Coronavirus: man refused appointment pulls teeth at home.
– a scene reminiscent of the Middle Ages. Dental services are now slowly and tentatively reopening, although there is a great deal of variation in the guidance given on the required safety procedures.
Recommendations for reopening dental services: a quick review of international sources.
Rather than restoring normal service, this crisis provides an opportunity to consider the future of dentists and address system-level failures.
During the pandemic, many dental staff were re-engaged in frontline health care to deliver a range of clinical procedures beyond their usual scope of work. The extent and pace of this integration of dental staff into the broader health care system has been remarkable. Dentists, dental hygienists and therapists, and dentists, have all had a substantial impact in supporting health care services during this crisis and have developed new skills and clinical knowledge in the process. Rather than being isolated and separated from mainstream healthcare, this crisis has clearly shown that dental staff can be integrated into the broader system – the challenge is to define the clinical roles of dental staff in a more integrated model of care.
and will undoubtedly aggravate the inequalities for oral health. Dental care systems now need to be more responsive to the needs of their local populations and prioritize care for groups in high need of care, such as low-income, marginalized and vulnerable groups, including those with multiple morbidities. Current restrictions on aerosol generation procedures provide an opportunity to reorient dental care to a less invasive and more preventive approach, one in which the dental team works collaboratively to address the shared risks of oral and other non-communicable diseases. This is also a time to stop delivering unnecessary and ineffective treatments. A perfect example of this is the routine provision of teeth scaling and polishing, a procedure that has no evidence base and is an expensive waste of resources.
- Clarkson JE
- Ramsay CR
- Averley P
- and others.
Radical reform of oral health care systems will make bold and bold decisions of our political and professional leaders. However, the time is ripe for change.
I do not declare competing interests.
References
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Coronavirus: man refused appointment pulls teeth at home.
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Society and the slow burning of inequality.
Lancet. 2020; 395: 1413-1414
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IQuaD dental trial; improving the quality of dentists: a multi-center randomized controlled trial comparing oral hygiene and periodontal instrumentation advice for the prevention and management of periodontal disease in dentate adults who are the primary care providers for dental care.
BMC Oral Health. 2013; 13: 58
Article info
Publication history
Published: August 15, 2020
Identification
DOI: https://doi.org/10.1016/S0140-6736(20)31529-4
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© 2020 Elsevier Ltd. All rights reserved.
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