Antimicrobial prescribing by dentists in Wales, UK: findings of the first cycle of a clinical audit.

Objective To describe the findings of the first cycle of a clinical audit of antimicrobial use by general dental practitioners (GDPs).Setting General dental practices in Wales, UK.Subjects and methods Between April 2012 and March 2015, 279 GDPs completed the audit. Anonymous information about patients prescribed antimicrobials was recorded. Clinical information about the presentation and management of patients was compared to clinical guidelines published by the Scottish Dental Clinical Effectiveness Programme (SDCEP).Results During the data collection period, 5,782 antimicrobials were prescribed in clinical encounters with 5,460 patients. Of these 95.3% were antibiotic preparations, 2.7% were antifungal agents, and 0.6% were antivirals. Of all patients prescribed antibiotics, only 37.2% had signs of spreading infection or systemic involvement recorded, and 31.2% received no dental treatment. In total, 79.2% of antibiotic, 69.4% of antifungal, and 57.6% of antiviral preparations met audit standards for dose, frequency, and duration. GDPs identified that failure of previous local measures, patient unwillingness or inability to receive treatment, patient demand, time pressures, and patients' medical history may influence their prescribing behaviours.Conclusions The findings of the audit indicate a need for interventions to support GDPs so that they may make sustainable improvements to their antimicrobial prescribing practices.

Development of the Maturity Matrix Dentistry (MMD): a primary care dental team development tool.

OBJECTIVES: To adapt the Maturity Matrix (a self-evaluation practice development tool for medical primary care teams) for dentistry, creating the Maturity Matrix Dentistry (MMD), a team development tool for general dental practices. METHODS: The MMD was adapted by a multi-organisational dental working group and run from within the dental section, Wales Deanery. Individual feedback questionnaires were issued and the results used to refine the tool. It was piloted twice with a total of 67 practices (563 participants) with 104 participating twice. RESULTS: The MMD was considered a useful tool for dental practices; agreement was high across job roles. Following participant feedback, refinement was made to the terminology used and the ordering of some of the dimensions. Facilitator involvement in the group session was highly valued. In the pilot, 97% indicated they intended to use the MMD to improve practice and 77% said they would use it to carry out an audit. Of those participating in a second visit, 78% reported an improvement against the dimensions and 83% had carried out an audit or were in the process of doing so. CONCLUSIONS: Dental teams indicated high levels of satisfaction with the process, and self-reported improvements against the MMD dimensions are encouraging for future use.