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Failure by health bosses to suspend non-urgent care as soon as social distancing was instigated put lives at unnecessary risk, a dentist has claimed.
NHS chiefs in England ordered all non-emergency appointments to be stopped last week in a bid to slow the spread of Covid-19, leading to Kent dental surgeries contacting patients to postpone or cancel pre-planned treatments.
But this order came too late, according to one Kent dentist, who says the health of his staff and their patients was put at risk by the continued treatment of "silent carriers" of the coronavirus.
Speaking to us on condition of anonymity, the dental doctor complained of a lack of adequate personal protective equipment (PPE) beyond standard surgical provisions, which he says would have been ineffective in preventing infection from the pandemic virus.
"As soon as Covid-19 was announced to be prevalent in the UK, we were faced with a shortage of face masks, alcohol gel, medical soap, visors, disinfectant products and gloves," he said. "We were advised by suppliers not to stockpile, and were able to order in small amounts which enabled us to continue with the provision of dentistry.
"But we were concerned, as we knew that normal face masks would not protect us from Covid-19 and we really needed FFP3 masks. Many dentists attempted to contact international companies to obtain these and distribute them to dentists, but were unfortunate to be advised to continue with routine dentistry and wear our normal PPE."
FFP3 masks are a piece of respiratory protective equipment which is tighter-fitting than standard surgical masks and they provide greater levels of protection against coronavirus.
"During this process, the CDO of England has let the dental profession risk contracting Covid-19."
As it became clear that the spread of coronavirus was increasing, the dentistry profession became increasingly alarmed that the Chief Dental Officer (CDO) for England had not yet advised the suspension of all but emergency treatment.
On March 22, the British Dental Association (BDA) issued a statement to its members urging a reduction in routine work. But it was not until March 25 that official advice from the CDO changed, cancelling all non-urgent activity - and it is this delay that has angered the Kent dentist who spoke with us.
He said: "During this process, the CDO of England has let the dental profession risk contracting Covid-19 and failed to protect the public who may attend our premises."
Concerns of the profession also include the level of financial support available now a majority of work at surgeries across the country has been cancelled. The NHS guidance issued on March 25 indicated that "practices benefitting from continued NHS funding will not be eligible to seek any wider government assistance to small businesses" as it may be duplicative.
It is understood this means dental firms who continue to receive NHS funding will not be able to claim from schemes such as wage relief for furloughed staff, a decision which our Kent dentist says will leave his business - which carries out both NHS and private dentistry - at risk of bankruptcy.
Responding to the issues facing the profession, BDA chairman Mick Armstrong said: "In the absence of clear leadership from NHS England many dentists took the step to suspend routine care themselves to keep themselves and their patients safe.
"That foot dragging continues, as in many parts of England a promised urgent care service is not yet in place. Colleagues are now busy fielding calls from patients in pain, but often with nowhere to send them.
"Sadly the lack of a proper safety net could see many practices go to the wall. They are being forced to chose between NHS and other government support, and inevitably large numbers fall through the middle. Patient access was already a problem. Without help things are set to go from bad to worse."
Urgent dental care centres are being set up across the country to provide what is described as 'hot' or 'cold' treatment depending on whether or not the patient is suspected of having the virus.
But the BDA still has concerns about the availability of appropriate PPE, saying the dental profession disputes claims by the government that all dental practices have received fresh supplies. The BDA also argues that provision of urgent care has "barely got off the ground" in many parts of the country.
"Weeks have been lost that should have been spent setting up a properly equipped emergency dental service," Mr Armstrong said.
An NHS England and NHS Improvement South East spokesman said: "Guidance has been provided for dentists and all routine dental care has been suspended. If a patient needs urgent dental care they should continue to call their dental practice as normal who are able to provide advice, analgesia and anti-microbials where appropriate.
"National advice is that dental treatment should not be carried out unless absolutely necessary. If needed dentists can refer patients to urgent care centres that are currently being established.
"The Department of Health and Social Care has secured millions more items of personal protective equipment which is going out to frontline staff. While the NHS is using high quantities of equipment to protect staff and combat the virus, the full weight of the Government is behind ensuring our staff have the high-quality protective equipment they need."
