It certainly wins the prize for the most surreal conversation I have had during lockdown – and when you’re living with two young children, there is tough competition. I was on the phone to an emergency dentist trying to get urgent treatment for my five-year-old son Ted who was in pain with a decaying molar after a filling became dislodged.
‘We’re only open for extraction under local anaesthetic,’ the dentist at the local hospital said when I finally got through. Or, to phrase it another way, they wouldn’t bother to assess him and it was up to me – with zero dental knowledge – to decide whether it was bad enough to justify putting my child through the trauma of having his back tooth yanked out.
There was, she continued hesitantly, another course of action.
Great, I’m all ears. Did I have any Babybel cheese? I paused as my brain raced through the contents of the fridge while trying to work out how the cheese I buy for my toddler could possibly help.
‘I know, I know but hear me out,’ she said. The red wax case of a Babybel can be used to make your own filling when it is ‘cut up, rolled into a ball, mixed with saliva and fixed into the hole’, she explained.
I was flabbergasted. Even if I could pull off this level of dentistry, we’re talking about a child in excruciating pain who would surely take it out or perhaps even swallow it.
Still in pain: Kate with son Ted, five, who has been plagued by toothache
In disbelief I messaged a friend who, trying to calm my rage, replied that it brings a new meaning to the photographer’s maxim: ‘Say cheese!’
But I’m struggling to see the funny side. Is this the state of Covid dentistry? Yank it out or do it yourself? It’s medieval.
Dentists – even private practices – were ordered to close two months ago at the start of the lockdown, and the mere fact that I managed to get a dentist on the phone at all was something of a miracle.
It had been the result of a dozen calls to our usual clinic, voicemails and texts to an emergency mobile number, and calls to NHS 111 staff who sent me back to square one by telling me to call my usual clinic. I tried my GP surgery and finally posted a desperate message on a local Facebook forum. Eventually, the emergency clinic at a local hospital called back.
My son’s case began last year when, to my horror, he was given a filling. I took it personally as I thought I’d been good by banning sugary snacks from an early age. A kindly dentist said that raisins – or ‘middle-class sweeties’ as he called them – were most likely to blame. But during lockdown, the filling had become dislodged causing him pain and I had hoped, not unreasonably, that a dentist might take a look. Dentistry in England now, however, is largely limited to phone consultations and the ‘three As’ – antibiotics, analgesics and advice.
The Department of Health says it has set up more than 500 urgent dental care centres but the location of these places is a mystery and treatment is mostly limited to ‘extraction under local anaesthetic’. The reason for this is to avoid ‘aerosol-generating procedures’, which means any treatment likely to spray around spit or blood.
With such scant provision, desperate people are taking matters into their own hands.
‘I’ve heard a huge number of stories from people who have got out a pair of pliers to do it themselves because of the desperation of waiting so long. It’s barbaric,’ says Eddie Crouch, vice-chairman of the British Dental Association.
James Goolnik, a dentist in the City of London, has tales of woe that will have you clutching your face.
‘People tell me they have been using knives, nail files and trying to stick crowns back on with superglue but getting them the wrong way round,’ he says.
‘Then there are some who have ulcers with no idea if they have cancer. Unless it’s a life-threatening infection, the emergency centres won’t see them. That’s not acceptable. As dentists, we’re frustrated because we want to help but we’ve been held back. We have PPE and we can work. We have been dealing with the risk of HIV for years and lots of other viruses.’
The case of Angela Wood highlights the sheer lunacy of the situation. The 49-year-old housewife from Sheffield started experiencing agonising toothache at the beginning of lockdown and was told by an emergency dentist that, under normal circumstances, a root canal would be performed and a new crown fitted. However, now all they would do was take it out.
She reluctantly agreed but when the pain returned to the same side of her face two weeks later, she went back.
‘They said the only thing we can do is take the tooth next to it out, too. I couldn’t believe what I was hearing. Where does it end? Do we keep taking my teeth out until we find the problem?’ Mrs Wood now spends most of her days at her computer, having gathered an extraordinary online community of people with similarly harrowing stories. She leads a renegade alliance of patients helping each other access dentists.
‘Today we’re trying to help a lady in Devon find treatment,’ says Anthony Foster, 39, who has joined Mrs Wood’s campaign. The financial services worker from Essex had to fight to save one of his front teeth after a dentist at an emergency hub told him the only option was to have it removed and, no, he wouldn’t be given a replacement. ‘It beggars belief that it’s such a shambles. Someone will die from it,’ he says. Those fears are shared by Dr Philip Lewis, president of the Mouth Cancer Foundation.
Dentists are trained to spot mouth cancer and they detect about 24 cases a day in the UK– often picked up by chance during routine check-ups. With clinics shut for nine weeks, there are hundreds of cases going undiagnosed, not to mention a huge backlog when clinics do eventually reopen. ‘It seems likely that even when general dental practices reopen, it may be a considerable time before a full service becomes widely available,’ says Dr Lewis. ‘Sadly, many cases of all head and neck cancers could be going undetected.’
Pictured: Babybel Cheese, stock image, the wax from which Kate Mansey was suggested by a dentist to make a temporary filling from
So how does Britain compare to the rest of the world?
Ireland has reopened its dentists, and Norway opened dentists a month ago. Germany has said dentists are low risk when it comes to transmitting the infection, while 42 out of 50 states in America have dentists operating again.
Even within the UK, there are huge discrepancies, with England faring the worst.
‘It’s a postcode lottery if ever there was one,’ says Eddie Crouch. ‘I’ve been speaking to colleagues in Gloucester and they had only one urgent care centre set up and they’re seeing seven patients a day for the whole of the county, which is pathetic.
‘Northern Ireland, Scotland and Wales have more authority to make decisions quickly, whereas the Chief Dental Officer in England is an employee of NHS England, so the decision-making is as slow as can be.
‘When this is all over, there has to be an inquest into how the decision-making process in England has been so snail-like.’
It’s not clear, however, that there will even be much relief once the lockdown has ended.
Financially, many clinics are in dire straits, with dentists furious that they haven’t been awarded the full business rate relief extended to bookmakers, for example. Even NHS practices, which rely on private work to supplement their income, are suffering.
It means many more of us may be providing DIY dentistry long after coronavirus has been wiped out. As for me, I’ve ordered a DIY dental kit online. I won’t be using Babybel cheese wax any time soon.