08 NEWS Dental Tribune Asia Pacific Edition | Autumn 2020 COVID-19 and the potential for dental reform An interview with Professor Richards Watt, University College London. By Brendan Day, Dental Tribune International Though the spread of SARS-CoV-2 has had an undeniably deleterious effect on many elements of the dental world, it has also opened up new possibilities for imagining how dentistry should be deliv- ered. That is the contention of Dr Richard Watt, professor of dental public health in the Department of Epidemiology and Public Health at University College Lon- don, in a recent letter to The Lan- cet. Watt spoke with Dental Tri- bune International about how points of emphasis in dentistry may change in a post-pandemic world. Prof. Watt, could you please ex- plain how the current pandemic has helped to highlight opportuni- ties for reform in dentistry? The COVID-19 pandemic has highlighted some of the underly- ing problems that dentistry is fac- ing globally. As many of us are aware, dentistry is recovering slowly, and in different countries, various issues have cropped up, but there are some common agen- das that we really need to begin to tackle. One of these issues is the lack of an emphasis on prevention in dentistry, either delivered within clinical settings or across community and public health are- nas. This was one of the main points I was trying to get across in my letter. What kinds of steps can, or should, be taken to implement these re- forms? I think the first thing to stress when dealing with such issues is that it’s not just simple reform; it’s not a straightforward issue. For many, many years, the dental pro- fession has recognised that pre- vention is important, and changes have been made in some coun- tries to address this. Largely, how- ever, dentistry remains a treat- ment-centred service, and that ap- proach is something that needs system-level reform. It’s not about the individual dental practitioner or the dental team, but instead it is the system of the delivery of den- tistry that needs to change. Sys- tem reform requires discussions to take place at the local and na- tional level between practitioners, policymakers and funding agen- cies in order to figure out how pre- vention can be strengthened in the dental practice, as there’s no one system that fits all circum- stances. creasingly implemented during the pandemic, can work to help reduce inequalities in dental access in the long term? identify opportunities that are beyond what has been done his- torically in terms of promotional materials and equipment. Yes, I think that is the case. In parts of the world such as Austra- lia, you have rural communities that are very isolated geographi- cally, and so, rather than expect- ing them to travel to a city for treatment, a notion like teleden- tistry should be explored for its potential to improve access for them. During this pandemic, are there any countries that you think have provided examples for how reform can be introduced into dentistry at a systemic level? It’s a bit too soon to say for sure, since we’re still very much in the middle of the pandemic. How- ever, if we consider the UK as an example, we can see how the role of many dental professionals has changed during this time owing to their redeployment. When den- tal services were shut down in the UK—as they were in many coun- tries—thousands of dental per- sonnel were redeployed to other areas of the healthcare system, ei- ther to support efforts to combat the pandemic or to provide other forms of healthcare beyond den- tistry. And that’s quite an amazing shift, because it changed the pro- fessional boundaries of what den- tists can do. Over the last few months, these kinds of changes have shown how radical shifts can happen quickly, even at a systemic level. Many major dental companies have experienced massive losses throughout this pandemic. Do you think this could have an impact on the provision of dental services and will this potential impact be posi- tive or negative? I think that’s an important point. I think very few people are very confident in their predic- tions of how the pandemic is going to pan out economically, but we know that there are already increased unemployment num- bers. If people are unemployed, they’re unlikely to go to the den- tist to get new crowns, bridgework or other forms of expensive treat- ment. So the effects on dentistry, and the wider dental industry, are potentially massive. It is hard to know at this stage how much of an economic bounce- back there will be and how long that will take. If I were working in the dental industry, I would be looking at trying to diversify and IMPRINT PUBLISHER AND CHIEF EXECUTIVE OFFICER Torsten R. Oemus CHIEF CONTENT OFFICER Claudia Duschek MANAGING EDITOR Franziska Beier ASSISTANT EDITORS Jeremy Booth, Brendan Day, Monique Mehler, Iveta Ramonaite COPY EDITORS Sabrina Raaff, Ann-Katrin Paulick AD PRODUCTION Marius Mezger DESIGNER Maria Macedo Dental Tribune International GmbH Holbeinstr. 29, 04229, Leipzig, Germany Tel.: +49 341 48474-302 Fax: +49 341 48474-173 GENERAL REQUESTS: info@dental-tribune.com SALES REQUESTS: mediasales@dental-tribune.com www.dental-tribune.com Material from Dental Tribune International GmbH that has been reprinted or translated and reprinted in this issue is copyrighted by Dental Tribune International GmbH. Such material must be published with the permission of Den- tal Tribune International GmbH. Dental Tribune is a trademark of Dental Tribune International GmbH. All rights reserved. © 2020 Dental Tribune In- ternational GmbH. Reproduction in any manner in any language, in whole or in part, without the prior written permission of Dental Tribune Inter- national GmbH is expressly prohibited. Dental Tribune International GmbH makes every effort to report clinical information and manu- facturers’ product news accurately but cannot assume responsibility for the validity of product claims or for typographical errors. The publisher also does not assume responsibility for product names, claims or statements made by advertisers. Opi- nions expressed by authors are their own and may not reflect those of Dental Tribu- ne International GmbH. AD www.dental-tribune.com Prof. Richard Watt. (Image: Richard Watt) “The pandemic has [...] had the most effect on those populations that are the most vulnerable and disadvantaged” To be fair, these are big issues that don’t have any quick, easy an- swers. But I think it’s important that, as a profession, we debate and discuss these bigger issues be- cause, at a time of crisis, there is an opportunity for us to really think through what the future holds. Do you think that the fact that SARS-CoV-2 has affected every- one’s lives, not just those who suf- fer from oral health inequalities, will have an impact on the poten- tial for reform in an area like den- tistry? In broader discussions taking place in the media, in academia, and so on, almost all sectors are taking stock of where they are and what this pandemic has meant to them. And overall, there seems to be a shared view that we don’t nec- essarily want to go back to how things were pre-COVID-19, not least of all because certain things are unlikely to ever be re-estab- lished. In a lot of countries—certainly across Europe—the pandemic has disrupted daily life for many, but it has, however, had the most ef- fect on those populations that are the most vulnerable and disad- vantaged. This was already a prob- lem in dentistry, since it often hasn’t managed to provide care for disadvantaged groups to the same extent as it has for other groups. So providing access to dental care for those groups who suffer from inequalities remains a challenge that we need to address. Do you think that a measure such as teledentistry, which has been in-