Coronavirus – the latest updates for dental professionals

The last month has seen the rapid escalation of isolation measures as the world bands together to reduce the spread of coronavirus.

At 9am on 22 March 2020, there were 5,683 confirmed cases of coronavirus in the UK. Of those who tested positive, 281 have died.

We have put together the latest information regarding COVID-19 and what it currently means for the UK dental industry.

New case definition

Since the country moved into the ‘delay’ phase of the virus, the instruction to self isolate extends to the whole family if one member has symptoms.

The new case definiton, in summary, is:

Travel history is now irrelevant

Anyone with symptoms who is well can stay at home and does not need to call NHS 111 or be tested

Anyone with symptoms who is unwell should go to NHS 111 online for advice. They should not approach their GP surgery or pharmacy

This advice applies to staff and patients

Those who are over the age of 70, are pregnant or have an underlying health condition are strongly advised to limit face-to-face interaction.

Advice from chief dental officers

The chief dental officers for England, Scotland and Wales offered advice to dental practices and how they should be reacting in the ‘delay’ phase.

Sara Hurley, CDO of England, advises practices to do the following:

Radically reduce the number of routine check ups by cancelling appointments of patients from vulnerable groups

Agree local arrangements to provide urgent dental care and any essential, routine NHS work that cannot be delayed

Check whether potential patients or anybody in their household has symptoms by phone or text before any visit

Consider the risk of asymptomatic cases attending the practice. Avoid all aerosol generating procedures whenever possible

Display the materials on COVID-19 available on this website

Use robust infection control procedures. For example, wipe down surfaces between patients with extra vigilance, including door handles etc.

Additionally, if aerosol-generating procedures are necessary, the dental team should wear a full face shield or goggles/visor alongside a surgical face mask.

Key workers

Last week, the government announced the closure of schools and nurseries across the UK.

Official advice for parents is to keep children at home wherever possible but schools will only remain open for those children who categorically need to attend.

This includes the children whose parents are critical to the coronavirus response and are, therefore, key workers. The BDA confirmed this includes dental professionals.

Key worker categories include health and social care, education, public services and food and other vital goods.

The principles for key workers are:

If children can be kept at home, then they should be

Education provision will be available if a child has a parent who is a critical worker, needs specialist support or is vulnerable

Parents should not rely on those in the social distancing category such as grandparents or friends and family with underlying conditions

Parents should do everything to ensure children are not mixing with others in a way that could spread the virus. Social distancing principles apply to all

Children should be cared for when possible at residential special schools, boarding schools and special settings

Advice for primary care

As part of its general standard operating procedures for handling coronavirus, NHS England’s general principles for primary care are:

Identify potential cases before clinical care is started

Isolate the patient and inform NHS 111

Seek specialist advice

Decontaminate the practice areas where the patient has been

Additionally, it issued further detailed advice for dental professionals.

Industry response

Following this new advice from the UK’s CDOs and NHS England, the British Dental Association (BDA) recommends dental practices cease all routine dentistry.

BDA chief Martin Woodrow believes dental professionals should only be treating emergency cases.

He urges practices to make their own risk assessment. This is to determine what is safe and what can be delivered in line with an ongoing emergency-only service.

Last week, the BDA also encouraged the government to extend business rates retail discount of 100% to dental practices.

They believe this will help to alleviate the financial difficulties that practices are experiencing in the face of COVID-19.

As it currently stands, this relief is being offered exclusively to the leisure and hospitality industries.

Addressing Robert Jenrick, secretary of state for housing, communities and local government, the BDA pointed out there are certain rates relief for NHS dental practices.

However, this does not apply to private practices and consequently urged Mr Jenrick to reconsider their exclusion.

Financial support

As it stands, the advice from the government is to work from home where possible. However, any bans are yet to be enforced.

To help alleviate the potential financial difficulties faced by dental professionals, the NHS in Scotland and Wales have issued assurances:

In Scotland, practices will be given 9o% of their monthly item of service income on the condition they agree to assist wider NHS services if their practice closes

In Wales, practices will contine to receive their monthly income and should continue to submut FP17W and collect PCR for patients that are seen

England’s CDO confirms NHS England remains supportive of ongoing dialogue with the BDA in regard to continuing with monthly contract payments in line with the SFE – during the response to and recovery after the pandemic

Dental Insurance Services and Andy Acton, of Frank Taylor & Associates, have offered financial advice for dental practices who are caught up in the coronavirus chaos.