Remimazolam statement

The Intercollegiate Advisory Committee for Sedation in Dentistry (IASCD) has issued a statement on the clinical use of Remimazolam for intravenous conscious sedation for dental procedures.

The IACSD, on which the College is represented, publishes Standards for Conscious Sedation in the Provision of Dental Care – the accepted national standard for
conscious sedation in dentistry in the UK – however the current version pre-dates the authorisation of Remimazolam.

The committee has set out the expected standard of clinical use and training to enable safe use of Remimazolam until an established evidence base becomes available. Relating only to patients over eighteen years of age, the committee’s advice is that Remimazolam should not be used in younger patients until further evidence becomes available.

The statement says:

  • Remimazolam, titrated intravenously as a single drug in adults, shall be used adhering to the same clinical standards and training required for midazolam.
  • The technique is classified as an operator-sedationist technique.
  • An appropriate adult escort is required for post-sedation care, in the same way as for the use of intravenous midazolam.
  • Remimazolam and midazolam should not be used in combination or sequentially on a routine basis and without adequate justification for the same episode of sedation in primary care.
  • Remimazolam should be reconstituted, drawn up and clearly labelled by the clinician administering the drug.
  • Providers of intravenous conscious sedation for dentistry, trained and experienced in the use of midazolam to IACSD standards, do not require further supervised clinical experience. However, clinicians must consult the manufacturer’s product literature and have knowledge of pharmacology, dosing and indications together with an
    understanding of how these fit with the IACSD standards. Evidence of this can be gained through CPD courses with appropriately set aims and objectives.

Further information is available here

The College is hosting a live webinar on 18 May 2023, free to all dental professionals, which will provide an introduction to Remimazolam.

College members are eligible for a 20% discount for a one-day CPD training course in the use of the Remimazolam taking place in Manchester on 5 July 2023.

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New PDJ online: Digital dentistry

The latest edition of the Primary Dental Journal, Digital Dentistry, is now live online.

Guest edited by Clinical Professor of Prosthodontics at NYU College of Dentistry USA, Ilser Turkyilmaz, the issue explores various techniques to offer even the most experienced dental professional the latest update on the evolution of technology and materials.

Professor Turkyilmaz clarifies, “Now, well into the age of digital dentistry, clinicians are constantly challenged to find the most modern, relevant material to provide the best quality of care to their patients and ease their labour-intensive workflows. The goal of this issue is to do exactly that, enrich the repertoire of current and new clinicians to help optimise patient care.”

The issue also features the second of five domains from the College’s Career Pathways in Dentistry: Professional Framework, which describes the knowledge, skills and other attributes expected of primary care dental professionals at different career stages – from safe practitioner through to accomplished practitioner. The ‘Professionalism’ domain published in this issue will be followed by ‘Reflection’, ‘Development’, and ‘Agency’ domains in future issues of the Primary Dental Journal. The first domain, ‘Clinical & Technical’, was published in the Autumn 2022 issue, and all domains for every career stage can be viewed online, using the above link.

In addition – and following his 2022 webinar with the College (the recording of which is available on-demand) – we explore Duty of Candour and how this relates to dentistry, with expert in the field, Kevin Lewis. Kevin explains the essentials of the legal, ethical, human, and sometimes contractual duty of candour, and the importance of organisational culture and involving the entire dental team in duty of candour, then focuses on notifiable safety incidents and takes us through the steps needed in dentistry.

Details of the College’s upcoming international conference, Excellence and the dental team (24–25 March 2023), in collaboration with Quintessence Publishing can also be found in this issue and online. Please check here for the up-to-date programme.

A single page cut-out-and-keep chairside synopsis of Antimicrobial Prescribing in Dentistry: Good Practice Guidelines is included, providing a handy, practical overview of treatment options for common conditions. The synopsis was developed by the Faculty of General Dental Practice (now College of General Dentistry) and the Faculty of Dental Surgery of the Royal College of Surgeons of England.

Full access to the majority of articles is reserved for College of General Dentistry members and Primary Dental Journal subscribers. For non-members / non-subscribers, individual print issues are available to purchase from £41. An annual print subscription, normally costing £125, is included with membership of the College. Membership is available from £100 for dentists and from £33 for all other registered dental professionals, and also includes online access to the PDJ Archive of over 1,300 articles, and a range of other benefits.

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

On behalf of the College, the PDJ editorial team would like to express its gratitude to all the authors and peer reviewers who have contributed to the publication of this issue.

A full list of papers is below.

CGDent members can view full articles via the links below by first visiting the PDJ Member Access page and clicking ‘Access the PDJ Archive’.

PDJ Winter 2022 digital dentistry issue contents

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New synopsis of antimicrobial prescribing guidelines

The College of General Dentistry and Faculty of Dental Surgery of the Royal College of Surgeons of England have co-published a chairside synopsis of Antimicrobial Prescribing in Dentistry: Good Practice Guidelines.

Antimicrobial Prescribing in Dentistry: Good Practice Guidelines offers clear, simple and practical guidance on the use of antimicrobials by dental teams, and the current third edition was developed by the Faculty of General Dental Practice (now College of General Dentistry) and the Faculty of Dental Surgery of the Royal College of Surgeons of England and published in 2020.

The new one-page synopsis summarises the recommended treatments for seven types of infection, including indications for the use of antimicrobials, and the first choice antimicrobial where use is indicated, with dosages and duration for adult patients.

Page references are indicated and a QR code included so that users can quickly and easily consult the appropriate section in the full guidance document, which also includes recommendations for other conditions, second choice antimicrobials (in case, for example, of penicillin allergy), dosages for children and hospital patients, consideration of medically compromised patients, and guidance on prophylactic prescribing for the prevention of local and distant site infections.

Dr Wendy Thompson PhD FCGDent, the College of General Dentistry’s lead on antimicrobial prescribing and stewardship, and the lead developer of the synopsis, said:

“The scale of the problem of antibiotic-resistant bacterial infections cannot be overstated. They already kill more people worldwide than HIV and malaria combined, and they will cause more deaths than cancer within a generation.

“By prescribing antibiotics only when strictly necessary, dental practitioners can keep antibiotics working and ultimately save lives. Using the new synopsis as an aide memoire, and referring to the full guidelines as necessary, will help them to do so.”

Mr Matthew Garrett, Dean of the Faculty of Dental Surgery of the Royal College of Surgeons of England, said:

“Our new one-page synopsis outlines treatment recommendations for a number of infections commonly encountered by dental practitioners, and makes it easy to access the full, detailed, condition-by-condition guidelines document, which is freely available online for the benefit of all dental professionals and their patients.

“If you only have time for one thing this World Antimicrobial Awareness Week, download and print out the new synopsis to help you play your part in combatting antimicrobial resistance all year round.”

Antimicrobial Prescribing in Dentistry: Good Practice Guidelines is available to view online free of charge, and College members can download it to access save, search and print functionality.

The new one-page synopsis is available for all dental professionals to download and print free of charge.

Both can be found on our Standards & Guidance page

Preventing antimicrobial resistance together: a joint statement from the UK’s dental professional bodies for World Antimicrobial Awareness Week 2022

‘Preventing antimicrobial resistance together’ is the theme of World Antimicrobial Awareness Week (WAAW) 2022. Held annually from 18-24 November, WAAW is led by the World Health Organization (WHO), in partnership this year with the World Organisation for Animal Health, the Food and Agriculture Organization of the United Nations, and the UN Environment Programme.

The World Health Organization has declared antimicrobial resistance (AMR) as one of the top 10 global public health threats facing humanity, requiring urgent multisectoral action to achieve the Sustainable Development Goals. Members of the wider oral healthcare community, including decision makers and those with influence in governmental, non-governmental, academic and regulatory domains, must therefore consider their impact on AMR as a critical part of the sustainability agenda.

During WAAW 2022, the College of General Dentistry, Association of Clinical Oral Microbiologists and Faculty of Dental Surgery of the Royal College of Surgeons of England, are highlighting the importance of working together to tackle AMR, supported by the Association of Dental Hospitals, British Academy of Cosmetic Dentistry, British Association of Dental Nurses, British Association of Dental Therapists, British Association of Oral Surgeons, British Association of Private Dentistry, British Dental  Association, British Endodontic Society, British and Irish Society of Oral Medicine, British Society of Antimicrobial Chemotherapy, British Society of Dental Hygiene and Therapy, British Society of Periodontology and Implant Dentistry, the Faculty of Dental Surgery of the Royal College of Physicians and Surgeons of Glasgow and the Faculty of Dental Surgery of the Royal College of Surgeons of Edinburgh.

“Everyone delivering and supporting oral healthcare has a role to play.”

They are reminding all those who deliver or support the delivery of oral healthcare that they have a role to play –working together, dental teams can identify service improvements and help keep antimicrobials working by auditing their prescribing practices, and the wider oral health community can reduce the need for prescribing of antibiotics by ensuring access to the right oral healthcare, at the right time and in the right place.

The organisations are encouraging dental teams to use a number of free resources to ensure that antimicrobials are used only when strictly necessary and appropriate:

They are also highlighting the Dental Antimicrobial Stewardship Toolkit (https://www.gov.uk/guidance/dental-antimicrobial-stewardship-toolkit), which provides links to a range of guidance, training, audit and patient-facing resources (including those above) which will be useful for all members of the dental team, including but not limited to prescribers.

Study programme 2022-23: events in all four nations, and webinars for all

The College has announced its programme of events between now and Spring 2023, with twenty CPD webinars anticipated as well as study days and conferences in all four nations of the UK.

Study days and conferences

In its first year, the College hosted major study days in Birmingham, Gateshead and Glasgow, and four more, including an international conference, will take place throughout the UK over the next six months:

Masterclass on aesthetic and restorative dentistry with Dr Walter Devoto

Friday/Saturday 14-15 October, Waterfront Hall, Belfast

Justin Durham on TMD, Finlay Sutton on prosthodontics, and The Caldwell Memorial Lecture delivered by Prof Jeremy Bagg on volunteering opportunities in dentistry

Friday 2 December 2022, Glasgow Science Centre

Mike Lloyd Hughes and Karun Dewan

Friday 17 February 2023, Stride Dental Academy, Bangor

Avijit Banerjee, Krzysztof Chmielewski, Vincent Fehmer, Guillaume Jouanny, Bertrand Khayat, Stefen Koubi, Amit Patel, Shanon Patel, Bjarni Pjetursson, Ana Poveda, Tif Qureshi, Irena Sailer, Werner Schupp, Wendy Thompson, Ulrike Uhlmann, Istvan Urban and Otto Zuhr

Friday/Saturday 24-25 March 2023, QEII Centre, London

All these events are open for registration via our events page, with significant discounts offered to College members.

The College is also hosting nine CPD sessions at Dentistry Show London on Friday/Saturday 7-8 October 2022, which are free to all.

CPD webinars

The College has hosted over 25 live webinars to date, and upcoming events include:

Kaushik Paul; Tuesday 4 October 2022, 7pm

Jashme Patel; Thursday 6 October 2022, 7pm

Pat Langley; Tuesday 11 October 2022, 7pm

Preetee Hylton, Alison Gregory; Tuesday 1 November 2022, 7pm

Derek Richards, Mark-Steven Howe; Wednesday 2 November 2022, 1pm

Mick Horton, Tuesday 15 November 2022, 7pm

Fiona Ellwood, Thursday 17 November 2022, 7pm

Derek Richards, Mark-Steven Howe; Wednesday 7 December 2022, 1pm

Abhi Pal; Monday 12 December 2022, 7pm

Jason Wong; Tuesday 10 January 2023, 7pm

Ross Hobson, Tuesday 17 January 2023 (7pm tbc)

Ross Hobson, Tuesday 24 January 2023 (7pm tbc)

Iain Chapple; Thursday 26 January 2023, 7pm

Ross Hobson, Tuesday 31 January 2023 (7pm tbc)

George Wright; Tuesday 7 February 2023, 7pm

Jacqui Elsden; Thursday 16 February 2023, 7pm

Abhi Pal, Pynadath George; Thursday 16 March 2023, 7pm

Dates for a series of webinars on Restorative and aesthetic dentistry, once confirmed, will also be published on our events page

All dental professionals are able to watch our webinars live. CPD certificates and on-demand access to the recordings are provided free of charge to College members, and are available to non-members on a chargeable basis.

College members can also access an online library of 1,000 hours of GDC-compliant e-learning, and an online personal development planning tool to identify and log areas for future learning tailored to their job role and aspirations.

Postgraduate qualifications

The College is also currently accepting expressions of interest for the next cohorts of its Postgraduate Certificate in Non-Surgical Facial Aesthetics, Postgraduate Diploma in Primary Care Orthodontics and Postgraduate Certificate and Diploma in Restorative & Aesthetic Dentistry

Education partnership with Dentistry Show London

The College will be the headline education partner for the Clinical Excellence Theatre at Dentistry Show London 2022, hosting nine seminars in three CPD theatres over the two-day conference.

CGDent speakers: top row: Jalpesh Patel, Kevin Lewis, Jason Wong, Wendy Thompson; bottom row: Tim Newton, Jacqui Elsden, Pynadath George, Abhi Pal

The College will be welcoming members and non-members alike to its sessions, with eight experts in their fields sharing their knowledge and giving advice on an array of subjects encompassing clinical dentistry, professionalism and career support:

  • Introduction to facial aesthetics and the current educational pathways
  • Duty of Candour: the legal and regulatory risk
  • Professionalism – a medico-legal perspective
  • Creating a positive patient safety culture in dentistry
  • Antimicrobial prescribing in dentistry
  • Mental health wellness in dentistry
  • Supporting staff through menopause (co-hosted with the BADN)
  • Mentoring in implant dentistry: good practice guidelines
  • Record-keeping in the real world of general dental practice

College representatives will also be available throughout the conference at Stand F58 to talk to delegates about the College, its vision for the profession and the benefits of membership, and to answer questions.

Conference registration is free, and delegates will have access to over 100 seminars in all across 6 lecture theatres, as well as over 180 exhibiting suppliers, and the opportunity to network with thousands of dentists, practice managers, hygienists and therapists, dental nurses, technicians and laboratory owners.

We look forward to seeing you there!

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Mentoring in implant dentistry

CGDent recorded webinar, Thursday 16 March 2023

Developed in conjunction with the Association of Dental Implantology, the Mentoring in Implant Dentistry: Good Practice Guidelines were published by the College in 2022. The guidelines describe the nature of mentoring which should be undertaken in order to safely carry out implant dentistry following completion of an appropriate training course.

This CGDent-hosted webinar helps both mentors and mentees in Implant Dentistry understand what the new guidelines are and why they were developed, and it provides an insight into what is expected from each other during the mentoring process.

Introduction:

  • Abhi Pal, President of the College of General Dentistry

Speakers:

  • Charlotte Stilwell, Specialist Prosthodontist
  • Dr Pynadath George, Dental Surgeon, Advanced Restorative Dentistry and Complex Dental Implants
  • Dr Sami Stagnell, Specialist Oral Surgeon

GDC development outcomes: B, D

CPD approx. 1.5 hours

This webinar is hosted by the College of General Dentistry and powered by our CPD delivery partner, ProDental CPD – watch the recording below.

It is free to view live for all dental professionals, and College members also have free access to the recorded webinar and can claim CPD hours for free.  A £20 fee will apply for non-members 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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Meta-analyses and their appraisal

CGDent recorded webinar, Wednesday 7 December 2022

This lunch and learn webinar is the third in the College’s Research and Critical Appraisal of Evidence series of webinars.

This third CGDent webinar outlines the main elements and key stages of meta-analysis and how to appraise meta-analyses. We examine heterogeneity and its causes, consider the interpretation of a forest plot and look at appraisal checklists.

Speakers:

  • Derek Richards, Specialist in Dental Public Health, Director of the Centre for Evidence-Based Dentistry
  • Dr Mark-Steven Howe, General Dental Practitioner

Further webinars in this series:

GDC development outcomes: A C

CPD approx 1 hour

This webinar is hosted by the College of General Dentistry and powered by our CPD delivery partner, ProDental CPD – watch the recording below.

It was free to view live for all dental professionals, and College members also have free access to the recorded webinar and can claim CPD hours for free.  A £20 fee will apply for non-members 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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Statistics in the real world

CGDent recorded webinar, Wednesday 2 November 2022

This lunch and learn webinar is the second in the College’s Research and Critical Appraisal of Evidence series of webinars.

This second CGDent webinar provides an overview of key statistical terms needed to support critical appraisal. We explore statistical terms and their real-world interpretation and discuss the difference between statistically significant and clinically significant results.

Speakers:

  • Derek Richards, Specialist in Dental Public Health, Director of the Centre for Evidence-Based Dentistry
  • Dr Mark-Steven Howe, General Dental Practitioner

Further webinars in this series:

GDC learning outcomes: A C

CPD approx 1 hour

This webinar is hosted by the College of General Dentistry and powered by our CPD delivery partner, ProDental CPD – watch the recording below.

It was free to view live for all dental professionals, and College members also have free access to the recorded webinar and can claim CPD hours for free.  A £20 fee will apply for non-members 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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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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