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Dentists across the UK are calling on the government to end to the “barbaric” lockdown of dental surgeries, saying patients are left in pain, with some resorting to “DIY dentistry” while services remain shut.
Since March, dental practices have been closed across the country and all routine dentistry has stopped. The advice for anyone needing emergency help is to ring their dentist for a telephone consultation, where patients are usually prescribed painkillers or antibiotics over the phone.
If a dentist believes a patient needs to be treated urgently, they can refer them to a dedicated urgent dental care hub, usually situated within a hospital. But Dr Rhona Eskander, one of the 150 dentists calling for action, says appointments at these hubs are difficult to access, meaning “needs are not being met”.
Minor dentistry problems are therefore turning into major ones due to neglect in care, she claims, telling HuffPost UK: “The NHS is having to extract teeth that could’ve been saved. More teeth are being pulled out now as patients can not live with the pain. It’s barbaric.”
Dr Eskander is part of an association of dentists called Pandora Dental, a group that has written to Matt Hancock calling for dental practices to reopen. They say they’ve managed to source their own PPE from a dental supplier, meaning they could reopen some practices with immediate effect if given the green light. The group has also called on the government to provide further PPE for all dentists to ensure their safety and the safety of their patients.
Their calls come as members of the public tell HuffPost UK the current system to access emergency dental care during lockdown is not working.
“We didn’t know what to do. We were worried about the possibility of him cutting his tongue and his lips.”
- Jim Banbrook, whose son smashed his two front teeth
Jim Banbrook, who lives in the Cotswolds, struggled to speak to a dentist when his eight-year-old son, Dexter, smashed his two front teeth in a garden accident. Dexter was pulling a spade out the ground when the handle flew up and hit him in the face, sheering his two adult teeth. The accident created “a near-perfect V”, where each tooth was cut diagonally from the outer base towards the centre roof of Dexter’s mouth.
“They were razor sharp, they were horrible,” says his dad. “We didn’t know what to do. We were worried about the possibility of him cutting his tongue and his lips on them.”
Banbrook and his wife called their usual dentist, but were met with an answering machine telling them to call 111. They rang 111 and received a call back, giving them a number to call the Gloucestershire emergency dental line. When they called this number they received another automated message telling them to call 111.
Banbrook says they were caught in this loop “for a couple of days”, calling various emergency dental lines, leaving voicemails where they could, hoping someone would pick them up. Dexter was distressed, in pain and struggling to eat throughout this period. Eventually, they were called back by an urgent care unit in Bristol Royal Infirmary and drove there for treatment.
“The experience we received once we got to the hub was absolutely superb, they really looked after him,” says Banbrook.
Dexter was fitted with a temporary covering, to protect exposed nerves and make his teeth less sharp. Unfortunately, the covering fell off within a week and the family had to drive to Bristol a second time to get it fixed. However, the parents say the dentists did all they could with their limited resources. Dexter will have to wait until dental surgeries reopen for longer-term treatment.
Dr Mark Cronshaw, director of Pandora Dental and a dentist working in Cowes, Isle of Wight, says he’s heard from “plenty of patients” who’ve struggled to access appointments in this way. Some have resorted to DIY dentistry, he says, including patients who have attempted to fashion homemade fillings, which is not advised.
“One lady’s daughter needed a wire on an orthodontic appliance trimming down and I had to instruct her over the phone how to do it herself,” he says.
Willow Crossley, 37, from Oxfordshire, has a veneer on her front tooth that has become loose. During a phone consultation, her dentist said it’s likely the root has snapped – but Crossley hasn’t been able to find an urgent care hub to fix the problem. Instead, she made herself a “DIY gum shield” to hold in the tooth.
Crossley is only able to eat soft foods and has eaten jacket potato for five meals in a row when we speak. Even chatting over the phone is stressful, because her tooth wobbles so much. “I feel very anxious,” she says.
“I know it’s vain, but I’ve had this veneer since I was 12 and I’ve always had nightmares about losing teeth – so this is just typical timing. I feel very wobbly – no pun intended – and helpless not knowing if I can do anything about it.”
In a desperate attempt to keep the tooth, Crossley moulded herself a gum shield, made by ordering a teeth whitening kit from Amazon. Biting into the mould was terrifying, she says, because she thought it might pull the tooth out. Although she made the shield, she says it’s uncomfortable to wear.
Thankfully, her “lovely” NHS dentist has agreed to help. Crossley dropped her mould at the dentist’s house – being sure to keep her distance – and the dentist is trying to make her a thinner, more comfortable retainer. Even then, it’ll only be a temporary measure until surgeries reopen or Crossley manages to secure an appointment at an emergency hub.
“No one really knows anything and that’s what’s so distressing,” she adds. “There’s no answer and no timeline either.”
Creating an at-home gum shield like Crossley’s is risky, says Dr Eskander, as you can damage the tooth in the process. In fact, any form of DIY dentistry is like “playing with biology” and should be avoided, she says, particularly extracting a tooth.
“Pulling a tooth is extremely difficult,” she explains. “The tooth in anchored into the bone, so it’s unlikely that you’ll be able to go through with it without local anaesthetic. The most likely thing is that the root will still be anchored to the bone, which will manifest and cause further infection.”
To help patients resist such measures, dentists are prescribing antibiotics at an “unprecedented” rate, says Dr Eskander, because they’re left with no other choice – “What are we supposed to do if a patient is in agony and we’re not allowed to see them?” But this could be an issue, as long term over-prescription may lead to rises in antibiotic resistance.
The more immediate problem, though, is that antibiotics don’t treat the root cause of the problem. “Say you need a root canal, the antibiotic may relieve symptoms but it’s just a mask,” Dr Eskander explains. ”The infection is festering and that could spread further in the body along to the bones. It could also mean that the tooth, if it’s saved, could have a poor chance of survival in the future because it’s getting further infected in parts you can’t see.”
“It makes me feel really sad, to be honest, because as a dentist our vocation is all about duty of care.”
- Dr Rhona Eskander, one of the 150 dentists calling for action
In severe cases, dental infections and abscesses can lead to sepsis, which can be life-threatening. Dr Cronshaw is also “very concerned” about the wider health implications of closures, pointing out that check-ups provide dentists with an opportunity to spot signs of oral cancer. “The longer this goes on, the more medium to long term effects will accumulate,” he says.
In response to the concerns, a Department of Health and Social Care spokesperson told HuffPost UK there are more than 300 urgent dental centres open and able to see patients will all the necessary PPE, “significantly exceeding the original goal of establishing 264 such centres”.
“Urgent dental centres are one the of priority areas for PPE distributed via local resilience forums,” they said. “We continue to work night and day to ensure our frontline health and social care staff, including dentists and their teams, have the equipment they need to provide safe urgent care.”
However, Dr Eskander believes there’s been “a real lack of information” given to dentists and the public on how to access these centres – and still believes regular dentistry needs to resume to prevent minor issues becoming urgent.
“It makes me feel really sad, to be honest, because as a dentist our vocation is all about duty of care and giving patients a service,” she adds. “When you have someone who is begging you to see them but you can’t, you feel helpless. You feel like your duty had been breached.
“A lot of us are happy to work for free, we just want to work.”