The Scottish Dental Clinical Effectiveness Programme (SDCEP) has also recently published the second edition of its ‘Prevention and Management of Dental Caries in Children’ guidance which is available on its website.
SDCEP has recently liaised with the other UK regions and offered them the opportunity to formally endorse its guidance but did not do so on this occasion. However, whilst not formally endorsed dental teams may find this guidance to be of interest, and maybe particularly so in respect of the restrictions on the use of amalgam in patients under 15 years old introduced under Article 10(2) of EU Regulation 2017/852 on Mercury, and effective from 1 July. The Full Guidance document includes illustrated step-by-step advice on individual clinical techniques and flowcharts for decision making about prevention and management options.
Whilst health is a devolved matter, the UK is the Member State that has to comply with EU Regulation 2017/852 on Mercury. The UK Chief Dental Officers had therefore sought the development of pan-UK guidance so that dental teams could adapt to the incoming restrictions on the use of amalgam in certain patient groups under Article 10(2) from 1 July onwards.
This process was carried out by the Scottish Dental Clinical Effectiveness Programme (SDCEP) and it has now published ‘Restricting the Use of Dental Amalgam in Specific Patient Groups - Implementation Advice for Article 10(2) of Regulation (EU) 2017/852 on Mercury’ which is now available for download via its website.
Patient Information leaflets are also available but a common version has been adapted for HSC use and will be available for patients on the nidirect website, and for dental teams on the dental pages of the BSO website.
Article 10(2) of EU Regulation 2017/852 on Mercury will come into effect on 1 July 2018 and introduces restrictions on the use of dental amalgam in certain patient groups, namely children under 15 years old and pregnant and breastfeeding women. Further guidance to dentists on the specific, practical, clinical issues relating to this Article was given into a second letter from the Chief Dental Officer.
The letter also offered clarification of the requirements of Article 10(4) regarding amalgam separators, and 10(6) regarding amalgam waste.
Additional information is available to download from the Amalgam Factsheet and FAQs page.
EU Regulation 2017/852 on Mercury became effective in Member States on 1 January 2018 and applies to mercury, mercury compounds and mercury-added products. The provisions of Article 10 of this Regulation applies to the preparation, use, and disposal of dental amalgam as a filling material and therefore the following guidance letter was issued to dentists by the Chief Dental Officer.
SDCEP’s August 2015 guidance ‘Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs’ has now been adopted for use in Northern Ireland. The full guidance, a quick reference guide, and some supporting documents are available electronically via its website www.sdcep.org.uk and represents a valuable aid to enhance patient care.
- Adoption of SDCEP’s August 2015 guidance ‘Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs’
DoH has now endorsed the Scottish Dental Clinical Effectiveness Programme (SDCEP) guidance ‘Oral Health Management of Patients at Risk of Medication-related Osteonecrosis of the Jaw’ (March 2017).
The attached letter to the dental profession provides more detailed information on the background to the guidance; the endorsement process; and the different formats of guidance documentation, and supporting tools, which are available on the SDCEP website at http://www.sdcep.org.uk/ .
The recommendations, advice and information within this new guidance should be very helpful to support dental practitioners in their management of patients taking anti-resorptive or anti-angiogenic drugs, and to enhance their care.
- Letter to the dental profession re SDCEP ‘Oral Health Management of Patients at Risk of Medication-related Osteonecrosis of the Jaw’ (March 2017)
The UK Chief Dental Officers wrote to dentists in April this year advising them that they had asked the Scottish Dental Clinical Effectiveness Programme (SDCEP) to consider the Intercollegiate Advisory Committee for Sedation in Dentistry Report ‘Standards for Conscious Sedation in the Provision of Dental Care’ (please see April 2016 section below).
SDCEP will shortly make a draft of its updated Conscious Sedation in Dentistry guidance available for a four-week open consultation. During this anyone with an interest in sedation for dental care in the UK may view the draft guidance and comment. The consultation draft and instructions for providing feedback will be provided via the SDCEP website.
This is to give you advance notice that the four-week consultation will run from Friday 6 January 2017 to Friday 3 February 2017.
During the consultation, short telephone interviews with individuals across the UK involved in the provision of dental sedation will be carried out to inform future implementation of the guidance. If you are interested in being interviewed, please email firstname.lastname@example.org providing your name, dental sedation role, location and phone number.
Simon Reid, our Chief Dental Officer, would commend you to take the opportunity to reply to the consultation and to also pass on this information about the forthcoming consultation with others who you think might be interested.
For the attention of dental team members who provide treatment under dental sedation.
In April 2015 the Intercollegiate Advisory Committee for Sedation in Dentistry (IACSD) published a report entitled ‘Standards for Conscious Sedation in the Provision of Dental Care’.
There has been some confusion in the profession, amongst some of those who provide dental treatment under conscious sedation, because the report asserted that “This publication creates a national standard for conscious sedation in dentistry and replaces the previous documents...”
As health is a devolved matter for the UK regions it is a matter for those Governments to decide what guidance to issue, or standards to set. The UK CDOs have been considering the matter of the IACSD report and have now jointly issued the attached letter to the profession in all four regions.
For the avoidance of any doubt the extant guidance for those who provide dental treatment under conscious sedation in Northern Ireland remains as has been previously issued, that is:
‘Minimum Standards Dental Care and Treatment’ (NI), 2011. Especially relevant are Standards 8.6 & 12.1-4.
‘Conscious Sedation in the provision of dental care’, Standing Dental Advisory Committee report, Department of Health, 2003.
[As has previously been endorsed by the GDC, along with support for ‘A Conscious Decision – a review of the use of general anaesthesia and conscious sedation in primary dental care’ (DH England, July 2000) and associated letters of advice from Chief Dental Officers in England, Northern Ireland, Scotland and Wales.]
The requirement to report Adverse Incidents re equipment/medicines to the Northern Ireland Adverse Incidents Centre.
That dentists practice in line with the information and action points contained in the NPSA RRR of 2008 when using Midazolam for intravenous sedation.
The above guidance remains applicable to dental teams in Northern Ireland and will continue to do so unless you are advised otherwise on the authority of the Chief Dental Officer for the Department of Health, Social Services and Public Safety Northern Ireland.
- Letter from the Four UK Chief dental Officers on Standards for Conscious Sedation in the Provision of Dental Care
DoH has now endorsed the Scottish Dental Clinical Effectiveness Programme (SDCEP) guidance ‘Drug Prescribing For Dentistry – Dental Clinical Guidance 3rd Edition’.
The attached letter to the dental profession provides more detailed information on the background to the guidance, the endorsement process, the importance of good Antimicrobial Stewardship, and how to access the guidance document and the associated App.
The intention is that this guidance should be used in conjunction with the British National Formulary, the British National Formulary for Children, and our own regional Northern Ireland Formulary.
Review of Community Dental Services
- The Report on the Implementation of the Recommendations Review
- Scope of Services Specification
- CDS Quality Assurance Checklist
Quality issues in record keeping: Recommendation from the Dental Hospital Inquiry
The team who carried out the independent inquiry into the Dental Hospital produced a report which included 45 recommendations.
Minimum Standards for Dental Care and Treatment
Guidance on Osteonecrosis associated with Bisphosphonate usage
Evaluation of Evidence Based Caries Reduction Programmes
- Report by Michael Donaldson, Consultant in Dental Public Health, RHSCB
- Summary of scheme by Chief Dental Officer
- Quality Issues in Radiography and Compliance with IR(ME)R (NI) 2000 - Letter from Acting Chief Dental Officer
Survey of Dental Services to People with Learning Disabilities in Northern Ireland
- Sedation: A Survey of General Dental Practitioners - Summary Report
- PDCS Questionnaires returned from CDS Dentists
The Future of Dentistry in Northern Ireland
- The Future of Dentistry in Northern Ireland Questionnaire
- The Future of Dentistry in Northern Ireland - A survey of all Dental Practitioners - Descriptive Statistics Summary