Page 7 - RADC 2020

significant. As dental professionals, we enjoy going to work to help patients and to improve their dental health so working from home was a very alien concept! That said, one huge positive which, I believe, benefited our patients during this period is how good we all are at keeping them dentally fit. In my experience, the numbers of emergencies were not drastic and, barring a few exceptions, were managed remotely and within acceptable levels of comfort.
Similarly, the lockdown period highlighted how well we look after our teams. From the bottom up, RADC staff across Defence will have played a vital role in ensuring that team spirit, mental health and staff training were all considered despite the isolation.
As DC Edinburgh became a hub DC, we amalgamated the patients and staff from Leuchars, Condor, Glasgow, Caledonia and RAF Boulmer. Weekly virtual meetings and training became the norm as we clung on
to the developing DPHC(D) guidance on getting us back into face to face dentistry. As the PPE supply chain cogs began to turn, DPHC J4 began to send our new enhanced PPE to the hubs. Priority was given to those caring for deploying units and at DCs Edinburgh and Woolwich we found ourselves conducting a deep dive into the OET of 2 Scots and 1 Royal Anglians for their deployment on Op TORAL 11 to Kabul, Afghanistan. Trying to find the ‘worst’ and most deserving mouths in a Scots infantry unit is not hard, most would win prizes, however, we did our best with the majority of effort focused on the new ‘Jocks’ who had just arrived from Phase 1 Training at
the Infantry Training Centre, Catterick. Both Commanding Officers of these units were very grateful for the care provided against the odds.
The new enhanced PPE for AGPs is a significant sea change from our scrubs, fluid-resistant surgical
masks, gloves and eye
protection. A surgical gown, head covering, an FFP3
mask and visor on top of loupes brings ones body temperature up to a slow boil with
the respirators adding to increased fatigue during longer appointments. Add to this the AGP fallow time after appointments and
one begins to appreciate how challenging the new ways of working could be. All this considered, we managed as a hub to treat the high-risk patients and with some old University contacts pulled out of the ‘roller- deck’, we got the outstanding oral surgery referrals completed at a time where some dental institutions remained completely closed - my sincere thanks to the Edinburgh Dental Institute for this.
Despite the ePPE frustrations, I’m sure we can all agree how lucky we are to receive gold standard kit to allow us to treat our patients and feel appropriately protected.
A quote from a locum working at DC Edinburgh brought this home when they said, “working within DPHC has made me feel nervous to go back to NHS or private practice as I know that the enhanced PPE will be nowhere near as good as yours”.
Conclusions
In the interest of positivity, I turned to the 1971 History of the Royal Army Dental Corps to draw some inspiration in a, ‘it could be worse’, fashion. Colonel CH James’ account of his time delivering dentistry
within a Japanese Prisoner of War Camp brings things sharply back into perspective - ‘sterilisation of instruments took place in a mess-tin over a charcoal burner’ and ‘{the use of} local anaesthesia was avoided as much as possible owing to risk of infection’. We are worlds away from this, however, the
mentality of doing the best we can for our patients and colleagues remains the same.
COVID-19 is a new enemy for us to deliver dentistry in the face of and many RADC personnel across Defence have
gone above and beyond in wide-ranging roles to ensure that the dental and general health needs of our population continue to be met. There are significant positives to be drawn from this period and future audits and research will be key to capturing the events accurately in a way that this article is not able to do.
References
1. WHO. Clinical Management of COVID-19.
2020. Available at https://www.who.int/ internal-publications-detail/clinical-management- of-severe-acute-respiratory-infection-when- novel-coronavirus-(ncov)-infection-is-suspected (accessed September 2020)
2. Chen N, Zhou M, Dong X et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China a descriptive study. Lancet 2020; 395: 507-513.
3. Shereen M A, Khan S, Kazmi A, et al. COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. Journal of Advanced Research 2020; 24: 91-98.
4. WHO. The classical definition of a pandemic
is not elusive. 2020. Available at https://www. who.int/bulletin/volumes/89/7/11-088815/ en/#:~:text=A%20pandemic%20is%20defined%20 as,are%20not%20considered%20pandemics. (accessed September 2020)
5. Worldometer. Covid-19 Coronavirus Pandemic. 2020. Available at https://www.worldometers.info/ coronavirus/ (accessed September 2020)
6. Petersen E, Koopmans M, Go U et al. Comparing SARS-CoV-2 with SARS-CoV and influenza pandemics. Lancet 2020; 20: 238-244.
7. Li R W K, Leung K W C, Sun F C S, et al. Severe Acute Respiratory Syndrome (SARS) and the GDP. Part II: Implications for GDPs. Br Dent J; 197: 130-134.
8. Monaghan P. Emerging infections - implications for dental care. Br Dent J; 221: 13-15.
9. New York Times. Coronavirus Worker Risk. 2020. Available at https://www.nytimes.
com/interactive/2020/03/15/business/ economy/coronavirus-worker-risk.
html (accessed September 2020) 10. Coulthard P. Dentistry and
coronavirus (COVID-19) - moral decision making.
Br Dent J; 228: 503- 505.
RADC BULLETIN 2020 5