Implementation of Clinical Practice Guidelines in Dental Settings

Soheilipour, Shimae; Dunne, Stephen Michael; Newton, Jonathon Timothy; Jabbarifar, Seyed Ebrahim

doi:10.1016/j.jebdp.2009.07.001

« Previous Next »Journal of Evidence-Based Dental Practice
Volume 9, Issue 4 , Pages 183-193, December 2009

Implementation of Clinical Practice Guidelines in Dental Settings

Shimae Soheilipour, DDD
- PhD student, Department of Oral Health Services Research & Dental Public Health, King's College London, London, United Kingdom; Member of Faculty, School of Dentistry, Isfahan University of Medical Science, Isfahan, Iran
- Corresponding Author: Shimae Soheilipour, Oral Health Services Research & Dental Public Health, GKT Dental Institute, King's College London, Caldecot Road, Denmark Hill, London, SE5 9RW. Office Tel: 0203 299 3481, Fax: 0203 299 3409.
Stephen Michael Dunne, BDS, LDSRCS, FDSRCS, PhD
- Professor in Primary Dental Care, Head of Dental Practice and Policy, Department of Primary Dental Care, King's College London, London, United Kingdom
Jonathon Timothy Newton, BA, PhD
- Professor of Psychology as Applied to Dentistry, Head of Oral Health, Workforce & Education Research Group, Department of Oral Health Services Research & Dental Public Health, King's College London, London, United Kingdom
Seyed Ebrahim Jabbarifar, DDS, MSc
- Associate Professor in Pediatric Dentistry, Department of Pedodontics and Torabinejad Dental Research Center, School of Dentistry, Isfahan University of Medical Science, Isfahan, Iran

Objective

This study aimed to determine the knowledge and application of current expert recommendations on antibiotic prophylaxis (AP) to prevent infective endocarditis (IE) both in the United Kingdom and Iran.

Methods

The study used a 3-part postal questionnaire survey of dentists in the United Kingdom (n = 467) and Iran (n = 200) covering demographic data, antimicrobial prophylaxis prescribing habits for adults treated under local analgesia, and sources of information about recommended schedules and changes in dentists' prophylaxis regimens.

Results

Most UK dentists (87%) reported following the British National Formulary guidelines (BNF) on AP. Seventy-five percent of Iranian dentists follow the guidelines of the American Heart Association (AHA). A significant proportion of practitioners prescribed the correct antibiotic regimens for patients who are nonallergic or allergic to penicillin in the United Kingdom, but in Iran the knowledge of and compliance with the available guidelines regarding antibiotic regimens was poor. Although dentists were familiar with the dental procedures that could place their patients at risk, and more than 80% prescribed prophylaxis for patients with “prosthetic heart valves” and “previous bacterial endocarditis,” they also considered AP for patients with medical conditions not known to be at risk. For the UK dentists, the most common source of information on AP is medical and dental journals, whereas for Iranian dentists, academic meetings, colleagues, and textbooks were cited as sources of information on AP. Furthermore, 80% of participants in both countries would like to attend further courses about this topic.

Conclusion

Generally, dentists in the United Kingdom were more familiar with the current expert recommendations on AP than dentists in Iran; however, dentists in both countries tended to overprescribe. This could contribute to the problem of antimicrobial resistance. Educational initiatives aimed at implementing updated recommendations and continuous assessment of dental practice might reverse this trend.

Keywords: Knowledge, Dental Practitioners, Antibiotic Prophylaxis, Guidelines