Dental Problems
Page Contents
Legal and Contractual Obligations
Advice for GPs for Requests to Prescribe Sedative Prior to Dental Procedures
Introduction
Dental problems are best assessed by dental practitioners who are fully trained in that field, there is a regulator for this area and anyone who wishes to treat dental issues must be registered with the General Dental Council.
The number of patients seeking dental advice from their GP is increasing. There are regional and national challenges around patients accessing NHS dental Services. General Practice is not commissioned to provide dental services. Most GPs will have had little or no training in managing dental issues and should not be expected to fill the commissioning gap or work outside of their competences. GP’s providing treatment for purely dental conditions are unlikely to be covered by the Clinical Negligence Scheme for General Practice.
The BMA has published guidance to inform GPs of their obligations to patients either requesting emergency dental treatment or asking for an NHS prescription for drugs recommended by private or NHS dentists. It is aimed at all GP’s including out of hours practitioners. The guidance can be accessed at:
BMA – Patients presenting with dental problems
Legal and Contractual Obligations
- Before refusing to treat a patient asking for emergency dental treatment, the GP must ascertain that the condition requires only dental treatment.
- Primary care teams must judge the nature of the patient’s condition by undertaking reasonable enquiries and, where appropriate, a clinical assessment.
- 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.
- Everyone in the practice team must do their best to ensure the patient doesn’t need the attention of a GP when signposting.
- If the patient has no usual dentist or there is no response from the usual dentist, the patient should contact NHS 111 (England).
- 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.
- The GP’s obligation to refer is set out in the GMS and PMS regulations.
More information on how to access local dental services, including urgent dental services, can be accessed via the following links:
-
-
- Dorset: Dental services – NHS Dorset
- Hampshire & IOW: Your services :: NHS Hampshire and Isle of Wight
- South West: NHS England — South West » What to do if you need urgent dental treatment
- Surrey & Sussex: Emergency dental care :: Surrey and Sussex Healthcare NHS Trust
- NHS England » How do I find an NHS dentist?
-
Prescribing
Dentists are obliged to issue NHS prescriptions to NHS patients where required.
The dental practitioner’s formulary, which is the list of drugs a dentist can prescribe is found on the BNF dental practitioners formulary.
Advice for GPs for Requests to Prescribe Sedative Prior to Dental Procedures
Our colleagues at Kent LMC have produced the following very helpful guidance which we are sharing with their permission:
“Dentists should not direct patients to GPs requesting they prescribes sedating medications, such as diazepam.
If a dentist wishes to prescribe sedating medications for anxious patients that dentist should be responsible for issuing the prescription. The dental practitioner’s formulary, which is the list of drugs a dentist can prescribe is found on the BNF dental practitioners formulary, includes Diazepam Tablets and Oral Solution.
If the dentist is treating a patient within their practice NHS contract, then the prescription should be on a FP14D form. Dentists do not have EPS.
If the dentist is treating a patient privately, they should issue a private prescription.
Dentists may contact a GP for information or advice, if, for example the patient has a complex medical history.”