Due to the COVID 19 epidemic we are following national guidelines to provide Emergency Care and routine dental care is no longer available at any of our clinics.
Public Health England have produced the toolkit in the link below to support care homes and commissioners to implement the NICE guideline (NG48): Oral health for adults in care homes. It also contains useful links for care home staff, residents, their families and friends to support good oral health and reduce oral health inequalities. https://www.gov.uk/government/publications/adult-oral-health-in-care-homes-toolkit
Patients who have a swelling affecting their eye or which affects their ability to swallow or breathe, or if they have dental bleeding which cannot be managed at home should go to A and E.
Dental conditions which may require urgent care include:
- Trauma including loss of a permanent tooth.
- Facial swelling that is significant and worsening.
- Severe dental or facial pain that cannot be controlled by the patient
- Fractured teeth or tooth WITH nerve exposure
- Dental and mouth infections.
- Suspected mouth cancer
- Dental conditions that may affect a serious medical condition
We are providing telephone triage system to assess emergency and urgent care and this can be accessed by calling the dental helpline on: 03001234010. For our own patients we ask that you call the clinic you usually attend and follow the instructions on the answerphone message.
Once a call has been received by the dental helpline service, patients will then be given an appointment to speak to a dentist. A dentist will ring you back to perform a remote consultation â€“ this will be either by telephone or video link. This will include taking a thorough medical and dental history .You may be asked to email photographs of the dental problem to a secure NHS email account.
We will follow strict guidelines and a structured pathway which follow national guidelines and concentrates on the 3 AAAsâ€“
Advice â€“ self-help, you will be given advice on how to manage your condition including possibly using a temporary filling kit available from chemists or one of our UDCs (Urgent Dental Centres).
Analgesics â€“ appropriate advice according to individual circumstances and medical history will be given.
Antibiotics - only if appropriate.
Each patient will be assessed and managed on their own merit taking into account their best interests and using professional judgement.
If Symptoms persist ring back after 48 hours and you will be triaged again, if all options have been exhausted than a referral to appropriate Urgent Dental Centre (UDC).
We have separate premises for those who are shielded / at high risk if catch COVID-19).
ONLY where a 3A approach has been tried, escalated and failed to manage symptoms, or where the patient is at risk of deterioration of general/mental health if they do not receive an active intervention, will a face to face consultation be considered.
Referral Forms and Guidance
If you are referred into a UDC please expect to be triaged again by telephone / video link first, this is to ensure that face to face contact is necessary and that you understand the treatment options available.
The Chief Dental Officer has categorised patients as:
- Patients who are possible or confirmed Covid-19 patients
- Patients who are shielded, those at the highest risk of severe illness from Covid 19.
- Patients who are at increased risk of severe illness from Covid 19 Appendix 1
- Patients who do not fit one of the above categories but bearing in mind that as the country is in the sustained transmission phase of the disease we need to consider that all patients may potentially have or carry the virus.
Patients in categories 2 and 3 will be seen at a separate site to categories 1 and 4. Because of this you may have to travel a significant distance.
Even when you get to the UDC options are severely limited, normal dentistry involves the generation of aerosols eg drilling, using air and water spray or cleaning teeth. Due to nature of COVID -19 and how it is spread in saliva and droplets from the upper airway we need to avoid using procedures which increase the generation of fine spray or aerosols (aerosol generating procedures or AGPs â€“ you may hear about these in the news). Therefore often the only treatment options may be an extraction or a dressing. Any procedures involving AGPs will be kept to a minimum and further treatment is likely to be required at some point in the future.
If you come to a UDC for face to face appointment there is risk of infection even though we are employing rigorous standards of social distancing, PPE and decontamination. Patients are kept separated physically and by timing of appointments. You may be asked to wait outside or in the car if we are not quite ready for you.
What to expect when you come attend:
Normal dental charges apply for emergency treatment. If you normally pay, a charge of Â£22.70 is payable by card via the phone prior to the visit or the exact amount in cash can be accepted. If you are exempt from dental charges, you will not be required to pay.
The Business Service Authority (BSA) has agreed for a receptionist on the premises to complete and sign the FP17 (blue form) on the patient's behalf due maintaining social distancing measures.
We are working on the assumption that all patients attending the clinic may be actively infected with COVID 19 or are carriers of COVID 19.
Please be prepared for the fact that staff will all being wearing varying degrees of PPE ie masks, aprons, visors, gowns gloves.
We are asking all patients to enter the clinic alone. Anyone accompanying a patient must wait outside the clinic. Young children may be accompanied by one parent or person with parental responsibility â€“ they will be asked to perform hand hygiene and put on a surgical mask on arrival.
Adult patients who need to attend with support staff should attend with the minimum number necessary and normally only 1 will be allowed into the surgery with them, they too will be asked to put on a surgical mask on arrival.
When you attend for the emergency appointment, you will be met at the front door by a nurse wearing a mask, gloves and an apron.
This nurse will:
- confirm your name, date of birth and the first line of your address
- ask you to refrain from touching anything (such as door handles) with your hands
- lead you into the reception area
- ask you to apply hand sanitiser
- check your temperature with an in-ear thermometer
- confirm details of your medical history
- ask you to wait in the reception area
(Failure to comply with any aspect of this may result in the cancellation of your appointment and lead to you being asked to leave the building)
Once the dentist has checked the information gathered, and is happy to proceed with treatment, you will be called into the surgery. You will be greeted by one dentist and one nurse wearing a full P.P.E. kit.
At the end of the appointment you will be escorted out of the building by one of the nurses.
To enable your visit to the surgery to run as smoothly as possible, it is preferable to obtain consent in advance for the most likely treatment outcome, you will have an opportunity to discuss the treatment, the risks and ask any questions with the dentist you speak to on the telephone. However consent will be confirmed on arrival and you will have the opportunity to address any concerns with the dentist who will be treating you.
Please make sure you have taken analgesic medication (where needed) and have had something light to eat approximately 1 hour before the emergency appointment.
We ask that where possible, you refrain from using the toilet facilities at the clinic.
Follow this link to view / print our Patient Information Leaflet
During this period we encourage people to look after their teeth by:
Brushing teeth twice daily for minimum 2 minutes using the toothpaste recommended by their dentist and flossing daily.
Restricting sugar intake to a minimum and keeping to mealtimes, avoiding sugary snacks and drinks between meals.