Dental practices are about to enter the next stage of phase 3 on Monday 17th August with regards to NHS treatment. You may have read how dentists will be allowed to “drill” again on the NHS and to a certain extent this is correct. However, guidelines received on 7th August from the NHS Primary Care Directorate states that aerosol procedures can only be carried out where “malignancy is suspected or there is acute and intractable pain, sepsis or trauma.”
This only means “opening root canal(s) for drainage, pulp extirpation and dressing to seal cavities in permanent teeth, splinting in connection with external trauma”. All these situations involve the use of a drill. We continue to be able to see patients with urgent non AGP problems such as facial swelling, uncontrolled bleeding, trauma and new lumps / non healing ulcers.
As you can see we are still not allowed to carry out routine NHS dental examinations, fillings, crowns, bridges and scale and polishes. In Forth Valley we have been told that the enhanced PPE required for urgent NHS AGPs will not be available for use until 24th August at the earliest. We are being provided with enhanced PPE for 2 dentists and 2 nurses.
We are allowed on the NHS to carry out soft tissue checks and so again we would urge those patients who are at higher risk of developing oral lesions to contact us for a soft tissue check up. You are at greater risk if you are over 50 and a smoker, or have a family history of oral cancer. It is also important to let us know if you have an ulcer that is still present after 3 weeks, or a new lump in your mouth.
We are continuing to cancel all routine check up and hygienist appointments to the end of August and realistically expect this to carry on in to September.
Anne is still carrying out Airflow appointments on the private plan patients at the weekends and we feel these patients should be completed by mid September. We will then start contacting the patients who usually have Airflow appointments 3 monthly with her, and then the patients who see her 6 monthly for Airflow appointments.
If you are an NHS patient who was due to have treatment during lockdown and would like it completed privately then please contact us and we can provide you with an estimate. Private procedures are generally based on the 60 minute time slot you are in surgery plus 60 minutes where the surgery is unable to be used, plus 15 minutes surgery cleaning.
Costs start from £120 for an AGP slot. During this time the dentist may also be able to do a proper check up with the air drying syringe and a scale and polish if required. For example a single filling, check up and scale and polish would be £120. Please email email@example.com with a contact telephone number rather than phoning reception and someone will get back to you to discuss your options.
So in summary we are continuing to try and provide our patients with the best care allowed at this time. We are still screening all patients before they are allowed an appointment and our dentists/hygienist temperature-check each patient before allowing them through the door. We have our doors shut to stop anyone coming in who is unscreened to protect staff and patients already in the building.
We hope things will get better in terms of our NHS patients being able to be seen and we are planning for when that is allowed.
Stay safe and well,
John & Jennifer Denham
All our dentists, and their nurses, have now been face fitted for respirator masks. This enables aerosol generating procedures (AGPs) to be carried out once permission has been given by the NHS to dental practices in Phase 4.
Our Standard Operating Procedures for Phase 4 have also been approved.
Our application has been agreed for the opening of 4 surgeries by Forth Valley Health Board for NHS patients for non-AGP use during the current Phase 3.
The most important point to say is that if you have an ulcer that is still present after 3 weeks, or a new lump in your mouth then we need to see you.
We understand patients will now be thinking about their routine examinations that we had to cancel during lockdown. At the moment we are unable to use our air drying syringe, as its use is considered an AGP. Without the use of proper drying a meaningful check up is not really possible. We also have the issue of having to consider social distancing for the safety of staff and patients and having multiple patients coming in and out increases this risk.
Each person that is given an appointment has to be COVID screened by phone and a medical history also updated. Both Jane and Faith are currently spending all day phoning patients to complete this task. We have one of our dentists answering the main phone.
To carry out a single routine examination we now have to allocate 20 minutes to allow for the donning of PPE, doorstep screening, hand sanitising, bagging of any bags/coats brought, escort to surgery, the check up itself, escorting back to the door, hand sanitising before exit, removal of PPE and then cleaning of the surgery ready for the next patient. As you can see this more than doubles the time for a check up at a time when we can only have, at best, half our dentists in at a time on any given day. Our ability to see patients is around 25% of normal capacity.
What we are still doing is contacting and assessing patients, and treating where possible those patients who have had problems. These patients still remain our priority at this time.
DRILLING PROCEDURES (AGPs)
We are now in the position of being able to carry out AGPs on a private basis. What we need patients to understand is that each procedure uses a surgery that then has to be left empty for 60 minutes after use. The surgery then requires cleaning thoroughly before another procedure can take place. This means that we can only carry out approximately 4 AGPs a day per dentist.
Each dentist needs a second surgery to be able to see non-AGP procedures whilst the first surgery is “fallow”. Therefore only 3 or 4 dentists can work each day. The working day has been extended and any private plan patients are being seen by John at the weekends. This means more slots are available to NHS patients during our normal working week.
The hygienist appointments are always AGPs. Anne will require 4 surgeries allocated to her when she is working. Each appointment now has to be a 30 minute slot. The hygienist and her nurse will require enhanced PPE. It is for this reason that the hygienist will only be working at the weekends so that surgeries are not taken away from dentists who need them for treatments. Anne will be seeing our private dental plan patients first who have continued to support the practice throughout the lockdown by paying their monthly fees.
Once those patients have been seen then those NHS patients who pay to have an Airflow appointment will be seen. We will have to increase the Airflow fee from £35 to £45 to cover both the enhanced PPE being used and the extra time. We do need to make it clear that Anne can only see up to 32 patients per weekend and so this service is also severely reduced in capacity.
If you are an NHS patient who needs a scale and polish then the NHS would allow a hand scale only with your dentist (they are unable to polish your teeth as it is an AGP under NHS regulations). Please telephone reception to make a hand scale appointment if you require this treatment. If you have periodontal disease and see the hygienist, or your dentist, 3 monthly for scales and polishes then this would be our advice to get your teeth hand scaled as a minimum.
We are all working very hard to work to the best capacity that is possible under all the restrictions.
Again we would ask for your patience and understanding of the position we are in and all of our staff are trying their best to help our patients. Please be polite and courteous to Jane and Faith when speaking to them on the phone as they really do appreciate a friendly and understanding patient at the other end.
Whilst this is not “business as usual”, please be assured that we are doing everything that we can to put the practice into a position so that we can return to normal service. We hope that day will not be far away.
Stay safe and well.
John & Jennifer Denham
We have today reopened for Phase 2 URGENT dental care but the practice remains closed to everyone except those patients whom we have contacted and given urgent care appointments to. For all other patients our dentists will continue to answer the emergency phone.
A dentist is available for advice 9am-5pm Monday to Friday on 01786 473579. Our new dentist Kirsten Hepburn joined the telephone triaging last week.
Phase 2 DOES NOT INCLUDE routine examinations, hygienist visits or any procedure that involves a drill (fillings, crown and bridges) or the construction of dentures. It is only for those patients with severe pain, swelling, trauma, uncontrolled bleeding from a socket, a non-healing ulcer or new lump in the mouth.
Patients who require a denture repair that affects their ability to eat or have a broken retainer may be considered for an appointment.
Patients who have a broken tooth or have lost a filling may be considered for a dressing but will be allocated appointments once more urgent care patients have been seen. Temporary filling kits are available from chemists (see our downloadable advice sheet).
There is a huge backlog of patients who have had problems in the last 100 days and we are only currently able to see 10 patients a day. An additional surgery has been agreed with the Health Board from the 6th of July. Each dentist has a long list of patients to see and are in the process of organising appointments for them.
Urgent Care Hubs are still available for us to refer our patients to, should they need an aerosol generating procedure or are COVID-19 symptomatic.
Please do not call the emergency mobile number to ask about appointments. If you have an enquiry please email the practice on firstname.lastname@example.org
Routine appointments have been cancelled until further notice. Text messages are being sent out or patients who we do not have a mobile phone number for are being phoned. If you think we may not have an up to date mobile phone number for you then please email us on email@example.com
Cancelled appointments remain in the books so that we can reschedule everyone’s appointments once we are in a position to resume routine care. This will be several months away.
We are not in a position to see patient’s privately for aerosol generating procedures or to see a patient quicker. Dentists and nurses require face-fitting of respirator masks and we currently have no details from the Health Board as to whether we will have access to this level of PPE for phase 4 when aerosol generating procedures are allowed for NHS patients.
We are sourcing respirator masks ourselves and hope to have these face-fitted very soon.
It seems a long time since we last had patients into the practice and we are very glad to be welcoming some of you back.
This lunchtime has seen the announcement of phase 2 reopening which begins on Monday 22nd June. This means that dental practices can, once signed off by the health board, be able reopen to emergency patients only for specific types of problems. We continue to work through the new protocols and next week will commence the new staff training that is required.
This phase DOES NOT include seeing patients for routine examinations, hygienist appointments and for anything involving drilling such as fillings, crown and bridge work or construction of dentures.
All routine appointments continue to be cancelled until further notice. We have a huge backlog of patients who have had problems during lockdown and we will only be allowed to see 10 patients a day in the practice. We ask for your understanding during this time from everyone and from those who have had problems as we aim to treat you as and when we are allowed during this next phase. The urgent dental care hubs will still be available for us to refer patients to who need emergency treatment which requires an aerosol generating procedure, or who are COVID symptomatic.
We will still have a dentist available for advice and triage 9am-5pm Monday to Friday on 01786 473579.
Could we please ask you not to call the emergency mobile number to ask about your appointments. You can either leave a message on the answer machine or email the practice on firstname.lastname@example.org if you have an enquiry.
All appointments remain in the appointment book and when we have seen all the patients with problems, and completed outstanding treatments we will then contact patients to reschedule their routine care.
For those patients who have been allocated an appointment during phase 2 this is how we will be greeting you when you arrive.
We will be using John’s surgery for all appointments. Kirsten and John are here showing you what the surgery will look like and how they are going to be dressed.
You can also download the following guide to the procedures that will be in place when attending the Dental Practice:
We hope that you are all staying at home and staying healthy and we will be back to normal as soon as it is possible.
John & Jennifer Denham and all the Team at Platt & Common
The practice is continuing to work towards completion of the toolkit sent to us by SDCEP and Forth Valley Health Board. This week we have been seeing our staff individually to discuss the reopening strategy. We will be commencing the training of the staff for the new PPE guidelines, resuscitation changes and surgery workings in preparation for phase 2a.
The Chief Dental Officer is expected to announce on 18th June the date practices would be able to open, subject to being signed off for opening by the health board. We hope to be ready for July 1st if we are allowed to be open.
During Phase 2a we will be able to see a maximum of 10 patients a day. We would normally see approximately 200 patients a day and so you will understand how logistically this will be very difficult. Therefore, the practice will REMAIN CLOSED to ALL scheduled routine appointments until we have seen those that have had problems during lockdown and those who had treatment planned during March onwards. Please understand that phase 2a only allows things like simple extractions, dressings, denture repairs, incise/drain swelling, and other urgent non-aerosol producing procedures. When we are allowed phase 2b then other types of problems will be able to start to be seen.
We will continue in phase 2a to have a dentist available 9-5pm Monday to Friday to triage and give telephone advice to patients on 01786 473579.
We hope you are all safe and well. Please find below the chief dental officer’s release for patients in Scotland. We are now operating under the new protocol for referrals to the Forth Valley urgent dental care centres.
In practice we are currently waiting for the SDCEP toolkit to be released next week. This will allow us to open one surgery to carry out non-aerosol procedures (drilling) such as extractions and dressings in the first instance. This is stage 2a of the opening of dental practices which the hope is all practices will have achieved by 31st July.
We understand how frustrating the current situation is for patients and for ourselves. There is nothing we would like more than being able to open and carry on as we used to be. We would ask you to please be patient with regards to appointments as we currently have a log of hundreds of patients that have had problems in the last couple of months and they will be prioritised at the various opening stages.
We ask that if you think we do not have a current mobile number for yourself please email it to email@example.com
CHIEF DENTAL OFFICER RELEASE 20/5/20
It was initially necessary to restrict the range of treatments available in urgent dental care centres and we are now able to expand the scope of this service to deal with a wider range of acute and urgent dental problems. Further information may be found at:
You should continue to contact your dental practice in the first instance to discuss your treatment need.
Due to the coronavirus outbreak and in accordance with instructions from Scottish Government and the Chief Dental Officer all general dental practices in Scotland have been ordered to close from Monday the 23rd of March until further notice.
One of our dentists will be available for telephone advice during the hours of 9:00am until 5:00pm Monday to Friday. Please telephone 01786 473579 and listen to the answer machine message as it will instruct you on how to access emergency advice and care.
Out-with of these hours patient’s should telephone NHS24 on 111.
All scheduled appointments are cancelled until further notice and we will re-schedule appointments once the practice is allowed to open. If you think we do not have a current contact number for you then please could you email us at firstname.lastname@example.org
Please do not phone the practice regarding the changing of appointments.
Symptomatic or COVID-19 positive patients with an emergency should still phone us and you will be triaged and if required you will be referred on to the Public Dental Service at Falkirk Community Hospital (FK1 5QE) who are set up for any treatment that you may require.
During the CoVid-19 lockdown, we are aware that you may have dental issues that need attention. If you are experiencing a dental issue, please do get in touch with the practice by calling 01786 473579.
You can also download the following guide to help you alleviate and dental pain you may be experiencing.
We hope that you are all staying at home and staying healthy.
We will be back to normal as soon as it is possible.
John & Jennifer Denham and all the Team at Platt & Common