Wage increase on the cards?

Dentists could be in line for a pay rise to help them absorb the added costs of switching to single-use reamers and files.

The Department of Health is investigating the likely impact of its recent decision to ask dentists to use disposable endodontic instruments. The results will be passed to the review body responsible for setting dentists’ pay.

In April dentists were warned against reusing instruments in root canal work following concerns they could spread the human form of mad cow disease.

Official guidance was sent to all dentists alerting them to research which showed files and reamers could pose an ‘effective route’ of vCJD transmission.

About one million NHS endodontic treatments are carried out every year in England and Wales.

When asked in the House of Lords last month to comment on the cost implications of the Department’s advice, Health Minister Lord Hunt revealed the government was carrying out research to ‘understand better’ how much dentists might have to spend to comply.

Lord Hunt said: ‘Analysis of historic treatment patterns suggests that, for the majority of dentists, the introduction of single-use reamers and files for endodontic treatment is likely to have a relatively small impact on overall practice expenses.

‘Costs will vary, however, between practitioners, and the department is undertaking further work to understand better the range of potential costs.’

The minister added: ‘This work will enable the department to consider what advice may need to be given to primary care trusts on additional costs in 2007/8 and what proposals may need to be made in evidence to the review body on doctors’ and dentists’ renumeration.’

The guidance on endodontic instruments, issued to all dentists in England ‘as a precautionary measure’, followed advice from the Spongiform Encephalopathy Advisory Committee and research conducted by the Health Protection Agency, which highlighted a potential risk of vCJD associated with root canal procedures.

Almost everyone is at some risk of being infected with vCJD due to dietary exposure to BSE, commonly known as mad cow disease.

Any additional risk from a root canal treatment could only arise if the instruments had been previously used on an infected patient, the Department of Health said.

Even if dental instruments had been used on someone carrying the infection, it is not clear how great the risk of vCJD being passed on would be.

Chief dental officer Barry Cockcroft said at the time: ‘There are no reported definite or suspected cases of vCJD transmission arising from dental procedures – this new guidance to dentists is purely an extra precaution.

‘The public should continue to attend their dentist as normal.’

Variant Creutzfeldt-Jakob Disease is one of the Transmissible Spongiform Encephalopathies, the group of prion diseases that include BSE, CJD and scrapie.

Since 1996 there have been 165 cases of vCJD. The proportion of people carrying an infection is ‘highly uncertain’ but is estimated to be between 1 in 1,400 and 1 in 20,000 people.

By Andy Tate, parliamentary correspondent

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