Changes are child's play for dentists


For immediate release: Thursday, 3 November 2011

Dentists in Scotland risk being penalised for making inappropriate claims if they fail to comply with recent changes to the children‟s dental health programme, Childsmile.

UK-wide dental defence organisation MDDUS is urging practitioners to familiarise themselves with changes to the initiative, which was introduced to help improve oral health among children in Scotland. Amendments made to Childsmile guidelines mean that purely giving advice to parents on their child‟s dental health is no longer enough.

“With the new guidelines, the emphasis is clearly on demonstrating and supervising,” says MDDUS dental adviser Rachael Bell. “Simply giving advice to parents on how to care for their child‟s teeth without actually demonstrating the technique actively, would fail the regulations.”

Childsmile provides free dental packs and supervised toothbrushing programmes from a young age, with particular emphasis on taking care of those in deprived areas. It has proved successful in improving children‟s oral hygiene and reducing oral health inequalities.

The Childsmile Practice programme was recently incorporated into the statement of dental remuneration (SDR) as an extension of the Childsmile scheme and MDDUS urges practitioners to be aware of the amendments to the programme.

“The devil is in the detail,” states Rachael. “Any dentist involved in the Childsmile initiative needs to be familiar with the details and have notes to back up their claims if they are to avoid having monies claimed back for alleged inappropriate claims.”

Practitioners need to be aware of, not just the codes for payment, but the provisions in the main narrative of the SDR where it states the following: “the demonstration of appropriate toothbrushing technique to the patient or the patient‟s parent, then supervising the parent whilst they brush the patient‟s teeth.

“There is also a growing need for detailed notes to be made on what occurs in the surgery,” adds Rachael. “The amended statement asks that care is „delivered and recorded‟ so we would advise that good record keeping is not only encouraged, but required, so that the regulation for payment is met.”

This is particularly the case with item 41 for tooth brushing and dietary advice. “Here the narrative states that dietary advice is to be targeted according to a caries assessment.

“You should ensure your notes contain a caries assessment recorded yearly for each child. The amendment also requires the practitioner to look up The Scottish Index of Multiple Deprivation (SIMD) score for each child up to the age of five,” says Rachael.

“This process is to be done on-line but not every dentist in Scotland has internet access in the surgery or at reception. Finding a computer to look up information on each child that comes through the door for examination is time consuming in an already busy dentist's day.”

A file of SIMD scores for Scotland is available here.

It may be helpful to download and store a copy of the spreadsheet on a nearby computer if internet access is a distance away from the surgery.

These new Childsmile guidelines were to be issued "urgently" to all dentists with NHS Scotland stating that: “We realise this is a major change to the SDR and it may take time for everyone to adapt. Therefore, the first six months we will be as flexible as possible if practitioners are facing difficulty with implementation.”

For more information on the amendment to the Childsmile programme, click here.


For further information contact Richard Hendry on 0845 270 2034 or 07976 272266, or email

Note to editors

MDDUS (The Medical and Dental Defence Union of Scotland) is a medical and dental defence organisation providing access to professional indemnity and expert medico- and dento-legal advice for doctors, dentists and other healthcare professionals throughout the UK. For further information on MDDUS visit their website here.

This page was correct at the time of publication. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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