EXTRAORDINARY TIMES
BY ANDY HEALY, PALL MALL DENTAL
Many of you reading this may have had your dental
appointment cancelled or postponed recently because of the
current Covid-19 pandemic. is liberated up into the surgery atmosphere. Over the next few
hours this aerosol lingers in the air and eventually lands on every
surface.
I thought I would take this opportunity to explain the reasons why
dental clinics across the UK have had to make this tough decision. This consequence of our drilling procedures has always been
known and our cross infection controls include wiping down
every surface with potent disinfectants in between patients.
Last week many of us in the dental profession instigated
additional procedures in order to reduce the risk of Covid-19
being transmitted to our staff or patients.
Initially these were intended to postpone non-essential
appointments such as check-ups, as well as any patients deemed
at high risk or serious complications if they caught Covid-19. By
reducing the number of appointments, we hoped to reduce footfall
through the clinic whilst allowing the clinical staff more time to
ensure greater disinfection of each surgery between patients.
We already have some of the most rigorous cross infection
controls in healthcare given every patient could be an unknown
carrier of an infectious disease. By adding further disinfection of
both clinical and public areas within the clinic several times per
hour, and combining pre-appointment screening of patients for
symptoms, we hoped this would allow us to continue providing
care to our patients, albeit with a reduced appointment schedule.
On Friday 20th March the Department of Health updated their
Standard Operating Procedures for Primary Dental Care which
recommended dentists reduce the amount of Aerosol Generating
Procedures (AGP) to as low as possible. This was followed by the
Chief Dental Officer also recommending that only severe dental
emergencies be treated, and not on anyone exhibiting Covid-19
symptoms (fever above 37.8°c and new dry, cough).
But why are AGPs such an issue?
The high-speed dental drill we use is powered by compressed air
and cooled by water that are both ejected at high velocity out of
the drill and onto the tooth as it is operated on. This high velocity
spray combines with the patient’s saliva to create an aerosol that
However, in the last week or so there has been new evidence about
the Covid-19 virus that ultimately changed our profession’s view
on the risk posed by these AGPs.
Some of you may have read about the Italian Authorities attempt
to control the virus spread in a town called Vo by mass testing,
contact tracing and isolation.
The significant piece of new evidence that came from this
endeavour was that after testing 3,300 people, 6 tested positive but
had no symptoms and would be able to spread the infection.
With an aerosol containing virus particles lingering around in the
air of the surgery for several hours this worrying evidence that
people with no symptoms could be spreading the virus led to a
swift decision to abandon all operative procedures.
To every dental practice this is a crushing blow to our businesses’
ability to thrive and move forward but had to be done for the
protection of our staff and our patients.
In our clinic we have postponed everything for 4 weeks, reviewing
the situation almost daily in response to the developing situation.
So if your dental appointment has been cancelled this week there
are very good reasons why your dental practice has taken these
extraordinary measures.
For we live in extraordinary times.
Finally I wish everyone a swift and healthy end to this
unprecedented time and remember please, Stay in, Protect the
NHS, Save lives.
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