Normalising dental care – the impact of the vaccination effort

dental carePaul Beresford examines how the vaccination effort may shape the population’s freedoms – and expectations – as the UK continues its steps on the roadmap out of lockdown.

The time has come for the government to bring forward a progressive strategy of normalisation of dental surgery care. Obviously, the government will have to undertake this with care, and all according to scientific data. They must give priority to safety of dental staff and patients.

Dentistry, especially complex restorative dentistry, with the much-feared aerosol spray, is difficult enough without all the PPE, masks and visors. I have huge respect for paediatric dentistry. They have to treat already worried children made more nervous by a clinician dressed up like someone from outer space advancing upon them.

Next steps

Even the BBC has accepted that the combination now of Boris’ action of lockdown and vaccination is progressively winning the battle against COVID-19. Even with the challenges posed by variant strains of the disease. (Interestingly, I do not think that there is any evidence of COVID-19 transmission in the dental surgery. This indicates the comprehensive protection procedures undertaken by dental practices.)

I believe that a new high-speed, more reliable lateral flow-type test is in the offing. The use of this test, plus the now-normal triage of extensive questioning and temperature taking should mean that dentists could be able to ensure that any patient entering the clinic is COVID-free. Also, that they could be safely treated with what was pre-COVID normal sterilisation and protection methods.

Burden of proof 

People have raised indignation at the possibility of the requirement of inoculation ID cards.

But it is foreseeable that, in a relatively short time, 100% of the population will have been offered inoculation. It is understandable that some, such as pregnant women, may wish to resist the inoculation. Some, for what I believe are erroneous religious reasons, also have the right, at least in the United Kingdom, to refuse the inoculations.

But we are already seeing a move towards the expectations for a requirement of proof of inoculation in certain circumstances. Not necessarily from government.

It seems to me that these are circumstances where a duty of care predominates. The most obvious of these will be care homes for the vulnerable. If one was choosing a care home for an elderly relative it should be important that your care home of choice required evidence of full inoculation for anyone entering the home. Be it staff other clients or visitors.

Public opinion

Already some airlines and cruise ships are likely, as part of the duty of care to staff and travellers, to require all to prove they have been inoculated. This has been a requirement for many decades for ships calling into yellow fever ports.

If that becomes acceptable it does not seem unreasonable for dentists to ask for evidence from their patients that they have had the vaccine. This would support early scientific indications that the inoculated are less likely to be COVID-19 carriers.

Interestingly, I believe the public opinion on some form of COVID-19 inoculation passports is heavily supportive. It would be sensible for the government to provide some means of providing such a document for every inoculated individual.

Of course, detractors will point out that you can forge documents. Also, that people will go to some lengths to get round the system. However, it would be an additional protection for those who need to exercise a duty of care, including dentists.

Let us have a pathway back to normality set out. Safety first and guided by the scientific data. 

This article first appeared in Dentistry magazine. You can read the latest issue here.

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