Dental Availability During COVID-19

 

Why can’t I get a dental appointment?

We are open! We are providing all services! We are tired, and we are slow! Have you tried to get a dental appointment recently?? Everytime the phone rings at the practice these days I feel a little sick to the stomach (and yes the phone rings every two minutes).  We hate not being able to accommodate someone!

I hope our own members haven’t been too inconvenienced and everyone’s routine appointments are somewhat on schedule!  I write this blog not just to address our own access problems but those across the board in Northern Ireland.  We were so proud of ourselves reopening as soon as we could back in late June 2020! We were the early adopters to Dentistry in COVID-19 era.  We had all our Standard Operating Procedures ready, all our PPE was sourced, Air Filtration systems installed.  We questioned why so many practices remained with their doors shut and as the weeks, months and years (!) begin to pass we are still asking these questions. 

At the start access for us wasn’t a problem! We had a very clear book! This coupled with the fact so many were still hesitant to come to the dentist, as time goes on and with the success of the vaccine roll out and the desire to return to ‘normality’ demand has increased to unprecedented levels. 

In no particular order these are some of the problems effecting dentistry.

 

Backlog

For fourteen weeks our drills sat silent, once a week diligently Derek and his 7 year old helper would take their only weekly outing from the house to the practice and they would oil the handpieces (drills), Flush the water systems in the chairs to keep the biofilm at bay, flush the toilets (who knew stagnant toilet water was a legionella risk?!)  I would answer the phones every day and on a Thursday I would get to go outside and post and hand deliver lost filling packs.  In the meantime our list of patients with urgent and emergency treatment grew and grew, the routine preventative appointments came and went and there was nothing we could do.  We usually booked on average three weeks ahead, at the point we reopened we were technically 17 weeks behind schedule.  No problem, let’s work all the clinic hours we can and clear some of the backlog…..But there is a problem

 

Reduced Availability

We have to leave every surgery to “fallow” an hour (Fallow a new word to all our vocabulary in dental) it means between each patient the room has to settle before it can be thoroughly cleaned and the floors mopped! So much for seeing as many people as we can to break the back log, now we can only see half of the amount of people we usually see.  As the months passed restrictions have eased a little, we have invested in thousands of pounds worth of equipment that recycles the air in the surgeries and we have reduced our fallow time to ten minutes.  This is much more manageable but it still results in Rachael our hygienist seeing one less patient per hour so our hygiene book is only running at 2/3 its previous capacity and is unlikely to recover.  The next thing that is slowing us down now are the fit tested face masks and gowns which restrict our breathing, movement and make us sweaty and tired (at least 2021 wasn’t the warmest summer on record?!)  Increased cleaning after the use of the drill requires all team members to get involved and we have had to increase our staffing levels even though we are seeing less patients. 

Increased demand

For all the reasons above so many practices have still not reopened fully, and are only offering emergency services.  Every day we have members of the public ringing us in dire need of dental treatment hoping we can see them, we are so busy with our own patients that we can hardly squeeze in another new patient.  This is difficult to explain especially when a member of our practice has recommended us- so often we hear “my friend in work told me to call you, he has had six routine appointments since the pandemic and my own dentist won’t see me even though I have lost a filling.”  We are also finding new patients are presenting needing extreme amounts of work. 

Other strange COVID time phenomenon have also impacted demand-

Working from home- patients who previously were busy commuting and working the 9-5 would put off treatment, and then suddenly they could find time for the dentist! For many it was exciting to have something in the diary albeit a dental visit! Treatments patients had been putting off for years were suddenly important!

Furlough Monies/unspent holiday money- has resulted in an unprecedented demand for adult braces/bonding etc.  The problem is not only does this make the clinician’s busy but the administration and phone answering regarding this is extensive. 

Oral health has deteriorated- Rachael our hygienist has noticed her own previously well maintained patients are needing more help to get back on track- This appears to be from a breakdown in routine during lock-down and an increase in sugar intake too, this too is requiring more time out of our already overflowing clinical diary. 

 

Unrealistic expectations

For our own patients many of them don’t understand the situation, we have reopened fully over a year ago now.  When they arrive we try to make things as normal as possible.  While they really aren’t normal we are working extra hard behind the scenes

This is also highlighted a rumbling issue of staff shortages within dentistry.  Hygienists have been a little scarce now in Northern Ireland for a few years since Queens stopped providing the degree course.  This has now reached an all-time crisis point and hygienists are like the proverable hens tooth. Made more difficult by the fact that we have been spoiled with the high standards given to us over the years by our own amazing @homegirlhygienist.   Good Private dentists aren’t any easier to find.  We are so blessed with an amazing team- reliable, loyal and steady most of them have been with us for years, we have also been able to make a recent strong addition to our front of house team.  Adding further to our team to improve our access is a challenge that we have yet to succeed with. 

Supply chains are improving but we are struggling with slower than usual and unpredictable deliveries of materials (not to mention severe price increases) and lab work, resulting in appointments needing rescheduled in an already difficult appointment book!

I have seen so many Facebook posts from practices asking for their patients to remain calm, calling out abusive behaviour! Ironically the only abuse I have got so far is from non-patients who are looking to book in with us as their own dentist won’t see them! I can honestly say our own patients have been so supportive and respectful! I cannot thank you all enough….

We are open and will accommodate new patients as much as we can!