22/05/2020
Re-opening of dental practices.
Information is beginning to emerge regarding the reopening of dental practices. Throughout the crisis Scotland has often been the first to instigate appropriate COVID-19 measures, and again they are taking the lead with a three phase plan.
• Phase 1 involves increasing the capacity of the Urgent Dental Care Centres. The UDCCs are currently treating patients with urgent dental care needs, but the centres should now grow their capacity to increase the range of treatments available to patients.
My comment here is that phase 1 of “re-opening” sounds a lot more like phase 42 of “Staying closed”.
• Phase 2 will see NHS practices start to see patients, initially for consultations using non-aerosol generating procedures (AGPs), and later for routine care – including examination and treatment – that can also be provided using non-AGPs. There is no precise timeline for Phase 2, though the Scottish Government expects to have made some progress by 31 July, with consultations available in every practice by then.
My comment here would be that where it says NHS practices it probably refers to private practices aswell.
• Phase 3 will involve a limited introduction of AGPs to dental practices, depending on risk and mitigation. There is no timescale yet for this phase.
My comment here is that they can’t guarantee the PPE.
I also believe that the faculty of General Dental Practitioners will be providing guidelines regarding re-opening of dental practices and these should be available next week.
As I have said before, I believe that PPE will be the crucial factor to re-opening and there continues to be a huge shortage. The number one piece of PPE shortage being FFP3 valved masks, of which I am expecting a delivery today, and hopefully Roberto will also be bringing masks from Greece next Tuesday. Once I have the masks within the practice, myself and all the staff will require fitting, so this will be a job for next week when I have the masks within the building.
By having the appropriate PPE in place, mike brown dental will have the opportunity to provide Aerosol Generating Procedures, as soon as possible (AGP’s). This is really important because a dentist cannot provide much care without AGP’s. Non- AGP’s would include check-ups, HAND scaling (no polish), SIMPLE recementing crowns, very simple filling repairs – the type of quick fix that I usually try to avoid. Also impressions for dentures, bite guards, sports mouth guards, orthodontic retainers may be possible, but FITTING a denture will probably require an AGP.
So although we are now beginning to get some welcome information, it is not “giving me permission” to get back to normal practice. Also, nearly all the patients on my urgent care priority waiting list will require AGP’s. However, I ask you all to remain patient and continue to call me at any time for help with your dental problems. On a positive note, both the GDC and CQC continue to state that they cannot compel any dental practice to close. The GDC and CQC are the two governing bodies that ensure dental care is delivered professionally and safely. These are the regulators that will investigate any dental practice that is operating “illegally”. Therefore, as soon as mike brown dental has the correct PPE, and the correct paperwork that says it is correctly fitted, I will be contacting the CQC for permission / advice regarding re-opening.
At present, given the information above, we are cancelling appointments in June. Patients with appointments at the beginning of June will already have been contacted, and we will continue to work our way through June on a day- by day basis.
In conclusion, I still find myself speculating as much as giving you solid facts. I do not expect to be seeing routine care in June, but it may not be impossible, and re-opening may be sooner than we think. To present this in another way – we are having some painting and decorating within the practice. We are also having some minor internal building works to divide Kaths surgery and provide the staff with a changing area. I expect this to be completed in the next three weeks, and I am slightly concerned it won’t be completed in time for the “Grand re-opening”.
Stay safe everyone, I’ll be back next week.
Mike