Supply of medicines

Individuals undergoing dental treatment who need a medicine to take home usually receive a prescription to be dispensed by a community pharmacist. However, there are other mechanisms for supply which depend on:

• the member of the dental team supplying the medicine
• whether the patient is receiving an NHS or private course of treatment
• the legal category of the medicine

Sale versus supply

The Human Medicines Regulations 2012 (HMR 2012) refer to the sale or supply of medicines. In legislation, these have different meanings. In general, ‘supply’ is used to indicate providing a patient with a medicine but strict definitions refer to how patients are charged.

Sale

Describes providing a medicine to a patient for their personal use where the patient pays a charge which reflects the cost of the medicine. For example:

• sale of a medicine from a pharmacy
• the charge for a private prescription

Supply

A medicine is provided to a patient but either there is no charge, or the charge does not reflect the cost of the medicine. For example:

• the NHS prescription charge is a tax and does not reflect the cost of the medicine
• some patients are exempt from NHS prescription charges

Mechanisms of supply

Mechanisms by which patients can obtain medicines or medical devices after treatment by a member of the dental team include:

• prescription, written by a dentist, to be taken to a community pharmacy
• supply directly to a patient against Patient Specific Directions (PSD) written by a dentist, only to be used within a private course of treatment
• supply of a medicine ‘for immediate use before the issue of a prescription’ by a dentist directly to a patient receiving NHS treatment
• supply directly to a patient by a dental hygienist or therapist under a Schedule 17 exemption, for patients receiving either NHS or private treatment
• supply directly to a patient by a dental hygienist or therapist under a Patient Group Direction (PGD), for patients receiving either NHS or private treatment
• sale of a General Sales List (GSL) medicine directly to a patient
• sale of medical device directly to a patient

See Supply and administration of medicines by staff group (A to G) for a list of the supply mechanisms each member of the dental team can use.

For further information see our pages

• Supplying Prescription Only Medicines: advice for dental teams
• Supplying P and GSL medicines: advice for dental teams
• Supplying medical devices: advice for dental teams

Classification of medicines

Licensed medicines in the UK fall into three categories. Different formulations and pack sizes of the same medicine may fall into different categories. The category for each product is specified in the BNF.

All original packs of UK licensed medicines are marked with the Product Licence number (PLXXXX/XXXX).

Prescription only Medicines (POM)

Manufacturer original packs must be marked with the initials POM within a box.

Examples of POMs used in dentistry include local anaesthetics, oral antibiotics, high strength sodium fluoride toothpastes, and betamethasone soluble tablets.

POMs are usually supplied against a prescription, but other mechanisms allow supply in a dental setting. Supplying Prescription Only Medicines: advice for dental teams explains when POMs can be supplied in dental practice.

Pharmacy (P) medicines

Manufacturer original packs must be marked with a P within a box.

Examples of P medicines used in dentistry include chlorhexidine dental gel (Corsodyl), benzydamine oral rinse/spray (Difflam) and hydrocortisone muco-adhesive buccal tablets.

P medicines are usually only supplied from a pharmacy but under some circumstances can be supplied from a dental setting. Supplying P and GSL medicines: advice for dental teams explains how and when P medicines can be supplied in dental practice.

General Sales List (GSL) medicines 

GSL medicines do not have a specific marking.

Examples of GSL medicines used in dentistry include some chlorhexidine mouthwashes (Corsodyl), fluoride mouthwash, small packs of paracetamol (16 tablets/capsules) and ibuprofen (16 tablets/capsules).

GSL medicines may be sold from various retail outlets, including dental practice. Supplying P and GSL medicines: advice for dental teams provides further detail.

Medical Devices

Medical device packaging must include the UKCA mark or CE mark. The packaging does not have a PL number because they are not medicines.

Examples of medical devices used in dentistry include some chlorhexidine mouthwashes (Curasept), saliva replacement products, and some fluoride varnishes (for example Fluor Protector S).

Supplying medical devices: advice for dental teams provides further detail.

Governance considerations

All dental practices must develop and follow good medicines governance policies and procedures as part of their clinical governance framework. This applies to all practices whether they hold an NHS contract or not.

These policies and procedures must detail all mechanisms used for prescribing, supplying, and administering medicines or medical devices to patients. This ensures that all healthcare professionals practise safely, competently and within the law. Legal mechanisms to supply and administer medicines to individuals) provides further detail.

Policies must cover all processes involving medicines, including:

• checking and documenting processes to ensure accuracy and to allow stock reconciliation
• Labelling and packaging medicines supplied by dental teams
• recording supply in the patient’s notes/record

The prescribing/clinical decision to supply a medicine and the action of supplying the medicine should usually be performed by different healthcare professionals. The same person should do both only if it is necessary in the clinical circumstances and is in the patient’s interests. A risk assessment must be in place, supported by appropriate documents, processes, and audit trail to limit errors.

A position statement and guidance have been produced by the Royal Pharmaceutical Society and Royal College of Nursing.

Recording supply of medicines or medical devices

Record the following in the patient notes/record for any product supplied to the patient:

• date and time of supply
• patient details such as name, date of birth, hospital or NHS number (where applicable), allergies, previous adverse events
• mechanism by which the product was supplied (for example, prescription, Schedule 17 exemption, PGD, protocol, sale)
• if supplied under a PGD or other protocol, the criteria under which the patent fits the protocol/PGD
• details of the product supplied, including name, strength, dose, route, manufacturer, batch number, and quantity supplied
• name and signature of dental professional supplying the medicine
• relevant information given to the patient/carer
• record whether consent was gained or refused and, if consent was refused, a record of actions taken

The Care Quality Commission provide additional information on Management of medicines in dental practice and Dental care records. See also the General Dental Council Standards and guidance from the College of General Dentistry (members only).

Legislation

Regulations and acts governing the supply of medicines and medical devices include:

• The Human Medicines Regulations 2012 (HMR 2012) – govern all aspects relating to medicines for human use, including legal categories, licensing, manufacture, sale and supply (who and how), labelling and packaging
• National Health Service Act 2006 – outlines NHS England’s role in providing dental care by commissioning services, including supply of medicines and prescribing, under a general dental services contract
• NHS (Charges for Drugs and Appliances) Regulations 2015 (the Charges Regulations) – outline when charges are due for drugs and appliances provided to NHS patients
• The Human Medicines (Amendments relating to Registered Dental Hygienists, Registered Dental Therapists and Registered Pharmacy Technicians) Regulations 2024 – amend Schedule 17 of the HMR 2012 to enable trained and registered dental therapists and hygienists to supply or administer listed medicines to individuals they are treating
• The Medical Devices Regulations 2002 (MDR 2002) – regulate medical devices, which are not subject to the HMR 2012.

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