New guidelines for practices in Wales still leaves sector in 'crisis', say dentists

On Friday, June 19, chief dental officer for Wales Colette Bridgman sent a letter to all dentists in Wales informing them that the industry would move from “red to amber” on Monday, June 22.

This means that dentists are now able to provide more care and treatment for patients more than a week earlier than initially expected.

But dentists must adhere to guidelines set out in the Standard Operation Procedure (SOP) set out on June 10, including a 60-minute break between patients known as the fallow time, and for all dentists to be kitted out with “enhanced" and "fitted” PPE.

The fallow time is to allow the air in the room to settle, meaning aerosol droplets, suggested to contribute to virus transmission, fall onto surfaces and are then wiped down.

Chris Lodge

Chris Lodge, who owns practices in New Inn and Abergavenny, said the guidelines mean dentists cannot treat more than a few patients a day, which will lead to an "inevitable backlog and will have a devastating impact on the industry”.

He said: “Particular problems are fallow time and obtaining PPE. The 60-minute break set by the chief dental officer is excessive and based on very weak evidence. That is shown by the fact Ireland, USA, Spain and Germany have no such restrictions."

Mr Lodge believes “many practices face going out of business” with the additional costs of making practices suitable for the “new normal”, saying it is “unsustainable and for some will be impossible”.

“The job retention scheme has been a welcomed lifeline for the sector, but this is masking over wider issues, and that is that fallow time and PPE guidelines need to be relaxed.”

Ioan Rees, who is a dentist working in Newport and Cardiff, said: “We’ve worn more PPE than anyone for 30 years and we are well-versed in virus protection.

Ioan Rees

“There is no evidence that aerosol is an issue, and the worst of it is that people are in a lot of pain and can't be seen."

Mr Rees said it is likely the pressure of backlogs with higher costs and lower incomings will be too high for some practices, but said he “just wants to get back to helping people”.

Miles Gladson, dentist and owner of Usk Dental Practice, said he was surprised to receive the letter on Friday, and said it gave dentists very little time to prepare.

“It’s the lack of guidance that is really peculiar,” he said. “To say late on Friday that you can open on Monday is questionable.

“I would also question how they are going to monitor which practices are doing the right things.

“On the whole it’s been okay during lockdown and I have enjoyed helping those that we can, and I’ve noticed people are very grateful, but it is so frustrating that we can’t help more people.”

Miles Gladson

When the Welsh Government was approached for comment, they forwarded a statement from health minister Vaughan Gething, which reads: “We have been clear the resumption of dental services needs to be gradual to protect dental practice staff and patients.

"The majority of practices and health boards still need and welcome the time available before July 1 to prepare, and we fully support that requirement.

"Practices who are ready to implement the SOP, particularly those who are already equipped with enhanced PPE and can implement all other measures to re-introduce aerosol generating procedures safely, should contact their health board or Healthcare Inspectorate Wales to give confirmation and assurance."