Dental Practice In Scotland Research Articles

Factors affecting the quality of endodontic treatment in general dental practice in Scotland: a qualitative focus group study

Introduction The quality of endodontic treatment worldwide is variable despite clear clinical guidelines being available.Aims Identify the factors that affect the quality of endodontic treatment in general dental practice in Scotland and how to overcome the barriers identified.Methods Four online focus group interview sessions were conducted in which a total of 16 participants were recruited, including general dental practitioners, endodontic specialists and educationalists. Topics for facilitated discussion were based on healthcare system theory and included education/training, patient factors, resources and equipment factors; themes were identified via template analysis.Results A number of themes and subthemes affecting the quality of care are reported, including aspects to do with remuneration, time, education, training, support from secondary care and the impact of COVID-19.Conclusion Findings support: increase practical experience for undergraduates; access to postgraduate mentoring and training; development of a managed clinical network to facilitate access to appropriately trained specialists; and increased remuneration to allow sufficient time and adequate equipment to achieve clinical standards.

Communication strategies to encourage child participation in an oral health promotion session: An exemplar video observational study.

BackgroundThe oral health promotion sessions for young children and parents in a clinical setting pose challenges to the dental team.AimTo apply PaeD‐TrICS (Paediatric dental triadic interaction coding scheme) to investigate the interaction of child, parent and dental nurse and determine the effect of nurse and parental behaviours on child participation within an oral health promotion session.MethodA video observational study was applied. The sample consisted of a dental nurse and 22 children aged 2‐5 years in a general dental practice in Scotland. Behaviours were catalogued with time stamps using PaeD‐TrICS. Analysis of behavioural sequences with child participation as the dependent variable was conducted using multilevel modelling.ResultsChildren varied significantly in their participation rate. The statistical model explained 28% of the variance. The older the child and longer consultations significantly increased child participation. Both nurse and parental behaviour had immediate influence on child participation. Parental facilitation had a strong moderating effect on the influence of the nurse on child participation.ConclusionsChild participation was dependent on nurse and parent encouragement signalling an important triadic communication process. The coding scheme and analysis illustrates an important tool to investigate these advisory sessions designed for delivering tailored messages to young children and parents.Patient or Public ContributionThe dental staff, child patients and their parents were involved closely in the conduct and procedures of the present study.

Are NHS dental practices socioeconomically distributed in Scotland, Wales and Northern Ireland?

Aim To investigate the relationship between deprivation and distance to NHS dental providers in Scotland, Wales and Northern Ireland.Methods A total of 1,795 NHS dental practices were located at the smallest geographic areas for Scotland, Wales and Northern Ireland. A geographic information system (GIS) was used to overlay the distribution of dental practices with areas graded by the Index of Multiple Deprivation (IMD) and population census from 2011.Results In Scotland, Wales and Northern Ireland, 15%, 17.8% and 27.5% of the population lived outside 2.5 km of an NHS dental practice, respectively. NHS dental clinics were distributed mostly among people that lived in IMD 1 and 5 areas across the respective deprivation measures of all three nations. There were negligible differences in area-based deprivation measures and NHS dental clinic distribution.Conclusion NHS dental practices in Scotland, Wales and Northern Ireland were not socioeconomically distributed, suggesting an equitable spatial availability of services based on need.

The effect of introducing a financial incentive to promote application of fluoride varnish in dental practice in Scotland: a natural experiment

BackgroundFinancial incentives are often used to influence professional practice, yet the factors which influence their effectiveness and their behavioural mechanisms are not fully understood. In keeping with clinical guidelines, Childsmile (Scotland’s oral health improvement programme) advocates twice yearly fluoride varnish application (FVA) for children in dental practice. To support implementation Childsmile offered dental practitioners a fee-per-item payment for varnishing 2–5-year-olds’ teeth through a pilot. In October 2011 payment was extended to all dental practitioners. This paper compares FVA pre- and post-roll-out and explores the financial incentive’s behavioural mechanisms.MethodsA natural experimental approach using a longitudinal cohort of dental practitioners (n = 1090) compared FVA pre- (time 1) and post- (time 2) financial incentive. Responses from practitioners who did not work in a Childsmile pilot practice when considering their 2–5-year-old patients (novel incentive group) were compared with all other responses (continuous incentive group). The Theoretical Domains Framework (TDF) was used to measure change in behavioural mechanisms associated with the incentive. Analysis of covariance was used to investigate FVA rates and associated behavioural mechanisms in the two groups.ResultsAt time 2, 709 74%, of eligible responders, were followed up. In general, FVA rates increased over time for both groups; however, the novel incentive group experienced a greater increase (β [95% CI] = 0.82 [0.72 to 0.92]) than the continuous incentive group. Despite this, only 33% of practitioners reported ‘always’ varnishing increased risk 2–5-year-olds’ teeth following introduction of the financial incentive, 19% for standard risk children. Domain scores at time 2 (adjusting for time 1) increased more for the novel incentive group (compared to the continuous incentive group) for five domains: knowledge, social/professional role and identity, beliefs about consequences, social influences and emotion.ConclusionsIn this large, prospective, population-wide study, a financial incentive moderately increased FVA in dental practice. Novel longitudinal use of a validated theoretical framework to understand behavioural mechanisms suggested that financial incentives operate through complex inter-linked belief systems. While financial incentives are useful in narrowing the gap between clinical guidelines and FVA, multiple intervention approaches are required.

A systems approach using the functional resonance analysis method to support fluoride varnish application for children attending general dental practice

BackgroundAll children attending General Dental Practice in Scotland are recommended to receive twice-yearly applications of sodium fluoride varnish to prevent childhood caries, yet application is variable. Development of complex interventions requires theorizing and modelling to understand context. This study applies the Functional Resonance Analysis Method (FRAM) to produce a sociotechnical systems model and identify opportunities for intervention to support application. MethodsThe FRAM was used to synthesise data which were: routine monitoring of fluoride varnish application in 2015/16; a longitudinal survey with practitioners (n = 1090); in-depth practitioner and key informant interviews (n = 43); and a ‘world café’ workshop (n = 56). ResultsWe describe a detailed model of functions linked to application, and use this to make recommendations for system-wide intervention. ConclusionsRigorous research is required to produce accessible models of complex systems in healthcare. This novel paper shows how careful articulation of the functions associated with fluoride varnish application can support future improvement efforts.

Use of the theoretical domains framework to further understanding of what influences application of fluoride varnish to children's teeth: a national survey of general dental practitioners in Scotland.

Despite recent improvements in the oral health of Scotland's population, the persistence of childhood dental caries underscores a need to reduce the disease burden experienced by children living in Scotland. Application of fluoride varnish (FV) to children's teeth provides an evidence-based approach to achieving this goal. Despite policy, health service targets and professional recommendations supporting application, not all children receive FV in line with guidance. The objective of this study was to use the theoretical domains framework (TDF) to further an understanding of what may influence fluoride varnish application (FVA) in General Dental Practice in Scotland. A postal questionnaire assessing current behaviour (frequency of FVA) and theoretical domains (TDs) was sent to all General Dental Practitioners (GDPs) in Scotland. Correlations and linear regression models were used to examine the association between FVA and the TDs. One thousand and ninety (53.6%) eligible GDPs responded. Respondents reported applying FV more frequently to increased risk and younger children (aged 2-5 years). Higher scores in eight TDs (Knowledge, Social/professional role and identity, Beliefs about consequences, Motivation and goals, Environmental context and resources, Social influences, Emotion and Behavioural regulation) were associated with greater frequency of FVA. Four beliefs in particular appear to be driving GDPs' decision to apply FV (recognizing that FVA is a guideline recommended behaviour (Knowledge), that FVA is perceived as an important part of the GDPs' professional role (Professional role/identity), that FV is something parents want for their children (Social influences) and that FV is something GDPs really wanted to do (Emotion). The findings of this study support the use of the TDF as a tool to understand GDPs application of FV and suggest that a multifaceted intervention, targeting dental professionals and families, and more specifically those domains and items associated with FVA may have the greatest likelihood of influencing the evidence-based behaviour.

Is further intervention required to translate caries prevention and management recommendations into practice?

In April 2010, the Scottish Dental Clinical Effectiveness Programme (SDCEP) published guidance on the Prevention and management of dental caries in children. The aims of this study were to determine if further intervention is required to translate the SDCEP guidance recommendations into practice and to identify salient beliefs associated with recommended practice. Two postal surveys circulated to two independent random samples of dentists working in general dental practices in Scotland, before and after the publication of the guidance. The questionnaire items assessed current practice and beliefs relating to the prevention and management of dental caries in children. Response rates of 40% (n = 87) and 45% (n = 131) were achieved. The results highlight a gap between current practice and recommended practice. The majority of dentists do not 'always' perform recommended behaviours and many are following treatment strategies specifically not recommended in the guidance. More positive attitude, greater capability and motivation were significantly associated with performing more guidance recommended risk assessment and prevention behaviours. These findings highlight the need for further intervention to translate the SDCEP guidance recommendations into practice and give initial insight into the salient beliefs that may serve as targets for future interventions.

Summary of: is further intervention required to translate caries prevention and management recommendations into practice?

In April 2010, the Scottish Dental Clinical Effectiveness Programme (SDCEP) published guidance on the Prevention and Management of Dental Caries in Children. The aims of this study were to determine if further intervention is required to translate the SDCEP guidance recommendations into practice and to identify salient beliefs associated with recommended practice. Two postal surveys circulated to two independent random samples of dentists working in general dental practices in Scotland, before and after the publication of the guidance. The questionnaire items assessed current practice and beliefs relating to the prevention and management of dental caries in children. Response rates of 40% (n = 87) and 45% (n = 131) were achieved. The results highlight a gap between current practice and recommended practice. The majority of dentists do not 'always' perform recommended behaviours and many are following treatment strategies specifically not recommended in the guidance. More positive attitude, greater capability and motivation were significantly associated with performing more guidance recommended risk assessment and prevention behaviours. These findings highlight the need for further intervention to translate the SDCEP guidance recommendations into practice and give initial insight into the salient beliefs that may serve as targets for future interventions.

Extending dental nurses' duties: a national survey investigating skill-mix in Scotland's child oral health improvement programme (Childsmile).

BackgroundChildsmile is Scotland’s national child oral health improvement programme. To support the delivery of prevention in general dental practice in keeping with clinical guidelines, Childsmile sought accreditation for extended duty training for dental nurses to deliver clinical preventive care. This approach has allowed extended duty dental nurses (EDDNs) to take on roles traditionally undertaken by general dental practitioners (GDPs). While skill-mix approaches have been found to work well in general medicine, they have not been formally evaluated in dentistry. Understanding the factors which influence nurses’ ability to fully deliver their extended roles is necessary to ensure nurses’ potential is reached and that children receive preventive care in line with clinical guidance in a cost-effective way. This paper investigates the supplementation of GDPs’ roles by EDDNs, in general dental practice across Scotland.MethodsA cross-sectional postal survey aiming to reach all EDDNs practising in general dental practice in Scotland was undertaken. The survey measured nurses’: role satisfaction, perceived utility of training, frequency, and potential behavioural mediators of, preventive delivery. Frequencies, correlations and multi-variable linear regression were used to analyse the data.ResultsSeventy-three percent of practices responded with 174 eligible nurses returning questionnaires. Respondents reported a very high level of role satisfaction and the majority found their training helpful in preparing them for their extended role. While a high level of preventive delivery was reported, fluoride vanish (FV) was delivered less frequently than dietary advice (DA), or oral hygiene advice (OHA). Delivering FV more frequently was associated with higher role satisfaction (p < 0.001). Those nurses who had been practising longer reported delivering FV less frequently than those more recently qualified (p < 0.001). Perceived difficulty of delivering preventive care (skills) and motivation to do so were most strongly associated with frequency of delivery (p < 0.001 for delivery of FV, DA and OHA).ConclusionsThis study has provided insight into EDDNs’ experiences and demonstrates that with appropriate training and support, EDDNs can supplement GDPs’ roles in general dental practice in Scotland. However, some barriers to delivery were identified with delivery of FV showing scope for improvement.Electronic supplementary materialThe online version of this article (doi:10.1186/1472-6831-14-137) contains supplementary material, which is available to authorized users.

Trends and costs of high concentration fluoride toothpaste prescribing in Scotland

Within Scotland there has been a significant increase in the prescription of 2,800 ppm and 5,000 ppm fluoride toothpaste. The objective of this paper was to analyse the trends in high concentration fluoride toothpaste (HCFT) in the five Scottish South East and Tayside (SEAT) health boards and consider the options for future national management of this prescribing. A retrospective analysis of routine prescribing data for the years 2006-2012 was carried out in primary care dental practices in Scotland. The cost of HCFT prescribing in the five Scottish health boards has increased from £15,243 (4,147 items) in 2006/07 to £206,529 (24,113 items), in 2011/12. Out of 2,430 dental list numbers, 100 list numbers (4.1%) accounted for 70% of the total prescribing costs (£144,367). The public dental service employs 153 (6%) of dentists working in Scotland, who in turn prescribe 11.6% HCFT. There is a need to ensure that the prescription of HCFT is both encouraged as best practice care but also managed appropriately to ensure that its delivery is targeted at those who are most in need.

Evaluating an audit and feedback intervention for reducing antibiotic prescribing behaviour in general dental practice (the RAPiD trial): a partial factorial cluster randomised trial protocol

BackgroundAntibiotic prescribing in dentistry accounts for 9% of total antibiotic prescriptions in Scottish primary care. The Scottish Dental Clinical Effectiveness Programme (SDCEP) published guidance in April 2008 (2nd edition, August 2011) for Drug Prescribing in Dentistry, which aims to assist dentists to make evidence-based antibiotic prescribing decisions. However, wide variation in prescribing persists and the overall use of antibiotics is increasing.MethodsRAPiD is a 12-month partial factorial cluster randomised trial conducted in NHS General Dental Practices across Scotland. Its aim is to compare the effectiveness of individualised audit and feedback (A&F) strategies for the translation into practice of SDCEP recommendations on antibiotic prescribing. The trial uses routinely collected electronic healthcare data in five aspects of its design in order to: identify the study population; apply eligibility criteria; carry out stratified randomisation; generate the trial intervention; analyse trial outcomes.Eligibility was determined on contract status and a minimum level of recent NHS treatment provision. All eligible dental practices in Scotland were simultaneously randomised at baseline either to current audit practice or to an intervention group. Randomisation was stratified by single-handed/multi-handed practices. General dental practitioners (GDPs) working at intervention practices will receive individualised graphical representations of their antibiotic prescribing rate from the previous 14 months at baseline and an update at six months. GDPs could not be blinded to their practice allocation. Intervention practices were further randomised using a factorial design to receive feedback with or without: a health board comparator; a supplementary text-based intervention; additional feedback at nine months. The primary outcome is the total antibiotic prescribing rate per 100 courses of treatment over the year following delivery of the baseline intervention.A concurrent qualitative process evaluation will apply theory-based approaches using the Consolidated Framework for Implementation Research to explore the acceptability of the interventions and the Theoretical Domains Framework to identify barriers and enablers to evidence-based antibiotic prescribing behaviour by GDPs.DiscussionRAPiD will provide a robust evaluation of A&F in dentistry in Scotland. It also demonstrates that linked administrative datasets have the potential to be used efficiently and effectively across all stages of an randomised controlled trial.Trial registrationCurrent Controlled Trials ISRCTN49204710

Using linked healthcare data to create a randomised controlled trial: the rapid trial (reducing antibiotic prescribing in dentistry)

We report the design of a three-arm RCT to compare the effectiveness of enhanced audit and feedback strategies for the translation into practice of published guidance on antibiotic prescribing in dentistry. The trial uses linked healthcare data from administrative datasets (dental workforce data linked with claims for treatment provision and pharmacy data) in five aspects of the trial to: 1. identify participants: all currently practicing General Dental Practitioners (GDPs) in Scotland. 2. apply inclusion/exclusion criteria; based on dental practice contract status and a minimum level of recent treatment provision. 3. carry out stratified randomisation; all eligible dental practices in Scotland were simultaneously randomised at baseline to current audit practice or to one of two audit and feedback interventions. Randomisation was stratified by single-handed/multi-handed practices. Intervention practices were further randomised using a factorial design. 4. generate the trial intervention; individualised graphical feedback on antibiotic prescribing. The initial feedback report contained 14 months retrospective antibiotic prescribing data. 5. analyse trial outcomes; the primary outcome is the total antibiotic prescribing rate per 100 courses of treatment over the year following the delivery of the baseline intervention. In describing the design of this study, we demonstrate that linked administrative datasets have the potential to be used efficiently and effectively across all stages of an RCT. We also discuss the various challenges and limitations that such an approach presents.

Audit to improve oral cancer screening procedures

Introduction: This audit assesses the screening procedures for oral cancer in a general dental practice in Scotland, along with the recording of patient risk factors.

Thirty-five year review of a mercury monitoring service for Scottish dental practices

To review a long-standing mercury monitoring service offered to staff in dental practices in Scotland. During the first 20 years of the service, dentists and their staff were contacted by letter and invited to participate. Respondents were asked to collect samples of head hair, pubic hair, fingernail and toenail for analysis of mercury. After 1995, head hair samples were collected initially and further samples were only measured if head hair mercury was elevated. At the start of this scheme many staff, including administrative staff, had systemic exposure to mercury (defined as increased mercury in all four samples). Incidents of exposure have decreased over the 35 years and are now very rare. Male staff were found to have higher mercury concentrations than female staff and dentists tended to have higher concentrations than other staff. Staff working in dental practices more than five years old had small but discernable increases in head hair mercury concentration. In recent years the use of reusable capsules such as Dentomats has been associated with a slight but statistically significant increase in head hair mercury concentrations when compared to the use of encapsulated amalgam systems. Staff wearing open-toed footwear had significantly higher toenail mercury concentrations compared to those who wore shoes. Exposure of staff to mercury in Scottish dental practices is currently now very low. This is probably as a result of increased awareness to the toxicity of mercury and improved methods of preparing amalgam. It may be possible to reduce exposure further, although probably only slightly, by upgrading practices and using encapsulated mercury amalgam.

Summary of: Thirty-five year review of a mercury monitoring service for Scottish dental practices

Aims and objectives To review a long-standing mercury monitoring service offered to staff in dental practices in Scotland. Methods During the first 20 years of the service, dentists and their staff were contacted by letter and invited to participate. Respondents were asked to collect samples of head hair, pubic hair, fingernail and toenail for analysis of mercury. After 1995, head hair samples were collected initially and further samples were only measured if head hair mercury was elevated. Results At the start of this scheme many staff, including administrative staff, had systemic exposure to mercury (defined as increased mercury in all four samples). Incidents of exposure have decreased over the 35 years and are now very rare. Male staff were found to have higher mercury concentrations than female staff and dentists tended to have higher concentrations than other staff. Staff working in dental practices more than five years old had small but discernible increases in head hair mercury concentration. In recent years the use of reusable capsules such as Dentomats has been associated with a slight but statistically significant increase in head hair mercury concentrations when compared to the use of encapsulated amalgam systems. Staff wearing open-toed footwear had significantly higher toenail mercury concentrations compared to those who wore shoes. Conclusions Exposure of staff to mercury in Scottish dental practices is currently now very low. This is probably as a result of increased awareness to the toxicity of mercury and improved methods of preparing amalgam. It may be possible to reduce exposure further, although probably only slightly, by upgrading practices and using encapsulated mercury amalgam.

Design of dental surgeries in relation to instrument decontamination

Recent guidelines advise that the decontamination of dental instruments should be undertaken outwith the treatment area. The aim of this study was to determine the physical area of rooms in dental surgeries that decontaminate instruments within and outwith the treatment area respectively, and other factors relating to practice layout and ventilation. Data were collected by interview and observation of dental healthcare workers in dental practice in Scotland, UK. Room layouts were recorded and measured at floor, benchtop and above benchtop heights. Thirteen surgeries with instrument decontamination processes occurring in the treatment area and seven surgeries with instrument decontamination outwith the treatment area were selected at random for detailed analysis of room dimensions. Of the 179 dental surgeries surveyed, 55% were located in converted residential premises and most practitioners (91%) did not share premises with other healthcare providers. The median number of rooms in the practices was 8 (range: 2-21) and the median number of surgeries present was 3 (range: 1-6). Regardless of whether instrument decontamination facilities were housed within the treatment area or not, the average treatment area room size for both was 15.8m(2) (range: 7.3-23.9) (P=0.862), with 20% of the room area available as work surfaces. The median size of the seven instrument decontamination rooms (local decontamination units) was 7.6m(2) (range: 2.9-16.0), with, on average, 63% of the room used for work surfaces. This survey suggests that the historical location of dental surgeries in converted residential properties places many restrictions on appropriate design for healthcare premises.

Actuarial life‐table analysis of lower impacted wisdom teeth in general dental practice

The appropriateness of extraction of asymptomatic impacted third molars has been much debated and as a result the number of extractions has fallen in the UK in the past few years. As a direct consequence of this decrease more impacted third molars are left in situ and yet, little is known about the natural history of these teeth. The aim of this study was to create an actuarial life-table and related survival analysis that would shed light on the natural history of an impacted lower third molar. Panoramic radiographs taken in 14 different general dental practices in Scotland were analysed and matched with their respective case notes in order to generate a sample of patients with asymptomatic impacted lower third molars. Subjects were assessed to confirm the presence of impaction and absence of symptoms and then re-assessed 1 year later for the development of symptoms during the study period to relate the incidence of symptoms within 1 year in the sample studied to age. Logistic regression was used to construct a life table based on the survival of symptom-free teeth (independently of extraction) during the study period. The number of patients included in the study was 583 and 421 for the baseline and follow-up assessments respectively. The total number of teeth analysed in both appointments was 676; from those 37 (5.47%) were extracted during the study period. About 562 teeth (83.13%) survived the study period symptom-free. There was a statistically significant inverse association between the development of symptoms studied and age. There was no statistically significant association between extraction and age. The study indicates that older patients are less likely to develop the symptoms studied. In addition the authors believe that there is evidence to suggest that general dental practitioners might not be following current guidelines when deciding whether or not to extract an impacted lower third molar in the centres studied.

Decontamination and maintenance of dental handpieces in general dental practice

Gareth Brock reviews the results of a survey of the decontamination and maintenance of dental handpieces in general dental practices in Scotland

Incidence of symptoms in previously symptom-free impacted lower third molars assessed in general dental practice

To determine the potential of a pathology-free impacted lower third molar to cause symptoms within a year and whether these symptoms can be linked to clinical characteristics, lifestyle or socio-demographic status. One-year prospective cohort study of patients registered in general dental practice in Scotland with at least one asymptomatic impacted lower third molar. All general dental practices with panoramic radiography facilities in Tayside, Fife and Greater Glasgow (Scotland, UK) were invited to participate in the study. Orthopantomographs taken between 1995 and 2002 were reviewed and eligible patients were contacted and invited to participate. Patients were assessed in their own dental surgery by the same research dentist. In this baseline assessment, the presence of impaction was confirmed and all patients with a previous history of symptoms and/or pathology were excluded from further analysis. Clinical characteristics such as the angulation and the degree of impaction were recorded. Patients also completed a socioeconomic questionnaire. Eligible patients were re-assessed by the same research dentist one year later when they were asked about their experience of symptoms within the past year. Information was cross-referenced with patients' dental records. A total of 613 patients attended the baseline appointment. Of those, 30 (4.89%) had a history of symptoms and were excluded from the study, leaving 583 (95.10%) eligible patients. From those, 421 (69%) patients with a total of 676 lower third molars were examined one year later. 22.67% of all vertically impacted teeth examined had developed symptoms, along with 13.15% of all mesially impacted, 30.69% of all distally impacted and 6.45% of all horizontal third molars. This association was statistically significant (p < or =0.001). 23.05% of all partially erupted teeth and a surprising 10.49% of all unerupted teeth were associated with symptoms during the study period. This association was also significant (p < or =0.001). There was also a statistically significant inverse association between the development of symptoms and age (p = 0.0028). The predictability that an impacted lower third molar will develop symptoms in future remains unclear. However, some clinical characteristics such as the angulation, the degree of impaction and the patient's age could be useful in predicting the likelihood of future symptomatology.

Summary of: Survey of the decontamination and maintenance of dental handpieces in general dental practice

Objectives To determine how dental handpieces are decontaminated and maintained in general dental practice. Design Observational survey. Setting The survey was carried out in general dental practice in Scotland. Survey visits ran from January 2003 until the end of March 2004. Methods Data were collected by interview and observation in 179 dental surgeries in Scotland. Results In virtually all surgeries, handpieces were cleaned before disinfection or autoclaving (99%; n = 177), most commonly by wiping the external surface with a cloth impregnated with disinfectant. Most surgeries lubricated their handpieces after cleaning and before sterilisation (91%; n = 162), although a number of surgeries (24%; n = 42) also lubricated their handpieces after sterilisation. In the majority (97%; n = 174) of dental surgeries, all handpieces were autoclaved after use, most frequently (89%; n = 160) in a bowl and instrument steriliser. In 38 surgeries (21%), handpieces were being wrapped (paper pouches) before sterilisation in bowl and instrument sterilisers. A minority of surgeries (20%; n = 36) had a dedicated handpiece for surgical procedures. Conclusions The majority of dental handpieces are manually cleaned externally with a disinfectant impregnated cloth and processed in a type N (bowl and instrument) bench top steam steriliser. Handpieces are lubricated with non-water soluble lubricants at different stages of reprocessing, indicating clarification is required in this area. More work is required by manufacturers to establish a validated cleaning and lubrication process to facilitate the sterilisation of handpieces.