The chief dental officer for England has responded the publication of a review looking into fallow time requirements.

CDO Sara Hurley said she welcomes the publication of the Scottish Dental Clinical Effectiveness Programme (SDCEP) review of mitigation of aerosol generating procedures in dentistry.

Published today, the report followed a review of the currently-available evidence on the generation of aerosols and the associated risk of COVID-19 transmission.

Ian Mills, dean of FGDP(UK), called it ‘a very significant moment in the recovery of dental practices’.

The review divides dental procedures into three categories of aerosol generation potential, according to the equipment used.

Multifactorial approach

As a result, fallow periods are recommended only for the highest risk procedures. It suggests the determination of fallow time using a multifactorial approach, citing a ‘benchmark’ of 15-30 minutes.

‘The rapid review of the evidence related to the generation and mitigation of aerosols in dental practice adds to our understanding and risk management of transmission of COVID-19 in dental settings,’ says CDO Sara Hurley.

‘As the authors state in the review’s introduction, it is important to stress that the SDCEP consensus recommendations do not have the status of guidance.

‘However, we can confirm that this review is informing Public Health England’s development of government infection prevention and control guidance necessary for the continuing restoration of dental care services whilst the COVID-19 pandemic continues.

‘In the event of Public Health England and the government updating the IPC advice, we will update our SOPs for dental practices in England to reflect changes. In the interim the current IPC guidance for dental practices in England still applies.’

Tackle patient backlog

The Faculty of General Dental Practice UK and the College of General Dentistry have also welcomed the report. Dean Ian Mills says adoption of the measures will help to tackle the building backlog of patients.

‘SDCEP’s review of dental AGPs has been extremely thorough, and followed a rigorous and methodical approach,’ he said.

‘Its publication is potentially a very significant moment in the recovery of dental practices in the midst of the coronavirus pandemic. I commend the SDCEP Team for the hard work and dedication they have shown in producing this report.

“We welcome in particular the more refined stratification of the transmission risk inherent in types of dental procedure; the allowance for fallow time to be calculated from the cessation of the procedure. Additionally, it takes a sophisticated approach to calculating fallow time, which considers both procedural and environmental mitigation factors. For example, high-volume suction, the use of rubber dam and provision of adequate air ventilation.

‘These approaches align exceptionally well with our own guidance. We feel it is important that current standard operating procedures are reviewed in light of SDCEP’s recommendations.’

Inequalities

He added: ‘Adoption of these measures will enable the increased delivery of patient care to tackle the backlog of unmet need. And avoid further deterioration in dental access and oral health inequality.

‘A reduction in fallow time will also support the viability of practices. While the maintenance of universal precautions will continue to keep both patients and members of the dental team safe.

‘We aim to update our guidance as soon as possible. We are currently working with partners to develop an online fallow time calculation tool to support its implementation.’

The full report can be read here.


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