COVID-19 - What it's like to work at a hot site

As more practices across the country return to routine dentistry, Dr Filipe Cardoso shares his experience of working in a ‘hot’ Urgent Dental Care Centre which carried out aerosol-generating procedures and treated COVIDpositive patients during the pandemic. He describes how a feeling of being powerless during lockdown has been replaced by a greater sense of purpose.

How long have you been working at {my}dentist?

I qualified in Portugal in 2008 and I have been working at {my}dentist for around seven years. How long have you been operating in a ‘hot’ site? I started treating COVID-positive patients at the start of June. Before then, the practice was open, like all the {my}dentist practices in the UK, but we were limited to providing emergency triage over the phone. It was frustrating not being able to treat our patients, especially when some were really suffering with dental pain and discomfort that we knew we could have done something about if only we were able to see them. When we opened as a ‘hot site’, I don’t know who was happier – us or the patients!

How did things change in practice?

It might be easier to say what things have remained from prelockdown practice life. It’s very different from how it was before the lockdown, but I can’t fault {my}dentist for how they’ve handled the challenges. The whole {my}dentist team has been great at keeping us and patients updated and supported, and they’ve worked hard to ensure the safety of everyone.

The patient journey has been transformed. Patients are asked to come alone to practice (when possible), to call from outside and they are escorted through the surgery. We have social distancing measures in place and a one-way system for patient flow to prevent contamination.

As a ‘hot’ site, we can provide aerosol generating procedures (AGPs) and that presents all sorts of challenges we didn’t have to consider before. One of the biggest differences is the reduction in the number of patients we’re safely able to see a day.

Did you have any concerns about working in a ‘hot’ site for your own health?

When the pandemic first broke, of course I was apprehensive but I never wanted dentistry to be stopped all together. Those months of only being able to speak to patients on the phone were incredibly frustrating. We didn’t open as a ‘hot’ site overnight; {my}dentist made sure we were supported, the practice had all the PPE and procedures in place to ensure our safety and that of patients. what it’s like working at a hot site

What has been the response of patients that have visited the practice?

Relief. Yes, the experience is different for patients, but they understand why that needs to be the case. We’ve seen some of the most severe cases and they’ve been really appreciative, that help is available, especially as some have had weeks and even months of being in pain. It’s been rewarding to be able to help. Just this morning, I was treating a patient in their 80s who had been suffering greatly. After the treatment she was so thankful and relieved.

What were the main problems patients experienced during lockdown?

We’ve seen a real mixture of cases; teeth broken after a fall as well as abscesses. We have noticed that quite a few patients who have been treated as emergency cases are people who haven’t always attended appointments regularly or have put off treatment in the past. The pandemic has really emphasised the importance of prevention rather than cure when it comes to dentistry.

What have you taken away personally from working in a ‘hot’ site?

It’s given me a greater sense of purpose. During lockdown, I felt powerless. Now we’re able to help patients not just provide phone advice and prescriptions. We all just want to continue working hard to get more patients back on track and return to some form of normality.

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