The British Dental Association (BDA) has today called once again for a full review of the evidence base for the HTM 01-05 guidance document on decontamination in dental surgeries. The BDA has written to the Department of Health (DH) renewing its 2007 call for a National Institute for Health and Clinical Excellence (NICE) review of the evidence, after it emerged that three areas of the guidance have already been amended before the document is even printed.

The three changes to the guidance that have already been made are:

1. The use of potable water for the rinse stage of decontamination is now permitted. This is a climbdown from the previously intended requirement for reverse osmosis and freshly distilled water, after studies showed low concentrations of endotoxins in England’s potable water supplies.

2. The period for which instruments can be stored after they have been processed in a validated vacuum sterilizer has been increased from 30 days to 60 days.

3. The revision of the requirement for two sinks for decontamination to allow the option of two bowls incorporated into a single unit instead.

Concern about these changes has been heightened by a consistent failure by the Department of Health to publish the references that they say form the evidence base for the document, despite repeated requests by the BDA for it to do so.

Calling for the guidance to be referred to NICE, BDA Executive Board Chair Dr Susie Sanderson said:
“It is telling that changes to the content of HTM 01-05 have had to be made already. The changes expose the uncertain evidence base on which the document is founded and will be a cause of great concern to dentists. These doubts can only be exacerbated by the failure of the DH to publish its evidence base for the document.

“This guidance will apply to family dentists and public dental facilities alike, so complying with it will cost both dental practice owners and the taxpayer significant amounts of money. The dental profession is absolutely committed to the highest standards of patient safety and is happy to invest in pursuit of those standards. But the investment has to be in changes for which there is a robust evidence base. To establish that evidence base the BDA believes the guidance must be looked at in detail by NICE.”

Ends

Notes to editors

1. The BDA first requested that dental decontamination guidance be referred to NICE for a proper scientific evaluation in July 2007. That request was not accepted.

2. The British Dental Association (BDA) is the professional association for dentists in the UK. It represents over 23,000 dentists working in general practice, in community and hospital settings, in academia and research, and in the armed forces.

3. For further information, please contact the BDA press office on 020 7563 4145/6.