To tell you all to take care over your dental hygiene!

[Cheapprimarkbra]

Folks... Please look after your teeth extra carefully over the next few months! Part of my molar randomly fell off this afternoon. Rang Dentaline (out of hours dentist) and no dentists are able to work in the lockdown, even for emergency treatment for the most severe pain! Totally understandable of course, but scary nonetheless. The lady on the phone literally quoted this: "You are either critically ill on a ventilator or you won't be seen". Very sobering and brings home again how much we take for granted. 🙏

Here's my top tip for warding off the need for dentistry😬use a waterpik type appliance at least every day😬use it with saline solution if you can😬I find it slightly kinder to the gums compared to plain water.
Is sonicare worth the extra money over and above bog standard electric toothbrush?🤔
Sensodyne toothpaste also seems help ...the remineralizing is real 😊👍
(or is it just a placebo? 🤔)

It must be a pretty scary and upsetting time for dentists?
If any dentists are reading do you think that long-term there will have to be changes to the way you practice because of this crisis?

My dad was prescribed antibiotics over the phone for an abscess, they said if it persists they are there for emergencies.

I'm actually happy I have no teeth!

@251976Bo no need for belligerence.
I will amend to say out of hours emergency services.
How come you know so much about who is and who isn't giving salient advice?
And DIY stores are taking online orders so there's plenty of grips to be had. You might want to explore that..

@58SimplySteveRedux 😂

@Monty27
It will be crystal clear to any dentist or DCP what the correct information is.
This is our field. HTH.

@Monty27
Also, FYI whatever you want to amend it to is irrelevant, the current situation with dentistry remains as several dentists , myself included, have detailed on this thread.
If you don't want to believe it, then that's your problem.

Grips😲😳😬

I'm a dentist. It's very worrying and extremely concerning, reading all these threads. It's such a fraught time for everyone. I wish we could help more but we simply can. There are 4 regions in U.K. ( Wales, England, NI and Scotland) with their own Chief dental officers, and each region has responded at different times, all slightly different, going on advice which was changing on a daily basis.
Basically it's to do with the aerosol spray that is generated each time we even blow air on a tooth. We have been designated the highest risk of any procedure/profession for spreading the virus.
So all hands on treatment has ceased. Advice analgesics sand antibiotics only, as described above. We are still busy doing this, and trying our best, hopefully helping to steer folk away from NHS24 by doing so.
If there is an emergency that requires urgent treatment, in due course these can be referred to central hubs that will be able to treat emergencies PROVIDING they have the correct PPE.
I think that's an issue in most parts of the U.K. I am hopeful that later in the year ( who knows when?) with enhanced PPE we will be able to start doing remedial work. There will be such a massive backlog, and to be honest, it's a service that is often overlooked and we've never gotten much thanks for it over the years. Ah well...
there are massive issues surrounding funding as well. Depending on your region there will hopefully be some NHS funding. That doesn't help if you are private or mixed, as there simply won't be enough money to keep all staff in a job.
Trying to navigate our way round it just now, with an ever changing climate.
Please be patient with us. And each other. Let's all try our best.
There should be a dentist manning ye phones at your local practice who can steer you in the right direction. Hope this helps

@041976Bo I hope I never get treated by you that's for sure. You're not helpful. I'd hate to see your bedside manner no you're not at all. Hth
@04UYScuti I know.

@Monty27 I beg to differ - I think @1976BO has been extremely informative and to the point.

@bettythedevilyouknow and @1976Bo have you been given any idea of the timescale for when you will go back to business? It feels like a lot of people think all this NHS / dentistry work will resume quick quickly once the lockdown is lifted but I'm wondering if it will actually be way longer than anticipated.

Surely you won't be able to perform AGPs routinely until this is over? I do endoscopy and we've been told we can't do them until covid is out the equation at some point in the future.

I'm sure there is an obvious answer and I understand Coronavirus is very bad. But why does this mean that dentist appointments have been stopped? It's a clinical environment they wear masks etc??

I've got decay in my tooth that needs removing and I'm really scared of how it will spread. I don't want to lose all my teeth!!

@38Cheapprimarkbra in that case I've clearly got the wrong end of the stick.
@38Cheapprimarkbra. Not my problem right now anyway. I look after my teeth 😁😁

We have no idea of the time scales involved and are just taking it day to day.

The English CDO has been very slow in getting guidance out to us hence some dentists still actually seeing patients later than others. Also as advice was coming from NHS England some private practices were thinking that advice did not apply to them.

All the agencies involved have made it very clear that there is no face to face contact unless you are in one of the emergency hubs with the correct PPE.

Yes please look after your oral hygiene

When this is over and we’re all back to normal us dental folk are going to be so busy catching up with lost crowns fillings and decay from all the rubbish we are all eating at the moment

Plus everyone will want/ need their routine checkups

@BananaChocolateLump, the problem is most dental procedures are aerosol generating. Even something as simple as taking an X-ray in the mouth could cause someone to gag or cough. So if there is a patient with Covid 19 who doesn’t have any symptoms and we did treatment then we would cause an aerosol of virus particles. Yes we wear masks (which are ineffective) but the next patient entering the room won’t be and now we’ve just spread it further.

@BananaChocolateLump aerosols produced during dental treatment stay in the air for 20mins+. So if the patient before you is infected you are likely to breath in the virus in the air when you are in the dentists surgery. Yes the dental staff wear masks and high level PPE but you can’t treat patients teeth if they are wearing a mask.
Since there is definitive evidence of how long it takes to clear the aerosol completely from a room even with specialist air pumps we are working blind.
First and foremost we are committed to protecting the patient first. This virus is incredibly infectious and it would be negligent of dentists to expose a patient to the virus for non emergency procedures.
We can protect ourselves and our staff with PPE but we can’t protect our patients.
Dentistry is likely to be very different for the next couple of years as are other areas of healthcare. I don’t think the public quite realise what a game changer this virus is.

Sorry *no definitive evidence

This is not scaremongering.
I posted on another dentistry thread that half a molar and filling broke off Thursday evening. Upper gum and a bridge fell out as a result. I am left with a sharp point of about 1/4 of a tooth and an exposed nerve.
The dentist told me what PP dentists have said.

People are misunderstanding the use of the word ‘emergency’ now. Losing a tooth, pain, not being able to eat or drink are not deemed an emergency anymore. Yes you get emergency treatment via a phone call and advice to get temporary filing kit but it doesn’t work in my scenario.
I’d need plaster of Paris to fill that gap. I am living in limbo atm and I am very worried as I have three teeth missing now.

I know this is not the dentists fault, they are following instructions and the they have no safety protection.
So, I don't think it’s unreasonable to tell folk to be mindful of their teeth and what they are eating just now.

I looked at the guidance and this is what you can get help for at of the emergency hubs:

The range of conditions provided for by local UDC systems are likely to include, but are
not limited to:
• Life threatening emergencies, e.g. airway restriction or breathing/swallowing
difficulties due to facial swelling
• Trauma including facial/oral laceration and/or dentoalveolar injuries, for example
avulsion of a permanent tooth
• Oro-facial swelling that is significant and worsening
• Post-extraction bleeding that the patient is not able to control with local measures
• Dental conditions that have resulted in acute and severe systemic illness
• Severe dental and facial pain: that is, pain that cannot be controlled by the patient
following self-help advice
• Fractured teeth or tooth with pulpal exposure
• Dental and soft tissue infections without a systemic effect
• Oro-dental conditions that are likely to exacerbate systemic medical conditions

www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/issue-3-preparedness-letter-for-primary-dental-care-25-march-2020.pdf

Not sure if that is the very latest version but shows that the range of conditions is pretty limited. I'm not so concerned about decay but usually have a tooth break up around a filling or just chip every so often. Please not now!

Good advice from all the dentists on here.
Personally I am not going for redeployment, I’m private so won’t get paid anyway. I’m off with anxiety and starting antidepressants and looking after/ home schooling DS.
Long term I am unsure about returning to work. I will certainly want a fit tested FFP3 mask and they are uncomfortable so won’t want to be doing big dentistry in one. If I had a positive antibody test or was vaccinated that would be my return point. Not sure I will have antibodies- had no symptoms as yet but know cases can be symptom free.
The viral load thing makes me very concerned about treating patients until there’s a vaccine.
I don’t care about teeth that deeply that I want to risk death tbh!

So we are looking down the barrel of a situation where no dentists are able or willing to practice which is completely understandable but, we are just left with ....pliers 😳🤯
As said the definition of 'emergency' has now shifted
Shit is going to get mediaeval 😳🤯

Even with FPP3 masks i dont see how much other than real emergency treatment can be done. Like a PP said the aerosols can remain in the air for 20mins, risking the next patient.

I am in hospital, so we are still seeing patients with facial swellings/lacerations. We have really limited PPE, each extraction/incision now takes about 1 1/2 hrs because of all the extra steps. We have to air the room etc. If we do an extraction on a suspected covid it takes about 3hrs, but could take all day because the room needs to be disinfected.

The FPP3 masks and visors are uncomfortable, and whilst i can do an extraction, doing an hour long fiddly root canal when it feels like you cant breath is not going to give best results.

I dont know when dentistry will start up again, I see no feasible way it can before a vaccine/antibody test. The risk is just so high to patients and staff

Personally Im fairly sure I have had it, and if I could get this confirmed with antibody test I would be happy to practice. But I need a dental nurse who is also willing and the risk of the aerosols to the next patient is still high, we would still have deep clean rooms etc.

The OP wasnt scaremongering, and she is absolutely right that we need to be really careful with our dental hygeine - i like to say at all times but particularly now.