DenScreen is a systematic screening system, allowing clinicians to individually and accurately assess each patient’s COVID-19 risk. Professor David Denning discusses why it is an important and crucial addition to dental practices during this time.
What motivated you to start DenScreen?
As the pandemic progressed, dentistry was highlighted as a profession with an elevated risk of being exposed to COVID-19. We were also aware that COVID-19 was likely to be present in society for some time until an effective vaccine could be produced – or controlling measures could stem the rate of transmission and make the virus extinct. We believed either of these would be long-term projects. Therefore, we wanted to try to develop a system that could allow practices to carry out a very high level of risk assessment and reduction. This would allow both the dental team and patients to feel safe when returning to their practices.
Why are dental practitioners at greater risk of COVID-19?
The live virus lives in the top of the respiratory system, close to the mouth. The very nature of dental work involves procedures that generate aerosols from this area. This puts dental teams at a much higher risk of receiving high viral loads. It’s this loading that creates the elevated risk for the profession. Thankfully, there haven’t been many documented cases of this in dentistry. This is mainly due to the nationwide closure of practices, and also partly because of the high cross infection standards already in place. But we have witnessed infection with a high viral load causing severe COVID-19 disease with the deaths of ENT surgeons early on in the pandemic.
What is DenScreen offering to practices to help mitigate this elevated risk?
DenScreen’s risk mitigation system is a multi-layered, evidence-based approach and can be broken down into three main elements:
- Training courses
- Triage tools
- Antibody test kits.
What training does DenScreen include?
Our tiered training and competency courses get your whole team – from receptionists to principal clinicians – up to speed with the latest COVID-19 science that is relevant to dentistry. It’s this training that is the key first step to beating this virus. It’ll arm you with the known facts on the virus, how it spreads, the infection it causes and strategies to mitigate its transmission. All our training is verifiable CPD. We’re also running our first CPD webinar on Tuesday 30 June at 7:30pm.
How can DenScreen’s triage tools help my practice?
DenScreen’s Advance Triage Assistant (ATA) brings automation and efficiency to your patient’s pre-appointment questionnaire. After a patient submits their answers to our simple yes/no questions, our algorithms rate their answers and produce three scores. This includes the current infection risk (likelihood of harbouring a live SARS CoV2 infection), vulnerability (likelihood of severe infection, if infected) and dental need (looks at procedure needed and pain levels to assess urgency of care). Additionally, the ratings and information the ATA gathers for you gives you a head start on the individual risk assessment the current guidance requires.
Why is antibody testing relevant to dentists?
By testing your patients for COVID-19 antibodies, you can add empirical evidence to your individual risk assessments, which in turn allows you to adjust your protection strategy on a per-patient basis. Patients that are IgG positive (green status) have fought off the infection. Therefore, they are non-infectious and almost certainly immune to further infection. The latest science tells us that the IgG antibody includes viral neutralising antibody and mirrors IgA and cytotoxic T cell responses. Most asymptomatic patients also produce antibodies.
How accurate is the DenScreen antibody test?
The DenScreen antibody test is one of the very best available. It has a 97% sensitivity and a 99% specificity (based on 900 patients tested in six countries). It detects IgG and IgM which are maximal three to four weeks after infection.
Is the DenScreen antibody easy to do?
It is really straightforward to do with a simple finger prick from the lancet provided. The result takes 10 minutes to appear and is easy to interpret.
Are dentists allowed to be performing these tests on patients?
Yes. The CQC has authorised dental clinicians to perform these tests under their ‘diagnostic and screening procedures regulation’. Most dentists are already registered for this activity.
What about indemnity?
The majority of indemnifies have approved the use of DenScreen’s screening system in practice. Because of our training and evidence-led approach, these indemnifiers have no issue with our quality-assured system. It enables dentists to maximise the flexibility granted in the guidance while adding multi-level risk mitigation tools that will help keep your staff and patients safe from COVID-19.
If a practice has already developed a robust SOP, why should they consider using DenScreen?
The DenScreen system has been designed to fit into any SOP. We believe that all SOPs will have a triage aspect built in. However, feedback from dental practices shows it can be complicated to not only record all the information required, but also turn this information into a risk assessment. Our Advance Triage Assistant simplifies this laborious process. It not only records all the information that would be required but also analyses the answers to risk profile the patient before they step foot into the practice. Once they are deemed suitable to attend, the DenScreen antibody test allows a second level of risk assessment to determine who has had COVID-19 and, therefore, who is currently not infectious.
Do you recommend antibody testing staff as well as patients, and if so why?
Yes. We believe that by testing all staff members we can risk assess the staff to a very high level. We split staff into three groups green, amber and red. Green status staff will have IgG+ results. Amber status staff will have IgG- results but no increased medical or social risk factors. Red status are IgG- but also have risk factors (such as diabetes), which would make them more susceptible to a severe illness with COVID-19. We believe that this risk profiling will allow practices to match higher risk patients to treatment teams with immunity. As a result, creating a safer environment for all.
What do patients think when asked to use your system?
Analysis of our system so far has shown that patients have felt reassured that dental teams are making every possible effort to reduce risks for them returning. There is increased anxiety within the population about returning to dental practices and patients need every possible reassurance that dental practices are safe to return.
The DenScreen webinar will take place on Tuesday 30th June. Click here to sign up.
