Vaccination: your questions answered – 27 January 2022

Thursday 27 January 2022, 7pm, live webinar

To register for this event, please visit: https://www.prodentalcpd.com/webinars/-p152-vaccination—your-questions-answered-

With the forthcoming deadlines for mandatory vaccination of health and care workers in both clinical and non-clinical roles in England, this webinar will deliver a deeper understanding of the impact of vaccination, helping to retain a protected and thriving workforce and promote patient safety.

As much as we are able, we aim to allay and address the fears of those who are concerned about getting vaccinated, and set out to provide the information needed for an informed choice.

Speakers: 

  • Prof Jason Leitch, Senior Clinical Advisor to the Scottish Government and a member of the Health and Social Care Management Board
  • Sarah Buxton, HR and Employment Solicitor, legal advisor for ADAM (Associate of Dental Administrators and Managers), the BDSHT (British Dental Society of Hygienists and Therapists) 
  • Further speakers to be confirmed

This webinar is part of the partnership between the College of General Dentistry (CGDent) and ProDental CPD.

It will be free to view live for all members of the dental professions. CGDent members and ProDental subscribers can claim CPD hours for free and have access to the recording after the event.  A £20 fee will apply for non-members/non-subscribers who wish to claim CPD.

Membership of the College of General Dentistry is open to all registered dental professionals. Membership for dentists is available from £94, and for other registered dental professionals from £33. The full list of CGDent membership rates is at https://cgdent.uk/membership-fees/

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New PDJ online now: Urgent dental care and COVID-19

The latest issue of the Primary Dental Journal, Urgent dental care and COVID-19, is now online. In it, we reflect on dentistry’s response to a global healthcare challenge, with articles from colleagues around the world.

The following articles are free to view for all dental professionals by visiting https://journals.sagepub.com/toc/prda/current:

  • Urgent dental care and oral health under the clouds of COVID-19 (Igor R Blum) (Editorial)
  • Urgent dental care and COVID-19 (Wendy Thompson) (Guest Editorial)
  • COVID-19 lockdown and recovery: a dental public health perspective from Lancashire and South Cumbria (Ross Keat)
  • COVID-19 Pandemic: The Urgent Dental Hub experience from a primary care perspective (Zohaib Khwaja, Awais Ali, Manraj Rai)


Members of the College of General Dentistry can unlock all articles by visiting https://cgdent.uk/primary-dental-journal-member-only. You will need to be logged in to the CGDent website.

Member-only content includes:

  • President’s update (Abhi Pal)
  • College news & events
  • Research abstracts: Urgent dental care and COVID-19 (Ario Santini)
  • Dentists deployed: an insider’s perspective of life on the NHS front line (Harriet E Powell)
  • Provision of dental care by public health dental clinics during the COVID-19 pandemic in Alberta, Canada (Heidi Rabie, Rafael Figueiredo)
  • Understanding behaviour change to promote regular dental attendance (Jessica Holloway)
  • Dental Emergencies: Perceived impact of the COVID-19 pandemic on the mental health and wellbeing of dental teams in the UK (Fiona Ellwood)
  • Delivering urgent oral healthcare in Sub-Saharan Africa: supporting sustainable local development (Rachael England, Andrew Paterson, Adam Jones)
  • Primary care research: views of a dental team on their experiences of a primary care study (Reem Al-Nashi Elia, Javed Ikram, Tim Clayton, Victor Chow, Emily Aldred, Kim Pilotille, Nichola Stones, Zhain Mustufvi)


CGDent members and PDJ subscribers should expect their printed copies to arrive in the next 2-3 weeks.

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Reduce antibiotic prescribing to pre-pandemic levels – it’s time to act!

Ahead of the annual global campaign on antibiotic awareness, Dr Wendy Thompson says that rates of antimicrobial prescribing across dentistry have been slow to reduce since passing the peak of COVID-19, even though we are returning to more normal practice and dentists should no longer be providing remote prescriptions.   

Providing the right care for patients with acute dental pain or infection at the right time was a challenge even before the coronavirus pandemic struck. At the CGDent/ProDental webinar on Tuesday 5 October, we heard some shocking statistics about how the public continues to experience urgent dental care.

Jacob Lant from HealthWatch told us that before COVID-19, dentistry accounted for around 5% of feedback from members of the public. However, the situation has deteriorated over time and the most recent statistics from Spring/Summer 2021 show that 25% of all feedback received by HealthWatch relates to dentistry. Sadly, the vast majority is about negative experience from people who are unable to access care for their toothache. Without additional funding, how on earth is the NHS system to deal with this backlog of care caused by the pandemic?

But to my mind doing this whilst keeping our patients safe from the potential adverse events of antibiotics is even more of a problem. We know that procedures are the most effective way to cure someone’s toothache and that dental surgeons are well equipped to diagnose and treat dental pain and infection during urgent dental appointments. However, we also know that this needs appointments which are at least 20 minutes long. The 15-minute appointment slots referenced in the NHS unscheduled dental care commissioning standard are simply not long enough to provide the procedures indicated by clinical guidelines.

The COVID-19 lockdown dramatically reduced access to urgent dental care suddenly and almost totally. For a while, remote care via advice, analgesics and antimicrobial (where appropriate) became the emergency guidance to get us out of a hole where there was simply not enough provision. Unsurprisingly during this time, rates of prescribing rather than procedures increased dramatically.

Confidently diagnosing acute dental conditions remotely is really hard. And without a diagnosis there should be no treatment. In normal times, therefore, remote diagnosis and management is rarely appropriate for dentistry.

Imagine how you would feel if your patient suffered a dramatic adverse reaction to the antibiotic which you remotely prescribed. How would you defend your position to the Coroner about why you gave a remote prescription rather than booking them into a face-to-face appointment? How would it wash that you, as a highly trained professional, were doing what a manager (with no prescribing competences within their scope of practice) told you to do?

In December 2020, the FGDP(UK) Antimicrobial Prescribing in Dentistry Good Practice Guidelines were updated, including highlighting the benefits of penicillin V over amoxicillin. Penicillin V is a narrower spectrum antibiotic and therefore less likely to drive the development and spread of antibiotic resistance. Now that we are returning to a more normal practice after COVID-19, the care we provide to patients with acute dental pain or infection should also be returning to normal. It is no longer appropriate to be providing remote prescriptions.  If someone’s condition is bad enough that they might need an antibiotic (ie a spreading swelling as indicated by guidance), then it’s bad enough for them to need to be seen.

Unfortunately, the rates of antibiotic prescribing across dentistry have been slow to reduce and the whole dental profession needs to work together to get back to the prescribing levels we were at before the pandemic. This isn’t just about dentists prescribing less, it’s about practice owners leading by example and holding their dental teams to account.  

Within the NHS, it’s about national commissioning teams, Local Dental Networks and managers within dental provider organisations setting the context to facilitate low rates of antibiotic prescribing, including long enough appointments for urgent dental procedures AND managing and monitoring service provision to ensure inappropriate antibiotic use is minimised (as per the Health and Social Care Act’s code of practice on the prevention and control of infections – Appendix B Primary Dental Care).

In the latest issue of the Primary Dental Journal, it is my pleasure to share with you papers from around the world about how urgent dental care has been provided since the start of the COVID-19 pandemic.  I am especially proud of a paper authored by members of dental teams who participated in (and helped deliver) my doctoral research about urgent dental care in general dental practice and out-of-hours clinics. The insight was particularly useful for me as I plan my next research in urgent dental clinics, and I hope that it might encourage you to get involved in research in the future.

During the World Health Organisation’s World Antimicrobial Awareness Week 2021, I will be hosting a CGDent webinar on antimicrobial prescribing and how dental professionals around the world are tackling antimicrobial resistance locally. The webinar is free to view live for everyone (Thursday 25 November, 7pm – register here) and CGDent members can also access the recording and CPD hours for free. If you aren’t a CGDent member, there is a small free to receive certified CPD or to access the recording.  I hope to see you there!

Dr Wendy Thompson PhD MCGDent is a general dental practitioner, lecturer in Primary Dental Care and the College of General Dentistry’s lead on antimicrobial prescribing and stewardship. A College Ambassador, she also holds advisory roles on tackling antibiotic resistance with the Office of the Chief Dental Officer (England), FDI World Dental Federation and the National Institute for Health and Care Excellence.

Guest Editor of the forthcoming issue of the Primary Dental Journal, which examines Urgent Dental Care and COVID-19, she hosted a recent College webinar on this topic, and is also the host of the upcoming College webinar on antimicrobial prescribing. Our full list of upcoming webinars and events is available here, with more webinars added regularly. In addition to our live webinars, CGDent members have free, on demand access to a rich library of 900+ hours of CPD and a linked e-PDP with our partner ProDental CPD.

Membership of the College of General Dentistry is open to all registered dental professionals. Membership for dentists is available from £94, and for other registered dental professionals from £33. The full list of CGDent membership rates is at https://cgdent.uk/membership-fees/

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Urgent dental care and COVID-19

Tuesday 5 October 2021, webinar recording available.

Participants take an honest look at urgent dental care (UDC) during and after the initial period of the COVID-19 pandemic. The opportunities and challenges that arose during the pandemic are examined and new models for UDC considered.

Chair:

Dr Wendy Thompson, general dental practitioner and academic

Speakers:

  • Simon Hearnshaw, Training Programme Director, Yorkshire and the Humber
  • Ian Kerr, general dental practitioner
  • Rachel England, dental hygienist
  • Jacob Lant, Head of Policy and Research, Healthwatch England
  • Dr Heidi Rabie, Chief Dentist of AHS Public Health Dental Clinics

CGDent members and ProDental subscribers have access to the recording of this event, and can claim CPD hours, free of charge.  A £20 fee applies for non-members/non-subscribers.

Part of the partnership between the College and ProDental CPD, this webinar is in our PDJ Live series, which discusses issues and topics highlighted in the College’s themed, member journal, Primary Dental Journal. To receive information on further upcoming events, sign up to the CGDent newsletter.

Membership of the College of General Dentistry is open to all registered dental professionals. Membership for dentists is available from £94, and for other registered dental professionals from £33. The full list of CGDent membership rates is at https://cgdent.uk/membership-fees/

Dental Teams ARE Healthcare Teams: Redeployment During COVID-19

Monday 6 September 2021, webinar recording available.

Dental healthcare professionals who have been redeployed during the pandemic discuss their experiences in this webinar hosted by the College and ProDental CPD. Reviewing real life stories, the panel talk about what it was like, who did what and what was learnt? They also consider whether the experience has helped others realise that dental professionals ARE healthcare professionals.

This event is part of the ‘PDJ Live’ webinar series that explores topics covered in the Primary Dental Journal, the College’s highly-regarded, quarterly journal for the entire general dental team.

Aims:

To consider the various redeployment options that were undertaken by dental professionals during COVID-19.

Objectives:

  • Review real life stories as to what happened
  • to consider the implications for dental teams going forward – What did we learn?

Chair:

Wendy Thompson

Speakers:

  • Shaun Howe
  • Stefan Serban
  • Harriet Powell
  • Sally Eapen-Simon
  • Jason Atkinson

The recording of this webinar is available here.

CGDent members and ProDental subscribers have free access to the recording and can claim CPD for free. A £20 fee applies for non-members/non-subscribers.

This webinar is part of the new partnership between the College of General Dentistry (CGDent) and ProDental CPD. To receive information on upcoming events, sign up to the CGDent newsletter.

Membership of the College of General Dentistry is open to all registered dental professionals. Find out more here. Membership for dentists is available from £94, and for other registered dental professionals from £33. The full list of CGDent membership rates is at https://cgdent.uk/membership-fees/

Safety, not activity targets, must be the priority

The College of General Dentistry (CGDent), Faculty of General Dental Practice UK (FGDP), and the Faculty of Dental Surgery of the Royal College of Surgeons of England have issued a joint message that safety must take clear priority over dental activity levels during the latest national coronavirus lockdown. 

The leading dental organisations have also highlighted the continued applicability of their guidance, and reiterated the need to consider the prevalence of COVID-19, and local rates of infection, when carrying out risk assessments.

Continue reading “Safety, not activity targets, must be the priority”

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 the College of General Dentistry (CGDent) and the Faculty of General Dental Practice UK (FGDP), 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 CGDent-FGDP 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 https://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. Register at https://myftc.co.uk/register.

Ian Mills FFGDP(UK), Dean of FGDP(UK) 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.”

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

The College of General Dentistry and Faculty of General Dental Practice UK and 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://cgdent.uk/standards-guidance and https://www.fgdp.org.uk/implications-covid-19-safe-management-general-dental-practice-practical-guide, 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.