BES sponsors patient information video to guide patients in treatment choices for dental pain

As part of World Antimicrobial Awareness Week (18-24 November 2020) the BES, along with the University of Lancaster, has sponsored a video that raises awareness of when antibiotics are not required to treat dental pain.

Overuse of antibiotics has led to the emergence of bacterial strains that are resistant to multiple groups of antibiotics. Infections with such bacteria can be fatal. Just seventy years after the introduction of antibiotics we are facing the possibility of a future without them being effective.

The idea behind the video is to mitigate patients’ expectations by explaining some of the ways in which dental pain should be treated. It offers viable alternatives to antibiotics and outlines the appropriate courses of action in different situations. The overarching message is that most causes of dental pain should not be treated with antibiotics.

“The video is just one and a half minutes long and simple to follow” explained Phil Tomson, Hon Secretary of the BES. “Its style makes it patient and family-friendly and we are very keen for it to be shared with patients and within the dental and health communities so the message reaches as many people as possible.”

The video concludes with a useful link to find out more about antibiotic resistance by visiting www.antibioticguardian.com.

The video was produced by Drs Shalini Kanagasingam (UClan), Nargis Sonde (UClan), Phil Tomson (BES).

The video can be found at: https://britishendodonticsociety.org.uk/patient-public/use-of-antibiotics/

The BES awards three COVID-19-related research grants

The British Endodontic Society (BES) recently invited proposals from UK-based applicants wishing to undertake immediate research to address the impacts of Aerosol Generating Procedures (AGPs) in dentistry during the COVID-19 pandemic. The Society had an excellent response and has subsequently increased its funding by more than 100%, awarding it to three separate research groups.

“We are delighted to have received such great feedback to our research call having received many, high quality, fundable submissions” said Dr Phil Tomson, Chair of the BES Research Committee.

“Due to the unique circumstances and potential tangible outcomes we have taken the decision to award three grants that offer different qualities. These will provide robust reassurance around the safety of carrying out AGPs with conventional mitigating factors whilst investigating new opportunities to improve things further.”

“The research committee and judging panel felt that there was urgent need for this research and took the longer term view to combine our 2020 and 2021 research funding allocation. COVID-19 is having far-reaching effects so we are keen to invest to improve things for our members and the dental sector. The projects have tight timelines so we hope that the outcome of the work has a significant effect on clinical practice as we navigate through these challenging times.”

The BES has allocated an £85,000 grant between three research groups:

Project 1 – “Quantifying dental aerosol generation and its mitigation in a generalisable way through visualisation and numerical modelling”

Jointly led by Professor Owen Addison, Chair of Oral Rehabilitation/Honorary Consultant in Restorative Dentistry and Dr Shanon Patel, Consultant in Endodontics Dental Directorate, Guy’s and St Thomas NHS Foundation Trust. Kings College London.

Co-investigator Professor Yannis Hardalupas, Imperial College London, Mechanical Engineering Department

Project 2 – “Dental aerosol generating procedures: assessment of risk and mitigation strategies”

Applicant: Mr James Allison, Clinical Fellow in Oral Surgery, School of Dental Sciences, Newcastle University

Co-Investigators at School of Dental Sciences, Newcastle University: Dr Richard Holliday; NIHR Clinical Lecturer in Restorative Dentistry; Miss Charlotte Currie; NIHR Doctoral Research Fellow; Mr David Edwards; NIHR Academic Clinical Fellow, Honorary Specialty Registrar in Endodontics; Dr Nicholas Jakubovics; Senior Lecturer; Dr Christopher Nile; Senior Lecturer in Translational Oral Biosciences; Dr Nadia Rostami; Research Associate; Professor Justin Durham; Head of School, Professor of Orofacial Pain, Honorary Consultant Oral Surgeon

Mrs Charlotte Bowes; Clinical Fellow in Restorative Dentistry

Project 3 – “An investigation into aerosol production during endodontic procedures and its potential mitigation; a simulation study with bioaerosols”

Applicant: Professor Brian Nattress, Clinical Professor/Honorary Consultant in Restorative Dentistry, Leeds Dental School and Hospital.

Co-Supervisor: Professor David Wood, Director of Research and Innovation, School of Dentistry, University of Leeds.

Co-Investigators: Dr Louise Fletcher, Lecturer in Waste Management, Aerobiology and Environmental Microbiology, Department of Civil Engineering, University of Leeds, Leeds; Professor Deirdre Devine, Professor of Oral Microbiology, School of Dentistry, University of Leeds; Mr Peter Nixon, Consultant in Restorative Dentistry, York District Hospital, York

 

“We are pleased to support this vital research” explained BES President, Sanjeev Bhanderi. “The quality and track records of the successful research groups and the standard of their research proposals will go a long way in bringing much-needed clarity and a robust evidence base for dentistry that has been lacking since the return to clinical practice. If at any time we were going to call upon the BES research fund for our members, this was the time to do it.”

Alyn Morgan explains the thinking behind the new BES Covid-19 research grant

Alyn Morgan BChD MSc MFDTEd, a GDC Registered Specialist in Endodontics, Director of U Dentistry Ltd in Ilkley, a Senior Clinical Teaching Fellow in Restorative Dentistry, and Honorary Secretary of the British Endodontic Society, explains the thinking behind the new BES Covid-19 research grant and calls for research to address the impact of Aerosol Generating Procedures in dentistry with respect to Covid-19.

To say that UK dentistry has undergone a monumental upheaval in recent months is a considerable understatement. New words and phrases have entered the dental lexicon which now form part of our lingua franca – it is almost impossible to look at dental social media sites, watch webinars or even have simple conversations with colleagues without “donning”, “doffing”, “FFP3”, “AGP” and “fallow time” being omnipresent.

Whilst the way we do dentistry has changed since our welcome return to clinical practice on June 8th some of the changes are relatively minor and in line with broader societal measures, such as no shaking hands with patients and maintaining a 2-metre distance from colleagues where possible being the most obvious. Other changes have made a huge difference and are affecting the financial viability of dental practices.

The increased concern over AGPs (aerosol generating procedures) and the requirement to leave surgeries fallow for a period after such a procedure is carried out is without question a threat to the ongoing survival of independent primary dental practices and indeed to many of our secondary care and teaching environments. The requirement to leave a surgery empty, not generating income for up to an hour following even the simplest of restorative procedures, presents an impossible barrier to the delivery of efficient and cost-effective dental care. Adding the requirements of enhanced PPE and the need for longer decontamination times the problem is compounded to the extent that it is impossible to consider that, at the time of writing, just a week into reopening, that any UK dental practices are operating other than at a considerable loss.

What makes this situation all the more unpalatable is that the evidence that these business defining guidelines are based on is weak or in many cases non-existent. Early on in the process it was apparent that many of the

decisions taken by Public Health England and NHS England were based on the medical experience where AGPs are different – even the use of the word aspiration, which in the dental context is a very strong mitigator for AGPs, was conflated leading to the suggestion that aspiration was something to be avoided.

Given the need to act and provide guidance in the presence of a weak evidence base, it was inevitable that the recommendations from those who regulate dentistry would be highly conservative, correctly placing a premium on patient safety. However, if dental practices are unable to operate viably then the nation’s dental health will suffer and patients will not be able to access the care they need. It is clear that we need to operate both safely and effectively; to do so we need access to good evidence that backs up our practice.

It was against this backdrop that the British Endodontic Society recently took the decision to issue a research call to consider the science behind AGPs in dental practice and what steps can be taken to identify and then mitigate the risk in the current COVID19 pandemic to allow both practitioners, regulators and, most of all, patients to take comfort that we are working in the most appropriate way possible.

The BES has made up to £40,000 available for this research call and looks forward to working with academic institutions to undertake a truly translational approach to this problem. We also welcome the opportunity to collaborate with any others in the dental community (for example, other professional societies and bodies or businesses in the dental equipment or supply trades) to ensure we can work together and provide, very quickly, much needed answers to the problems we currently face on this issue.

BES announces new Covid-19 research grant

The British Endodontic Society (BES) has announced a new research grant of up to £40,000 in response to the current Covid-19 pandemic. The Society is inviting proposals from UK-based applicants wishing to undertake short-term research that addresses or mitigates the impacts of Aerosol Generating Procedures (AGPs) during the Covid-19 outbreak.

“The impact of Covid-19 on dentistry has been significant and as we begin to return to the ‘new normal’, we face a complex and evolving situation” said Dr Sanjeev Bhanderi, BES President. “There is an abundance of guidance available, but a common theme is the lack of robust evidence to guide the adoption of behaviours in practice. Many questions surround AGPs in dental practice and the interaction of these with Covid-19 so the BES is investing in research that will lead to a better understanding” he finished.

Applicants do not need to be BES members and the closing date for submissions is 15 July 2020. The application process is outlined on the BES website and all applications will be considered by the BES research panel appointed by the BES Council. Due to the immediacy of this research, the successful applicant will be notified by July 31st 2020. https://britishendodonticsociety.org.uk/profession/grants/call-for-research-to-address-the-impact-of-aerosol-generating-procedures-in-dentistry-with-respect-to-covid-19/