Returning to practice post-lockdown: Reflections so far

15 September 2020

Dr Kieran O'Connor, General Dental Practitioner and Chair of the General Practitioner’s Committee of the Irish Dental Association, looks at the impact of COVID-19 on dentistry.

With restrictions on accessing dental services being lifted on 18 May following revised guidance from HPSC and the Dental Council, there has since been a gradual return to practice.

HPSC acknowledges that the “situation continues to change rapidly both with respect to the scientific knowledge about the virus, and virus transmission, and the epidemiological situation”.[1]

As in all matters relating to our practice, we need to follow the science and the evidence. The HPSC document gives clear guidance and allows us to assess risk as we have always done; the Dental Council’s Facebook post [2] on 17 May highlights the importance of risk assessment. Speaking to colleagues in other jurisdictions, it seems our return has been more familiar, bolstered by low levels of community transmission.

However, the transition has been challenging for the whole dental team and also for our patients. The return has been slower for associates than practice owners in many instances. I think most will agree a patient’s dental needs are the same but dental practices look and operate differently compared to a few months ago. What was routine is now governed by staff and patient screening, organisational measures, social distancing requirements and increased environmental cleaning. The result is a reduction of capacity. There is also the rise in cost of Personal Protective Equipment (PPE), our last line of defence, which is in scarce supply. With these significant cost factors, dentists are questioning the viability of the two state schemes as the new realities emerge.

It is clear to me that patients appreciate our return and have a new perspective on our already high and trusted standards of infection control and prevention. A patient recently said to me that he couldn’t understand why we became restricted to emergency care as he felt we were always such a safe healthcare place. However, some are fearful of accessing any healthcare, so it is important that we are sensitive and reassuring.

Within the Irish Dental Association, advocacy is a huge piece of work and we have started engaging with the new Government to explain the realities of returning to practice during the pandemic. Extensive interest and engagement from the media have also been very useful in reassuring the public, with increased public confidence in attending dental appointments.

In mid-March we were in many ways preparing for war as the certainties of all our lives and the practice of dentistry were challenged. We were bombarded with science and pseudoscience, information and misinformation. Now the fog is clearing, and our country is emerging into a new normality with patients being safely provided with dental care once again. Undoubtedly challenges remain and new ones may appear as the science emerges. We have greater confidence in our infection control and prevention measures as they relate to COVID-19 than we had in early March, but we still need to remain vigilant to ensure that dental practices are not deemed a risk for community transmission. Essentially, we need to continue to look after the wellbeing of our teams, our patients and ourselves.

The war against this coronavirus is not over and I am certain that in the future, when we reflect on this time, hindsight will be 2020.

Dr O’Connor has also shared his experiences with Dental Protection on the podcast “In conversation with Dr Kieran O’Connor: a general dentist’s perspective on a COVID-19 world”. You can listen to this and other Dental Protection podcasts here.

[1] https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/dentalservices/Guidance-ManagingInfectionRisk-DentalServices-COVID19.pdf

[2] https://www.facebook.com/pg/dentalcouncilireland/posts/