That sinking filling: Dentists fear take five years to repair damage
Scotland’s dental health will take five years to recover to its pre- lockdown state, dentists have warned.
And they say up to half of the country’s NHS dental surgeries could close by next year as the current restrictions on what procedures can be carried out are making them financially unsustainable.
Now dentists are demanding a meeting with Scotland’s Chief Dental Officer Tom Ferris to try to avert irreversible damage to practices.
Dental surgeon Mohammed Samad, an executive committee member of the Scottish Dental Practice Owners’ Group, said: “The service is at breaking point now. If things don’t change very soon, Scotland could lose around half its NHS practices because it is simply not sustainable to keep going as we are.
“While dental surgeries were closed across the country, practices in Europe kept going, treating patients, and there was no evidence that caused any increase in Covid-19 infection.
“Scotland’s dental health was already worse than other countries before lockdown. We reckon it could take us at least five years to repair the damage done to patients not being able to access treatment, and fear a major spike in oral cancer and other serious health issues.”
Dr Samad, whose organisation represents about 400 practices with four million patients across Scotland, said government orders to triage and diagnose patients by telephone rather than face to face, and hand out antibiotics and painkillers to keep as many as possible away from the handful of “dental hubs” across Scotland offering emergency treatment only, has been a “dangerous disaster”.
He said: “Oral cancer is an often deadly disease which patients are usually unaware they have, and diagnosing them necessitates examining them. You simply cannot do that over a phone.”
Dr Samad, who runs the Tollcross and Carntyne Dental Care surgeries in Glasgow, said: “Even now we’re back working in surgeries, offering extremely limited NHS treatments, government restrictions mean I still cannot do much more than look at a patient’s mouth.
“I can’t carry out proper explorations, or testing for NHS patients, and I still can’t do fillings or most of the other treatments we used do routinely. But, if a patient pays privately, I can treat them.
“This has created a two- tier service patients are struggling to understand. And, frankly, so are we.”
David Mccoll, chairman of the British Dental Association’s Scottish Dental Practice Committee, said: “The future of Scotland’s dental services still hangs in the balance. Over six challenging months, our teams have responded well, but at considerable cost. Staff are stressed and facing information overload from all quarters. What they need is definitive guidance and support.
“The pandemic has shone a light on the broken model at the heart of NHS dentistry. It’s the right time for ministers to look afresh and provide firm foundations and fair funding.”
Cameron Mclarty of the Scottish Dental Association, who runs a practice on Bute, said: “We need to sit down with the Chief Dental Officer (CDO) and work out a way forward before this situation gets completely out of hand and we lose more dentists from NHS practice.”
He said about 500 dentists wrote to the CDO calling for a meeting, but he said: “We got a dear John- type reply around two months later. It’s been hugely disheartening because all we want to do is do the best for our patients and keep going through this crisis.
“Instead of setting up expensive hubs, it would have been far more practical to give practices a one-off grant of around £500 to buy whatever extra PPE they needed and we could have stayed open for business as usual and prevented all the damage done to patients’ long- term oral health. Covid- 19 may be a new virus, but we all operate strict infection- control practices to combat HIV or hepatitis C, and the correct PPE would have allowed us to keep going as other countries such as Germany did.
“With no consultation with frontline practitioners and no firm evidence that dental practices could play a role in the spread of Covid- 19, Scotland chose to operate a no- risk strategy that has left patients losing teeth they didn’t need to lose, children not being able to access specialist paediatric services, and the elderly and those with serious health issues such as oral cancers being left at greater risk because we couldn’t possibly diagnose them over the phone.”
Dental surgeon James Millar, of the Scottish Dental Association, said: “There is a worrying uncertainty as to how dental services in Scotland will be provided on the NHS.”
Donald C a m e r o n, Sco t t i s h Conservative Health spokesman, said: “Patients are being abandoned and there is a clear disparity between those who can and cannot pay, which is completely wrong. Many dentists and patients feel that nobody is on their side.”
Scottish Greens health spokeswoman Alison Johnstone said: “We already had a deeply unfair two- tier system before this pandemic hit, and it seems this has only deepened. In the short term, dentists need access to regular Covid testing and adequate PPE so that the nation’s oral health doesn’t fall behind. In the long term, we need to look at why this vital part of the NHS is not always free at the point of use.”
A Scottish Government spokeswoman said: “As most dental procedures involve the generation of a fine spray of moisture droplets, they are considered high- risk procedures for the transmission of coronavirus. We have therefore taken a precautionary approach to remobilisation of NHS dental care in Scotland.
“To ensure the continuity of NHS dental services, the Scottish Government is making substantial payments to the value of £12 million per month to support NHS dental incomes. On top of this, we are investing an additional £ 2.75m per month in dental services.”
We fear a spike in serious health issues