Article: Volume 47 Number 11 Page 900 - December 2020

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  Dent Update 2020; 47: 900-905

Guest Editorial:  Moving on from AAA: the 3Ps and 3Rs protocol for remote management of dental patients

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Abstract: With the coronavirus disease 2019 (COVID-19) pandemic limiting movement, and dental services being somewhat reduced, there is a need for remotely managing patients through teledentistry. The ‘advice, analgesics, antibiotics’ (AAA) protocol has become common practice but concerns have become apparent on its application, as some patients’ needs are not met, sometimes with potentially serious consequences. Throughout different phases of the pandemic, there may, at times, continue to be a need to minimize direct clinical contact with a patient, while safely managing their care. We suggest an alternative protocol for the remote management of the dental patient: the 3Ps and 3Rs, namely phone, photo, prescription and record, refer, review. This modified protocol has the potential to improve safe patient care throughout the current crisis and beyond, by providing an enhanced structure to the remote management of the dental patient.

Clinical relevance: The current widely practised 'AAA' clinical protocol may be appropriate for some patients, but also has scope for much improvement. An alternative acronym is suggested, presenting an improved structure for how a dental patient could be managed remotely.

Author notes: Samy Darwish, BSc, BDS, MSc, MClinDent, LLM, DipDSed, MFDRCS, MRDRCS, FDSRCS, Specialist Oral Surgeon and Specialist Periodontist, Dakatra Ltd, London. email:

Objective: To reflect on the currently widely practised AAA protocol for the remote management of dental patients and to consider an alternative structured approach with a memorable new acronym.

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