Changes to Primary Dental Care services

Read the new guidance from the NHS regarding changes to Primary Dental Care services in response to COVID-19.
Woman lying on a dentist chair with a dentist

Correct as of 25 March 2020

You may face an increase in public enquiries about how to access dental services. NHS England have provided an update with changes to services, with a focus on managing urgent dental care needs. While people should be able to access dental care where essential, routine treatment will not be available during this time.

Dental practices will be updating their websites and messaging to reflect this, and informing their commissioner so that the 111 service is kept up to date.

We have pulled together the updates including the immediate changes, which affect both the delivery and operation of general dental practices and community dental services.

Changes to Primary Dental Care services:

1. Regular dentist appointments

All routine, non-urgent dental care including orthodontics should be stopped and deferred until advised otherwise.

2. Urgent care

All practices should establish a remote urgent care service; independently, or in collaboration with others. This should provide telephone triage for their patients with urgent needs during usual working hours.
Where possible, these services should provide:

  • Advice.
  • Analgesia.
  • Antimicrobial means where appropriate.

3. Urgent care – more serious cases

If people’s conditions cannot be managed through the remote urgent care service, they will be referred to their Local Urgent Dental Care system. 

Conditions that might be referred include, amongst others:

  • Life threatening emergencies, such as breathing/swallowing difficulties due to facial swelling.
  • Fractured teeth.
  • Swelling round the mouth and jaw that is significant and worsening.
  • Post-extraction bleeding that the patient is unable to control with local measures.
  • Dental conditions that have resulted in acute and severe systemic illness.
  • Severe dental and facial pain: i.e. pain that cannot be controlled by the patient.

4. Designated providers

Some practices and community dental services may need to become designated providers of urgent dental care as part of these Local Urgent Dental Care systems during the COVID-19 pandemic.

While not in place yet, these will be set up to meet the distinct needs of the following groups within the population with urgent dental care needs:

  • Patients who are possible or confirmed COVID-19 patients – including patients with symptoms, or those living in their household.
  • Patients who are shielded – those who are at most significant risk from COVID-19.
  • Patients who are vulnerable / at increased risk from COVID-19.
  • Patients who do not fit one of the above categories.

5. Community outreach

All community outreach activities such as oral health improvement programmes (e.g. Starting Well, routine non-urgent work in care homes) and dental surveys should be stopped until advised otherwise.

Why are these changes important?

The new arrangements are designed not only to maintain safety, but also to free up staff to support the wider response to COVID-19:

  • Urgent dental care services being set up in the NHS regions.
  • NHS colleagues working in wider primary care.
  • NHS colleagues working in the acute COVID-19 response.
  • Local authority and voluntary services COVID-19 response.

Further updates and guidance for primary dental care can be found here.

What are people telling you about their experiences of COVID-19?

We want to know what COVID-19 advice and information people are asking you for or issues they are raising. This is so we can spot any gaps in information, identify any issues and keep Government and the NHS informed. Let us know the issues people are raising with you.

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