Covid: Tooth loss fears over dentist check-up delays

People could lose teeth unless Covid rules in Wales are eased to allow more to get check-ups, leading dentists have warned.

The British Dental Association said it wants rules for dentists relaxed now most of Wales' Covid rules have eased.

Russell Gidney, chair of the BDA's Welsh General Dental Practice Committee said delays could mean tooth decay, gum disease and cancer may go unspotted.

The Welsh government said it had given £450,000 to help practices in lockdown.

Routine appointments were postponed when Wales was placed into coronavirus lockdown in March 2020 and dentists only saw patients face-to-face for urgent care.

Practitioners did undertake video or phone consultations - of which there have been about 350,000 in Wales in the past 18 months - for patients with less urgent problems.

After the pandemic hit, the number of treatment sessions claimed on the Welsh NHS fell by 97%, from 1.1m in January to March 2020, to 22,713 in April to June 2020, as missed appointments in England topped 19 million.

While more routine treatments have since resumed in Wales under a phased return of services, strict hygiene measures remain in place due to Covid, including allowing downtime between patients.

Under guidance, this time has to be used if dentists need to use air, such as for fillings or cleaning, to allow the room to ventilate and then be deep cleaned before the next patient.

Mr Gidney, principal dentist at a practice in Monmouthshire which has 7,000 patients, said the "dead time" was limiting how many non-urgent patients they could see and creating a "bottleneck" in the system.

He said, while surgeries were prioritising so-called "red patients" - those with underlying issues like gum disease - and emergencies, the wait was making it difficult for dentists to see anyone else.

Mr Gidney said it meant minor issues, like a small hole in the tooth, which may not be obvious to a patient, could end up needing a major procedure if people were not able to book routine check-ups.

"By the time it causes problems, we are often talking towards root fillings or teeth coming out, and then you've got things like gum disease or cancer, where there can be no symptoms," he said.

"The only time you really get symptoms with gum disease is when the teeth have already come loose and by that stage it's too late.

"It might mean people end up losing teeth that we could have saved."

The Chepstow-based dentist fears children and adults could face problems after lifestyle changes in lockdown and said measures should be eased now so many have been vaccinated.

"It's kind of causing us sleepless nights at the moment, because we don't know how long it's going to take to be able to get there," added Mr Gidney, who is also a clinical supervisor at the dental teaching hospital in Cardiff.

Rebecca Cotterell tried to get an appointment when she started getting tooth ache in mid-2020, but said she was told she could not be seen as her practice was only seeing urgent cases.

She was eventually seen in May this year, and had a temporary filling put in, but said she was then told she could not be seen again for a permanent solution until September.

"It got to the point that over the counter painkillers just weren't working," said Ms Cotterell, from Cardiff.

"As a parent of a young child who's very energetic, it was quite upsetting to not be able to take them out and do activities with them as I was in just too much pain."

She said the pain got worse and she had to have an emergency appointment in the end to remove her tooth in August.

Ms Cotterell added while she felt lucky to be an NHS patient when so many people were struggling to find a dentist, not being able to get a face-to-face appointment for months was "not ideal when in pain".

The Welsh government said it had provided £450,000 to health boards to provide ventilation for practices to help reduce the time between patients.

It added routine dental appointments had not stopped during the pandemic, but like all NHS services people were being seen "according to need".

"Since the beginning of the pandemic, dentists have seen more than 1.5m people and provided 350,000 consultations remotely, via phone or video services," a spokesman said.

"Dentistry has been one of the most challenging services for us to deliver during the pandemic because of aerosol generating procedures such as fillings, and the need for dentists to be in such close proximity to the patient which requires enhanced PPE."