Thousands of people in England are potentially unable to access urgent dental services in the wake of the coronavirus pandemic.
The British Dental Association (BDA) told the BBC that dentists in England are being bombarded by calls from patients in real pain, but there is often nowhere to send them.
What’s the problem in England?
At the moment, all routine dental care has stopped. On 20 March, a letter was sent by England’s chief dental officer asking practices to “radically reduce the number of routine check-ups”.
Five days later, practices were told to stop all routine treatment “until otherwise advised”. The decision was made in order to reduce the spread of coronavirus.
For patients with emergency dental problems, NHS England is in the process of creating local Urgent Dental Care hubs (UDCs) across the country.
However, the BDA says only a tiny number of these sites have been set up so far.
UDCs are designed to provide care for people with urgent and emergency dental problems, after a referral from their local practice. They are meant to offer treatment to patients with symptoms that include:
- Fractured teeth
- Post-extraction bleeding
- Facial swelling
- Gum and other soft tissue infections
UDCs are also meant to accommodate patients both with and without Covid-19 symptoms.
Some hospitals are offering emergency walks-ins for dental patients, which means some treatment is still available. The NHS also says that some surgeries will offer appointments at short notice.
However, a number of patients have told the BBC they were struggling to access any local service, despite being in constant pain.
In a statement, NHS England says that 50 UDCs are currently open, a further seven are expected to open this week and the remaining 103 will be able to treat patients from next week.
How many people are being left untreated?
The BDA says it cannot give a precise figure.
However, it says that almost every practice is receiving an emergency call every day and that large numbers of cases are going untreated.
It says that if some conditions are left untreated, such as an abscess, they could potentially develop into life-threatening situations.
The organisation says it has already expressed its “profound concern” to NHS England about the current situation.
It believes some of the problems in setting up the UDCs are down to a lack of personal protective equipment (PPE) for staff.
What happens if you need to see a dentist?
In the first instance, patients are advised to call their local practice.
If symptoms are serious, local dentists can prescribe medication over the phone (such as painkillers and antibiotics). In such cases, dentists can contact local pharmacies, which can then prepare medication for patients to pick up.
However, a number of patients cannot be seen for emergency appointments because most practices are not allowed to see patients face-to-face.
In those circumstances – or if a patient is not registered with a dentist – then the advice is to use the 111 online service.
‘It’s scary not knowing’
Kathryn Hey, 47, is a teacher from Biddulph in Staffordshire.
She told the BBC that she woke up with a sudden sharp pain last Thursday. Mrs Hey believes she is either suffering from lost fillings or is developing an abscess.
“I’ve spoken to my local dentist twice, but I was told they would only see me if my face was swelling up,” she told the BBC.
“I’ve done a lot of internet research; I must have looked at 20 local dentists. But they all say the same – unless my face is swollen they won’t see me.”
Mrs Hey says she has been able to manage the pain with prescription painkillers.
“It’s down to me to self-diagnose, which is not acceptable.
“It’s scary not knowing if I have an abscess forming and what the long-term implications are.
“I just have to manage the pain myself.”
What about Scotland, Wales and Northern Ireland?
The BDA says Scotland, Wales and Northern Ireland seem to be far more advanced in getting UDC centres up and running compared with England.
- The Scottish government says that its dental practices can offer advice over the phone. However, where urgent or emergency dental care is required, it says dental care centres are available in every NHS board across Scotland
- The Welsh government has set up 15 UDC centres across the country. The government says that patients should contact their local dentist in the first instance. In case of an emergency, the advice is to call 111. If the pain is unmanageable, the Welsh government says urgent centres should be able to handle referrals
- Northern Ireland’s Health and Social Care Board says emergency dental clinics are being set up across the country’s five health and social care trusts. It says these clinics will only see patients with urgent needs, and after a referral from a local dentist