Coronavirus: 300 dentists criticise guidance and seek halt to elective services

Over 300 dentists have signed a letter criticising official guidance on Covid-19 and calling for all elective dentistry to stop due to the threat posed by the disease.

Separately, the Irish Dental Association has said almost one-fifth of dental practices have scaled back services amid warnings that the profession is "on the brink of collapse" due to the virus outbreak in the State.

On Monday, the chief dental officer in the Department of Health advised practitioners that "dental practices can remain open and there is currently no need for change in practice".

The dentists in their open letter describe this advice as “extremely troubling” and say they are particularly concerned about procedures that generate aerosol spray. “These have the potential to expose all patients and dental workers to significant risk of contracting Covid-19.”

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The dentists also query the advice that aerosol equipment can be safely used if a patient is asymptomatic.

“The evidence base is rapidly growing that asymptomatic transmission is not only possible, but likely,” their letters states.

“The HSE has in fact moved (correctly) to an entirely different protocol, with all their public clinics and hospital units ceasing all elective procedures. They are treating only the most urgent emergencies, and their dentists are advised to keep aerosol generating procedures to an absolute minimum.”

The dentists say “elective dental procedures must stop. Otherwise even more lives in our vulnerable and elderly populations in particular will be lost”.

The IDA said 18 per cent of members who responded to a survey have already closed practice in some form, while nearly half of respondents estimated income to their practices will fall at least 90 per cent due to the outbreak.

Dentists say they are seeing widespread cancellations of appointments.

The IDA said it is seeking a "wide-ranging package of supports" in order to survive. Fintan Hourihan, the organisation's chief executive, said the vast majority of practitioners in Ireland "receive no support at all from the State, so are extremely exposed to this crisis. We have received notifications from dozens of practices saying they have already closed their doors, and our fear is that this number will multiply over the coming days".

He said the IDA “has made numerous efforts to communicate this message to politicians, and we have received no clear direction whatsoever. Politicians need to wake up to the fact that the dental profession as we know it is disintegrating before our eyes due to the fact that dentists simply cannot practice under these circumstances.”

Members of the profession who spoke to The Irish Times have also highlighted a lack of personal protective equipment, which they say is especially needed due to the proximity between a dentist and a patient.

The letter from the chief dental officer advises that if a patient is showing symptoms of Covid-19, dental care should only be considered after consulting with their GP.

A Q&A document circulated along with the letter states that “currently the advice is that dental practices do not need to avoid certain procedures or close the practice”, and that “currently there is no advice to alter current dental professional practice.” It advises that aerosol devices can be used for asymptomatic patients.

It goes on to state that there is no requirement for the use of face masks when using suction or aerosol for patients who are asymptomatic.