Audit of qualitative fit testing for FFP3 respirators.

Introduction Dental team members require fit testing for respirators to deliver aerosol generating procedures (AGPs) during the COVID-19 pandemic. Five general dental practitioners (GDPs) in Yorkshire and the Humber were trained to fit test staff at urgent dental care sites (UDCs) with filtering facepiece (FFP3) respirators.Aim To review the quality of fit test records and provide an overview of the outcome of fit testing of UDC staff.Method Audit of fit test records for FFP3 respirators against Health and Safety Executive standards.Results Six percent of records had missing or incomplete data and 6% of fit test records required follow-up. Of 583 people fit tested with an FFP3 respirator, 80.6% (470/583) passed the test and 19.4% (113/583) failed. Of those, 479 individuals were fitted with a 3M 1873V respirator, of which 82.7% (396/479) passed the test and 17.3% (83/479) failed.Discussion The audit enabled efficient resolution of problems associated with fit testing, informed learning needs and highlighted that a significant proportion of individuals are unable to wear certain makes/models of respirators.Conclusion GDPs have been successfully trained to provide fit testing and make accurate fit test records. The high fit test failure rate for FFP3 respirators has important ramifications for delivery of safe dental care during the pandemic.

Variations in the provision and cost of oral healthcare in 11 European countries: a case study.

AIM: To compare the provision and costs at the point of delivery of dental treatments in a sample of European Union (EU) Member States. MATERIALS AND METHODS: A questionnaire with open-ended questions was sent to oral health policy-makers in Denmark, England, France, Germany, Hungary, Ireland, Italy, the Netherlands, Poland, Romania, Scotland and Spain. They were asked to answer questions on the probable costs and provision of treatment in their country for a vignette presented as a pre-defined case. RESULTS: All respondents returned answers to all questions. Wide variations were reported in: who would deliver care, cost of items of care and total cost. For example, in France, only a dentist would provide the treatment. In Denmark, England, Germany, Ireland, Italy, the Netherlands and Scotland, it was likely that the treatment would be provided by a combination of dentist, dental hygienist and dental nurse. Fees ranged from €72 in England (if treated within the NHS) to €603 in Denmark. In Italy, Spain and for most patients in Romania, all treatment costs were paid by the patient. In the other nine countries, some subsidy from public funds was available. In terms of percentage of per capita Gross National Income, the cost to the patient ranged from 0.12% in France to 1.57% in Spain. CONCLUSIONS: It was apparent that there are wide variations between EU Member States in the manner in which oral healthcare is delivered, its cost and the extent to which the cost of treatment is subsidised from state funds or through private insurance.

Using High Fluoride Concentration Products in Public Policy: A Rapid Review of Current Guidelines for High Fluoride Concentration Products.

Despite improvements in dental caries levels since the widespread introduction of fluoride toothpastes, it is still a disease which is considered to be a priority in many countries around the world. Individuals at higher risk of caries can be targeted with products with a high fluoride concentration to help reduce the amount and severity of the disease. This paper compares guidance from around the world on the use of products with a high fluoride concentration and gives examples of how guidance has been translated into activity in primary care dental practice. A rapid review of electronic databases was conducted to identify the volume and variation of guidance from national or professional bodies on the use of products with a high fluoride concentration. Fifteen guidelines published within the past 10 years and in English were identified and compared. The majority of these guidelines included recommendations for fluoride varnish use as well as for fluoride gels, while a smaller number offered guidance on high fluoride strength toothpaste and other vehicles. Whilst there was good consistency in recommendations for fluoride varnish in particular, there was sometimes a lack of detail in other areas of recommendation for other vehicles with a high fluoride concentration. There are good examples within the UK, such as the Childsmile project and Delivering Better Oral Health, which highlight that the provision of evidence-based guidance can be influential in directing scarce resources towards oral health improvements. Policy can be influenced by evidence-based national recommendations and used to help encourage dental professionals and commissioners and third-party payers to adopt higher levels of practices aimed at oral health improvement.