BDA Calls For Roadmap On Relaxation Of Restrictions

BDA Calls For Roadmap On Relaxation Of Restrictions

The British Dental Association has called on the UK’s Chief Dental Officers to help develop a roadmap for the safe relaxation of current restrictions in dental practice.

The BDA is asking the four CDO’s to commission the Scottish Dental Clinical Effectiveness Programme (SDCEP) to develop a strategy in order to relax the restrictions which are preventing dental practices from giving full access to their services.

The BDA says that nationwide, practices are continuing to operate at a fraction of their pre-pandemic capacity in order to meeting infection prevention and control guidance.

The BDA website said that an estimated 30 million appointments have been lost since March 2020, in England alone.

The BDA said the SDCEP is best placed to review new scientific literature, assess ‘wider prevailing conditions’ and produce recommendations for Infection Prevention and Control (IPC) de-escalation.

The BDA says that evidence is mounting that infective aerosols principally come from coughing by COVID-infected patients and aerosols associated with medical procedures pose a relatively low risk.

The website cited an article in the Lancet which said  “Despite this, the generation of a cough during a procedure is not considered sufficient for that procedure to be designated an AGP.”

“Consequently, current UK infection control guidance advises the highest aerosol precaution PPE for procedures that are demonstrably not high risk (compared with coughing) and advises lower grade droplet precaution PPE when infectious aerosol risk is high (eg, caring for coughing patients with confirmed COVID-19 for a prolonged period of time in poorly ventilated health-care settings).”

The BDA’s stance has been mirrored by the  news that the American Dental Association has told the White House “There does not appear to be a grave danger of being exposed to COVID-19 in dental settings, particularly as the pandemic is decelerating.”

The ADA told the White House Office of Management and Budget that dentists have experienced “Exceptionally low monthly incidences of COVID-19.”

ADA President Dr Daniel J Klemmedson and Executive Director Dr Kathleen O’Loughlin told officials that the cumulative COVID-19 infection rate was just 2.6% for dentists and  3/1 for dental hygienists as of November 2020 and October 2020, respectively, prior to the widespread availability of COVID-19 vaccines.

The BDA wants the review to consider the impact of reduced access on those suffering poor health and inequalities, citing poor lockdown diets and altered oral hygiene habits as being a particular risk.

The BDA is also concerned at the potential for oral cancers to be either missed completely, or for treatment to be delayed. Dental antibiotic prescribing is also a worry, with prescribing levels remaining high compared to 2019, potentially fuelling “A further global health disaster due to antimicrobial resistance.”

The website said that  current IPC requirements have a profound effect on the dental workforce, saying that 47% of dentists in England have indicated they are likely to leave the profession in the next year if existing SOP’s remain in place.  The BDA says a similar proportion intend to reduce their NHS commitment.  

Dr Eddie Crouch, Chair of the BDA told the website “It’s a year since face to face care resumed in England, but the restrictions we work to remain largely unchanged.”

“So today we have asked all four UK Chief Dental Officers to begin work on a roadmap to ease restrictions.”

“The risk we face today from the virus needs to be balanced against the millions unable to access care, and threats to the very sustainability of this service.”

“It is time to let the experts weigh up the risk of COVID transmission with the dangers of prolonging the status quo. We know this issue is already high on the official agenda but patients and the profession deserve clarity on the way ahead.”

The Belfast Telegraph reported today that in  a joint statement, all four CDO's  replied “All four UK chief dental officers share their profession’s ambition for increasing access which needs to be done safely and effectively, which is why there is now going to be a further review of the UK-wide infection control guidance in the light of the current science and prevalence.” 

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