The British Dental Association (BDA) reports that it is responding to National Health Service (NHS) guidelines for the COVID-19 outbreak that probably spell the end of most routine care in England while lamenting the absence of any current safety net to support services through the crisis.
Emergency care will continue, though the NHS England guidance effectively means that most routine treatment that involves aerosol-generating procedures will end. While not ruling them out, NHS England now advises avoiding all aerosol-generating procedures wherever possible.
England is the last nation in the United Kingdom to provide up to date clinical guidance following the declaration of the pandemic, the BDA says, and the ramping up of the official response. Many practices across England have already suspended non-urgent care unilaterally in the face of equipment shortages and concerns around staff and patient safety, the BDA adds.
With patient numbers already in freefall, the BDA says, guidance has been published without clarity on the shape of any rescue package to maintain the financial viability of practices in England through the crisis.
Other nations in the United Kingdom have begun setting out financial mitigation plans, the BDA says, and have stated aspirations to preserve the same levels of patient access when the pandemic ends. Talks continue with NHS England to identify what help might be provided for dentists and their teams, the BDA says.
“We are likely to see the end of routine dentistry as we know it. The question of whether or not normal service ever resumes rests entirely with government,” said BDA chair Mick Armstrong.
“From fillings to scale and polish, the vast majority of procedures are unlikely to be an option for most patients. Many colleagues have already had to make this difficult choice in the absence of up to date guidance,” said Armstrong.
“Our priority is keeping patients and staff safe, but now all practices face a deeply uncertain future,” said Armstrong.
“The challenge facing every dentist, whether providing NHS or private care, is keeping this service afloat. We needed a safety net, but to date we have been offered little more than warm words,” said Armstrong.
The BDA further says that the NHS should consider how its more than 3,000 employed dentists could play a role using their skills and experience in caring for those affected by the COVID-19 pandemic.
“Community dentists provide care for many of the most vulnerable in society. As many of our patients face withdrawing themselves from routine care, we offer unique skills that can be put to work for the wider NHS at this challenging time,” said Charlotte Waite, chair of the BDA’s Community Dental Services Committee.
“As universities halt face to face teaching and dental school clinics close their doors, dental academics are an untapped resource. With formidable skills and experience in treating diverse specialties, now is the right time to consider options as to how these dentists can best support the NHS,” said Giles McCracken, chair of the BDA’s Academic Dentists Committee.
“Hospital dentists already work shoulder to shoulder with medical colleagues,” Armstrong said. “Redeploying them alongside medical colleagues would not only be simple, but could be the right thing to do.”