BDA noted that medical services, such as GPs would be available and, in our view, this should include dentistry. She added that [in the absence of any formal notification] the BDA would provide an update, as soon as we know.

The Sun reported on the situation for dentistry since lockdown, pointing out that now ‘dentists can continue somewhat normal service by seeing patients face-to-face as long as strict measures are adhered to.’ It added that dentists were only able to see five patients when they reopened in June and most practices have been running a "skeleton service", with a warning from the BDA that there would be no return to "business as usual" for dentists. It noted that when practices opened in June that one of the biggest concerns back then for dentists was the lack of personal protective equipment for their practices. The article also highlighted the range of measures adopted by dental practices to ensure social distancing. “In reception and waiting areas, markers have been placed two metres apart while perspex shields are being used as physical barriers. Staff are expected to be screened daily and face regular risk assessments. Patients' time at reception desks will also be minimised, meaning digital appointment booking systems to be in place and limit on receipts. In the treatment rooms, appointment times have been amended so that there is enough time in between to ensure decontamination protocols are being followed. Meanwhile, sanitising stations have been put in place for patients to use upon entry, while dentists are required to have sufficient PPE stock in advance with many already wearing during treatment.”
In its update, the Independent cited several dental organisations, including the BDA which said it was seeking urgent clarification in light of Boris Johnson’s speech on Saturday. It also highlighted the Conservative Dentists’ group tweet on Saturday that Jo Churchill, the parliamentary under-secretary of state for prevention, public health and primary care, had confirmed dentistry will remain open during the second lockdown.

Meanwhile, the Express highlighted the British Association of Private Dentistry announcement that private practices would remain open for routine and emergency treatments during the second lockdown and it was safe to attend the dentist.

Scotland: As NHS treatment restarts, there are fears of rocketing waiting lists and faster treatment for private patients
DENTAL leaders have questioned why routine NHS treatment is being restarted in Scotland amid a spike in coronavirus cases as they warned that patients should not expect a return to normality. Dentists told The Herald on Sunday that NHS waiting times are “going to shoot through the roof” amid a cap on patient numbers, and that six-monthly check-ups are unlikely to ever return. There are also fears that “two-tier” access to dental care will continue as some dental practices invest in powerful ventilation systems that will enable them to see far more private patients per day, driving many more people who can afford it to pay for quicker treatment. From today (2 November), all routine dental services such as fillings, scaling and root canal can be performed on the NHS in Scotland for the first time since lockdown in March. For months aerosol-generating procedures (AGPs) have been banned in the health service amid fears over viral transmission, with patients requiring emergency. Professor Phil Taylor, Dean of the Royal College of Surgeons Edinburgh’s Faculty of Dental Surgery, said it “doesn’t add up” that practices are now being told it is safe to restart. He said: “Why, all of a sudden, can you do AGPs when we’re in the middle of a second wave that almost seems to be worse than the first in some areas? If we accept the Scottish Government logic that we can’t do AGPs on the NHS because of COVID, when prevalence was much lower, then it makes no sense to say we can start up again now in the middle of a spike. I don’t see why they couldn’t have been done from the beginning, with the right precautions.” Dentists will be limited to seeing 10 patients and performing a maximum of five AGPs per day on the NHS. They must wear full PPE, including respirator masks when drilling, and allow a one hour “fallow period” from the time the drill stops so the particles released into the air can settle.

Only then can the treatment room be cleaned, a process which adds another 42 minutes to the turnaround time according to David McColl, chair of the BDA’s Scottish Dental Practice Committee. He said: “It’s going to take a full morning to do two patients, plus we need to tie up another surgery for donning and doffing PPE and then there’s the requirements for social distancing in the waiting area. “If you think about the backlog of that’s built up since March, you can see that routine dentistry is still a long way off.” David McColl, who is based at a practice in Govanhill, Glasgow - one Scotland’s most deprived communities - said he expects the pressures brought about by COVID to usher in the end of routine check-ups, something which the profession had already been debating pre-pandemic. If someone hasn’t had a filling in three years, they’re looking after their mouth, and everything’s okay - you probably don’t need to see them every six months,” David said “Maybe more affluent patients could be seen once a year so that you can spend more time on the deprived - but it all comes down to risk assessments. We’re not going to go back to everyone getting a check-up every six months, but some people might need a check-up every three months.” David added that it was “foolish” that a full dental service was rebooting when virus levels are higher than they were in summer, but said he believes the Scottish Government is pushing it forward amid widespread criticism of a “two-tier” dental system. Since July, private dentistry has been able to carry out the full range of dental treatments, including AGPs, because the Scottish Government has no power to stipulate what services are provided in the independent sector. However, one East Renfrewshire dentist, who spoke to The Herald on Sunday on condition of anonymity, warned that two-tier dentistry “will rocket” despite the ban on AGPs in the NHS being lifted. The dentist, who works in a mixed practice providing both NHS and private care, said that while NHS and private practitioners were subject to the same guidelines on PPE, fallow time, and cleaning, some practices are investing in expensive ventilation systems which deliver at least 10 air changes per hour.

Two-year wait to see hospital dentists as result of COVID restrictions
Patients are facing a two-year delay for dental surgery as waiting times have doubled in the last year because of the coronavirus pandemic, according to the Sun. It claims that many people suffering with serious tooth problems have not been seen by specialists in hospitals, despite being sent by their dentist months ago. The article highlights that appointments had to be rescheduled because of the coronavirus lockdown, which pushed back surgeries and left tens of thousands in agony during the lengthy delays. On top of routine checks, the delays have caused fears that people with early symptoms of serious mouth diseases may have been missed. It quoted Matthew Garrett, of the dental faculty at the Royal College of Surgeons, as saying: "It is inevitable that planned dental surgery will be affected and these operations will be delayed. Where it is safe to do so, we need to try to keep services going. Already a considerable backlog has been created, and waiting lists will become insurmountable if we halt again, with disastrous consequences for patients."

The average wait time at the Eastman Hospital in central London has almost doubled, from 16 weeks last October to 28 at the end of August. The longest wait time, reaching nearly two years, soared from 60 weeks to 92 weeks for a patient needing corrective treatment to their teeth in the orthodontics department. In total, 10,303 patients are on the waiting list needing some form of oral surgery. In total, 7,781 patients have been waiting more than 18 weeks between referral and treatment. A spokesperson for University College London Hospital said: "[The trust] took a decision... to transform its services to be able to treat Covid-19 patients as well as the sickest patients in the community. This meant that routine dental appointments were temporarily halted." Meanwhile, waiting times have almost tripled at both Liverpool University and Birmingham Dental Hospital.

The Sun included commentary from BDA chair, Eddie Crouch, who said that some patients waiting for hospital treatment will end up simply having their teeth removed because of the neglect and deterioration their mouths have faced because of the delays. And he suggested that some patients showing symptoms of oral cancer – which has a low survival rate if detected late – may have been missed because they were unable to see their regular dentists during lockdown.

NHS England said: "[We] opened over 500 urgent dental centres to ensure all who needed emergency care during the pandemic got it and now routine treatment has resumed, anyone with concerns should get in touch with their local dentist, as they usually would for further advice."

Sound Health and Lasting Wealth - Thousands of Britons are left in agony as waiting times for NHS treatment double
LBC - urgent dental care
Last Saturday the BDA got a mention on Andrew Castle’s morning programme on LBC radio. In an interview with Professor Sally Cutler (University of East London) on the pandemic and health inequalities, Andrew Castle said - in passing - that he spoke to BDA chair Eddie Crouch, about the wait for dental patients to get urgent care.

Not available onine.