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Dental Care

Volume 803: debated on Wednesday 20 May 2020


Asked by

To ask Her Majesty’s Government when they plan to permit the resumption of routine dental care.

The Question was considered in a Virtual Proceeding via video call.

My Lords, the NHS and the Chief Dental Officer have worked hard to reopen the dental sector, with the aim of restarting routine dental care as soon as we safely can. In the meantime, over 500 urgent dental treatment centres have been set up in each NHS region, to provide urgent face-to-face care for patients.

I thank the Minister for his reply. Untreated and moderate dental problems can become severe and potentially life-affecting. Infected teeth were a major cause of death in the 19th century. I note the 500 urgent dental care hubs already set up in England following strict guidelines, but can my noble friend say why the regulator cannot simply modify the existing guidelines used in the hubs to make them transferable to local dental practices?

The noble Lord is entirely right that poor dental care is extremely damaging to individual health. The current situation is one that we massively regret, but the safety of patients and dental professionals is paramount. The aerosols generated by dental drilling and other dental practices leave the threat of germs in the air in a dental practice for hours to come, which could be caught by staff or future patients. It is for that reason that we have focused the infection protocols in 500 special units that have the right kit, the right training and the right arrangements.

My Lords, I declare my interest as president of the British Fluoridation Society. I recognise the work done in setting up urgent treatment centres, but they are patchy in England and many provide only for pain relief and tooth extraction. Many high street dentists are in danger of bankruptcy, because the Chancellor’s schemes to help businesses have not been applied to them. Will the Minister consider setting up a programme of work with the BDA and the Chief Dental Officer to establish a national plan to get dentistry back on track and save the profession from ruin?

My Lords, I completely understand the points that the noble Lord has made. He refers to a situation that we are fully aware of, and I completely agree with his analysis. The truth is that tooth extraction avoids some of the risks that I described, but treatment in the centres is not limited to extraction and other protocols are arranged. The Chief Dental Officer is working on a dental plan, and we are liaising with colleagues in the Treasury to see what more can be done to help dental practices.

My Lords, United Kingdom dentists, too, are heroes and heroines of this pandemic. In Northern Ireland 100 dentists were sought to run emergency clinics, but more than 400 stepped forward, and dozens more have volunteered to work in care homes. A recent BDA survey warned that three-quarters of Northern Ireland’s dental practices could collapse by the summer because of Covid-19. Like the noble Lord, Lord Hunt, I ask the Minister urgently to consider adopting a UK-wide approach to saving our dental sector from disaster.

The noble Lord’s concerns are well understood. Practices that depend on private income are particularly affected, because the NHS has guaranteed the income to NHS practices for their NHS work. We are working on a UK-wide national plan, and it is a massive priority for the Government.

My Lords, I echo the points made by the previous speaker: £7.8 billion is spent on private dental health care, yet dental practices of this nature are among the only businesses not to receive the full business rate relief. Will the Minister commit to ensuring that they receive adequate provision, as a matter of urgency, to ensure that these practitioners do not disappear from the high street?

My Lords, I cannot make the commitment that my noble friend seeks at the Dispatch Box, but I promise to convey his thoughts to the discussions taking place between DHSC colleagues and the Treasury.

My Lords, a recent poll of around 2,000 dentists and dental professionals found that 97.5% of them supported a vote of no confidence in the leadership of the office of the Chief Dental Officer of England. What is the Government’s assessment of this?

My Lords, it is not the role of the Department of Health and Social Care to have a view on the popularity of the Chief Dental Officer. All I can say is that the support he has provided for the profession is enormously appreciated, and we have a lot of confidence in his work.

My Lords, I declare an interest in that my brother-in-law is a dentist. My noble friend will be aware that many private dental practices have already sourced and stocked their requirements of PPE. Is he satisfied that when NHS dental care resumes, practitioners will have adequate supplies for dentists, their staff and their patients?

My Lords, the Government are buying billions of items of PPE and putting them into the supply chain. That supply chain includes dentists, and we are working hard to ensure that all dentists, both in the urgent treatment centres and in other dental practices that may reopen in the short term, have exactly what they need.

My Lords, when will the NHS be able to look beyond the current crisis and get back to routine eye care by opticians and eye clinics, which plays such a vital part in preventing blindness?

The arrangements for eye care, similarly, are an extremely delicate matter, because the eye is a potential source of infection, and both workers and patients are at risk through work done by opticians. We are extremely keen to get back to normal, but we put the safety and care of patients and staff first.

My question to the Minister is an amalgam of those already asked, and I want to press him on them. Everyone needs dentists to be able to survive this pandemic and to be open to do their job as soon as possible. What financial support might be given to the sector to make that happen? What steps are the Government taking to ensure that there are treatment guidelines and access to PPE?

My Lords, I completely endorse the point made by the noble Baroness, Lady Thornton. I lost a front tooth a few weeks ago and I cannot wait for the dentists to reopen because it is both uncomfortable and embarrassing. We are providing enormous financial support through NHS contracts, which we have honoured 100% through the epidemic whether or not dentists are seeing patients. However, we recognise that there is a problem with the private sector, and we are working with colleagues in the Treasury to try to find a solution.

It is the private dental sector that is probably in most trouble, because of a lack of financial support given by the Government and the question whether private dentists have adequate access to PPE, to which the Minister has referred. Will he address those questions? What meetings have taken place with the BDA to deal with these problems?

My Lords, at present there are restrictions on private dentists opening; the guidelines are clear on that. We are putting in place provision of PPE for when those guidelines are amended to allow the reopening of dental practices. We are also giving thought to how we will get through the large backlog of dentists’ work that will need to be done to catch up on those missed appointments.

It was pointed out recently by Public Health England that snack buying has gone up hugely in the past few weeks of the crisis. As Ministers know, the main reason that children go into hospital and have anaesthetics is to have all their teeth out as a result of eating sugary foods. Will the Minister guarantee that, when the crisis is over, the Government will bring the obesity Bill back to Parliament and get it through this time, because this is a tragedy for our youngsters?

The noble Baroness is entirely right. I confess to having a profound biscuit habit through the Covid epidemic which I am wrestling to get over. On a serious note, the Covid epidemic has put a spotlight on the health of the nation. There seems to be some evidence that we have suffered badly from the epidemic partly because of obesity. The Prime Minister has commented personally on this issue. It will be a priority of the Government to address this point once the epidemic is over to restore the health of the nation and to tackle obesity.

My Lords, the time allowed for this Question has now elapsed. I thank all who put questions and the Ministers who answered. That concludes the Virtual Proceedings on Oral Questions. The Virtual Proceedings will resume at a convenient point after 12 noon for the Private Notice Question on scientific evidence relating to the reopening of schools.

Virtual Proceeding suspended.