The British Dental Association Northern Ireland has said further action is needed to ensure Health Service dentistry can recover from the impact of the COVID-19 pandemic as new figures reveal the full extent of the collapse in attendance.
The General Dental Services Statistics for 2020/21 show the volumes of dentistry delivered since April 2020 were less than a third of usual levels, with over 3 million fewer treatments delivered to adults and children. Just 40% of patients were seen compared to the previous year, with over 440,000 fewer adults and nearly 70,000 fewer children.
Dentistry has been hit by the imposition of strict new infection prevention control measures such as enhanced PPE, social distancing measures, and extra cleaning and 'fallow time' - mandated gaps between patients - which have impacted considerably on the ability to see patients, with activity still reduced to around 40% of pre-COVID-19 levels.
Oral health inequality is set to widen as a result of the COVID-19 pandemic, given the ongoing disruption to dental services, the suspension of public health programmes, and the impact of lockdown diets. Northern Ireland has traditionally been at the bottom of the UK league table for oral health, with just under a fifth (19%) of 15-year-old children in Northern Ireland considered to have good oral health overall. With an election potentially looming, dentists are calling on all parties to pledge to deliver a three-pronged approach to guarantee that Health Service dentistry in Northern Ireland can survive the impact of the pandemic:
A new Oral Health Strategy aimed at delivering improved outcomes for the population and reducing oral health inequalities
Work to begin on a new General Dental Services (GDS) contract to safeguard a future for Health Service dentistry
Provide needed capacity at the Department of Health to be able to progress the major reforms needed in dentistry.
The BDA has long advocated a root and branch overhaul of Northern Ireland's oral health strategy which is now over 14 years old. It says a new policy must run in parallel with reforming the decades old activity-based contract that Health Service Dentistry is based on, which is simply unworkable post-COVID-19. The change of emphasis being called for is to move away from 'counting widgets' to a model that recognises and rewards work improving the oral health of the population.
The profession has acknowledged the short-term support provided to dentists under Financial Support arrangements over the past year, and the Minister's recent confirmation that a new GDS Rebuilding Stakeholder Group will be established to help tackle these issues and that limited administrative capacity in DoH will be reviewed.
Richard Graham, Chair of the British Dental Association's Northern Ireland Dental Practice Committee said: 'With an election possibly just months away, these figures underline why dentistry must be on every party's agenda.
'A service long teetering is now broken and will require nothing less than a full rebuild if it's ever going to meet demand from the hundreds of thousands who have missed out on needed care. Morale across the profession has collapsed. Things were barely sustainable pre-COVID-19, and now many colleagues simply cannot see a future providing Health Service dentistry.
'There is much work to do to ensure access to Health Service dentistry can be sustainable going forward, and we urge every party that values it commit to taking that work forward in earnest. Our message to every MLA, candidate, and party is simple: it is high time to give oral health the priority it desperately needs.'
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Dentists call for action as figures show full impact of pandemic on service in Northern Ireland. BDJ In Pract 34, 6 (2021). https://doi.org/10.1038/s41404-021-0817-1