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Health / Dentists as frustrated as patients with coronavirus restrictions

NHS SHETLAND’s new dental director has expressed his frustration with the way current Covid-19 restrictions are impacting on dental care.

NHS Shetland new dental director Antony Visocchi.

Antony Visocchi, a dentist from Banchory in Aberdeenshire, has started his new role at the local health board with immediate effect as he replaces Brian Chittick, who has moved to the position of director of community health.

He praised the health board’s “patient patients” and said the health profession was as frustrated with the limitations of dental care currently possible as those waiting for treatment.

Up until now any dental care that involves using a drill has been limited to emergencies only, and only in urgent dental care centre, which is located at the Montfield clinic.

As of 17 August, other dentist surgeries are also allowed to carry out such procedures, but strict Covid measures will continue to severely limit the amount of patients any dentist will be able to see.

“The biggest problem that we got in dentistry is the drill, and using the drill creates a water spray, and when that spray goes into the mouth in mixes with the saliva and it creates what is called an aerosol,” he said.

Under current rules, patients seeking routine treatment can get a check-up, an X-ray where needed, but they can’t have the filling unless it is an emergency.

“There is still that confusion out there that the general public believes that they can go to a dentist to get routine care – and they can to an extent, but anything that involves a drill is not possible,” he said.

“We are still at a stage of being very restricted in what we can do, in the patient numbers that we can see, and despite the terminology that might be coming from the first minster there is a difference between what we are being told by the chief dental officer and what a patient’s perception is.”

Currently dentists are advised not to see more than ten patients a day to limit the possibility of the virus spreading. In addition, once an aerosol generated procedure (AGP) has been used, an hour will have to be allowed for the fine mist to settle before the whole area and all surfaces need to be deep cleaned.

Dr Visocchi said that the waiting list of those waiting for such routine treatment will unfortunately get longer and longer.

“This is as frustrating for us as it is for patients. Having patients coming to see you and knowing you can’t actually complete the treatment has a great concern from us as health care professionals.

“The last thing you want to see is not being able to do your best for the patient […]; it is causing a lot of frustration from the dental profession side too.”

He added that the other thing dentists were missing out on while unable to see the same number of patients is picking up early signs of oral cancer.

“One of the things that has been a great concern to us is that not seeing patients routinely every six months has meant that people have not had the opportunity to have these issues picked up.

“So if anybody has concern about anything in their mouth, and not necessarily tooth ache, I would encourage them to still contact their dentist just to have a discussion at least to find out whether it is worth having a look at or not.”

Dr Visocchi spent more than two decades in general practice before he sold the practice in 2016.

His clinical interest lies in endodontics (this is the treatment of the pulp of a tooth which most people will know as root canal treatment) and oral surgery. However, over the years, his passion in dentistry has expanded to include how it is practised – especially law, ethics and integrity of the profession.

Earlier this year he was accepted as an Associate Fellow of the Higher Education Academy (AFHEA) and was accepted as a Fellow of the Faculty of General Dental Practice.

He is also a Fellow of the Royal College of Physicians and Surgeons of Glasgow in the Faculty of Dental Surgery and a clinical lecturer at the Aberdeen Institute of Dentistry.

He is currently working towards his LLM in Medical Law and Ethics.