Dental Practices Reopening – Watching the World Wake Up from History
As I write this, I am seeing the world wake up from a very strange kind of history. The last 3 months have been challenging to say the least. While our practice has been closed for any face to face work, our team has been working throughout the crisis. During the lockdown period we triaged patients and gave advice over the telephone, some sent in photographs too. We also did some Zoom discussions and all this helped to get patients through a very difficult time.
On the 28 May 2020 the Chief Dental Officer announced to the BBC that Dental Practices would be reopening. We were then advised, officially, that this was the case! Fortunately we had been preparing for this by ordering in the necessary protective materials and equipment. We have also had to consider how our policies would change in this new world. This has led to changes in our Standard Operating Procedures, which you will experience when you visit us. You can look at guidance for attending our practice on the home page of our website www.onedevonshireplace.co.uk
The difficulty for us is that the official advice has often been given at short notice. Sometimes the advice has been mixed in that different bodies are giving different advice. The scientific advice given in different countries is different. A good example of this is the guidance for social distancing in metres. If you are in the UK it is 2 metres, in Germany it is 1.5 metres and in France it is 1 metre. In China and in South Korea, there were systems in place to react quickly to Covid 19. This seems to be because of the problems that these countries faced, with SARS virus years ago. I hope that we can all learn from this in the future.
Practices in Germany have not been allowed to close throughout this crisis. In Ireland Dental Practices have been allowed to see patients for emergency treatment. While in Wuhan, China, there were a number of practices that remained open throughout the crisis. These practices had set criteria for remaining open safely and there was a closely monitored track and trace service in the country. There was no evidence that transmission occurred in relation to these practices.
The policies and standard operating procedures that NHS England have sent out to us, have been evolving on a week by week basis. As this happens we are looking at the changes and seeing how we adapt these to our own working environment. The British Orthodontic Society have also been helpful in giving advice. This was on specific aspects of best practice during this crisis. There are also some good videos that patients can access by visiting https://www.bos.org.uk/COVID19-BOS-Advice/COVID19-BOS-Advice We have also taken some of our own measures such as purchasing air purifiers for each treatment room and we have also bought a fogger to thoroughly clean the practice with an antiviral agent.
Seeing patients again
We started back to our face to face work by only seeing emergency patients. We have now built this up to include patients who need treatment but have not been seen for a long time. Our staff are starting with those who were about to have adjustments. In time we will be able to start seeing a wider range of patients but it will be difficult to see new NHS patients at the present time.
We are now seeing patients again but we are only allowing one patient at a time into the practice, to see an orthodontist. There is also a specific flow for patients through the building. We have a number to call us when you arrive in your car, so that we can ask you some questions. If there are no problems then you will be invited to come to the door of the practice. A nurse (wearing protective gear) will greet you and take your temperature with a contactless thermometer.
You will then be directed through to the treatment area and allowed to put your bag, coats etc in a container. When you are seated we will ask you to rinse for 15 seconds with a peroxide mouthwash. This can be released back into the rinse cup and we will dispose of this for you. Using protective gear, we will carry out any necessary treatment and then show you the way to exit the practice. We will then phone you to make your next appointment.
How you can help
Please, please arrive at the practice 5 minutes early if you can. We have only been able to book 1 patient every 30 minutes. You would be surprised at the number of people who did not turn up and did not let us know in advance. If you arrive late, we will not be able to have the surgery ready for the next patient. We have also had to rebook some people who have arrived 10 minutes late, to avoid complete disruption to the rest of the day which would result. Please bear with us while we process this.
The system above has been working well and as time goes on we will introduce more complex procedures. Time between each patient has, for obvious reasons, increased significantly and this will have an effect on how quickly we can see patients.
Many of our suppliers have found it difficult to secure equipment for practices but as the situation eases, this will improve. There are a few things that we still have on order but these are mainly for carrying out Aerosol Generating Procedures. We can provide most of the care we need to without the need for such procedures.
We are very much looking forward to getting back to a new kind of normal. Please be assured that we are doing our utmost to do this in the safest way possible for you. I very much hope that we can look back at this as history but history we can learn from and will change the way we deliver our care for the better.