Shortage of PPE may force reopened dentists to limit treatments

People suffering from toothache may continue to struggle to get appointments with their dentist and more could be forced to resort to extreme DIY measures, despite the government announcement that dental practices can open from next week.

The chief dental officer for England, Sara Hurley, last week asked the country’s 10,000 practices to start offering routine appointments from 8 June but the British Dental Association has warned that many surgeries will be unable to carry out a full range of treatments because of widespread shortages of personal protective equipment.

Eddie Crouch, vice-chair of British Dental Association executive committee, said dentists would need professionally fitted respirator masks to safely deliver routine procedures such as drilling and filling teeth because they generate millions of potentially infectious microscopic droplets. “Many practices will struggle to get the PPE they need to reopen fully,” he said. “It is unrealistic to think it is going to be business as usual in a few weeks’ time.”

Dental practices have been closed since 25 March, with reports growing of desperate people attempting to deal with their own dental pain at home. “DIY dentistry has been around for quite some time. But it has been exacerbated by coronavirus. People often don’t have anywhere to go,” added Crouch.

Kate O’Neill resorted to filling her own tooth twice this month at her home in Stockton-on-Tees. “A filling came out and it was causing me a lot of discomfort,” she said. “I called my dentist in a panic and he left me some paste in a sealed bag outside the practice. I watched a YouTube video and then did it all myself. I was in tears. It was really awful.”

O’Neill, 46, was unable to get a referral to an NHS urgent dental care centre, which were set up after practices closed and only deal with the most serious cases such as life-threatening infections and acute pain. People with less severe toothache are given painkillers and antibiotics in order to prevent the skeleton service from being overwhelmed.

The BDA said the emergency dental system had been plagued by delays and shortages of equipment. “It took between two and three weeks to set up urgent dental care centres, with some parts of the country only getting emergency provision a week ago,” said Crouch. “Many areas went six weeks without any provision at all. There is a huge backlog of cases now.”

O’Neill’s dentist, Paul Woodehouse, said he had never imagined he would be asking patients to fill their own teeth. “We are one of the richest countries in the world with an advanced healthcare system,” he said. “We shouldn’t be doing this – it’s not right.” 

Another of Woodehouse’s patients also filled her own tooth. Shirley Courtney-Sinclair, 63, was unable to get a referral when her filling came out. “I had no idea what I was doing,” she said. “I was worried I might not have cleaned it properly. What if it gets infected?”

One frustrated man came close to using a power tool to file down a troublesome tooth. “I had a call last week from a man who took a Dremel Multi to the top of his teeth. He bottled it when he felt the vibrations getting close to his teeth,” said Woodehouse.

Woodehouse, who is getting 30 emergency calls a day is struggling to source enough PPE to allow his practice to fully reopen.

He said he had donated most of his equipment to the NHS in the early weeks of the crisis. “Dentists are not even at the back of the queue for personal protective equipment – we’re not in the queue,” he said.

This month health minister Lord Bethell claimed in a Lords debate that the government was buying billions of items of PPE, including equipment for dentists.

A Department of Health and Social Care spokesperson said: “As we continue to tackle this global pandemic, we are working around the clock to make sure frontline healthcare staff have the PPE they need and have set up special distribution routes for all urgent dental care centres.

“Until dental practices begin offering a wider range of services, which will start gradually from 8 June, the 550 NHS urgent dental care centres will continue to treat patients in need.”