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Dentists down in the mouth about new hygiene drill

DENTISTS today warned that practices could be forced out of business by new guidelines requiring them to set aside up to four rooms as "decontamination units" at their surgeries.

The measures for cleaning and sterilising instruments are intended to improve patient safety and beat infections.

But dentists say many practices do not have space to meet the demands, due to come into force in 2009, and could opt to close.

The warning comes at a time when only about 20 practices in the Lothians are still registering new NHS patients, while more than half of all adults and more than a quarter of children in the region are not registered with an NHS dentist.

Marchmont dentist John Davidson claimed health bosses had moved the goalposts and had gone from requiring a one-room decontamination unit to recommending separate rooms for cleaning and sterilising, together with ante-rooms for handwashing and putting on protection equipment.

Mr Davidson said: "The profession was beginning to come to terms with the idea that we would have to have single-room decontamination units and now they are saying that is 'sub-optimal'.

"They are saying that we should have at least two, possibly four, rooms. They say we should clean the instruments in one area and sterilise them in another.

"Very few practices have the space to do that. It's a bit of a nonsense. The powers-that-be seem to have got the bit between their teeth and they are pushing at us."

Mr Davidson said there was widespread concern among dentists about the decontamination demands.

He said: "Even with the single-room decontamination unit, there will be practices that close because they simply don't have enough space, or they have to convert a surgery into a decontamination unit, so they end up a dentist down.

"A lot of older dentists will simply decide they can't be bothered with it all and just retire."

Mark McCutcheon, secretary of the Lothian local dental committee, said he understood only a single-room decontamination unit would be compulsory when the guidelines came into force, but that a multi-room unit could be required within five or ten years.

"Most dental premises are not purpose-built but are converted residential or commercial properties, and they have often expanded to use every available space," he said, adding that if practices could not find alternative accommodation in their area, some might decide to close.

Mr McCutcheon warned the requirements could act as a disincentive to younger dentists setting up new practices, often in poorer areas.

NHS Lothian was last month given more than 800,000 to help dentists with the extra costs.

But Mr McCutcheon said the sum worked out at about 7000 per practice in this financial year, with some more to come next year. He added: "We have priced a decontamination unit at between 25,000 and 40,000."

A Scottish Government spokeswoman said: "Health Protection Scotland are working with dentists to ensure appropriate steps are put in place for when the guidelines come in."


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