DENTISTS WARN OF NEW HEALTH CRISIS IN WALES
DENTISTS believe routine dental work, such as getting a filling, will not be available until 2021 at the earliest as they struggle with the current Covid-19 guidelines and an ever-growing backlog of patients.
Some say they are being forced to pull out perfectly “saveable” teeth and arrange treatment in England at the weekends because of the current rules in Wales.
There are even reports of one patient travelling to Sweden to get a chipped tooth fixed and people waiting for false teeth after their dog ate their dentures.
Dr Charlie Stephanakis, a dentist in Cardiff, has warned there is an “impending disaster” facing the dental health of the Welsh public and that people in Wales are being discriminated against
Dr Stephanakis, owner of the Pontcanna Dental Practice in Cathedral Road, said: “If you live in Wales you can’t have your teeth done, and if you cross the Severn Bridge, you can.”
He was speaking yesterday as the Welsh dental sector waits for new guidance to be issued by the Welsh Government. On June 8, practices in England were allowed to reopen and treat patients as required, having been closed since lockdown began on March 24.
Surgeries in Wales have remained open for some procedures during lockdown, with emergency cases sent to one of 15 urgent dental care centres. The Welsh Government has said that reinstating services in Wales needs to be “gradual”.
From July 1, patients in Wales will be able to be assessed for urgent care at their practices, but those requiring invasive procedures such as highspeed drilling will still be referred to specialist ‘urgent dental care’ centres.
Under the phased guidelines set out by Wales’ chief dental officer, Colette Bridgman, routine assessments and care will only be reinstated between January and March next year.
Currently, any “aerosol-generating procedures”, such as drilling, are not allowed to be carried out in surgeries due to the risk of transmitting coronavirus.
Dr Stephanakis said: “If you went with a tooth that could be saveable under normal conditions, the only option is to do nothing, take some antibiotics and hope it will work, or have the tooth taken out. So what it means is that teeth that could be saved are being removed.”
He is desperate for the new standard operating procedure to be released, which was promised this week. “The standard operating procedure will tell us how to treat patients in our surgery, if we’re given permission to do aerosol-generating procedures.”
But even with this, some treatment will still remain unavailable in Wales. “But if you go across the border you can have whatever the dentist feels he is capable of giving you safely,” he added. “I’ve got a client who just happens to have a business in Sweden, who snapped her front tooth, and luckily the people organising the courses she was doing found a dentist for her so she’s had it done whilst in Sweden.
“If you need a filling, as things stand, the chief dental officer in Wales is not allowing you to have that done at this point in time until 2021.”
He also warned that the financial strain of lockdown could force a lot of dentists to go out of business, with dire consequences for dentistry in Wales.
“The provision of dentistry in Wales will be greatly reduced and that means the NHS will have to take up the slack, and to be honest it’s pushed to capacity at the moment,” he said.
“I know of a lady in Penarth who had been in pain, had antibiotics and now she’s going to be booking an appointment today, in Bristol. She wants to go locally but she can’t.
“There is a solution and that solution is pretty straightforward. If the urgent dental centres are set up to provide dentistry in a safe way then all we’re asking for is to be given the procedures to allow those practices who can to get on and start treating patients.”
Even so, the backlog of cases is massive, he added. “Most dentists that I’m speaking to are working out how they can work from eight until eight, every day in the week, to get this sorted out.
There are even some who live on the border coming to arrangements with dentists across the border so they can take their clients there and treat them at the weekends.”
Dr Stephanakis, who has owned his practice for 15 years, said his surgery had measures in place to create a safe environment, including a special machine to change the air in the surgery 10 times in 10 minutes between every patient.
“If something isn’t done soon, people are going to have irreversible damage to their teeth,” he added.
It is a sentiment echoed by Tom Bysouth, a dentist in Llandovery and Llandeilo, and also the chairman of the Welsh General Practice Committee for the Welsh Dental Association.
Since March 24 he has been mainly limited to taking out teeth and carrying out some temporary fillings, he said.
He too is worried that the phased approach means some routine care might not be in place before the new year, at the earliest. It means Welsh dentists have now “fallen behind” their English counterparts, said Mr Bysouth.
He has one patient whose dog has eaten their dentures, leaving them unrepairable.
Mr Bysouth said: “Looking at current guidelines as they stand now, we can’t even fix false teeth. So if your false teeth have been eaten by your dog, I currently am not allowed to make you new false teeth.
“We’ve got a huge backlog of treatment,” he continued. “We’ve got a lot of patients who have got problems that still need to be fixed, and when we are due to start going back from the start of July it will be at a vastly reduced capacity.
“We will prioritise those most in need but when you’ve got a large list of people, that can be quite difficult to do.” He is also worried that many early signs of mouth cancer, often spotted during routine appointments, are being missed.
“England practices went back on June 8, having not been able to see any patients in their practice since March,” Mr Bysouth said. “Wales had been better placed during lockdown as they were able to offer some treatment, but now England has overtaken Wales.
“Everyone is doing things a bit differently, which can be confusing. The Welsh Government need to put in measures that allow dental practices to open up as soon as possible.
“We don’t want to put anyone at risk. We don’t want to be causing any problems. But let’s learn from what other countries are doing and start treating patients so we can clear the backlog. Dentists just need the guidance so they can start planning.”
Dr Colette Bridgman said she shared dentists’ concerns and recognised routine care cannot be postponed indefinitely.
She said: “Many dental procedures, such as fillings or scaling, use highspeed drills and other tools which are “aerosol generating” – this means they create spray. This, in the current pandemic, could risk spreading the virus and that’s why we’ve asked dentists to stop routine activity for the time being.
“Coronavirus has not gone away and it is likely we will be living with the virus and its consequences for some time to come. The return of dental services will be gradual, in line with the Welsh Government’s cautious, wider approach to easing lockdown.
“As levels of coronavirus stabilise and restrictions begin to ease, we are looking at how we can restart dental services through three phases:
■ First phase: Urgent dental centres and dental practices will introduce more treatments and a full range of care, including fillings, will be available at some local dental practices to everyone who urgently needs them and has experienced problems during lockdown. This group of people will be offered assessment and care first.
■ Second phase: A full range of care will be available in more practices and prioritised for people who need treatment, including those who have had treatment delayed because of the pandemic.
■ Third phase: routine check-ups for people with no dental problems and good oral health will be resumed.
“The first phase will begin from 1 July, prioritised by need.”