Sir, there are two reasons why the current guidelines pose an existential risk to dental practice:

  • The additional costs involved plus the required fallow periods make general practice dentistry unsustainable

  • The necessity to approach our patients while dressed like Darth Vader will raise perceived levels of fear and panic among them. Many will think that our practices are 'hot beds' of COVID-19 infection and they will simply stay away.

The policy as it stands (both in terms of national control and the dental protocols) will simply allow us to lurch falteringly to the inevitable second lockdown, due in the autumn or winter. The only way forward is to take charge of our own profession and use our own applied knowledge and skills. There is a workable alternative approach and it relies on two fundamental factors:

  • In dental practice the vast majority of dental patients are booked as 'elective' patients. We know who they are, we know when they are coming and we know what we are planning to do for them when they arrive. This means we can plan in advance of treatment and we can choose to delay treatment if necessary. Medical personnel in ICUs at hospitals have to be in close proximity to infectious patients - we do not have to be, nor should we be

  • The only patients who present any form of risk from dental treatment (AGPs included) are those patients who are actively infectious at the time of treatment. Someone who has not been infected by the virus poses zero risk and someone who has been infected but recovered and seroconverted poses zero risk. Only a very small percentage of the population are infectious at any one time and these individuals are infectious only for a limited time.

The smart strategy means we need to identify the risk patients by advance swab testing of our patients when they require an appointment. Swab testing could be done onsite by a trained practice member in advance of any appointment booking. Those who test negative would be allowed normal full access to dental services. These appointments would be undertaken using exactly the same protocols as were used prior to the COVID-19 outbreak. Those who test positive will need to delay booking until they have a negative test - presumably about four weeks later if they remain well.

The main advantage of this approach is that it is proportional, specific and minimally disruptive. Furthermore, if the dental profession begins to test all of our patients this will have a significant advantage for the population as a whole, taking a burden away from the government or other healthcare sectors.

Therefore, we do not need to change dentistry fundamentally forever, we need to be SMART and TARGETED for now. If testing is done by the dental profession there will be spin-off benefits for all. To use the current 'management speak' it is a win/win situation.