Sir, our experience in a community dental service has shown that provision of domiciliary visits to care homes, including dementia patients, have come to an abrupt halt due to the increased risks associated with COVID-19 in an enclosed setting as well as the change in provision of care as we turn into an urgent dental centre.

The COVID-19 guidance and SOP document published by NHS England highlights that vulnerable patients may be seen for urgent dental care following unsuccessful implementation of remote management via advice, analgesia and antimicrobials.1 However, there is no further guidance regarding the factors to consider during a domiciliary visit and this is left to the individual clinician to risk-assess and decide. This document has changed three times since it was first published in April 2020, and the guidance changing numerous times during this period can leave a lack of clarity and thus inconsistencies in the provision of care.

We would greatly urge that there needs to be clearer guidance for domiciliary visits in order to provide effective and safe care to the dementia patient cohort as significant risks leading to potential safeguarding issues and increased comorbidities can arise if these issues are not addressed.