The Faculty of Dental Surgery is urging school dinners in England to go sugar free.
It hopes this will help combat high tooth decay rates amongst school children.
The faculty has produced 12 recommendations to reduce tooth decay prevalence including:
- All schools in England to introduce supervised teeth-brushing schemes before 2022
- All schools to become ‘sugar free’
- Extending the soft-drinks levy to include sugary dairy drinks
- Limiting advertising and promotions for high-sugar products
- Reducing the sugar content of commercial baby foods.
‘It is incredibly worrying that levels of tooth decay among children in England remain so high,’ Professor Michael Escudier, dean of the Faculty of Dental Surgery, said.
‘Especially when you consider that it’s almost entirely preventable through simple steps.’
Free dental care
A campaign to remind parents how often to take children to the dentist is also recommended by the faculty.
The British Dental Association (BDA) has previously highlighted how parents are unaware that dental treatment for children is free.
Its figures show nearly 42% of children in England are missing out on free dental care.
‘It’s a scandal that tooth decay remains the number one reason for child hospital admissions,’ BDA chair, Mick Armstrong, said.
‘We will not see real progress until ministers start going further and faster on prevention.’
Almost six in 10 (57.7%) children between one and four years old didn’t visit an NHS dentist last year.
That’s according to analysis of NHS Digital data by the Faculty of Dental Surgery (FDS).
Almost half (41.4%) of children up to 17 years old didn’t attend an NHS dentist appointment in 2018.
‘It’s disappointing that nearly six in 10 one- to four-year-olds didn’t see an NHS dentist last year,’ Professor Michael Escudier said.
‘Children who experience early childhood tooth decay are much more likely to develop subsequent problems.
‘This includes an increased risk of further decay in both baby and permanent teeth.
‘It’s so important a child’s first interactions with the dentist are for simple check-ups rather than more serious treatment.
‘Just getting a child into the habit of opening their mouth for a dentist is useful practice for the future.’
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Representatives from the dental and care sectors met at the British Dental Association to discuss the findings of the Care Quality Commission report on the poor state of oral health in care homes.
Collaboration, education and awareness have been decided as the key components to improving oral health in care homes at a conference of dental professionals following a damning Care Quality Commission (CQC) report into the matter.
Smiling matters: oral health care in care homes is the result of six months of field work that began in October 2018, building on three to four years work within the sector. The CQC visited 100 care homes for the review and found that 52% did not have a policy to promote and protect oral health of their residents, while 17% didn’t review oral health on admission.
The report found that many people living in care homes are not being supported in maintaining and improving their oral health, and three years after the publication of the NICE guideline (NG48), oral health in care homes is still not a priority.
It also revealed that 39% of care home managers were not aware of the NICE guidelines about oral healthcare. Of the 28% who had heard of it, 39% felt they had fully implemented the recommendations and inspectors found many of the oral health plans lacked detail. And 47% of care homes visited admitted their staff didn’t receive any oral health training.
The conference, held at the BDA headquarters in London on 1 July, aimed to present the findings and evidence, and make the report’s recommendations a reality.
Janet Williamson, deputy chief inspector at the CQC, opened saying it is a ‘call to action in terms of what we can do to make a difference to people across England’.
She added: ‘Every care home we visited took very practical steps. In the next 12 to 18 months we want to review these findings and see if they have made a difference for those people in care homes.’
The report gave six recommendations for action:
- People who use services – their families and carers need to be made more aware of the importance of oral care
- Care home services need to make awareness and implementation of the NICE guideline ‘Oral health for adults in care homes’ a priority
- Care home staff need better training in oral care
- The dental profession needs improved guidance on how to treat people in care homes
- Dental provision and commissioning needs to improve to meet the needs of people in care homes
- NICE guideline NG48 needs to be used more in regulatory and commissioning assessments.
Antony Hall, head of inspection at the CQC, presented a summary of the findings and said the report is ‘a catalyst for improving the care sector and in the dental sector’.
He said: ‘Many of the care plans we saw were “support Mr X on his teeth” or “Mrs X needs her dentures cleaned at night”. That was the oral health plan. We did actually find a more comprehensive plan for hairdressing than we did oral health.
‘Homes looking after people with dementia were the most likely to not have anything in care plans around oral health, whereas the smaller homes looking after those with learning difficulties did have a plan in place. People didn’t know how to complete assessments, there was no training so it didn’t get completed.’
Mr Hall also addressed the monetary factor of who pays for dental visits, both for the care home resident and the dentist themselves.
He said: ‘When someone enters the care home, the relationship with the dentist stops. More often than not the relationship only connects in an emergency or when someone is in pain. Who pays for this? Who pays for the care home to take two staff off the floor to accompany somebody to a dental surgery? Is it the family? It the person’s own budget? Is it the care home? No one was quite sure.
‘From the dentist’s perspective, who is going to pay for this? We don’t get paid for going in a care home: some dentists say they don’t know how to deliver this treatment.
‘This isn’t a blame game of [singling out] one individual part of the system – it’s all of our business to make sure good oral health has a greater priority and becomes all of our responsibility.’
To assess and reflect on the report’s recommendations, CQC senior national dental adviser John Milne chaired a panel session consisting of Charlotte Waite and Martin Woodrow from the BDA, deputy chief dental officer Janet Clarke, Carol Reece of NHS England, Anita Astle of the National Care Association and Sandra White of Public Health England.
Charlotte Waite was first to speak, saying: ‘We must strive to break down barriers to care and end the postcode lottery. We need a true collaboration across health and social care, ensuring that care and services are underpinned by robust needs assessments and adequate commissioning services.
‘This requires nothing short of a revolution in the approach to dentistry and oral care in care homes.’
Janet Clarke talked about the need for consistency and using the funds we have in dentistry in a flexible way.
She added: ‘The situation locally, oral health in care homes has been highlighted in the long-term plan. We saw the publication of the long-term plan implementation guide and that talked about a local system approach, which should be in place by November 2019. We need to get our local dental networks, local dental committees and our commissioners to work together.’
Anita Astle said: ‘My plea is let’s all get smarter. We need the guidance and the evidence space, but also we need it to be simple so everybody can embrace it.’
Sandra White spoke of the time she was called out to help a care home resident: ‘I have 21 years as a clinical dentist. I got a call from a care home at five to five on Christmas Eve to ask if I could look at a resident.
‘When I got there a lady couldn’t eat: she had a problem with her gums. But she had never had an assessment, never had her teeth cleaned, and I don’t think they knew she had a partial denture.
‘With some difficulty I took out the partial denture past all the bleeding gums and we cleaned her up. But this is what we’re talking about: when people are missed and can’t even eat their Christmas dinner.’
During the Q&A session, BDA chair Mick Armstrong suggested a need for better education and asked where the budget for this would come from.
In response, Carol Reece said: ‘It has to be a local decision. Primary care networks, local care network chairs, the whole community will make the decision on what needs to be commissioned to meet the needs of that local population. How can we utilise the resource we have available to us in the best interest of the patients?’
Call for unity
To close the conference, Dr Williamson called for unity in the profession and between the representatives from the various groups present.
She said: ‘What we have in front of us is a unique opportunity for people in care homes and their relatives. What matters is making sure granny has her toothbrush, or making sure grandad or uncle or aunt have the things they need. These people are very vulnerable and it’s for us to unite across the system to try to make a difference.
‘It’s easy for us to stand here and comment and say what needs to be done, but what matters is we collectively put our energy into solving that. It requires good leadership and behavioural change, and the leaders who will make this happen are in this room.’
To read or download Smiling matters: oral health care in care homes, visit www.cqc.org.uk/publications/major-report/smiling-matters-oral-health-care-care-homes.
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The first Cardiff Dentistry Show saw hundreds of attendees flock to Wales’ capital to learn what’s new in the industry and rack up CPD hours.
Hundreds of delegates descended on the first Cardiff Dentistry Show, which received praise for being the first general dental exhibition held in the city for many years.
The free-to-attend event, held at Sophia Gardens on 6 July, featured a number of mini ‘power’ lectures on various contemporary topics, and more than 40 exhibitors displaying technological and industry developments.
The FMC-hosted show also saw more than 200 delegates get access to nine hours of enhanced CPD.
From the opening of the show at 9am, the lectures covered clinical, financial and business advice, and each aimed to pack as much information for attendees within their 20-minute allocation, though some struggled to keep within this limit with the high quantity of good advice they had to share.
On the patient side of things, DDU deputy head Leo Briggs talked about the importance of communicating with challenging people: that patients mostly care about the results of surgery so you should discuss the treatment with them rather than present, the need for your practice to have a solid complaints procedure, and why you should keep good records.
Les Jones, marketing director at Practice Plan, said while a patient with a plan in place is more valuable and reliable, ‘the first thing to think about when growing a plan is everyone in the practice has to think it’s the right thing for the patient’.
Kevin Lewis lectured about his ‘magnificent seven’ tips for keeping your patients happy, including how to trust your instincts and not think you are smarter than them, embracing change, and being good at the right things. In terms of keeping yourself free from legal action, he said to remember to treat the patients not their teeth because ‘teeth don’t sue you, people do’.
Looking practically, Barry Oulton delivered a 20-minute solution to parafunction that he followed with a demonstration of applying a sleep clench inhibitor at the S4S stand, which attracted a big crowd.
Towards the end of the day, Nicky Ricketts from DD gave a detailed talk about infection control, highlighting the importance of prevention, and why staff should be aware of the details of safety protocols and read them, not just acknowledge they exist.
As well as the lectures, delegates were able to visit stands headed by some of the biggest names in dentistry. In addition to technology and equipment displays, there were financial and dental plan organisations on-hand to explain the services they provide.
Those who attended praised the event for delivering brief but insightful lectures, giving the opportunity to check out some of the latest technological developments and gain industry advice.
Attendees also welcomed such a show being held in Cardiff, being located close to where they live or work.
Raid Ali, a dentist based in Cardiff, said: ‘It’s really nice to start to see Cardiff host such a thing, because the nearest shows held are in Birmingham or London. This is the first time and FMC are always good with these things, as it was them that started everything like this: the Private Dentistry Show, the Implant Dentistry Show, CPD Essentials, so it’s nice of them to think of Cardiff.’
Suzanne Noorbhai, who lives in Cardiff and works as a dentist in Hereford, said: ‘I like the idea of quite short lectures – that’s good. I’m learning quite a bit and it’s small, I like that, so you don’t get too lost with it. It’s close to me – I live nearby – and it’s good that it’s free. I learned a lot of information; not just clinical, but financial as well.’
Said Albakov, a student at the University of Bristol, said: ‘I think the lectures were really interesting. I like how the stands were accepting that we were students and keen to show us around. What I wanted to see was the new technology and how dentistry is progressing.
‘With the lectures, they encourage you think in different ways and I’m interested in a few books they mentioned, so I might get those, too.’
Rebecca Pallin, also a student at Bristol, agreed with how accommodating the show was. She said: ‘You came away from each lecture feeling more inspired and that you could apply them yourself.
‘All the stands were really engaging and it was never too big of an ask for them to help. They have some of the major technology here, specialty wise, and they really go into a lot of detail even though I’m just a student.’
Registration for the 2020 event in Cardiff on 4 July opens soon. Visit www.cardiffdentistryshow.co.uk for more details.
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Kevin Lewis warns how commoditisation is the greatest threat to the future of UK dentistry and we are unsure where things are going.
The internet has a lot to answer for. I will refrain from calling it (and anything that flows from it) ‘new technology’ simply on the basis it didn’t exist back in the day when my fellow baby boomers and I were dependent on ‘old technology’. And anyway, my go-to expert on these things, Paul Redmond, assures me anything that is around while you are growing up, is not even ‘technology’, let alone ‘new technology’. It’s just ‘stuff’.
Paul has a sure-fire generational acid test for one’s relationship with technology. You fail the test if you ever refer to possessing a ‘mobile phone’, and you pass the test if you regard the adjective ‘mobile’ as superfluous. It’s a phone. You graduate with honours if you find the adjective positively confusing: after all, was there ever a time in history when a phone was not ‘mobile’? Please don’t feel compelled to answer that question – nor indeed to ask it. My feelings are easily hurt.
There will be those among our readers who, like me, remember a time when all phones needed to be linked by a cable to the wall. Then came the technological miracle of phones that didn’t need the cable. Or the wall. The phones were mobile in a sense, I suppose, but only actually portable if you had a couple of Sherpas on hand to carry the battery packs for you.
The internet has certainly been the essential transformative tool for the information revolution. It puts a boundless range of information at our fingertips, 24/7 and (almost) wherever we happen to be at the time. It makes it easier and more convenient to compare products, and often cheaper to buy and sell, and do business generally.
But, as has become increasingly apparent, it has also become the platform for access to misinformation: the internet makes it easier to access fake news, scam and ‘lookalike’ websites purporting to be genuine ones (but just as keen to accept your money).
It is easier to mislead and deceive others, easier to access bigger slices of the population and – here’s a paradox – easier for dishonest people to remain anonymous, but more difficult for innocent people to maintain their privacy. It is a funny old world, but at least you can get lost with much greater accuracy.
The internet has, of course, been a catalyst for rapid social change as much as technological change and a valuable adjunct to education and for self-improvement.
It has transformed the way many of us find out about things, compare things, and decide how and from whom to buy goods and services. It has sounded the death knell for some businesses, and the dawn chorus for others.
One business at a time, it has been dismantling the cohesiveness and inter-dependence of the traditional high street, while simultaneously empowering the ‘no street’ virtual business community.
But where does dentistry fit into all of this? Unlike many of the products gracing the shop window of the internet, the sharp end of dentistry hardly lends itself well to search engines. You may be able to compare different prices for precisely the same seat on the same flight, or for the same hotel room, or dishwasher, or lawnmower, and so on, but searching for the cheapest molar endo in town makes about as much sense as searching for the cheapest heart bypass. Even if you could find it, who would want it?
Furthermore, 99% of dentistry is necessarily delivered from a physical location, by and to real people in real time – and therein lies the crucial difference between one source of dental services and another. These are attributes that can only be assessed at first hand. That should be the end of the story, yet primary care dentistry has been increasingly sucked into the dangerous and short-sighted world of commoditisation.
The lure of the internet has been enough to turn intelligent graduates into masters of hype and unthinking imitation.
It is hardly surprising dentists so often break the basic rules of business because they didn’t feature on the dental school curriculum. It is easy to be thrilled with the success of your ‘deal of the day’ promotion if you don’t grasp the difference between turnover and profit.
A restaurant that aims to be the cheapest in town, with so many special offers that it redefines the meaning of ‘special’, has a completely different business model to the high-end restaurant that prides itself on exclusivity, impeccable service and quality – and charges accordingly.
The first enterprise needs to be full all day, every day, to repair the damage inflicted by the low price it has committed to. The latter can not only afford to have tables sitting empty, it makes it heaps easier to satisfy people who show up. Less obviously, it has already priced for the empty tables. In the first model, food is made a commodity and price is all they have left to compete on. In the second, you are buying something altogether different, and the food itself is only one part of it.
Promising top quality at lowest price has always been the strategy of fools and/or deceivers. The NHS does it, of course, but the key difference is that it promises that you will deliver top quality, while it is paying you the lowest price. Not the same thing at all.
Nevertheless, a cursory review of a selection of dental practice websites reveals dentists talk a lot about the range of ‘products’ they offer and some talk quite a lot about themselves – as if to avoid the trap that they are offering essentially the same list of products as others.
The payoff for bigging up yourself, your skills, your knowledge, training and experience is that you fall short at your peril. The bigger the bigging, the deeper the hole you have dug. You may – in theory – attract more patients, but they will all be patients with much higher expectations than they might otherwise have had.
So good luck with that! Whenever you unilaterally raise the bar, you set yourself up to fail and disappoint; but to make matters worse, your failure doesn’t sit quietly and privately in the shadows as might once have been the case. Yes, you will get complaints, financial disputes and, perhaps even litigation to deal with, but more damaging is the negative feedback that gets posted – sometimes without your knowledge – on a plethora of online feedback portals and across social media.
Genie in a bottle
I genuinely believe commoditisation presents the greatest threat to the future of UK dentistry and, like the proverbial genie in the bottle, we can never be quite sure where things will finish up, now that the cork is out (we won’t be offered three wishes, that’s for sure).
Commoditisation manifests itself in surprising ways and one of them is that once you have reduced something to a mere commodity, you can use your metaphorical search engine to seek out the cheapest provider. We have unwittingly been facilitating that process, and the direction of travel is that primary care dentistry is becoming disaggregated into a series of products and services, and then streamed into simple, intermediate and complex.
You can work out for yourself whether third parties (whether government, patients or others) will want a specialist or a ‘tier two’ provider, or any registered dentist or someone else, to provide them.
That ‘someone else’ is worth keeping a close eye on, because that may well prove to be the end game.
Read more from Kevin Lewis:
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Taking large doses of vitamin D during pregnancy could improve the oral health of children.
A clinical trial split 600 women into two groups, one taking vitamin D supplements and the other taking a placebo.
Six years later children of the women that took vitamin D experienced a 47% lower rate of enamel defects.
‘You can’t have cavities without first having enamel defects,’ senior author and professor of paediatrics at the University of Copenhagen, Dr Hans Bisgaard, said.
‘This is an extremely robust finding, and I have no doubt that it does not come by chance.
‘By age 10, we will see plenty of cavities and this same protective effect.’
Defects in tooth enamel effects 38% of school-aged children, the research states.
The research stops short of linking vitamin D supplements with the prevalence of caries in children.
Researchers also point out the study could be limited by bias due to it being unblinded.
‘This (research) suggests prenatal high-dose vitamin D supplementation as a preventive intervention to reduce the prevalence of enamel defects with a significant potential effect on dental health,’ the study summarises.
Public Health England (PHE) advises that 10 micrograms of vitamin D are needed daily to help keep healthy teeth.
This advice is based on the recommendations of the Scientific Advisory Committee on Nutrition (SACN) following its review of the evidence on vitamin D and health.
‘A healthy, balanced diet and short bursts of sunshine will mean most people get all the vitamin D they need in spring and summer,’ Dr Louis Levy, head of nutrition science at PHE, said.
‘However, everyone will need to consider taking a supplement in the autumn and winter if you don’t eat enough foods that naturally contain vitamin D or are fortified with it.
‘And those who don’t get out in the sun or always cover their skin should take a vitamin D supplement throughout the year.’
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Anna Olczak calls on dentists to lead the fight with dentistry’s reliance on single-use plastics.
Like me, most of the dentists I know are really ethical. In fact, at our fully private practice, Tooth in Waterloo, our whole vision and ethos is shaped around ethical dentistry. But, aside from doing everything we can to give exceptional ethical patient care, there’s always been something else which hasn’t sat right with us – namely, the sheer amount of single-use plastic we have to use and dispose of every single day.
As the world wakes up to the plastic crisis, it feels like the dental sector is dragging its heels. And whilst it’s obvious why plastic clinical disposables can’t be recycled, and whilst we know that they aren’t adding to the staggering 8 million metric tonnes of plastic that goes into our oceans each and every year (as clinical waste is incinerated), the continued use of single-use plastics in dentistry and elsewhere, still has a big environmental impact. What’s more, using plastic irresponsibly doesn’t reflect Tooth as a brand nor as a business, and being based in the heart of a forward-thinking and cosmopolitan city, we don’t feel it reflects well with our patients either.
Tooth’s War on Plastic
As a practice we’ve worked with the team and with our suppliers to do what we can to help reduce our single-use plastics and we’ve come up with a 10 point pledge and launched our ‘Tooth’s War on Plastic’ campaign.
We’re realistic and we know that these 10 steps alone unfortunately will not change the world and we also know that there will still be lots of plastic waste at our surgery, but we also deeply believe that if every single dental surgery made these small changes, not only would the world be a better place, but also suppliers would stand up and listen, and it could be just the nudge that the dental industry needs right now.
Here’s our 10 point pledge:
- Give all of the team refillable Chilly’s water bottles
- Replace our patient cups with compostable plant-based cups
- Replace our plastic 3in1 tips with autoclaveable tips
- Trial new eco plastic-free suction tubes
- Start selling bamboo eco Tepe alternatives
- Discuss dental plastic waste with suppliers and industry leaders
- Start selling bamboo eco toothbrushes
- Place an additional recycling bin in the clinical area for non-clinical recyclables
- Explore additional alternatives to cut our plastic waste
- Talk to customers about our campaign and why we are doing it and share best practice.
All of these actions are easy to do and have a direct and immediate impact. True, they aren’t the cheapest way to do business, but can we really put a price on our planet’s health?
Developing and starting with the pledge has also been great for business. We had no doubts that our patients would love it, but an unforeseen additional benefit was team morale. Not only did the team absolutely adore their beautiful and bright new Chilly bottles (each chose their own designs), but also the level of team engagement was amazing! Loads of ideas were shared on our Tooth gang Whatsapp group from the whole team, and even a former team member who saw the campaign on our social media channels got in touch to ask where we were sourcing our wonderfully cute Decent Cups – which are entirely plant-based and compostable too, so they could share the details with their current practices as they too were concerned with plastic waste in dentistry.
Calls for change
It hasn’t been an entirely easy journey though. One challenge that we found with the campaign was from the supplier and manufacturer end of the chain. The learning was that it’s incredibly hard to find eco versions of most of the disposables we use. Our main supplier (who were really engaged with this campaign and helped us source some of the products), doesn’t, for example, stock eco-friendly cups.
This led us to think that surely these dental manufacturers and suppliers have a duty of care to bring these products into the world of dentistry and make them not only widely available, but also affordable? Well at Tooth we certainly think so!
Whilst at Tooth we’re happy to eat into our profits a bit to make these changes, we know that not every practice will be willing or able to do this, so what we really need is a level playing field to make this work – in quality, availability and pricing. To help make this happen, we will be writing to each of our suppliers and the lead dental disposable manufacturers to call for this.
It’s not to say that there haven’t been any changes seeping through though, but the question is are these changes soon enough and big enough?
We’ve seen big manufacturers like Tepe introduce some eco products, but can you imagine how many Tepe’s are thrown away in surgery demos and households every single day? Whilst Tepe recently advertised a Tepe recycling trial in partnership with Cannon Hygiene, by the time we went to register the scheme was already closed. I wonder how many other surgeries missed this opportunity.
I don’t want the dental sector to get left behind in this fight, and that’s why my team and I at Tooth are calling on all dentists, hygienists, and practice owners and managers to make the change, or make some change. Our planet needs you too.
Let us, as a sector of trained professionals, lead, not follow. Let us show that the current situation isn’t good enough and let us show our patients that truly being ethical extends beyond our dental treatments and patient care.
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This article explores the options dental professionals have in order to remain current when it comes to the latest evidential findings in relation to oral health (brought to you by Johnson & Johnson, the makers of Listerine).
The General Dental Council’s continuing education requirement for registered dental professionals changed in 2018, including the need to have a personal development plan (PDP), to spread the hours evenly over each five-year cycle, to align activity with development outcomes and to ensure continuing professional development (CPD) corresponds to individual fields of practice (GDC, 2017).
This enhanced CPD (ECPD) essentially requires four elements – to plan, do, reflect and record, whilst the old system could be described as a ‘[…] method of simply doing and then recording CPD activities […]’ (Brindley, 2018).
Placing this need into everyday context, Brindley (2018) wrote: ‘The requirement for professional development will never be complete. The evidence base that underpins our professional development is continually evolving and as such our ability to learn and develop is an intrinsic part of professional life. In order to identify Enhanced CPD activities, we should take time and effort to move past the basic question of “what do I need to learn to get through the day?” and instead look to finding activities that facilitate us with opportunities to live a worthwhile professional life’.
Sourcing quality education
The Royal College of Surgeons (England) states that: ‘People learn through study, experience, personal reflection and shared learning. Lifelong learning is not just about going on courses and it is now possible to access a wide range of learning opportunities including those involving IT’ (www.rcseng.ac.uk, 2019).
In line with this ethos, it suggests the following as possible sources for Enhanced CPD (www.rcseng.ac.uk, 2019):
- Formal education providers
- E-learning activities
- Postgraduate lectures and hands-on courses
- Distance learning
- Reading information
- Common interest groups
- Special interest groups.
Maguire and Blaylock (2017) suggest that: ‘Carrying out an assortment of CPD activities to achieve specific learning objectives is likely to be more successful than one-off occasions.’
However, they also acknowledge: ‘[…] study leave from training or clinical practice is limited in nature due to contractual restrictions, clinical work requirements and the financial considerations involved with attending various events, so dental professionals should examine what they will acquire through attending the event or course which gives […] CPD.’
Personal development plans
Taking the time to reflect on your role, the tasks you perform, your career progress and then evaluating your professional development is an important aspect of delivering the best possible standard of care to patients.
On this subject, the www.dentalnursenetwork.com (2019) states: ‘Completing and utilising a personal development plan (PDP) effectively can help support you on your road to progression and what you really want to achieve. It can give you, as an individual, structure, focusing on quality and accountability, which are significant considerations in terms of future goals, not only for the individual, but for a dental practice too. A PDP is a method for identifying your developmental needs and devising the best solutions to achieve this development.’
It has been acknowledged, however, that this can seem a daunting exercise and, to help overcome this, it has been suggested that it may be useful to reflect on the following ideas (www.dentalnursenetwork.com, 2019):
- What are you good at?
- What could you do better?
- What do you think you could change to benefit your practice?
- Do any patients make you feel uncomfortable or uneasy?
- Has a patient asked you something you don’t know the answer to?
- Have you ever needed to look anything up?
- What issues have been raised in your appraisals?
- Does your practice run effectively? The best it can?
- What doesn’t run well in practice?
- Have there been any significant events in practice?
- What are the practice development priorities? How do they affect you?
When it comes to creating the PDP itself, this is a document personal to each individual and can take a form that suits you, but must include (GDC, 2017a):
- What CPD is planned to be undertaken during the cycle, including CPD that is relevant to current or future field(s) of practice
- The anticipated development outcomes linked to each activity
- The time-frame for completing each component in relation to the CPD cycle.
There are example documents available online to help dental professionals complete their PDP, including on the GDC’s website (GDC, 2017a).
Dentistry is always advancing and changing, leading Maguire and Blaylock (2017) to write: ‘Once the dental professional has completed the goals set out in their PDP, these should be reflected upon to ascertain how useful the new knowledge or training was, how it can be applied to current or future practice, and to identify potential areas for future development or learning needs. The individual would ideally also reflect upon the method used to achieve these objectives so that it aids future learning decisions. This strategic thinking ensures that time and energy is directed towards learning activities that address the goals or objectives which need to be challenged.’
Brindley J (2018) The role of reflection in ECPD. BDJ Team (5) 18027: 21-3
GDC (2017) Enhanced CPD guidance for providers
GDC (2017a) Personal development plan: GDC template
Maguire W and Blaylock P (2017) Preparing a personal development plan for all members of the dental team. BDJ 223(6): 402-4
www.dentalnursenetwork.com/news/dental-nursing-library/646-personal-development-planning.html (2019) accessed 14 January 2019
www.rcseng.ac.uk/dental-faculties/fds/nacpde/overseas-qualified-dentists/personal-development-plan/ (2019) accessed 14 January 2019
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A glass of wine has topped the poll as the UK’s favourite alcoholic beverage, according to a Yougov poll.
The survey found that 81% of people in the UK had consumed wine in the past 12 months.
Beer was the nation’s second favourite drink at 79%, closely followed by spirits also at 79%.
‘These findings put to bed the outdated stereotype of wine as a preserve of the middle classes,’ wine writer, Helena Nicklin, said to The Sun.
‘They show clearly it’s the nation’s number one alcoholic drink.’
Sauvignon Blanc and Pinot Grigio were the nation’s favourite wines, closely followed by Malbec, Shiraz and prosecco.
The survey was carried out by Wine Drinkers UK, a campaign group aimed at reducing duty levels applied to wine.
It says tax rises on wine in the last decade (39%) have ‘far outstripped those on beer (16%) and spirits (27%).’
Alcohol consumption guidelines
Last week the government announced alcoholic labels will contain updated advice on low risk drinking guidelines.
The chief medical officer advises not to drink more than 14 units of alcohol per week on a regular basis.
If drinking more than 14 units the CMO recommends spreading consumption evenly across three or more days.
‘People often do not know the damage that regularly consuming more than 14 units a week can do to their health,’ chief medical officer Dame Sally Davies said.
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Almost 40% of dental claims made in 2018 relate to cases where treatment started 10 or more years ago.
That’s according to Dental Protection, which says these claims are also for larger amounts of money, sometimes up to £100k.
Many of these claims involve allegations relating to the management of periodontal disease and caries.
‘We clearly live in an increasingly litigious environment,’ Raj Rattan, dental director at Dental Protection, said.
‘Dentists need to be confident that they can request support from their indemnifier in 10, 20, or even 30 years time.’
Dental Protection believes the claims environment will continue to be challenging due to changing patient expectations.
It also points to claimant law firms actively targeting periodontal claims and long-term care.
This, it says, is due to an increased understanding of the importance of record keeping.
‘To learn more about the nature of periodontal claims and what can be done to reduce the risk of a claim,’ Mr Rattan continues.
‘Dental Protection members can take a free online e-module and also join a webinar on 17 September.’
Top five claims
Earlier this year the Dental Defence Union (DDU) listed the top five aspects of dental treatment that resulted in claims.
The top five reasons include:
- Extractions (24%)
- Root canal treatments (20%)
- Caries and fillings (17%)
- Periodontal disease (10%)
- Implant treatment (9%).
‘A lot has changed in the dental landscape in recent years,’ John Makin, head of the DDU, said.
‘Despite this, many of the allegations of clinical negligence made against DDU members relate to routine aspects of treatment.
‘There are steps dental professionals can take to minimise risks if they understand where issues can arise.’
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Jon Cowie talks about the advantages of reciprocating file systems over hand files.
As a specialist endodontist I work primarily in a referral practice, as well as being a part-time clinical instructor for the MSc in endodontics at King’s College, London. Along with my business partner, Luca Moranzoni, we run an endodontic training company, Contemporary Endodontics, which specialises in running hands-on endodontic education courses. We get to hear first-hand about the challenges general dental practitioners encounter along the way, especially when it comes to the transition from hand files to reciprocating systems such as Waveone Gold.
Making a change for the better
One of the primary advantages of a reciprocating file system is its usability. Rather than struggling from a size 10 to a 15 to a 20 hand file, the simplified rotary sequencing with the Waveone Gold Glider provides a nicely expanded glide path. Followed by the Waveone Gold Primary file this becomes a far more straightforward sequence, which significantly reduces the risk of transportation of the root canal, results in less canal preparation errors and allows for more consistent root filling.
Another advantage of a reciprocating file system is how few files are needed to complete treatment. With Waveone Gold, in the majority of cases, just three files are needed to complete treatment – a size 10 hand file, Waveone Gold Gilder and a Waveone Gold Primary file.
Quality is key
One of the most important things for me as a specialist endodontist is the quality of the endodontic instruments I use in daily practice. Talking to our delegates, some may try cheaper file systems but soon find they need to use more files to complete treatment. Using a single well-made instrument instead is considerably more cost-effective in the long run rather than if you have to continually discard inferior instruments that are unwinding or becoming fatigued more quickly.
Waveone Gold Glider makes treatment easier and more comfortable for the patient and GDPs. The results are more predictable and from a purist’s point of view I believe it respects the canal anatomy far better than hand files.
The Waveone Gold Glider has completed the Waveone Gold family. It’s a very simple file to use, very quick and what really sets it apart is its ability to be pre-bent, a real bonus especially on challenging access cases or where a patient has limited opening. It makes the transition to the Waveone Gold Primary files for canal shaping very smooth and straightforward. Waveone Gold has definitely become my file system of choice.
To find out more about the Dentsply Sirona extensive range of endodontic solutions please visit dentsplysirona.com/endodontics or call 01932 838 338.
You can visit the online Dentsply Sirona Academy for a wide range of education resources, video tutorials, courses and CPD webinars at dentsplysirona.com/ukeducation.
Earn Dentsply Sirona Rewards on all your endodontic solution purchases at dentsplysirona.com, all the solutions you need under one roof.
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