/ Health

Have you needed dental care during lockdown?

With dentists being forced to close and routine appointments cancelled, has a lack of access to dental care affected you?

All routine dental care has been put on hold due to the coronavirus pandemic, and 68% of Which? members we surveyed who’d had a dental appointment booked said it was cancelled.

Others said they’d been rescheduled or changed to a phone appointment.

Only 8% of booked appointments went ahead.

Dental surgeries are still fielding calls from patients and are to provide advice over the phone, as well as prescribing antibiotics and analgesics for more serious cases.

Read all the latest COVID-19 news and advice on our dedicated hub

Emergency dental care

Patients with emergency dental problems that need to be attended to in person can be referred to urgent dental care centres (UDCs), which are being set up across the UK at the moment.

In the first instance, patients are advised to call their dental practice for advice.

Emergencies which may be referred to a UDC include:  

🦷 Facial swelling

🦷 Loss of a permanent tooth

🦷 Post-extraction bleeding

🦷 Severe dental pain

🦷 Fractured teeth

🦷 Abscess or soft tissue infections

These conditions can become really serious or even life threatening if left untreated, but the British Dental Association points out that other things that don’t fit the emergency criteria can cause patients trouble as well.

A spokesperson for the BDA told us that many problems that have huge impact on quality of life – such as broken dentures and lost crowns – are unlikely to get needed assistance.

Urgent dental care centres have struggled to get off the ground in England, and hitting full capacity almost as soon as they have opened.

Last week, the BDA revealed that more than half of dentists in England said a lack of PPE has impacted the urgent care sites’ ability to operate.

This has left millions without access to urgent dental care across large regions of England, and concerning reports of people resorting to potentially dangerous or gruesome DIY dentistry procedures.

The system is reportedly working better in Scotland, Wales and Northern Ireland.

Have you had to access dental care?

We want to know about your experiences with dentistry during lockdown and how it’s affected you.

Have you had an important appointment cancelled, or rescheduled? Have you sought or were you offered advice or medication over the phone?

Advice: what you can do about medical appointments

Without regular check-ups, are there things you’ve had to change about your dental care routine? 

We also want to know how well emergency care is working. Have you needed emergency dental care and did you get it? How easy or difficult was the process?

Please share your experiences with us in the comments.

Comments

I am a permanent wheelchair user and have difficulty transferring to a dental chair. Are the UDC’ s wheelchair accessible and are they able to provide some form of assistance for those who have similar difficulties

Trevor Smith
I broke an incisor tooth on my new upper denture during lockdown & used Hermes to courier it
for repair. Hermes promptly lost it. Little chance of it being located now. A new one is unavailable
whilst Lockdown continues.

Janet says:
1 May 2020

I have a tooth broken in half exposing my filling ,I am concerned my tooth is now weakened ,I am in mild pain at minute and have been advised to use painkillers and a tooth repair kit. I believe they should start seeing patients who also like me don’t have swellings etc but are still in discomfort .

I had a broken crown and tooth just before lockdown and a bad metallic taste in my mouth. The dentist put a temporary filling in place and x rayed it which showed no infection. I had two appointments booked to take out the broken filling and repair the tooth and fit a new crown. Both of these were then cancelled and I have been told to wait till the BDA allows dental work to take place again but to get in touch if the pain increases as I will be able to have the tooth removed as emergency treatment. I don’t want the tooth out if possible so am coping with mild pain and a metallic taste which I really hope is not amalgam leaking into my system.

Susan says:
1 May 2020

I broke a molar some of it came away the rest is cracked but still in my mouth. I was advised by the dentist I would probably not be considered for emergency treatment and all that would be offered would be extraction anyway which obviously I want to try to avoid. The dentist advised me to try and keep it clean, and to try and keep the loose bit in with polygrip if necessary as diy fillings have sold out and possibly would cause more harm in my case. I’m on a list for call in but obviously they don’t know when they might be allowed to see people like me. As if lockdown isn’t stressful enough without not being able to eat properly.

I lost the entirety of a fully restored tooth the day dentistry stopped. It sheered off leaving two vertical pieces of the original tooth cutting into my cheek like two daggers. The original tooth bit that came away, can fit back in but I have no way of keeping it in place, the kit suggested just doesn’t work and I cant get hold of anything else. It’s absolutely horrendous, I can’t eat properly, am in pain, and my inside cheek is being torn to shreds but I don’t “qualify” for emergency treatment. I am in tears everyday. and it’s been like this for 5 weeks. I feel as if I have been completely abandoned by the dentistry profession.

Sarah says:
1 May 2020

We feel as dental practices totally let down by the government. Believe me I would rather be working than sat at home.

Yvonne Milner says:
1 May 2020

I’m sure the general public think that their dentists have abandoned them!! When infact dentists have been abandoned by the government and it’s governing body !! The edu”s have taken for ever to set up and are no more use to anyone than what is being done by local practices anyway and this apparently down to lack of Ppe?? People need to realise that dentistry is one of the most dangerous things to be doing right now due to aerosol generating procedures hence why we can’t do our jobs and are closed for everyone’s safety !! And yes we/I understand how hard this is and I really think we have been forgotten about ..but then it’s never been top of the government’s priority lists !!!!

Andrew says:
2 May 2020

I work in a Community Pharmacy, we have no PPE and are here for our customers as usual. We get a lot of requests for temporary dental repair kits, which we cannot source currently, from people who have been advised to use them by their Dentist. A lot of the time I feel the advice to use this type of product is inappropriate for the problems, as described by the patients. The Dentist has not seen the patient and a lot of the people I see are frustrated and in pain or discomfort. They feel they are abandoned. While I empathise with the Dentists’ concerns over treating potentially Covid-19 positive patients, the service offered is not good enough. There must be some way to help these people and give a better service. Get better PPE to the dental practices so that Dentists can deliver emergency treatment safely. We have seen innovation from Industry in the form of perspex screens used during intubation procedures, in hospital ICU’s, to reduce risk for those working there. It must be possible to use something similar in a dental surgery allied with good quality PPE, to deliver treatment in an emergency situation.

I had a painful tooth due to canal treatment and my appointment has been cancelled . The dentist has advised me to take antibiotic which I am mixing with other antibiotics

Steph Henderson says:
4 May 2020

I am a community pharmacist working in Scotland and currently see many patients daily with dental issues looking for pain relief and temporary repair kits which due to the surge in demand are mainly unavailable.
I too have developed toothache due to a portion of a filling fracturing off. After contacting NHS24 out of hours,I was referred via my dentist to EDC only to discover that the only procedure available was extraction. I was hoping the tooth could be refilled before the situation deteriorated to that stage and meanwhile, more importantly, putting my ability to perform my role as pharmacist in jeopardy due to sleeplessness/inability to concentrate sufficiently. It was a growing sense of anxiety over how this would impact my performance and safety within my practice that drove me to seek help.

Given that the government is increasing COVID testing significantly I do not understand why testing would not be linked into dental surgeries as a priority to allow COVID-free patients access to treatment.

gary Warmington says:
5 May 2020

I have a abscess, I had antibiotics before lockdown but the pain returned a few weeks ago. I talked to a dentist who said I couldn’t have more antibiotics and wasn’t an emergency unless my face swelled up, he said to take painkillers and salt water rinses until dentistry returns to normal. As I understand taking ibuprofen indefinitely is not recommended. At this point the pain is sending me crazy. So yes we have been abandoned. By the government I presume. The organisation and communication during this pandemic has been woeful.

If your dentist is closed and calling does not provide a number for an emergency dentist you can call the NHS number 111 and you should be given a number to call. Best of luck, Gary.

It is a matter of great concern that many people find it difficult, or in some areas impossible, to get access to a dental practice that provides NHS treatment. They are therefore not having regular check ups and hygiene attention. Sometimes regular examinations can identify emerging dental problems before they become painful or require surgery. This is another area where a more preventive policy would pay dividends both for patient well-being [including less time off work] as well as for relieving pressure on the NHS.

I sympathise with anyone with a tooth abscess at the moment and can’t add anything more in the way of advice except to say any untreated infection requires urgent attention to avoid sepsis occurring, which is very a serious condition and would need hospital
treatment.

For minor toothache I would strongly recommend Bonjela the same stuff we used to gently rub on our babies gums when teething, but there is an adult version which is much stronger. Don’t forget, as with all medication bought over the counter, to read the enclosed leaflet before using and treat this as a temporary fix until you get to see a dentist.

The adult version of Bonjela should never be given to children: https://www.gov.uk/drug-safety-update/oral-salicylate-gels-not-for-use-in-those-younger-than-age-16-years

The manufacturer should never have been allowed to sell a product with the same trade name as the one that is safe for kids and has a different composition.

I agree, On checking the pharmaceutical company Reckitt Benckiser responsible for its production have now redesigned the packaging to make it easier to differentiate and choose the right gel between the adult and children’s version of it.
It always works for me when I have toothache ensuring a good nights sleep but it’s important to read the accompanying leaflet before applying it.

After the risk to children was identified, the packaging was clearly changed to prominently labels products as ‘Adult’ as shown in this archived web page from 2013: https://web.archive.org/web/20130128193642/http://www.bonjela.co.uk/press_release.php The Bonjela website shows that the packaging has changed, removing this labelling and replacing it with a much smaller ’16+’ label: https://www.bonjela.co.uk/mouth-ulcers/for-adults/#bonjela-for-adults

I wonder if we can expect children to read the leaflet provided for adults. They are more likely to see and identify with a familiar brand name. Yes it would be good if Which? would take action.

Salicylate is a form of aspirin and should not be given to children under 16.

Aspirin was originally considered the new wonder drug that once was very popular and taken for minor ailments before paracetamol was introduced, until it emerged as a blood thinner causing unnecessary internal bleeding. It is now used with caution but still widely prescribed in low dosages by GP’s for people with problems pertaining to the circulatory system.

I think it is important to remember to specify when visiting the pharmacy whether you need the adult or the children’s Bonjela as both bear the same name but are different and the person serving you may not be aware of this. I agree definitely something that Which? could pursue.

It’s the other way round – aspirin (acetylsalicylic acid) is a salicylate. Bonjela contains choline salicylate.

Dentists use choline salicylate dental gel BP, which is probably much cheaper than Bonjela. I don’t know if that is available from a pharmacy.

Which? did draw our attention to the spurious advertising for Nurofen targeting specific types of pain and the ASA asked Reckitt Benckiser not to make such claims. I don’t know if Which? complained to the ASA.

Acetylsalicylic acid is something of a wonder drug, according to a study in 2014, when a review led by Jack Cuzick at Queen Mary University of London found that in the UK, more than 130,000 deaths from cancer would be avoided if all people aged 50 to 64 took a low-dose aspirin daily. The effects were greatest for bowel, stomach and oesophageal cancer, with smaller effects for prostate, breast and lung cancer.

Use of acetylsalicylic acid (aspirin) for treatment of those who have cancer is currently an unlicensed use of the drug. The Cuzick article suggests that it takes two years for aspirin to show a benefit.

Licensed or unlicensed, aspirin is still widely prescribed by haematologists for certain blood cancers alongside chemotherapy drugs. To minimise the risk of internal bleeding it’s important to remember never take aspirin on an empty stomach.

One problem with taking unprescribed synthetic drugs such as
aspirin as a precautionary measure, there may be a tendency towards unhealthy eating habits in the misguided belief they will protect you.

There are however, certain healthier options such as foods that contain small amounts of salicylate a natural chemical found in many plants such as ginger, avocados, some berries, chillies and cherries but more research is needed to establish whether eating these can be as effective as prescribed medicines.

I turned on the radio and heard part of this story about problems with dental hubs:

Thursday 7 May

BBC Radio 4: better PPE supply needed to provide advanced treatments
Today’s BBC Radio 4’s, You and Yours, highlighted our concern that some people are having teeth extracting unnecessarily because some of the urgent dental care hubs in England don’t have the appropriate PPE to perform aerosol generating procedures. The consumer programme included an interview with vice chair, Eddie Crouch, who said we would like to see the urgent care centres getting a better supply of PPE, so that dentists can provide more advanced treatments. He regretted the fact that in some centres the lack of appropriate PPE meant that treatments were largely limited to extractions which was like going back to our grandparents’ days.

When asked to comment on how many people were waiting to be treated, Eddie pointed out that dentists are taking between five and 20 calls a day, and the numbers of patients needing help was increasing. Eddie noted how few urgent care centres there are in England – 400 – relative to the number of dental practices – 9,000 and said we need to get back to opening private and NHS practices. He expressed concern over the lack of clarity when this might occur. Eddie said: “There is no plan as to when we are coming out of this.”

Commenting on why people have resorted to DIY extractions, Eddie pointed out that this wasn’t advisable but he said he understood how desperate people could become when they cannot access a dental service.

(From BDA website)

Sarah says:
20 May 2020

I chipped my tooth at the front, then it cracked and snapped and now I have only a tiny bit of tooth left, I’m not in pain at the moment but it looks awful and I am due back at work shortly 😬 I’m just hoping dentists will be up and running soon!!!

I have two teeth that need to be extracted. They should have been done in January but dentist cancelled twice due to dentures not being ready. One tooth is at front and the other is at the back. I can’t bite or chew on either of them as it is too painful. Since lockdown I have had abscess 5 times. The last one I couldn’t open my mouth properly, the whole side of my face was swollen and my lips were numb. The only way I could get relief was to use a needle to burst them. Now my lower denture has broken. I can’t get any treatment or repair

Please call the NHS number 111, Callie. Unless you get treatment you could end up with sepsis, which can be very serious.

I have already spoken to dentist and I have to wait until after coronavirus for dentists to ‘re open.

I don’t know what to suggest, Callie. The official advice is here: https://www.nhs.uk/common-health-questions/dental-health/how-can-i-access-an-nhs-dentist-in-an-emergency-or-out-of-hours/ Please ring again.

Can anyone else offer advice to Callie?

Which?’s guidance very much echoes you here, Wave:

If you have a dental emergency and are otherwise in good health, you can call your dental practice who may refer you to urgent care. Do not visit your practice without calling first.

If you have a dental emergency and are self-isolating with symptoms of coronavirus, contact NHS 111.

(from https://www.which.co.uk/news/2020/04/coronavirus-what-to-do-about-medical-appointments-including-seeing-your-gp-dentist-or-opticians/#dentist)

If you’ve not already done so I’d suggest ringing your dental practice back, explaining the situation, and asking to be referred for emergency treatment. If that doesn’t work, or if you’ve already tried that, try NHS 111 – https://111.nhs.uk/

2@msn.com says:
6 July 2020

Thankyou I will ty 111 as have rang dentist a few times but as they’re still not open I can only get antibiotics.

Amanda says:
23 June 2020

On March 13th I had my remaining teeth extracted and an impression taken afterwards to make dentures. Obviously all this was cancelled and since this day I have been left with no teeth. It’s been horrific

2@msn.com says:
6 July 2020

I was due to have 2 broken teeth out on the 27th March after months of pain only my appointment never went ahead due to lockdown. I have been in severe pain and now i can only eat little food and sip warm water as the pain is excruciating. I have been given antibiotics twice but they do nothing.
my face and chin are swollen and very warm I am worried about the damage this is doing to my jaw yet still can’t get an emergency treatment done.