College of General Dentistry Blog

Standards in Dentistry, 3rd edition: what’s changed?

As members of the editorial team responsible for the recent revision of Standards in Dentistry, Professor Christopher Tredwin FCGDent, Dean of Queen Mary University of London Institute of Dentistry and Lorna Burns, Lecturer in evidence-based healthcare at the University of Plymouth, introduce the updated guidance.

Professor Christopher Tredwin
Lorna Burns

The third edition of Standards in Dentistry has been published and is now available to view online. Members of the College can also download and save it to their desktop or other devices.

The editorial team tasked with updating the guidance was led by Ewen McColl FCGDent, Professor of Clinical Dentistry and Head of Peninsula Dental School at the University of Plymouth, and included Chris Tredwin FCGDent, Professor of Restorative Dentistry, Dean and Director of Queen Mary University of London Institute of Dentistry; Robert Witton FCGDent, Professor of Community Dentistry at Peninsula Dental School and Chief Executive of Peninsula Dental Social Enterprise CIC; Lorna Burns, Information Specialist at Peninsula Dental School and lecturer in evidence-based healthcare at the University of Plymouth; and general dental practitioners Nicola Gore FCGDent and Susan Nelson MCGDent. The team also worked closely with Abhi Pal FCGDent, then President, now Immediate Past President of the College.

The fully revised edition incorporates new and updated guidelines and standards which are appropriate for the whole primary care dental team. It follows the structure of the previous two editions, and contains two main sections: summary tables of clinical standards, and lists of guidelines, arranged topically by area of care. The publication does not intend to imply that patients should receive identical care.

Guidelines provide recommendations for effective practice in the management of clinical conditions where variations in practice occur and where effective care may not be delivered uniformly. 

Clinical standards are used to describe the specific elements of care that need to be correct in order to optimise the outcomes for patients. Standards must be unambiguous and measurable.

The clinical standards tables are presented as A: Aspirational, B: Basic and C: Conditional. The A,B,C clinical standards are process measures, not outcomes. 

  • Aspirational – gold-level standards which are not essential
  • Basic – minimum standard necessary to ensure patient safety
  • Conditional – these recommendations only apply in particular situations

Clinicians can use the aspirational standards to improve their practice whilst ensuring that basic standards are met. However, clinicians must assess each clinical situation, the circumstances and the evidence available to them, and use their clinical judgement to settle on the course of action which is in the patient’s best interests. It is recommended that clinicians explain the choices to the patient, the reasons for recommending the chosen course of action and then seek the patient’s consent before clearly justifying the reasoning and recording the consent in the patient’s records. 

The editorial team drew the summaries of clinical standards from multiple, authoritative sources of guidance for primary care dentistry. All of the summary tables have been reviewed and updated for this edition, and revisions were peer-reviewed in consultation with representatives from across the UK dental sector. 

There are new summary tables for Digital Dentistry and Aesthetic Dentistry, reflecting changes in dental care. The newly incorporated standards for Digital Dentistry recognise that dental practices are at different stages of implementing full digital workflows. Therefore, the basic standards in this table refer to the legal necessities such as meeting GDPR requirements and maintaining secure electronic systems. However, in recognition that practices will be working towards the aspirational goal of full clinical digital workflow, there is also a basic standard for members of the dental team to develop the skills and knowledge to enable the transition. 

The new standards for Aesthetic Dentistry are aligned with the legal position decided by the GDC in light of the High Court ruling in the case of GDC v Jamous. Tooth whitening treatment is the practice of dentistry and can only legally and safely be carried out by registered dental professionals. The basic standards for Aesthetic Dentistry highlight the importance of communications with patients, including discussion of risks and managing expectations. There is also clear emphasis on the responsibilities of the dental care professional to act within their scope of practice, competence and training.

The new 2025 edition of Standards in Dentistry is designed for the busy practitioner as a chairside guide which compiles guidelines from multiple bodies, covering all aspects of clinical care from diagnosis to treatment. 

In updating this publication, the editorial team reviewed and updated summaries of the guidelines of more than twenty, mostly UK guideline-producing bodies such as the College of General Dentistry, Scottish Dental Clinical Effectiveness Programme, British Endodontic Society, British Orthodontic Society, British Society of Paediatric Dentistry, British Society of Periodontology and Implant Dentistry, and Royal College of Surgeons Faculty of Dental Surgery. 

This comprehensive guidance for all members of the oral healthcare team, plays an essential role in maintaining standards of excellence within general dentistry, and supports practitioners to continue providing high standards of care to their patients.  

The third edition of the Standards in Dentistry is available to view online. To gain access you must be signed in as a College Member or as a free College Subscriber. Members of the College can also download it to their devices as a PDF for personal use, giving access to search, text-select and print functionality.

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College of General Dentistry Blog

Building the right bite: occlusion and the successful delivery of aligner therapy

Dr Andy Toy FCGDent, a general dental practitioner and educator with a special interest in occlusion, highlights the fundamental link between occlusion and the long-term stability of aligner therapy.

Simply aligning a few anterior teeth can significantly alter a patient’s occlusion.  Whilst many patients seem to cope with their ‘new bite’, there are others who suffer from TMD, chronic pain or mobile teeth because of their aligner therapy.  There are also patients presenting with challenging occlusal problems that could be resolved with the right type of aligner orthodontics.  Every aligner case requires the dentist to understand how to diagnose, plan and finish their patients with a healthy functional occlusion.

I will be delivering a half-day lecture at the Perio-Occlusion Symposium on Saturday 20 September, to address issues like these. My presentation will provide a clear and simple approach to occlusion and clear aligner therapy based on over 40 years of learning and teaching. My aim is to help you:

  • Differentiate between easy and challenging aligner cases
  • Assess the patient’s TM Joint and occlusion and create a treatment plan to deliver a healthy, functional bite
  • Know how to finish and retain your aligner cases

Why is Cassie easier to treat than Jim?

Cassie
Jim

If Cassie and Jim walked into your practice, in my experience most novice orthodontists would steer clear of Cassie and see Jim as an easy win.  Jim has mild crowding with some wear that’s crying out for your best bonding technique.  What a great Align-Bleach-Bond case!  Ker-ching!!  Cassie has more crowding and, even worse, an anterior open bite?  What a nightmare!

In fact, once you do a thorough assessment of TMJ function and occlusion, combined with discovering the patient’s wishes, you would find that Cassie is much easier to treat than Jim. 

Why is this?  Jim has an edge-to-edge occlusion on a class III base – these cases are often much more difficult than they first appear.  The challenge is creating enough overjet to give you space for your bonding and create a healthy envelope of function.  You will need to: a) create lots of space in the lower arch with inter-proximal reduction; and b) control the anchorage to maximise the lower anterior retraction. 

Case photos: Jim

Cassie simply wants to align her teeth and isn’t bothered by her anterior open bite.  Comprehensive assessment of her TMJ and functional occlusion indicates that her bite is healthy.  She just needs some levelling and aligning.  Simple!

Case photos: Cassie

Correct biomechanics ensures successful aligner therapy  

Jeff is another class III case.  I used Invisalign Go™ (that is moving 5-5 only and up to 25 aligners) combined with class III elastics to support anchorage and we finished with a great looking result and healthy occlusion.  In fact, Jeff is easier to treat than Jim.  Can you see why?  It’s all down to how you assess a cross-bite.   Once you know how, it’s much easier to choose your winners and avoid creating an occlusal cripple.

Case photos: Jeff

Aligner therapy can eliminate occlusal dysfunction

Brenda is not too concerned about her appearance, but she is very worried about the pain she is experiencing and the possibility of losing her teeth.  She’s also in her 70s and not overly keen on dental treatment.

Brenda has multiple crossbites, tilted teeth and missing molars.  Where do you start?  My approach is: thorough assessment and diagnosis of her TMJ function and dynamic occlusion; careful planning of her Invisalign Comprehensive™ treatment; and a patient-centred consent process.  That way Brenda knows what the problem is, how we may treat it and what benefits and risks she may encounter as a result.  This gives Brenda the confidence to go ahead with the plan and enjoy a healthy, comfortable bite for the rest of her life.  Come along to the Symposium and I’ll show you how I used aligner biomechanics on Brenda’s case so that you can apply them on your own patients.

Case photos: Brenda

If you are able to attend the symposium, you’ll be better placed to avoid cases that are beyond your experience level; feel confident that the cases you do treat will have a healthy, functional bite; and sleep better at night. You can find out more and book your place here.

The Perio-Occlusion Symposium takes place on Saturday 20 September in London.

Click here for further details and to secure your place

Read our blog on Pink Aesthetics to find out more about the topics included in the morning lecture, delivered by Dr Reena Wadia.

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College of General Dentistry Blog

Why should early career dental professionals learn about gum aesthetics?

Dr Tom Bereznicki FCGDent, founder of the Tom Bereznicki Dental Educational Foundation, considers the vital role of gum aesthetics in digital smile design, an area of dentistry which early career practitioners are increasingly becoming involved in.

It is increasingly important to consider the appearance of the gum when treating aesthetic cases, particularly in digital smile design. But despite the crucial role of ‘pink aesthetics’ in aesthetic dental practice, it is a topic that is often not so well understood by early career dental professionals, mainly due to a lack of education in this area.

In many cases, paying attention to a patient’s pink gum can be as vital as treating the shape, position and colour of their dentition. Cultivating the right balance between the tooth and periodontal tissue may be key to achieving the ‘ideal smile’ and improving your patient’s confidence.

In days gone by, patients were happy with their appearance if they avoided dentures. These days, patients are much more discerning and restorations like the cases shown below from my archives, would now be regarded as aesthetically unacceptable.

If a patient has a low lip line, the position of the gum, in theory, is not an issue. However, many patients these days often judge outcomes by aesthetics when they lift their lips out of the way.

If a lot of gum is visible when the patient smiles, the appearance and position of the gingival tissue, as well as the teeth, will certainly need to be carefully planned – in particular matching zenith points and ideally showing no ‘black’ triangles.

Correct diagnosis is essential. In the two cases below, both patients attended asking to have their teeth veneered as they hated their smiles because they thought their teeth looked too short. However, neither case required procedures to lengthen their teeth, they merely had too much gum showing and required crown lengthening.

Correct treatment planning is also crucial to greatly improve the final aesthetics of treatment. In this case, crown lengthening around the lateral incisors prior to the provision of two veneers delivered the best result for the patient.

Improving a patient’s smile by treating the appearance of the gum does not have to be complex. Even the smallest minimal surgical procedure can have a dramatic effect on aesthetics and patient confidence. 

Whereas carrying out crown lengthening procedures exposes more of the patient’s tooth to achieve a harmonious balance between the gum and the tooth, gingival recession can also be treated through minor surgical procedures. In the cases shown below, a laterally repositioned flap provided a successful, long-term solution. 

30-year follow-up

The upcoming Perio-Occlusion Symposium on 20 September addresses gum surgery cases similar to the cases covered in this blog. My introduction to the topic will be followed by a half-day lecture delivered by Dr Reena Wadia MCGDent, a well-known specialist periodontist. Reena will examine the indications and steps of crown lengthening surgery and the optimal aesthetics we aim for. In addition, she will discuss the indications of gum recession surgery and the various procedures available. The afternoon session will be delivered by Dr Andy Toy FCGDent on how occlusion can affect the long-term stability of treatment using aligner therapy.

For those who wish to extend their knowledge further, information will also be available on postgraduate courses which cover these topics in greater depth.

The Perio-Occlusion Symposium takes place on Saturday 20 September in London.

Click here for more information and to book your place

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College of General Dentistry Blog

Our Coat of Arms: an encapsulation of the College’s ethos and aspirations

Sir Nairn Wilson CBE FCGDent, President Emeritus of the College, describes the symbolism and meaning behind each of the heraldic elements in the College’s newly-granted Coat of Arms.

Sir Nairn with the Grant of Arms presented to the College on 19 May 2025

A Grant of Arms is a formal recognition bestowed by the official heraldic authority, the College of Arms, and symbolises legitimacy and identity. Dating back centuries, grants of arms are typically conferred upon those organisations and individuals which meet established criteria of permanence, achievement, and contribution in their respective fields, and the College (intended Royal College) of General Dentistry has recently been so honoured.

The process leading up to the Grant of Arms involved the design of an ‘Armorial Achievement’ – colloquially known as a Coat of Arms – which includes various heraldic elements such as a shield, crest and motto, each imbued with symbolic meaning. These elements collectively encapsulate the ethos and aspirations of the organisation.

The Armorial Achievement (Coat of Arms) of the College of General Dentistry

The shield – the centrepiece of the heraldic achievement – has a blue background (field). The central feature of the shield is a golden pelican ‘in her piety’ – feeding a brood of three chicks in a nest, with the chicks pecking and wounding their mother’s breast, anxious to be fed. The principal meaning evoked by the pelican is caring: first and foremost for patients, secondly for early career oral healthcare professionals and students, and thirdly for the moral compass of the profession – hence the three chicks.

The pelican is surmounted by a golden band (‘chief’) displaying three snakes, each knotted (‘nowy’). The knotted snakes symbolise unity within the profession, unity with other health professions and unity of purpose in healthcare, emphasising the importance of oral health to general health and wellbeing. Together the pelican and snakes symbolise trust and reliance.

The crest on top of the helm features the upper half of an ‘opinicus’, resting its right (‘dexter’) foreleg on a giant pearl. The traditional opinicus, derived from the crest of the Company of Barber Surgeons, which was incorporated in 1462, is a symbol of influence, and of strength in diversity and inclusivity within the College. The pearl signifies wisdom in the art and science of dentistry. The opinicus, rarely included in heraldic achievements, resembles a dragon in the forepart and in the wings, with a beaked head and ears similar to those of a griffin. The hind part and the legs resemble those of a lion. The tail is similar to that of a bear.

The mantling around the shield and helm displays the livery colours of the College – azure blue and gold.

Below the shield sits the College motto: Sanitate oris venit fortitudo – Strength through oral health – strength for patients and strength for the profession.

The College of General Dentistry badge

The badge of the College is a proud and bold opinicus in College blue and rampant posture (standing on one hind foot in profile, with raised wings and tail), holding the giant pearl of wisdom, as featured in the crest of the Arms, between its clawed forepaws.

The Grant of Arms adds to the legitimacy of the College, which is now firmly part of the healthcare establishment, and is considered to be an important step towards eligibility for the granting of a Royal Charter – a priority for the College in its further growth and development. The College is only the ninth dental organisation in the UK, Australia or New Zealand to have receive a Grant of Arms, and will now start making use of its Arms and badge in, for example, a re-design of diploma certificates and the introduction of College regalia.

The full text of the Grant of Arms can be read here.

This abridged article is presented with the kind permission of the Dental Historian, the journal of the Lindsay Society, a membership organisation which promotes interest, study and research into the history of dentistry and brings together people who share these interests.

The version of record (‘Making history: The grant of arms to the College of General Dentistry’) is available in the Dental Historian, volume 70 (2025), issue 2.

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College of General Dentistry Blog

Marking another milestone

Igor Blum FCGDent, Clinical Professor of Primary Care Dentistry and Advanced General Dental Practice at King’s College London and Editor of the Primary Dental Journal, and Sir Nairn Wilson CBE FCGDent, President Emeritus of the College and the journal’s first Editor, celebrate the publication of its fiftieth issue

Prof Igor Blum FCGDent (left) and Sir Nairn Wilson CBE FCGDent (right)

The latest issue of the Primary Dental Journal (PDJ) – the 50th to date – is a truly special ‘general dentistry’ edition marking this significant milestone.

Not only does the PDJ have a rich history of serving general dental practice, but it is also one of the premier journals for intellectual discourse on all aspects of primary dental care pertinent to members of the whole dental team.

First published in 2012, shepherded under the tenure as Editor-in-Chief of the then Professor (now Sir) Nairn Wilson, it brought together three publications of the former Faculty of General Dental Practice (FGDP[UK]): Primary Dental Care (a research journal for dentists), Team in Practice (a journal for Dental Care Professionals) and the newsletter First Hand.

The fourth volume of the journal, published in 2015, was produced with the assistance of a new Clinical Editor – Dr (now Professor) Igor Blum. In addition to themed issues on Consent (curated by Guest Editor, Andy Toy), Special Care Dentistry (Guest Editors, Debbie Chandler and Richard Valle-Jones) and Paediatric Dentistry (Guest Editor, Richard Welbury), the volume included the journal’s first ‘general issue’ with papers on a range of topics, including temporomandibular dysfunction, contemporary laboratory work, tooth surface loss, the effects of bisphosphonates in implant dentistry, reducing harm (iatrogenic damage) in the provision of care, risk assessment and the prevention and management of dry sockets.

Volume 6, issue 1 was a special, one-off, commemorative issue of PDJ to help mark and celebrate the twenty-fifth anniversary of the formation of the FGDP(UK). In addition to a ‘conversation’ between Professor Nairn Wilson and the then Dean of the Faculty, Mick Horton, and a photo montage of the history of the faculty, the issue included commissioned papers by leading dental experts in the UK. This commemorative issue and the subsequent two themed issues – Dental Emergencies (Guest Editor, Russ Ladwa) and Extended Integrated Care (Guest Editor, Kathy Fan) were Professor Wilson’s last contributions to PDJ before passing on the baton to Dr Blum in 2017.

Professor Blum’s first issue as Editor-in-Chief was the December 2017 (Volume 6, issue 4) themed issue on Removable Prosthodontics (Guest Editor, Graham Stokes). Professor Blum’s vision for the journal was to evolve, grow and, in the process, continue to go from strength to strength. A further vision was to make the journal accessible on an international level, rather than limiting it to the readership in the UK, for the benefit of primary dental care teams and their patients around the world.

Within each annual volume, two or three issues are themed on specific and relevant fields of interest, and one or two ‘general dentistry’ issues cover a wide range of topics. Each issue offers a combination of research, clinical best practice papers and scenario articles which allow the whole dental team to work together to improve standards of patient care. In Spring 2021 the PDJ published its 10th Volume Anniversary special issue celebrating this remarkable milestone.

After nine years’ publication by the FGDP(UK), the College took over in 2021, and this 2025 Spring issue marks fifty issues of the journal as a source for dissemination of contemporary research, clinical and non-clinical articles relevant to general dental practice.

Since its inception, the PDJ has evolved substantially and earned an established place as an authoritative source in today’s dental literature. As such, it provides CGDent with one of its most valued membership benefits. While its purpose has been constant – to be a professional development journal for the whole dental team, and a record and source of news about the College – its editorial and production processes and standards have evolved over the years.

Most significantly, in 2019 the FGDP entered into a contract with Sage Publishing and the PDJ has progressed from an in-house ‘cottage industry’ publication to an internationally accessible publication with an electronic editorial management platform, ScholarOne. As such the journal benefits from the resources available through our publisher, which has facilitated its continued growth.

Over the years, we have watched with great pleasure how the PDJ has grown and gained ever-increasing standing and status in becoming an internationally recognised and esteemed journal, aimed at the whole primary care team. The journal is now indexed in PubMed/MEDLINE and Scopus, and 1,500 papers – past and present – are available online to CGDent members through the PDJ Library and in over 10,000 academic institutions worldwide.

With the current international exposure of articles published in the PDJ, there have been many thousands of downloads and citations of articles. This confirms that the PDJ has an international reach and impact on the dental team and clinical practice, both nationally and internationally, improving standards of patient care.

As a result, the PDJ has started to attract international dental experts as guest editors. In the context of a new membership organisation borne out of a more established one, the journal has also played a central role in providing reassurance and continuity of service to members over the last four years and has developed an important role in supporting the College’s membership retention and growth.

Looking back, we would like to express our sincere gratitude to the very many authors, guest editors, peer reviewers, staff and others who have contributed to each of the 50 issues to date and enabled us to reach this important milestone.

Special thanks must be extended to the former and current managing editors of the journal – Amy Brewerton, Hillevi Sellén, and Lily Atkins; to a member of the founding Editorial Board, Ario Santini FCGDent, who continues to provide highly rated abstracts of relevance to the contents of each issue of the journal; and to Darren Westlake, who has designed the covers and laid out the figures in each and every issue.

We are confident that we have created an attractive, distinctive, reader-friendly journal and it is our hope that you will enjoy the 50th issue and join the previous and current editorial team in celebrating all it stands for.

FIND OUT MORE ABOUT THE 50TH ISSUE

A list of the themed editions within the first 50 issues of the PDJ is available here

The titles and abstracts of PDJ papers are available to all dental professionals via the searchable PDJ homepage, with full paper access available to College members through the PDJ Library

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College of General Dentistry Blog, Uncategorized

The year in review 2024-25

Dr Mick Horton FCGDent, Chair of Trustees and co-host of the recent Annual Members’ Meeting, reviews the College’s achievements over the past twelve months.

I am delighted to open this report with the confidence that steady growth in membership supplies, strengthening our youthful organisation at a time when wider trends are not so positive amongst professional bodies. Fellowship in particular is proving an attractive goal for many senior practitioners, who have lacked the opportunity of such recognition in a healthcare system which provides too few opportunities to celebrate excellence in general practice. Growing strength in membership enables greater ambition in our service to the public through our professional community.

In the short existence of the College, more than 20,000 dental professionals and others have set up online CGDent accounts to make use of the key services we provide – and most significantly, our authoritative Standards and Guidance publications. In December, we launched our College Subscriber offer, as a means to serve this rapidly-expanding community more effectively – and to give us a much richer picture of who is using our guidance, and how.

This January, we published a vital statement of the mission of the College and Council’s Vision for Dentistry, shaping our thinking and planning for the future. This defining document sets out very clearly, how and why the College should be at the heart of thinking on the future for oral health in the UK and beyond.

Training and development is an increasingly confusing arena for all members of the dental team, and the College has been giving very careful thought to the most effective role that we can play to improve matters. We have a reputation built on the hugely respected qualifications delivered by the former FGDP over decades, but in today’s thriving postgraduate dental education market there is little room for the College to add value in quite the way that our predecessor organisation did. In 2024, we embarked on the development of a new ‘credentialing’ role, which will result in the launch of new forms of recognition for higher skills, in the first half of 2025. We have been delighted with the support and cooperation from so many organisations and agencies, enabling us to bring forward credentialing systems that will carry real weight and credibility.

Early careers are equally a focus for the College. The first Tom Bereznicki Charitable Educational Foundation awards were made in the summer, and we are delighted to be working hand in hand with the Foundation on Tom’s greater aspirations to develop the skills of early career practitioners. The first cohort of successful candidates, gaining remarkable training opportunities in Europe, were celebrated at our Fellows’ Summer Reception.

We reported last year on our partnership with Haleon, for which the College engaged a range of dental practices around the UK in an analysis of the opportunities for them to promote preventative care. We published our joint report in the autumn of 2024, and followed it up with a parliamentary meeting attended by MPs and officials.

Implant Dentistry has been a focus of activity for the College in the past year, with a pair of themed issues of the Primary Dental Journal and the launch of the College’s authoritative Register of Implant Mentors in partnership with the ADI and the ITI. This is just the first of a number of Registers of Expertise that have been mooted to raise standards in key areas of practice.

We celebrated the 50th issue of the Journal at Cutlers Hall, London, before the Fellows’ Winter Reception in January. Under the inspired Editorship of Prof Igor Blum, the journal now reaches worldwide audiences, gaining substantially in authority and credibility, and many of our themed issues have been commended as key points of reference for every practitioner – take, for one example amongst many, the recent issue on Dental Trauma.

The Fellows’ Receptions themselves have proven perennially popular for our senior membership community, and we plan to build on this in 2025 by linking the Reception to our first College Lecture. The College Lecture cements our role in thought leadership and our academic standing.

Fresh ideas and energy have been brought to Council with the election of a significant number of new representatives, and the appointment of our new President, Roshni Karia, following the completion of Abhi Pal’s three-year term of office. Abhi served as the College’s first President, and has done so much to establish the credentials of a new organisation, with boundless energy and ideas that have shaped our direction.

Thank you for your continued support.

The next Annual Members’ Meeting will take place on Tuesday 3 March 2026, 7pm-8pm, online.

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College of General Dentistry Blog

Why learning about occlusion is vital for early career dentists

Dr Tom Bereznicki FCGDent, founder of the Tom Bereznicki Dental Educational Foundation, explains the importance of occlusion and why he is committed to educating younger colleagues on the topic.

The modern undergraduate curriculum allows very little time for occlusion to be covered as a topic. Through my experience of teaching younger dentists, I have noticed in recent years that when I ask what the clinical occlusal examination findings are, the reply often comes back with an orthodontic classification. Few early career dentists are aware of the importance of studying not just the static occlusion, but the dynamic one too.

In over 40 years of practice, I have seen many cases of occlusally-related failure, highlighting the vital importance of paying due consideration to the occlusal scheme in treatment planning. I am passionate about educating early career dentists and through my charitable foundation, I have organised a symposium on the topic of occlusion, in collaboration with the College, which aims to enhance delegates’ knowledge of the basic principles of occlusion and how they can support the success and longevity of restorative treatment.

With the odd exceptions such as anterior open bites and skeletal Class 3’s, patients’ occlusal schemes should adhere to the basic principles of occlusion, not just when providing complex multiple indirect restorations and treatment of wear cases, but also simpler single indirect restorations, and most importantly, the long-term maintenance of intact healthy dentitions.

The cases illustrated below draw attention to some common examples of occlusally-related failure.

To avoid occlusal derangement, the extracted tooth should have been replaced as soon after extraction as possible

Failure to investigate the crack when it first appeared – now the tooth needs to be extracted

Correct dynamic mandibular excursions when fitting fixed restorations to help prevent failure especially with cantilever designs

Missing the tell-tale signs of unwanted wear, seen here as wear facets, can lead to root fracture

Spotting early signs of unwanted occlusal wear helps prevent extensive treatment at a later date

Failure to check excursive mandibular excursions, especially when fitting restorations, can result in loss of canine guidance and restorative failure

In bruxers, veneer failure can also frequently be seen as fracture of the porcelain in the gingival third of the restoration

Over instrumentation during root canal therapy weakens the root making it susceptible to fracture particularly when acting as a cantilever abutment

Although titanium is extremely hard, it is not unbreakable. If occlusal forces are not refined, fracture or associated non-perimplantitis bone loss can lead to failure

I will be addressing occlusally-related failure cases like these in the opening session at the Introduction to Occlusion Symposium. I will be joined by a fantastic line-up of experts: Professor Paul Tipton, Dr Ken Harris, Dr Tif Qureshi, Dr Shiraz Khan and Dr Koray Feran. Through a series of lectures, they will examine the five basic principles of occlusion in detail and how they can support the placement of successful, long-term restorations.

Information will also be available on a range of postgraduate courses which cover aspects of occlusion in greater depth, for those who wish to extend their knowledge further.

The Introduction to Occlusion Symposium, takes place on Saturday 5 April 2025 in London.

Click for further information and to book your place

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College of General Dentistry Blog

CGDent Scotland Study Day 2024: a review

Patricia Thomson FCGDent, Council representative for North and West Scotland, reviews the College’s recent annual study day in Glasgow.

The 6 December 2024 witnessed the most recent gathering of our dental community for the College’s annual Study Day in Scotland, at the Science Centre, Glasgow. This was the fourteenth year that we have held the event at this venue due to its convenient location and the superb facilities, including an Imax Theatre and an outstanding AV team. After registration, breakfast rolls and coffee, and an initial inspection of the sponsors’ stands, delegates entered the Imax Theatre at 9am for the start of the programme.

Once again the event was fully subscribed, with both sponsorship and delegate spaces sold out well in advance, and we had an in-person attendance of around 360 plus additional delegates who joined virtually. We were delighted to welcome back a core of GDPs and trade sponsors who are loyal supporters of the day, but we also welcomed many new faces, including those who had travelled from outside of Scotland.

It was a pleasure to host Dr Roshni Karia MCGDent, the recently appointed President of the College, as well as Professor Aileen Bell (Dean of Glasgow Dental School), Dr Andrew Paterson (Education Lead for Restorative Dentistry at Glasgow Dental School), and representatives of organisations including the BDA, GDC, National Services Scotland, Practitioner Services (Dental), NHS Education Scotland (NES), MDDUS, DDU/MDU, and LDCs from Greater Glasgow and Clyde Health Board and Lanarkshire Health Board.

This year we were also joined by several charities: Bridge to Aid; Maldent; GOHISS (Glasgow Oral Health Improvement Student Society); Smileawi (2019 winner of the Dean’s Award given by the former Faculty of General Dental Practice); and the Canmore Trust (whose CEO, Professor John Gibson, was awarded the College Medal earlier in the year). All had a very successful day, networking with the dental trade and our community of practice.

Glasgow Dental School also enabled its final year BDS students to attend, and they were joined by a number of undergraduates from Dundee Dental School.

Unfortunately, Government fiscal restrictions prevented NES funding the attendance of Vocational Dental Practitioners this year, but despite that, a group of trainers facilitated the attendance of their own VDPs,  recognising the value to early career colleagues of joining the wider professional community and attending face-to-face CPD events.

Our speakers for the day, all Fellows of the College, were: Dr Catherine Rutland, Clinical Director at Simply Health and Denplan, who leads a team providing clinical governance advice to all areas of the clinical group; Dr Andrew Chandrapal, practice owner and educator with a special interest in aesthetic dentistry, composite bonding and complex rehabilitation; and Dr Wendy Thompson, a microbiologist and GDP in Cumbria who is Chair of the FDI World Dental Federation Task Team on Preventing AMR and Infection.

The lecture programme commenced with tributes to the late Dr Louis MacKenzie FCGDent, delivered in the first instance by Professor Gibson, whose own personal tragedy brought about the establishment of the Canmore Trust, which raises awareness of suicide prevention and postvention and works with individuals touched by suicide.

We had engaged Louis as our main speaker eighteen months previously, and he was to present on the topic of anterior and posterior composites. On initially planning the day, Louis had suggested that Dr Catherine Rutland would be an ideal complementary speaker. The devastating loss of Louis before Christmas 2023 resulted in the painful dilemma of how to move forward with the Scotland Study Day 2024. After a period of reflection, Catherine agreed that she was willing to present at the event. It was felt that we should approach Andrew Chandrapal as an appropriate replacement speaker on the topic of composite restorations. We are immensely grateful to both of them, as they had been close colleagues and friends of Louis, and both delivered the most touching tributes to him that morning, despite the emotional difficulty that this involved.

All of these tributes ensured that Louis was not forgotten, and was an enduring presence throughout the day.

After our introductions, Catherine delivered a very thought provoking lecture on the “Ethics of Aesthetics”. This foray into the world of consumer-driven dentistry, and the perils of dentists engaging in social media without regard for professional ethics, was a timely reminder of the pitfalls that can be encountered, and made those of us of mature years relieved that we have the excuse of age not to engage in such activity.

After our mid-morning break, which involved networking, refreshments and a visit to the trade stands, Andrew Chandrapal spoke on the topic of anterior composites. His lecture was delivered in the format of “top tips”, and covered such subjects as the use of enamel and dentine composites, replication of tooth anatomy, shade selection, appropriate matrices and wedges, and tips on finishing.

Following this, the delegates retired for a sit-down lunch with an opportunity for further networking and professional fellowship. Old acquaintances were renewed, and new ones established.

After lunch, the final year students reconvened in another lecture theatre for the delivery of their own programme, initially addressed by Dr Karia, followed by representatives of three of our sponsors, Scottish Dental Care Group, Martin Aitken Accountants and MDDUS. On their way to the theatre, the students took full advantage of privileged access to the Science Centre’s fun exhibits of wonky mirrors and optical illusion floors, proving that they are still students!

Meanwhile, in the main lecture theatre, Andrew continued with his afternoon lecture, providing top tips on posterior composites and advice on establishing fissure depth and reproducing accurate occlusal morphology and anatomy. He also imparted excellent tips on rubber dam placement, sectional matrices and wedges.

The afternoon break allowed the students to re-join the main delegate body, and all to enjoy further refreshments and chat, and a final opportunity to interact with the dental trade.

Dr Wendy Thompson, our third speaker of the day, delivered the Caldwell Memorial Lecture on the subject of “Antibiotic Sustainability”. We were all extremely relieved when Wendy did not force the delegates to take part in an aerobics session that she was threatening, and allowed us to sit down and be thoroughly convinced that antibiotics do not cure toothache, along with a very sobering message on the effects of antimicrobial resistance delivered through video by a devastatingly affected patient.

After the rigours of the day we all retired to the much-deserved drinks reception, observing the rivulets of rain on the outside of the triple-height windows which signalled the arrival of Storm Darragh, proving once again that we have a lot of weather in Glasgow. There was also opportunity for the more mature delegates to sample the wonky mirrors and sloping floors of the exhibits, sensibly, before they had even touched a glass of wine.

The day is structured to provide six hours of high quality CPD, the opportunity for our community of practice to gather with ample time for professional networking, and interaction with the trade and other stakeholders.

We specifically thank the local members of our profession who give so much time and effort on an altruistic basis for the benefit of our professional community, and ultimately for the benefit of patients. We could not deliver this day without them.

We would like to acknowledge our gratitude to the various members of the trade whose sponsorship and loyalty enables us to deliver an event on this scale and subsidises the cost of attendance for delegates.

Specifically, our Platinum Sponsor was Scottish Dental Care Group, and our Gold Sponsors were Nexus Lab, MDDUS, Martin Aitken Accountants, the BDA, Clyde Munro, the Scottish Centre for Excellence in Dentistry and Strictly Confidental.

Our Silver Sponsors were Acteon, Align Technology, the DDU, Denplan, GC UK, the GDC, Haleon, Greater Glasgow and Clyde LDC, Kettenbach Dental, NHS National Services Scotland, Optident, Patient Plan Direct, Real Good Dental, the Royal Bank of Scotland, Septodont, Thorntons and Wrights.

This year’s event will take place on Friday 5 December 2025 and the programme for the day is already well advanced. All College members receive a hefty fee discount, and we strongly encourage you to come wherever you’re based in the UK (or elsewhere). There’s no better way to kick off the Christmas season and you’re guaranteed a warm welcome – hope to see you there!

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College of General Dentistry Blog

My journey to College Fellowship: Fatimah Jawaid

Fatimah Jawaid FCGDent, a general dental practitioner based in Birmingham, describes her professional journey and how her experience led to Fellowship of the College.

Q. Can you tell us about yourself and your career?

A. I am a dedicated general dentist working in Edgbaston, Birmingham. I graduated from the University of Birmingham in 2012 with Distinction in Clinical Dentistry. I completed my FD year and went on to complete a further DCT year in Restorative Dentistry at Barts Dental Hospital, London. After this, I settled into an associate role in Birmingham, completed my MSc in Fixed and Removable Prosthodontics, PGCert in Dental Education and have recently completed my Implant Training. I am currently in the process of becoming a principal dentist and look forward to the new challenges ahead!

Outside of work, my main job is being mummy to Liyana (aged 5) and Layth (aged 3). We live in Moseley, Birmingham, with my husband, Sadiq, who is a currently a maxillofacial registrar. I enjoy going to the gym, travelling and exploring new cultures with my tribe in tow!

Q. Why did you decide to apply for Fellowship of the College?

A. I obtained College Fellowship (FCGDent) through the ‘Fellowship by experience’ route. I felt this achievement allowed me to demonstrate high standards in primary care dentistry and reflect the commitment I had put into my career since graduation. Upon researching the criteria, I realised that I was able to meet the domains and successfully achieve Fellowship.

Q. Which three of the five fellowship domains does your professional experience meet?

A. The three domains that I used for my Fellowship application were Clinical; Teaching, Learning & Assessment; and Publications & Research.

My Masters in Fixed and Removable Prosthodontics from Kings College London (2019) provided me with the evidence for the Clinical Domain as it had more than the required credits.

The final year dissertation allowed me to the achieve the Publications & Research Domain.

For the Teaching, Learning & Assessment Domain, I used my PGCert in Dental Education and I demonstrated that I had at least four years’ experience in a role as an Educational Supervisor for Foundation Dentists.

Q. What would you say to others who are considering applying for Fellowship through the experience route?

A. Still considering myself as a young dentist, I am excited to see the opportunities and ideas that are being undertaken within the College and how they will impact my future practising career.

Having completed several challenging postgraduate courses, the recognition I received from the College, and being able to call myself a Fellow of the College at 31, felt very rewarding indeed!

Dental professionals can apply for admission to Fellowship of the College – the mark of accomplishment in dentistry – by two routes: Fellowship by Experience and Fellowship by Equivalence.

To apply for Fellowship by the Fellowship by Experience route, you will need to submit a CV and detailed evidence showing how you meet the eligibility criteria for three of the five fellowship domains. The domains are:

  1. Clinical
  2. Teaching, learning & assessment
  3. Leadership & management
  4. Publications & research
  5. Law & ethics

We have “Gateway” criteria which require less evidence and will be processed more quickly, if you meet all these requirements.

Full details about routes to Fellowship and how to apply are available here.

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College of General Dentistry Blog

Why I became a College benefactor and philanthropist

Dr Tom Bereznicki FCGDent, founder of the Tom Bereznicki Charitable Education Foundation and a major donor to the College, talks to Professor Sir Nairn Wilson CBE FCGDent, President Emeritus, about his motivation to put something back into the profession

Tom Bereznicki FCGDent (left) and Sir Nairn Wilson CBE FCGDent (right)

Nairn Wilson: Tom, what motivated you to become a Founder of the College, the College’s first major benefactor, and a significant College legator? 

Tom Bereznicki: In recent years, I have been increasingly anxious to find ways to put something back into the dental profession, with emphases on making good some of the deficiencies in undergraduate dental education, encouraging early career dentists to develop their skills and knowledge to better meet the ever-increasing expectations of patients, and to enhance the standing and status of dentistry, both in healthcare in general, and in the eyes of the public.

The creation of the College, intended Royal College of General Dentistry, was a bold move to give oral healthcare professionals the benefits enjoyed by all those in healthcare who have their own independent Royal College – career pathways with recognition of enhanced skills, standards set by the profession for the profession, and a community of practice, together with, and very importantly in the case of CGDent, a much-needed, unified voice for the whole of the profession.

Also, I share the vision of the College to elevate the importance of oral health in the eyes of other healthcare professions, politicians and the public. The College initiative was one I identified with and considered worthy of my support, both to get it started and help secure its future.

Nairn Wilson: What are the aims, objectives and aspirations of your Educational Foundation?

Tom Bereznicki: My Foundation was created to support recently graduated and early career dentists and therapists to acquire knowledge and skills they were unlikely to have acquired in their undergraduate training, but which are needed to succeed in everyday practice. The focus is on aesthetic dentistry, occlusion and related aspects of periodontal health, all of which are fundamental to contemporary routine dental care.

Given my experience as a part-time clinical teacher and the interactions I have with newly qualified colleagues, I am increasingly concerned by the disconnect between undergraduate curricula and the reality of everyday clinical practice. Graduates who have not been instructed in at least the basics of aesthetic dentistry, underpinned by a detailed knowledge of tooth morphology, and have little if any idea of how to recognise and diagnose occlusal discrepancies, let alone manage them, are destined to run into all sorts of difficulties in the management of patients.

My Foundation cannot reach out to all new graduates, early career dentists and dental therapists, but it is hoped that the activities of the Foundation, specifically its competitions, will encourage much-needed personal development amongst those embarking on their careers in dentistry, with an emphasis on the importance of interactive, high quality, face-to-face learning. While online learning has a place, and there are many good programmes, much of what new graduates and early career oral healthcare professionals access, typically on their phones, is advertorial material, often presented by self-professed experts with limited experience, either lacking an evidence-base, or frankly wrong and potentially harmful to patients. Determining what is good quality online learning material is challenging, especially for colleagues transitioning to independent practice.   

Nairn Wilson: What is the intended synergy between your Foundation and the College? 

Tom Bereznicki: The Foundation is an independent body which seeks to work in partnership with other organisations and the dental industry to realise its aims and objectives. The link with the College is intended to introduce new graduates and early career oral healthcare professionals to CGDent, and what the College does and can do for them and the profession.

It is hoped that young colleagues, especially those who benefit from the activities of the Foundation, will appreciate the benefits of membership of the College, with a view, over time, to being recognised as an accomplished practitioner – a Fellow of the College. Young colleagues need to appreciate the value and importance of being part of the forward-looking College – part of the new, increasingly powerful, unified voice for dentistry, contributing to standards set by the profession for the profession, taking advantage of a recognised career pathway, mentoring and much more.

Nairn Wilson: With the need to grow and further develop the College, with one of its immediate, pressing priority being eligibility for the award of a Royal Charter, what is your message to Fellows who are not yet donors to the College?

Tom Bereznicki: The College has achieved a great deal from, in effect, a standing start three years ago, and still has a lot to do to achieve its potential, let alone operate on a level playing field with the long-established Royal Colleges, which history tells us, benefited from huge support during their development. There is no ‘something for nothing’. Dentistry must help itself to justify Royal recognition of its own independent college.

Rather than apply a development levy to subscriptions, it is better and more powerful to grow by means of voluntary donations. Yes, these are challenging times for colleagues, but it is also a challenging time for our profession, which needs parity with other mainstream healthcare professions, new UK-wide leadership and direction and recognition in general healthcare and in the eyes of the public – all the things the CGDent aims to deliver. This surely is worthy of support, specifically by those the College has recognised to be leaders in the field.

Nairn Wilson: Tom, thank you for your views and comments, which I very much hope will be read and taken to heart by both all members of the College and colleagues yet to join CGDent. Thank you also for your tremendous ongoing support of the College, which would not be where it is today without your contribution, nor without the support provided by all existing donors.  

Tom Bereznicki is a Fellow and Founder Member of the College and a College legator. The Tom Bereznicki Dental Education Foundation supports the CGDent-GC Award for Foundation Trainees, the Tom Bereznicki Award for Advanced Aesthetic Dentistry and the upcoming occlusion and perio-occlusion symposia for early career dentists.

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