A County Derry dentist has said a lack of Personal Protective Equipment (PPE) is restricting emergency provision for dental care during the Covid-19 pandemic.
Claire McMullan of Dental 32 in Magherafelt is currently volunteering at one of five Emergency Dental Treatment Hubs across Northern Ireland.
The hubs were set up when a shortage in PPE made it impossible to supply every dental practice with the necessary equipment to carry out procedures safely.
She told the County Derry Post: “From mid-March, we began postponing non urgent appointments.
“This was to ease the number of patients coming through the practice as social distancing measures were introduced. By the end of that week we were treating emergency cases only.
“As dentists, dental hygienists and dental nurses work in such close proximity to our patients while carrying out these procedures, we are at very high risk of personal exposure.
“In order to protect our teams, patients and the wider community it is vital that we have the correct PPE and decontamination protocol to keep the risk to an absolute minimum.
“At present there is a drastic shortage in the required PPE for Aerosol Generating Procedures (AGP).”
Almost every procedure in dentistry creates an aerosol when the use of a drill, ultrasonic scaler, water or compressed air propels droplets of saliva into the air.
In order to prevent transmission of Covid-19 through these droplets, the Health and Social Care Board ceased all AGPs and all consultations are now carried out by telephone.
“All patients requiring advice or emergency treatment are asked to phone the practice so the dentist can triage their call,” Claire explains.
“If they require a simple dressing or extraction, we may be able to offer this in practice if the patient is not isolating, experiencing Covid-19 symptoms or been in contact with anyone experiencing symptoms.”
“We will offer advice or prescription where possible. If the patient requires an AGP, for example, to begin root canal treatment, they will be referred to the Urgent Dental Centre (UDC).
After an initial request for 100 volunteers, over 400 dentists came forward to staff the emergency hubs, but many are yet to reach operational capacity.
This is due to the time it takes to process such a big number of volunteers and fit them with the appropriate PPE.
Claire said: “Some volunteers are still waiting to be fitted for their FFP3 masks. Every dentist must be specially fitted for an FFP3 mask to safely carry out AGP.
“Any patient who requires an emergency AGP is referred to the hub where dentists work in pairs wearing full PPE; plastic gown, FFP3 mask, cap, full face visor, apron and gloves.
“With the current lovely weather, working in all the PPE, in a surgery with no air conditioning or open windows has been a challenge!”
Given the usual high standard of cross infection control in dentistry, there are concerns for practices when the Covid-19 pandemic eventually begins to recede.
A return to normal within dentistry will require the correct standard of PPE, and Claire says there are concerns in sourcing and fitting the equipment, as well as how it will be funded.
She said: “Our main concern is the urgent need for PPE so we can carry out normal dental treatment.
“I think treatments will be reintroduced gradually to general dental practice. The Hubs will continue to function while the reintroduction is happening and there is a demand.
“We will have to organise our diaries and treatments differently to limit exposure, allow for more efficient use of PPE and leave time between appointments for settling and cleaning.
“We are acutely aware of the effect Covid-19 limitations have on the population. Necessary treatment is being postponed and dental conditions are potentially worsening as a result.
“It is vital that we get appropriate guidance, PPE and financial support to start caring for the population’s dental health as safely and quickly as possible.”
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