Three New Codes of Practice introduced by the Dental Council

Three new Codes have been recently published by the Dental Council in relation to the following three areas:  

1. Management of Medical Emergencies within the Practise of Dentistry;
2. Dental Conscious Sedation; and,
3. Non-surgical Cosmetic Procedures.

The Code for the Management of Medical Emergencies within the Practise of Dentistry is an important new development that is relevant to all dental practices. Both the Code for Dental Conscious Sedation and the Code for Non-surgical Cosmetic Procedures are revisions of the 2005 and 2013 Codes respectively.

The Code of Practice regarding Management of Medical Emergencies within the Practise of Dentistry

The Dental Council has introduced this Code to ensure that dental practitioners and their teams have the relevant emergency drugs and equipment available in the event of a medical emergency. The Code aims to outline the minimum standard of care that should be available in the event that a medical emergency arises where dental care is provided and the range of medical emergencies that the dentists and their teams should be prepared for.

This newly introduced Code considers the following areas:

• Planning for medical emergencies.
• The training and quality assurance in managing medical emergencies.
• Ensuring that all necessary drugs are readily available.
• Ensuring that all necessary emergency equipment are readily available.
• Immediate management of potential emergencies.
• Risk assessment for dental care provided outside of the general dental surgery.
• Drugs and equipment for dental care provided outside of the general dental surgery.

A copy of the new Code of Practice regarding Management of Medical Emergencies within the Practise of Dentistry can be found here Code of Practice regarding Management of Medical Emergencies within the Practise of Dentistry.

The Code of Practice regarding Dental Conscious Sedation

The Code of Practice regarding Dental Conscious Sedation replaces the Dental Council's 2005 Code of Practice Relating to the Administration of General Anaesthesia and Sedation and on Resuscitation in Dentistry. The Code has been updated to reflect the recent reports on sedation from the following bodies:
 

1. Intercollegiate Advisory Committee for Sedation in Dentistry.
2. The Academy of Medical Royal Colleges.
3. The Scottish Dental Clinical Effectiveness Programme.

The Code defines conscious sedation as it applies to dentistry as follows;

"A technique in which the use of a drug or drugs produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation. The drugs and techniques used to provide conscious sedation for dental treatment should carry a margin of safety wide enough to render loss of consciousness unlikely".

The Code considers the following areas:
 

• Education and training – A dentist must have successfully completed a relevant training programme before sedating a patient and carrying out the dental procedure.
• Location of treatment – Equipment and facilities appropriate to the method of sedation must be in place.
• Patient age – Guidelines for acceptable sedation techniques for different age groups must be followed.
• Preparation for sedation – Valid written consent must be obtained before the administration of any sedative drugs.
• Clinical sedation techniques – Safe sedation demands knowledge of each drug’s time of onset, peak effect and duration of action.
• Monitoring – Sedative and Anaesthetic agents must be carefully monitored due to potential serious complications.
• Complications – The team delivering sedation must be able to recognise adverse events and manage them appropriately and safely.
• Recovery and discharge – A trained member of the dental team must supervise patients during their recovery from sedation and until the patient can be discharged.

A copy of the revised Code of Practice regarding Dental Conscious Sedation can be found here Code of Practice regarding Dental Conscious Sedation.

The Code of Practice regarding Non-Surgical Cosmetic Procedures

The Dental Council has revised its Code of Practice regarding Non-Surgical Cosmetic Procedures.  The most significant change in the revised Code is the removal of the statement that the Dental Council does not regard non-surgical cosmetic procedures as the practice of dentistry.

According to the Dental Council, "This reflects the reality that a growing number of dentists are safely providing these treatments to their patients, and it removes any ambiguity regarding the council’s ability to consider complaints from patients concerning these treatments under its fitness to practise process".

A registered dentist administering anti-wrinkle (botulinum toxins) or dermal fillers as cosmetic treatments has the following obligations: 
 

• "Be competent and experienced
  • only provide these treatments if you have undertaken additional education and training, and you have achieved the necessary competence to provide these treatments safely.

• Get informed consent from the patient
  • inform your patient of your proposed treatment plan and the risks associated with treatment;
  • have the patient give their informed consent before the treatment, including consent to the risks and fees involved.

• Use products authorised by the Health Products Regulatory Authority
  • only use products authorised by the Health Products Regulatory Authority;
  • comply with the general conditions of use in the Summary of Product Characteristics including warnings, precautions, contraindications (a specific situation in which a drug should not be used because it might be harmful to the person) and monitoring requirements when they are relevant to the proposed use;
  • be aware of the conditions for the authorisation of products you use and the advice that different preparations of botulinum toxin are not interchangeable;

• Make sure you are properly insured and/or indemnified
  •  be adequately and appropriately insured or indemnified for the risks relevant to this activity".

A copy of the revised Code of Practice regarding Non-Surgical Cosmetic Procedures can be found here Code of Practice regarding Non-Surgical Cosmetic Procedures.