Sir, during this current global crisis, is it not appropriate at this time to ask the question: 'how will COVID-19 impact on future dental care provision?' I feel it is appropriate to raise the topic early so that the dental community can begin to think about the problem and thus devise a strategy to manage the future.

Almost all dental procedures generate aerosols, from the 3-in-1 used during an examination, to the high-speed handpiece and the aspirator. We are all familiar with the concept of 'universal precautions' whereby in the past we have assumed that every individual is a source of potential cross infection, now more so than ever before our current environment exemplifies this.

Whilst we must expect that coronavirus will exist amid the general population of the world for some extended time period, we must by definition assume that the dental profession will need to adopt equally rigorous PPE and procedural policies (pending the progress of COVID-19 testing amongst the populace). This is not only to address any perceived risks from the general public, but also those real threats to patients and staff.

Arguably, should the air-flow of clinical spaces, either generally or in the immediate working area of the mouth, need reviewing? Would the return to treating patients in an upright sitting position reduce the need for aspiration? As a clinician who regularly treats some patients in this sitting position, I am aware of the limitations of some chairs and dental units in adopting this posture, as well as the differences between working with direct and indirect vision, and the postural issues for both operator and nurse. Is the modern dental surgery fit for purpose post COVID-19?

Reports seem to indicate that the current patient throughput of the Urgent Dental Care centres, recently set up to cope with dental emergencies, is around eight patients per day. Even with honing and practice this falls far below the pre-COVID-19 patient throughput figures for even private clinicians. Ultimately, should we not be recognising that the dental profession as a whole will be operating in a very different environment to that which we began the new year of 2020? This not only extends to the UDA re-imbursement system but also to our mode of working.