• Describes an audit undertaken in the East of England on antibiotic prescribing in general dental practice.• The protocols of an original North West of England audit published in 2001 were deliberately replicated, in order to be able to pool the data and obtain a sample size of at least 1% of all UK dentists.• The combined Regional results confi rm that clinical audit reduces both the number of errors made by dental practitioners when writing out a prescription, as well as the number of those which are issued inappropriately, as compared to contemporary prescribing guidelines. I N B R I E FThe impact of clinical audit on antibiotic prescribing in general dental practice Objective To reduce the number of antibiotics inappropriately prescribed by general dental practitioners, and to increase overall prescription accuracy. Design A prospective clinical audit carried out between September and March of 2002-3 and 2003-4. Setting General dental practices in Eastern England. Subjects and methods The pre-audit antibiotic prescribing practices of 212 general dental practitioners were recorded over an initial six week period. On each occasion this included which antibiotic had been chosen, together with its dose, frequency and duration, as well as the clinical condition and reason for which the prescription had been raised. When related to prophylaxis, the patient's medical history was also noted. Following education on contemporary prescribing guidelines, presentations which illustrated the practitioners' previous errors, and the agreement of standards to be achieved, the process was repeated for another six weeks, and the results compared. Results In the pre-audit period, 2,951 antibiotic prescriptions were issued, and during the audit this was reduced by 43.6% to 1,665. The majority were for therapeutic reasons, with only 10.5% and 13.6% for medical prophylaxis during the pre-audit and audit periods respectively. Over both periods, amoxicillin and metronidazole were the two most commonly prescribed antimicrobials (63.4% and 21.2% respectively). In the pre-audit period, only 43% of all prescriptions were error free in dose, frequency, and/or duration of use, but this rose signifi cantly to 78% during the audit. Equally, using contemporary published guidelines, out of all the prescriptions made in the pre-audit period, only 29.2% were deemed to be justifi ed, as compared to 48.5% during the audit. Conclusions Clinical audit, in conjunction with education, and prescribing guidelines can favourably change antibiotic prescribing patterns among general dental practitioners.

Clinical audit using appropriate DUWL disinfectants can result in the improvement of the quality of water that is discharged through DUWLs, thereby minimising both the risk of cross-infection to vulnerable patients as well as to dental staff chronically exposed to contaminated aerosols.

A questionnaire was sent to 193 United Kingdom Hospital Consultant Orthodontists, in order to survey their individual involvement and clinical protocols for neonatal cleft palate impressions. Information regarding any untoward events that might have been experienced with this procedure during the period 1983–1992 was sought. Sixteen episodes where withdrawal of an impression had been extremely difficult and five respiratory obstructions due to an impression fragment were reported. Eighty-nine cyanotic events were reported, of which four resulted in asphyxiation, although none progressed to a fatality. Factors such as the level of consultants' experience or the choice of impression material used did not appear to be contributory.

Clinical audit can result in the improvement of the quality of water that is discharged through DUWLs, thereby minimising both the risk of cross infection to vulnerable patients, as well as to dental staff chronically exposed to contaminated aerosols.

This report describes two cases seen over a 5-year period, each with a labially impacted maxillary canine found in close proximity to the adjacent first permanent premolar, which had a deviated palatal root. The issue as to whether the premolar root deviation either produced the canine impaction or vice versa is discussed, both with reference to the processes considered to be involved in normal tooth eruption, and to three previously published similar cases.

The results of this audit indicate certain key areas of deficiency in the knowledge and understanding of informed consent amongst consultant orthodontists. The findings provide an opportunity for all clinicians to improve their education and therefore their potential to comply with both the ethical obligation and the legal requirement of gaining valid consent before the start of any treatment.

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