29 May Jonathan Cartu Reports: Dentists to reopen in the UK on June 8
Dentists in the UK are set to reopen in the UK on June 8, following Boris Johnson’s speech today. However once they do, it’s not going to be business as usual.
‘A return of high street dentistry will be welcome news to millions of patients left with few options during lockdown,’ says Mick Armstrong, chair of the British Dental Association, in a briefing following the Prime Minister’s address. ‘Dentists will be keen to start providing care as soon as safely possible, but we will need everyone to be patient as practices get up and running.’
On May 28, chief dental officer Sara Hurley released ‘return to work’ guidance for dentists in the UK. It includes details on everything from the preferred patient flow and practice layout that’ll encourage social distancing and minimise the amount of people in the practice at one time, to hand-washing signage and hand sanitising stations to promote excellent hygiene and keep staff and clients safe. It means your traditional dental appointment as you knew it is set to change.
What will I have to do before my appointment?
‘Many practices are already re-opening in the US, and I expect the new process for their appointments to be similar to the UK,’ says orthodontics specialist Dr Emma Laing. ‘If this is the case, a health questionnaire will be sent to the patient beforehand, then if well, patients (who will have to attend solo) wait outside or in their cars for their appointments until they are greeted by an assistant who will take their temperature before allowing them in.’
Once inside, you’ll be required to clean your hands before and after any treatment at one of the many stations. Once your treatment has been completed, you’ll have to leave the surgery immediately, paying only with a contactless method or via bank transfer.
‘We’ll call to brief our patients beforehand so they know what to expect when they arrive,’ says Catherine Tannahill of Portman Dental Care. ‘We may also require them to complete and return a new medical history form digitally.’
‘There will be only one person at a time in the waiting room, and if the patient is escorted, they will be told that the person waiting for them can have a coffee around the corner to avoid the clinic becoming crowded,’ says Dr Rhona Eskander of the Chelsea Dental Clinic.
How will securing appointments work?
So that unnecessary contact is kept to a minimum, appointments will be scheduled over the phone or online only. There’ll also be a 30-minute turnaround time for decontamination between appointments: the main risk in dentistry is aerosol creation when using the vibrating water cleaners. There’s speculation among dentists that the use of aerosols could be prohibited once they initially re-open, particularly as they work so closely to the respiratory tract.
Regardless, a deep clean will be needed between patients, so less appointments will be scheduled in one day to make time for this. It means you’ll likely have to wait a little longer to secure an appointment as there’ll be less available.
‘We would typically see 10 patients a day,’ says Dr Mervyn Druian from The London Centre for Cosmetic Dentistry. ‘Currently, however, we are looking at a maximum of four or five patients a day.’
Will a full range of treatments still be available?
Treatment options will differ between practices depending on what they’re able to offer, but generally, emergency treatment will take priority.
‘We’re hoping to open for emergency treatment first, and in my clinical opinion we can’t delay some of the emergency cases any further,’ admits Dr Druian. ‘At the practice we currently have ten patients who (without seeing them and being able to fully diagnose) I would deem urgent and 20 who need to be seen in the next month.’
With a backlog of emergency treatments, less appointments overall and a huge question mark on whether treatments regarding aerosol can continue, it’ll be a while before routine check-ups are available every day.
Will I have to wear a mask and gloves?
By its very nature dentistry is as hygienic as possible due to cross infection control, and dentists have long been wearing gloves, masks and protective clothing. This will continue, with the addition of hair coverings, perspex visors, eye protection and shoe covers. As dentists can’t carry out social distancing during routine check-ups or treatments, they’ll wear full medical-grade PPE.
Previously, this wasn’t necessary for patients, but in a post-Covid world, it’ll be an essential. When undergoing treatment, of course said mask will need to be removed, but shoe covers will be given out and you may need to place coats and accessories in a sterilised box for collection on your way out.
These will all be provided by the surgery on arrival to ensure they offer full protection, though dentists have expressed their fears over having to add a PPE fee to each patients’ bill to cover the new costs: ‘each gown is £5 and needs to be thrown away after each patient, and our total PPE cost per patient is £25,’ advises Dr Druian.
Will the practice look different to before?
It’s likely your practice will have perspex shields erected to protect receptionists, and a single entry and exit point will likely be in place. New floor markings will advise on how to navigate the practice at a safe distance from others, and signs will make them easier to find where you need to be and avoid wandering around.
‘All dental waiting rooms and dental surgeries will be fitted with Radic8 clean air systems,’ advises Dr Eskander. ‘These systems were developed in South Korea in 2004 in response to the SARS outbreak, and have been proven to kill coronaviruses in the air, and ensure that airborne, droplet viruses, such as Covid-19 are neutralised before they are inhaled.’
Sara Hurley’s return to work guidelines state that waiting rooms should be reconsidered: magazines, TV remotes and toys should all be removed, with chairs two metres apart, though patients should be encouraged to wait outside.