Dental
Dispensing
maDe easy
how to guiDe
DENTAL DISPENSING MADE EASY
HOW TO GUIDE
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INTRODUCTION
Welcome to your new Dental Prescribing and Dispensing System
The highest level of patient care is based on making every element of your treatment meet the needs
of each particular patient.
Prescribing and dispensing pain relief or antibiotics is one important step for some patients.
Doing this inside your practice guarantees that your patient has the right drugs and the right advice
– research has shown that perhaps a third of patients intend to follow your advice but fail to do so as
they are distracted by the pressures of just getting on with their lives and all that this involves.
Getting started
1. Your drug storage area (for S3, S4 and S8 products) needs to be secure and out of any area where
patients will be allowed to access.
2. Read this guide and make sure that each member of your team has read the guide and understands
how the dispensing process works.
3. We suggest you use Avery Labels, go to www.averyproducts.com.au and go to the product labels
area. We have provided a sample at the back of the guide. On the site you will also see templates and
software tab. There are two ways to do the labels as shown at the rear of the guide. We use Avery
L7163.
4. You will need to personalise each label to your practice with the title, name and qualification of the
dentist along with the practice address and daytime telephone number to the bottom of each label.
5. Set up the Warning labels near the Drug Cabinet and the Dispensing Quick Reference Guide
– now you are ready to make up the dentist’s prescription for the dentist to hand to the patient. Please
find your copy at the back of this guide.
6. Discuss the introduction of this new program with each team member especially all the dentists in the
practice – a different set of labels will need to be created for each dentist that dispenses products.
7. Determine how you will bill your patients and set this up at the front desk – most practices use Item
Number 927 and adjust price, some practices just have a single price of $29.95 for the item number
that covers the product.
[email protected] | Fax: 03 9568 2885 | PO Box 608 Carnegie 3163
© Ingenuity Dental
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DENTAL DISPENSING MADE EASY
HOW TO GUIDE
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ACTION PLAN FOR DISPENSING
Program protocol
In surgery
1.
Determine need for a script.
2.
If “No” then terminate plan.
3.
If “Yes” – ask patient if they would like their script filled at the practice because…
• You can legally now offer the service.
• You can provide the antibiotics and pain relief at equivalent prices to the pharmacy.
• The practice has included dispensing as a convenient service.
4.
Write the script at the conclusion of the treatment once the dentist has de-gloved – due to infection
control protocols.
5.
Enter details of the script in computer/on card. Item number for dispensed drugs is 927.
6.
Print label – write in patient name and date. Add Warning Labels as required.
At reception
7.
Nurse or dentist collects drugs from dispensing cabinet.
8.
Apply labels and dentists checks that label matches dispensed drugs on packaging.
9.
Patient signs the script.
10. Patient pays (fees and cost of drugs – for prescribing, advice, dispensing and product.)
11. Drugs are handed to patient by dentist – you need to confirm any advice on side effects,
use frequency and highlight any warning labels.
12. Store script in safe place – you will need to keep it for three years.
[email protected] | Fax: 03 9568 2885 | PO Box 608 Carnegie 3163
© Ingenuity Dental
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DENTAL DISPENSING MADE EASY
HOW TO GUIDE
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DISPENSING GUIDE FOR DENTISTS
1. Complete your patient’s script as usual.
2. Complete the label writing the date and name of patient.
3. Refer to your MIMS to ensure instructions and pharmaceuticals are correct.
4. Obtain a copy of Therapeutic Guidelines – Oral and Dental, visit www.tg.org.au. Go to the Products page, then
the Oral and Dental section for a current version. This should be readily available in one place where every
practice team member knows it is stored.
5. Check Medical History to ensure prescription is appropriate.
6. Have a set of blank labels if other instructions that are needed.
7. Follow-up patient to ensure compliance or for a visit to review status.
8. Please keep clinical records as per AHPRA Guidelines for clinical notes.
Special case for dispensing less than a full box
There may be a small number of prescriptions (for drugs such as Cilicaine VK) where you may need to prescribe less
than the complete tablet pack.
For these cases, obtain some small sealing bags and attach labels – the standard patient label along with the
appropriate warning labels can be put on this bag.
[email protected] | Fax: 03 9568 2885 | PO Box 608 Carnegie 3163
© Ingenuity Dental
Page 4
DENTAL DISPENSING MADE EASY
HOW TO GUIDE
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GUIDELINES FOR DISPENSING
Reference: Dental Board Information for Dentists 1993. In accordance with the Drug, Poisons and Controlled Substances Regulations
1985 and Drug, Poisons and Controlled Substances Act 1981.
General
1.
As a dentist under the Act your are entitled to obtain, possess, use or supply most drugs for the lawful practice
of the profession of dentistry, but there are some specific limitations which will be described below.
2. Authorisation does not extend to using drugs for conditions other than those related to the dental treatment of
patients under your care, and where a prescription is written, to the person named on the prescription.
(S 13: Reg. 801(4), 100 (5), 1012 (1)).
3. No licence is required; your registration as a dentist authorises you to obtain, possess, use or supply most
drugs and poisons listed in the schedules to the Act (S 13).
4. The health department or police can at any reasonable time enter your premises inspect your stock and records
of drugs (S42).
5. Self-administration of drugs is prohibited (Reg. 801 (6), 1143).
Dispensing restricted substances (Schedule 4)
1.
You must dispense a restricted substance for a patient under your care but you cannot delegate this activity to
dental nurses or receptionists
2. If you dispense, sell or supply a restricted substance to a patient, a label must be attached to the
container stating (Reg.1018):
• The patient’s name.
• The date.
• The name, address and telephone number of your practice.
• The name, strength and form (i.e. tablets and capsules) of the medication (unless you deem otherwise),
directions for use, the words “keep out of reach of children” in red capital letters.
Records
A true record of any drugs administered or supplied needs to be maintained and kept for three years. Your treatment
card showing the patients name and address, the date of the medication administered or supplied is a suitable form
of record (Reg. 1025, 1145).
Visit www.ahpra.gov.au, if you have any questions, go to the dental section under Policies, Codes and Guidelines
and see the sections especially under Dental Guidelines on Dental Records.
Stock & storage
Your stocks of restricted substances are to be stored in a locked storage facility such as a room, receptacle,
cupboard, drawer or refrigerator and access by authorised persons (as defined in the Act) only.
Manufacturers storage instructions are to be observed (Reg. 1010(1)(b)).
Your supplies may be obtained from a licenced wholesaler or from a pharmacist to whom a signed order should be
provided (S 24, Reg. 1001 (6)(b)). Ingenuity Dental is a licenced wholesale provider.
Any loss or theft is to be reported to the Department and to the Police.
[email protected] | Fax: 03 9568 2885 | PO Box 608 Carnegie 3163
© Ingenuity Dental
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DENTAL DISPENSING MADE EASY
HOW TO GUIDE
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PROCEDURES FOR DISPENSING
These procedures need to be understood by all practice members.
General
1.
Only dispense to patients where their dental treatment is under your care (you have a card on them).
2. Only dispense to patients where a prescription is written, to the person named on the prescription.
(S 13: Reg. 801(4), 100 (5), 1012 (1)).
3. Keep clear records of your stock and records of drugs.
4. Self-administration of drugs is prohibited.
Dispensing restricted substances (Schedule 4)
1.
Only a dentist can dispense a restricted substance to a patient under your care – the dentist must personally
hand the drug to the patient.
2. If you dispense, sell or supply a restricted substance to a patient, a label must be attached to the container
stating (Reg.1018):
• The patient’s name.
• The date.
• The name, address and telephone number of your practice.
• The name, strength and form (i.e. tablets and capsules) of the medication (unless you deem otherwise),
directions for use, the words “keep out of reach of children” in red capital letters.
3. Use preprinted labels that meet the standard required.
Records
1.
Keep a true record of any drugs administered or supplied needs to be maintained and kept for three years.
2. Your treatment card showing the patients name and address, the date of the medication administered or
supplied is a suitable form of record (reg. 1025, 1145).
3. On your computer system on the patient file or in a document specifically designed to track the dispensing
meeting the regulations.
Stock & storage
The storage cabinet is only to be opened when a dentist is on the premises – no dentist – no access to the drugs.
Stock is to be stored in a locked storage facility.
Manufacturer storage instructions are to be observed.
Your supplies may be obtained from a licenced wholesaler.
Simple action guidelines
1.
Dentist writes script and records on file/card.
2. Nurse enters data and generates label and places label on bottle/packet.
3. Dentist checks label and bottle/patient signs script/packet and dispenses to patient.
[email protected] | Fax: 03 9568 2885 | PO Box 608 Carnegie 3163
© Ingenuity Dental
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DENTAL DISPENSING MADE EASY
HOW TO GUIDE
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RECOMMENDED SELLING PRICES (EXAMPLE ONLY)
As a professional medical practitioner, you set your own fees.
The recommended selling prices reflect pharmacy guidelines and include the normal pharmacy dispensing fee,
check prices at your local pharmacy from time to time.
Method 1 (example only)
Dental Cabinet Product
Maxigesic 30’s
Prodeine (15)
Prodeine Forte (20)
Mersyndol Forte (20)
Abbocillin VK 250mg (25)
Abbocillin VK 500mg (25)
Metronide 200mg (21)
Metronide 400mg (21)
Amohexal (Amoxycillin) 250mg (20)
Amohexal (Amoxycillin) 500mg (20)
Augmentin Duo Forte (10)
Diazepam DP Tab (50)
Karlor Kd (10)
RRP
$9.95
$9.95
$16.50
$24.90
$15.95
$18.45
$16.50
$419.50
$16.50
$19.50
$31.90
$9.50
$21.30
GST
Sales of prescribed or recommended scheduled drugs as part of the professional treatment plan of your patients
forms part of your professional services and is the same as your dental services in these are free of GST. Sale of
any products to “walk in” patients not as part of your professional care may be subject to GST – in all cases, you
should consult your accountant as to the exact circumstances that may apply in your practice.
Method 2 (example only – recommended) – Easy to implement!
1.
Have a single item number 927.
2. Charge every product at $29.95 (or the fixed fee you choose) which includes the product, advice, dispensing
fee and administration fee. It is simple for all staff.
[email protected] | Fax: 03 9568 2885 | PO Box 608 Carnegie 3163
© Ingenuity Dental
Page 7
DENTAL DISPENSING MADE EASY
HOW TO GUIDE
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ADDITIONAL INFORMATION
Attachment 1
Following is a copy of the Dispensing Reference Guide – there are two copies provided in the package and these
should be in each surgery – additional copies can be provided on request with replacement drug orders.
Attachment 2 – Copies of Label Samples
(This should be faxed or mailed to the locations indicated on the form. We would recommend that one staff member
has primary responsibility for ordering and receiving drugs so that adequate stock is always available and correct
records are maintained.)
Attachment 3 - Copy of Order Form (Example Only)
Fax back a completed order form to place a product order with Ingenuity Dental, using one of the order forms supplied
with this booklet. Additional copies can be supplied on request.
Additional products
Ingenuity Dental holds a DHSV Drugs and Poisons Licence to wholesale S3, S4 and S8 drugs to dental practitioners.
We can source and provide to your practice any drug that comes within these Schedules – we would require that a
practice purchases a reasonable quantity (say 10 to 15 units) in each order to maintain our minimum offtake with our
wholesale suppliers.
Questions
Please email [email protected] or fax (03) 9568 2885 with questions about setting up this system or for
another copy of the order form.
[email protected] | Fax: 03 9568 2885 | PO Box 608 Carnegie 3163
© Ingenuity Dental
Page 8
Dental Dispensing Quick Reference Guide
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Treatment issue
Drug type
Cabinet product
Superficial infection 1 & 2
Penicillin V
Abbocillin VK 250mg (25) / Abbocillin VK 500mg (25)
Always confirm no
allergy to penicillin
before prescribing
these drugs
Take ONE tablet FOUR times a day on an empty stomach at
least 30 mins before food or 2 hours after food, until all taken
2
DO NOT TAKE ALCOHOL
while being treated with
this medicine.
PSA 2
B
If unresponsive:
Metronidazole 200mg (21)
Metronidazole 400mg (21)
PSA-B
Take ONE tablet THREE times a day until all taken
Amoxycillin
Amohexal 250mg (20) / Amohexal 500mg (20)
Take ONE tablet THREE times a day with food until all taken
2
DO NOT TAKE ALCOHOL
while being treated with
this medicine.
PSA 2
B
If unresponsive:
Metronidazole 200mg (21)
Metronidazole 400mg (21)
PSA-B
Take ONE tablet THREE times a day with food until all taken
Superficial infection 1
Penicillin allergy
Cephalosporin
Karlor Cd 375mg (10)
Take ONE tablet TWICE a day until all taken
2
DO NOT TAKE ALCOHOL
while being treated with
this medicine.
PSA 2
B
If unresponsive:
Metronidazole 200mg (21)
Metronidazole 400mg (21)
PSA-B
Take ONE tablet THREE times a day with food until all taken
ANUG
For Acute (Necrotising) Ulcerative Gingivitis prescribe Metronidazole
Significant surgery
planned 1
Amoxycillin
Amoxyl 3g sachet
Take the contents of sachet 1 hour prior to dental procedure
Paracetamol 500mg/Codeine phosphate 15mg (20)
Take ONE to TWO tablets every THREE to FOUR
hours when required for mild pain relief
Maximum of EIGHT tablets in 24 hours
This medicine may affect mental
alertness and/or coordination.
If affected do not drive a
motor vehicle or operate machinery.
PSA 1
PSA 12
This medicine may cause
drowsiness and may increase
the effects if alcohol.
If affected, do not drive a motor
vehicle or operate machinery.
This medicine may affect mental
alertness and/or coordination.
If affected do not drive a
motor vehicle or operate machinery.
19
Paracetamol 500mg/Codeine phosphate 30mg (20)
12
Day: Prodeine Forte (20)
1
Severe pain
This medicine may cause
drowsiness and may increase
the effects if alcohol.
If affected, do not drive a motor
vehicle or operate machinery.
12
Prodeine 15 500mg/15mg (20)
1
Mild to moderate pain
Contains PARACETAMOL.
Consult your doctor or pharmacist if
taking other paracetamol products.
Night: Mersyndol Forte
Paracetamol 450mg/Codeine phosphate 9.75mg/
Doxylamine succinate 5mg (20)
Take ONE to TWO tablets every FOUR to SIX hours
when required for moderate to severe pain relief
Maximum of EIGHT paracetamol tablets in 24 hours
Anti inflammatory
Ibuprofen
2
PSA 1
PSA 12
PSA 19
MAXIGESIC (Paracetamol 500mg & Ibuprofen 150mg)
B
PSA-B
10a
Take TWO tablets initially then ONE to TWO
tablets every SIX hours when required
Check for heartburn, ulcers
Maximum of EIGHT tablets in 24 hours
Do not take more than one asprin
tablet or capsule each day while
being treated with this medicine.
PSA-10a
“KEEP OUT OF THE REACH OF CHILDREN” label must be fixed to each patient drug label.
Notes:
Notes:
11 Antibiotic
onlyonly
to be
if spread
of infection
is beyondisconfines
jaw or physical
or when
there is
or systemic
symptoms.
Antibiotic
toprescribed
be prescribed
if spread
of infection
beyondofconfines
of jaw system
or physical
system
orfever
when
there is fever
or systemic symptoms.
22 Confirm
no Ibuprofen
sensitivity
or hypersensitivity
to Asprin,
other NSAIDS.
Confirm
no Ibuprofen
senstivity
or hypersensitivity
to or
Asprin,
or other NSAIDS.
3 Advil can promote thinning of the blood so should not be prescribed until surgery plan is completed (suggest 24 hours post surgery).
Fax: (03) 9568 2885
Mail: PO Box 608, Carnegie VIC 3163
Email: [email protected]
Amohexal (Amoxycillin) 500mg (20)
Take ONE tablet THREE times a day with food.
Patient:
Practice:
Dentist:
Phone:
Amohexal (Amoxycillin) 500mg (20)
Take ONE tablet THREE times a day with food.
Patient:
Practice:
Dentist:
Phone:
Amohexal (Amoxycillin) 500mg (20)
Amohexal (Amoxycillin) 500mg (20)
Take ONE tablet THREE times a day with food.
Take ONE tablet THREE times a day with food.
Patient:
Practice:
Dentist:
Phone:
Patient:
Practice:
Dentist:
Phone:
(10)
Paracetamol 500mg Ibuprofen 150mg
Take ONE to TWO tablets every SIX hours.
Patient:
Practice:
Dentist:
Phone:
(10)
Paracetamol 500mg Ibuprofen 150mg
Take ONE to TWO tablets every SIX hours.
Patient:
Practice:
Dentist:
Phone:
(30)
Paracetamol 500mg Ibuprofen 150mg
Take ONE to TWO tablets every SIX hours.
Patient:
Practice:
Dentist:
Phone:
(30)
Paracetamol 500mg Ibuprofen 150mg
Take ONE to TWO tablets every SIX hours.
Patient:
Practice:
Dentist:
Phone:
Metronidazole 400mg (21)
Metronidazole 400mg (21)
Take ONE tablet THREE times a day with food.
Take ONE tablet THREE times a day with food.
Patient:
Practice:
Dentist:
Phone:
Patient:
Practice:
Dentist:
Phone:
Prodeine Forte (20)
Prodeine Forte (20)
Paracetamol 500mg Codeine Phosphate 30mg
Paracetamol 500mg Codeine Phosphate 30mg
Take ONE to TWO tablets every FOUR to SIX hours.
Take ONE to TWO tablets every FOUR to SIX hours.
Patient:
Practice:
Dentist:
Phone:
Patient:
Practice:
Dentist:
Phone:
Prodeine 15 (20)
Prodeine 15 (20)
Paracetamol 500mg Codeine Phosphate 15mg
Paracetamol 500mg Codeine Phosphate 15mg
Take ONE to TWO tablets every FOUR to SIX hours.
Take ONE to TWO tablets every FOUR to SIX hours.
Patient:
Practice:
Dentist:
Phone:
Patient:
Practice:
Dentist:
Phone:
Please implement this program responsibly and follow all regulations and guidelines.
©Ingenuity Dental
© Ingenuity Dental