Dentists call for clarity on PPE as they grapple Covid backlog

Infection control rules placed on dentists could have “serious consequences” on patient care, leading dentists have warned.

Dentists have said that the number of appointments they can offer patients is being hampered by the stringent requirements for infection control in dental practices implemented early in the coronavirus pandemic.

In a letter to the UK chief dental officers, the British Dental Association (BDA) said that poor dental health is expected to have increased during the crisis.

The letter, shared with the PA news agency, raises significant concerns about delayed or missed cases of oral cancer due to delays to dental care.

Since the start of the pandemic more than 30 million dental appointments have been missed in England alone, the BDA said.

But while dentists try to tackle the significant backlog they are being hampered by infection control guidance, they said.

There have been no super-spreading events linked to dentistry, and experts have questioned whether the heavy duty personal protective equipment (PPE) required for dental procedures is necessary, the letter adds.

“Collateral damage to patient access and outcomes continues to grow while capacity remains limited by Covid-19 IPC (infection prevention and control) requirements, with an estimated 30 million appointments now lost since March 2020 in England alone and NHS practices struggling to increase activity levels across all UK nations,” the letter states.

“Poor oral health and inequalities are expected to have increased during the pandemic as a result of limited access to care, the suspension of dental public health programmes, poor lockdown diets and altered oral hygiene habits,” the letter adds.

“We remain particularly concerned about missed or delayed diagnosis of oral cancers across all UK nations as a result of reduced access to dental services.

“The impact of the current IPC requirements on the dental workforce is severe, which will have serious consequences for patient care.”

Coronavirus – Mon Jun 8, 2020
Dentist Dr Salisha Amin prepares for an aerosol generating procedure wearing full PPE at Woodford Dental Care in north London in June 2020 (Victoria Jones/PA)

The letter states that with high levels of PPE and “fallow time” – the time needed to separate appointments under the current rules – means that many dentists are struggling to see as many patients as they would like.

The BDA called for a review of the infection control guidance and of waiting room arrangements, which are also limiting the number of patients who can be seen.

It comes after a damning report by Healthwatch England, shared with the PA news agency, highlighted the struggles that patients face when trying to book an NHS dentist appointment.

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Some people have been told to wait for three years for an appointment while others are being removed from their practice lists for not making appointments sooner, according to the report.

The BDA said that the UK dental officers should work to create a “road map for relaxation of current IPC requirements in dentistry across the UK”.

BDA chair Eddie Crouch said: “It’s a year since face-to-face care resumed in England, but the restrictions we work to remain largely unchanged.

“So today we have asked all four UK Chief Dental Officers to begin work on a road map to ease restrictions.

“The risk we face today from the virus needs to be balanced against the millions unable to access care, and threats to the very sustainability of this service.

“It is time to let the experts weigh up the risk of Covid transmission with the dangers of prolonging the status quo. We know this issue is already high on the official agenda but patients and the profession deserve clarity on the way ahead.”