Impact case study
Dental research and global health priorities
Published on 12 May 2022
Enabling safe dental care during Covid-19 and tackling antimicrobial resistance through dental antibiotic prescribing.
The University of Dundee’s Dental Health Services Research Unit (DHSRU) investigates areas of global and national priority in clinical dentistry. The unit plays a leading role in the provision of evidence and the development of policy for dental care in Scotland and across the UK, working in partnership with NHS Education for Scotland, to deliver national clinical guidance through the Scottish Dental Clinical Effectiveness Programme (SDCEP). Internationally, the unit has established extensive collaborative partnerships that have developed into world-leading research programmes.
Changing dental antibiotic prescribing
Evidence from the DHSRU has led to changes in policy and types of intervention to impact dentists’ antibiotic prescribing, addressing what the World Health Organization describes as "one of the most urgent health threats of our time" (Tedros Adhanom Ghebreyesus, WHO Director-General)
Led by Professor Jan Clarkson, the Scottish Government funded initiative ‘Translation Research in a Dental Setting’ monitored routine dental antibiotic prescribing data between 2007-2011. The evidence uncovered a year-on-year increase in dental antibiotic prescribing, showing that despite guidance, dental prescriptions increased by 55,000 (16%), accounting for 10% of all antibiotics dispensed in the UK and contributing to the global health threat of antimicrobial resistance.
In response to the findings, the Scottish Government funded further research, again led by Dundee. This time a randomised control trial involving all 2,700 dentists in Scotland tested strategies for improving dentists’ antibiotic prescribing. The intervention saw national prescribing rates reduced by 6% - equivalent to 20,000 antibiotic items over 12 months - and identified a range of policies and interventions that could further improve dentists’ antibiotic prescribing.
The findings led directly to changes in the SDCEP 2016 Drug Prescribing Guidance, and has changed prescribing behaviour, contributing to the 24% reduction in dental antibiotic prescribing since 2013 with a saving to Scotland’s NHS of an estimated £850k.
Other UK-wide trials led by the DHSRU have addressed evidence gaps in UK health policy for routine dental care, such as safe intervals between dental check-ups, and have provided a robust evidence-base to inform clinical strategy and funding. Findings from these trials have contributed to The Scottish Government’s 2018 Oral Health Improvement Plan, and the 2021 updates to Public Health England’s evidence-based toolkit Delivering Better Oral Health.
Enabling safe access to dental care during Covid-19
The Covid pandemic had a detrimental and widespread impact on dental services. Patient access was severely restricted and treatment options were limited due to the uncertainty of safety of aerosol generating treatments such as drill and ultrasonic scaling.
The national and international collaborations led by DHSRU provided robust evidence to support the international reopening of dental services during the COVID-19 pandemic. Supported by the World Health Organisation, Federation Dentaire Internationale World Dental Federation and Chief Dental Officers from around the world, the Dundee team led a collaboration in a rapid review of 63 international guidelines and the associated evidence.
Their findings resulted in evidence-based guidance and resources that have supported the re-opening and return to routine dental care internationally, with research-based resources downloaded over 320,000 times in the three months from March 2020. The rapid reviews of international guidelines have been distributed by the WHO Director for Oral Health to the worldwide network of Chief Dental Officers and collaboration with this group continues to support global guidance for the recovery of dental care, prevention and treatment around the world.
UN Sustainable Development Goals
The Research Excellence Framework (REF) is the system for assessing research in UK Higher Education Institutions (HEIs).