NEWS DIGEST Scotland playing “catch-up” on children’s dental health
DENTAL health among children in Scotland has improved by 24 per cent since 2000 but the high levels of social inequality in dental care are still unacceptable, says the British Dental Association. New figures from the National Dental Inspection Programme in Scotland show that
more than two-thirds (69 per cent) of five-year-olds now have no obvious signs of tooth decay. But the same survey also reveals a huge gap in dental health in P1 children from more affluent areas compared to the lowest income households – with 55 per cent from the most deprived areas free from tooth decay compared with 82 per cent from the least deprived. Scotland also still lags behind countries of similar development, such as England and
Norway. Comparable figures show that two-thirds (75 per cent) of five-year olds in England are decay-free, with broadly similar figures for Norway (73-86 per cent). Robert Donald, chair of the BDA’s Scottish Dental Practice Committee (and also an MDDUS Board member), said: “Scotland is leading the way in investing in children’s dental health. The huge improvement we have seen in youngsters’ teeth since the millennium is testament to investing in an early years’ prevention scheme, which operates in our nurseries and schools. “However, despite this improvement Scotland is still playing catch-up with our neighbour south of the border, so there is no scope for standing still. There is no escaping either the fact that far too many children from our most disadvantaged communities still bear the burden of tooth decay, a largely preventable disease. “Government ministers must continue to invest in ChildSmile, to tackle this unacceptable inequality in dental health. The BDA has also called on the Scottish government to expand the ChildSmile programme to five to 12-year-olds and we have championed wide-ranging action on sugar, including taxation, public education and marketing, and for proceeds from the sugar levy to be directed to oral health initiatives.”
behalf of NHS trusts in England during 2015/2016 and the RCS is concerned that this bill could go up significantly if hospitals do not take the Montgomery ruling seriously. The ruling set a legal precedent changing how doctors must communicate risk. The court held that patients must now be made aware of any and all risks that they – not the doctor – might consider significant. Doctors can no longer be the sole arbiter in determining what risks are material to the patient. Mr Leslie Hamilton, a Royal College of
Surgeons Council Member, said: “The RCS is very concerned that doctors and hospitals haven’t fully appreciated how much the judgment given in 2015 changed our understanding of patient consent. The watershed judgment in the
Montgomery case shifted the focus of consent towards the specific needs of the patient. Hospitals and medical staff are leaving themselves very vulnerable to litigation and increased pay-outs by being slow to change the way the consent process happens.”
Antibiotic prophylaxis for infective endocarditis
NICE has made a small but significant change to its guidance on the use of antibiotic prophylaxis against infective endocarditis in cardiac patients undergoing dental procedures. In 2015 NICE had reaffirmed its 2008 guideline that antibiotic prophylaxis against infective endocarditis in at-risk heart patients is not recommended for
those undergoing dental treatment. There was then a re-think in response to research published in an article in The Lancet suggesting that rates of infective endocarditis had increased in England after NICE advised against giving antibiotics to prevent the infection. NICE decided to assess the research but found “insufficient evidence” to warrant a change to the existing recommendations. But in July of this year NICE announced that the recommendation had been changed to say that dentists should not “routinely” give antibiotics to patients at risk of infective endocarditis during dental procedures. The new ruling allows flexibility so that dentists and cardiologists can recommend antibiotic cover when it is in the best interests of the patient.
multimorbidity. Access at
www.nice.org.uk/guidance/ng56 ● NEW DENTAL IMPLANT TRAINING STANDARDS The FGDP(UK) has published new revised standards for implant dentistry setting out what training
WINTER 2016
a reasonable dental practitioner in the UK should undertake before embarking upon patient care in this discipline. The document is available free to download at
www.fgdp.org.uk as part of the Open Standards Initiative.
● ONE-HOUR SCAN LIMIT FOR STROKE Suspected stroke patients should undergo a brain scan within one hour of being admitted to hospital, according to new guidance from the Royal College of Physicians. This is a
dramatic reduction on the previous recommended limit of 12 hours and is designed to help identify causes and ensure patients receive timely treatment. Access at www.
strokeaudit.org/Guideline/ Guideline-Home.aspx
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