National dental organisations have come together with a reminder: Antibiotics do not cure toothache

National dental organisations have come together to support the World Health Organisation’s Antibiotic Awareness Week, which runs from 18-24 November.

The Faculty of General Dental Practice UK, Association of Clinical Oral Microbiologists, College of General Dentistry, British Dental Association, British Association of Oral Surgeons, Association of Dental Hospitals and the dental sub-group of the Scottish Antimicrobial Prescribing Group are repeating the message to patients that “antibiotics do not cure toothache”, and reminding dental teams that antibiotics should only be used as an adjunct to definitive clinical management of the cause, and only where indicated.

Since the start of the Covid-19 pandemic, the dental profession has focussed on preventing the transmission of SARS-CoV-2 to their team, patients and the wider population. During the first national lockdown, the provision of general dental services was severely restricted and limited to the referral of urgent and emergency cases and the provision of advice, analgesics and antimicrobials where appropriate.

As a result of these constraints, a marked increase in antibiotics prescribed in NHS general dental practice has been reported. In England the number of prescriptions was up 22% during April to June 2020, and in Scotland there were steady month-on-month increases from April, peaking at a 50% rise in July, when compared with the same periods in 2019.

It is estimated that dentists account for around 10% of all oral antimicrobial agents prescribed in healthcare, and a clear link has been established between the consumption of antimicrobial agents in human medicine, animal healthcare and agriculture and increasing rates of antimicrobial resistance.

While antimicrobial resistance continues to be a long-term problem, a government review reported that 700,000 people worldwide are already dying of antibiotic-resistant infections every year, and estimated that by 2050 the annual global cost could be 10 million lives and £66 trillion.

Prudent prescribing of antimicrobials can slow down the further development of antimicrobial resistance, and all healthcare prescribers play a vital role. The dental profession has shown its clear commitment in addressing antimicrobial resistance by significantly reducing the use of antibiotics in dental practice over the last decade.

Last year alone, dentists in the UK reduced their prescribing of antimicrobials by 9%, and the organisations say it is vital that the profession maintains and builds on this success. They are encouraging all dentists to continue to play their part in reducing the development of antimicrobial resistance by ensuring appropriate prescribing of antibiotics when managing their patients during the Covid-19 pandemic and into the future.

Guidelines for antimicrobial prescribing in dentistry are available at https://www.fgdp.org.uk/guidance-standards/antimicrobial-prescribing-gdps and https://bnf.nice.org.uk.

Posters and leaflets for patients are available at https://www.fgdp.org.uk/antimicrobial-prescribing, and a Dental Antimicrobial Stewardship Toolkit, developed by FGDP(UK), the British Dental Association and Public Health England, is accessible at https://www.gov.uk/guidance/dental-antimicrobial-stewardship-toolkit

Janet Goodwin to be honoured with new FGDP award

The Faculty of General Dental Practice UK (FGDP) is honouring the legacy of the late Janet Goodwin FFGDP(UK)(Hon.) with an award to recognise the achievements of dental care professionals.

Over a career spanning almost 50 years, Janet was a staunch advocate for the advancement and recognition of DCPs. An Affiliate Member of FGDP, she served the Faculty as a representative for the interests of the wider dental team, chairing its DCP Committee, contributing to the development of standards and sitting on the National Faculty Board, and in 2019 she was awarded Honorary Fellowship.

The new Janet Goodwin Award will recognise leadership, standards of professionalism and patient care, commitment to life-long learning, service to the profession and advocacy for the whole-team approach to general dental care.

Open to all GDC-registered DCPs, the inaugural award will be made as part of the FGDP(UK) Annual Awards 2021, and the winner will also receive Affiliate Membership of the Faculty, and its associated benefits, for 2021-22. Nominations are open until 23:59 on Monday 1 March 2021.

Commenting on the new award, FGDP(UK) Dean Ian Mills said: “Janet was a ground-breaking and influential figure in dentistry, and her passing was mourned throughout the dental profession. She was a fantastic ambassador for our profession, a passionate advocate for the role of the dental team, and a strong supporter of the Faculty. I am therefore delighted that we have been able to commemorate her contribution to dentistry by introducing an annual FGDP(UK) Annual Award in her memory.”

Further details are available at https://www.fgdp.org.uk/news/fgdpuk-annual-awards-2021.

Malcolm Pendlebury Lecture to be delivered online

This year’s Malcolm Pendlebury Memorial Lecture will be delivered online, and accessible to the whole of the dental profession for the first time.

Malcolm Pendlebury TD LDS FDS DGDP(UK) FFGDP(UK) was a Nottingham-based general dental practitioner, and a founder member of the Faculty of General Dental Practice UK (FGDP), serving as its third Dean between 1997 and 2000, and its educational adviser at the time of his death in 2004. He is remembered for his lifelong commitment to raising standards in dental practice, and made a considerable contribution to vocational training. His research work included identifying an enzyme that causes gum disease in smokers, and his wide-ranging interests and experience also included working on behalf of the World Heath Organisation in the quality assurance of examination systems of medical schools in the former Yugoslavia. As Secretary of the erstwhile College of General Dental Practitioners (UK), he also believed that the general dental profession should establish an independent academic home, an ambition now being realised by the College of General Dentistry.

A much-admired colleague, the lectures held in his memory are an opportunity to discuss matters of importance to general dentistry, and are  one of the highlights of the profession’s calendar.

The 2020 lecture will take place on Thursday 12 November at 7pm, and will be delivered by Professor Liz Kay MBE FFGDP(UK), Trustee of the College of General Dentistry, on the theme of The Future of Dentistry – Lessons From COVID-19.

Liz Kay

Prof Kay is President-Elect of the British Dental Association and was the Founding Dean of Peninsula Dental School, where she also led the MBA in Healthcare. With a particular interest in inequalities in oral health, she has published over 180 papers and six books, and lectures locally, nationally and internationally on clinical care, dental education, communication and her research. The National Institute for Health and Care Excellence’s Topic Expert in Oral Health, and former President of the Oral Health Foundation, she also chairs the Shirley Glasstone Hughes Foundation Management Committee, which oversees the commissioning of research in dentistry. Also Vice Chair of the British Medical and Dental Students Trust, Non-Executive Director of Plymouth Hospitals NHS Trust, and Editor of Evidence-Based Dentistry, she graduated from Edinburgh in 1982, and was awarded a Master’s in Public Health and PhD from Glasgow in 1984 and 1991. A Fellow of the FGDP(UK), she is also a member of the joint FGDP-BDA Equality, Diversity and Inclusion Programme Board.

The lecture will be delivered online via ProDental CPD, and introduced by Stephen Rear MBE FFGDP(UK), Founding Dean of the Faculty.

Ian Mills, current Dean of FGDP(UK), said: “The Malcolm Pendlebury Memorial Lecture commemorates an inspirational colleague who had a significant influence on general dentistry, and on the establishment and evolution of the Faculty. Though we cannot meet in person this year, I am delighted that we can uphold this important tradition virtually, and that in so doing we can invite the whole profession to join us.”

The event is free for all dental professionals to join, and early registration is encouraged at https://us02web.zoom.us/webinar/register/WN_OIjVf3xDRm2j6eaBddwOYQ.

FGDP(UK) & CGDent update COVID-19 guidance synopsis

The Faculty of General Dental Practice UK and College of General Dentistry have published an updated synopsis of their guidance on the implications of Covid-19 for the safe management of general dental practice.

The synopsis highlights key recommendations at each step of the patient journey, and supports dental professionals to take a risk-based approach to providing safe care regardless of the national Covid-19 threat level.

The new version reflects the recently-revised guidance, which includes updated and additional recommendations on fallow periods, air ventilation, the 3 in 1 syringe, dental headpieces, air cleaners, decontamination, the protection of vulnerable staff, and the relevance of the R number and prevalence rate.

It is available at https://www.fgdp.org.uk/implications-covid-19-safe-management-general-dental-practice-practical-guide and https://cgdent.uk/standards-guidance.

Production of the synopsis has been supported by Sensodyne.

Dental Fallow Time Calculator launched

A new free-to-use Fallow Time Calculator has been launched to enable dental professionals to determine, justify and record the fallow period necessary following dental procedures carrying a higher risk of exposure to potentially infectious aerosols. 

Built by digital consent platform Flynotes, supported by Practice Plan and Wesleyan, and endorsed by the Chief Dental Officer for England, the new tool complements the COVID-19 guidance published by the Faculty of General Dental Practice UK (FGDP) and the College of General Dentistry (CGDent), the recent update of which incorporates the Scottish Dental Clinical Effectiveness Programme (SDCEP) recommendations on fallow time. 

Public Health England guidance currently recommends a fallow period of 60 minutes in a treatment room with less than 10 air changes per hour from the point that an aerosol-generating procedure is completed. The FGDP-CGDent guidance recommends that practitioners justify any decision to stray from this, record factors which allow reduction of the time, and include details in the clinical record for each patient. 

The Fallow Time Calculator is designed to facilitate this process and is based on SDCEP’s multifactorial approach to determining fallow time. Set out in its recent publication, Mitigation of Aerosol Generating Procedures in Dentistry – A Rapid Review, this sets a ‘benchmark’ time of 15-30 minutes, which will vary dependent on the type and length of procedure, the employment of procedural mitigations such as high-volume suction and rubber dam, and the availability of environmental mitigations such as air ventilation. 

Available at www.myftc.co.uk, the Fallow Time Calculator also offers a full audit trail, updated regularly in accordance with the guidelines, which practices can use to aid diary planning, allowing efficient patient treatment flows whilst ensuring necessary fallow periods are implemented. 

Ian Mills FFGDP(UK), Dean of the Faculty and a Trustee of CGDent, said: “I’m proud and delighted to launch the new Fallow Time Calculator, which is the result of a fantastic collaborative effort. I particularly want to thank two fellow members of our guidance task group for their work in developing it – Flynotes CEO, Govin Murugachandran, and Faculty member and Deputy CDO for England, Jason Wong – as well as Wesleyan and Practice Plan for their generous support, which has enabled both the development of the calculator, and its free publication for the benefit of the whole profession. 

“The tool is based on the recent SDCEP recommendations, which provide a sensible, pragmatic and safe approach to managing fallow time and the potential risk from bioaerosol. I am confident that the Fallow Time Calculator will be seen as a significant aid to the dental team and will support dental practices to continue their transition back towards delivering routine care.” 

FGDP(UK) & CGDent COVID guidance update reduces fallow times

The Faculty of General Dental Practice UK and College of General Dentistry have updated their guidance on the implications of Covid-19 for the safe management of general dental practice, incorporating the reduced ‘fallow’ times recommended by the Scottish Dental Clinical Effectiveness Programme.

The guidance, first published on 1 June, supports dental professionals to take a risk-based approach to providing safe care, whatever the national Covid-19 threat level, at each step of the patient journey.

Among the distinguishing features of the document was its consideration of the risk of exposure to potentially-infectious aerosols arising from dental procedures as being on a continuum, rather than defining some procedures as ‘non-AGPs’ and treating all ‘AGPs’ as if they carry equal risk.

Members of the guidance task group felt compelled at the time to accept the 60-minute fallow period recommended by Public Health England following higher risk procedures. However, they also felt it would be more appropriate to adopt a more nuanced approach which also considered the length of procedure, as well as the potential to employ procedural and environmental risk mitigations, and suggested that reduced fallow times based on such factors might be justified.

The SDCEP review of aerosol-generating procedures in dentistry, published last week, takes just such factors into account in recommending context-specific fallow periods of between 10 and 30 minutes. While the FGDP-CGDent guidance has been thoroughly reviewed in light of the latest evidence and the experience of dental practices over the last four months, the most significant change is therefore the adoption of SDCEP’s fallow time recommendations, which have also been incorporated in an accompanying Fallow Time Calculator, which will be launched soon.

SDCEP’s review also divides dental procedures into groups according to their potential to generate aerosols, and to avoid any confusion over which procedures require fallow time, the FGDP and CGDent have ensured that those they classify in their guidance as posing a ‘higher exposure risk’ correspond to SDCEP’s highest-risk ‘Group A’ categorisation.

Available free of charge at https://www.fgdp.org.uk/implications-covid-19-safe-management-general-dental-practice-practical-guide and https://cgdent.uk/standards-guidance, the revised document also provides additional detail and updated guidance on:

  • air ventilation and air cleaners
  • the use of the 3 in 1 syringe
  • the risk of aerosolisation from dental handpieces
  • decontamination of the surgery
  • the relevance of the R number and prevalence rate
  • the protection of vulnerable staff

Dental professionals are invited to learn more by joining two related webinars, which will be free to view live through Prodental. On Monday 5 October at 7pm, representatives of FGDP, SDCEP, the BDA and the Office of the CDO for England will discuss The Mitigation of Aerosol Generating Procedures in Dentistry, and on Monday 19 October, Mythbusters 2 will look at the latest changes and challenges of COVID-19 in light of the recommendations of SDCEP, FGDP and CGDent.

Onkar Dhanoya FFGDP(UK), Vice Dean of FGDP(UK) and Chair of the task group which developed and revised the guidance, said: Our revised guidance, incorporating the fallow time recommendations arising from SDCEP’s thorough review of evidence on the generation and mitigation of aerosols in dentistry, will enable general dental practices to increase delivery of patient care while maintaining the safety of both patients and members of the dental team. This in turn should help improve access to dentistry, addressing some of the unmet oral health need which has built up in recent months, and support the viability of dental practices as the pandemic continues. Thanks are due to all the members of the task group, which represents a huge range of organisations and professional disciplines, for once again pulling together for the benefit of our profession at this critical time.”

FGDP(UK) & CGDent to update Covid-19 guidance following SDCEP AGP review

The Faculty of General Dental Practice UK and College of General Dentistry have welcomed the Scottish Dental Clinical Effectiveness Programme’s review of the mitigation of aerosol-generating procedures, and will be issuing updated COVID-19 guidance shortly in view of its recommendations.

The SDCEP document, published today, represents the agreed positions of a working group comprising dental professionals from across primary care, secondary care, academia and public health, in addition to expert opinion from subject specialists in particle physics, aerobiology and clinical virology. The consensus report was compiled following a review of the currently-available evidence on the generation and mitigation of aerosols in dental practice, and the associated risk of coronavirus transmission.

Among the key positions, and in contrast to those adopted to date in official protocols, the report divides dental procedures into three categories of aerosol generation potential according to the instruments used, with fallow periods recommended only for the highest risk procedures, and suggests the determination of fallow time using a multifactorial approach with a ‘benchmark’ of 15-30 minutes.

The FGDP-CGDent guidance, published in June, also set out a more nuanced approach to considering the generation of aerosols in dental practice, and while allowing for potential adjustment of fallow time, accepted a 60 minute period following procedures carrying a higher risk of exposure to potentially-infective aerosols.

Ian Mills, Dean of FGDP(UK), Trustee of CGDent and a member of the SDCEP’s review group, said: “SDCEP’s review of dental AGPs has been extremely thorough, and followed a rigorous and methodical approach. Its publication is potentially a very significant moment in the recovery of dental practices in the midst of the coronavirus pandemic and I commend the SDCEP Team for the hard work and dedication they have shown in producing this report.

“We welcome in particular the more refined stratification of the transmission risk inherent in types of dental procedure; the allowance for fallow time to be calculated from the cessation of the procedure; and the sophisticated approach to calculating fallow time, which considers both procedural and environmental mitigation factors such as high-volume suction, the use of rubber dam and provision of adequate air ventilation.

“These approaches align exceptionally well with our own guidance and we feel it is important that current standard operating procedures are reviewed in light of SDCEP’s recommendations. Adoption of these measures will enable the increased delivery of patient care to tackle the backlog of unmet need, and avoid further deterioration in dental access and oral health inequality. A reduction in fallow time will also support the viability of practices, while the maintenance of universal precautions will continue to keep both patients and members of the dental team safe.

“We aim to update our guidance as soon as possible, and are currently working with partners to develop an online Fallow Time Calculation Tool to support its implementation.”

SDCEP’s Mitigation of Aerosol Generating Procedures in Dentistry – A Rapid Review is available at https://www.sdcep.org.uk/published-guidance/covid-19-practice-recovery/rapid-review-of-agps.

The current FGDP-CGDent guidance, Implications of COVID-19 for the safe management of general dental practice – a practical guide, is available at https://www.fgdp.org.uk/implications-covid-19-safe-management-general-dental-practice-practical-guide and https://cgdent.uk/standards-guidance.

FGDP(UK)’s Ian Mills and Onkar Dhanoya on equality racial prejudice (S01 E02)

Ian Mills and Onkar Dhanoya from the  Faculty of General Dental Practice – better known as FGDP(UK) – join The Probe Dental Podcast to discuss the issues of equality and racial discrimination within the dental profession, which have come to forefront of general conversation thanks to the Black Lives Matter movement. 

Ian Mills is the current Dean of FGDP(UK), while Onkar serves as one of the Vice Deans. They discuss their own experiences and where there’s severe inequality within the dental industry, as well as how they both continue to learn. For more information, you can watch a webinar that Ian and Onkar both took part in in conjunction with CGDent, titled Why Colour is the Elephant in the Room, which you can view here: https://www.prodentalcpd.com/module1316/-black-lives-matter—experiences-from-the-dental-profession-

Listen here or search wherever you get your podcasts. 

 

For details on FGDP(UK), visit https://www.fgdp.org.uk/

 

The Probe Dental Podcast is presented by The Dental Awards.

The Dental Awards is the original and most respected awards programme in British dentistry. 2021 marks the 22nd anniversary of the Dental Awards, and over the decades, this prestigious event has recognised the outstanding individuals and teams whose commitment and drive continue to raise standards throughout the profession.

The Dental Awards is attended by over 600 clinicians each year. Winning, or being a finalist, is a tremendous accolade and provides a massive publicity boost to the profile of your practice and your team. After all, who wouldn’t want to be treated by the Dentist or Dental Team of the Year?

The Dental Awards are sponsored by B.A. International, Carestream Dental, Colgate, Coltene, Dental Elite, Geistlich Biomaterials, Simplyhealth Professionals, Sparkle Dental Labs, and Water Pik. The Probe and The British Dental Conference & Dentistry Show are official partners.

For more information, please visit the-probe.co.uk/awards

 

For more from The Probe, visit the-probe.co.uk. Theme tune courtesy of Bensound.

Why Colour is the Elephant in the Room – Webinar to explore experiences from the dental profession

On Tuesday 21st July at 7pm, FGDP(UK), in collaboration with ProDental CPD and the College of General Dentistry, is hosting a webinar titled Why Colour is the Elephant in the Room, which will take a look at real life experiences of and what we can do about racism in dentistry.

Looking at the response of the dental profession to the Black Lives Matter movement, the webinar aims to provide an honest exploration of racial inequality and prejudice with real life experiences from colleagues working in all areas of dentistry.

Chaired by FGDP(UK) dean Ian Mills, the panel will comprise:

CPD will be available. GDC outcomes: A,B,C,D

To register for the event, follow this link.

FGDP(UK) issues statement in support of the Black Lives Matter movement and anti-racism

George Floyd’s horrific death and the events of the last month have highlighted the issues of inequality and racism that are present globally, including in the UK.

The FGDP(UK) is proud of its long standing commitment to promoting equality and inclusion. The diversity of our Board is central to its effective representation of the general dental profession, however we know that more needs to be done. We want to be proactive in addressing these issues in our organisation and in our profession. We stand in solidarity with the Black Lives Matter movement and are an anti-racist organisation.

The FGDP(UK) represents general dental practices throughout the UK. The dental team is a diverse community of dental care professionals which includes many members of the BAME community. The term BAME is homogenous and describes a wide group in which the members have very different experiences. We are aware Black colleagues are a more disadvantaged group and do not have equality of representation and opportunity in dentistry. We are committed to addressing the impact of discrimination and believe this will benefit our patients and our profession.

Actions we will be taking immediately; we will:

  1. Educate ourselves about the issues that affect the various groups within the BAME community, and ensure our organisation actively promotes inclusion at every level. As part of this, we will review our ongoing equality and diversity training for FGDP(UK) Board members and educational programme leads to ensure that it is fit for purpose, and can implement positive and lasting change.
  2. Invite dental health care representatives from Black, Asian, Chinese and other minority groups to join a task force, to be chaired by FGDP(UK) Vice Dean Onkar Dhanoya, to identify the areas in dentistry which directly or indirectly disadvantage these groups.
  3. Collaborate with organisations and individuals across the profession to actively promote equality, diversity and inclusivity in general dental practice.

Dean of the Faculty of General Dental Practice (UK), Ian Mills (pictured), said: “This is an extremely important issue and I am extremely grateful to Onkar, and many other colleagues, who have had a significant role in influencing changes within dentistry. I am proud of the progress which our Faculty has made over the years to embrace equality and diversity, but it is clear that we still have significant work to do. The first step is to acknowledge that inequality exists within many areas of dentistry, and large sections of our profession are at a disadvantage in terms of opportunities and progression. This is particularly evident in relation to leadership roles within dentistry, where there is a distinct lack of diversity within many organisations. The FGDP(UK) and the new College of General Dentistry are amongst a number of dental organisations who are committed to influencing change to ensure that there are equal opportunities for all.”