Last updated on the 7th of June 2020
This update is to inform you about what has been happening behind the scenes whilst we were in lockdown, and how we plan to reopen our practice. This blog is a ‘living update’ as the guidelines and advice we have been receiving keep changing day by day, as new evidence and information about this novel virus are emerging. We will therefore be updating this blog as soon as new information is received and we will also be notifying you through our Facebook page.
Since the Prime Minister’s announcement on the 28th of May 2020, about dentists reopening, there have been alot of stories and headlines via social media, the newspapers and national news, which do not always contain correct or accurate information and could be misleading.
On the 25th of March all dental practices in England were forced to stop seeing patients for face to face treatment. An Urgent Dental Care (UDC) Service was put in place to treat any severe dental emergencies. We were asked to offer advice for any other less severe emergencies and triage our patients including referral to these hubs if our patients required urgent treatment. Our dentists, Nick and Anastasios, were and still are available via our emergency number 7 days a week and they have offered appropriate advice to a number of our patients. Most of the patients we referred to the UDCs were treated promptly and well. Alongside supporting our patients, our clinical team (dentists, practice manager, dental nurses, hygienist, clinical technician and orthodontist) have been keeping up to date with their Continuing Professional Development (CPD) learning new skills and keeping abreast of guidelines related to Covid.
At the beginning of the pandemic we were asked by the local community health service to donate our Personal Protective Equipment (PPE), including masks, aprons and gloves, and our Oxygen Cylinder. We happily donated part of our stock to support our community and help the NHS to save lives.
Since the global COVID-19 outbreak, there has been a shortage of PPE internationally. Despite this, Nicholas Dee Shapland, our practice owner, has sourced high quality PPE including enhanced protection FFP3 masks. However, there is a backorder for PPE and we are expecting this to arrive in the UK sometime in June.
Nick and Anastasios have also been closely following all the advice and guidance from different agencies and authorities (Public Health England, Health and Safety Executive etc), to ensure that our practice will be compliant with the relevant COVID-19 regulations. This has not been an easy task as the advice constantly changes, sometimes it’s conflicting and some of it doesn’t apply specifically to dental practices. Several measures and policies have been put in place to allow social distancing when we reopen and optimise staff and patient safety and protection. These measures include installing hand hygiene stations in different areas of the practice, placing a barrier at reception desk, maintaining equipment and stock and ordering Personal Protective Equipment compliant with the latest guidance.
Above you can see our compliant to social distancing reception area, our hand rub station and our uncluttered waiting room area (which we will not be able to use).
On the 28th of May 2020, communication from the Chief Dental Officer (CDO), Sara Hurley, was released. Although the letter was dated 19th of May, it was not made available until the 28th of May. This letter was entitled ‘A prompt to Prepare’ and it outlined some of the requirements that should be put in place to allow dental practices to reopen. Ironically, on the same day we found out by watching the PM’s speech, that dental practices will be reopening FROM the 8th of June. A letter titled ‘Resumption of Dental Services in England’ dated on 28th of May was also released in the evening of the same day, countersigned by the Chief Dental Officer and the Director of Primary Care and System Transformation, Matt Neligan. In this letter we have been asked to reopen our practice FROM the 8th of June, as long as specific training, policies and availability of Personal Protective Equipment is in place.
The British Dental Association on the 28th of May expressed their concerns about the delay in the release of the CDO’s communication.
The official government’s advice document explaining how dental practices are supposed to operate during the pandemic and how to resume dental care provision, entitled Standard operating procedure Transition to recovery A phased transition for dental practices towards the resumption of the full range of dental provision, was published in the evening of the 4th of June 2020. As a result we are currently working very hard to complete the necessary training and finalise our policies and operating procedures to ensure that all the measures required to offer you safe and effective care are in place.
Our lives and daily routines have been undoubtedly affected by this novel disease outbreak. Although we would have liked to go back to the pre-COVID-19 normality, this is not going to be the case for some time, and we need to adopt to the ‘new normal’. This also applies to your dental experience.
In summary we have been asked to observe social distancing, limit the number of patients in the practice premises at a given time, and reduce the contact time we have with you. This means that we will be able to treat less patients than before. However, we are extending our hours and working extra days at the weekends to try to accommodate your needs.
The following video describes what your dental visit may look like, based on the guidance we have received from the government so far.
Details about your ‘New Normal’ Dental Journey with us can be found here.
We understand how much you want to see us right now, and we have missed you too. We have been asked to take a phased approach in reopening our practice in order to prioritise those who have pain or discomfort. This approach has been endorsed by the latest CDO communication and it will be based on the COVID-19 Alert Risk Levels as determined by our government. Therefore, please be patient and do not call us for routine appointments. We will be calling you to rebook your appointments in due course.
The phases we will follow will be:
1st Phase: We have kept a log of patients who have had dental emergencies during the lockdown. We will make sure that we see these patients first. Of course, if you have a dental emergency (pain or swelling) please call us and we will try to see you as soon as possible. Please, note, that we may still need to refer you to an Urgent Dental Care centre in specific circumstances.
2nd phase: We will then try to see patients that are in the middle of ongoing treatment. This will be completed when we have the appropriate PPE and training and the authorisation to do so. See below ‘What about my fillings and hygiene?’ section.
3rd phase: Routine care. We have kept a log of the patients we had to cancel. We will be ringing you in a chronological order starting from the patients whose appointments were in March. Please bear with us we are hoping that it won’t be too long before we see you again.
Details about our Phased Re-Opening Plan can be found here.
Later this week (week commencing 1 June 2020), guidelines from our government and dental governing bodies, gave us a framework to plan our return to practice. It appears that the treatments we will be allowed to offer will be based on the UK ‘Alert Risk’ as determined by the COVID- reproduction number (R). Currently the COVID-19 alert risk level for England is 4 (the most severe level being 5).
For drilling and cleaning your teeth, we normally use devices that generate aerosols. We have been advised that routine dental procedures which generate aerosols, such as using the drill , should not be considered whilst the country is at an Alert Risk Level of 4 and 5. Due to the high infectivity of the COVID-19 virus, the guidelines suggest that we should be using enhanced PPE (masks, gowns, hats and visors) . These masks have to be fitted properly on our faces and we are undergoing training on how to fit check and use them properly. For your safety, your cleaning initially will be performed using hand instruments (hand-scaling), which has been shown to be equally effective as the use of the powered ultrasonic instruments that we normally use- it just takes a little longer!
There has been a lot of controversy surrounding the most appropriate personal protective equipment dental staff should use. This guidance has been continuously changing and we will be following the advice given by Public Health England. As it currently stands:
2.a For procedures which do not involve aerosols (examination, hand-scaling and extractions) they will wear their scrubs, an apron, a surgical mask, gloves, and appropriate eyewear – this is usually a full-face visor.
2.b For drilling procedures, they will wear a protective long-sleeved gown over their scrubs, head cover, an enhanced protection filter mask, gloves and additional eyewear (for example the dentists may wear a visor over their magnifying loupes/glasses).
This ‘new normal’ means that we will be able to see less patients than the pre-COVID era. Also, it means that we will not be able to hold our lovely conversations in the patient lounge, at reception or in the surgery. But please be assured that if you need to speak to us, we will be available on the phone in the evening when we have finished our working day. Most of our discussions prior and after your dental appointment will be taking place via a phone call or video call. These are unprecedented times and we are working really hard to continue to offer our high-quality care in the safest possible way.
With best wishes
The Dee Shapland Dental Team
This blog was written by our Associate dentist Anastasios Plessas and our Principal Dentist Nicholas Dee Shapland on the 29th of May 2020.
Updated on the 7th of June 2020.
What you need to know about Coronavirus (COVID-19) A blog from Public Health England (PHE)
The COVID-19 Risk Alert Levels explained: BBC
Find out more about our Phased Re-Opening Plan.
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