By Dr Andrew Culbard

THERE is no doubt that Covid-19 has brought disruption to everyday life. As restrictions begin easing across the country and we move toward Phase 2, it’s clear that what we understood as “normal” is no more.

Working in close proximity to patients, according to national statistics, dental care professionals are among those at highest risk of exposure during the Covid-19 pandemic. Following the advice from the Chief Dental Officer, dental practices across the UK were shut down at the end of March and were ordered to stop all non-urgent treatment and work on a remote prescription and advice basis, with referral to NHS urgent care hubs. This has presented challenges for patients in terms of the availability of urgent dental treatment, not to mention managing pain in non-urgent cases.

For the dental profession there is not only the concern for patient health but also worry over the survival of dental surgeries – a fear resulting from reduced income whilst overheads and operational costs are set to increase due to stringent protocols for virus control. The dentistry profession already adheres to the most stringent infection control protocols, yet even with such high standards, Covid-19 has added to and elevated the requirements.

It has been widely agreed that viruses like Covid-19 require a higher grade of PPE, particularly during aerosol generating procedures used in dentistry. Increased demand has resulted in inflated prices and this combined with the installation of air ventilation and purification systems has seen surgery operational costs increase drastically.

Online video consultations have become the new normal and mark a big change for patients. Familiar to me in my practice, video calls are a useful tool for patient communication, to triage potential problems and monitor treatment. Complementing this will be patients completing online medical forms.

I believe this new “virtual dentistry” to be a positive outcome, as it helps to reduce clinical time and remove an element of non-essential contact which in turn reduces risk. For patients, this could mean reduced travel to their dental practice for issues easily resolved over the phone and decreased waiting times for appointments. However, the need for dental services will not disappear and the current inability to access care is likely to create an urgent demand. Pre–pandemic access to NHS dentistry was difficult enough: According to the British Dental Association in 2019 more than four million people across the UK were said to have an unmet need for dental care. The subsequent need for increased treatment time will mean fewer patients treated per day, only adding to the backlog. As a consequence, dental practices will for a period see a continued reduction in revenue which when combined with significantly increased running costs will mean that many practices will struggle financially.

When surgery doors open again, only patients who are asymptomatic and have had no contact with an infected person will be allowed to attend appointments initially. In some cases, temperature tests may be required. Social distancing rules will limit patients and staff in waiting rooms. Risk assessments and staff self-monitoring will take place to ensure a controlled and infection-free workplace – this may also be combined with regular antibody testing as a further preventative measure.

I have no doubt that this will be a difficult time for dentistry, however additional infection control measures mean a safer environment for patients and dental care professionals. I believe with the introduction of virtual consultations and digitisation, the dental profession will emerge stronger and renewed.

Dr Andrew Culbard is with Philip Friel Advanced Dentistry, Glasgow