PPE shortages hamper dental care.

Dentists face "critical shortages" of personal protective equipment (PPE), forcing patients with urgent problems to "take matters into their own hands", their professional body says.

More than half (54%) of dentists in England say PPE shortages are hampering efforts to treat patients at urgent dental care (UDC) hubs, according to the British Dental Association (BDA) survey.

The BDA, which surveyed one thousand dentists, says a lack of PPE has meant some UDC hubs could not treat patients. The survey said that a third of sites in England remain inactive, compared with just 2% across Scotland, Wales and Northern Ireland.

In response, chief dental officer for England, Sara Hurley, said 219 hubs were open and that: "every hub has the relevant PPE and work is ongoing to ensure that supply is maintained."

UDC hubs provide emergency dental treatment for patients with urgent needs, such as cracked teeth, gum infections and facial swelling. Patients requiring emergency treatment should be referred to a UDC hub after a telephone consultation with their local dentist.

Local practices were told to suspend routine, face-to-face services on 25 March to slow the spread of coronavirus and to set up local UDC hubs to treat patients with urgent needs.

However, BDA chair, Mick Armstrong, says progress has been too slow. He said: "Many dentists have been redeployed, only to find their hands tied by a critical shortage of kit, and delays in training and fit-testing. The depth of these problems will fatally undermine any progress on getting this network up and running."

One dentist, who wanted anonymity, said they had been redeployed to a UDC hub in the Midlands but it was unable to treat patients until a testing kit to be used on masks arrived.

The dentist said: "It's frustrating and disappointing when we know there is a significant need for urgent care because of a lack of training and PPE.

"The testing kits are shared across the region and they're being been taken up and down the motorway, and we're still waiting for it to arrive. But as soon as we get the PPE, the hub will be up and running."

Another dentist said that while their hub was treating patients, they only had about 20 days' of FFP3 masks, which offer one of the grades of highest protection, remaining.

They said they would have to stop treating patients if they ran out of masks and replacement ones could not be sourced.

The BDA's survey found that two thirds of dentists in England reported shortages of FFP3 masks and gowns and that 58% of dentists say they do not feel fully protected.

Dentists say PPE is necessary because they can be only 20cm from patients' mouths putting them at a high risk of contracting and spreading Covid-19.

A dentist in Brighouse, West Yorkshire, Dr Michael Ehrlich, says he's been giving advice to patients by phone for the past three weeks.

He said: "A broken tooth, a sharp bit of tooth, a lost crown, are not urgent but still cause discomfort. And then there are certain things that really need sorting out, but at the moment we have nowhere to send people."

If a patient has an urgent dental problem, they should be referred to a UDC hub. Other emergency treatment may also be available as some hospitals may offer emergency dental walk-ins.

However, if a patient cannot reach their local dentist - or is not registered with one – they are advised to use the 111 online service. Dental surgeries can reopen from 8th June 2020 but many anticipate dealing with a backlog of patients requiring urgent treatment, for many weeks.