Lecturer and Tier II-accredited Oral Surgeon, Dr Sukhvinder Atthi FCGDent, discusses some of the common medical emergencies that can occur in dental practice.
“Help… call 999 and tell them to get here quickly!” – the dreaded words you might find yourself exclaiming, when you realise something is not right, and you find your patient unconscious before you!
As dental professionals not only are we responsible for maintaining the oral health of our patients, but we also have a duty to be appropriately trained to deal with medical emergencies that may arise in the dental practice setting. It is an essential skill that the GDC recommends is maintained annually.
I treat a lot of nervous minor oral surgery patients and am sharing key advice in a CGDent lecture on managing medical emergencies at the British Dental Conference and Dentistry Show 2024 on Saturday 18 May (4.15-5pm).
Numerous studies have shown that rehearsing medical emergency training within a dental practice can increase the team’s confidence to manage and treat medical emergency scenarios. Keeping up to date with the required knowledge and undertaking skilled CPR and AED training is crucial in the successful outcomes of managing such patients.
The most common medical emergency is the vasovagal syncope, also known as the simple faint. There are many causes of fainting, however, within a dental practice it is mostly related to pain, emotional stress, fear and anxiety. Some patients may suffer from fainting spells due to other neurological or heart conditions too.
Early recognition of medical emergencies can improve patient outcomes and often avoid further deterioration. We have all heard it before; a patient enters the surgery and you’re there smiling and greeting them whilst they mumble, ”I don’t like the dentist!” or ”Last time I had an injection it made me go all funny and ill”. At this moment, take a minute to think about their anxiety and the apprehension which has led them to feel like this.
Usually, these patients have been kept awake all night worrying about their upcoming appointment. They have often only had a light meal or skipped eating all together because their stomach can’t manage any food.
If patients have not eaten prior to attending, their appointment can worsen their condition hence this can be combated with something as simple as a glucose high energy sweet or glucose-based drink, which helps to maintain the patient’s blood glucose so they can cope with their body undergoing stresses that they are going through prior and during their appointment.
There is also an increased likelihood of encountering medical emergencies during treatment involving intravenous sedation. As an IV sedation provider, implementing the necessary Immediate Life Support (ILS) training is essential, and if you are thinking of applying sedation through your clinical practice workforce, you will need to make sure your training is up-to-date.
Sepsis from dental infections has become increasingly frequent in my referral clinics based on patients that have encountered failed extractions or are still unwell from being on antibiotics for dentoalveolar infections or pericoronitis, alongside other medical factors that the patient has been diagnosed with. When infection spreads within the head and neck region, there is a risk that the airway can be compromised. Patients can present with noisy breathing, stridor, trismus, breathing rapidly with a fast heart rate, alongside dysphagia. Initial management should include ensuring the patient is in an upright position, administering 15 litres per minute of oxygen, and calling for the ambulance.
Join me in the Enhanced CPD Theatre at BDCDS24, where I will discuss these topics as well as my own journey and experiences, and will talk through essential practice to help you deal with the most common medical emergencies.
Dr Atthi’s lecture will update your knowledge of managing medical emergencies within dental practice, including a review of the mandatory audit process for drugs to use in medical emergencies, how to deal with an unconscious patient and how to recognise and manage suspected sepsis.
College members who are UK taxpayers can now claim income tax relief on their membership subscription fees.
The College began enrolling founding members in 2020, and qualifying professional bodies can apply after three years to have their subscriptions allowed as a tax deduction. The College has now been added to HMRC’s List of approved professional organisations and learned societies (List 3), where it is listed under ‘G’ with the title ‘General Dentistry College of (with effect from 6 April 2023)‘.
Both employed and self-employed members of the College can therefore now claim tax relief on their full annual fee, and the size of the saving made will vary from £8 to £228 according to the individual’s team role, membership grade, tax position and jurisdiction.
However, tax relief can only be claimed by those who pay the fee themselves. It cannot be claimed by those whose employer pays their membership fee, nor by those who claim the cost of membership back from their employer, nor in most cases by retired practitioners, and claims for tax relief cannot be made in relation to fees paid in tax years prior to 2023/24.
The tables below illustrate the effective cost of current membership fees for each team role and membership grade after relief at the basic and higher rates of income tax currently applicable in England, Wales and Northern Ireland. These are also now shown on the College’s membership fees page. (Please note that the effective costs will differ for additional rate taxpayers and those living in Scotland.)
The College has confirmed its programme of CPD lectures for the British Dental Conference & Dentistry Show (BDCDS), which is taking place at the National Exhibition Centre in Birmingham on Friday 17 and Saturday 18 May 2024.
The College is the headline education partner for the Enhanced CPD Theatre, where it is hosting four lectures:
10.15am- 11.00am: An update from the Interim Chief Dental Officer for England – Jason Wong FCGDent 11.15am-12.00pm: Sleep to live: an introduction to dental sleep medicine – Dr Aditi Desai 12.15pm-1.00pm: Both sides of the fence: the reality of head and neck cancer treatments for patients and professionals – Jocelyn Harding FCGDent 1.15pm-2.00pm: Consent and medico-legal update – Simon Thackeray
Saturday 18 May
9:15am-10.00am: An update on mouth cancer – Tripat Mahajan 12.15pm-1.00pm: Why is dentistry stressful? A toolkit for survival – Jeremy Cooper FCGDent 2.15pm-3.00pm: Oral health and the menopause: supporting patients throughout the menopause and beyond – Juliette Reeves 3.15pm-4.00pm: A practical guide to endodontic access – Rachel Derby
Staff and senior members of the College are also looking forward to meeting members and prospective members at Stand Q01, and to answering any queries you may have about the College and membership.
BDCDS is the UK’s largest dental event, attracting 9,000 dental professionals with its offer of 11 CPD theatres, 200 lectures and access to over 400 exhibiting suppliers.
Attendance is free for all registered dental professionals – register now via the link below.
John Brookman FCGDent, FFGDP(UK)(Hon.), one of the founding board members of the Faculty of General Dental Practice, and an instrumental founder of Vocational Training for GDPs, passed away peacefully on 27 January, aged 92.
John at the teaching laboratory bearing his name at the Guildford Education Centre
Born David John Brookman in Watford in 1931, he pursued a desire to be a dentist from childhood, and in 1954 qualified from the Royal Dental Hospital, London, with both the LDS and BDS.
Working as a general dental practitioner in Surrey, in 1957 he married Penny, with whom he had four children, Mark, Lucy, James and Claire.
In the early 1960s, he suffered a mental health breakdown and had to suspend his dental career. With support from friends and family he made a full recovery, during which he re-trained as a teacher. This proved to be a pivotal experience in his return to dentistry.
In 1970, he purchased a practice in Banstead, expanding it to five full-time dentists with part-time associates and hygienists, serving a mix of NHS and private patients.
In 1973, he became an assistant dental tutor for the British Postgraduate Medical Federation. Recognising the gap between the degree of competence required for daily dental practice and the level acquired at dental school, from 1975 he established the UK’s first Vocational Training scheme for general dental practitioners in Guildford. This laid the foundation for nationwide vocational training, which was later organised on a voluntary basis for some years by the Committee for Vocational Training (of which he was a member) before it became a statutory requirement in 1993. He also set up educational programmes for dental tutors and teachers, introducing clinical audit and peer review and emphasising problem-solving through practical application.
He had university links including being a research lecturer at the Eastman Dental Hospital and was Senior Dental Advisor to Surrey Health Services and the Thames Post Graduate Regions. It was a particular pleasure for him to be present for the naming after him of the skills room at the Guildford Education Centre in 2013 to commemorate his achievements.
He passed the Membership in General Dental Surgery examination of the Royal College of Surgeons of Edinburgh, achieved Fellowship of the Faculty of Dental Surgery of the Royal College of Surgeons of England (RCS) and was Chairman of the UK Conference of Dental Advisors. He was also President of the British Dental Association’s Southern Counties branch, a founder advisor to the editorial board of The Dentist, and co-produced three educational films with the editor of the British Dental Journal on techniques for fissure sealing, impressions and endodontics.
A founder of the College of General Dental Practitioners of the United Kingdom (CGDP) – one of several organisations established at the time to pursue the postgraduate educational interests of general practice dentists – he was among those involved in discussions which ultimately united like-minded GDPs behind the formation of the Faculty of General Dental Practitioners at the RCS, and in 1992 he became one of the Faculty’s founding board members.
John and Penny retired to Keswick in 1993, and he embraced life, enjoying fell walking and wood turning. They were both active members of the village church and his Christian faith was hugely important to him, shaping how he lived and worked.
He received Honorary Life Membership of the BDA in 1999, and in 2012 was awarded Honorary Fellowship of the FGDP in recognition of his significant contributions both to postgraduate dental education and to the Faculty’s history. He joined the College of General Dentistry at its launch in 2021, later becoming a Life Fellow.
Alongside his many professional accomplishments and community commitments, he was regarded by those who knew him as a true gentleman.
Sadly, Penny died from cancer in 2007. John continued to walk the fells well into his eighties, and it would have meant the world to him that he was able to live out his life in the home he loved so much.
Please note this obituary was amended in March 2024 in light of further biographical information
The College of General Dentistry has endorsed newly updated guidance on periodontal diseases from the Scottish Dental Clinical Effectiveness Programme.
The second edition of Prevention and Treatment of Periodontal Diseases in Primary Care, published this week, aims to help dental teams recognise patients at risk of developing periodontal diseases early, and provide them with preventative care and treatment to improve their oral and general health.
The guidance has been updated following a thorough review of the evidence, and after consultation with dental organisations including the College of General Dentistry.
The changes in the new edition include:
new advice on the assessment of risk
updated information on diagnosis of periodontal diseases to reflect the 2018 Classification of Periodontal Diseases
information on planning treatment that reflects the stepwise approach to periodontal therapyand consideration of tooth prognosis
expanded advice on the management of risk factors and assessing the response to periodontal treatment
advice on the specific management of patients with furcation involvement and the management of patients with systemic conditions linked to periodontal disease
expanded advice on the management of patients considering dental implants
updates to the evidence and basis for the key recommendations
Phill Brown FCGDent is a Facilitator on the College’s Certified Membership Scheme and dental therapist Poppy Dunton, Associate Member, is enrolled on the programme and supporting its development. In a recent conversation with Roshni Karia MCGDent, they shared their experiences of the scheme.
Phill Brown FCGDent, Poppy Dunton, Roshni Karia MCGDent
Roshni Karia: Thank you both for talking with me today. Can you briefly tell me about your roles in dentistry?
Phill Brown: Hi Roshni, I have a keen interest in primary dental care and have been a General Dental Practitioner for 17 years. Within that time I have worked in several practices as an associate dentist and was also fortunate enough to own a large NHS practice in the North West. My role in Dental Education began in 2017 where I have developed a career in Clinical Academia at the University of Liverpool School of Dentistry.
Poppy Dunton: I accidentally fell into dentistry, when a graphic design work experience placement fell through, I began training as a dental nurse, left for university to train in dental therapy and hygiene. I graduated in 2011, and from there have been fortunate enough to be able to complete my full scope of practice in a busy NHS surgery for over eight years; throughout that time I was privileged enough to be offered a business management position, and have since set up and manage a squat practice which is a private facility providing a multidisciplinary team. I currently serve as a Dental Hygiene Therapist focused on Periodontal care.
RK: Speaking as a Facilitator and a member on the Certified Membership Scheme, how does the Professional Framework support you to plan your development?
PB: As a Facilitator, the Framework allows me to structure and focus sessions with colleagues like Poppy who are on the Certified Membership Scheme. Each career stage within the framework has clear and concise examples of how each capability maps to their current career development and so for me as a Facilitator I can easily help and support discussions when a candidate has identified further areas of development.
PD: The Framework allows me to consider my next choice of professional development by allowing me to discuss my personal goals with my Facilitator. These could be examples of postgraduate training or new qualifications or skills I wish to gain. Once discussed this then supports me to see how my skills or day-to-day work life will match with the current direction of my professional development. We can then plan the next six months of my education together.
RK: Poppy, what does Certified Membership mean for you personally?
PD: Ultimately Roshni, I feel it means I am working towards a career goal. I qualified in 2011 and there were minimal postgraduate courses offered compared to the options available to undergraduates in today’s climate. However I have spent a lot of money in the past on courses – which I have only discovered post-qualification do not hold university merit. Therefore, by joining the Certified Membership programme I am able to ensure, with the help of my Facilitator, that my future investments into postgraduate education are the correct ones in line with my advancing through the Career Pathway towards my goal of Fellowship of the College. In addition it allows me to keep focused and not waste time or money on education which may not fit the goal I have set myself.
RK: Why do you think the CMS is a good idea for those working in primary care dentistry, Phill?
PB: Quite simple really! We have no other scheme currently like this in the dental primary care sector. The College has been very inclusive in who can join its programme. You have access to a Facilitator who will provide support alongside a uniquely developed Professional Framework, which maps to your own development no matter what discipline you work in. With the support of the College, primary care colleagues can start to consider how to develop a career pathway in a primary care setting, gaining recognition at every stage of their career development.
RK: So Poppy, can you explain what’s involved for you as a member of the scheme?
PD: Well, every six months I meet online with my Facilitator Martin, he is lovely! The meetings are structured and generally can be around 2-3 hours in length. Yes I know…this may sound like a long period of time, mapping out and planning career progression is based on forming a professional relationship with your Facilitator. Martin took the time to learn about my career, and I his – how I reached the current status of my job role, my concerns, and my desires to achieve more in further education. During the meeting we will set SMART goals together.
Following this meeting I will complete a reflective journal which allows me to self criticise, peer review my own goals and reflect on what needs improvement. This is then sent into the College to ensure my program is being completed and I am being held accountable. Throughout the six month periods there are constant streams of support and online study programme webinars which is helpful and allows me to focus on particular areas for improvement.
RK: One of the benefits of taking part in the CMS is ongoing support from a Facilitator like you Phill. What’s involved in your role?
PB: As a Fellow of the College I am privileged enough to be able to support colleagues at earlier stages of their career by being a Facilitator of the CMS. My role is to engage with those on the scheme throughout their development at specific points during the programme. The role requires me to set time aside to discuss candidates’ personal development plans and reflective logs, and further encourage, through active discussion, areas of professional development that may be helpful to them.
RK: Online Study Modules are another component of the CMS. What are these, Poppy? Do you find them helpful and what sorts of things do you discuss with your Facilitator?
PD: Online study modules are Zoom meetings and teaching lessons, on topics such as Record Keeping, that I attend with other members on the Certified Membership programme. They allow us to focus on a learning outcome for the next six months in terms of making improvements in our own dental daily workflow. We learn from each other and then listen to peers’ reflections and experiences. During my Facilitator meetings with Martin, we discuss recent events and my clinical progress – such as experiences, challenges faced – and we have an open discussion regarding any of my concerns. Reviewing achievements and planning the next six months make up a fair amount of our time – allowing Martin to guide me in regards to particular courses which will benefit me the most or help me to reach my goal of Fellowship.
RK: I wanted to ask both of you about the reflective journal, which is another requirement of the scheme. Have you learnt anything that you think might have been missed without a journal?
PB: As Poppy suggests the journal is very helpful and is structured in a way to guide and map development of skills to the Professional Framework. There are a lot of skills that we all naturally develop over time and so having a clear space to record these achievements ensures you can identify any gaps within each capability. It is really easy to focus on just the skills you are naturally good at and so encouraging CMS candidates to journal throughout can avoid missing important areas for consideration in their PDP goals.
PD: I must admit Roshni, I am a big fan of daily journaling; I think it forces your mind to reflect on exactly where you are. Therefore at times, I cannot recall missing anything but the opposite has allowed me to explore options which I haven’t previously or disregard ideas that upon reflection may not have been suitable in working towards my goals. I’m a particular fan of the Agency Domain in the Professional Framework, which includes the Autonomy competency, the ability to be self directed and take ownership of the work. This encourages you to look at yourself via the power of self audit.
RK: The fourth element of the Certified Membership Scheme is the objective evidencing of your capability, so formal qualifications you’ve gained or courses you’ve completed. Poppy, do you think this sort of external validation is useful for your career and are you currently working towards anything?
PD: Absolutely, I am proud to be part of the College and am so excited for all fellow dental care professionals who are going to achieve recognition for their contribution to the dental world. In the future this may also aid patients in finding an experienced clinician. I am currently working towards gaining Fellowship of the College. I previously completed courses which unfortunately did not qualify for the correct number of credits – therefore I am restarting my journey from a Level 7 status.
RK: Well thanks so much for sharing your thoughts about the CMS and your experiences so far. I’d love to catch up with you again a little further down the line to find out how it has been going.
PD: Thank you for allowing me to be part of this discussion, I am very grateful for the invite.
PB: Many thanks Roshni.
For further information about Certified Membership, click the button below.
The Certified Membership Scheme is open to Associate Members, Full Members and Associate Fellows of the College, and in the first phase, specifically for dentists – we will be opening to other dental team roles soon.
Elections will soon be held for twelve regional and role-based seats on the College Council, and all eligible members are invited to consider standing.
The Council is the voice of our members. It oversees our role as a professional body and guides the Trustee Board on the development of the College to fulfil its mission.
Elections are being held this year for eight of the thirteen regional seats on the Council, and for the first time also to four seats representing specific roles within the dental team.
Nominations will be open from Friday 15 March to Monday 15 April. Following validation of nominations, voting will open during the week commencing 22 April and will close 30 days later, with the results announced shortly thereafter.
The role
As a Council member, you would provide leadership, strategic input and direction in all the professional affairs of the College. You would be helping to shape key moments in the College’s growth and could also get involved in specific initiatives on areas such as careers, policy and standards.
If elected, you would serve a three-year term, from June 2024 – June 2027, during which you would be expected to attend face-to-face Council meetings on three Fridays each year, as well as regular online meetings and occasional committees outside of business hours. Your first Council meeting would be on Friday 21 June 2024 in London.
You would also be expected to vote, and eligible to stand, in the annual election of two Vice Presidents; to participate in the triennial appointment of a College President; and to attend College events around the UK.
You would be able to stand for re-election in 2027, and individuals may serve up to three elected terms (i.e. nine years) on the Council. The role is voluntary, but we do cover essential expenses. A role profile is available below.
To stand for election to a regional seat, you must be a Full Member, Associate Fellow or Fellow of the College (in any team role) and must live or work within that region, and be registered to that region with the College.
To stand for election to a role-based seat, you must be an Associate Member, Full Member, Associate Fellow or Fellow of the College, and must be registered with the GDC (or overseas equivalent) in a relevant role for the seat. All members are automatically assigned to one of the College’s four faculties for electoral purposes, based on the team role in which they have registered their College membership.
If you are a member considering upgrading your membership in order to stand or vote in an election, or a non-member considering joining, you will need to allow at least two weeks ahead of the relevant date(s) below for this process to complete.
Council seats for electionin 2024
Nomination are sought for the following seats:
Central London
Mersey and North West
North East and North West Thames
South West
Trent and East Anglia
Wales
West Midlands
Yorkshire and Northern
Faculty of Dental Hygiene & Dental Therapy
Faculty of Dental Nursing & Orthodontic Therapy
Faculty of Dental Technology & Clinical Dental Technology
Faculty of Dentists
College electoral regions
If you are unsure which College region you are in, check your entry on the Member Register
Nominations process
On 15 March 2024 (tbc), all eligible members will be emailed a link to the nominations website by the College’s election services provider, Mi-Voice.
If you are interested in standing for election, you will need to complete the nomination process via that link (once received), where you will be asked for further information, and to submit an election statement.
You will also be required to provide the names of two supporters of your nomination. For regional seats, your supporters must each be a Full Member, Associate Fellow or Fellow of the College. For role-based seats, your supporters must each be an Associate Member, Full Member, Associate Fellow or Fellow of the College. If you are unsure of the membership status or region of potential supporters, please consult our Member Register
If you think you might like to put yourself forward as a candidate and would like further information before deciding, we would be pleased to have a confidential discussion and answer any questions about the role and the process. Please get in touch via [email protected]
Please note that this item was amended on 28 February 2024 to reflect the addition of Central London to the list of regional seats being elected this year
Foundation Dentist and CGDent NextGen Ambassador, Dr Choudhury Rahman, describes his experience transitioning from undergraduate studies to Foundation Dental Training, along with tips on how to make this change smoother and get the most out of the year!
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 this time last year, running up to finals, wishing it would be over with, I never thought I would have learnt as much as I have now, in just a few months 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!
Overall it’s been a tremendous experience. I have been 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 into this year. If you put in 100%, you will get so much out of your FD year.
One last thing I recommend is to become a member of the College of General Dentistry. I’ve been told by many colleagues, at this stage of your career, the world is your oyster. It can be difficult to navigate and work out exactly what you want to do. Should I do Dental Core Training (DCT)? Is MFDS really worth it? What postgrad training course should I enrol for? These are all questions a mentor will help you answer when you enrol on their Certified Membership Scheme, which is crucial at this stage of your career.
Author bio
“I Graduated from University of Manchester in 2023 and am currently doing 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.”
The College is in the process of appointing its next President, and all full members are eligible to apply.
The President chairs and represents the elected College Council, is accountable to the Board of Trustees, and is the College’s most senior and visible office holder. (S)he will work closely with the Chief Executive to deliver the College’s ambitions as a professional body and charity in the public interest, and will provide leadership across the profession at a critical time on the journey to secure dentistry’s own Royal Charter.
The current President, Dr Abhi Pal, was elected the eleventh and final Dean of the Faculty of General Dental Practice UK (FGDP) in 2021, and has served the majority of his three-year term of office as the first President of the College. The second President will be the first to be appointed by the College since its independence.
While Deans of the FGDP were elected by and strictly from within the Faculty Board, all Full Members, Associate Fellows and Fellows of the College are now eligible to apply for the post of College President, and the appointment will be made by a selection panel with a majority drawn from the elected College Council.
The Presidency is a paid position for 1.5 days per week, but demands flexibility in time commitment, with frequent travel to London and other parts of the UK. A role profile is available below.
Applications should be made by email, headed “President”, to [email protected], attaching a CV and covering letter, and citing two supporters who are also current Full Members, Associate Fellows or Fellows of the College. College membership status can be checked on our Member Register.
The closing date for applications is Monday 18 March 2024.
Interviews are expected to be held in the week beginning 8 April, and the appointee will take office at the College Council meeting in London on Friday 21 June 2024.
If you have questions or would like a confidential discussion about the role, please contact Simon Thornton-Wood PhD, Chief Executive of the College, at [email protected]
The College has published its full response to the government’s Dental Recovery Plan, adding further detail to the interim response from its President, Dr Abhi Pal FCGDent, which was issued earlier this week.
Announcing the plan, Health Secretary Victoria Atkins MP quoted the College on the importance of making use of the full range of skills of all dental team members
The updated statement from the College includes responses to the proposal to speed up entry to the NHS Performers List; to the idea of commissioning private-only dentists to deliver NHS care; to the intention to press the GDC in relation to the recognition of additional qualifications as being equivalent to the UK BDS; to the intended expansion of the LDS, and to the plan to provide preparatory support for LDS candidates. It also includes additional considerations in relation to the proposed ‘golden hello’; to the creation of a provisional registration scheme; and to the increase in the number of dental school places.
The new commentary is as follows:
“While we support in principle the NHS making use of available local capacity to provide much-needed dental care, the proposal to use private-only dentists to do this would either fail or be completely iniquitous to those practitioners who have remained committed to NHS delivery. The correct solutions are to take measures to support the recruitment and retention of dental professionals in the NHS, and to support the financial viability of practices through adequate funding of contracts.
“We are already looking forward to an increase in the number of sittings and places for the Overseas Registration Examination, and we welcome the proposed expansion of the LDS examination. We also welcome proposals to support candidates in preparing for the LDS, and would advocate for similar support to be made available to candidates preparing for the ORE.
“We support the intention to speed up entry to the NHS Performers List, and the possibility of provisional registration, but public safety must not be compromised in our haste to fill gaps in the workforce. There must be proper structure in the training and assessment of provisional registrants, and a robust Quality Assurance process must be developed to ensure that the end product is a Safe Practitioner. Additional training and support may also be required for supervising dentists, as this role may well be more challenging than that of Educational Supervisor of Foundation Dentists.
“Similarly, we support the intention to identify non-EEA qualifications which meet the standard required for registration as a dentist in the UK, but due care and rigour must take priority in order to ensure patient safety. In time, this may prove a useful additional means of ameliorating the labour shortage experienced by dental practices, and the consequent lack of access to NHS dental care experienced by so many patients.”
The sections of the response which have been expanded are as follows:
“The planned ‘golden hello’ scheme also brings implicit recognition of the difficulties experienced by dental practices in the recruitment and retention of clinical staff to deliver NHS dental care. However, we are concerned that the proposed short-term offer, which is in any case limited to dentists, may fail to overcome many practitioners’ long-term concerns about embarking on a career in NHS care delivery, among which are burnout, lack of career progression and insufficient recognition for enhanced skills. We would emphasise that these factors apply not only to dentists but to other members of the dental team, especially dental nurses, and consideration should be given to exploring alternative models of incentivisation to support their recruitment and retention.”
“We are already looking forward to the increase in the number of dental school places available for dentistry, dental hygiene and dental therapy students. The planned expansion of student numbers must be accompanied by an appropriate increase in academic teaching capacity and resources so that the quality of undergraduate training is maintained.”
The College response in full is below.
The College’s response to the ‘Dental Recovery Plan’ in full
Responding to the government’s Dental Recovery Plan, Dr Abhi Pal FCGDent, President of the College, said:
“The government has set out a range of initiatives intended to help tackle some of the many longstanding problems facing NHS dental provision in England. These include some potentially positive new initiatives, which we welcome, alongside previously made announcements. However, while some further positive changes to the dental contract are anticipated later this year, the Dental Recovery Plan does not represent the more fundamental contract reform which is required, nor will the additional £210m in funding behind the plan, welcome as it is, restore universal access to NHS dental care.
“We welcome the proposed Smile For Life programme, with its focus on intervening early to prevent oral diseases in children. Tooth decay remains the leading cause of hospital admission for 6–10-year-olds in England, and a preventative approach has the potential to reduce the need for restorative treatment. However, we wait to see whether sufficient resources will be invested for the programme to be a success.
“The additional temporary funding aimed at those who have been unable to access dental care for two years or more is much needed. However, we would like to see consideration of the ongoing care of individuals benefitting from this initiative.
“The intention to bring NHS dentistry back to some of the many communities who have lost access to it is also very welcome. While mobile units may help in the short term, bricks-and-mortar dental surgeries should remain the backbone of routine ongoing care delivery, and appropriate funding should be put in place to support the re-establishment of NHS practices to address lack of access and meet the volume of need.
“While we support in principle the NHS making use of available local capacity to provide much-needed dental care, the proposal to use private-only practices to do this would either fail or be completely iniquitous to those practices which have remained committed to NHS delivery. The correct solutions are to take measures to support the recruitment and retention of dental professionals in the NHS, and to support the financial viability of practices through adequate funding of contracts.
“The planned ‘golden hello’ scheme also brings implicit recognition of the difficulties experienced by dental practices in the recruitment and retention of clinical staff to deliver NHS dental care. However, we are concerned that the proposed short-term offer, which is in any case limited to dentists, may fail to overcome many practitioners’ long-term concerns about embarking on a career in NHS care delivery, among which are burnout, lack of career progression and insufficient recognition for enhanced skills. We would emphasise that these factors apply not only to dentists but to other members of the dental team, especially dental nurses, and consideration should be given to exploring alternative models of incentivisation to support their recruitment and retention.
“We are already looking forward to the increase in the number of dental school places available for dentistry, dental hygiene and dental therapy students. The planned expansion of student numbers must be accompanied by an appropriate increase in academic teaching capacity and resources so that the quality of undergraduate training is maintained.
“We also look forward to the implementation of medicines exemptions for dental hygienists and therapists. Greater recognition and use of the full range of skills of all team members will enable the delivery of more care and make NHS dentistry more attractive to dental professionals. We also look forward to further proposals which empower the wider dental team when the next set of contractual changes are consulted upon.
“We also recognise that an increase in the minimum UDA value will support a minority of practices to continue delivering NHS dental care. And we support the intent to introduce community water fluoridation in areas of high need as this has the potential to reduce the prevalence of oral diseases and the need for invasive interventions.
“Finally, while dental practices struggle to recruit and many patients struggle to access care, there are many dental professionals who have qualified and practised overseas and who could be providing care here in the UK, but are unable to do so due to the waiting lists for registration exams.
“We are already looking forward to an increase in the number of sittings and places for the Overseas Registration Examination, and we welcome the proposed expansion of the LDS examination. We also welcome proposals to support candidates in preparing for the LDS, and would advocate for similar support to be made available to candidates preparing for the ORE.
“We support the intention to speed up entry to the NHS Performers List, and the possibility of provisional registration, but public safety must not be compromised in our haste to fill gaps in the workforce. There must be proper structure in the training and assessment of provisional registrants, and a robust Quality Assurance process must be developed to ensure that the end product is a Safe Practitioner. Additional training and support may also be required for supervising dentists, as this role may well be more challenging than that of Educational Supervisor of Foundation Dentists.
“Similarly, we support the intention to identify non-EEA qualifications which meet the standard required for registration as a dentist in the UK, but due care and rigour must take priority in order to ensure patient safety. In time, this may prove a useful additional means of ameliorating the labour shortage experienced by dental practices, and the consequent lack of access to NHS dental care experienced by so many patients.”
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