The following principles will underpin our safe return to a new normal:
To achieve the above, apart from the physical measures we have already put in place, we have been asked to take a risk-based phased approach on our return. We are currently putting in place all the appropriate protocols, processes and risk assessments which will enable us to welcome you back and offer you the high quality care we pride ourselves on.
As a result, our phased return and the care and treatments we will be able to provide will be based on:
The risk posed in England by coronavirus is measured by a five-level, colour-coded alert system. These levels are determined by the COVID-19 Reproduction (R) number, which is a scientific measure of how fast the virus is spreading. England is currently still at level 4.
Alert Risk Level 5 – Remote Care Phase
In the unfortunate event of a future COVID-19 epidemic wave, it is likely that we will be asked to cease our face-to face patient encounters and offer you telephone advice and referral to an Urgent Dental Care UDC hub, where it is appropriate.
Alert Risk Level 4 – Dental Health Stabilisation Phase
Once we reopen, we will prioritise the care of people who are having or have had dental emergencies during lockdown.
Whilst the Alert Risk Level is 4, we have been asked to minimise the provision of routine dental procedures which produce aerosols. These include the use of the drill and ultrasonic scaler (waterjet teeth-cleaning device).
Depending on the availability of the appropriate enhanced personal protective equipment (PPE), which we are expecting to be delivered to the UK this month, we will be able to offer emergency treatments which require the use of drill. We may still have to refer our patients to the dedicated local UDC hubs if we are faced with PPE shortages.
Once we have seen the patients who have had emergencies, we will re-instate the appointments that we were forced to cancel due to the imposed Lockdown by the government. We will call our patients in a chronological order beginning from those who had appointments in March. During your examination, we will offer you hand-scaling (removal of tartar from your teeth by hand instruments/scalers), which has been shown to be as effective as scaling with powered devices; it just takes a bit longer. You will still have your polish as well.
For patients with a broken tooth, we will be able to offer a semi-permanent filling solution (Reinforced Glass-Ionomer Filling without the use of drill), which may require replacement in the future.
For patients, whose treatment was interrupted, we are planning to see patients who have dental conditions that can be stabilised by the use of measures other than the use of the dental drill. These may include temporary fillings without the use of the drill, these are used to dress open cavities, we can also perform extractions and make dentures.
Routine fillings requiring the use of drill however, will be postponed until the Alert Risk Level drops.
Alert Risk Level 3- Resumption of Routine Dental Procedures
In this phase, we will resume the routine use of the dental drill, based on enhanced PPE availability. We will contact all the patients that require routine fillings and root canal treatment, following again a chronological approach, by reinstating the appointments which were cancelled during lockdown. Our dentists and hygienist will continue offering hand-scaling and polishing. Elective procedures such as provision of crowns will be postponed till the Risk Alert level drops further.
Alert Risk Level 2 and 1 – Full Resumption of Dental Care Provision
In this stage, the number of cases and transmission will be low, and we will be offering a wider range of procedures including scaling with powered ultrasonic devices and provision of elective treatments such as crowns and bridges. It remains uncertain whether the additional measures we have taken in the face of this pandemic will be lifted or become the new normal of dentistry.
Patients with suspected or confirmed COVID-19 who experience severe dental problems, will be referred to a local Urgent Dental Care (UDC) hub for emergency dental treatment. For our Denplan Care patients the cost of this visit will be reimbursed by our practice. Patients with suspected or confirmed COVID-19 will be asked to defer their routine care till the symptoms have resolved and they have recovered from COVID-19.
According to the NHS, some patients are at higher risk of developing more and more severe complications if they contract the virus and develop COVID-19. There are two levels of Higher Risk: High Risk (clinically extremely vulnerable) and Moderate Risk (clinically vulnerable).
We will ask any patients who are shielding and are at High Risk (clinically extremely vulnerable) to postpone their routine dental appointment at this stage, till the Alert Risk drop to 2 or 1. If you are at high risk and you develop a dental emergency, we will refer you to a UDC hub, as per published guidelines.
Patients who fall within the Moderate risk (clinically vulnerable) group, will be offered a morning appointment (first patient in the day list), to protect them form contact with other patients.
With best wishes
The Dee Shapland Dental Team
Find out what to expect when you visit the practice, here.
Find out what has been happening behind the scenes during Lockdown, here.
Find out whether you fall in any of the higher risk categories, here.
Check your COVID-19 Status, here.
Find what you need to know about Coronavirus (COVID-19), here.
The COVID-19 Risk Alert Levels are explained here.
This Blog has been written by our Associate dentist Anastasios Plessas and our Principal dentist Nicholas Dee Shapland.
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