There has been a new update from the CDO this evening (18th March 2020) that aims to give the clarifications around the sustainability uplift and the definition of aerosols. The letter is attached below.
- As feared, the 90% sustainability uplift is not adjusted to take into account the fact the patients are not actually in the building to pay their 80%. This is deeply disappointing as it discriminates against practices who have higher numbers of non-exempt patients. We will be expressing our concern and disappointment at every level. We suggest all dentists affected do the same.
- Clarification around AGPs (Aerosol Generating Procedures) is given. High-Speeds, Ultrasonics, and anything that requires use of 3-in-1 syringes are classed as AGPs. It appears we can only use AGPs to drain a tooth in an emergency (whether this means pus or to remove inflamed/necrotic pulp is again unclear).
- In a somewhat contradictory statement, use of the 3-in-1 may be possible. The CDO seems to suggest that minimising mixed air/water jets may limit aerosols.
- Non-AGP procedures that are mentioned (despite the lack of 3-in-1) are Examinations, Hand-Scales, Denture Stages and Simple Extractions. The assumption here is that the CDO expects us to continue with these procedures for patients who do not fit the high-risk categories (70+, immunocompromised, pregnant, COPD, Asthma, Diabetes etc), still refusing those who should be self-isolating. Based on all recent teaching the diagnosis of dental caries requires air-drying… perhaps using cotton wool as an alternative to dry surfaces may mitigate the risks posed by aerosols.
- We understand GG&C Oral Health Directorate are working to set up a referral service for those who are suspected to have contracted COVID-19 and need emergency treatment. NHS 24 is the first port of call until a referral pathway is set up.