Jack Ward: “Testing Times”

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Jack Ward reflects on COVID’s impact on dental practices

Despite the difficulties over the past year dental practices across the nation have maintained stability, making COVID-safe adjustments, accommodating social distancing measures and meeting ever-changing PPE requirements, while delivering care to those most in need.

Over a year after the first lockdown, and in the face of a survey by the Oral Health Foundation and Colgate-Palmolive which finds that over 45 million Brits risk dental decay under current conditions [1], now is the time to reflect on the extent of the impact and ask – how long will dental practices be affected?

Issues faced along the way

During the past year we have constantly heard about the uncertainties and challenges of adjusting to the ‘new normal’ while recognising that dental practices have had to overcome many limitations to ensure that dental care was not significantly impacted. 88% of dental practices said they had to make considerable changes to adjust to the new climate without endangering their patients.

Access to professional dentistry became limited after their closure on 25th March 2020. Although practices reopened on the 8th of June many members of the public feared travelling to them, and as a result 66% of dental professionals felt that the number of patients receiving care would decrease during 2020, most likely affecting their more vulnerable patients.

Misinformation and confusion also impacted dental care. 30% of patients were unsure of what services were available once restrictions had eased. BDA Chairman Eddie Crouch observed: “For many people, dentistry effectively ceased to exist at lockdown.” Faced with limitations on travel and the growing fear of infection, many went without the care they needed.

Many vulnerable patients suffered pain and dental disease without visiting their dentists, some even choosing to self-treat by pulling out their own teeth, the ramifications of which has impacted patients and dental professionals alike.

It is not hard to understand the pressure this has put on dental professionals. Because coronavirus has forcibly limited the amount of care dentists could provide to their patients, they have become concerned for their oral health, especially the health of the most vulnerable.

Susie Sanderson, dentolegal adviser at Dental Protection highlighted the impact such concerns have had on dentists, stating: “45% of UK dentists say their mental wellbeing is worse compared to the start of the pandemic.”

These stressful conditions also impacted on confidence among dentists. According to data from Lloyds Bank Healthcare Confidence Index, confidence amongst dental professionals hit a significant low point during 2020. Limitations created by social distancing and cross contamination measures had thrown any belief that all patients would receive the healthcare they required onto disarray.

Lloyds Bank also found that post-pandemic costs have certainly impacted practices with over a third of dentists expecting financial pressures to increase over the next five years. Adjusting to the new conditions is not without cost, and although lockdown restrictions continue to be alleviated in other sectors, practices may still be impacted by reduced capacity.

Dental teams face the increased costs of adhering to regulation in their ongoing effort to limit the spread of COVID-19 while still working to the best of their ability. Head of Healthcare Banking Services at Lloyds Bank Marytn Kendrick stated that dentists: “Have been one of the hardest hit healthcare sectors as a result of the pandemic. Now more than ever it is vital dentists are supported.”

Thankfully some leading figures in the profession have been able to provide some degree of support. In a statement the BDA promised: “Unparalleled support and flexibility for its member during the COVID-19 pandemic,” reducing its rates while still maintaining the benefits, protections, and security of their policies, while also lobbying the NHS and government for greater financial support.

Dentists’ Provident has also supported its members by adjusting its processes accordingly in order to maintain its function and continue working in an effort to provide security during such an uncertain time.

And yet it seems there may at last be some light at the end of the tunnel this summer, as two thirds of practices have now reported that they are operating back at pre-COVID levels. Practices are finding new ways to adapt to the conditions by adopting new technologies including remote video consultation.

“Telehealth” has been a topic for discussion in the dental profession since the 1990s, but its value has become more evident amid the pandemic in helping break the barriers which separate vulnerable patients from their dentists. Other innovations have seen small ideas and big changes comes to the fore which have helped improve the quality of care under trying circumstances.

For example, a report by the British Society of Dental Hygiene & Therapy (BSDHT) found that an overwhelming number of patients felt confident to assess their own mouths for oral cancer once a month at home, providing hope for a viable solution for patients who are unable to come into dental practices for screenings.

In conclusion – undeterred by the bleak year which has posed such a threat to dentists – the nation has adapted. Four out of five practices say they expect to bounce back from the COVID pandemic within three years. The same data that demonstrated the dip in dentist’s confidence also showed that over half of dentists would still encourage their friends or family to join the profession; perhaps emphasising the short-term nature of the pandemic’s impact.

Although it is important to recognise the continued need for support following COVID-19's impact, we must also equally acknowledge the extent to which dental professionals have adapted to difficult conditions, limited the damage done to their practices, and continued to care for those most vulnerable.

Author

Jack Ward works at Dentists' Provident.

Reference:

1] New survey by the Oral Health Foundation and Colgate-Palmolive shows 45 million Brits at increased risk of tooth decay: Dental Review. Link- click HERE. (Accessed 28-4-2021)