Dental practices have been instructed to remain open in all tiers of COVID-19 restrictions and throughout the current lockdown.
NHS dentists are open but services are limited due to the extra precautions being taken for COVID-19.
To help keep their patients and dental teams safe, some NHS dentists may be restricted to an emergency and urgency only service during the COVID-19 pandemic.
Is NHS dentistry safe?
NHS dentists across England have been sent a clear message to focus on volume of patients over need.
In stark contrast with NHS dentists in Scotland, Wales and Northern Ireland, and against advice from the British Dental Association, the government has imposed high financial targets on NHS dentists in England. Any NHS dentists that fail to meet government targets will face steep penalties. The targets put pressure on NHS dentists to see as many patients as possible, and to abandon some of the time consuming precautions they were taking before the targets we introduced.
These targets are the wrong choice, at the wrong time. COVID rates are surging, and many patients will understandably be reluctant to attend. Why are ministers encouraging potentially unsafe volumes of patients into practices?
These targets are bad for practices and bad for patients. Perverse targets will force dentists to focus on routine cases, over the huge backlog of urgent cases that need priority.The British Dental Association
It seems, however, that the government and NHS England are happy that the risk in dentistry is reduced to an acceptable level.
The risk with COVID-19 and dentistry
Unlike most other infectious diseases, it is feared that COVID-19 may spread between people in tiny particles of water called aerosols. Aerosols may be generated by common dental procedures such as drilling, scaling/cleaning, blowing cold air and water, and even by coughs and sneezes.
Larger splashes and droplets of water tend to fall to the floor and can be easily cleaned away and disinfected between patients. The much smaller and lighter aerosols can stay in the surgery’s air for around an hour – until the air in the room is changed.
All dental practices carefully screen all patients to help avoid patients with COVID-19 symptoms from attending the surgery. It is known however, that some patients who are infected with COVID-19 do not display any symptoms. It is thought that these asymptomatic but infected patients may still have the virus in their saliva. Dental treatment on these patients could generate aerosols containing the virus and potentially infect the following patients and staff.
COVID-19 Risk management in dentistry
While it is not possible to eliminate the risk associated with coronavirus in dentistry, this risk is currently being managed by:
- operating a telephone triage service to book face-to-face appointments
- requiring patients to wear face coverings
- asking patients to attend alone to help social distancing
- asking patients to social distance while inside dental practices and using protective screens where social distancing is not possible
- use of appropriate PPE
- avoiding aerosol generating dental treatment where possible
- leaving a ‘fallow time’ of up to 1 hour after any aerosol generating procedure to allow the air to change before thorough cleaning
- using technology to help change and/or filter the air after any aerosol generating procedures to help reduce the required fallow time
Affect on capacity
The fallow time and social distancing are having a negative affect on the capacity of all dental practices. It means less appointments are available each day, and practices may have to use a waiting list for some treatments.
How and when to see your dentist
NHS dental practices are trying to prioritise dental emergencies and urgencies. You may have to wait for routine treatment, but emergency and urgent appointments and advice should be readily available.
If you are already registered with a dentist then the best way to find out how and when you can and should see your dentist is to check your dentist’s website for more information.
If your dentist does not have a website then you should call them and ask instead.
Do not attend your dental practice without first having booked an appointment. All dentists are still operating a telephone triage service to book appointments. You will not be permitted to walk-in or sit-and-wait.
Emergency and urgent dental treatment
Routine dental treatment
If you are not registered with a dentist already then you should search for a local NHS dentist. Be prepared that you may have to travel further than you would like due to. The restrictions in place to help manage the risk of COVID-19 have reduced the capacity of dental practices so that most do not have the spare capacity to accept any new patients.
Dental practices are not restricted by catchment areas so you can register with any NHS dentist accepting new patients. You can also register at more than one practice. So should a more conveniently located practice start to accept new patients in the future, it’s fairly easy to register again.
Registering with a new NHS dentist takes time and so is usually only suitable when you need routine treatment.