Ensure prescribing patterns meet current guidance


For immediate release: Tuesday, 6 May 2014

Dentists should not feel pressurised into prescribing drugs outside of the recommended guidance – even when dealing with patients requiring emergency treatment, says UK-wide dental defence organisation MDDUS.

MDDUS has noticed a trend in the number of GDC cases critical of dentists’ prescribing patterns and are reminding practitioners that they must follow GDC and the Faculty of General Dental Practitioners (UK) guidance on prescribing or risk sanctions.

“There have been an increasing number of both civil and GDC Investigating Committee cases that make criticisms of the prescribing patterns of general dental practitioners,” says MDDUS dental adviser Rachael Bell.

This is especially the case with patients needing emergency treatment. “Emergency patients present several challenges to the busy practitioner but none more frustrating than acute pulpitis where the tooth responsible is difficult to identify,” says Bell.

“When a number of teeth appear to be tender, the pain is intermittent or its nature is hard to determine, it can be difficult to send a patient away with no definitive treatment.

“Patients often expect and request a prescription when attending in pain, but it is important that practitioners stand their ground and only prescribe according to current guidance.”

MDDUS has dealt with cases where dentists have prescribed antibiotics as a stopgap in the hope of alleviating their patient’s symptoms. “Dentists may see this as an option due to time pressures or problems isolating the source of a patient’s pain,” adds Bell.

GDC’s Guidance on prescribing medicine says: “you must make an appropriate assessment of your patient’s condition and prescribe within your competence. Part of prescribing medicines responsibly means prescribing only where you are able to form an objective view of your patient’s health and clinical needs.”

Further prescribing guidance can be found with both the Faculty of General Dental Practitioners UK and the Scottish Dental Clinical Effectiveness Programme (SDCEP).

The SDCEP guideline clearly states: “prolonged courses of antibiotic treatment can encourage the development of drug resistance and therefore the prescribing of antibiotics must be kept to a minimum and used only when there is a clear need.”

The guidance goes on to state that: “as a first step in the treatment of bacterial infections, use local measures. There is no evidence to support the prescription of antibiotics for the treatment of pulpitis or the prevention of dry socket.”

“No matter how difficult it is for dentists to determine the cause of a patient’s pain, they must think twice before picking up their pen and prescribing antimicrobials,” says Bell. “If antimicrobials are prescribed for pulpitis and a complaint proceeds to the GDC, practitioners will come under criticism from the regulating body.

“MDDUS would advise all practitioners to be aware of current prescribing guidelines and to adhere to them if they are to avoid censure from the GDC or lay themselves open to criticism in civil cases.

“When a patient does require drugs, the reasons for prescribing should be clearly stated within their dental records - it is not enough to simply write the name of the drug prescribed. Dentists must also make a note of the number of tablets prescribed, dose prescribed in milligrams as well as the frequency of intake of any drug.”

Access to current guidance can be found either here or by ordering Antimicrobial prescribing for general dental practitioners from the FGDP(UK).


For further information contact Richard Hendry on 0845 270 2034 or 07976 272266, or email rihendry@mddus.com.

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 go to www.mddus.com.

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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