BSP, FGDP, CGDent issue joint statement on the provision of a dental prophylaxis under Level 4/3 Covid-19 alert status

The British Society of Periodontology and Implant Dentistry (BSP), Faculty of General Dental Practice UK (FGDP) and College of General Dentistry (CGDent), working with the Office of the Chief Dental Officer for England, have issued a joint statement to clarify and contextualise the differences in guidance issued relating to the provision of a dental prophylaxis under Level 4/3 Covid-19 alert status:

The BSP guidance relates to prophylaxis as part of professional mechanical plaque removal (PMPR) in  people with periodontitis. The FGDP guidance relates to the more general term of ‘tooth polishing’,  which may not necessarily be undertaken for therapeutic reasons.  

The international evidence‐based S3‐level treatment guidelines in periodontology strongly recommend PMPR (highest evidence level: 100% consensus) in managing periodontitis. Clinical  harms may result in periodontitis patients if this is withheld.  

A prophylaxis undertaken with a slow speed handpiece, with no water, reduced prophy paste and due diligence, is considered a Non‐Aerosol Generating Procedure (non‐AGP) as defined by emergent particle sizes (WHO 2007) and can be safely undertaken with level 2 PPE (R11 mask, gloves,  goggles/visor, plastic apron over scrubs). However, non‐AGP procedures are not without some risk and polishing teeth for cosmetic reasons is not recommended until Level 2 alert status is reached.  Prophylaxis does cause splatter which can travel in a ballistic manner between 15‐120cm from  patients’ mouths and which may contact the eyes, mouth and skin of the operator/assistant; hence the need for level 2 PPE. Teeth should be dried with gauze and high volume aspiration is recommended.  

The BSP guidance provides a risk categorisation based on procedure. The FGDP-CGDent guidance adopts a similar approach but uses the terms low and high‐risk Aerosol Generated Exposure (AGE), to ensure additional factors are taken into consideration when considering exposure to risk. These include length of procedural exposure to splatter, risk of exposure to naturally-generated aerosol (coughing, sneezing or breathing), and the potential to apply mitigation measures. These are different approaches and both have value and require professional judgement by clinicians on a case-by‐case basis, whilst accounting for the Covid‐19 risk of the operator and assistant.

Professor Nicola X West, Honorary Secretary, British Society of Periodontology and Implant Dentistry

Ian Mills, Dean, Faculty of General Dental Practice UK, and Trustee, College of General Dentistry

Sara J Hurley, Chief Dental Officer for England

A prompt to prepare from OCDO England

The Office of the Chief Dental Officer (OCDO) England has issued a ‘promot to prepare’, offering considerations applicable for safely reopening primary dental care settings. 

While the risk of Covid-19 transmission to staff and patients arising from clinical proximity and the unique aerosol generating procedures involved in dentistry remains a key factor in the temporary suspension of routine dentistry, dental care cannot be postponed indefinitely. Therefore, a sustained reduction in Covid-19 transmission risk will provide an opportunity to safely resume some elements of dental care. 

In preparing for the resumption of routine dental care, practices may wish to consider patient priorities, practice pace, proximity and levels of protection required for the safe delivery of dental care. The prompt to prepare considerations released have been produced by dental practitioners for use in primary care settings to provide guidance, which is due to be published by recognised professional bodies. Dental teams are advised to ensure that they regularly update their knowledge and understanding of the published Covid-19 Public Health England guidance and its application in a dental setting. 

The guidance is laid out in what has been termed a ‘Consideration Pathway’. Practice considerations outlined cover patient flow and practice floorplans, communal areas, supplied and equipment. To ensure safety of staff, training, screening, work schedules and guidance on health and wellbeing is considered. Factors explored for patient care include communication, care plans, and travel to and from the practice. 

“In preparing for the activation of the broader public health conditions that both herald and safeguard our ability to resume routine dental care, ‘prompt to prepare’ offers considerations applicable to primary dental care settings,’ explained Sara Hurley, chief dental officer for England. “There will be inevitable changes with regards to pace, proximity and levels of protection that are required for effective risk management and the safe delivery of dental care. This is the time to review and make the appropriate adjustments to protocols, procedures and practice infrastructure for the safe and effective resumption of routine dental care. Further guidance will follow, these will cover urgent dental care and alternative (non-AGP) evidence-based care planning. 

Deputy Chief Dental Officer to open National Dental Nursing Conference

The 2018 National Dental Nursing Conference, to be held at the Blackpool Hotel Conference Centre and Spa (formerly the Blackpool Hilton) on 16 and 17 November, will be opened by the Deputy Chief Dental Officer England, Eric Rooney.

Mr. Rooney will be the Keynote Speaker at the Conference at the Opening Ceremony on Friday 16 November, following the ‘Meet the President’ Welcome Lunch.

Other subjects on the Conference programme include counterfeit equipment and materials, head and neck cancer, alcohol awareness, sepsis, communities of practice, dentistry for the disadvantaged, pride in practice and a GDC Update.

The Conference will offer eight hours of verifiable CPD, which will meet the GDC’s new development outcomes.

There will also be an optional informal dinner at local restaurant Twelve ( for delegates and guests.

More information and a reservation form is available at

British Association of Dental Nurses (BADN) is the professional association for dental nurses in the UK. Membership is open to all dental nurses (registered, student and former) working in all areas of dentistry.