A LEADING dentist says he has seen a ten-fold increase in demand for implants amid fears that lockdown caused a spike in tooth extractions that might have been avoided.
Duncan Black, one of Scotland’s most experienced dental implantologists, said many patients are coming to him after having teeth – including front teeth – removed at emergency dental hubs which under normal circumstances dentists would have tried to save.
Mr Black, who is based at Halo Dental in Glasgow but treats patients from as far afield as Ayrshire and Lanarkshire and also runs an outreach clinic in Galashiels, said it is probably an inevitable consequence of lockdown.
He said: “People have not been able to access their usual dental care, that’s the crux of the matter.
“We were told by the Chief Dental Officer to leave the practices and not come back again, but no one thought it would be nearly three months before we came back.
“During that time we had to provide an emergency service.
“I don’t want to beat up on them [dental hubs] too much because it was scary times for everyone.
“Some people were in extreme pain.
“There was probably a lack of PPE available for normal dentistry to carry on so the hubs were the best solution, but yes, I think that due to Covid some people had teeth removed rather than, if they had been accessing normal care through their own dentist, attempts would have been made to save the tooth.
“I think that’s fair comment.”
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Mr Black’s practice, which is part of the Clyde Munro dental group, re-opened in mid-July and since then has seen ten times as many people requesting dental implants as they have in previous years, with most patients self-referring.
Implants are titanium screws which dentists attach directly to the jawbone, replacing the missing tooth root. A false tooth, such as a crown, can then be held securely in place.
Unlike dentures, which tend to last around five to 10 years, implants can last as long as natural teeth provided they are cared for properly.
However, they are more expensive. Mr Black said a single implant, without any other complications, will cost around £2000 in Glasgow.
The service is only available on a private basis, meaning NHS patients have to pay the full cost of the treatment.
Mr Black said: “Normally, if someone goes to their dentist and says ‘I have a problem with this tooth’ and the dentist takes and X-ray and concludes it’s unsalvageable, that they need an implant or whatever, they’d be sent along to us and we’d order everything for them so that they wouldn’t go without a front tooth.
“They’d have a temporary of some description.
“But because the dental labs weren’t open either during lockdown there wasn’t even a possibility for any sort of temporary provision to be made for people.
“So quite often they just had to go around with a gap for an extended period of time.”
He added: “Our patients that come to us are in varying situations, some are desperate because they have a front tooth missing and their confidence has gone.
“Others are fortunate enough to have saved money during lockdown, or had a holiday cancelled and see the value in investing in a healthy smile.”
A Renfrewshire-based dentist, who did not want to be named, said he too had encountered patients who had had teeth extracted that might normally have been saved.
He blamed it on a reluctance to carry out aerosol-generating procedures (AGPs) such as fillings at some hubs due to poor quality or shortages of personal protective equipment (PPE).
He said: “People were being sent to urgent dental care centres where the treatment was very limited.
“Any tooth including molars – normally you would be encouraged to try to save the tooth, but these teeth were just being taken out.
“It even extended to front teeth if there looked to be a complicated root structure.
“They weren’t being offered treatment to try to save the tooth – that was a blanket policy.”
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He added that he was also concerned that antibiotics have been “handed out like sweets” to try to keep gum infections at bay until normal dental services resumed.
“For the past 10 years dentists have been berated over a perception of over-prescribing antibiotics, and here we were being told just to dish them out like sweets. It’s wholly inappropriate.”
David McColl, a dentist in Glasgow’s Govanhill and chair of the Scottish Dental Practice Committee, said he knew of patients who had received AGPs at hubs.
“You’re always going to get anecdotal stories, but an upturn in implants is probably normal after practices have been closed for several months,” said Mr McColl.
“We haven’t seen any evidence that teeth are being taken out that could have been saved, but we haven’t got all the data yet from hubs. That will come.
“Every case is different, and not every tooth can be saved.”