Wirral Life July 2020 | Page 66

W L DENTAL THE NEW NORMAL BY ANDY HEALY, PALL MALL DENTAL Finally after 76 days of an enforced Lockdown closure, we re-opened our doors on Monday June 8th. To say that was a relief is a vast understatement. The Government blindsided the dental profession with its announcement on Thursday 28th May and at the same time spectacularly failed to provide any information on how we could open in a safe manner. Those Standard Operating procedures (SOPs) only materialised the following Thursday at 3pm, leaving us just a single working day to prepare to open. What followed was a superhuman effort by all my team to be ready for that big day. What preceded that was intensive preparations involving: • Creation and deployment of risk assessments for staff, patients, clinical areas, working practices • Creation of patient workflows to follow social distancing rules • Installation of high volume air extraction in each surgery to remove aerosol created when drilling or scaling teeth • Acquisition of extensive Personal Protective Equipment (PPE); waterproof gowns, respirators, face shields, disinfectant fogging machines etc etc • Fit testing of our reusable respirators for every staff member Believe me when I say none of this has been simple. The SOPs we were given were woolly and lacking in clarity or thought. It is one of the reasons why many dental practices haven’t yet re-opened. PPE is almost impossible to come by, and much of what is advertised for sale has fake certification and would put us and our patients at risk. In one of my previous articles I discussed the risks of the aerosols that are created whenever we drill or clean teeth. This aerosol may contain Covid-19 particles as it is a high velocity mix of air, water and saliva. Much of the work we have been doing is centred on mitigating that risk. One of the basic requirements for a dental practice to reopen is leaving every surgery fallow (i.e. empty) for 60 minutes following any patient procedure that creates aerosol. As you can imagine this would mean practices seeing very few patients per day and for many this would be financially impossible. We took the decision to install a high volume room air extraction system across our clinical areas that means the air in each surgery is changed every 5 minutes. This means we only have to fallow each surgery for 20 minutes making us able to operate more efficiently. Few practices are fortunate enough to be able to do this and it’s the main reason why we were able to open safely at that very first opportunity. I’ve always believed that dental practices are an incredibly safe environment as we have been dealing with cross infection risks all our careers. With the added PPE guidelines our patients can be safe in the knowledge that the surgery environment is quite possibly the cleanest place they will ever visit. We have now been back for 4 weeks, working 6 days a week trying to catch up on all of the treatment that has been postponed these last 3 months. That dentistry doesn’t go away, it is still required. Our staff have been truly amazing; our patients have been grateful, understanding and a genuine pleasure to see again. They've all never been so happy to see me! Yes we have social distancing and PPE rules to follow, but we are getting through the backlog and also helping new patients who cannot get treatment elsewhere. Finally if your dentist hasn’t reopened yet, please be patient and understanding of the challenges that they are working hard to overcome. Many dental nursing staff have young families and childcare is hard to come by, meaning many practises cannot open as they do not have safe staffing levels, or are struggling to obtain adequate PPE. When you do finally get an appointment please remember nobody wanted to be closed for months, and the service they will be providing in the short to medium term will be limited by those factors I’ve mentioned above. Let’s all hope that this is the beginning of the end of this awful pandemic and these are the first green shoots of normality returning. Good luck to all my dental colleagues as we move forward delivering the best care we can to our patients, in the safest possible environment. 66 wirrallife.com