Dentists urge Public Health England to amend ‘unworkable’ PPE requirements
Published: 6/29/2020 12:00:00 AM
The British Association of Private Dentistry (BAPD) is calling on government to relax its stringent government COVID-19 guidelines.
It has shared the results of its recent survey with Public Health England (PHE) to demonstrate the universal challenges faced by dental practitioners caused by to ‘overly onerous’ PPE requirements.
In an open letter to the body, it calls into question the evidence supporting the government expectations regarding masks, suggesting: ‘Frustratingly, much of it is based on very weak scientific evidence, for example the use of FFP2 and 3-type respirators.’
It adds: ‘In addition, the associated fit-testing requirements and the continued lack of availability of this resource, means that many practices will remain closed to anything more than the most basic treatments for the foreseeable future. The patients being turned away from or facing long waiting times at Urgent Dental Centres (UDCs) are further evidence of the challenges patients are facing.’
The BAPD says its survey of around 1,000 dental practitioners reveals key obstructions to optimal provision of care for patients in a list that the Association suggests are ‘alarming findings’. They include:
- Reduced number of patient interactions per day and thus reduced access for patients
- Reduced average appointment time per patient: directly related to operator discomfort
- Reduced dental treatment completed per patient visit due to reduced appointment length
- Reduced dental staff availability for patient facing roles as a consequence of fit test issues
- Increased direct costs to practices which is passed on to patients
- Reduced perceived quality and scope of treatment availability due to workflows compromised by PPE
- Markedly reduced communication with patients due to PPE issues. This obviously affects informed consent
- Lack of availability of fit-testing
- Challenges with regard to quantitative/qualitative specificity and rationale for fit-testing.
One question reveals that 80% of dentists could not envisage tolerating FFP3/FFP2 masks for the next six months, whilst 45% felt their ability to communicate is ‘markedly reduced’ by their wear.
The letter notes that whilst, at the beginning of the pandemic, little was known about SARS-CoV-2, which meant it was classed as a High Consequence Infectious Disease (HCID), this classification has subsequently been removed for COVID-19 by both PHE and the Advisory Committee on Dangerous Pathogens (ACDP).
It adds: ‘We would therefore urge PHE to amend the present unworkable and unnecessary high-level PPE guidance, to reflect not only the non-BBV status of COVID-19 and its declassification from a HCID, but also the standard comprehensive mitigating factors that already exist in the dental clinical setting.’
The BAPD argues that the adoption of a’ more appropriate, attainable base-line PPE requirement for primary dental care’ help to improve access and prevent any deterioration in public oral health due to the COVID-19 crisis.
The results of the survey can be found here: https://www.surveymonkey.com/results/SM-QKWJWJN37