Welsh Dental Committee newsletter: October 2024

This is the third WDC newsletter, reflecting the diverse range of work that the committee is doing to support the dental profession and the oral health of the population of Wales.

This edition will provide updates on Direct Access for DCPs, World Antimicrobial Resistance Awareness Week, and the effect of energy drinks on children’s teeth. We also would like to introduce the British Dental Association's (BDA’s) Equality Diversity and Inclusion Committee.

Adam Porter, Chair of WDC.

General dental practices are reminded that Dental Care Professionals (DCP) can now be set up as ‘Clinicians’ on a contract. This allows them to open and close courses of treatment using a unique PIN number. This means that dental hygienists and dental therapists are now allowed to diagnose and treatment plan within their scope of practice on the NHS.

Visit the NHS BSA (Business Services Authority) website, and search for DCP Clinician to find a guide of how to set up PIN numbers for DCPs in your practice.

At the end of June this year the legislation regarding use of Prescription Only Medicines such as local anaesthesia and fluoride varnish has changed.

A new mechanism called ‘exemptions’ has now come into effect, which allows dental hygienists and dental therapists to apply certain prescription-only medicines, including some local anaesthetics and fluoride varnish, without needing a patient-specific direction (prescription) from a dentist or a patient-group direction (PGD) in place.

It is important to note that this is only possible if the DCP has undergone training in use of the exemptions mechanism. This is a 3 hour online course, provided by HEIW, followed by a short portfolio. Further details of the course are available on the HEIW website.

For some time now, dental care professionals in many clinics have been administering prescription-only medicines under Patient Group Directions (PGDs). The exemptions training is now the most appropriate route for DCPs to administer such medicines and we would strongly advice DCPs to undertake the training and cease using PGDs as soon as possible.

This is in line with National Institute for Health and Clinical Excellence (NICE) guidance regarding PGDs which states: ‘Do not use PGDs for medicines when exemptions in legislation allow their supply and/or administration without the need for a PGD.’

The ‘Making Prevention Work in Practice’ programme from HEIW (Health Education and Improvement Wales) has been training clinicians to train their own dental nurses in delivering oral health promotion and administering fluoride varnish for several years now.

This programme has enabled many practices across Wales to achieve their fluoride varnish metrics more efficiently and has undoubtedly benefited many young patients across the country.

The ‘Making Prevention Work in Practice’ training is available from HEIW.

18 to 14 November 2024

Educate. Advocate. Act now.

Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial agents. As a result of AMR, antibiotics and other antimicrobials become ineffective and infections become difficult or impossible to treat, increasing the risk of disease spread, severe illness and death.

The World AMR Awareness Week (WAAW) is a global campaign to raise awareness and understanding of AMR and promote best practice to reduce the emergence and spread of drug-resistant infections. WAAW is celebrated from 18 to 24 November every year.

Antimicrobial resistance (AMR) is a pressing global health and socioeconomic crisis. It has significant impacts on human and animal health, food production and the environment. Drug-resistant-pathogens pose a threat to everyone, everywhere.

Antimicrobial Resistance (AMR) is one of the top global public health and development threats. The Lancet notes it is estimated that bacterial AMR was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths.

AMR puts many of the gains of modern medicine at risk. It makes infections harder to treat and makes other medical procedures and treatments such as surgery, caesarean sections and cancer chemotherapy much riskier. More information about antimicrobial resistance can be found on the World Health Organisation website.

The WDC would like to introduce this important new BDA committee. Chaired by Lauren Harrhy and Ellie Heidari, the EDI is dedicated to making the dental profession more inclusive, fair, and welcoming. Its goal is to ensure equal opportunities for all, regardless of background, while tackling issues relating to discrimination based on ethnicity, gender, age, disability, sexual orientation, or socioeconomic status.

The EDI aims to promote diversity in leadership and amplify underrepresented voices in decision-making. By fostering inclusivity, the EDI hopes to enhance patient care by ensuring dental professionals understand and are able to meet the diverse needs of their patients, building a more open, supportive dental community which is reflective of the society we serve. EDI believes that by fostering inclusivity, we not only create better workplaces but also improve the care we provide to our patients.

Welsh Government's Healthy Eating programme recently launched a consultation regarding the sale of energy drinks and free refills of sugary beverages.

WDC took the opportunity to highlight the impact of energy drinks on children’s oral health in Wales.

Welsh Government's Healthy Eating programme recently launched a consultation regarding the sale of energy drinks and free refills of sugary beverages. WDC took the opportunity to highlight the impact of energy drinks on children’s oral health in Wales. The effect of energy drinks on children’s oral health in Wales Energy drinks contain high proportions of free sugars and have a very low pH. In a Cardiff University survey of Welsh 12 to 14-year-olds, almost half of participants consumed sports drinks more than once a week, with 14% drinking one or more every day. Boys were more likely to consume sports drinks during physical activity and mealtimes, while girls were more likely to consume them at home or socially ^{[footnote 1]}.

International studies link the consumption of energy drinks and dental caries in children. Most energy drinks have pH below the critical value for erosive tooth surface loss. In a European study of 15 to 21 year olds energy drink consumption was associated with an increase in dental erosion ^{[footnote 2]}.

A study conducted at Cardiff University in 2019 analysed the free sugar content of five energy drinks. A typical serving of one of these drinks accounted for up to 187% of a child’s daily sugar recommendation ^{[footnote 3]}.

One third of 5-year-olds (32.4%) and three in ten 12-year-olds (29.6%) in Wales have experienced dental caries ^{[footnote 4]}.

The prevalence of tooth wear in children is high, with the 2013 Dental Health Survey finding more than 50% of 5-year-olds had signs of tooth wear and nearly 40% of 15-year-olds ^{[footnote 5]}.

If you have any queries about the work of WDC, please contact CommitteeSecretariat1@llyw.cymru.

[1]. Broughton et al. A survey of sports drinks consumption among adolescents. Br Dent J. 2016 Jun 24;220(12):639-43.

[2]. Margaritis et al. Multicenter study to develop and validate a risk assessment tool as part of composite scoring system for erosive tooth wear. Clin Oral Investig. 2021 May;25(5):2745-2756.

[3]. Clapp et al. The top five selling UK energy drinks: implications for dental and general health. Br Dent J. 2019 Apr;226(7):493-497. 

[4]. Welsh Oral Health Information Unit. Picture of Oral Health 2023. Dental epidemiological inspection of school year one (5-year-old) children in Wales 2022/23.

[5]. Children's Dental Health Survey 2013. Report 2: Dental Disease and Damage in Children England, Wales and Northern Ireland. 2015.