The landscape of dental practice in Australia is constantly evolving, driven by new clinical evidence and a commitment to patient safety. The most recent milestone in this evolution is the release of the Therapeutic Guidelines – Oral and Dental Version 4 in September 2025.
For practitioners and candidates preparing for the Australian Dental Council (ADC) examinations, staying current with these updates is not just a matter of best practice—it is a requirement for professional success.
The Therapeutic Guidelines serve as the "gold standard" for clinical decision-making in Australia. The latest revision involved an extensive process with 16 expert group members and 12 external reviewers to ensure the advice is practical, evidence-based, and modern.
According to the latest summary from the ADC, these updated guidelines will come into effect for Written Examinations starting in March 2026. For practical examinations, general dentists will see these changes reflected from Period 2, 2026, while other dental professions will follow in June 2026.
The updates cover a broad spectrum of clinical areas, ranging from prescribing habits to the management of complex patient profiles. Here are the highlights:
One of the most significant shifts involves how we treat odontogenic infections. The choice of antibiotic is now heavily driven by the timing of the dental procedure.
Prompt Treatment (within 24 hours): Penicillin monotherapy is often recommended.
Delayed Treatment: A broader-spectrum approach (e.g., Penicillin plus Metronidazole) may be necessary to cover anaerobic activity.
Penicillin Hypersensitivity: The guidelines provide clearer pathways for assessing antimicrobial hypersensitivity, with Cefalexin preferred for non-severe cases.
New guidance for managing fractures and luxations includes emergency splinting techniques supported by a new library of photos. Notably, Amoxicillin is now the preferred choice for avulsed permanent teeth, replacing previous recommendations for other antibiotics like doxycycline (which is now reserved for penicillin-hypersensitive patients).
The update expands on "periprocedural" considerations. There is now dedicated content for treating patients with:
Cognitive disabilities and neurodegenerative diseases.
Obesity, liver failure, or kidney failure.
Obstructive sleep apnoea (emphasizing the dentist's role in screening and using mandibular advancement appliances).
The guidelines reinforce a non-pharmacological first-line approach to anxiety. When medication is required, the guidance supports the careful, consolidated use of minimal sedation with updated safety requirements.
The transition to Version 4 means practitioners must retire old habits and adopt these new protocols. The Therapeutic Guidelines website provides comprehensive tables, flowcharts, and printable figures to help clinics integrate these changes into their daily workflows.
For ADC candidates, this is a crucial time to update your study materials. Relying on outdated versions of the guidelines could lead to "critical errors" during your practical assessment or incorrect answers in your written papers.
The path to dental registration in Australia is rigorous, and keeping up with guideline updates is a full-time job in itself. Don't leave your success to chance.
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Changes to the Oral and Dental Guidelines. This video provides a detailed discussion between dental experts regarding the specific changes in Version 4, including prescribing rights and the management of patients with special needs.