Editorial

How Covid-19 May Have Contributed to a Dental Health Crisis in the UK

The global coronavirus pandemic has caused significant disruption to nearly all aspects of life since initial restrictions were implemented by the government in March 2020. With the NHS under considerable strain, many non-essential services were postponed or cancelled to reduce transmission and free up professionals for urgent care.

One area of healthcare in the NHS that experienced substantial disruptions during the pandemic was dentistry. This has been described as a hidden dentistry crisis across the country. Some are suggesting it could lead to increased levels of tooth decay and possibly oral cancer.

Missed Routine Procedures

In 2020, the Association of Dental Groups (ADG) carried out a survey to investigate the pandemic’s impact on non-emergency dentistry. More than half of the parents in the UK who responded reported that their child had missed a routine dental check-up due to lockdowns and government restrictions.

Additionally, a worrying number also reported that they could not schedule a routine appointment because of the disruption. Some experts have suggested that this could indicate a growing problem in the country. In fact, some professionals have begun warning of a wave of untreated tooth decay among children because of difficulties with scheduling appointments.

At the beginning of the pandemic, a nationwide lockdown was implemented across the UK in March 2020. This saw dental practices across the country close their doors until the 8th of June 2020, so routine procedures were no longer available on the NHS.

While there was some provision for urgent care through the hubs set up by April, the range of treatments on offer was limited. There have even been some reports of teeth being extracted in emergency situations when other treatments could have saved the tooth had dentists been open.

The study’s results suggest that the problems caused by the pandemic could worsen an issue that was already prevalent in the country. Pre-pandemic, severe backlogs in dental care were already common; however, the disruptions made this significantly worse.

Reduced Capacity

According to the British Dental Association, 19 million fewer dental procedures were performed in the NHS by the end of October 2020. Since then, the easing of restrictions has allowed the services to catch up on the issues, but there is still a massive backlog of procedures that need to be performed.

Even as restrictions eased, dental practices were still required to operate at a reduced capacity. As a result, dentists in the country have had to make difficult decisions about which treatments to prioritise. For many patients waiting for healthcare, this has meant living with tooth decay or other uncomfortable conditions.

Lacking Incentives for Providing Urgent Care

Some have alleged that the current system for assessing the success of NHS dental practices has worsened dentists’ ability to provide urgent care for those that need it.

In the NHS, dental funding is paid according to a points system. However, the way the approach is structured means that NHS surgeries might receive the same number of points for a 15-minute routine appointment for three hours of emergency dental surgery.

This puts dental healthcare specialists between a rock and a hard place. While they might want to provide the treatment that is needed, they often cannot. If a dental practice doesn’t hit its points target, it risks losing a significant amount of funding from the NHS.

Most dental practices in the UK have a mix of private and NHS patients. Like other businesses, dentistry has also suffered from the strains of the pandemic. As a result, difficult decisions have had to be made to maintain cash flow to these businesses, often at the expense of access to dental healthcare.

The Current Situation

Since the ADG’s study, the independent dental healthcare patient watchdog, Healthline, has warned that those requiring urgent dentistry in the UK struggle to find appointments. In addition to the pandemic’s effect on patient’s ability to find healthcare, Healthline has also suggested that the loss of EU dentists has also impacted dental services.

According to the report, 90% of the calls made to the watchdog in Cumbria are due to people having difficulties booking NHS dental appointments. This example mirrors the current climate in nearly every region of the UK, according to Healthline. Access to dental healthcare has been severely affected in the country, with complaints about the availability of treatment rising 452% during the pandemic.

The watchdog has found that over seven in 10 people have struggled to access dental healthcare due to the pandemic. Additionally, waiting times have been substantially longer for those who have sought treatment than they were pre-pandemic. In fact, wait times have increased to months, and in one case, a patient was told they would have to wait two years for their treatment.

Some reported that they had called more than 40 dental practices in an attempt to find urgent care, as they had been experiencing an excruciating toothache. This even led to some taking matters into their own hands, pulling out their affected teeth in often unsanitary or unsafe conditions because they couldn’t bear the pain.

Experts have warned that the problems many are experiencing when trying to find dental healthcare could have severe, deleterious consequences for some of the most vulnerable people in society. A segment of the population in the country is classified as “high needs”. These people require regular dental care and support to maintain their oral health, and if they are not seen at least once every 12 to 18 months, they can begin to have serious problems.

For those in this group, inadequate care can lead to abscesses, hospitalisations, tooth loss and even oral cancer.

What Can Be Done About the Crisis?

Problems with the provision of care in NHS dental surgeries has led many to turn to the private sector for their treatment. Private practices offer shorter wait times which has allowed many to receive the services they need; however, this comes at a cost. For example, a Fulham dentist can see patients much faster than an NHS practice can in the same area. You can find out more about dentists in Fulham at https://www.fulhamroaddental.com/.

Additionally, many are calling for increased recruitment into the dental profession. Currently, issues with the number of NHS dental professionals in the UK compound the problems caused by the pandemic. Experts have suggested doubling the number of dental-school places at universities in the country to counteract staff shortages.

Staffing issues have also been exacerbated by Brexit. A large number of licensed dentists in the country originate from the EU. With the UK withdrawing from Europe, some professionals have left the country, and fewer are coming to the UK. Therefore, more needs to be done to incentivise talent to come to the UK, or more dental professionals need to be trained up from within the country.

Conclusion

Overall, the coronavirus pandemic has caused significant disruption to the dental healthcare provisions across the country. Issues present before Covid-19 have been exacerbated by the closure of practices and reduced capacity for appointments across the country. Some have turned to private options due to difficulties accessing healthcare, but experts fear that many could be left behind. Industry experts have warned this could cause an ongoing crisis in oral health unless measures are taken to resolve the backlog.

 

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