Patients face ‘new normal’ as dentists reopen doors as lockdown eases

The Government announced that dentists would be reopening across the nation today – but medical experts have warned people to expect a “skeleton service” as many practices are not ready to go back to life before Covid-19.

Of 229 dental practices in the region questioned in a poll for the British Dental Association, 64 per cent estimate they will be able to treat less than a quarter of the patient numbers they saw before lockdown.

Barely 11 per cent are in a position to offer a full range of treatment, and only 37 per cent have PPE to hand to provide face-to-face care.

Cash flow problems, difficulties getting practices ready for social distancing and access to childcare were other barriers to reopening.

British Dental Association chairman Mick Armstrong said: “Those expecting dentistry to magically return on Monday will find only a skeleton service.

“Practices reopening across the West Midlands now face fewer patients and higher costs and will struggle to meet demand.

“Dentists returning to work still lack the support offered to our neighbours on the high street, and even clarity on key worker status when it comes to childcare.

“Ministers must change tack if dentistry is going to survive the new normal.”

Dental practices in Shropshire that were planning to reopen today say patients will have to get used to new safety measures that have been introduced.

Patients attending appointments may be asked to wait in their cars until the very last minute and pay over the phone, while extensive cleaning practices also need to be followed after procedures.

Dawley Dental Practice in Telford was one of the surgeries planning to reopen today.

Owner Natalie Walker says she is looking forward to welcoming patients back.

She said: “We feel like our job is an essential service and we’ve felt a bit helpless.

“I’m happy the practice is reopening and I’m feeling excited about going back. Obviously it will be different.

“We’ve had to take additional precautions. Patients are going to be told to wait in their car and make their way to the entrance a minute before their appointment time.

“There will be a car park attendant and they will be directed on where to go.”

She says emergencies will be prioritised, but some routine appointments may be able to go ahead where possible.

“We have guidance to follow, for example PPE we need to wear for different procedures,” she said.

“The major risk to us is aerosols.

“After an aerosol generating procedure (AGP) we have to leave our PPE within the surgery and leave the surgery wearing our mask. We can’t go in for an hour, and it has to be fully cleaned.”

Her practice has seven dentists, but she says only three will be allowed in on a single day – and each will have access to two surgery rooms.

Natalie said: “Because you’ve got two surgeries you can switch between them.

“It might be more difficult for smaller practices. As soon as they do an AGP they will have to vacate the room.”

Despite having to shut during the pandemic, staff at the practice have been busy on the phones to offer advice to patients whenever they can.

“There’s been one of us on call each day answering the phone and giving advice to patients,” Natalie said. “Any severe cases, we’ve been able to refer to an urgent dental surgery, and we have been able to prescribe antibiotics remotely that are collected from a local pharmacy.”

Also having to adapt to the changes is Bruce Grainger, who is one of two dentists at Radbrook Dental Practice in Shrewsbury.

The practice, which he owns, was planning to reopen today but it will be on a restricted basis at first, as staff need to get their hands on enhanced PPE.

Bruce said: “We can do check-ups, temporary fillings if a tooth is broken and is sharp, and we can take impressions for dentures.”

He said dentists will still wear PPE, such as a mask, visor and apron, but will not be able to perform any AGPs for now.

“We are trying to get the advanced PPE we need. We can’t yet so we are limited in what we can do,” he added. “The whole dental profession feels slightly ignored and let down.

“There’s been a lot about hospitals and care homes and their PPE, and quite rightly so, but dental practices have been put towards the back.

“We are part of the primary care system. We haven’t had an awful lot of assistance from the Government.

“We are very loyal to our patients, we want to do our best for them.”

While more than 80 per cent of practices expect to reopen to some level by the end of June, the BDA has said major constraints will remain on the service.

Decontamination and social distancing policies mean longer treatment slots – leaving many practices unable to maintain their financial viability in the face of fewer patients and higher costs.