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17th Mar 2020

Advice for Orthodontic Practices in Primary Care Settings regarding COVID-19 or the novel coronavirus

BOS Admin

During this pandemic, the British Orthodontic Society would like to extend its support to all members and recommends strongly that the advice and recommendations of the Government, the NHS, and the Inspectorate Bodies are followed. This advice is changing on a daily basis and every practitioner needs to be familiar with recommendations in their area.

Review Coronavirus (COVID-19): UK government response here

We recommend you review the links to the up-to-date guidance for healthcare professionals

England: Here

Scotland: Here

Wales: Here

Northern Ireland: Here

View the Novel coronavirus (COVID-19) standard operating procedure produced on the 5th March 2020 by NHS England here

View the BDA Advice pages for Live Blog, FAQ’s here


This is an unprecedented time for healthcare delivery in the UK. The landscape is changing quickly and the advice from government sources and the dental authorities is being updated regularly.

The following are suggestions to assist you in your daily practice. We must emphasise again that the NHS in your area, and the government, will advise you of protocols that you must follow.

  • It is important that each practitioner ensures they are up-to-date with all developments at all times and communicates this information to their staff, colleagues and patients regularly.
  • Make sure Patient Information Posters are displayed so they can be seen before patients enter the premises. Messages can be delivered via text messages, your social media pages and at your practice including on the front door.
  • The team should be updated daily on Travel Advice on Prepare the team for a possible incident.
  • Practices should remain open unless advised to close by their Health Protection Team. They will conduct the necessary risk assessments and advise you of what additional precautions to take. If this happens, the CQC should be notified.
  • NHS practices with a Designated account will get updates regarding for COVID-19 by the NHS. Appoint a COVID-19 lead to coordinate training and implementation of PHE guidance.

Practical Guidance

  • Consider contacting all patients with upcoming appointments to discuss with them the status of their treatment and the need for them to attend the surgery.
  • Consider asking those patients who need to come to the practice to only attend at the time of their appointment and to avoid bringing other siblings and relatives with them.
  • Consider waiting outside the practice until their appointment can commence.
  • Consider leaving the practice immediately after their appointment.
  • Consider making follow up appointments once they have left the practice by phone.
  • Consider making individual appointments longer to ensure there is adequate time for cleaning and management of waste.
  • Decontamination – follow best practice protocols for infection prevention and control. If a suspected case has been in the practice, follow Section 4 of the Guidance from PHE.
  • All staff should wear forms of PPE dependent on their proximity to the clinical area and avoid direct physical contact, including physical  examination, and exposures to respiratory secretions.
  • Each patient and their attendants should have their medical history checked before treatment is started and specifically questioned with respect to symptoms associated with COVID19 – Fever, Cough, Shortness of breath.
  • Direct any patients who call the practice and meet the Case Definition to NHS 111

For Suspected Cases

  • Identify potential cases as soon as possible before clinical care is started.
  • Isolate the patient in a separate room, obtain specialist advice from NHS 111 and determine if the patient is at risk of COVID-19. Practices should designate and prepare a suitable space for patient isolation until NHS 111 can arrange safe transfer of the patient.
  • Practice staff in contact with suspected cases do not need to self isolate unless advised by the Health Protection Team. The government has issued guidance on Self Isolation.
  • Contract holders need to notify their local commissioning team of any contact with suspected cases with details of the incident and how it has been managed.
  • If the practice has to be closed for cleaning, they should follow their business continuity arrangements.

What to do if a patient with suspected COVID-19 calls and genuinely needs emergency orthodontic treatment.

The patient should be told to call 111. This NHS team will triage and assess options for referral to a designated receiving unit for any COVID-19 urgent dental care cases.

What to do if a patient with confirmed COVID-19 calls and needs emergency orthodontic treatment?

The dental practice should call their Health Protection Team (England) who will advise the nearest hospital or specialty unit that the patient may be seen at.

Other health protection teams may be located at:

Public Health Wales

Health Protection Scotland

Public Health Agency (Northern Ireland)

Clinical Governance Directorate

British Orthodontic Society

March 2020

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