Seb Evans explores the possibility of COVID-19 testing as a way of avoiding expensive PPE costs and fallow time in surgeries.
Following CDO for England, Sara Hurley’s recent announcement, dental practices are set to open their doors to patients from the 8 June.
There have been many suggestions over what dentistry will now look like in England. The FGDP(UK), in conjunction with several other organisations, was first to publish its guidelines on a safe return to dentistry.
Its 68-page guidance includes clinicians making contact with patients before they attend for their appointments, extensive PPE and leaving surgeries fallow for 60 minutes before cleaning.
The cost implications of this would be massive. Additional staff training, PPE and reducing surgery time are just a few of the problems.
But what if there was another way?
Last month Health Secretary Matt Hancock announced trials for a 20-minute coronavirus testing kit. The swab test would show whether somebody currently has the virus and it would not need go via a lab to get the results. It involves taking a swab from the nose and back of the throat.
Drug firms Roche and Abbott have approved the tests as accurate. However, costs for the swab are yet unknown.
If the tests are completely accurate, they may offer an opportunity for dental practices to avoid the new guidelines and maybe even run at pre COVID-19 capacity.
Just after lockdown started, Claire Berry, dental hygienist, highlighted how dental practices are the perfect location for COVID-19 antibody testing.
‘The government has spoken of plans to have tests available on Amazon and in Boots stores,’ Claire said. ‘Whilst also stating that data needs collating to assess who has been asymptomatic. And indeed, to know who has and has not had the virus.
‘I feel that using dental teams for this with an appointment system will allow the antibody testing to remain organised. It also allows more effective collection of any necessary data.’
How would it work?
We await to see the outcome from the government’s six-week trial as to whether the tests are effective.
However, as suggested in the urgent dental care centre standard operating procedure (SOP), practices could ask patients to wait in car parks or an area away from the practice. The patient could then take a swab test and wait for their results.
After 20 minutes the patient and practice would know whether they have COVID-19. The staff could then offer advice on self-isolation and steps to take next if they are. Or the clinician could carry on as normal without the need for additional precautions if the test came back as negative for COVID-19.
This method might save the practice PPE costs and the surgery would not need to remain fallow for 60 minutes after each patient. All for the cost of a 20-minute swab test.
Focus on the team
‘When describing, what you do if you are given lemons…our profession often has to think outside the box,’ Ben Atkins says.
‘At the time, I thought Claire’s COVID-19 testing in practices was brilliant. Actually why we did not do that was beyond me. However I really think times have changed.
‘As a practice owner, my focus really would have been on getting practices back to norm as quickly as possible. Becoming a testing centre now, would cloud this journey at a complicated time.
‘Sixty-minute fallow periods just beggars belief. However, my aim as a business owner would be to mitigate this as much as possible. Running two surgeries, extending working time, masks, rubber dam – the list runs on.
‘The utilisation of COVID-19 testing is really interesting. There are many providers entering the market, from Amazon to Boohoo. How we will be involved with these will come out in the wash.
‘As an NHS dentist at heart, I would be looking at the NHS to lead on this. But with experience this can take its time. So my focus would firstly be on my team, like any other business, mitigation is so important.
‘Could these tests be used as part of the monitoring the health of my team? Yes, and this is the area I would probably focus on. Maybe even regular testing, to make sure we catch any illness early, and to reduce pressure on the team if someone gets a cold (negative results will be as important as the positive ones).’