Month: July 2020

Freezing dental charges in England

Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation, on actions taken to help support dentists amid COVID-19.

Throughout lockdown, the Oral Health Foundation has been supporting patients achieve a better quality of life through good oral health.

We wrote an open letter to the Secretary of State for Health and Social Care, Matt Hancock MP, to address one very urgent request – the freezing of NHS dental charges in England:

Dear Secretary of State,

I am writing on behalf of the Oral Health Foundation to call for NHS dental charges in England to be paused.

Undoubtedly, COVID-19 has put a financial strain on millions of people. While the government’s furlough scheme has protected around 7.5 million workers, many of these are missing out on 20% of their income. In normal circumstance, dental costs remain a significant barrier to attendance. More than one-in-three (36%) adults say the costs associated with NHS dental treatment have prevented them from accessing treatment. It is sensible to assume that at a time where more people and families are experiencing deeper financial struggles, dental visits will not be deemed a priority. This is specifically discriminatory to households on lower incomes, people with preexisting medical conditions and those at higher risk of dental disease.

From dental practice closures on 23 March to the partial re-opening on 8 June 2020, an estimated 2.3 million NHS adult dental patients in England had appointments cancelled or postponed. This translates to around 4.5 million less courses of treatment for adults who are expected to pay NHS dental charges. The cancellation of these procedures, if left untreated or unmanaged, could lead to more invasive and expensive treatments in the future, as well as deterioration of oral health. We are concerned that a rise dental caries, periodontitis and tooth loss are all very real possibilities.

There is an urgent need to offer help to those people at risk of dental disease, so their conditions are cared for in an appropriate and timely way. By temporarily pausing NHS dental costs, we believe it will offer an incentive for those in poorer health, needing more expensive treatment, to have their conditions treated. These are also the groups who might be more at risk of other diseases like mouth cancer. New cases of mouth cancer are on the rise in England (increasing by 64% in the last decade) and early diagnosis is essential for beating the disease and improving quality of life. Visiting the dentist is the main opportunity for early diagnosis of mouth cancer. In the wake of COVID-19 we have seen the suspension of UDAs, along with recommendations to postpone aerosol generating procedures, where possible. This will undoubtedly lead to many patients receiving multiple courses of treatment and incurring excessive cumulative patient charges. This places an unnecessary and unfair financial burden of those most in need.

The new set of dental practice guidelines also emphasise the need to reduce the amount of time a patient spends in a waiting room, and highlights the potential hazards caused by transferring cash. A pausing of NHS charges addresses both issues.

Since re-opening, dental practices in England have been given strict new ways of working, which include a fallow period in between patients. This means that dental practices are seeing far less patients than usual and experts are suggesting that dental practices are operating at 25% of their normal capacity. While this remains the case, any costs associated by pausing NHS dental charges would be a negligible expenditure for the Treasury. It is important that dentistry remains a fundamental part of a person’s health and wellbeing and must be reflected within the government’s wider health strategy.

Our data polling more than 2,000 people shows that 48% of the adult population are hesitant about returning to dental practices in the wake of COVID-19. Since then, dental practices across England have done amazing work to change the way they work, creating a safer and more comfortable environment for patients. We believe a financial incentive for patients in the form of a temporary pause on NHS dental charges would further help to encourage attendance. Ultimately, we believe pausing NHS dental charges will help hundreds and thousands of people combat dental disease and prevent a deterioration of health across the broadest spectrum of society.

I would ask that this request receives early consideration to help safeguard and protect the oral health of the nation.

Yours sincerely

Dr Nigel Carter OBE

You can support a freezing of NHS dental charges by writing to your local MP. Download the template letter by visiting: www.dentalhealth.org Find the details of your local MP at https://members.parliament.uk/constituencies.

Expansion of services in NHS dental practices in Scotland

NHS dental practices are to re-introduce a range of procedures, such as the use of drills, on a limited basis in Scotland. Practices have been able to see NHS patients for certain types of non-aerosol routine care as part of Phase 3.

Now dental practices, if they are ready, will be able to provide aerosol generating procedures (AGP) on patients with urgent dental problems from 17 August. This move will be supported by the provision of enhanced Personal Protective Equipment (PPE) to dental practices which will require to be individually fitted to dental team members to ensure they work effectively.

This limited introduction, with care prioritised for patients in need of urgent care, replicates the arrangements in place in urgent dental care centres.

Chief Dental Officer Tom Ferris said: “NHS patients have been able to receive care and treatment including aerosol generating procedures through one of the 71 urgent dental care centres in Scotland. Now a limited range of AGP procedures will be available at NHS practices – this decision has been taken after carefully and thoroughly considering the balance between the overall risk of infection with the needs of patients to be seen by dentists.

“I am pleased that patients seeking such urgent procedures can now been seen at their NHS practice, and in turn, that practices can expand their services to patients.”

Background

AGPs are defined as any patient care procedure that results in the production of airborne particles, known as aerosols.

These are relevant to the spread of COVID-19 since transmission may occur through both direct air-borne infection and through contact with contaminated surfaces.

In urgent dental care centres dentists and the dental team are provided with enhanced PPE, including face-fitted masks.

Dental practices that wish to provide AGP care to NHS patients will be provided with a similar level of PPE.

The Chief Dental Officer and his team are in regular contact with NHS Boards to ensure dental practices have clear guidance on appropriate procedures for seeing patients. The Scottish Government have also been working closely with BDA (Scotland) in making the necessary preparations.

Towergate Health & Protection predicts a significant rise in businesses offering dentistry benefits

With dentists across the UK beginning to open their doors to patients, a significant backlog of people needing dental treatment as a result of the pandemic, and costs of treatment likely to increase – offering access to dental care is set to become one of the most popular health and wellbeing benefits, predicts Towergate Health & Protection.

Brett Hill, Distribution Director at Towergate Health & Protection, said: “With most dentists forced to shut due to Covid-19, only treating or referring urgent cases, businesses and employees alike will want to get back on track with dental care now that surgeries are gradually reopening. With access to NHS dentistry about to become more difficult than ever, and costs for private dentistry expected to rise, we are likely to see an increase in businesses investigating options available to support staff with their dental health, such as providing greater financial support for check-ups and treatment.”

Supporting increased cost

Dentists may well look to pass increased cost – due to additional spend required for Covid-19 infection control – on to patients. As a result, businesses will be looking at ways to help employees manage the additional financial burden by providing benefits that can support this outlay. Dentist surgeries are having to invest in PPE, to meet Public Health England requirements for operating safely, and won’t be able to see as many patients as before – to adhere to social distancing and cleaning regulations. Some associated costs will need to be transferred to the patient, and dental benefits – such as cash plans or those included within private medical insurance – can help employees with covering the expenditure.

Minimising related absence

Employers will also be keen for those staff suffering with non-urgent requirements to be treated as soon as possible, for their personal wellbeing, and to return to work more quickly and comfortably. As dentists work through the lockdown-induced backlog, demand for services may outstrip supply – so delays are to be expected. Waiting for slots to become available, the increased time required to physically attend appointments, and inability to work because of dental health issues can increase dentistry-related absence; but benefits can help with affordability if treatment is required – potentially preventing further delays from returning to work.

Hill added: “Employers will be very aware of the health concerns their staff may have faced during lockdown and will be eager to support them as restrictions are being lifted. With dental surgeries beginning to reopen across the UK, a key way for businesses to support staff will be by helping them to afford treatment and check-ups. By providing benefits, such as dental insurance or health care cash plans, businesses can support employees with getting their health back on track – in turn, potentially improving wellbeing and absence.”

Study links gum disease to dementia

New research, conducted by a team from the University of Minnesota in Minneapolis and published in Neurology, has found that gum disease is associated with double the risk of being diagnosed with dementia. The team, examined more than 4,500 adults who initially did not suffer from the memory deteriorating condition and, 18 years later, discovered that more than one in five of those with no teeth (23%) or severe gum disease (22%) had developed dementia. In comparison, only 14% of the participants with good oral health at the start of the study had developed dementia.

“We looked at people’s dental health over a 20-year period and found people with the most severe gum disease at the start of our study had about twice the risk for mild cognitive impairment or dementia by the end,” said the study’s lead author, Dr Ryan Demmer, epidemiologist at the University of Minnesota. “The good news was people with minimal tooth loss and mild gum disease were no more likely to develop thinking problems or dementia than people with no dental problems.”

Dementia is a syndrome comprising various conditions that ultimately cause the ongoing loss of brain functionality, affecting a patient’s memory, thinking, behaviour, and motor skill. Dementia affects 850,000 people in the UK, a number that is expected to rise to 1.6 million by 2040.

To gain an understanding of just how dental health can affect the risk of dementia, the Minnesota team began by looking at more than 8,000 people, whose average age was 63 and who did not have dementia. The subjects underwent a full dental examination, measuring bleeding, gum recession and plaque, before being grouped by the severity and extent of their gum disease, and number of lost teeth. A follow-up was conducted an average of 18 years later on each patient to reassess their situation.

The results, which were published in Neurology, showed that, overall, almost one in five (19%) had developed dementia. Only 14% of those who had healthy gums and all of their teeth at the startof the experiment were diagnosed with dementia. For those with mild or severe gum disease, 18% and 22%, respectively, had developed it. The highest rate of 23% was from those with no teeth, including cases in which they had been replaced by implants.

Those with no teeth were therefore around twice as likely to develop dementia or mild cognitive impairment than those with healthy gums and all their teeth in tact. Those with intermediate or severe gum disease, but who still had some teeth, showed a 20% higher risk.

These results reportedly remained true when adjusting for other factors that can affect the risk of dementia, such as diabetes, high cholesterol and smoking.

“Good dental hygiene is a proven way to keep healthy teeth and gums throughout your lifetime,” said Dr Demmer. “Our study does not prove an unhealthy mouth causes dementia and only shows an association. Further study is needed to demonstrate the link between microbes in your mouth and dementia, and to understand if treatment for gum disease can prevent dementia.”

CDO issues letter regarding nominations from the dental profession for national honours

Sara Hurley, Chief Dental Officer for England, has issued an open letter regarding nominations from the dental profession for national honours:

I am writing to request your support in acknowledging those individuals who merit state recognition.

We are now looking ahead to Birthday 2021 Honours and I would appreciate it if you can take the time to nominate those colleagues who you work with who have made an outstanding impact in dental care and the improvement of oral health.

Nominations can cover specific activities or a life time achievement. Status or seniority isn’t important – what matters is what the person has done and the impact they have had on people’s health and care over a sustained period of time.

I would ask you to note that the workforce of the NHS is predominantly female. As such the Health Honours Committee is looking to reflect this in its awards. In addition, the Committee is actively looking for deserving recipients of the British Empire Medal (BEM). This is awarded to those who have made a significant difference and gone beyond their day job, at any level. It is particularly apt for individuals at the beginning of their careers or even still in training. Deserving candidates may have carried out innovative work over a short period of time (3 to 4 years). Their endeavours may relate to their professional arena or voluntary work with a local community in need. The hallmark is of their contribution is frequently exemplary dedication and quiet perseverance.

Recent correspondence from DHSC states:
– People who fit the Prime Minister’s priorities for Honours:

  • Create jobs and economic activity across the country and support a global, outward looking Britain;
  • Support children and young people to achieve their potential, whatever their background;
  • Aid social mobility, enhancing life opportunities and removing barriers to success;
  • Give their time to improve their local community; and
  • Work to tackle discrimination in all its forms.

The Prime Minister is keen to recognise activity which supports diversity and social mobility.

– Women, people from black and minority ethnic backgrounds and young people
– Frontline NHS workers and those in under-represented professions or occupations
– Those working in areas outside the South East.

When crafting your nomination, please remember it is not about replicating an individual’s CV. There is a fine art to composing and developing a successful nomination. As well as articulating the evidence of merit it is vital to adopt the right tone and language. The Honours Committee often asks for details on the number of patients, public, health care workers impacted by the nominee. The online Department of Health: Honours nomination form and guidance – Publications – GOV.UK.is useful to help develop your draft. We have attached a copy of this along with the latest Honours Citation form.

Your nomination will need to be with england.cdoexecutive@nhs.net no later than close of play Tuesday 25th August 2020 Nominations should ideally have the support of recognised bodies/individuals and be signed-off by the Chairman/Chief Executive of the employing/educational organisation.

Further development of text and evidence may be required to pass muster with the variety of mandatory honours boards that filter nominations ahead of any final endorsement. Whilst success is not guaranteed every time, for those with significant achievements there is no expiry date and the opportunity to revise and re-submit at a future date always remains an option worth pursuing.

Thank you in anticipation of your assistance and receipt of your nominations in due course.

With thanks and best wishes.
Yours sincerely,

Sara Hurley

For guidance on completing the form from DHSC  a sample citation and the latest honours template can be found here:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/766815/honours-process-guidance.pdf

{my}dentist research reveals the urgent need to grow access to dentistry

Unprecedented levels of decay and periodontal disease, dental health neglect, lockdown overindulgence and life-threatening diagnoses missed – just some of the predictions for the UK’s dental health from professionals on the front line if access to affordable care isn’t increased.

A survey of {my}dentist’s clinicians across more than 600 dental practices, carried out during lockdown, revealed 96 per cent of dentists, therapists and hygienists believe lockdown has had an adverse impact on the nation’s oral health and that greater access to affordable dental care is needed. {my}dentist, the country’s largest provider of affordable and NHS dental care, is calling for an urgent review of access to dentistry in response to the challenges.

Prevention has been prevented

Eighty-eight per cent of dental professionals believe the UK’s dental health could decline because of a lack of routine appointments leading to preventative dental issues worsening.

And a further 77 per cent are especially worried that oral cancers will be missed and not referred.

Sixty per cent of the clinicians asked also believe that some patients could put off going to the dentist to treat minor symptoms, such as toothache and bleeding gums, leading to larger problems in the longer-term. 

Lockdown diets

But it’s not just a lack of access to dental practices during lockdown that dentists fear will leave a lasting impact on the nation’s health.

Seventy-eight per cent of {my}dentist clinicians worry about the impact on oral and dental health of lockdown comfort eating and over-indulgence in alcohol, sweets, snacks and sugary drinks.

In-demand dentistry

As clinicians return to practice, they are bracing themselves for more caries, periodontal disease and trauma.

Seventy per cent of dental professionals believe treatment for children with caries will be the most common reason for a visit to practice post-lockdown.

While 69 per cent of clinicians predict an influx of adults looking for treatment to cope with periodontal disease and 58 per cent believe treatment for trauma caused by broken or knocked out teeth will be one of the main reasons adults return to their practice.

The lockdown hangover

Overall, 41 per cent of clinicians believe it will take between a year and 18-months for the UK’s oral health to return to ‘normal’ after the COVID-19 crisis.

And a further 12 per cent predict it will take at least two years for the nations dental health to recover from lockdown. Without the right decisions, including ensuring there are enough dentists able to practise in the UK, it may take longer still.

Even before the pandemic, more than 50 per cent of all dental practices across the UK were closed to new NHS patients, with more than 75 per cent reporting difficulties in recruiting enough dentists to meet demand. 

Nyree Whitley, group clinical director at {my}dentist comments: “Temporarily suspending routine dentistry during the pandemic was absolutely the right thing to do to protect patients and colleagues and to help stop the spread of the virus. But it came at a cost and it will be felt by both the profession and patients for several years to come.

“As our research shows we’ve got a long journey ahead of us, particularly since access to affordable dentistry was limited before the pandemic. We’ve worked hard to reopen as quickly and as safely as possible to help get the nation’s dental health back on track, but we need an urgent review of access to dentistry to ensure no patient misses out.”

Since reopening its practices in June, {my}dentist has made significant investment to protect its  colleagues and patients.

Temperature checks have been introduced across all of its dental practices, as has the installation of protective screens and social distancing POS, floor stickers and posters, a review of suction in all surgeries, appropriate PPE for both AGPs and non-AGPs, hand sanitiser stations and a new patient journey to minimise time in practice. 

To cope with patient demand and capacity issues {my}dentist practices are still offering the phone triage service which was put into place during lockdown and individual practice plans are being rolled out to help maximise capacity in the fastest and safest way possible. 

Nyree adds: “How the dental community has responded to this challenging time has been nothing short of fantastic, we’ve all adapted to new ways of working and pulled together to support one another.”

One of the ways which Nyree and her colleagues are supporting the wider dental community during this challenging time is through the {my}dentist Academy.

A resource previously available only to {my}dentist professionals, access to the academy has now been extended for a limited time to all the whole dental community so everyone can take part in world-class CPD through a variety of workshops and lectures. 

For more information visit www.mydentist.co.uk

College of General Dentistry recruits for an Advisory Strategy Group to guide its development

The College of General Dentistry is recruiting an Advisory Strategy Group, seeking contributions from across the dental team. This is an important opportunity for people across the Registrant community to make an active contribution, guiding the future direction of the College. 

The Group will play a crucial role in advising the Board of Trustees as they make plans to launch the College. The Group’s 15 members, who will have first-hand experience working across the dental team, will provide much-needed insight into the ideas, perspectives and priorities of people working in dentistry. 

Chair of Trustees, Prof Nairn Wilson, said:  “This is an exciting moment for the College, a step closer to its formal launch, and a mark of our commitment to embrace the interests and contributions of the whole dental team. We believe that a lack of diversity in leadership and influence in dentistry is a barrier to effectiveness – and we want our Advisory Strategy Group to draw upon strengths across the many communities that have such an important role to play for the future.”

Applications close on August 21st, with interviews planned in early September. Details can be found at https://wp.me/P8ZZcL-tx

Dentsply Sirona will not take part in the International Dental Show (IDS) in March 2021

Taking into account all the different factors for its customers and employees and following intensive discussions, Dentsply Sirona has decided the Company will not attend the International Dental Show (IDS), scheduled to be held from March 9th to 13th, 2021 in Cologne, Germany. This also applies to Dentsply Sirona brands VDW, MIS and Zhermack.

Charlotte/Bensheim, July 28th, 2020. Current estimates indicate that the expected restrictions due to the COVID-19 pandemic in March 2021 will almost certainly not allow the proximity and depth of consultation that Dentsply Sirona and its customers know and value.

In particular, this environment would mean that customer meetings, interactions and consultations would not have their usual quality. Dentsply Sirona also believes that travel conditions will result in significantly fewer national and, especially, international visitors attending the IDS. The company puts the safety of its customers and employees first when making these types of decisions.

Walter Petersohn, Chief Commercial Officer at Dentsply Sirona, says, “It was a difficult decision to make, but much of what makes the IDS and its unique dynamics what they are, will not be possible in March 2021 because of the conditions we expect due to COVID-19. We would not be able to provide our customers and visitors with their usual experience at the show at this time. The same applies to the quality that they expect of Dentsply Sirona. We trust that the situation will change in due course, and we already look forward to taking part in the next IDS.”

BSPD creates new committee dedicated to research excellence

A new committee has been created by the British Society of Paediatric Dentistry (BSPD) to have scrutiny over all aspects of the Society’s work with academic and clinical governance components. The Quality and Improvement Research Committee (QIRC) will encourage all clinicians in the specialty to produce, disseminate and implement the highest quality evidence. It will co-ordinate national audits, prioiritising ideas, reviewing protocols and allocating leads.

Other functions will include:

  • Providing clinical expertise and guidance to BSPD
  • Reviewing external guidelines and signposting to these
  • Coordinating approaches for representation on external guidelines
  • Advocating for academia, to ensure the best projects are funded
  • Encouraging paediatric dentists to be research active and consider an academic career
  • Having oversight of all requests to BSPD for questionnaires to be disseminated for membership feedback, making sure they are of value and scientifically valid
  • Supporting BSPD’s trainee research collaborative CONNECT
  • Responsibility for the annual Clinical Effectiveness Bulletin

The group has been created at the behest of BSPD’s Executive Committee by Professor Paul Ashley, Senior Clinical Lecturer and Honorary Consultant at UCL, who will be the first Chair, supported by Dr Chris Vernazza, Senior Lecturer and Director of Research at the University of Newcastle’s School for Dental Sciences.

Prof Ashley said: “I am delighted to be asked to Chair this new and important committee for BSPD. It’s our aim to drive the evidence base, support research and encourage more dentists to take a more active interest in research too.”

Dr Vernazza commented: “In the past, it might have been BSPD’s role to write guidelines but bodies like NICE or SDCEP are producing national documents which we can signpost to, leaving QIRC to focus on maintaining the most rigorous and consistent standards in the society’s work.”

As the incoming honorary BSPD Editor for the International Journal of Paediatric Dentistry Dr Vernazza has an automatic place on QIRC.

Other roles to be represented on QIRC are:

  • Consultant group
  • Specialists Group
  • Trainee Group
  • Clinical Effectiveness Bulletin Editor
  • Clinical Effectiveness Bulletin Editor Assistant
  • CONNECT Trainees
  • Teachers group

Claire Stevens, spokesperson for BSPD said: “With the creation of QIRC, BSPD anticipates more national audits in the field of paediatric dentistry as well as more support and encouragement for our members who wish to become or remain research active. These are exciting times.”

Dental payroll services – why it’s time to outsource

From calculating employee wages and taxes, to updating holiday and sick pay or deducting employee-contributed payments for benefits, managing payroll is complex. Lansdell & Rose’s specialist dental payroll services, delivered by our sister company, Wagemate (www.wagemate.com), are designed to take this headache off your to do-list, while saving you time and money.

Should you outsource your payroll?

The answer tends to be “yes”. This is especially true for practices who employ more than five individuals, either as staff or contractors.

In general, outsourcing payroll costs 50 per cent less than doing it yourself, whether your practice is large or small. That’s considering the investment you’ll need to make in time and money in order to learn and process your practice’s payroll needs. Outsource payroll and you’ll have more of both, which can be used for other areas of your business.

Other advantages include:

Convenience Simply provide Wagemate with the details of all staff and/or contractors and let them take care of the rest.

Efficiency Wagemate can seamlessly link into other areas of the business for support with auto enrolment, preparing tax returns for owners, managing HMRC submissions, reimbursing expenses, providing p45s and P60s and more.

Accuracy Everyone knows payroll needs to be accurate to ensure people are paid what they expect; it will be another job to rectify a mistake. The other side of an accurate payroll is ensuring you are up to date with HMRC regulations; get it wrong and, at worst, there could be financial penalties to pay. This leads us neatly on to….

Compliance Wagemate will make sure you are fully compliant when you are paying yourself, Partners, staff, and contractors. HMRC has a lot of rules that must be followed, which quite often intertwine, making for an increasingly complex process. Compliance is essential, no matter how many or few people you need to pay.

Grants and government schemes There are various government initiatives that you could benefit from, reducing how much money you have to hand over from staff/contractors/HMRC to a third party – we can make you aware of these opportunities.

As your practice grows, payroll will only become more time consuming. Outsourcing payroll gives you back more time to spend on your business, and peace of mind that it is being done accurately.

 

How do you arrange managed payroll services?
Contact Lansdell & Rose via the form below or call 0207 376 9333. Or contact Wagemate directly on 0330 102 102, or via their website www.wagemate.com.