Practice Update 26/06/2020 – “Reopening”
We hope this finds you and your family in good health.
The Covid 19 pandemic has created challenging times for us all in many different ways, but hopefully, we can now make a start on getting back to normal. What that ‘normal’ will be is yet to be seen.
Dentistry changed from a normal service at the start of the outbreak to a sudden and dramatic stop in March. This caught the profession by surprise and as a result, it took a while to get the emergency dental cover that was needed due to the cessation of the majority of dental treatments. I would like to thank all patients who have contacted me over this period for emergency dental treatment for their fortitude, perseverance and understanding in light of the limitations placed on me and the treatment I could provide.
During the restricted access period that started in March, the main questions the Dental profession were asking were what do we need to do to get back treating our patients and how will we survive as a business? Over the last month or so, this has started to become clearer.
Dentistry will change dramatically from how it was provided before Covid 19 and I expect to hear of job losses, practice closures, practices seeing fewer patients for treatment and struggles to gain access to dental care for some people. The next few months will be the toughest for dental practices yet. I can assure you that we will not be closing and all the familiar faces will still be there at your visits. We may just look a bit different in all the PPE we have to wear!
There has been lots of press coverage about dental practices being able to reopen and the challenges they face in the new post-Covid 19 environment.
The information from our regulatory bodies in Wales we have received has been vague, contradictory and changes regularly. I have decided to make my own interpretation of the guidance and will be working with the team to move forwards a soon as we can.
Every practice is different, but we all have some similar challenges. Access to PPE is still very difficult and the cost of it has dramatically increased from pre-Covid 19 prices. You may be aware that some practices have decided to implement a charge to try and cover the cost that they are incurring from the excessively high costs of PPE. This is something that I am NOT planning to do we need to thank you, as the monthly direct debits have kept the practice alive over the lockdown period. So as a way of thanking you for your continued support, we will not be introducing a charge.
The dust needs to settle and we need to see how we work in the new dental environment, so I will be keeping our financial structure on review. This may mean in the future there may be some changes to our prices, but it is too early to give any more insight into possible changes now.
Our practice will be opening on 1st July 2020 but we just wanted to be clear that this will not be business as usual. The treatments you are offered may be different from those you received before, depending on staff and equipment available. It will take some time before services return to what you previously experienced as normal. Please be patient.
We will need time to get the practice reopened to ensure that it is a safe environment for patients and staff. As the practice has been idle for a few months now apart from the emergency patients that we have seen, we will have to check over the equipment and ensure we meet the new regulations and standards that have been developed. Once we feel it is safe to bring in patients we will concentrate on those patients who have had emergencies first. These will be followed by those patients who were scheduled for treatment before lockdown and finally, we will return to all routine examinations. Slowly we will introduce other treatments and patients over time as the threat status level of dentistry changes. We will contact you to arrange your attendance at the practice. To conserve our very precious PPE and to maximise our time, we will be carrying out annual examinations on all patients that we call in for treatment. This will also mean that you will need fewer visits to us.
Please do not contact the practice unless you require emergency dental treatment.
If you have an appointment booked with us, that appointment is now no longer valid and will be postponed until we can work out our new booking system. We will be in touch to rebook the appointment. We will be contacting all patients of the practice over time to arrange their dental visits as and when we can provide the treatment.
It will be a new experience for us to provide dental treatment with all the new PPE and operating procedures, so we will take our time to ensure we do things properly and safely.
Our commitment to your safety remains and Infection control has always been a top priority for our practice and you may have seen this during your visits to our surgery. Our infection control processes are made so that when you receive care, it’s both safe and comfortable. We want to tell you about the infection control procedures we follow in our practice to keep patients and staff safe.
Our practice follows infection control guidelines made by the governing bodies. We are up-to-date on new guidance that has been issued. We do this to make sure that our infection control procedures are current and adhere to recommendations.
As you can see from the table below, the UK has the highest standard of protection for Dentists required in the world.
You may see some changes when it is time for your next appointment. We made these changes to help protect our patients and staff. For example:
- Our practice will communicate with you beforehand by telephone or video call to ask some screening questions. You’ll be asked those same questions again at your appointment
- We have hand sanitiser that we will ask you to use when you enter the practice. You will also find some in the reception area and other places in the practice for you to use as needed.
- We no longer offer magazines, children’s toys and so forth, since those items are difficult to clean and disinfect
- Appointments will be managed to allow for social distancing between patients and the new fallow time for each treatment room that we have to leave between patients. That might mean that you’re offered fewer options for scheduling your appointment.
We will do our best to allow greater time between patients to reduce waiting times for you, as well as to reduce the number of patients in the reception area at any one time.
How you can help:
- With the exception of children and patients with carers, patients should come alone
- A distance of at least 2 metres must be observed if another patient is present in the dental practice
- Payment should be made by card where possible. If you don’t feel comfortable using the machine, we can take card payment a different way
- Staff will not shake your hand
- If you show symptoms following appointment booking, you should contact the practice by phone
- Please do not arrive early to the practice. If necessary, you should wait outside the practice, depending on the weather. We will call you in when we are ready
- Please do not arrive without an appointment. We are not allowed to let you in whatever the circumstances
- Patients should come wearing a mask if possible or be prepared to wear one that we will give you
The standards and operating procedures we will be following are being assessed and changed all the time as new information comes in. It is a very fluid situation and confusing at times. Please bear with us as we try to navigate the new normal.
Nick and the team
Practice Update 15/06/2020
Dentists in Wales need your help!
On 11th June the Chief Dental Officer for Wales announced that from 1st July dentistry in Wales will be entering the start of the de-escalation phase of dentistry and drop down to Dark Amber provision from the current Red level. In the real world, most patients apart from some orthodontic patients will see no change. Welsh dentists will still not be able to provide treatment that can be carried out by English and other dentists in Scotland and soon Northern Ireland. If we stick to the timetable of the Chief Dental Officer for Wales, we will not be getting back to normal until January 2021.
There will be some expansion of the Urgent Dental Centres, but this will not allow dentists to see their own patients. The British Association of Private Dentists (Wales) has started a petition to get the Welsh Parliament to debate the situation in Wales and to get all dentistry back up and running as England has started doing. Although the petition has reached the required 5000 signatures to get the petition reviewed for debate, we would be grateful for more people to sign the petition to put pressure on the Welsh Government to reopen Welsh dentistry quicker.
Please follow the link below to sign the petition:
Practice Update 29/05/2020
A few thoughts from Nick on the current situation with Dentistry in Wales and the UK
Dentistry hit the headlines yesterday with the announcement that Dental Practices in England are being allowed to reopen from June 8th. The situation here in Wales is still very different at the moment.
The last guidance we had from the Chief Dental Officer for Wales came last Friday at 5:30 pm, just before the bank holiday. The guidance explained the pathway Wales will be taking towards resuming routine dental care and changes to the way NHS dentists in Wales will get paid. The document proved a depressing and quite shocking read.
It was being proposed that dentistry in Wales would not be back to normal until January 2021, with a staged escalation of treatment being available every three months. There was no indication why it would take so long for Wales to return to routine dental care compared to other countries that have only taken a few weeks. Some countries have not shut dental practices at all. Sweden has continued to provide all dental treatment with new guidance on treatment safety. Denmark restricted Aerosol Generating Procedures (AGP) but kept practices open for all other treatment. Italy and Spain, two countries heavily impacted by Coronavirus, have also resumed a normal treatment service but with additional safeguards. I suspect the delay in Wales is being caused by the decision to change the NHS payment system. I have no evidence for this, just a feeling.
Why has England moved so quickly? The profession wasn’t even aware that the restrictions were about to change. 24 hours before English dentists had been told that there would be a slow, phasing in of treatment. Private dentists in England had started a legal challenge to their practices being shut and as a result of this pressure on the regulatory bodies, it became clear that none of them had the legal right to shut Private practices. Many practices, as a result, were planning to reopen as soon as possible. I think the Government responded to avoid a situation with Private but not NHS practices being open.
So, what about Wales? I was hoping this morning to see a change to the advice to Welsh dentists, but so far none has been forthcoming. The date for English dentists may put some pressure on the Welsh Government to follow suit, but I think it is a case of – it has all changed, but nothing has changed. The situation will be very fluid for the next few weeks and getting practices up and running again will take time. I expect us to take a few weeks getting ourselves prepared before we can feel confident to open again and ensure that all staff and patients are safe. There is still widespread confusion within dentistry with what standard operating procedures we need to follow, what PPE we will need and can we get hold of it. There will be no sudden change even when we are allowed back to work for routine care.
There could be a lot of information coming out in the next few weeks, so I will be updating the website and our social media regularly with the new information. I will try and restrict any emails to a shorter amount of text, with links to the website for more detail.
Keep safe and well,
Nick and the team
Practice Update 20/05/20
The six-monthly practice newsletter will be arriving on your doorstep next week. In it, we talk about why dentistry has been affected badly by the Coronavirus pandemic and some indication of the steps that will need to be taken when we are able to reopen again. As yet there is no indication as to which date we will be reopening, but there is movement in the profession to get us back to work as soon as possible. I am hoping that by the end of this month there will be a clearer picture of our route back to some semblance of normality, although dentistry will be quite different on our return.
If you have broken a tooth or lost a filling the following videos may be useful to help you use a emergency temporary filling kit. Kits are available online from Amazon, Ebay, Superdrug and other retailers. It seems that they have been popular and some retailers are out of stock at the moment.
With more clarification coming through in the last few days about what treatments we can provide and what situations we will consider as a dental emergency, there will be a need for some self treating of dental problems.
We are being advised to stop all social contact and to provide telephone support mainly. This is because many procedures for emergency dental treatment generate an aerosol, which has the potential to spread the virus to the dental team. Any treatment that is required, that does generate an aerosol, will now only be able to be carried out at specialist centres that are being set up. The staff manning these centres can be given enhanced protection and specialist equipment to deal with the extra risk.
Unfortunately, this leaves patients in a potentially difficult situation, so a booklet has been put together to help you understand what situations are being classified as a dental emergency and how to manage other dental problems at home.
You can download a copy of the guide HERE
As patients may need to take painkillers during this period of home management, there is guidance from the NHS on how to take your painkillers correctly HERE
URGENT PRACTICE UPDATE 23/03/2020
Following guidance from the British Dental Association and the Chief Dental Officer for Wales, all dental practices are being placed on Red alert and are being instructed to switch to provision of emergency dental treatment only. This guidance is to help protect the dental team, but more importantly to help reduce social contact and unnecessary journeys amongst the general population during the current level of virus threat.
From Tuesday 24th March, we will not be arranging any routine dental appointments for the forceable future. Once we have received guidance that we can change this position we will let you know as soon as possible. We are contacting all patients currently with an appointment arranged to postpone the treatment. If you have an appointment between now and May 31st 2020 and you haven’t heard from us, please get in contact with us, preferably by email if you can.
Please be advised that what qualifies for emergency dental treatment has changed as well.
Situations that qualify for Emergency Dental Treatment:
- Bleeding following an extraction or after trauma
- Trauma causing a tooth to break resulting in strong pain
- Swelling on the face and/or extending to eye/neck
- Severe pain that does not respond to painkillers
Situations that DO NOT qualify for Emergency Dental Treatment:
- Loose or lost crowns, bridges or veneers
- Broken or loose dentures
- Broken, loose or displaced fillings
- Chipped teeth with no pain
- Bleeding gums
- Loose orthodontic wires
In the above situations, we advise emailing the practice for advice.
If you have been self isolating because you have come into contact with someone with Coronavirus or suspected of having Coronavirus or you have Coronavirus yourself and you require emergency dental treatment, please contact NHS 111. A special clinic has been set up to deal with patients experiencing a dental emergency but are suffering from Coronavirus.
How to contact us for Emergency Dental Treatment
Please call the practice on 01792 297629. Information will be on the recorded message of how to contact Nick.
The situation is changing rapidly so please follow us on Social Media and the practice website for up to the minute information.
Practice Update 18/03/2020
WE ARE STILL OPEN!
The Chief Dental Officer of Wales has placed all practices in Wales on an Amber alert. This means certain dental treatments can no longer be provided in certain situations. Due to research showing that some members of the population are carriers of the Coronavirus, but display NO symptoms, some dental treatments need to be avoided as they increase the risk of the dental team being exposured to the virus. These measures are to protect the dental team and DOES NOT reflect any incresed risk to patients catching the virus from dental treatment.
The practice can still continue to provide most dental treatments such as examinations, hand scaling, root fillings, dentures, some types of fillings, orthodontic treatment and emergency care. We may need to modify some techniques as required on a case by case basis. If you have any concerns, please contact the practice. We will be trying to provide dental care for as long as possible and there is no reason why anybody who is not displaying symptoms cannot come to an appointment. We will be sending out annual examination recall reminders as normal as we wish to maintain your dental health as much as possible.
Please read the information below to see if what to do if you have any symptoms, suspected symptoms or been in contact with someone with symptoms or suspected symptoms.
We are also looking the opening hours of the practice as staffing becomes more of an issue. Schools are now being closed so my team are having childcare issues and Sam who is pregnant has gone into self isolation to protect herself and her expectant child.
It is a very fluid situation at the moment and there will be many more changes to come. All updates will be posted on our social media as well, so it may be worth following the practice accounts to get up to the minute information. Links to our accounts can be found at the bottom of this page.
With the declaration of the Coronavirus Pandemic, we wanted to outline measures we are implementing at the practice, plus provide you with some practical advice to keep you as safe as possible during the coming months.
We will be endeavouring to keep the practice open throughout the virus period and try to provide as normal service as possible. People will still get toothache, broken teeth and other dental issues. As a dental practice, we have to adhere to high standards of cross infection control and hygiene, so we are well equipped and trained in how to prevent the spread of infection.
With the number of coronavirus cases increasing at the moment we will be implementing some additional safeguards to protect patients and staff of the practice.
- We will be asking all patients entering the practice to disinfect their hands with a disinfectant rub which we will provide.
- Extra tissues will be provided in the waiting area for those who may feel a sneeze or a cough coming on – Catch it. Bin it. Kill it.
- We will also be temporarily shortening our working day by thirty minutes to allow us to adopt extra decontamination processes to ensure the practice remains a safe place for all staff and patients. We apologise for any inconvenience this may cause, but we need to ensure as much as possible that the practice remains open to allow us to provide treatment to those that need it.
- If you have a dental emergency (severe pain and/or facial swelling. A broken tooth will not be considered an emergency) and have been diagnosed as being infected with Coronavirus, please contact NHS 111 to arrange treatment at a specialist centre that has been set up for the purpose.
- If you have potentially been in contact with someone suspected of having coronavirus or displaying symptoms similar to those of coronavirus then please do NOT attend the practice. Please call to seek our advice and to postpone your appointment.
If the practice is forced to close due to suspected coronavirus infection, we will arrange for emergency cover to be provided by another dental practice. All details will be on the practice website, facebook page and on the practice answerphone message if this happens. An email alerting you to the changes will also be sent out.
Keeping yourself safe
To protect yourself and other people:
wash your hands with soap and water often – do this for at least 20 seconds
always wash your hands when you get home or into work
use hand sanitiser gel if soap and water are not available
cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
put used tissues in the bin straight away and wash your hands afterwards
try to avoid close contact with unwell people
do not touch your eyes, nose or mouth if your hands are not clean
Wearing gloves when out and about will give you some protection, but remember that they will need regular washing at the end of the day. Leather gloves can be disinfected with hand sanitiser. Eventually, it will affect the leather of the gloves, but it will help in the short term. Fabric-based gloves will need to be washed regularly. Don’t forget to wash your hands after taking the gloves off.
Bleach is an effective product for disinfecting work surfaces and door handles. Dilute it to make a cleaning solution to be used with a cloth.
As part of our cross-infection training, we are introduced to the concept of Red Paint. Imagine you have red paint on your hands and everywhere you touch would show a trace of red paint left on it. Doing an exercise such as this will soon highlight all the surfaces that we touch throughout the day. It may be a bit overwhelming when you work them all out. Don’t worry, you can’t keep them all clean, but it will help raise your awareness of the number of surface contacts we have daily. Just remember to make sure you wash your hands regularly and especially before touching your face.
Please watch the video below to see how to wash your hands correctly
If you require any guidance on how to keep safe during the outbreak, please do not hesitate to contact us.
If you do need to isolate for suspected infection of coronavirus there is more information on the Public Health Wales website HERE.
Further information on Coronavirus is available on https://phw.nhs.wales/coronavirus/