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Dental practices shut as surgery restrictions take hold

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Dentists are scrambling to adjust to tough new restrictions on surgeries which ban check-ups and fillings, as dental practices across South Australia shut amid the economic fallout of COVID-19. 

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Police Commissioner Grant Stevens, who is also the state coordinator under the Emergency Management Act, made a direction yesterday to limit “surgery, treatment and procedures” to emergencies or those that are required to prevent the loss of life, loss of limb or permanent disability.

It comes after the Federal Government on Friday escalated restrictions on dental practices to “level three”, meaning dentists are only allowed to treat patients who are in severe pain, or who require urgent treatment to avoid going to hospital.

The guidelines also mean that dentists across the state are unable to perform examinations, routine check-ups, fillings or cleaning for the foreseeable future.

Australian Dental Association state branch president Dr Angelo Papageorgiou told InDaily there was a “huge concern” that people would develop dental problems over the next few months, but the restrictions were necessary to protect people’s health. 

He said some practices remained open to perform emergency surgeries to temporarily stabilise serious dental problems, but some of those practices would “probably eventually close” as financial pressures force the industry into shutdown.  

“Dentists have been distressed, they’ve been alarmed by what’s happening and they’re scrambling to adjust to the restrictions,” he said.

“Patients who we’ve seen on a regular basis for their checks and cleans, we know that most of them will be OK over the next three or four months, but there are many patients who aren’t as regular in visiting the dentist, or haven’t had regular maintenance and checks over the years, who may present with problems now.  

“This is uncharted territory, we don’t know what’s going to change or happen, there’s a lot of uncertainty, so we’re just gauging that over three or four months patients can wait.” 

Dentists are advising elderly South Australians and those who are pregnant or who have pre-existing medical conditions to not enter dental practices.

Others are voluntarily choosing to cancel appointments as they self-isolate at home.

Papageorgiou said dentists whose practices were still open were doing “what they can” to treat patients with emergency needs by implementing strict hygiene practices and social distancing, including screening people before they entered practices, having patients wait in their car instead of waiting rooms, and implementing pre-procedural mouth rinses.

He said practices that remained open were finding it challenging to get sufficient supplies of personal protective equipment (PPE) including masks, gloves and gowns.  

“We know there’s been a master supply shortage, so we’re working towards improving those supplies, but we do have our frontline workers to think about as well,” he said.

“I’ve asked dentists who have closed to donate their masks not only to their colleagues who are still able to work to see patients, but also our medical colleagues helping people in need.” 

Papageorgiou said there were “a number” of practices across South Australia that had closed, but he was unable to provide specific figures.

If we’re only relying on emergency surgeries we just can’t pay the high overheads to stay open

Those closures were prompted by the lack of PPE, financial strain and concerns about dentists’ health.

“Dentists unfortunately have huge overheads in their practices,” Papageorgiou said.

“We’re quite well regarded for our cost-effective procedures and how we run our practices and these things cost money.

“We have our leases and our rents to pay, our mortgages, families to take care of, so of course this is having a big impact and these costs don’t stop.”

Bridgewater dentist Dr Sharyn Borrett said she had decided to not return to work next week because she was concerned that she could become susceptible to coronavirus and subsequently transmit the disease to her family.

She said her practice planned to remain open to provide emergency care, but it had stood-down staff because of the reduced patient demand.

“We are certainly limiting the number of patients that we’re seeing, but it probably wouldn’t be enough to sustain the practice,” she said.

“If we’re only relying on emergency surgeries we just can’t pay the high overheads to stay open. 

“We still have to pay our rent, our business loans, so it’s just quite difficult. 

“My practice was open four days a week and we’re now looking at being open for only two half days to make sure that we can still service the population because we don’t want to lose patients either by not being open at all.”  

Borrett said her practice was also restricted by the lack of essential medical supplies such as alcohol gel and masks.

She said the restrictions on preventative dental work such as fillings would have implications on people’s health.  

“Certainly if you leave anything it will get bigger, but hopefully it won’t cause a toothache,” she said.

“It sort of goes against our philosophy of being preventative and proactive to delay things, but we just have to do it for reduction of community-based transmissions.”

The Australian Dental Association SA has published a list of practices that remain open on its website.  

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