The World Health Organization classifies edentulism as a disability. This CGDent webinar unpacks the details of this disability, looking at both qualitative and quantitative research in this field. The quality of life of these individuals, both before and after all the teeth are lost, is discussed, along with treatment modalities, from the most commonly provided conventional complete dentures, to management with dental implants for both removable and fixed prosthodontic solutions.
The webinar is hosted by Dr Amin Aminian FCGDent, a Specialist in Prosthodontics and guest editor of the ‘Implant dentistry (part one)’ issue of the Primary Dental Journal, published in Autumn 2024.
Speaker:
Dr Sarra Jawad, Consultant in Restorative Dentistry at Guy’s and St Thomas’ NHS Foundation Trust.
Dr Sarra Jawad is the author of ‘The edentulous patient: the impact of implants on quality of life’, which was published in the ‘Implant dentistry (part one)’ issue of the Primary Dental Journal, in Autumn 2024.
Members of the College can access the article in the PDJ online library by first signing in to their online account and then visiting the PDJ Library webpage.
It was free to view live for all dental professionals, and College members also have free access to the recorded webinar and can claim CPD hours for free. A £20 fee will apply for non-members who wish to claim CPD.
Membership of the College of General Dentistry is open to all registered dental professionals. Membership is available from £130 for dentists, £44 for dental nurses and £87 for other registered dental professionals. The full list of CGDent membership rates is here
The College and Haleon have published a report on improving the provision of preventative oral healthcare.
Preventative care is defined as proactive dental care and advice that helps a patient to take action to maintain a healthy mouth, protecting against tooth decay, gum disease and more serious issues such as tooth loss and negative impacts on general health. The new report, The Dental Health Barometer, provides recommendations based on the experience and insight of general dental professionals on how to bridge the gap between intentions and practical delivery.
The underlying research began last year with a survey of 2,000 UK dental patients and over 500 dental professionals which highlighted inconsistencies in the provision of preventative oral healthcare advice. (A poster summarising those findings is available, as is a webinar examining them in more detail). This has since been built upon with rich discussions held with 77 oral health professionals, from all dental team roles, in focus group meetings hosted at eight general dental practices throughout the UK.
The most consistent finding is that oral health professionals seek redesigned NHS contracts to allow for more time and financial support in giving preventative oral care advice. The research also finds that the profession would like to see more resources devoted to providing nationwide preventative oral healthcare education, and a national communications campaign to tackle oral health misinformation.
The report highlights wider societal barriers to improving preventative oral care, such as competing social media narratives around oral health, diet and appearance; the erosion of long-term patient relationships; a continuing professional skew in some practices towards clinical treatments; and a tendency among non-dental health professionals not to deliver basic oral health messages.
The creation of a consumer-facing version of the Delivering Better Oral Health toolkit
Working with non-dental health professionals such as health visitors and midwives to inform them of the benefits of preventative oral care
Greater provision of CPD on the delivery of preventative care
Encouraging businesses to provide dental cover to employees
Celebrating team members such as dental hygienists in the mainstream media
Better use of digital communications such as apps and video streaming platforms
Roshni Karia MCGDent, President of the College, said:
“Our focus groups found that many dentists may feel that they are conducting a lonely battle against entrenched patient habits around oral health care, and doing so within NHS contracts which are unfavourable to providing adequate preventative advice. Our work with Haleon highlights the need to take action to support oral health professionals in a real time of need.”
Bas Vorsteveld, Vice President of Haleon and its General Manager for Great Britain and Ireland, commented:
“With a new Prime Minister in 10 Downing Street, our findings could not come at a more pivotal time for the future of dentistry in the UK. Working alongside the College of General Dentistry, we outline the key opportunities, our jointly developed solutions to safeguard the future of preventative oral care provisions for UK consumers and oral health professionals alike. We welcome the new Labour government’s plan to rescue the UK’s dental sector, but we urge them to go further and make NHS contracts fit for purpose by prioritising prevention. Only by working alongside the profession and industry can the new government make the step-change that UK dentistry clearly needs.”
Haleon, formerly the consumer healthcare division of GlaxoSmithKline, is the manufacturer of well-known oral health products such as Sensodyne, Corsodyl, Aquafresh, Poligrip, Biotene and Parodontax.
The College and Haleon will continue to work together to advocate for improvements in the provision of preventative oral healthcare.
The College and Haleon would like to thank all those College members who volunteered to host a focus group in their practice, and all the members, colleagues and patients who participated in the research.
As it approaches its 50th issue, the journal’s longstanding Editor, Professor Igor Blum, will be standing down in 2025, and the College is now seeking a highly accomplished individual to succeed him.
The Editor is the academic lead of the PDJ. They commission individual themes and papers, appoint guest editors, authors and peer reviewers, and act as decision maker in editorial matters, giving final approval of all content and issues. They are also the public face, representative and main spokesperson for the PDJ, helping to ensure that it continues to be seen as a leading journal for primary dental care and that it fulfils its aims as well as those of the College.
The ideal candidate for the role will be a clinically active dental professional who is qualified to consultant level and has experience encompassing primary care, secondary care and academia. A full person specification and role description is available below:
Applications should be made by CV and a covering letter addressing the requirements described in the role profile. This must be received by Friday 18 October 2024, addressed to [email protected]. Interviews will then be held.
There is no fixed term for the role, and it is intended that the successful candidate will be in place by December 2024. Initially this will be as Editor designate to work with the current Editor on the development of journal issues for publication in the second half of 2025.
The NAO’s London office, the Grade II listed former Imperial Airways Empire Terminal
The public spending watchdog, which supports Parliament in holding government to account for its expenditure, is in the process of looking into how the previous government developed its ‘Dental Recovery Plan’ for NHS Dentistry, what progress has been made since the plan was announced, and how the government plans to evaluate and monitor its impact.
The College was among the organisations invited to give evidence on the extent and nature of any involvement of the profession in the development of the dental recovery plan; what opportunities there have been to engage with the ongoing delivery of the plan; and how it assesses the likely impact of specific measures in the plan.
The Dental Recovery Plan, announced in February 2024, set out a range of initiatives, both new and previously-announced, intended to help tackle some of the many longstanding problems facing NHS dental provision in England. These included a Smile For Life programme, a new patient premium, mobile dental vans, the use of private practices to deliver NHS care, a ‘golden hello’ for new graduates, an increase in dental school places, medicines exemptions for dental hygienists and therapists, an increase in the minimum value of a Unit of Dental Activity (UDA), more community water fluoridation, more places and sittings for the Overseas Registration Examination and Licentiate in Dental Surgery, faster entry to the NHS Performers List, provisional registration, and the identification of qualifications from outside the European Economic Area which meet the required standard for GDC registration.
The College was not involved in the development of the Dental Recovery Plan, and following its publication issued a point-by-point response.
An update on the new patient premium, minimum UDA value, ‘golden hellos’ and mobile dental vans was published by NHS England in May. The College continues to engage in discussions around introducing medicines exemptions and expanding community water fluoridation, both of which are longstanding government policy, and has also participated in early discussion of provisional registration.
The NAO is expected to publish its report later this year.
CGDent NextGen Ambassador and Associate Member of the College, Dr Choudhury Rahman, graduated from the University of Manchester in 2023 before moving into Dental Foundation Training. Here he offers tips to this year’s Foundation Dentists on how to get the most out of their training.
As I sat down waiting for my first patient as a qualified dentist, I debated how to introduce myself. Dr Rahman, or just Choudhury? I felt the same nerves I did when I saw my first patient as an undergrad, a sense of imposter syndrome. Am I really a dentist now?
When I think back to last year, having just graduated, I never thought I would have learnt as much as I have now, after just one year of FD training. Nothing quite prepares you for general practice.
The pace at which you learn and develop is unbelievable. From seeing three patients a day in the undergrad clinic to 20-30 in general practices, along with vast quantities of treatment. When people tell you that you’ll do more treatment in a month of FD vs the whole of undergrad, they aren’t joking.
Of course, the experience you get will depend on where you work. If you’re fortunate enough to work in an area of high needs like mine in Rochdale, you will get bags of treatment – lots of caries, restorations, extractions, and root canals. However, you may also work in an area where you can do more aesthetic work, or somewhere with great oral surgery experience.
Here are my tips on how to make the transition smoother and get the most out of your FD year:
Spend time making good treatment plans
Sit down with your Educational Supervisor (ES), discuss cases with them, and get help with deciding what treatment to do. This will be your biggest learning curve, deciding independently what treatment to do and when. The more experience you get doing this, the better you will be at planning by yourself over time. Remember, you don’t have to make it at your initial appointment, you can always bring the patient back for this.
Don’t worry about how long you need for treatments
Want to spend three hours doing a molar endo? Or two hours on some posterior composites? Do it. FD year is when you get the chance to spend as long as you want on the treatments you want to do. You aren’t paid by Units of Dental Activity (UDAs), you’re paid a fixed salary. Use the time you have to provide good, high-quality treatment, and then you can focus on building speed towards the later stages.
Push yourself with complex treatments
You will have the support of an Educational Supervisor by your side throughout the year. They are there to help you and guide you. Take on that difficult molar endo, and plan for that surgical extraction. It’s your one year where you have help at every step of the way if you need it.
Build a good relationship with everyone at your practice
From the receptionist, the practice principal, and of course, your nurses. If you build a good bond with your team, and look after them, they will look after you!
To make the best of your Foundation Training, I think it’s also important to plan some specific investments during the year. After five years of grafting in dental school, you can’t beat the feeling you get when you receive your first pay cheque as a dentist – you are finally being remunerated for your hard work. Not only that, if you haven’t earned any money during the current tax year, you won’t have tax deducted from your pay cheque for the first month or two! I’m sure many of you reading will be thinking of the holidays you want to plan or the new car you want to buy for yourself, but there are some key things that I recommend you invest in early which will set you up for the rest of your career in dentistry!
Loupes
If you haven’t already got a pair of loupes, I cannot stress enough the importance of buying some. The initial investment may seem steep, costing upwards of £2,000 for a good quality pair, but the return on investments is enormous. I got my loupes during 5th year of undergrad, and they have transformed the way I practice dentistry. I used to dread doing certain treatments because I just couldn’t see the fine details in certain procedures such as root canal treatments or crown preparations, however after getting loupes, these are now treatments I actually enjoy, and am able to do at a higher quality. Not only that, I have found my posture has greatly improved, especially since my loupes are refractive. To summarise, getting loupes will make your general dentistry more enjoyable, better quality, and potentially elongate your career by looking after your neck, shoulders, and back! I personally use the Bryant dental 3.8x Refractive loupes.
Camera
One of the first things I put money aside for was my own camera. Many of the training practices will have a camera lying about somewhere, but having your own is much better. You can set it up and leave it so you can easily and quickly take pictures whenever you need to. Photography is mega important in dentistry for several reasons. Firstly, it supports patient consent. By showing the patient what their teeth look like, and exactly the issues you are seeing, they are better informed in their decision-making, thus ensuring the consent you have obtained is valid. In addition to this, having before and after pictures for treatments is very useful medico-legally if you find yourself in some hot water (make sure your camera’s date and time settings are correct). Lastly, and most importantly, by taking pictures of your work, you can reflect on the good and bad things, finding ways to improve your work and develop as you go along. A bonus of having pictures of your work is that it enables you to compile a portfolio that you can use to show patients and future employers what you are capable of.
It may seem daunting at first when trying to figure out exactly which photography equipment to buy, as I found out for myself. To break it down, most camera set-ups will require a body, lens, and flash. My own build consists of the Canon 2000D body, 105mm Sigma lens with a Sigma ring flash (Pictured below). This is by no means the best set-up, however it’s a good place to start if you want to get into dental photography!
Income protection
I’m sure many of you guys reading will remember the Wesleyan finance lectures from undergrad – I think most of us will have attended just for the free food and goodies. At the start of your career, you will think and feel like you are invincible, but you never know what life will throw at you which could cause you to put your tools down. I recently sprained my wrist and didn’t anticipate how much impact this would have on my work. Thankfully I recovered quickly and fully, but imagine if you had a serious injury, accident, or decline in health. If dentistry was your only source of income, and you had dependents/bills to pay, you would be under immense stress trying to stop the ship from sinking. By having income protection, if life throws a curve ball at you, you will be in a better position to manage financially, allowing you to focus on yourself and getting back to work. As a Foundation Trainee, the NHS will provide some form of sick pay for a limited period, but by having an additional income protection, if for whatever reason you had an extended period off work, you could be paid a certain % of your earnings until retirement age. It is one of those things to have, which you hope don’t need to use it, but is there if you do!
Membership of the College of General Dentistry
As I spent my time going through Foundation Training, I felt more and more unsure of what I wanted to do with my career. I applied for Dental Core Training (DCT) but felt as though I enjoyed working in general practice. However, I knew that I wanted to continue expanding my skills through postgraduate training. That’s where the College of General Dentistry is really helpful. They provide an excellent framework to help you navigate the world of being an associate in general practice, helping you develop the knowledge and skills you require to progress your career in dentistry and foster a commitment to lifelong learning.
These are only some of the things which I recommend you invest in for yourself. There are many more investments you will make over your career such as your own equipment, materials and postgraduate training. You don’t have to do them all at once, or at the beginning. Don’t make yourself feel like you are behind if you see your colleagues or friends having invested in more of these things than you. Dentistry is not a race; you should learn, improve, invest and develop at your own pace. At the centre of this all is providing the best care possible for your patients, whilst also looking after yourself.
Overall, Foundation Training for me has been a tremendous experience. I was very fortunate to have an amazing practice and a supportive ES. FD training is a unique and enjoyable experience. You can practice all the things in dentistry you love, not worry about UDA targets or lab bills, and push yourself with challenging cases knowing someone has your back. But one thing is for sure, you will get out what you put in, and if you put in 100%, you will get so much out of your FD year.
I’ve been told by many colleagues that at this stage of your career, the world is your oyster. Yet it can be difficult to navigate and work out exactly what you want to do. Personally, having completed my year, I’m now working on becoming a well-rounded GDP, and with clinical interests including oral surgery and prosthodontics, I aspire to be able to provide full-mouth rehabilitation including placement and restoration of implants. Membership of the College reflects my commitment to becoming the best dentist I can be for my patients.
Our Student Advice and Careers blogs are written by members of the College and offer advice and tips, and share experiences with dental students and early career professionals.
CGDent NextGen Ambassador, Dr Choudhury Rahman, made some important investments during Foundation Training and shares his advice about investing wisely.
Ahhhh… the feeling of getting your first pay cheque as a dentist. Nothing quite beats that feeling! After five years of grafting in dental school, you are finally being remunerated for your hard work. Not only that, if you haven’t earned any money during the current tax year, you won’t have tax deducted from your pay cheque for the first month or two! I’m sure many of you reading will be thinking of the holidays you want to plan or the new car you want to buy for yourself, but there are some key things that I recommend you invest in early to help you get the most out of your Dental Foundation Training (DFT), and set you up for the rest of your career in dentistry!
Loupes
If you haven’t already got a pair of loupes, I cannot stress enough the importance of buying some. The initial investment may seem steep, costing upwards of £2,000 for a good quality pair, but the return on investments is enormous. I got my loupes during 5th year of undergrad, and they have transformed the way I practice dentistry. I used to dread doing certain treatments because I just couldn’t see the fine details in certain procedures such as root canal treatments or crown preparations, however after getting loupes, these are now treatments I actually enjoy, and am able to do at a higher quality. Not only that, I have found my posture has greatly improved, especially since my loupes are refractive. To summarise, getting loupes will make your general dentistry more enjoyable, better quality, and potentially elongate your career by looking after your neck, shoulders, and back! I personally use the Bryant dental 3.8x Refractive loupes.
Camera
One of the first things I put money aside for was my own camera. Many of the training practices will have a camera lying about somewhere, but having your own is much better. You can set it up, and leave it so you can easily and quickly take pictures whenever you need to. Photography is mega important in dentistry for several reasons. Firstly, it supports patient consent. By showing the patient what their teeth look like, and exactly the issues you are seeing, they are better informed in their decision-making, thus ensuring the consent you have obtained is valid. In addition to this, having before and after pictures for treatments is very useful medico-legally if you find yourself in some hot water (make sure your camera’s date and time settings are correct). Lastly, and most importantly, by taking pictures of your work, you can reflect on the good and bad things, finding ways to improve your work and develop as you go along. A bonus of having pictures of your work is that it enables you to compile a portfolio that you can use to show patients and future employers what you are capable of.
It may seem daunting at first when trying to figure out exactly which photography equipment to buy, as I found out for myself. To break it down, most camera set-ups will require a body, lens, and flash. My own build consists of the Canon 2000D body, 105mm Sigma lens with a Sigma ring flash (Pictured below). This is by no means the best set-up, however it’s a good place to start if you want to get into dental photography!
Income protection
I’m sure many of you guys reading will remember the Wesleyan finance lectures from undergrad – I think most of us will have attended just for the free food and goodies. At the start of your career, you will think and feel like you are invincible, but you never know what life will throw at you which could cause you to put your tools down. I recently sprained my wrist and didn’t anticipate how much impact this would have on my work. Thankfully I recovered quickly and fully, but imagine if you had a serious injury, accident, or decline in health. If dentistry was your only source of income, and you had dependents/bills to pay, you would be under immense stress trying to stop the ship from sinking. By having income protection, if life throws a curve ball at you, you will be in a better position to manage financially, allowing you to focus on yourself and getting back to work. As a Foundation Trainee, the NHS will provide some form of sick pay for a limited period, but by having an additional income protection, if for whatever reason you had an extended period off work, you could be paid a certain % of your earnings until retirement age. It is one of those things to have, which you hope don’t need to use it, but is there if you do!
Membership of the College of General Dentistry
As I spent my time going through Foundation Training, I felt more and more unsure of what I want to do with my career. I applied for Dental Core Training (DCT), but felt as though I enjoyed working in general practice. However, I knew that I wanted to continue expanding my skills through postgraduate training. That’s where the College of General Dentistry is really helpful. They provide an excellent framework to help you navigate the world of being an associate in general practice, helping you develop the knowledge and skills you require to progress your career in dentistry and foster a commitment to lifelong learning.
These are only some of the things which I recommend you invest in for yourself. There are many more investments you will make over your career such as your own equipment, materials and postgraduate training. You don’t have to do them all at once, or at the beginning. Don’t make yourself feel like you are behind if you see your colleagues or friends having invested in more of these things than you. Dentistry is not a race; you should learn, improve, invest and develop at your own pace. At the centre of this all is providing the best care possible for your patients, whilst also looking after yourself.
Author bio
“I Graduated from University of Manchester in 2023 and am just completing my FD Training in the Greater Manchester North Scheme. I’m also a NextGen Ambassador for the College of General Dentistry. My clinical interests include Oral Surgery and Prosthodontics. I aspire to become a well rounded GDP, able to provide full mouth rehabilitation including placement and restoration of implants. Outside of work, I enjoy running and 5-a-side football.”
If you are planning to discontinue your GDC registration at the end of the year, you can maintain a link with dentistry by staying a member of the College.
Retired members enjoy the same benefits, rights and privileges of the College as practising members, but enjoy a fee discount of up to 66% from their next renewal.
If you retire as an Associate Fellow or Fellow of the College, or are eligible to upgrade to one of these statuses, you will be eligible to attend our biannual Fellows’ Receptions.
If a Fellow and 65 years of age or older, you will also be eligible to become a Life Fellow of the College for a one-off payment, which the College can treat as a donation (and, with your approval, add to it with Gift Aid).
It is also anticipated that retired members will provide a rich resource of mentors for early career colleagues.
Retired Fellows of CGDent or the former FGDP are also eligible to join the 1992 Circle, which is named to commemorate the formation of the FGDP and gathers informally twice a year before Fellows’ Receptions, at no further cost. This provides the opportunity to maintain some professional standing and status throughout your retirement, and to support the further growth and development of the College – for example, Circle members have recorded the history of the FGDP and spearheaded fundraising to support the College’s application for a Coat of Arms. Circle members also receive information on the events and activities of the Lindsay Society for the History of Dentistry.
Retiring and retired members are invited to contact Sir Nairn Wilson CBE ([email protected]), for further information.
The College will once again be an education partner at the upcoming Dentistry Show London 2024.
CGDent speakers at Dentistry Show London 2024: Helen Kaney (bottom left), Kaushik Paul (top left), Andrew Gulson (top right) and Sukhvinder Singh Atthi (bottom right). Top centre: representatives at the College exhibition stand
The College will be a partner for the Enhanced CPD Theatre, which will feature 11 lectures over the two-day conference, with experts in their fields sharing their extensive knowledge, and offering practical advice, on an array of important CPD areas. All lectures will be free of charge for both members and non-members of the College. Four of these lectures will be delivered by College representatives:
Dr Kaushik Paul BDS, MFDS, MJDF, Cert (MOS), Cert (Dental Practice Appraisal), PgCert (Leadership and Management), PgCert (Education), Dip (Con. Sed.), MSc (Oral Surgery), FCGDent, FHEA; accredited Tier 2 Oral Surgery provider and sedation trainer, Clinical Director for MyDentist in the North West.
Andrew Gulson, Principal Radiation Protection Specialist and Dental X-ray Protection Services Technical Manager at the UK Health Security Agency; Specialist Radiation Protection Scientist; certified Radiation Protection Adviser; editor of Guidance Notes for Dental Practitioners on the Safe Use of X-Ray Equipment
Dr Helen Kaney BDS, LLB, MBA, FCGDent, FFFLM; dually qualified dentist and solicitor; Dento-Legal Advisor with the Medical and Dental Defence Union of Scotland
Dr Sukhvinder Singh Atthi BDS, MFDS, Cert (MOS), Cert (Dental Practice Appraisal), PgCert (Conscious Sedation), PgCert (Leadership and Management), PgCert (Learning & Teaching in Higher Education), Dip. FFGDP(UK), MSc Oral Surgery, MSc Orthodontics, FCGDent, FHEA, ILM; Lecturer in oral surgery, University of Birmingham; Tier II-accredited oral surgeon
Full details of all the College lectures are available via the above links, and details of the full programme for the Enhanced CPD Theatre and other theatres are available here.
College representatives will also be available throughout the conference at Stand F61 to talk to attendees about all aspects of membership, fellowship and the College’s vision for the profession.
It is not possible to register for any specific lecture in advance, however those wishing to attend will need to register for Dentistry Show London 2024, which is free for all dental professionals. Conference attendees will have access to up to 100 CPD lectures, as well as 180 exhibiting suppliers, and the opportunity to network with 4,000 dentists, practice managers, hygienists and therapists, dental nurses, technicians and laboratory owners.
The College is supporting government proposals to extend community water fluoridation in north east England.
Around half of the North East either has naturally fluoridated water or has had its water artificially fluoridated for around half a century, including Newcastle, Gateshead, North Shields, Wallsend, Whitley Bay and parts of County Durham. The Department of Health and Social Care, supported by the relevant local authorities, is proposing to extend this to a further 1.6 million people in Cleveland, Darlington, Durham, Hartlepool, Middlesborough, Northumberland, Redcar, Stockton, Sunderland and Tyneside, as well as neighbouring parts of Westmorland, Furness and North Yorkshire.[i]
The College has submitted a positive response to the proposals, in which Simon Hearnshaw FCGDent, the College’s lead on community water fluoridation, highlights epidemiological data demonstrating significant differences in the prevalence of tooth decay, and rates of extraction, between fluoridated and non-fluoridated areas in the region which otherwise have similar indicators of deprivation.
Tooth decay is the most prevalent disease in the UK, and the College supports localised water fluoridation as one means to help reduce its incidence and severity, and the consequent need for invasive oral health interventions, particularly in areas of high need.
There is evidence that the provision of water which is either naturally or artificially fluoridated to around 1 milligram per litre is both safe [ii][iii] and effective [iv][v][vi] in reducing dental caries in a given population. A Cochrane Review in 2015 estimated that water fluoridation resulted in children with no other sources of fluoride having 35% fewer decayed, missing and filled baby teeth and 26% fewer decayed, missing and filled permanent teeth. It also led to a 15% increase in children with no decay in their baby teeth and a 14% increase in children with no decay in their permanent teeth.[vii]
Tooth extraction due to preventable decay remains the most common cause of hospital admission in England for five- to nine-year-old children [viii], and the Office for Health Improvement and Disparities (OHID, formerly Public Health England) estimates that if all five-year-olds currently drinking water with 0.2mg/l of fluoride instead received fluoridated water of at least 0.7mg/l, then the number experiencing decay would fall by 28% in the most deprived areas, and the number of hospital admissions for tooth extractions due to decay would reduce by up to 68%. An analysis by OHID also found that water fluoridation is the most cost-effective intervention to prevent tooth decay, offering a return on investment of over £12 after 5 years, and £22 after 10 years, for every £1 spent.[ix]
While the four UK Chief Medical Officers have published a statement describing water fluoridation as an effective public health intervention in reducing both tooth decay and oral health inequalities [x], only around one in ten households in England currently receives tap water containing fluoride at the recommended level [xi], and since 1985 over 60 local health authorities have consulted on initiating water fluoridation without success.[xii] But the government now has the power to directly introduce or vary water fluoridation schemes [xiii], and the proposals for the North East will test whether this will lead to new community water fluoridation schemes in England for the first time in 40 years.[xiv]
[iv] Griffin SO, Regnier E, Griffin PM and Huntley V, 2007. Effectiveness of fluoride in preventing caries in adults. Journal of Dental Research, 86(5), pp.410-415
[v] Slade GD, Grider WB, Maas WR, Sanders AE. Water Fluoridation and Dental Caries in U.S. Children and Adolescents. J Dent Res. 2018 Sep;97(10):1122-1128
[vi] Touyz LZG, Nassani LM. Affirmation: Fluoridated Water Reduces Caries in Children. J Pediatr Dent Hyg. 2019; 1(1): 1003
[vii] Iheozor-Ejiofor Z, Worthington HV, Walsh T, O’Malley L, Clarkson JE, Macey R, Alam R, Tugwell P, Welch V, Glenny AM. Water fluoridation for the prevention of dental caries. Cochrane Database Systematic Review. 2015 Jun 18;2015(6):CD010856. Available at: https://www.cochrane.org/CD010856/ORAL_water-fluoridation-prevent-tooth-decay
[xii] Goodwin M, Emsley R, Kelly MP, et al. Evaluation of water fluoridation scheme in Cumbria: the CATFISH prospective longitudinal cohort study [Internet]. Southampton (UK): National Institute for Health and Care Research; 2022 Nov. (Public Health Research, No. 10.11.) Chapter 3, History and implementation of water fluoridation as a public health intervention. Available at: https://www.journalslibrary.nihr.ac.uk/phr/SHMX1584/
2024 BDS graduate from the University of Liverpool, Zaira Cantara explains why it’s important to develop good communication skills at university and provides her tips on effective patient communication.
“The dentists who get the most complaints are the ones who lack communication skills”, is a quote I remember hearing from a tutor during second year. It’s something that stuck with me because one of the reasons I decided to embark on a journey into dentistry in my late 20s was my own negative experience with a dentist.
It’s true, quite often when I’m reminded why a patient “hates going to the dentist”, the key word being “hates”, it’s usually one of two reasons: that time they felt they were being butchered; or the dentist simply lacked one of the fundamental skills in this profession – good communication. We hear now and then the importance of communication for clinicians, but I think as students we need to focus on this skill more to realise its benefits before we head out into the real world.
Reading feedback patients had left me recently, I assumed comments would be made on the procedures themselves, but I was surprised by how many focused on my communication skills. Thankfully this was seen as a positive and congenial experience during the appointment as they highlighted what I said, rather than what I did. I didn’t realise how much a patient would appreciate and value me doing something I saw as routine.
Dentists are often seen as specialists of the mouth, but a holistic approach is something students benefit from greatly. Good communication leads to appointment slots being filled, the patient leaving with more motivation to engage in the advice you gave and a better undergraduate portfolio. Taking this into practice will lead to fewer complaints, better staff morale and of course a broader depth of success.
Furthermore, great communication skills are essential when it comes to patient consent, which links in with ethics and law. We are taught to obtain ‘valid consent’ at each appointment, every single time we see a patient using effective communication skills. This involves ensuring the patient has capacity to make a decision, that they are well informed by clearly explaining planned treatment and finally that they are not coerced into any treatment.
From my experience, here are five suggestions to help you improve patient communication:
1. Don’t just treat the mouth
Ask about your patient’s general health, how are they getting on with ‘x’ they disclosed to you in their medical, is it all under control, how was the holiday they were looking forward to after your last session? It’s important to ask about other medical conditions as it might affect the patient’s oral health or the treatment that you are planning.
2. Empower the patient
Any time your patient wants you to stop for a break or feel uncomfortable, ask them to raise a hand, so you can follow their lead and resume once it’s okay for them.
3. Explain what the treatment is and why you are doing it
Explain how the treatment will benefit them, why it is important to follow advice at home and what to expect at the next appointment.
4. Show organisation
Be attentive and have all the clinic set up with what you need; this demonstrates efficiency and reduces the patient’s anxiety.
5. Finally, thank them for showing up
I often thank my patients as soon as we have greeted each other in the waiting room. Their time is playing a significant part in our journey to becoming clinicians, without them things would be very different.
Author bio
“I studied the BDS at the University of Liverpool and graduated in July 2024. What I most enjoyed about my course was the early exposure to patients as well as the variation of different clinics this included one being urgent care for those patients without access to a dentist. During this clinic I enjoyed the history taking, coming up with a diagnosis and then treating to relieve the patient out of pain within the same appointment whilst having an holistic approach.
I will be doing my DFT within North Yorkshire and am currently focusing on improving my skills as a general dentist. My hobbies include reading, travelling and getting together with friends.”
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