08/02/2021
This is quite a long read but it's an issue which affects us all.
When dental surgeries closed during the first lockdown, patients were left in pain, needing major treatment and despairing about where to go for help.
Almost a year on, a shock report by watchdog Healthwatch Sheffield has found that many patients are still "confused and distressed" and the NHS reveals some practices are only offering a fifth of the services pre-pandemic.
Dental patients have been left with broken dentures, gum disease, in pain and needing fillings and root canal work for months on end because of the impact of Covid. Healthwatch says enquiries have increased significantly during the pandemic.
It says delayed treatment is having a serious impact with some people trying for over a year to get an appointment.
One person told the watchdog “I am aghast how he can be left in such a terrible state, in so much pain”
And another said: "Called NHS 111 but issues regarding dentures do not count as an emergency”
Healthwatch says: "We are beginning to hear from people about the longer term impacts of delayed or paused treatment.
"People who needed fillings or root canal work told us that they had been left in pain for a significant amount of time, and the pain medication prescribed over the phone isn’t always enough to help them.
"There is a lack of clarity about what is ‘urgent’ care. We know that dental pain can be very distressing so when people are told their issue isn’t urgent or they can’t access care, it can be confusing.
"Guidance advises that dentists should triage people who contact them for treatment, but we’ve heard this doesn’t always happen, and some people do not get chance to explain their issue.
"One person told us her dentures had broken and she could not eat properly, but after phoning several dentists without being triaged and being able to explain her issue, she didn’t know what else to do.
"Others feel it’s unclear what is considered urgent - a person with gum disease who’s been unable to get this checked for over a year, as he was told it wasn’t urgent.
"We know that dentists have limited capacity while trying to care for patients and maintain proper safety procedures; however for patients who are told their issue isn’t urgent enough, it can be difficult to accept."
Healthwatch says patients, who are often in a significant amount of pain, need clearer public communication about what their options are, and what they can expect when phoning a dentist for triage.
"Many of the people who phone us say they are struggling to find information online, or that they hear an out of date answerphone message when they phone their dentist.
"As a local Healthwatch, we also struggled to access clear information in order to support people with their enquiries.
"Advice that we gave people based on public information didn’t always match their experience when they phoned their local dentist."
Patients accessing a new dentist had more issues than people with a regular practice, including parents trying to get an appointment for a child.
One person said: "I've been trying to get an appointment for over a year, but can't get one”.
Another said: "I contacted several dentists who have all said that she must be registered with them as an NHS patient to be seen.”
Healthwatch says: "NHS England guidance states that patients can phone a local dentist for urgent care even if they have not been treated there before.
"However, we have heard confusion about this - whilst dental practices don’t have a patient list in the same way that GP practices do, people tell us that their local dental practice has cited ‘not being registered’ as a reason they cannot access an appointment.
"It is unclear where this miscommunication is coming from, but clearer information both publicly and internally may help to alleviate this confusion."
Accessing an NHS dentist was also a problem with some people being told waiting lists were 18 to 24 months long.
One person said they couldn't afford private prices while another said dentists were prioritising people who had more money.
Healthwatch says: "Others have told us that their local dental practice were unable to see them as an NHS patient at all, but said they could pay for private care and be seen more quickly.
"The number of people telling us about this has increased significantly since November and people who cannot afford to pay for private care tell us they’re very concerned about this disparity.
"Access to NHS vs private dental care could have an ongoing impact on existing health inequalities."
Dentists were told to stop treatment and provide remote consultations at the end of March 2020. Practices reopened in June but Covid is still impacting on services.
Debbie Stovin, dental commissioning manager of NHS England Yorkshire, says in a report: "All practices must follow stringent infection prevention and control measures.
"This is impacting on the level of service that can be delivered and is as low as one-fifth of the activity that was being delivered prior to Covid at some practices.
"Strict infection control procedures between appointments reduces the number of patients that are able to be treated on a daily basis.
"The other impact is on those patients wishing to resume their routine dental check-ups and treatments. Practices have been asked to prioritise those patients with an urgent or emergency dental need."