Practice manager Lauren Davis speaks to {my}dentist about working in a UDC and where she sees dentistry heading in the future.
Nobody could have predicted the COVID-19 crisis and how it has affected daily life routines.
In dental practices, teams have had to adapt to treating patients as best they can with advice analgesics or antimicrobials, or very quickly setting up to operate as urgent dental care centres (UDCs). At {my}dentist, all 600+ practices remained open for telephone triage – but of those, a proportion have become UDCs.
Those working in UDCs have had to quickly adapt to new operational processes to ensure patients, and everyone in the practice, stays safe. One practice that has gone through this process is {my}dentist Blyde Road, Sheffield, which began operating as a UDC in April. It is a ‘cold’ or ‘green’ site which means that it doesn’t undertake aerosol-generating procedures. It also does not see see patients who have symptoms of COVID-19.
We interviewed practice manager, Lauren Davis, to discuss the impact on the practice team and patients, and how she thinks COVID-19 will change the future of dentistry.
How have practice procedures and ways of working changed?
Some of the processes put into place are not entirely new to dentistry. We have always worked with infectious diseases and viruses every day. Some of the UDC processes are very similar to implant dentistry in regards to the extra infection control processes. It just means rather than using these processes for more complex procedures, such as implants, we are implementing them into general dental procedures to further protect everyone.
The key difference is that, right now, we are seeing only the most urgent cases. So far, we have seen three patients on our busiest day. If there is a robust triage process in place, we are finding most patients can be treated with advice, analgesics or antimicrobials.
What are the criteria for accepting a face-to-face appointment?
We are a cold site which means that we are seeing patients who have no symptoms of COVID-19 and we are not offering any aerosol generating procedures (AGPs). The criteria is severe pain, persistent bleeding, swelling or trauma that cannot be successfully treated via triage only sites by advice/self-care, analgesics or antimicrobials where clinically indicated.
Patients receive a separate triage on referral here firstly to determine COVID-19 status and suitability. For example, patients who are vulnerable or need an AGP would require further referral to a suitable site.
What treatments are being provided in practice?
The most common issues we are dealing with are periodontitis-related problems such as painful mobile teeth requiring extraction, periapical abscesses, fractured teeth and broken dentures.
The treatment we can provide is extractions, temporary fillings, sedative dressings, incising of abscesses and review and referrals of suspected oral cancer. We also have a variety of skilled professionals we are utilising. This includes a qualified oral health educator, who is available via phone to provide self-care advice which has worked really well. {my}dentist is at the forefront of driving staff development and, during the current pandemic, the UDC has been able to effectively use these skills.
Did the team have any reservations about seeing patients face-to-face?
The practice team was apprehensive at first as the situation was alien to them, which is why good communication was key. Each member of my team works within dentistry because they are passionate about it and put patient care at the forefront of what they do. The guidance on personal protective equipment (PPE) was very clear and provided promptly by {my}dentist, which reassured them.
They have all found it very rewarding being able to offer care to patients during the pandemic. They have gone above and beyond, making sure that elderly and vulnerable patients receive their medication. And they’ve even delivered it by hand after a full day at work where necessary.
{my}dentist is constantly issuing new communication. Sometimes it was hourly within the early days of the pandemic. This reassured staff the company was constantly working hard behind the scenes to ensure we had the correct information. The practice has quickly adapted to the new way of working. What felt alien in the beginning now feels routine.
What do patients think? Are they nervous about treatment or are they just happy to be seen?
Patients are relieved and extremely grateful to be seen. They think it’s a positive step being able to access emergency care. One patient we saw is a nurse working on the front line. She was experiencing severe pain and may have otherwise been unable to work due to her symptoms. Another lady burst into tears after being offered an appointment as she was in pain and had nowhere to turn. We offered our support to her when faced with uncertainty.
How do you think the practice has changed by becoming a UDC?
The practice becoming a UDC meant we had a massive opportunity to lead within the industry, provide feedback and learnings to the local area team and perhaps shape the future of dentistry.
Providing urgent dental care to not only our own patients but the wider public too gave us an opportunity to really engage with them and build a positive relationship. When we return to some sort of normality, the practice has an opportunity as we will be at the forefront of people’s minds when deciding where to seek treatments. Our reputation will be that we put patient care first in uncertain times.
There is also an overwhelming sense of team within the practice as we are all in it together. We are providing more support to each other than ever which has a positive effect on working relationships
What is the likely legacy of COVID-19 on general dentistry? Will we see these enhanced safety measures used routinely now?
I think enhanced safety measures will remain for a while. The UDCs will become a route back into routine dentistry. There will also be an even greater emphasis on prevention within dentistry than ever before. The NHS/BSA may adapt and change the delivery of NHS dentistry to reflect the learnings provided from UDCs.
