Covid Historical

Covid and it's impact on Dental Care

The article below by Professor Mike Lewis outlines our clinical viewpoint as Coronavirus became an emerging public health and dental threat last year.
Dentistry is fairly expert in controlling our clinical environment and making cross-infection an insignificant risk for everyone .... however dentistry requires close proximity and most clinical work will either generate a minor air contamination from a Coronavirus asymptomatic patient right through to a "room contaminating event" especially  if we use any of our advanced aerosol generating hi-tech instruements. Coronavirus as an easily spread airborne virus was a cross-infection "game changer".
Last year we upgraded our clinical systems with respiratory cross-infection in mind.....  installing Swiss medical, viral air filtration and using powered ventillated filtered hoods to create as safe a clinical environment as possible for our patients ....  this offers a very high level of protection even compared to hospitals. However overall safety depends on community Coronavirus infections remaining relatively low.
Without indulging in the blame game....Coronavirus infections didn't stay low and in fact reports state that as many as 1 in 12 were infected in some areas.  In our opinion this meant that our practice could become a contaminated area on a weekly, maybe daily  basis and this virus can survive for days on various surfaces. We are used to cleaning  surfaces under "normal circumstances" ... literally domestos mopping the floors and alcohol wipes on surfaces between patients. The issue is that we don't yet know how easily the "new variant" transmits but clearly the massive spike in infections around the Christmas period seems to indicate that it transmits very easily.
Coronavirus is a randomly deadly disease that particularly picks on you as you get older or if you have health issues. Recently we passed 100,000 deaths in the UK and even with the vaccination we expect deaths in the UK to exceed 150,000, a Sage member has said it could be as high as 220,000.
The guidance given to dentists is ....... "you decide....you make a professional decision!"???
Our decision was that you don't risk patients getting Covid for routine dental care. Emergency support is a different matter.... so we are available 7 days a week to triage, reassure, addvise, diagnose and prescribe.  Generally our patients are sensible and intelligent enough to understand the issues and risks. Inevitably we will get a rare case that cannot be "postponed" and maybe an emergency filling or extraction is the only solution. The dental profession realised this early on so there are a number of emergeny centres across the country offering appropriate treatment.
The important point in this rather depressing news is that we are available to talk to you, diagnose and check issues via images on "smart phones" to get everyone through this awful period. As with everyone else....we are looking at the figures......  If there is a silver lining....some experts think that March will show definite signs of "light at the end of the tunnel"......I sincerely hope so because to us dentistry is a "hands on" affair.

Professor Mike Lewis on Dentistry and Coronavirus

A dentist has warned the environment he is working in is like "coronavirus heaven" as he said he does "not foresee" a return to normal any time soon.

All routine and non-urgent care in Wales was suspended in March due to the coronavirus outbreak and many community dental practices are doing consultations over the phone. Professor Mike Lewis, who is a dentist and professor at Cardiff University and works at the emergency clinic at University Hospital of Wales Dental Hospital told ITV Wales "people are still presenting in the same way before COVID-19."

"The dental environment is coronavirus heaven because it is present in saliva and a lot of the dental equipment like a drill or an ultrasonic scaler create what are called aerosols and that's spraying the virus, if it's present, into the room's atmosphere. It will stay present for many hours", he said.

He described it as "an absolute nightmare" in terms of trying to keep safe while treating patients.

Surgeries are still taking calls if there is a dental emergency to help anybody who might need help with their teeth at this time.
"The community dentist is still providing advice, pain relief and antibiotics but there will come a time when the teeth will need to be extracted," said Professor Lewis.
"There are more teeth being taken out now than if we were would be if we had full access to a full range of dental treatment."
"I do not foresee an early return to normal dentistry."
The risk of cross-infection is high at a dental surgery, but equipment is available to make the atmosphere safe for patients and dental staff.
Professor Lewis said this is why dentistry is going to be one of the areas of medicine that is going to "find it very difficult to return to normal because of the aerosol generation." "There is some equipment available which will be able to clean the atmosphere in the surgery."

It's like sneezing a thousand times over.

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