1st June 2020
Covid-19 and your care
Today, we received clear guidance as to what dental procedures we can safely carry out and at what stages during the pandemic.
Below is a summary of the guidance as we understand it, although we may modify this over the next few days as some small inconsistencies are clarified.
- The government has set five different risk levels for the pandemic 1-5 (low to high). Today we are at level 4.
- The treatments that we can carry out safely in dental practice will change with the risk level.
- Treatments are significantly limited at level 4.
This week, we will attempt to contact each patient that has contacted us with a significant dental problem during lockdown, and we hope to book an assessment appointment for those patients in the week commencing 8th June.
Practice doors will be locked at level 3, 4 and 5. Entry to the practice will be limited to pre-booked appointments.
There will be very clear criteria provided later in the week as what is required before arriving at the practice, and what the procedure will be upon arrival. We will endeavour to ensure that each person knows exactly what to expect at their visit as this will be quite different to what you have been used to.
The appointment diary will be structured to take into consideration those patients who are shielding, may have underlying medical issues and so on.
The first week is expected to be a slow start as we ensure that the new protocols are working effectively for everyone’s safety. These protocols will be audited and modified until required. All staff will need to undergo fresh training before returning to work.
At level 4 we should be able to carry out the following:
- Dental assessment (initially restricted to patients who have current urgent need, or did and contacted us during lockdown).
- X rays but only for patients who tolerate them well.
- TEMPORARY re cementation of crowns. (We cannot dry the tooth effectively enough to cement a crown permanently with the restrictions we face).
- Fabrication or repair of removable dentures.
- Simple dental extractions. If a tooth breaks, it is probable we will have to leave the roots in place until we are at a lower level of risk. Naturally, we will assess the risk very carefully prior to treatment.
- Tightening of loose dental implants if possible, without using a high-speed handpiece (drill).
- Temporary fillings.
- Draining of a swelling/abscess.
- Provision of antibiotics.
- Trimming of sharp orthodontic wires (not reliable re cementation of loose brackets, or replacement of missing brackets).
Treatment is only to be offered after careful assessment.
At The Old Surgery, we provide many of these treatments. We may now be able to progress some of our Invisalign cases. We will be in touch with each patient shortly, but please allow us to contact you; we hope that it is understandable that we will be prioritising patients with urgent dental need.
The PPE (personal protective equipment) requirements for the above are not too onerous, and we will not look too different to normal. As you are aware, the cross-infection control at The Old Surgery has always been exemplary.
Some items of PPE are not with us yet. As with most practices, supplies are due mid-June, and until confirmed today, none of the profession knew what we needed and what to order. Even being organised well in advance is no guarantee of success. We were expecting the delivery of 2000 gowns this week, (which will be mandatory once we can lift a handpiece again), only to receive an email on 29/5 to let us know that these will now be 10 weeks late. We are currently trying to source another supplier. All practices are attempting to source everything we need to keep you and us safe, but supplies are scarce and consequently very expensive. Certain masks will need something called a fit test. Every time a different type of mask is sourced, new fit tests will need to be booked for each team member (and there are over 40 of us).
Whilst we are at level 4, we cannot use the high-speed handpiece (drill). We will be able to use the slow one in specific circumstances. We cannot use the 3 in 1 syringe (to wash and dry teeth) properly.
Once the threat level reduces to 3, we can start to use handpieces and the 3 in 1 again, albeit with some restrictions in place. One significant challenge is that today’s guidance suggests that a surgery may have to be left empty for 60 minutes after using a highspeed handpiece or the ultrasonic scaler used by the hygienist. This will clearly have a significant impact upon the number of patients we can see each day. The guidance on this is likely to change regularly depending on new research as it occurs.
At level 3 we hope to be able to return to providing
- routine examinations,
- permanent fillings,
- permanent cementation of crowns and bridges,
- removal of roots,
- straightforward implant placement,
- removal or fit of orthodontic appliances,
- root fillings,
- ultrasonic scaling (cleaning).
At this stage, whilst we will be able to provide more routine dentistry, we will still have the doors locked, closed waiting rooms and a significantly reduced volume of appointments available.
We will be looking at changing practice opening hours and other flexible options to try and provide as comprehensive service as possible, but in the short term it is possible that each dentist will require two surgeries to be available to be able to work at greatest efficiency. Even then, initially we expect only to be able to work at around 30-50% of normal capacity.
On top of these clinical challenges, each team member will require an individual assessment as to whether they are physically able to return to a clinical role, and additional training procedures will be required, for example in how to safely put on and remove the new PPE. Not all faces adapt to the new masks, some team members may fail a fit test and not be able to assist in surgery.
This is going to be a whole new way of providing your care. You can rest assured that every action we take will be with the safety of both you and our team at the very forefront of our minds.
Please be patient with us as we put new protocols into place and refine them.
Please keep checking our website, and social media feeds for the latest updates.
Stay safe, stay alert, and don’t go for a jolly day out in Barnard Castle.
29nd May 2020
Good Morning to our wonderful patients.
We hope that you and your families are happy and healthy.
As many of you may have probably heard….at the same time as us!!
The Government and Chief Dental Officer announced yesterday, that dental practices in England can start seeing patients again on the 8th June 2020.
We are happy to be given the green light to go back to treating and caring for our patients again and we will start a phased return. We hope to start our return on the 8th under the new “normal” but as yet we still have not been given official guidance and also need to ensure we return safely, and due to the shortage in PPE, this will be an obstacle that we are working very hard to overcome.
However, please be patient with us as we now need to prioritise the patients who have been needing urgent care over the last 2 months. All our patients are important to us, but we are sure you will allow some understanding to those in extreme pain.
As you are all aware…the whole team at The Old Surgery follow the highest standards of care and cross infection and with the addition of the required additional PPE our systems and standards will safeguard our team and patients in this COVID world.
We predict that as we start back, we can increase our flow of patients and will aim to be able to provide a more comprehensive service and resume more routine care by July. This will allow us to ensure all procedures are able to be done safely.
We will be contacting our list of urgent patients shortly and will continue to triage any patients in difficulty and schedule an appointment for you. We also have numerous patients with unfinished treatment…they will also be contacted.
As you can imagine our phones lines are on fire with enquiries and our team are working non stop to help our patients….please allow us time to process these calls, you are important to us and you will not be forgotten.
Thank you again for your patience and understanding. We look forward to seeing you all in due course. In the meantime, please stay safe.
22nd May 2020
Dear Patients and Friends,
Despite recent media reports that dentists are open, we are unfortunately still NOT able to see patients face to face.
The political position is that all dentists are open because we are still answering the phones everyday and providing telephone advice and antibiotics and being there for our patients as best as we possibly can.
Although currently, The Old Surgery Dental Practice remains temporarily closed; we do hope to be able to see some of our own emergency patients soon, reliant upon fresh guidance from the Chief Dental Officer and the availability of PPE (personal, protective equipment).
We will update with further information, as soon as we can.
23rd March 2020
Dear Patients and Friends
We are in this together, but all need to work alongside guidance whilst ensuring we are also caring for you in the safest way possible.
Due to COVID-19, the Practice is following the NHS guidelines for dentists and is unable to provide routine dental care.
Your safety is our priority!
Given the unprecedented situation in the UK regarding the COVID-19 virus, we wish to reassure you that we are continuing to keep our practice clean and safe for both you and our team.
We are regularly checking with Public Health England for updates in the interests of safety and wellbeing for our patients and team, and adjusting our protocols as and when advised.
We are only able to see patients who are experiencing a dental emergency.
We are working in very small teams split over different days and we are available to provide advice and support for any dental needs or concerns.
We will see all non-plan private patients on the NHS, the dentist may only be able to give advice, temporise or get the patient out of pain.
We are very limited in what we can provide but can triage any difficulties and we are doing our very best to get some supplies of masks and protective equipment to enable us to provide more care.
As dental practices have not been provided with much needed protection yet, the government are setting up centres where you can be treated safely in an appropriate environment using the most protective measures, we can help you to access this care if required.
You can access and the most up to date government guidance at www.gov.uk/coronavirus
Our team will be contacting you to reschedule any of your booked appointments.
Do ask if you have any questions or concerns – we are here to help you throughout this difficult time. Call us on 01270 587820.
Thank you for your support in keeping everyone safe. Our thoughts are with all who have been affected by the Coronavirus pandemic.
Keep safe, keep well.
Steve Lomas, Rich Willis and all The Old Surgery Team