Fallow time calculator launched after AGP review

Jeremy Booth, Dental Tribune International

Wed. 14 October 2020

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LONDON, UK: A review of the evidence relating to the use of aerosol-generating procedures (AGPs) and the risk that they pose for the transmission of SARS-CoV-2 in dental settings has resulted in a further reduction to the fallow time that is recommended by UK dental authorities. Dental professionals can now calculate the time necessary between dental procedures using a free online tool.

The latest guidance from the College of General Dentistry (CGDent) and the Faculty of General Dental Practice (UK)—FGDP(UK)—now sets the fallow time benchmark as a duration of 15–30 minutes, depending on the treatment environment, the use of procedural mitigation, and the type and length of dental procedure being undertaken.

A free-to-use online fallow time calculator has been launched to support the use of the new guidance. The FGDP(UK) said in a press release that the online tool has been endorsed by Chief Dental Officer for England Dr Sara Hurley and that it enables dental teams to determine, justify and record the fallow periods necessary after the use of AGPs.

The new guidance from CGDent and the FGDP(UK)—published on 2 October in the second version of Implications of COVID-19 for the Safe Management of General Dental Practice: A Practical Guide—was based on a 25 September review of the evidence relating to AGPs that was conducted by the Scottish Dental Clinical Effectiveness Programme (SDCEP).

The SDCEP’s review was undertaken by a working group consisting of specialists from the fields of dentistry, clinical virology, physics and aerobiology, and it recommended a multifactorial approach to calculating fallow time, depending on the type of dental procedure, the ventilation rate of rooms, and the use of high-volume suction tools and dental dams. The SDCEP’s review was welcomed by UK dental authorities, including Dr Matthew Garrett, dean of the Faculty of Dental Surgery at the Royal College of Surgeons of England, who called it a timely “step in creating a fuller evidence base to inform future guidance”.

Previously, dental teams in the UK were required to plan for a 60-minute fallow period between appointments, which greatly limited the number of patients that they could treat each day. This guidance was updated in late August, when Hurley announced that a reduction in fallow time to 20 minutes was permitted at dental practices where it was possible to achieve ten to 12 air changes per hour in a single treatment room.

For dental professionals, AGPs have become a prime example of the occupational risks and hardships that they have faced since the pandemic began. AGPs have come to represent a serious threat both to their own health and to the sustainability of their livelihoods. As recently as 20 August, a blanket recommendation from the World Health Organization relating to the risk posed by aerosol transmission in dental settings threatened to rescind the critical progress towards the resumption of elective dental treatment that had been made by dentists in many countries.

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