Saturday 2nd May The Coronet Diaries.

Coronavirus and my tooth cavity.



Our Dental Practice (and mine) is currently closed in accordance with the government restrictions. Unfortunately this means we are currently unable to see and treat any patients.
Our telephone and email will be monitored as usual during this time.
May you and your families keep safe and healthy during these incredible and very difficult times. We remain here to support you as always

As I mentioned in an earlier blog all the dentists in England have been shut down by Government and there are now dental hubs dotted around where I fear dentists of the Willy Wonka breed are gleefully waiting to pull out national teeth. Around the first week of lockdown when John baked his first batch of sourdough, I reported feeling something foreign in my mouth. No sign of a dislodged crown, or a filling, no sign of anything except the rapid and increasing appearance of an alarming cavity the size of half a five pence coin. When I realised there was no go with my dental practice I started to search in vain for others. Apart from my customary stark FOD map diet I was now confined to slops and slops. Every morning I woke up in terror that the nerve would expose.

Yesterday, I felt the first rumblings of a neural grumbling. In panic I rang 111. It turns out as my dentist Q, yesterday afternoon, explained to me as I sat in his dental chair that has been unoccupied now for over four long weeks, the 111 dental hubs are more or less still using the same categorisations and amalgam as they used for conscripts signing up to the Vietnam War. Yes, they really are. Which means that unless you are haemorrhaging from the gum, have a lose tooth in the socket, advanced cellulitis, or are having breathing troubles, more breathing paranoia, or a seeping abscess, there is nothing to be done beyond painkillers and antibiotics. Where a root canal or crown is called for, temporary fillings may be allowed, or in the case of advanced infection an extraction. During the Vietnam war it was discovered that teeth emergencies ranked higher than other physical ailments. As a result of this negative effect on combat a categorisation of dental care that had three main categories was devolved by the medical command in Washington for the Vietnam conscripts.

In 1968, reports that field commanders in Vietnam were con-cerned that the combat effectiveness of their units was being
jeopardized by dental emergencies reached Washington. On a fact finding visit to Vietnam MG Robert B. Shira, then Chief of the Army DC, was overwhelmed by tactical commanders’ complaints that soldiers who were lost to dental emergency (DE) care significantly and negatively affected the combat mission. 

While he numbed my gum with great solicitude, Q explained to me that the Xray he was taking would reveal my combat category: whether or not a temporary filling using the same 1968 amalgam would be possible. I did not dare to ask what the alternative would be. There was only one alternative and that was a referral to 111. The conscripts’ dentists’ recommendations to delay comprehensive treatment for a temporary solution, if it could be delayed in favour of combat were identified by either white, blue or pink amalgam. 111 has abandoned the colour chart.

Q also explained that all the dental practices (both private and NHS) are closed down because very few of them have the correct ventilation systems required to extract not teeth but COVID microbes exposed by drills etc. Neither do they have specialist PPE. Their water fountains will be forbidden territory while there is any future form of social distancing. I don’t know why he did, but I shall forever be grateful that Q allowed me to sit in his untouchable and abandoned chair. (He happened to be on rota duty to take my beseeching phone call.) After studying the Xray, Q agreed to fill my cavity using portable hand-held instruments. Forget being telephone phobic, forget being dental phobic, the whole process – conducted in an abandoned practice with only conventional masking – was like manna from heaven. Never has an injection felt more like the high of heroin, (In-spite of this granny- taking- a- trip, I have no idea what heroin-high feels like). Every procedure, every twist of the hand held drill became more like a caress than an invasion in my relief that I was not in the hands of Willy Wonka but my own forbidden-fruit dentist.

We talked more than usual because nobody was waiting … Q confirmed my own thoughts about COVID, albeit his are based on discussions with more scientific colleagues than mine. His, and every other dentist’s financial and professional future lies in COVID’s metamorphoses. As many other sceptics are saying, or whispering, the idea of a vaccine within ‘years’ is highly unlikely. Forget 2022. We agreed, as do many others in the scientific community, our best chance of competing with COVID is in the more likely discovery of combative and non-invasive treatment for the life-threatened. The real fear that nobody can yet attest to – we are unlikely to know before an autumn spike – is whether or not infection confers immunity. If it does he/we are likely to be back in operation before the end of the summer, or earlier. If it doesn’t Q is equally likely to have to shut down permanently. Yikes! That is the unspeakable spoken!

My dental phobia has been cured. I have a temporary if severe filling. The injections were painless. I would have surrendered without anaesthetic to have my tooth and diet restored … To avoid the 111 Willy Wonka dressed in hazmat and bearing outsized forceps.


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