How is COVID-19 Affecting the Dental Teams and Patients in the UK? Insights from Natalie Bradley

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24 Mar 2020

The COVID-19 outbreak presents an unprecedented challenge for all health and care workers in the UK, and we know what a worrying time it is for everyone involved in the oral care profession. 

The RCSEd is in regular communication with our network of Dental Ambassadors, who are representing the College in 17 regions across the UK and internationally. We caught up with one of our Early Careers Dental Ambassadors, Natalie Bradley, who is a Specialist Registrar in Special Care Dentistry. Natalie offered us insights on how the pandemic is affecting her work environment and patients.

How has the COVID-19 outbreak affected your dental practice and patient treatments?

 "I work in several different places and different services are working things out for their patients depending on the setting. In hospital we have cancelled all routine patients but will see urgent patients. Initially this was just for vulnerable groups, but gradually we are seeing fewer routine patients. Some of our staff have been fit tested for the FFP3 masks and so are able to carry out aerosol generating procedures if needed on urgent patients. The patients are screened prior to being seen for symptoms of Covid-19 or if anyone in their household is self-isolating or showing symptoms. In these cases we are asking these patients to return home and call 111 for advice and onward referral.

In the emergency dental service I work at, we do not have access to FFP3 masks and so we have not been doing any AGP and 111 are triaging patients appropriately as I could only provide extractions, dressings and prescriptions. Following guidance released today, this is likely to change depending on whether the correct PPE can be sourced. Our service has also stopped all domiciliary visits into care homes and other people’s homes. If they have an urgent need, a clinician calls to triage and give advice over the phone".

What measures is your practice taking to increase standards in care and hygiene?

"In hospital we are donning full PPE now even for exams in urgent patients – FFP3 mask, apron, visor, gloves and surgical hats. We ask all patients to wash their hands or sanitise before entering clinic, minimising patients who are waiting in the waiting room (asking if there are escorts to wait in the car if possible) and our nurses follow normal cross infection of wiping down all surfaces between patients.  If patients are coming in, we try and space them out during the day to minimise the number of people waiting in the waiting room". 

How is the dental team adapting during the COVID-19 pandemic and what are the main priorities established during these difficult times?

"The main priorities for our team are good communication and leadership in this challenging time, ensuring the safety and health of our staff as well as ensuring our patients still have access to dentistry if they have an urgent need. This is especially important for some of the vulnerable patients I see who cannot communicate if they are in pain. We have stressed to carers and to our staff who are triaging, that as well as the usual dental emergencies like swelling, trauma, pain, to also ask if there may be changes in behaviour which could be a sign of dental pain in patients with learning disabilities or cognitive issues e.g. lack of appetite. Because of the complex adults and children our service sees, it is important for our service to have access to emergency theatre slots. In order to free up space in the hospital, important anaesthetic staff and ventilators, all dental specialities have consolidated their lists into one GA session a week for adults and paediatrics. We will soon we asked to adapt further by possible redeployment to other areas in the hospital in order to take pressure off medical staff". 

For regular updates and developments, keep an eye on our NEWS section. 

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