Your care

There are a number of new checks and assessments to ensure patients and staff are safe.

We will contact you at least the day before your visit to ensure you and your household do not have Covid-19 symptoms. That means that in the last three days you or your household have not had:

• A fever (temperature of 37.8°C or above)
• A continuous cough (coughing a lot more for more than an hour, or three or more coughing episodes in 24 hours, if you have a cough normally it may be worse than normal)
• A loss or change of sense of smell or taste (you cannot smell or taste anything, or things smell or taste different to normal)

If you or your household have had any of these symptoms in the past three days we will reschedule your appointment. If you have urgent dental symptoms, make this known to the caller who will alert the service leads to contact you about your symptoms.

If you or your household do not have these symptoms please attend your appointment. On arrival we will:

1. Check these symptoms again with you to ensure nothing has changed
2. Ask you to remove your own face covering
3. Sanitise your hands using our sanitising gel
4. Put on a new face mask that we provide for you

Guidance for intensive dental care - rapid Covid-19 testing

Intensive dental care can expose even small amounts of the Covid-19 virus into the air. In order for us to create as many appointments as possible, some of you will be invited to undertake a rapid Covid-19 test. This will ensure that you do not have Covid-19 and can undertake more intensive dental treatment whilst keeping all of our patients and staff safe.

This involves a simple swab of the opening part of your both of your nostrils. This swab will be carried out by our trained team and analysed within 60 minutes using our advanced analytical team. During this time you will be asked to remain in the waiting room or may depart the Dental Hospital but you must keep your face covering on at all times, sanitise your hands regularly and remain more than 1m from other people at all times.

You will be informed once your results are returned. If the results do not show any presence of the virus your care can be continued safely and you will be called through following checking in at reception.

If your results show some presence of the virus one of our trained staff will explain the next steps. We may not be able to complete your care but we can rearrange to see you at a convenient time.

We will ask your consent to undertake this test. You are free to decline, however we may not be able to complete your care on the same day as we will need to make alternative arrangements.

This test is not diagnostic of Covid-19, therefore a positive result on our rapid test does not guarantee you have the virus actively right now. We will offer you a standard Covid-19 test if your results of our rapid test are found to be positive, along with more information about this.

Patients with prosthetic heart valves, a previous history of endocarditis and other heart problems are advised to see their local dentist regularly for preventative therapy, routine care and maintenance.

Antibiotics should not be prescribed before dental treatment but prevention of acute and chronic dental infections is very important for patients with cardiac problems to prevent a serious condition known as bacterial endocarditis so regular check ups and good oral hygiene and dental care is essential.

This clinic is supervised by staff who are experienced in the provision of conscious sedation. Conscious sedation techniques may be helpful for patients who are particularly anxious about dental treatment. It can also help some patients with gagging problems and movement disorders.

Only simple dental treatment is provided. We do not provide root canal treatment on back teeth or crowns or bridges on this clinic. The provision of dentures will be limited to patients who have problems with impressions.

If you are referred for treatment, you may be offered an appointment on our assessment clinic. Your suitability for conscious sedation will be assessed and discussed with you. We offer two types of conscious sedation in the Dental Hospital: inhalational sedation and intravenous sedation using a drug called Midazolam. For intravenous sedation, it is essential that patients bring a suitable escort who will wait while treatment is carried out and accompany the patient home and look after them for the rest of the day. We cannot offer conscious sedation to those patients who are difficult to sedate, such as those who have problems with this in the past.

If you wish to be considered for dental treatment with us under conscious sedation you will need to have a referral from your own dentist. We do not provide emergency dental treatment under conscious sedation.

Please note that we cannot accept all patients for treatment. Restorative dental treatment using conscious sedation is provided on an undergraduate teaching clinic during term time only.

We offer a limited general anaesthesia service for patients with severe learning difficulties.

If it is not possible to carry out an examination at the assessment appointment, then this will be carried out under general anaesthesia. Only simple restorative treatment can be provided which will include cleaning and fillings, multiple extractions may be indicated.

At the assessment appointment, treatment will be discussed with the patient where possible and with the family and carers involved where appropriate. Where possible, we may to be able to offer this group of patients treatment under conscious sedation.

Referrals will only be accepted from our colleagues in the community dental services. Once treatment is completed, patients will be discharged back to the care of the commmunity dental services for their oral health reviews to include maintenance as required.

Please note that this service is not for anxious adults.

Patients with haemophilia and other inherited bleeding disorders should see a local dentist regularly for preventative therapy, routine care and maintenance they do not need to be seen in a hospital setting except for:

• Dental extractions, dental surgery including periodontal treatment.
• Procedures requiring an inferior dental block or lingual infiltration injections should be referred to the Dental Hospital.

Are people with Type 2 diabetes more likely to develop dental caries?

We would like to invite you to take part in our one dental visit study in which we aim to see how diabetes mellitus could affect teeth by evaluating risk factors causing dental caries (dental decay) in people with Diabetes Type 2 and compare to people without any type of diabetes. This study will give us a deeper insight and more knowledge about the complication of diabetes to oral health. This study is have been approved by regulatory authorities

You may be able to take part if you:

• Are 18 years of age or older
• Have been diagnosed with diabetes type 2 or Not been diagnosed with any type of diabetes

Participants will be asked to undergo:

• One dental clinic visits
• Saliva, plaque and blood sample collection

The participant will receive:

• Dental screening and cleaning if required
• Vitamin D and average blood glucose levels (HbA1c) tests
• Oral health care instructions and products

If you are interested to know more or to book an appointment,

please contact the principal investigator, details as follows:

ASHWAQ ALKAHTANI

a.s.s.alkahtani@qmul.ac.uk

Tel: 0207 882 8975

Patients who have organ transplants may experience swelling of their gums and should be referred to the Dental Hospital.

Routine treatment can and should be carried out in general practice.