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Dental Prescribing
Guidance set out by the British Medical Association to GPs with regard to treating dental infections
A recent study found that a typical GP practice can expect to see 30-48 patients with dental problems a year, possibly due to the charge for dental services.
GPs and practice teams should be aware of dental services available locally to manage emergency dental conditions, including:
- the NHS website
- NHS 111
- local dental access centres
- local NHS dentists.
Local arrangements vary; this information should be available from local commissioning bodies.
Emergency dental services
- GPs are NOT responsible for treating dental problems.
- GPs should NOT attempt to manage a condition requiring dental skills unless they have appropriate training.
- Both the CIVIL COURTS and the GMC require doctors to have APPROPRIATE SKILLS for any treatment they offer.
- Patients should be advised to contact local emergency dental services or the emergency department.
- General dental practitioners have an ethical responsibility to provide access to advice and emergency treatment for patients, including those under a private contract.
- General dental practitioners have an ethical responsibility to provide access to emergency treatment outside normal hours.
- NHS commissioning bodies are responsible for out-of-hours dental care.
- Most provide emergency out-of-hours dental treatment, and they may also buy in-hours open access urgent sessions from dental practices.
Legal and contractual obligations
- Having established an apparent dental problem, GPs or practice teams should direct the patient to a dentist or local emergency service, or refer them to secondary care.
- If the patient has no usual dentist or there is no response from the usual dentist, the patient should contact NHS 111 (England), NHS 24 (Scotland), NHS Direct or local dental helplines (Wales) or the Health and Social Care Board (Northern Ireland).
- Patients presenting with signs of spreading infection or systemic involvement of a dental infection should be referred immediately to secondary care for appropriate surgical management.
Acute Dental Conditions
Clinical guidelines recommend that the first-line treatment for acute dental conditions should be an operative intervention, such as extraction or root canal treatment.
Acute dental abscesses respond well to local surgical treatment. For patients presenting with bleeding and trauma , early diagnosis and referral to a dentist is advised.
Antibiotics should only be prescribed in patients exhibiting signs of local or systemic spread or for those who are moderately or severely immunocompromised.
Prescribing
This guidance applies to patients seeking an NHS prescription following the issue of a private prescription or recommendation of a drug by a dentist.
- Dentists are obliged to issue NHS prescriptions to NHS patients where required.
- Dentists have a duty of care to issue private prescriptions to private patients.