Welcome to a new style of dental practice....
COVID-19 UPDATE 29th MAY 2020
Dear Lovely Patients,
Most of you will have seen the daily news briefing last night by Boris Johnson who stated that 'Dentists have been told they can re-open on 8th June' and this will no doubt have greeted you with excitement that at last you can re attend for your routine dental care after such a long absence.
It is with great regret I inform you that sadly, this is simply not true and Smile will not, and cannot, be open then. You may well be surprised to hear this and deserve to hear a thorough explanation, which is what I will try to give you here.
The announcement last night was the first that dentists up and down the country have heard about a date for re-opening and frankly we were all aghast. For Boris Johnson to say 'Dentists have been told they can re-open on 8th June' is simply not true. Many dentists who missed his briefing, were first made aware of it when patients called them last night to book appointments and therefore found out from members of the general public! As dentists, we have read the daily briefings on offer from NHS England, the Chief Dental Officer, the General Dental Council, the Care Quality Commission, the British Dental Association .... to name but a few ... and have been crying our for proper information on when and how we can re-start dentistry but there has been no information forthcoming at all. The Chief Dental Officer (CDO) for England, whose advice primarily shapes the return of dentistry after Covid-19, released a long-awaited document yesterday, just a few hours before the Prime Ministers speech last night, and there was absolutely NOTHING in it about a return date. Instead, it was simply a regurgitated list of restrictions about what we cannot do, if or when dentistry returns.
The decision last night to announce the return of dentistry was nothing more than a political move to deflect increasing heat away from the government and pass the responsibility and blame for the lack of available care back to dentists. This greatly concerns the dental profession, particularly us here at Smile, and is the reason I am explaining this to you here in detail, so you can understand the facts and the mistruths, and the real reasons we cannot open just yet.
Not only were we not advised of a return date, but lies are beginning to circulate, probably from the spin office of Dominic Cummings which would, I suspect, not come as a surprise to many of you. The 'Daily Mail Online' last night reported that 'Dentists were permitted to perform emergency treatments throughout lockdown'. This is simply not true. The fact is, we were all told by our most powerful regulatory bodies (the CDO, GDC and CQC) that we could NOT see patients face to face and that all we could offer was 'AAA' - Advice over the telephone, Analgesics (painkillers) and Antibiotics. If patients needed to be seen, this could only happen if they were referred on to designated 'Urgent Dental Centres' (UDC's) for simple extractions and that was about all. These emergency centres were late to appear, few in number and poorly organised. Patients were left suffering and often in life threatening situations. Many of you may have heard of my personal intervention on BBC Spotlight News over the Easter Holiday weekend, to save the life of a young girl with a life threatening infective dental swelling, who could not get even a basic tooth extraction despite trying herself to get seen for a week and my personal referral of her to an emergency centre. In the end, it took a direct and urgent telephone call from me directly to a local hospital and with the involvement of politicians nationally, bypassing the local emergency dental centre, to get her the very basic and simple treatment that was desperately needed and only just in time. My story is not unique - this has been happening up and down the country to countless other patients. The second thing said by the 'Daily Mail Online' in the same article last night is that 'Sara Hurley, the Chief Dental Officer (CDO) for England, said today that dentists can start taking routine appointments in just 10 days'. Again, this is simply not true. As stated, the first we heard about it was in the Prime Minister's announcement last night! One of the few things the Chief Dental Officer has said, is that when dentistry returns and potentially for some considerable time, dentists are not allowed to undertake 'aerosol generating procedures' (AGP's) which is, essentially, 90% of what we do! It means that, amongst other things, we cannot use air and water sprays to clean teeth properly for inspection and we cannot use the drills that are necessary to do fillings, crowns, root fillings, surgery and tooth polishing. It is simply akin to saying 'Butchers can return to work, but they cannot use knives' or 'bakers can return to work but they cannot use ovens' .... they can meet with you to talk about the meat and bread they could provide, if they were allowed to provide it, but are not able to do so!
Essentially, what is being said is 'Dentists can now meet with patients face to face and can undertake a limited examination of their mouths and tell them what needs doing, but with the exception of a dental extraction, cannot do anything until they are allowed to do aerosol generating procedures'. This is anything BUT the message that was portrayed by the Prime Minister last night!
Be reassured, we want to open at Smile as soon as is practicably possible, but this needs to be done in a timely and safe manner. You will all be aware of the various social distancing measures in retail stores - plastic screens at tills and 2 metre distance markers on floors etc. These are for reasons of safety to protect both customers and employees from infection. They are simple measures to implement, in potentially safe and low-risk environments. You may not be aware but Dental Nurses sit in the number 1 spot in the highest ranked 'most at risk' jobs for contracting Covid-19, with all dental related occupations (dentists, technicians etc) ranking within the top 6. It is important to be aware that it is not just the dental professionals who are at risk, but you, as patients, are at equally high risk, as the virus can pass both ways. The dental profession on the whole and particularly us at Smile, take cross infection very seriously and we practice to the highest possible standards to reduce all risks. That said, Covid-19 plays by very different rules and the medical profession at large is still trying to work out how to totally eliminate the risk and this may not be possible until we have a vaccine.
In order to reduce the risk, dentists have been told, amongst many things, that for face to face meetings, the length of appointments has to be dramatically increased, patients should not congregate waiting rooms and PPE (Personal Protective Equipment) needs to be far more extensive. The best estimates suggest that dentistry, for the very limited and restricted number of treatments it can provide, will at best be running at a quarter or a fifth capacity. As you will understand, this comes at a cost. A greatly increased cost. Dentistry is a business like any other. If the necessary income is not generated by a business, it will go bust. Simple as that. It has been estimated that 1 in 5 dental practices are currently on the brink of going under, just like many other businesses across the country from retail to hospitality. We want Smile as a business to thrive for the long term benefit of our patients and we also know that you will want this too. The risk of opening up too soon under these restrictive conditions is that many dental practices will be forced into administration due to the high costs they face and the lack of income that can be generated. The alternative is to charge patients five times the cost of a typical appointment, simply to tell them what is wrong (for example, a filling is needed) but apologise that we are unable to provide it. This does not seem right or fair. In the current climate, where we have Urgent Dental Centres (UDC's) that can currently provide the very limited number of procedures that are allowed, it makes sense for us to continue to refer patients on to this service and not open up ourselves. Moreover, we have been told that if we see patients at Smile, we are duty bound to offer an onward referral to a UDC anyway!
The current situation breaks our hearts. The whole team at Smile have a natural compassion and desire help people. Moreover, we have amongst the most highly trained clinicians in the country providing specialist care to a very high standard. Now, more than ever, we need to protect our business and be honest with you, as these current issues are outwith our control. However, they are not outwith the control of the government and our failing regulatory bodies, who could provide the necessary and appropriate guidance and assistance to enable us to get back to work. If you could find the time, it would be greatly appreciated if you would write to your local MP to highlight the real truth behind the problems dental practices are facing and ask them to apply more pressure on the government. The truth needs to be understood and as always, it comes best directly from patients. Dental colleagues up and down the country are similarly asking their patients to do the same. Continued pressure is desperately needed.
Please keep referring back to our website for regular updates. We will keep you informed with up to date information as soon as we get it. For registered patients with problems or emergencies, please continue to call our emergency service for advice via the main practice telephone number.
Assuring you of our best intentions to get back to work as soon as possible, as safely as possible for both you and us, and to provide the highest quality treatment at a fair and reasonable cost to our patients. In the meanwhile, we will continue to lobby our professional regulators to increase the number of procedures that we can undertake safely to get the pratice open as soon as possible.
David, Sharon and the Smile Team
COVID-19 UPDATE 20th MAY 2020
Dear Lovely patients,
We hope you are keeping well and that your family and loved ones remain safe after the initial wave of Covid-19 hit our nation.
Sadly, the practice remains closed under the instruction of the government and our professional regulatory bodies. Be reassured that we are doing all we can to re-open as soon as possible, but as yet there is no set date for this to happen. Our best guess from Boris Johnson's latest announcement to the nation is early July but before this can happen, the 'powers that be' in dentistry need to decide how we best go about protecting our patients and our teams from the virus with new and updated safety protocols. One thing we know for sure is that dentistry will be very different when it returns, at least in the immediate term. Dental practices have always been at the forefront of infection control in medical practice across the world, but there will be another level soon to which we have to elevate. This will inevitably come with longer appointments times and vastly increased costs, but for now we wait and see how the 'new dentistry' will look and function in practical terms.
The situation is the same across the nation. Virtually all dental practices remain closed, save for about 200 mainly NHS practices across the nation who have been selected to provide an emergency service for a tiny number of patients, after a very strict triage filtering process, to do little more than extract teeth on an urgent basis. As a result, we have a nation of people walking around with pain, missing front teeth, broken dentures and worsening gum disease. The news reports a truly medieval situation out there with patients having to extract their own teeth and fashion cosmetic replacements out of wax - something as a profession we never thought we would see again.
For now, we continue to provide an on-call service at Smile for our registered patients, but are restricted to telephone advice and AAA - 'Advice' and the prescription of 'Analgesics' (painkillers) and 'Antibitoics'. If you have an emergency and need to speak to us, please call the emergency on call number which can be obtained via the main practice number and one of the dentists will speak to you. If your situation is extreme, for example you need a tooth extracting, we can make the onwards referral for you to one of the emergency treatment centres.
As soon as we know more with regard to when we can re-open and which patients we can see, we will announce this on the website. Be mindful though that for a while, and possibly until we have a vaccine for Covid-19, dentistry will not be 'normal' and we will probably only be seeing emergency patients but hopefully with a slightly wider scope of practice than the emergency centres are currently providing.
In the meantime, stay safe and enjoy the glorious weather we continue to be having.
David, Sharon and the Smile Team