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UK Dental Medicines Advisory Service: questions asked by dentists - part 4: prescribing of high-strength fluoride toothpastes and use of fluoride varnishes in dental practice

British Dental Journal volume 231, pages 623–628 (2021)Cite this article

A Correction to this article was published on 08 April 2022

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Abstract

The UK Dental Medicines Advisory Service (UKDMAS) provides advice to dentists and other dental healthcare professionals concerning the use of medicines and medical devices in dental prescribing, administering, or dispensing. The commonly asked questions posed to the UKDMAS concerning the prescribing of high-strength fluoride toothpastes and use of fluoride varnishes in dental practice are discussed with answers, supplemented by relevant information from clinicians. These include: the prescribing of high-strength fluoride toothpastes and application of fluoride varnish in particular patient groups; issues concerning the amounts of fluoride toothpaste that can be prescribed; regulations related to the supply of fluoride toothpastes by dental hygienists and therapists; and the constituents and selection of fluoride varnishes.

Key points

  • The UK Dental Medicines Advisory Service (UKDMAS) provides advice to dentists and other dental healthcare workers on the prescribing of medicines, and the use of medicines and medical devices in dental practice.

  • Highlights commonly asked questions posed by members of the dental team to the UKDMAS, concerning high-strength fluoride toothpastes and fluoride varnishes, providing responses from relevant dental specialities.

  • Addresses the concerns related to the use of fluoride products in particular patient groups, with respect to prescribing and supplying of high-strength fluoride toothpastes and varnishes within the regulatory frameworks.

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References

  1. MHRA. Products. Available at https://products.mhra.gov.uk (accessed September 2020).

  2. MHRA. Product information about medicines (Summary of Product Characteristics). Available at https://www.gov.uk/guidance/find-product-information-about-medicines#spcs (accessed September 2020).

  3. Randall C, Finn D, Field E A. UK Dental Medicines Advisory Service: questions asked by dentists - part 1: prescribing regulations and medicines use. Br Dent J 2021; 231: 393-397.

  4. Public Health England. Delivering better oral health: an evidence-based toolkit for prevention. 4th ed. 2017. Available at https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention (accessed November 2021).

  5. FGDP(UK). Appendix 5: Caries Risk Assessment Guide. Available online at https://cgdent.uk/wp-content/uploads/2021/08/Clinical-examination-and-record-keeping-3e-final-text.pdf (accessed November 2020).

  6. NICE. Dental checks: intervals between oral health reviews. 2004. Available at https://www.nice.org.uk/guidance/cg19 (accessed September 2020).

  7. SDCEP. Oral Health Assessment and Review. 2011. Available at https://www.sdcep.org.uk/published-guidance/oral-health-assessment/ (accessed September 2020).

  8. BNF. Sodium Fluoride - indications and dose. Available at https://bnf.nice.org.uk/drug/sodium-fluoride.html (accessed September 2020).

  9. MHRA. A guide to what is a medicinal product. 2020. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/872742/GN8_FINAL_10_03_2020__combined_.pdf (accessed September 2020).

  10. MHRA. Off-label or unlicensed use of medicines: prescribers' responsibilities. 2014. Available at https://www.gov.uk/drug-safety-update/off-label-or-unlicensed-use-of-medicines-prescribers-responsibilities (accessed September 2020).

  11. Marinho V C C, Worthington H V, Walsh T, Clarkson J E. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2013; DOI: 10.1002/14651858.CD002279.pub2.

  12. Shen C, Autio-Gold J. Assessing fluoride concentration uniformity and fluoride release from three varnishes. J Am Dent Assoc 2002; 133: 176-182.

  13. Downs A M R, Sansom J E. Colophony: a review. Contact Dermatitis 1999; 41: 305-310.

  14. SDCEP. Prevention and Management of Dental Caries in Children. 1st ed. 2010. Available at https://www.sdcep.org.uk/published-guidance/caries-in-children/ (accessed November 2021).

  15. Sharma P R. Allergic Contact Stomatitis from Colophony. Dent Update 2006; 33: 440-442.

  16. Isaksson M, Bruze M, Niklasson B. Contact allergy to Duraphat. Scand J Dent Res 1993; 101: 49-51.

  17. Scully C. Allergies. In Medical Problems in Dentistry. 6th ed. pp 411-414. London: Elsevier, 2010.

  18. Kumar P J, Clark M L. Respiratory disease; Asthma. In Kumar and Clark's Clinical Medicine. 6th ed. pp 912-922. London: Elsevier, 2005.

  19. Anderson H R, Pottier A C, Strachan D P. Asthma from birth to age 23: incidence and relation to prior and concurrent atopic disease. Thorax 1992; 47: 537-542.

  20. Colgate-Palmolive Company. Duraphat Dental Suspension Varnish. 2015. Available at https://www.colgateprofessional.co.uk/content/dam/cp-sites/oral-care/professional/en-uk/article-pdf/brochure/duraphat_dental_suspension_pdf_july_2015.pdf (accessed September 2020).

  21. Peters P, Schaefer C. Vitamins, minerals and trace elements. In Schaefer C, Peters P, Miller R K (eds) Drugs During Pregnancy and Lactation: Treatment options and risk assessment. 2nd ed. pp 479. London: Academic Press, 2007.

  22. General Dental Council. Direct access. 2019. Available at https://www.gdc-uk.org/information-standards-guidance/standards-and-guidance/direct-access (accessed September 2020).

  23. NICE: Patient group directions. 2013. Available at https://www.nice.org.uk/guidance/mpg2/chapter/Recommendations (accessed September 2020).

  24. UK Government. The Human Medicines Regulations 2012 - Chapter 3 Exemptions. 2012. Available at https://www.legislation.gov.uk/uksi/2012/1916/contents (accessed September 2020).

  25. Specialist Pharmacy Service. Questions about Patient Specific Directions (PSD). 2020. Available at https://www.sps.nhs.uk/articles/questions-about-patient-specific-directions-psd/ (accessed September 2020).

  26. NHS England. Avoidance of Doubt - Application of Fluoride Varnish by Dental Nurses. 2016. Available at https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2016/09/avoidance-doubt-v4-1.pdf (accessed September 2020).

  27. Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment. COT Statement on the 1997 Total Diet Study. 2003. Available at https://cot.food.gov.uk/sites/default/files/cot/fluoride.pdf (accessed September 2020).

  28. Specialist Pharmacy Service. Fluoride toothpaste - what are the dangers of chronic ingestion in adults? 2019. Available at https://www.sps.nhs.uk/articles/fluoride-toothpaste-what-are-the-dangers-of-chronic-ingestion-in-adults/ (accessed September 2020).

  29. Iheozor-Ejiofor Z, Worthington H V, Walsh T et al. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev 2015; DOI: 10.1002/14651858.CD010856.pub2.

  30. Public Health England. Improving oral health: community water fluoridation toolkit. 2016. Available at https://www.gov.uk/government/publications/improving-oral-health-community-water-fluoridation-toolkit (accessed September 2020).

  31. The British Fluoridation Society. Extent of Water Fluoridation. Available at https://bfsweb.org/extent/ (accessed September 2020).

  32. Toxbase. Homepage. Available at https://www.toxbase.org/ (accessed September 2020).

  33. Bánóczy J, Petersen P E, Rugg-Gunn A J. Milk fluoridation for the prevention of dental caries. 2009. Available at https://www.who.int/oral_health/publications/milk_fluoridation_2009_en.pdf (accessed September 2020).

  34. Joint Strategic Needs Assessment Blackpool. Dental Health. 2020. Available at https://www.blackpooljsna.org.uk/Developing-Well/Children-and-young-peoples-health/Dental-Health.aspx (accessed September 2020).

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Author information

Authors and Affiliations

  1. Clinical Lecturer in Restorative Dentistry, School of Dentistry, University of Liverpool, Pembroke Place, L3 5PS, UK

    Phillip M. Brown

  2. Honorary Senior Clinical Lecturer in Restorative Dentistry, School of Dentistry, University of Liverpool, Pembroke Place, L3 5PS, UK

    Kathryn Fox

  3. Consultant/Honorary Professor of Oral Medicine, Liverpool University Dental Hospital, Pembroke Place, Liverpool, L3 5PS, UK

    E. Anne Field

  4. Assistant Director, North West Medicines Information Centre, 70 Pembroke Place, Liverpool, L69 3G, UK

    Christine Randall

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  1. Phillip M. Brown
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  2. Kathryn Fox
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  4. Christine Randall
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Correspondence to E. Anne Field.

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Brown, P., Fox, K., Field, E. et al. UK Dental Medicines Advisory Service: questions asked by dentists - part 4: prescribing of high-strength fluoride toothpastes and use of fluoride varnishes in dental practice. Br Dent J 231, 623–628 (2021). https://doi.org/10.1038/s41415-021-3664-x

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