U.K. National Clinical Guidelines in Paediatric Dentistry

In 1994 the Department of Health requested the Royal College of Surgeons to produce National Clinical Guidelines. This task was delegated to the Paediatric Dentistry Clinical Audit Committee which is a subcommittee of the Consultants in Paediatric Dentistry Group of United Kingdom and Ireland.The purpose of Clinical Guidelines is to improve the effectiveness and efficiency of clinical care through the identification of good clinical practice and desired clinical outcomes. Each Guideline is intended to assist clinicians in making decisions about appropriate management of specific conditions. The aim has been to choose commonly encountered clinical situations and make recommendations on their management. In many areas of practice there is a shortage of reliable research data, so that although some recommendations are supported by robust data, others are made with a lesser degree of confidence, and may represent only ‘best current practice’. An anticipated benefit is that shortage of data will be highlighted, so stimulating research aimed at improving the scientific foundation of our clinical activity. It will be important to refine the existing Guidelines as further information becomes available, and also to add to the number of Guidelines in the future.The production of a guideline follows a consistent and thorough method. Draft authors were asked to review the scientific literature on selected topics and produce a draft guideline which was then circulated to an ‘Expert Panel’ for comment and opinion. Expert panels varied according to the subject of the guideline and consisted of all Consultants, the British Society of Paediatric Dentistry and individuals from other disciplines who were identfied as having a particular expertise in that subject. Where applicable each guideline consists of three broad sections. The first section is a series of recommendations for diagnosis and management, the second contains explanatory notes relating to the evolution of these recommendations, and the third section contains references and comments to assist further research into the subject. A final Guideline was eventually produced which, if appropriate, was assessed, according to the Scottish Intercollogiate Guideline Network (SIGN) classification, as to whether it was based on proven scientific evidence or currently accepted good clinical practice with limited scientific evidence. The SIGN classification is shown in Table 1 together with the Grading system used in the text of each document. The first guideline is published below.It should be understood that a Clinical Guideline is intended to assist the clinician in the management of patients in an effective and efficient way. It is not intended to restrict clinical freedom in the management of an individual case.