George Wright, Senior Dental Educator and Dentolegal Consultant at Dental Protection, looks back at a turbulent year for everyone – and how dentistry responded
A year ago, the UK Government announced the biggest one-day increase in COVID-19 cases to date, with 34 new cases bringing the total to 87. Meanwhile, Italy announced it was shutting schools and universities. It would be a further 12 days before Boris Johnson began his daily press briefings, urging everybody to work from home and avoid pubs and restaurants.
People began adapting to working from home and preparing for the expected closure of schools across the UK. Schools in England were subsequently closed and the nation went into a full lockdown on 23 March 2020. There are a small number of significant life events that stick in my mind. I can recall, for example, exactly where I was and what I was doing when the 9/11 twin towers terrorism attack took place. So too can I recall where I was when I heard Boris Johnson solemnly address the nation on 18 March 2020 to confirm schools would be closing.
One year on from those weeks of rapid shift in our daily lives, I thought it would be a good time to reflect on what the dental profession has learnt and how the profession responded to the global pandemic.
A united profession
As dentists reacted to the news that dental practices would close and urgent patient care would be provided by urgent dental care centres, there was a feeling of unity among colleagues. Unity in sharing information and advice on how to approach the planned closures. Unity in supporting each other – either by covering for colleagues that were shielding and sharing triage responsibilities, or by offering support to those struggling with balancing the demands of the job, home life and a largely unknown novel virus.
At the same time, the support offered to NHS practices – and the lack of support offered to private practices – created an unpleasant divide. At times, partly owing to frustration, this boiled up and manifested on social media with hotly debated discussions around NHS and private practice. With the government capping support for self-employed workers at £50,000, any private dentists earning even a penny above this threshold have received £0 in support, despite having been asked to close their doors. Naturally, this created a range of challenges and pressures that dentists had to manage.
It was refreshing therefore, in the face of such challenge, to see Dental Protection step up and fill in some of the gaps (no apologies for the dental pun there). A rapid mobilisation of colleagues across Dental Protection saw us provide regular panel webinars – often attended by thousands of members – helping to fill the information void in the early weeks and months of the pandemic. At the same time, I was able to talk to dentists with pride when asked what financial support would be offered. Two months of membership fees returned to members at a time of such need provided some much-needed relief to many.
Dentists are key workers
As a dentist, I am allowed to play the ‘woe is me’ card when it comes to the age-old medic vs dentist debate. For years, dentists have been considered the poor relation. Not necessarily in the eyes of colleagues or other healthcare workers, but perhaps in the eyes of politicians and policy-makers, who often conveniently overlook dentists in key communications.
The pandemic has shown what a valuable role dentists can – and do – play in the provision of healthcare. Colleagues from across the country put themselves forward for redeployment. At the height of the first, second and third waves, you may well have come across a dentist as the family liaison for patients in intensive care. Similarly, by keeping dental care in the dental surgery by keeping services running, dentists have helped to ease pressure on secondary care services and, crucially, keep patients out of hospital.
Most recently, dentists across the UK have responded to the call for healthcare workers to support the vaccination effort. Indeed, you may find that your COVID-19 vaccination is administered by a dentist. Just another example of how the profession has responded – and stepped up – at a time of national crisis.
Dentistry can’t be delivered outside the surgery – or so we thought. With dentists being asked to close their doors, and the introduction of the so-called ‘triple A’ approach of Advice, Analgesia and Antibiotics, dentists had to quickly adapt to a totally new way of delivering care to patients. At Dental Protection we were quick to respond with a series of webinars on teledentistry, highlighting the opportunities, risks and guidance around delivering remote care.
At the same time as this drive to provide remote care, Dental Protection has been able to partner with Chairsyde to deliver a very timely benefit of membership to dentists. The pandemic has undoubtedly sped up what was an inevitability; that the digital revolution would change the way dental care is provided forever. Now, patients are able to consult with their dentist remotely before, during or after treatments to discuss issues such as treatment planning, consent and aftercare. It will be interesting to watch how this develops over the months and years ahead.
A key element of a dentist’s professional life is the requirement to undertake a defined number of hours of CPD. The pandemic removed the opportunity to network and meet colleagues at dental conferences and brought new challenges – understanding what Zoom was and getting to grips with the mute/unmute function! GDC hearings are now conducted almost entirely by video conference and if you wish, you can find a dental webinar most nights of the week. Against this background, Dental Protection has had to adapt to supporting members at virtual hearings and to delivering CPD remotely within a highly competitive market.
PPE and AGPs
Who knew that Personal Protective Equipment (PPE) could be so interesting? Over the past year, dentists have gone through a cycle of turning up at hospital doors to donate any unused PPE when practices were closed, through to having to get hold of PPE (which was in very short supply) when practices reopened. At the same time, the profession had to navigate the new territory of enhanced PPE, FFP2 and FFP3 masks. New terms such as fit-testing and Aerosol Generating Procedures (AGPs) required some fast learning to get to grips with the requirements for providing safe care. As a result of the profession’s existing diligent approach to cross-infection, the leap to providing care in a COVID-safe environment was smaller than it might otherwise have been.
I think all of us can agree the past year has been filled with unique challenges that are unlikely to repeat themselves in our lifetimes. I hope the above brief summary of some of the highlighted challenges outlines how the dental profession has stepped up and shown the public the vital role the dental team play in the provision of healthcare. Who knows what the next year will bring? I for one am looking forward to seeing the government's road map unfold and being able to get back to normal.