coronavirus

GC Europe launches Safe4Dentistry.com to provide safe and effective treatment options

GC Europe Launches Safe4Dentistry.com, a Resource Centre for Dental Professionals on Mitigating Risks of Aerosols During Treatment.

Recognising how dramatically the Covid-19 pandemic has impacted the practice of dentistry, GC has developed a microsite dedicated to providing the latest updates on evolving guidelines for dental professionals. Safe4Dentistry.com is a continually updated resource centre that provides safe and effective minimally invasive dental treatment options and data, including information on how to reduce aerosol production to protect staff and patients during appointments.

The Safe4Dentistry.com site is populated with podcasts, clinical case examples, continuing education (CE) courses, and access to live webinars, recent articles and other resources. Topics include placing minimally invasive low-aerosol fillings, how to approach emergency treatments, ways to keep the dental practice safe and secure, and much more.

Minimally invasive restoration techniques often eliminate the need for high-speed drilling, which creates aerosols that can impact both patients and practitioners. Using glass ionomer and glass hybrid restorative technology systems provides interim and long-term restorative solutions. Featured cases demonstrate how blending glass hybrids and traditional materials and methods can reduce aerosols, such as utilising materials like EQUIA Forte HT glass hybrid restoratives that require no high-speed drilling or extensive tooth preparation.

Implementing the correct protocols is paramount to patient and staff safety but keeping track of the rapidly changing recommendations and guidelines can be daunting. The Safe and Secure Practice section of the microsite contains the latest updates on evolving guidelines by organisations such as WHO, FDI, and many other European associations, step-by-step procedures, and relevant articles and resources for the dental practitioner.

The Additional Resources section contains systematic reviews, additional tutorials, webinars and podcasts. Presenters include Prof. Dr. Ivana Miletić, Prof. Dr. Sevil Gürgan,

Prof. Dr. Sebnem Türkün, Dr. José Ignacio Zalba Elizari, Dr. John Nicholson and many others. Dental professionals can also request online training and in office visits with their local representatives.

GC Europe is committed to the safety and wellbeing of both oral health providers and patients and the quality of its products. To gain user opinions and suggestions, Safe4Dentistry.com also includes tools to collect the opinions of our customers on certain topics.

For more information, please visit http://Safe4Dentistry.com/.

BDA: Data misses dramatic fall in access during Covid

The British Dental Association has warned the latest NHS Dental Statistics do not fully show the unprecedented fall in access driven by the Covid-19 pandemic.

While limited figures have been offered for the period up to 30 June 2020, data focuses on treatment delivered by high street NHS dentists in England in between 31 March 2019 and 31 March 2020. In this period only 58% of children had attended an NHS dentist in the previous 12 months, and 49.6% of adults in the last two years. 

Freedom of information requests by the BDA indicate access to the Urgent Dental Care Network – set up to treat emergencies during lockdown when face-to-face care was suspended in practice – amounted to little over 2% of normal levels of activity. Paperwork lodged by dentists with the NHS Business Services Authority indicate just 83,300 courses of treatment were delivered in May 2020, compared to an average of around 3.5 million per month in January to March. 

The BDA has warned that England has not yet turned the page on low levels of access. Recent BDA surveys indicate the overwhelming majority of practices are now operating at less than a quarter of their former capacity following the resumption of face-to-face care on 8 June. 

According to NHS data 38.4 million courses of treatment were delivered last year, an average of around 9.6 million per quarter. Low levels of capacity mean it will be a major challenge to deliver anything assembling those levels going forward. 

Practices are facing significant barriers to expanding capacity, including the need to leave surgeries fallow for 60 minutes after an aerosol generating procedure. Unless regulations evolve, the BDA has warned tens of millions of patients in England will effectively lose access to dental services.   

Dave Cottam, Chair of the British Dental Association’s General Dental Practice Committee, said: “This is data is from another era. Since March patient access has fallen off a cliff, and there is no certainty when or if it can be restored. Access was in bad place pre-pandemic. We should lament how few children and adults made it to an NHS dentist last year, but the real question now is how we can even bring the service back to these levels. We have practices struggling, and tens of millions of patients need somewhere to go. We need government to work with us to rebuild capacity.”

BSPD responds to the Local Government Association over the impact of Covid-19 on children’s oral health

The British Society of Paediatric Dentistry (BSPD) has stated that it agrees with The Local Government Association that there should be a resumption in toothbrushing schemes in early years settings as soon as practical and such schemes are essential to counteract the possible increase in dental decay as a result of lockdown.

Dr Claire Stevens, BSPD’s spokesperson, says the LGA is right to highlight the risk of worsening dental decay in children as a result of Covid-19 as well as the guidance that is now available on establishing such toothbrushing schemes. (1)  

BSPD is collecting the data to assess the impact of the pandemic on children’s oral health.  Prior to the pandemic, the figures for children having general anaesthetics for multiple extractions were starting to come down. This was thanks to the concerted efforts of many people, driving up preventive interventions and activities.

The cancellation of general anaesthetics for multiple dental extractions during COVID-19 will inevitably mean that hospitals are working through a backlog of cases once elective (non-emergency) procedures restart. There is also the possibility of increased dental caries in children, the result of being out of education and stuck at home with greater opportunities to snack.

BSPD would like to see children suffering from dental decay to be treated in primary care where possible, to reduce the need for onward referral into hospital. We have been producing resources to support GDPs provide silver diamine fluoride, a technique which arrests the progress of dental decay and may avoid the need for a general anaesthetic entirely. (2)

Dr Stevens commented: “As ever BSPD is keen to work with all stakeholders involved in the care and welfare of children to minimise the impact of Covid-19 on their oral health.”

Meanwhile, Dr Saul Konviser from the Dental Wellness Trust, also spoke on the matter: “Everyday we, as dentists, see a large number of children that require not just a simple filling but often multiple fillings or extractions which is often a result of consuming too many sugary foods and drinks. What is worse is that it is almost completely unavoidable. From the work that we do, we know strategies such as oral health prevention and toothbrushing programmes in schools and nurseries is one way of supporting this long overdue ‘prevention better than cure’ ethos. We now urgently call on the Government for more funding – especially as lockdown prevented many children from accessing a clean toothbrush and toothpaste.”

(1) https://www.gov.uk/government/publications/covid-19-supervised-toothbrushing-programmes

(2) https://www.bspd.co.uk/Professionals/Resources

ADG launches campaign as Covid-19 takes its toll on the nation’s oral health

The Association of Dental Groups has launched a national campaign calling on ministers to take urgent action to deal with the growing crisis in access to dentistry.

Ten weeks after dental practices started to re-open, the ADG is exploring the impact that lockdown has had on the national’s oral health. The centrepiece of the campaign will be new analysis showing how different parts of the country have been affected by Covid-19 restrictions.

The analysis will be shared with MPs and policy makers to ensure they are aware of how Covid-19 has further exacerbated existing problems with access to dentistry in constituencies across the UK.

It will include several recommendations for ministers to take forward to deal with the crisis in access to dentistry, with the focus on securing an increase in recruitment and retention of dentists.

The new campaign has been launched with a comment article here by Neil Carmichael, chair of the ADG.

Neil Carmichael says: “Few dentists are looking forward to seeing the full impact that lockdown has had on the nation’s teeth. But while dentists are already sounding alarm about where lockdown has left us, this is just the latest part of a bigger crisis we are seeing in UK dentistry. The reality is that Covid has made the situation worse and we will shortly be bringing forward new analysis that sets out just how bad it has become. At this stage, all of the signs point to a worrying picture with lockdown having led to less patients being seen and some of the most vulnerable groups being hit hardest.

“Our goals are attracting and training people here in the UK to become dentists and reforming the registration process for overseas dentists to work for NHS dentistry which has been exacerbated by lockdown and Brexit.”

Top associate contract concerns revealed by the DDU

The Dental Defence Union (DDU) has revealed the most common areas of concern that members face when negotiating a new contract. This comes as many dental professionals face a great deal of uncertainty regarding how associate positions may change as a result of Covid-19.

The most common themes and queries from our members include:

  • Remuneration – sometimes payment calculations are either overly complicated, or poorly written, both of which leave room for interpretation. Since the start of the pandemic, many members have contacted us regarding NHS pay and associate contracts. Our advice is that any written agreement concerning NHS payments should be in line with current guidance from the various Chief Dental Officers, and if temporary holding arrangements in place, there should be a degree of flexibility for both parties.
  • Retained fees – the contract should clearly set out how much money will be withheld, for how long and also how the money will be used and why
  • Termination – a contract can usually be terminated by either party by giving the required period of notice, or immediately for specific reasons. However, termination clauses should be balanced, and apply equally to the associate and practice owner
  • Restrictive covenants – also known as “binding out” clauses these set out a radius within which the associate will be unable to work for a set period of time after the contract ends. In order to be enforceable, such clauses may need to be considered reasonable if scrutinised in a formal dispute

As part of their membership, DDU members are able to access a free associate contract checking and advice service. The service, which is available to both associate and practice principal members has had 383 files since its launch in June 2019 and includes:  

  • Free advice on the wording of associate agreements from dento-legal experts
  • Free checks on contracts against best practice guidelines
  • Free access to a model contract, developed with specialist dental lawyers
  • Competitive rates negotiated for DDU members who wish to take a contract dispute further and need specific legal advice

David Lauder, dento-legal adviser at the DDU, said: “Since we introduced our associate contract checking service in June 2019, it has proved to be a very popular service offered as part of the standard DDU membership. However, it cannot be denied that Covid-19 has had a significant impact on dentistry and as a result there is a great deal of uncertainty regarding how associate positions may change in the coming months.

“In these unprecedented times, it may be helpful for associates and practice owners to discuss their contracts, including the achievability of any agreed targets and how any changes to the contract would be made if necessary going forward. Our expert dento-legal advisers are trained to handle the vast majority of queries and members can access this advice by calling our 24-hour dento-legal helpline.”

For more information on the DDU’s associate contract service, please visit: www.theddu.com/contracts.

WHO calls for routine dental checkups to be delayed until Covid-19 risk is known

As dental professionals return to work following lockdown, the World Health Organisation (WHO) has called for a delay in routine dental checkups until the full risk of the spread of Covid-19 is known.

WHO states that there is currently no data on the spread of coronavirus from the dentist’s chair, while adding that more research is needed into common procedures that produce tiny floating particles that may cause infection if inhaled. These include three-way air/water spray, ultrasonic cleaning equipment that removes deposits from the tooth surface, and polishing. Dental facilities must have adequate ventilation to reduce the risk of the virus spreading in closed settings, WHO added.

“WHO guidance recommends in case of community transmission to give priority to urgent or emergency oral cases, to avoid or minimise procedures that may generate aerosol, prioritise a set of clinical interventions that are performed using an instrument and of course to delay routine non-essential oral health care,” said Benoit Varenne, a WHO dental officer. “The likelihood of Covid-19 being transmitted through aerosol, micro-particles or airborne particles … today I think is unknown, it’s open to question at least. This means that more research is needed.”

Last month, WHO released general guidelines on the transmission of the coronavirus, which acknowledged some reports of airborne transmission, but stopped short of confirming whether the virus spreads through the air.

“We think that the most pressing issue is related to the availability of essential personal protective equipment, PPE, for all health care personnel undertaking or assisting in the clinical procedures,” Varenne concluded.

BACD Annual Conference postponed until 2021

Due to the challenges posed by Covid-19, the BACD (British Academy of Cosmetic Dentistry) has made the difficult decision to postpone this year’s Annual Conference until November 2021. Don’t despair, however, as next year’s event promises not to disappoint with an educational programme that’s bigger and better than ever.

Delegates will be treated to a fresh line up of highly relevant and exciting lectures, seminars and hands-on workshops. These insightful sessions will be presented by world-renowned speakers from 2020’s programme, as well as whole new cast of speakers for 2021, who are keen to share their knowledge and experience.

Besides the outstanding education on offer at the BACD’s 2021 Annual Conference, there will be plenty of networking opportunities, plus the chance to explore the latest dental technologies and materials at an eclectic trade show. The BACD looks forward to seeing you there – you won’t want to miss out!

BACD members benefit from being part of an innovative academy where online education is swiftly released and executed to the exacting standards that would be expected. The BACD has always offered education led by world-class speakers, which is being made available to members across the globe through BACD Online Education, which can be accessed through the online members portal on www.bacd.com.

Dental practices in Wales reportedly ‘operating at less than a quarter of capacity’

ITV News is reporting that dental practices are ‘operating at less than a quarter of capacity’ in Wales and that they will not be operating fully until ‘at least October’ according to some claims.

The report states that while services at dental surgeries across Wales are able to resume, as lockdown restrictions have been eased, stringent guidelines have made it difficult for them to operate fully. The Welsh Government allowed dental practices to resume from 1 July, however, a “phased approach” was taken due to the fact that, in some procedures, the risk of cross-infection is high due to the transfer of saliva.

Professor Mike Lewis told ITV News that this is why dentistry was going to be one of the areas of medicine that is going to “find it very difficult to return to normal because of the aerosol generation.”

Dental practices in England could fully resume on 8 June, while practices in Wales are currently operating under an ‘amber light’ in which some, but not all, procedures can resume.

A spokesperson for the British Dental Association said: ” The green status, where routine care returns, is unlikely to be reached till October at the earliest. Both nations are operating fallow time and maintaining 60 minute gaps between patients to reduce risk of viral transmission. This is a major barrier to access for all. It is not a return to business as usual in either nation. Most practices are operating at less than a quarter of their pre-pandemic capacity.”

The BES awards three COVID-19-related research grants

The British Endodontic Society (BES) recently invited proposals from UK-based applicants wishing to undertake immediate research to address the impacts of Aerosol Generating Procedures (AGPs) in dentistry during the COVID-19 pandemic. The Society had an excellent response and has subsequently increased its funding by more than 100%, awarding it to three separate research groups.

“We are delighted to have received such great feedback to our research call having received many, high quality, fundable submissions” said Dr Phil Tomson, Chair of the BES Research Committee.

“Due to the unique circumstances and potential tangible outcomes we have taken the decision to award three grants that offer different qualities. These will provide robust reassurance around the safety of carrying out AGPs with conventional mitigating factors whilst investigating new opportunities to improve things further.”

“The research committee and judging panel felt that there was urgent need for this research and took the longer term view to combine our 2020 and 2021 research funding allocation. COVID-19 is having far-reaching effects so we are keen to invest to improve things for our members and the dental sector. The projects have tight timelines so we hope that the outcome of the work has a significant effect on clinical practice as we navigate through these challenging times.”

The BES has allocated an £85,000 grant between three research groups:

Project 1 – “Quantifying dental aerosol generation and its mitigation in a generalisable way through visualisation and numerical modelling”

Jointly led by Professor Owen Addison, Chair of Oral Rehabilitation/Honorary Consultant in Restorative Dentistry and Dr Shanon Patel, Consultant in Endodontics Dental Directorate, Guy’s and St Thomas NHS Foundation Trust. Kings College London.

Co-investigator Professor Yannis Hardalupas, Imperial College London, Mechanical Engineering Department

Project 2 – “Dental aerosol generating procedures: assessment of risk and mitigation strategies”

Applicant: Mr James Allison, Clinical Fellow in Oral Surgery, School of Dental Sciences, Newcastle University

Co-Investigators at School of Dental Sciences, Newcastle University: Dr Richard Holliday; NIHR Clinical Lecturer in Restorative Dentistry; Miss Charlotte Currie; NIHR Doctoral Research Fellow; Mr David Edwards; NIHR Academic Clinical Fellow, Honorary Specialty Registrar in Endodontics; Dr Nicholas Jakubovics; Senior Lecturer; Dr Christopher Nile; Senior Lecturer in Translational Oral Biosciences; Dr Nadia Rostami; Research Associate; Professor Justin Durham; Head of School, Professor of Orofacial Pain, Honorary Consultant Oral Surgeon

Mrs Charlotte Bowes; Clinical Fellow in Restorative Dentistry

Project 3 – “An investigation into aerosol production during endodontic procedures and its potential mitigation; a simulation study with bioaerosols”

Applicant: Professor Brian Nattress, Clinical Professor/Honorary Consultant in Restorative Dentistry, Leeds Dental School and Hospital.

Co-Supervisor: Professor David Wood, Director of Research and Innovation, School of Dentistry, University of Leeds.

Co-Investigators: Dr Louise Fletcher, Lecturer in Waste Management, Aerobiology and Environmental Microbiology, Department of Civil Engineering, University of Leeds, Leeds; Professor Deirdre Devine, Professor of Oral Microbiology, School of Dentistry, University of Leeds; Mr Peter Nixon, Consultant in Restorative Dentistry, York District Hospital, York

 

“We are pleased to support this vital research” explained BES President, Sanjeev Bhanderi. “The quality and track records of the successful research groups and the standard of their research proposals will go a long way in bringing much-needed clarity and a robust evidence base for dentistry that has been lacking since the return to clinical practice. If at any time we were going to call upon the BES research fund for our members, this was the time to do it.”

BOFA Publishes Aerosol Extraction Guidance for Dental Clinics

BOFA, specialists in airborne contaminant extraction, has published a detailed guidance paper for dental clinics comparing the effectiveness and limitations of multiple aerosol extraction methods.

The paper considers the hierarchy of control at a time when dental surgeries are looking at measures to minimise risk for staff and patients from Covid-19. This methodology is used widely across industries to assess the impact of changes in working practices and the introduction of technology that can minimise exposure to hazards.

In the case of the dental sector, this includes the use of PPE and implementing engineering solutions (such as an extractor) to provide the safest possible working environment. 

Luke Ziolkowski, business development manager at BOFA, commented: “While it is common practice for dental clinicians to wear PPE, this only mitigates some of the risk of transmission in the case of viruses and does not provide total protection to the wearer. This new paper looks at what can be done to prevent aerosols reaching surfaces, equipment and the breathing zones of the dental staff by diverting, capturing and containing aerosols.”

Viruses such as coronavirus spread primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes, or via aerosols created during dental examination and procedure. Within a dental clinic setting, aerosols can remain airborne for a long time and may be transported over long distances in airflows, causing contamination in areas beyond the patient’s immediate vicinity.

The paper compares the effectiveness of direct aerosol capture at patient source with other methods, including PPE, room scrubbers, HVAC, push/pull airblade barriers and localised extraction.

The paper is available to download via the BOFA website: www.bofainternational.com/en/your-industry/dental/