A RECENT appointment at Murrayfield Dental Practice proved to be quite a startling and revealing encounter, and I’m not talking about the poor state of my teeth and the humongous costs that were quoted to repair them.
Nor was it the fright I received when Euan Smith, my long-standing affable dentist awkwardly welcomed me into his surgery, wearing what looked like a polythene butcher's apron, gloves and mask borrowed from the set of a Hammer House of Horrors production.
No, it’s what I learned throughout our one sided 30-minute conversation, one sided because it’s hard to speak when your mouth is being pulled open, and crammed full of tubes, fingers, picks, swabs, and polisher, about the problems dental practices have experienced in their dealings with the Scottish Government during these long dark Covid days. Problems and issues that Scotland’s beleaguered hospitality and nightclub industries, in particular the absence of guidance over ventilation, are sadly all too familiar with.
They are furious because, they say, that since the beginning of this crisis last March there has been a total lack of consultation, communication, accountability, planning, advance notification, funding, and strategic road mapping from the Scottish Government. A government which has had more spin than the Large Hadron Collider and blown more hot air than a Saharan sirocco.
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They claim there's a very real and worrying disconnect between them and the Scottish Government, with lack of guidance as to what airflow and ventilations should be installed in order to reduce fallow times between procedures and patient waiting lists, which are now at an all-time record high. And, more importantly, who should pay the costs of installation, especially if the practice happens to be, as most are, an NHS practice.
As my dentist Euan Smith says: "To continue dentistry with minimal interruptions, remain viable, avoid wasted surgery time and reduce waiting lists we are now required to have mechanical ventilation. The Scottish Government are not funding this, and these costs will have to be borne by the dentists themselves, even if they are a fully NHS practice."
These prohibitive costs could range from £2k-£50k depending on where a practice is situated. Each one having to be individually surveyed and assessed and then costed up by bone fide contractors. All a very time consuming and costly process, particularly if the surgery is located, as many are, within a listed building or tenement.
David McColl, chair of the Scottish Dental Practice Committee (SDPC) said: “We are constrained by surgeries being adequately ventilated for any aerosol generative procedures (AGP) in order to get the fallow time reduced. Ten air changes per hour are required to get this fallow time down to 10 minutes which would be followed by 20 minutes of surgery, cleaning prior to the surgery being used again.
"Surgeries without any ventilation cannot provide AGP activity at present and the situation needs immediate recommendations. The Scottish Government need to urgently address the ventilation requirements within dental surgeries. Interim guidance is needed and an exercise in quantifying the requirements for the 1000 practices in Scotland is required. Practices also need an interim funding review for sustainability and planning of NHS dental delivery”.
Serious concerns, which along with constraints on PPE, strict social distancing measures, and confusion over tier levels, have had Scotland’s 3000 dentists gnashing their molars in collective frustration at a risk-adverse government which has failed miserably to deal with their concerns. It’s like pulling teeth to get an unsupportive government to make a decision. A dead-end root canal instead of a route map to recovery?
All the more surprising and ironic when you consider that the government is currently guided by a former dentist, our genial but grandstanding National Clinical Director Professor Jason Leitch. Someone who has bumped his gums on numerous occasions that one of his biggest concerns is airflow transmission of the virus, especially within hospitality sectors, but who has so far failed miserably to properly engage with them.
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