College endorses menopause policy for dental employers

The College has endorsed the menopause policy and advice recently published by the British Association of Dental Nurses (BADN).

In the UK, 99% of dental nurses, 96% of orthodontic therapists, 94% of dental hygienists,  92% of dental therapists, 52% of dentists and 27% of dental technicians are female – 78% of the regulated dental profession as a whole – and the policy outlines the challenges faced by menopausal women in the workplace and suggests ways in which employers can support menopausal employees. 

The Association is asking dental practices, laboratories and clinics to adopt the policy and implement it in their workplace, and is asking dental organisations to support it by encouraging its widespread adoption.

The College of General Dentistry, membership of which is open to all dental and oral health professionals, is the first organisation representing dentists to do so. The College is the independent professional body into which the Faculty of General Dental Practice transferred last year, and is the UK’s only medical college run by and for oral health professionals.

Abhi Pal, President of the College of General Dentistry, said:

“The BADN’s Menopause Policy is important, practical and succinct advice which helps dental professionals to better understand the menopause, to appreciate relevant employment law, and to implement a menopause policy in their practice.

Making appropriate adjustments for staff affected by the menopause is both a moral duty enabling committed and experienced colleagues to remain in valuable employment, and a legal duty not to discriminate on the grounds of gender, age or disability. Supportive dental practices and understanding employers will also find they benefit in return from improved staff retention and reduced sickness absence.

On behalf of the College, I congratulate the BADN on its publication, and am pleased to endorse it.”

The policy is also supported by the British Society of Hygiene and Therapy (BSDHT), the British Association of Dental Therapists (BADT), the British Dental Industry Association (BDIA), the Dental Laboratories Association (DLA), the Dental Technologists’ Association (DTA), the Orthodontic National Group (ONG), and the British Veterinary Nurses’ Association (BVNA).

The publication is available on the BADN website here

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College publishes new national guidelines on implant dentistry mentoring

The College of General Dentistry has published new guidelines on mentoring in implant dentistry.

Mentoring in Implant Dentistry: Good Practice Guidelines describes the nature of mentoring which should be undertaken in order to safely carry out implant dentistry following completion of an appropriate training course, including:

  • the experience, skills and qualities expected of a mentor
  • the experience, skills and qualities expected of a mentee
  • the mentoring process
  • the mentoring agreement

Providing practical help to mentors and mentees, it also sets out the component parts of three recommended means of work-based assessment during the mentoring process: Case-Based Discussion, Direct Observation of Procedural Skills and Clinical Evaluation Exercise.

Designed to support educators and students, and to promote patient safety, the new document complements Training Standards in Implant Dentistry. Developed by the former Faculty of General Dental Practice (FGDP) and now published by the College, this has defined the accepted standards of training in implant dentistry in the UK since 2005, and includes a requirement to have an experienced clinician acting as a mentor. However, this requirement has not previously been expounded upon, and the publication of Mentoring in Implant Dentistry: Good Practice Guidelines seeks to address this.

The College of General Dentistry – intended Royal College – is the independent professional body into which the FGDP transferred upon its separation from the Royal College of Surgeons of England last year. Building on the legacy of the Faculty, it is the UK’s only medical college run by and for oral health professionals, and is unique in welcoming all dental and oral health professionals with relevant postgraduate qualifications into full membership.

The new guidelines are the result of a collaboration between the College and the Association of Dental Implantology, and were developed by a joint working group. Their publication follows consultation with over 30 organisations and individuals with interests and expertise in the field, and they have been endorsed by the Association of British Academic Oral and Maxillofacial Surgeons, the British Association of Oral Surgeons, the Foundation for Oral Rehabilitation, and the UK and Ireland sections of the International Team for Implantology and the Platform for Exchange of Experience, Research and Science.

The document is the College’s first new standards publication since its formal launch last year, and is available to view online free of charge, alongside its COVID-19 guidance and all of the guidance and standards documents of the former FGDP.

College members can also download the publication for personal use, and have access to search, text-select and print functionality. Membership is available from £94 per year for dentists, and from £33 for all other dental professionals.

Dr Abhi Pal, President of the College of General Dentistry and Co-Editor of the new guidelines, said:

“The publication of Mentoring in Implant Dentistry befits our mission to empower dental professionals to deliver high standards of care, and I am delighted that the College is building on the legacy of the FGDP in supporting practitioners to develop their clinical skills in this significant and evolving field of practice. The guidelines will act as an important adjunct to Training Standards in Implant Dentistry, and I would like to express my thanks to all those involved in their development.”

Click here to view Mentoring in Implant Dentistry: Good Practice Guidelines

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CGDent endorses updated guidance on anticoagulants and antiplatelet drugs

The College of General Dentistry has endorsed newly updated guidance on anticoagulants and antiplatelet drugs from the Scottish Dental Clinical Effectiveness Programme.

The second edition of Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs provides clear and practical recommendations and advice to enable the dental team to assess bleeding risk, and to plan and deliver treatment to dental patients taking various types of anticoagulant and antiplatelet medication.  

The guidance has been updated following a thorough review of the evidence, and following consultation with dental organisations including the College of General Dentistry. While most of the recommendations remain unchanged from the original 2015 edition, changes include the addition of advice on the direct oral anticoagulant Edoxaban, and on patients taking low molecular weight heparin.

The full guidance document, together with a quick reference guide and a series of pre-and-post-treatment information leaflets for patients, can be downloaded at https://www.sdcep.org.uk/published-guidance/anticoagulants-and-antiplatelets

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Dementia-friendly dentistry

Recorded webinarThursday 19 May 2022

Part of our ‘Talking Standards’ series, which sets out to examine areas covered by our evidence-based standards and guidance, this webinar explores Dementia-Friendly Dentistry: Good Practice Guidelines 

The recorded webinar is free to view for CGDent members and ProDental subscribers who can also can claim CPD hours for free.  A £20 fee will apply for non-members/non-subscribers.

We examine the evolving epidemiology of dementia and the changing demography within the UK population and the issues these raise for care provision. We explore how the dental team can ensure that it best meets the likely care needs of this segment of the population.

Speakers (TBC):

  • Paul Batchelor, Editor, Dementia-Friendly Dentistry: Good Practice Guidelines 
  • Dr James P Wise, Dentist, Special interest in the care of the elderly and medically compromised patient

This webinar is powered by our CPD delivery 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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Safe use of x-ray equipment

Recorded webinar. Thursday 17 February 2022, 7pm

CGDent members and ProDental subscribers have free access to the recorded webinar and can claim CPD hours for free.  A £20 fee will apply for non-members/non-subscribers who wish to claim CPD.

This webinar is part of our ‘Talking Standards’ series which sets out to examine areas covered by our evidence-based standards and guidance. The webinar explores the content of the Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment – 2nd Edition (published October 2020) and will draw attention to areas where the guidance differs from that in the first edition, or where new guidance has been introduced.

The first edition of the Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment (the Dental GNs) was published in June 2001 following the establishment of a working party by the National Radiological Protection Board (NRPB) and copies of the guidance were distributed to every dental practice in the UK by the Department of Health.

In the 20-plus years since then there have been significant changes requiring further guidance to be developed. These include:

  • a move from film-based dental radiography towards digital imaging techniques,
  • the appearance of dental cone-beam CT and hand-held dental X-ray equipment in general dental practice,
  • revised radiation protection legislation.

Good practice guidelines for the dental profession have also moved with the times, with, for instance, evidence-based selection criteria and national diagnostic reference levels now available for all imaging modalities. A substantial amount of experience has also been accrued by those organisations and individuals providing radiation protection advice and services to dental practices.

The webinar aims to refresh and update viewers on:

  • the means of restricting the exposure of staff and patients as far as is reasonably practicable,
  • the principal requirements of relevant legislation, namely –   The Ionising Radiations Regulations 2017,  The Ionising Radiation (Medical Exposure) Regulations 2017and the associated guidance: Guidance Notes for Dental Practitioners on the Safe Use of X-Ray Equipment – 2nd Edition.
  • how to apply the basic principles of practical radiation protection in a dental practice.

Speaker:

  • Andrew Gulson, Specialist Radiation Protection Scientist and Certificated Radiation Protection Adviser

This webinar is part of the new partnership between the College of General Dentistry (CGDent) and 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/

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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Antimicrobial prescribing in dentistry

Recorded webinar. Thursday 25 November 2021.

In the first of our Talking Standards webinar series, which sets out to examine areas covered by our evidence-based standards and guidance, we shone the spotlight on global efforts to tackle antimicrobial resistance locally.

We explore the ways in which dental teams can help keep patients safe from untreatable infections, consider why dental practitioners might overprescribe antibiotics and discuss the impact of COVID-19, referring to the Antimicrobial Prescribing in Dentistry Good Practice Guidelines.

Speakers:

  • Dr Wendy Thompson, general dental practitioner and academic
  • Vanessa Carter, ePatient and hcsm Consultant

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.

This webinar is part of the new partnership between the College of General Dentistry (CGDent) and 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/

College endorses updated prevention guidance

The College of General Dentistry has endorsed the newly-published fourth edition of Delivering Better Oral Health: an evidence based toolkit for prevention.

With chapters covering behaviour change, dental caries, periodontal diseases, oral cancer, tooth wear, oral hygiene, fluoride, healthier eating, alcohol, smoking and tobacco use, the revised document gives dental teams access to the best evidence of what works for oral health improvement, all in one place, to help them provide high quality preventative care and advice to patients.

The summary guidance tables remain an invaluable resource for general dental professionals, and new content has been added on infant feeding and early detection of oral cancer, further detail given on tobacco cessation and alcohol reduction, and a new table included which focusses on accelerated tooth wear.

The fourth edition also offers case studies in supporting behaviour change, as well as greater consideration of the oral health of older people and other vulnerable groups, and a new digital format provides better accessibility on mobile devices.

Issued jointly by Public Health England and the Departments of Health in England, Wales and Northern Ireland, it is the result of a comprehensive review of published evidence on prevention involving over 100 experts, among them frontline dental teams and patient representatives.

Ian Mills FCGDent, College Ambassador and past Dean of the Faculty of General Dental Practice, was among those overseeing its development, and Yann Maidment MCGDent, Council Member and College Research Lead, is on the Delivering Better Oral Health Implementation Group.

The document is available at https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention

FGDP standards and guidance now available at cgdent.uk

The standards and guidance documents previously published by the Faculty of General Dental Practice UK (FGDP) are now available on the website of the new College of General Dentistry (CGDent), the first independent college and only professional membership body in the UK specifically for primary care dentistry. 

The FGDP recently transferred from the Royal College of Surgeons of England into CGDent, and the new College has assumed the Faculty’s function to develop and maintain evidence-based guidance and standards for the general dental professions. 

Titles now available from the College include:

  • Standards in Dentistry, a comprehensive collection of standards and guidelines for primary dental care
  • Clinical Examination & Record-Keeping, a complete reference guide to record-keeping and examination, including history-taking, consent, confidentiality, data protection and more
  • Antimicrobial Prescribing in Dentistry, which gives clear, simple and practical guidance to dentists on when to prescribe antimicrobials, what to prescribe, for how long and at what dosage
  • Selection Criteria for Dental Radiography, the leading guideline on indications for radiographic investigation, covering treatment planning and monitoring, ionising radiation regulations and best practice
  • Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment, which helps dental practices meet the standards required by the Ionising Radiation Regulations 2017 (IRR17) and Ionising Radiation (Medical Exposure) Regulations 2017 (IRMER17)
  • Training Standards in Implant Dentistry, which summarises the training that should be undertaken to carry out implant dentistry safely, and the standards which should be met by training courses
  • Dementia-Friendly Dentistry, which enables dental professionals to understand dementia and its implications for dental practice, and adapt their patient management and clinical decisions accordingly
  • An Introduction to Research for Primary Dental Care Clinicians, which introduces the principles of research methodology, discusses the relevance of research to primary dental care, and provides an overview of the different stages in a research project

These publications join the College’s COVID-19 guidance documents, which were developed with the FGDP last year:

  • Implications of COVID-19 for the safe management of general dental practice: a practical guide, which supports dental professionals to take a risk-based and evidence-based approach to providing safe general dental care, whatever the national threat level
  • Dentistry during COVID-19: Psychological advice for dental teams, policy makers, and communicators, which offers straightforward suggestions to address common challenges arising from the COVID-19 pandemic in dental practices, and lists resources and organisations which can support dental professionals’ mental wellbeing.

Digital copies are available free of charge at https://cgdent.uk/standards-guidance, and print editions will soon be available.

A programme of webinars exploring each of the publications, and how they can be put into practice, will begin soon. Co-hosted by the College of General Dentistry and ProDental, the UK’s largest independent provider of online dental CPD, many of the events will be free for all dental professionals to watch live, with access to the recordings and CPD certification also free for CGDent members.

Events to discuss Selection Criteria for Dental Radiography, Standards in Dentistry and Clinical Examination & Record-Keeping are expected between October and December 2021, with Dementia-Friendly Dentistry, Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment, Training Standards in Implant Dentistry and An Introduction to Research for Primary Dental Care Clinicians among those anticipated next year.

To keep informed about these events as dates and times are confirmed, sign up to the monthly CGDent newsletter at cgdent.uk/college-newsletter

To find out more about the benefits of joining the College of General Dentistry, visit cgdent.uk/benefits.