Dr Roshni Karia MCGDent, President of the College of General Dentistry, describes the four pillars of its new philosophy of care, an approach it encourages all oral healthcare professionals to adopt in the interests of patients.
When I first took office as President of the College of General Dentistry, the College Council worked hard to focus our priorities. We carefully crafted our mission and vision for dentistry, which set out our values and anchored our initiatives in professional morality, institutional integrity and the public interest. This ethical foundation speaks directly to our ongoing aspirations for a Royal Charter for our profession.
To help guide the evolution of contemporary oral health care, the College has now established a four-pillar philosophy of care – a living blueprint which serves as a professional compass for our entire oral healthcare community:
1. Holistic care
Oral health is inextricably linked to general health, and we are developing an Oral Health for Healthcare curriculum for the wider health and social care workforce. This initiative, in which we are working with the Chief Dental Officer for England and supported by Colgate, will create an ecosystem of resources which finally recognises oral health as a central tenet of systemic health and wellbeing.
By adding an oral health dimension to their practice, healthcare colleagues beyond dentistry will be equipped to raise awareness of oral-systemic connections. Actionable prompts and accessible resources will empower patients and streamline communication throughout health and social care. Importantly, it will aim to synchronise the care patients receive between general and oral healthcare systems.
We are already collaborating with stakeholders in many relevant sectors:
pharmacy and retail
general nursing and general medical practice
dietetics and diabetes care
cardiology, bone health and oncology
health visiting, early years, and care homes
undergraduate medical education
This means the resources will be directly applicable to those involved in:
early years and maternity care
care of adults and chronic disease management
elderly and dementia care
disabilities and complex care needs
To ensure widespread clinical utility, we have collated early insights and hosted a workshop designed to understand the real-life challenge that our frontline colleagues face. We have now started to work through potential solutions to navigate these hurdles, as we progress to engineer simple, realistic and pragmatic resources. This initiative will position the College as the leading authority in oral health among our health and social care colleagues.
2. Assured care
Through our formalised career pathways, credentialling schemes and portfolio of guidelines, the College promotes higher standards of care to assure clinical quality and patient safety. Our Faculty Deans have worked hard to develop progressive career pathways, underpinned by our Professional Framework, to provide a more structured and supported career trajectory for all those working in dental primary care.
To take but one example, our Certified Practitioner programme will help to validate the higher skill levels individuals have achieved, and the greater knowledge and further experience they have gained, in specific disciplines. Planned to extend to all members of the oral healthcare team, this will support colleagues in more strategic decisions about their career choices as well as help patients to make informed decisions about the care they receive.
Fellowship, the most distinguished membership of the College, focuses on how members of the whole team have developed their practice for the benefit of both patients and the wider profession. Whether it be through clinical expertise, teaching, research, leadership or in the legal/ethical field, Fellows help the College serve as a catalyst for a shared community of practice. This ensures we can support one another in realising our professional aspirations and reinforce our sense of belonging, while serving patients at our very best.
To ensure greater confidence among practitioners in navigating postgraduate and post qualification education, the College is launching a Training Provider Forum. This group will allow post-qualification education providers to help shape the College’s developing role in quality assurance, guide early-career practitioners, and support our credentialling schemes. Furthermore, our Academic Court will recognise those whose intellectual contributions are central to the delivery of the College’s mission, bringing them together to ensure the College’s continued authority in promoting high standards in education and practice.
Together, these initiatives empower the workforce, advance the profession and support the public and patients to achieve and maintain good oral health.
3. Responsive and proactive care
We aim to drive a major shift from reactive treatment to patient-centred prevention, early detection and tooth preservation, and have convened an international expert consensus group to review the evidence and create a pragmatic framework around initial caries management for the whole oral healthcare team.
Supported by vVardis, this work is led by Professor Avijit Banerjee FCGDent, Dean of the CGDent Faculty of Dentists, who has set out the details of this pivotal aspect of our philosophy of care in the latest issue of the Primary Dental Journal (PDJ). It is intended that this paper will form the basis for upcoming, evidence-based recommendations on the management of early caries in general dental practice.
4. Ethical and Professional Care
The College actively promotes a moral and ethical framework for treatment choices. This includes the importance of beneficence and the decided focus on diagnosis, while carefully weighing the nuanced detail and salient facts that inform our management options.
Some of you will have heard the inaugural College Lecture, Satisficing standards in dentistry: Who decides? Who benefits?, which was delivered by Mr Martin Kelleher FCGDent in June 2025; these questions will also be discussed in the next issue of the PDJ. Building upon the same themes, Dr Catherine Rutland FCGDent will be delivering the 2026 College Lecture, The Ethical Shield: Protecting enamel, professional integrity and patient smiles, on Thursday 12 November in London; this is open to all dental professionals, and others with professional interests in contemporary dental practice, and I encourage readers to attend if you can.
Our upcoming articles and frameworks will guide the profession’s philosophy of care – proving that true sustainability in dentistry starts with preserving enamel.
Writing the future of dentistry
Through these four pillars, we aim to write the future of dental care for the UK and beyond. We are setting a bold direction built upon the firm foundations we proudly inherited from the former Faculty of General Dental Practice UK (FGDP).
As we celebrate the fifth anniversary of the College, I encourage you to be a part of this journey, where our ambitions speak confidently toward a future Royal College – as our Honorary Founding President, Professor Sir Nairn Wilson CBE, has previously said, “a College that befits excellence in the care of patients with dedicated support for the profession.”
I urge all those delivering oral healthcare to adopt this philosophy of care for the benefit of patients everywhere, and to get behind your future Royal College so that it can stand tall on behalf of all the dental professions. Working together, let these be our greatest achievements.
This article was first published in the recent ‘Dental education’ issue of the Primary Dental Journal, further information on which is available via the button below.
‘Initial dental caries management: a College of General Dentistry (CGDent) philosophy of care statement’, by Professor Avijit Banerjee, is in the same issue. This paper is currently restricted to College members and PDJ subscribers, however it is intended that it will be made available to the whole profession in due course.
Dr Stuart Ellis FCGDent, Director of the Postgraduate Certificate in Dental Education at the University of Cambridge and Guest Editor of the new issue of the Primary Dental Journal (PDJ) dedicated to dental education, reflects on the meaning of competence in dentistry.
Competence. It is worth pausing for a moment and reflecting on what we mean by this word, which at first glance may seem obvious. Competence is the central concept that dental education has been revolving around since dentistry first became a profession. Competence has become, as Lingard pointed out, a “god term”.1 It has evolved into a word that sits superior to all other expressions of ability. As a “god term” it is often used as the final word in debates on how dental professionals should function. It is a term with such high moral power that it is inherently accepted, without question, as a self-defining trump card. The new edition of Primary Dental Journal (PDJ) explores deeper thinking about competence by addressing questions such as, what is it, how do we know we have it, how do we hold on to it and what can we do if we lose it?
At undergraduate and postgraduate levels, we pass examinations to show that we are competent. We aim to demonstrate that we can be trusted to treat patients safely. Since Biggs’ model of constructive alignment highlighted the need to ensure that assessments measure what they should measure, healthcare educationalists have been striving for better ways to assess the competence of professionals.2 It became clear that a dentist who could write a competent essay in an examination was not necessarily demonstrating the ability to be a competent dentist. The paper in the new issue of PDJ by Thomas O’Connor explores the increasing use of Entrustable Professional Activities (EPAs) as an assessment tool in dentistry. The utilisation of EPAs as a form of workplace assessment was first proposed by ten Cate as a means to bridge the gap between theory and “real world” clinical practice; a tool to enable a person to demonstrate what they can do, rather than just what they know.3
The conventional understanding of competence, as a predetermined stage of ability to be reached by an individual, has its limitations. After gaining a dental degree, a postgraduate certificate or a postgraduate diploma the expectation is that the dental professional has reached a general level of competency in a specified field of learning. This simplistic conceptualisation of competence fails to account for the complexities of human performance. An individual may be competent one day, and incompetent the next. Human behaviour is multifaceted and sinuous. Numerous emotional factors can exert a significant influence on the actions of professionals. Particularly prevalent in surgical fields, such as dentistry, ideas of competency are situated within a narrow and highly technical orientation. We tend to look at communication skills, diagnostic skills and operative skills without consideration of the wider context that dental professionals work in. The airline industry realised long ago the effect that human factors could have on the situational awareness, communication and decision-making abilities of air crew, leading to the introduction of training programmes in non-technical skills for pilots.4 The paper by Christopher Fowell describes the introduction of non-technical skills training for surgeons and explores how improved training in this field could help to improve patient safety in dentistry.
“Patient safety” has become another “god term” with such enormous rhetorical power that it deserves a closer look. Again, it is the airline industry who led the way when realising that passenger safety was best served through an open culture of transparency, where professionals are encouraged to report near misses and honest mistakes, so that the entire industry could learn from them. This was facilitated through the development of a “Just Culture”, where the focus of the system is on understanding why honest mistakes happen rather than punishing those who make them. Pilots are encouraged to admit errors without fear of unfair punishment, within an open system of learning that is overseen by a Just Culture Champion appointed by the Civil Aviation Authority.5 Shamir Mehta’s paper on Early Remediation explores ways in which the General Dental Council are working towards a more open culture of learning in dentistry through changes to the Fitness to Practice (FtP) procedures. Accepting that otherwise competent dental professionals can, for a variety of reasons, lose their competency, Early Remediation aims to support dental professionals in difficulty during the early stages of the FtP process. My own paper on mentoring in dentistry explores how this underutilised resource, which is awarded a high degree of importance by many other professions, can help all of us whether we are a practitioner in difficulty or just a professional seeking supported career development.
The other two papers that I have contributed to the issue delve into what we mean by competency and how we can show patients and colleagues that we have achieved a certain level of knowledge and skill. The research study that I conducted with my University of Cambridge colleague, Rachel Williams, explored the opinions of learners who took a practical skills assessment in implant dentistry, with no time limits for the assessed tasks. The responses showed that, in our fast-moving modern world, competency is often equated with speed. Faster operators are viewed as better operators, faster thinkers as smarter people. It is interesting to see how this concept has changed over time. Many of the greatest thinkers in human history, from Socrates to Descartes, were valued for the depth of their thinking rather than the speed of their thinking. These great minds were known for the extensive amount of time they spent contemplating wisdom, not the speed that they produced it. Perhaps our modern perspective has been moulded by the consumerisation of society, under contemporary ideas that time is money and money equals happiness.
I hope that my third article in the Dental Education issue will help colleagues to navigate the plethora of postgraduate qualifications and awards in dentistry. I aim to persuade the reader that postgraduate qualifications and awards should be viewed as tools rather than trophies and that the most effective training course is the one that strengthens professional judgement, improves patient care and supports a coherent career direction.
This article was first published in the recent ‘Dental education’ issue of the Primary Dental Journal, which is now available online via the button below. Printed copies should arrive with College members by the end of October.
The Primary Dental Journal is the College’s quarterly peer-reviewed journal dedicated to general dental practice. 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.
References
Lingard L. What we see and don’t see when we look at ‘competence’: notes on a god term. Adv Health Sci Educ Theory Pract. 2009;14(5):625-628. Available at pubmed.ncbi.nlm.nih.gov/19856124/
ten Cate TJO, Snell L, Carraccio C. Medical competence: the interplay between individual ability and the health care environment. Med Teach. 2010;32(8):669-675. Available at pubmed.ncbi.nlm.nih.gov/20662579/
Professor Igor Blum, Editor of the Primary Dental Journal (PDJ), explores the challenges facing educators in preparing dental professionals for emerging technologies and the evolving needs of patients and healthcare services
Dental education in the UK stands at a critical inflection point. Rapid advances in digital technology, changing patient expectations, evolving regulatory frameworks, and increasing pressures on the NHS workforce are reshaping the knowledge, skills, and professional behaviours expected of dental professionals. Although the fundamental goals of dental education remain unchanged – to develop safe, competent and ethical practitioners – the means by which this is achieved are undergoing considerable transformation. Across undergraduate and postgraduate education, the question is no longer whether change is necessary, but how best to prepare current and future members of the dental team for an increasingly complex, technologically enabled and dynamic healthcare environment.
This challenge is explicitly recognised in the General Dental Council’s Safe Practitioner framework.1 The framework reflects a broader conception of professional competence, extending beyond clinical knowledge and technical proficiency to encompass professionalism, communication, cultural awareness, wellbeing, sustainability, reflective practice and the ability to work safely within one’s scope of practice.1,2 In doing so, it signals an expectation that dental education should not merely equip students to meet current standards, but should also develop the adaptability, judgement and commitment to lifelong learning required to respond to the evolving needs of patients, healthcare services and society.
The articles in the upcoming themed issue of the Primary Dental Journal (PDJ), guest edited by Dr Stuart Ellis FCGDent, offer a timely illustration of these developments. Collectively, they demonstrate how dental education is evolving beyond a traditional focus on technical proficiency towards a more holistic model of professional formation. Articles addressing the alignment of undergraduate dental education with primary care, remediation, mentoring, workplace-based assessment, non-technical skills, credentialing and postgraduate career development reflect a growing recognition that excellence in dentistry depends on far more than procedural competence alone. It also requires professional discernment, effective communication, professionalism, adaptability and a sustained commitment to continuous learning and development.
An article on aligning undergraduate dental education with contemporary primary dental care develops one of the central propositions of the issue: dental primary care should not be regarded merely as the destination to which graduates are delivered, but as a partner in determining what and how they are taught. It argues for stronger primary care representation in curriculum design, authentic and well-supported outreach education, closer feedback between dental schools and the regional dental deaneries responsible for foundation training, and the teaching of digital dentistry and artificial intelligence (AI) within the clinical contexts in which they will be used. This perspective is especially important because primary care is where scientific knowledge, technical capability, professional behaviour, technology and individual patient circumstances must be integrated in everyday decision-making.
Another notable contribution relates to the growing recognition of professional development as a continuous process rather than a succession of discrete educational milestones. The discussion of early remediation in the context of Fitness to Practise processes reflects a broader shift towards supporting dental professionals through timely feedback, structured reflection and developmental intervention. Such approaches align with contemporary educational thinking and acknowledge that professional growth often arises from identifying, addressing and learning from difficulties, rather than from avoiding them altogether.
Closely related to this is an article examining the role of mentoring, which has assumed increasing prominence across the healthcare professions. The growing complexity of clinical practice, together with concerns about practitioner wellbeing, workforce retention and career satisfaction, has made mentoring an increasingly important component of professional development. Effective mentoring can support transitions from undergraduate education to foundation training and through subsequent career stages, helping students and dental professionals navigate uncertainty, develop confidence, strengthen professional identity and make informed decisions about their future development.
At the same time, advances in educational theory are reshaping how competence is conceptualised and assessed. The growing interest in Entrustable Professional Activities (EPAs), explored in this issue, reflects a wider international trend towards competency-based education. EPAs define key units of professional practice and provide a framework for making explicit judgements about whether a learner can be entrusted to undertake them safely with a specified level of supervision. By assessing the integration of knowledge, clinical skills, professional behaviours and judgement within authentic clinical settings, this approach moves beyond the evaluation of isolated competencies. EPAs may therefore offer a more meaningful means of determining readiness for progressively independent practice and align closely with contemporary understandings of workplace-based learning.3
Assessment itself continues to evolve. The experiences reported in this issue of candidates undertaking Objective Structured Assessments of Technical Skills (OSATS) without fixed time limits raise important questions about the purpose of assessment and the constructs it is intended to measure. Dental educators have long recognised that performance under examination conditions does not necessarily equate to capability in the workplace. Although efficiency is an important component of safe clinical practice, assessment should distinguish between appropriate clinical fluency and speed for its own sake. As curricula place increasing emphasis on patient-centred care, critical thinking, professional judgement and professionalism, assessment strategies must reward integrated and meaningful competence rather than rapid task completion alone.
The future direction of dental education is inseparable from technological innovation. Digital dentistry has progressed from a relatively specialised area to an increasingly important component of contemporary clinical practice. Intraoral scanning, computer-aided design and computer-aided manufacturing (CAD-CAM), three-dimensional printing and advanced imaging technologies are becoming more widely used across primary and secondary care settings.4 Undergraduate dental programmes must therefore ensure that graduates possess the digital literacy required to practise safely and confidently within technologically enhanced clinical environments. Postgraduate education must likewise provide opportunities for practitioners to develop, update and critically evaluate their digital capabilities as technologies and their clinical applications continue to evolve.
AI may prove even more transformative. AI-assisted radiographic interpretation, clinical decision support and predictive treatment-planning systems are already beginning to influence healthcare delivery.5 Although these technologies offer considerable potential to improve efficiency, consistency and diagnostic accuracy, they also present important educational, ethical and professional challenges.6-8 Undergraduate and postgraduate dental education must therefore prepare practitioners not only to use AI-enabled systems, but also to interrogate their outputs critically, recognise bias and uncertainty, understand their limitations and maintain appropriate safeguards for patient information.9,10 Crucially, professional accountability for clinical decisions cannot be delegated to an algorithm. The ability to use intelligent technologies to augment – rather than replace – clinical judgement is therefore likely to become a defining professional competency.
Advances in simulation technology are similarly reshaping dental learning environments. Virtual reality, augmented reality and haptic simulation platforms enable students to practise procedures repeatedly within safe and controlled settings. These technologies have the potential to support deliberate practice, improve standardisation, provide objective and immediate feedback, and enhance patient safety, particularly during the early stages of clinical training.11,12 Nevertheless, simulation must remain a complement to, rather than a substitute for, authentic patient care. It can prepare students for clinical encounters, but it cannot replicate the uncertainty, complexity and human interaction inherent in treating real patients. Communication, empathy, adaptability and professional judgement can be rehearsed in simulated environments, but they are ultimately developed and tested through genuine clinical experience.
An article examining non-technical skills is particularly relevant in this context. Evidence from healthcare has consistently shown that communication failures, ineffective teamwork and loss of situational awareness are important contributors to adverse events.13 Lessons from medicine, aviation and other high-reliability industries have therefore emphasised leadership, teamwork, decision-making and the management of uncertainty as essential components of safe professional practice.14 Increasingly, these non-technical skills are being recognised not as desirable additions to technical competence, but as indispensable attributes of the contemporary dental professional.15 Technical expertise alone is insufficient if it is not accompanied by the ability to communicate effectively, anticipate risk, work collaboratively and respond appropriately when circumstances change.
This broader understanding of competence also has important implications for postgraduate education and workforce development. NHS England’s Dental Education Reform Programme, informed by the Advancing Dental Care review, seeks to establish training pathways that better prepare dentists for multidisciplinary practice and evolving patient needs.16 The reforms emphasise broader clinical exposure, greater flexibility in training and closer integration with wider healthcare systems. They acknowledge that future dental professionals will increasingly be expected to work across traditional professional and organisational boundaries, contribute to integrated models of care and respond to the needs of populations rather than individual episodes of treatment alone.16
Articles concerning credentialing and postgraduate qualifications highlight a related evolution in professional development. Expertise has traditionally been viewed through a binary distinction between generalist and specialist practice. Yet the increasing complexity of patient care has created a need to recognise enhanced skills and experience that sit between these established categories. Appropriately governed credentialing could provide a means of recognising such expertise, supporting more flexible workforce models and improving access to care.
However, credentialing must be transparent, consistent and underpinned by robust educational and assessment standards. The possession of a postgraduate qualification should not automatically be equated with clinical capability, just as the completion of a course does not in itself establish readiness to undertake more complex care independently. Any system intended to recognise enhanced practice must demonstrate that the practitioner can apply knowledge, skills and judgement safely and consistently in the workplace.
The expanding range of postgraduate qualifications nevertheless reflects a profession in which lifelong learning has become an expectation rather than an aspiration. Education can no longer be understood as something completed at graduation or at the end of formal training. Rapid technological and clinical change requires practitioners continually to review their knowledge, refine their skills and reconsider established approaches throughout their careers.
The COVID-19 pandemic accelerated many of these developments. Digital learning platforms, virtual seminars, remote assessment and blended-learning approaches rapidly became commonplace, demonstrating that many aspects of education could be delivered effectively through technology-enhanced methods.17 Although dentistry will always retain a substantial face-to-face and clinical component, the pandemic exposed the limitations of assuming that education must invariably be delivered in a particular place, at a particular time and in a single format. It also created opportunities to develop more flexible, accessible and student-centred educational environments.17 The challenge now is to retain what proved educationally valuable rather than simply reverting to familiar practices.
As these changes continue, dental schools and postgraduate education and training providers face a delicate balancing act. Innovation must be embraced, but not merely because a technology or educational approach is new. Its value should be judged by whether it improves learning, strengthens professional capability or enhances patient care. Scientific rigour, technical competence, ethical practice, patient safety and professionalism remain the foundations upon which all educational innovation must be built.
The articles in the issue, which will be published shortly, will offer valuable perspectives on many of the challenges and opportunities currently facing dental education. Whether addressing the alignment of undergraduate education with primary dental care, remediation, mentoring, workplace-based assessment, non-technical skills, credentialing or postgraduate career development, they collectively portray a profession adapting to substantial change. They also reinforce a central message: the future dental professional must be more than technically accomplished. They must be digitally literate, critically reflective, professionally resilient, ethically grounded and capable of working effectively within increasingly complex healthcare systems.
Dental education in the UK is therefore experiencing more than incremental change; it is undergoing a fundamental reorientation. Yet transformation should not be measured by the number of technologies introduced, curricula rewritten or qualifications created. Its success will ultimately be determined by whether undergraduate and postgraduate dental education produce practitioners who can integrate technical expertise with sound judgement, humanity and professional accountability.
By embracing technological innovation, strengthening the continuum between undergraduate and postgraduate development, supporting meaningful approaches to learning and assessment, and maintaining an unwavering commitment to patient-centred care, dental educators can prepare practitioners and dental care professionals not only for the demands of contemporary practice but also for a future that will continue to evolve. The inflection point has arrived. The decisions made now will shape not only how the next generation is educated, but also the kind of profession dentistry becomes.
To receive the Dental Education issue of the PDJ, join the College by Wednesday 23 September 2026.
The Primary Dental Journal is the College’s quarterly peer-reviewed journal dedicated to general dental practice. 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.
The Dental Education issue will be available online in late September and printed copies should arrive with College members in October.
Ten Cate O. What entrustable professional activities add to a competency-based curriculum. Acad Med. 2014;89(4):691-692.
Zitzmann NU, Matthisson L, Ohla H, et al. Digital undergraduate education in dentistry: a systematic review. Int J Environ Res Public Health. 2020;17(9):3269.
Schwendicke F, Samek W, Krois J. Artificial intelligence in dentistry: chances and challenges. J Dent Res. 2020;99(7):769-774.
Annamma LM, Varma SR, Abuttayem H, et al. Current challenges in dental education: a scoping review. BMC Med Educ. 2024;24(1):1523.
Khanagar SB, Al-Ehaideb A, Maganur PC, et al. Developments, application, and performance of artificial intelligence in dentistry: a systematic review. J Dent Sci. 2021;16(1):508-522.
Uribe SE, Maldupa I, Schwendicke F. Integrating generative AI in dental education: a scoping review of current practices and recommendations. Eur J Dent Educ. 2025;29(2):341-355.
Kavadella A. Guest Editorial: Artificial Intelligence in Dental Education. Eur J Dent Educ. 2024;28:923-924.
Reddy MS, Nalliah R, Ohyama H. Human-centered dental education in a time of advancing technology. J Dent Educ. 2024;88(10):1315-1317.
Al-Saud LM, Mushtaq F, Allsop MJ, et al. Feedback and motor skill acquisition using a haptic dental simulator. Eur J Dent Educ. 2017;21(4):240-247.
Towers A, Field J, Stokes C, et al. A scoping review of the use and application of virtual reality in pre-clinical dental education. Br Dent J. 2019;226(5):358-366.
Leonard M, Graham S, Bonacum D. The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care. 2004;13(Suppl 1):i85-i90.
Catchpole KR, Giddings AEB, Wilkinson M, et al. Improving patient safety by identifying latent failures in successful operations. Surgery. 2007;142(1):102-110.
Flin R, O’Connor P, Crichton M. Safety at the Sharp End: A Guide to Non-Technical Skills. Aldershot: Ashgate; 2008.
NHS England. Dental Education Reform Programme. Workforce, Training and Education. [Internet]. London: NHS; 2026. Available via NHS England Dentists in Training programme, hee.nhs.uk/our-work/dentists-training [Accessed Aug 2026].
Quinn B, Field J, Gorter R, et al. COVID-19: The immediate response of European academic dental institutions and future implications for dental education. Eur J Dent Educ. 2020;24(4):811-814.
Dr Mariam Ahmed, one of the successful candidates in the 2026 CGDent-GC Award, reflects on entering the competition and what she gained from the experience.
More than a competition: The award explained
The CGDent-GC award was founded by the Tom Bereznicki Charitable Educational Foundation in conjunction with the College of General Dentistry and GC. The award requires entrants to submit a clinical case report involving at least one anterior tooth restored with composite, with winning entrants each being awarded a fully funded place on a two day composite layering course in Belgium.
Entering the award is an easy process, with guidance documents available on the College website providing everything an entrant could need, from examples of acceptable photography to advice on compiling a written case report. As well as this, a dedicated email address is available for further enquiries with helpful staff on the receiving end to provide support. After gaining consent to enter the award from your patient, educational supervisor, and preferably your training programme director, it’s time to take and submit pre-op photos following which suitable cases will be accepted. Then once the case has been completed, submit your post-op photos and final report, and patiently wait to hear if you are one of the successful candidates. There is also a window of opportunity to change your case should you identify a more suitable case later on.
Inside my winning entry
After hearing about the award on social media during my final year of dental school, I was keen and ready to enter as soon as I identified a suitable case. As I am undertaking joint dental foundation and core training, my case was carried out in the Dental Hospital Restorative department and involved six anterior composite build ups to manage tooth surface loss aided by a diagnostic wax up. The timeline of the award is extremely manageable. I entered the award in September 2025, submitted my report in February 2026, and was proud to have been selected as a winner in May 2026.
Belgium unwrapped
Home to the GC European campus (and plenty of chocolate), winning entrants travelled to and stayed together in Leuven, a university city just east of Brussels. With a whole host of restaurants and ice cream parlours lining the cobbled streets, entrants had plenty of time to get to know each other on arrival to the city and throughout the evenings, before returning to the hotel to wind down over games of cards and pool. It was rewarding to meet likeminded foundation trainees from across the country and share our experiences so far, as well as our future ambitions. A highlight for many from this trip was our final night in Belgium during which we joined the CGDent and GC team for a celebratory dinner before finishing the night enjoying Leuven’s annual open air summer music festival.
Layering composite and learning new skills: The course
The course itself was split over two days and led by Dr Simone Moretto, GC’s training manager. The campus was well equipped with a comfortable café, spacious seminar rooms and an advanced clinical skills unit. The first day involved a lecture on colour theory, bevelling, and material selection before moving onto phantom models and working in tandem with Dr Moretto to restore a class IV cavity on a central incisor using a layered technique. The second day involved further clinical practice to restore a discoloured lateral incisor using a direct composite veneer, and multiple class II cavities using various approaches such as a cusp by cusp, injection moulding, and stamp technique. Emphasis was placed on recreating anatomical details, utilising new instruments and materials appropriately, implementing a step wise polishing protocol to achieve life like results. Over both days, Dr Moretto was on hand to critically appraise our work under the microscope and provide personalised feedback and demonstrations.
The course helped me develop an understanding of how small anatomical details can significantly improve the aesthetics of the final restoration. I gained practical experience in creating a natural emergence profile and contact point using anterior sectional matrices which I found provided me with a consistent outcome as opposed to the traditional mylar strip I previously used with difficulty. I began learning how to layer enamel and dentine shades in order to highlight anatomical features such as mamelons to create a more lifelike result. I also had the opportunity to learn about polishing protocols and how altering the direction and speed of my polishing discs could better enhance surface anatomical details such as perikymata whilst still achieving a gloss finish.
The pace of the course encouraged precision, and with the help of further tutorials and regular feedback from my educational supervisor, I have begun to consolidate my knowledge and implement these skills in practice.
Thinking of entering? My top tips
Photos are key
The advice I would give future entrants is to take photos of everything! Clinical photography is an invaluable skill to develop early in your career. Photos are essential in completing milestone cases and case based discussions which is a requirement of successful completion of foundation training, but are also invaluable for reflection and self-improvement, building a portfolio to aid future employment, to gain second opinions and make referrals, and in educating and motivating patients.
Picking up a camera can be daunting, especially early in your career when you have so much else to focus on, but confidence comes with practice. Take notes during your photography study day, request further practice in a tutorial with your educational supervisor, and practice on your colleagues during cancellations!
Advice from colleagues
The second piece of advice I would give future entrants is to discuss cases with colleagues! Make use of the experience your senior colleagues have and ask how they would approach the case, what materials and instruments they would use, what problems they think you could encounter, and how to overcome these. Before beginning my case I presented the pre-op photos to my educational supervisor in practice and a Restorative consultant in hospital and asked all of the above which made me feel much more prepared to manage my case. Discussing with colleagues also reminded me that dentistry is dynamic, there is rarely one right answer to a problem and the best way to learn is by trial and error until you find out which techniques work in your hands.
The power of reflection
The third and final piece of advice I would give future entrants is to not rush your reflection. It’s easy to become tunnel visioned when focusing on minute details for an extended period of time. Step back from the case and revisit it with a fresh set of eyes, whether that be reviewing post-op photos or the patient themselves sometime after completing the case. I have found that my best reflection often comes weeks after completing a case, particularly if I have observed or carried out a similar style treatment since then. I am lucky to work alongside a large team of trainees and specialists in Restorative Dentistry in hospital, and I asked one of my supervising consultants to provide feedback on my winning case. They kindly agreed and when the patient returned for review, they carefully inspected my composite work from aesthetics to function and enquired about my technique, giving me much to reflect on when compiling my final report.
I am a firm believer that every day is a learning opportunity if you are willing to look for it. Implementing the above three pieces of advice will help any foundation dentist or therapist begin their journey of development from trainee to trusted clinician.
Dr Tom Booth FCGDent, a general dental practitioner based in Cumbria, describes his professional journey and how his knowledge, skills and experience led to College Fellowship.
Q. Can you tell us about yourself and your career?
A. I am a general dentist, working in the private sector for 21 years. I have always strived to stay educated and up to date. Early in my career I completed a Master’s in Oral and Maxillofacial Surgery, followed by a Diploma in Dental Implantology, Certificate in Periodontology, Diploma in Orthodontics and most recently a Master’s in Fixed and Removable Prosthodontics.
I work 3.5 days providing general dentistry and more specialist work, mainly oral surgery, implantology and complex restorative cases. I also teach one day a week on the Fixed and Removable Prosthodontics Master’s course at the University of Manchester.
I am a Fellow of the Higher Education Academy and have a mentoring qualification too. I am currently halfway through a six-year part-time Law degree, studying with the Open University, with the aim of helping dentists in medicolegal trouble, offering independent legal advice.
Outside of dentistry, I am a keen road cyclist, runner and car enthusiast, which I hope I can pursue into old age!
Q. Why did you decide to apply for College Fellowship?
A. I applied to become a College Fellow, as it provides a pathway which recognises my commitment to education in dentistry, as well as the high standards I aim to achieve for my patients. It also now represents an avenue in which clinical and academic credentials can be recognised in the Certified Practitioner Scheme, which is currently being rolled out. This will hopefully help me become even more referral based and carry out more of the advanced procedures I am trained to do.
Q. Which three of the five fellowship domains does your professional experience meet?
A. My professional experience fits in with the Clinical & Technical, Teaching & Assessment and Research & Publications domains.
Having obtained a Master’s of Science in both Oral and Maxillofacial Surgery, Fixed and Removable Prosthodontics, I met the Clinical & Technical domain. These qualifications also satisfied the Research & Publications domain via a written dissertation for both qualifications.
I managed to satisfy the Teaching & Assessment domain, as whilst working at the University of Manchester I was lucky enough to complete the Fellowship of the Higher Education Academy, an eligible teaching qualification.
Q. What would you say to others who are considering applying for Fellowship through the experience route?
A. I would advise anyone considering applying for Fellowship through the experience route to give it a try! The process is fair and allows a wide range of evidence to be used across all domains and recognises years, sometimes decades, of hard work!
Collating all your evidence and checking and organising your curriculum vitae is essential to a successful application, with all criteria clearly stated on the College of General Dentistry website.
Fellowship of the College
Fellowship of the College is the mark of accomplishment in dentistry, celebrating achievement across the different dimensions of your career.
All dental professionals can apply for admission to Fellowship by providing evidence to show how your knowledge, skills and experience meet the criteria of our fellowship domains.
Dr Pardeep Saini AssocFCGDent, a Specialist Orthodontist practising in Bristol, reflects on the College’s Leadership Development Masterclass led by Professor Sreenivas Koka FCGDent and Professor Elizabeth Carr FCGDent.
Have you ever booked onto a CPD course convinced it’s exactly what you need but quietly suspect that it would probably just be…OK?
You clear your clinic weeks in advance. You make the journey, your attention is ‘maintained’ by multiple cups of questionable ‘coffee’, you listen politely for six hours and leave having been reminded of things you already knew. It wasn’t a bad day – it just wasn’t memorable.
If you’ve been there, then you’ll understand why I saw the word “leadership” on the programme and assumed this course would be much the same.
On 14th October 2025 I attended the College’s inaugural Leadership Development Masterclass, and everything began exactly as expected: an early commute into London, a welcome break from clinic and the quiet assumption that I’d leave with a few useful reminders. I couldn’t have been more wrong.
It was a day that opened my mind and my heart to a different way of thinking about leadership.
What surprised me most wasn’t the extensive CVs of the speakers. It was the humility with which they shared their failures, their uncertainty and the lessons they’d learnt along the way. This wasn’t leadership as charisma or authority; it was leadership cultivated from curiosity, service and continual learning.
This course has lived with me every day since. I’m still revisiting my notes. I’m still working through the brilliant book references. Concepts from the course still resurface before difficult meetings or when I’m thinking through challenges with my team. I’ve attended many CPD courses over the years; very few continue teaching me long after I’ve left the room.
I was fortunate to hear about lessons taken from a diverse range of sources including the Navy Seals, The Mayo Clinic and M.I.T to name a few. What struck me was how every idea was grounded in evidence. Concepts that could easily have remained abstract were supported by data, research and real experience – a combination that’s surprisingly rare.
Before this course, I tended to think feedback was simply feedback. I now realise that appreciation, coaching and evaluation are all different forms of feedback. Failing to understand the difference and when to use each often leaves team members confused or demoralised – even when our intentions as leaders are good.
Since then, I’ve become much more intentional about conversations with my team. Before giving feedback, I ask myself a simple question: what does this person need from me right now? Recognition? Coaching? Or evaluation? That one change has improved the quality of conversations far more than any leadership skill I’ve previously learnt. This is just one example of the many lessons I learnt at this masterclass. Listing them all would be impossible. Suffice to say the value of the course to me wasn’t the individual learning points but more how it improved the way I think.
I’m fortunate to spend my days as an associate Specialist Orthodontist leading a busy NHS service in primary care. Alongside treating patients, I oversee three orthodontic therapists, a wider clinical support team and have been heavily involved in reception training. It’s a role I love, but one that has occasionally left me feeling less prepared as a leader than I am as a clinician.
As Chair of both the Bristol Orthodontic MCN and, nationally, the Orthodontic Specialists Group at the British Orthodontic Society – leading highly-intelligent and accomplished peers requires a different style of leadership from that used in the clinic, yet I found that the principles from the masterclass apply equally well in both settings.
This masterclass didn’t give me a checklist for becoming a better leader. It gave me something much more valuable: a different way of thinking about people, conversations and responsibility. Those lessons have already changed how I lead today and will undoubtedly shape me as the director of an independent Specialist Orthodontic Practice I hope to build in the future.
I’m deeply grateful to Professor Sreenivas Koka and Professor Elizabeth Carr for sharing their knowledge, ideas and experiences with such honesty and generosity. I’m equally grateful to the College of General Dentistry for organising the masterclass and giving me the opportunity to be part of its inaugural cohort and attend one of the few CPD courses that didn’t require copious cups of coffee to keep me engaged!
We often measure CPD in hours. The best CPD, however, is measured in the decisions it changes long after the certificate has been filed away.
Nine months on, it’s still teaching me.
The 2026 Leadership Development Masterclass will take place on Thursday 24 September in London. There are limited places available and College members benefit from a reduced fee. To find out more and secure your place, click the button below.
Caroline Persaud, a Clinical Dental Technician and board member of the College’s Faculty of Dental Technology and Clinical Dental Technology, describes her experience of the Foundation Nakao – CGDent Award in Coaching and Mentoring.
I qualified as a Clinical Dental Technician in 2007 and have practised, within my own business, for 19 years. Although I have been on the Faculty Board representing my profession for several years, at times I have lacked the confidence to impart my knowledge and opinions with others without seeming too direct. So when the Foundation Nakao – CGDent Award was announced last year, my primary motivation in applying was to gain skills to support this role. My second driver was that opportunities like this do not come along every day – and it was specifically for Dental Care Professionals. I took the plunge, pushed the nervous twitch to one side, submitted my application and was delighted to be awarded a place.
The course provided an opportunity to step back from day-to-day practice and reflect on how we support colleagues, trainees and the wider profession. Although many of us naturally share knowledge and experience in practice or the laboratory environment, the course helped me gain a greater understanding of the differences between advising, coaching and mentoring. The result was that I gained a base knowledge of how each can positively influence professional growth and confidence.
One of the most valuable aspects of the programme was enjoying learning alongside fellow DCPs from a range of professional backgrounds. The course was delivered online, which I had some reservations about as any type of home-based or non-face-to-face learning is often fraught with distractions. However, all my misgivings were dispelled within the first 45 minutes. The discussions were engaging, supportive and thought-provoking, with relatable content and scenarios that brought about a meeting of minds from the group of DCPs in attendance. The course leaders created an excellent environment for open conversation and shared learning.
The most useful part of the course for me was the Coaching Supervision Interview. Conducted just ahead of Day 3, this exercise gave me the opportunity to put the knowledge learned so far into my everyday practice and illustrate how effective it was for me and my mentee.
Having sat on the Faculty board for some years, I have at times struggled to find my voice. However, I have realised that the environment of smaller gatherings of board members, where your opinions do not feel under scrutiny, seems to bring out my best thoughts and ideas; over time my fear of personal expression has alleviated, and I have truly found my voice. I also perceived that there was a similar pattern within some of my fellow board colleagues, so I wanted to encourage them to grow the same level of confidence to raise their hand and speak aloud. The coaching model I adopted for my test case worked seamlessly. Through a series of questions and conversation, the mentee was able to identify the problem, provide solutions and implement them in real time to achieve the end goal. I must say: it felt satisfying to have made a difference. Perhaps it was a small difference, but ‘mighty oaks from little acorns grow‘.
As all professionals will confess, time is a precious commodity. One of the most poignant moments of Day 2 was a role-play session whereby I was mentor, and my mentee came to me with time management issues. This issue hit home hard; I am known for working some rather unorthodox hours and so I had a vested interest in this scenario. After five minutes of following a particular coaching model, the mentee had devised an action plan that seemed realistic. I sensed that this was genuinely going to be implemented and felt that I had influenced some key decision-making which would benefit the mentee going forward. It also illustrated the versatility of these techniques, and how they can apply to our personal situations as well as our professional roles.
When the final session commenced, there was an air of confidence and a real buzz amongst the delegates. Everyone had started to put into practice the skills learned during Days 1 and 2, and the open discussions revealed the positives and challenges, including some real personal triumphs. The groupwork flowed with a level of calm and conviction, with a real sense of pride that we all had applied ourselves and felt richer for the experience. Three days invested and well worth it!
Since attending, I have become more aware of how effective coaching and mentoring can support confidence, communication and career development within the dental team. The idea that ‘you get out what you put in’ is a timeless principle. As a group, we invested our time, our minds and our passion for the profession. In turn, we all came away enriched compared to where we began at the start of Day 1. If you follow the philosophy learned here, this course will broaden your thinking and provide you with the tools to gain the most from your colleagues, mentees and the wider dental community.
Attending the course was an extremely worthwhile experience, and one I would strongly encourage other Dental Care Professionals to consider applying for now that the course is being run again this year. I would highly recommend it to anyone who is passionate about supporting others and giving something back to the profession along with those who may see their future in a teaching environment of any kind.
An extended thank you to Foundation Nakao and to Professor Avijit Banerjee FCGDent for their generosity, and for working with the College to provide DCPs with this opportunity.
The Foundation Nakao – CGDent Award 2026 is now open to registered dental therapists, dental hygienists, dental nurses, orthodontic therapists, dental technicians and clinical dental technicians with at least two years’ post-qualification experience in their role. Applications close on Friday 31 July. To find out more and apply, click the button below:
Dr Choudhury Rahman, Associate Member,andDr Francisco Casserley FCGDent, discuss why informed patient consent and accurate record‑keeping are essential, and share their practical advice on the key points early career clinicians should consider.
Choudhury RahmanFrancisco Casserley
Something which worries many new dentists is the issue of litigation. We all dread that moment we get an email or a letter about a patient who is unhappy with something which we have done, or is wishing to make a complaint. One of the ways we can help ourselves is by ensuring we have really good consent, and clear record-keeping. Both of these things go hand-in-hand, and in this blog we will discuss how we can ensure we are protecting ourselves well.
Disclaimer: This is not an exhaustive guide to consent or record-keeping, but suggestions based on personal experience. We would recommend referring to the CGDent guidance on Clinical Examination and Record-Keeping, or undertaking CPD to ensure you gain a good understanding of best practice in consent and record-keeping.
GDC principles and putting patients first
As undergraduates we will have spent a lot of time learning and understanding the GDC Principles. Many of these link together, especially back to principle 1 which is to “Put patients’ interests first”. This should be at the centre of everything we do and ties strongly into principle 3, “Obtain valid consent”.
What informed consent really means
Consent is not just asking the patient what they want to do, but it’s giving them all the possible options for treatment so that they are able to make an informed decision. Some of these options may be things you can’t undertake, for example, a tricky root canal treatment (RCT), a difficult extraction, crown lengthening to improve restorability, or even implants. The possibility of alternative options out of your scope, including private options, should be given to every patient. You shouldn’t let any pre-conceptions about the patient stop you from giving those options. Whether the patient goes ahead with any of those, is up to them, but you need to document clearly all the options you have given, along with what the patient has decided to do.
We’ve also seen many colleagues worry over giving the patient a recommendation of treatment. However, in Principle 3.1.3, the GDC says that it is fine to give your patient “your recommended option”. As long as the recommendation is clinically reasonable, it will always be appropriate to give them a recommendation based on your opinion and clinical scenario. Many patients also value your expertise and experience and will be happy to go with your advice.
Discussing risks, benefits and alternatives
It’s very important to discuss all risks and benefits with patients for each option of treatment so the decision they make can be informed. You need to have this discussion recorded in your notes with all the risks and benefits given. For example, if you have a particularly tough extraction for an upper molar which is close to the sinus, you need to advise the patient there is a risk of pain, bleeding, bruising and swelling. You would also need to advise there is a risk of tooth fracture, oroantral communication (OAC), damage to adjacent teeth and tuberosity fracture (if it’s an 8). We’d suggest also warning your patient that if a fracture occurs, they may need to be referred to see someone else to have any remaining bits of tooth taken out. If there was a particularly high risk of OAC, you may want to offer the patient the option to be referred for an extraction, so that if an OAC occurs, it can be repaired straight away. The reason to refer due to the higher OAC risk needs to be specified. The patient may be in pain, for example, and happy to accept this increased risk, but you need to make that option clear to the patient. This issue was highlighted in an article by the Dental Defence Union (the DDU).
Montgomery 2015 and material risk
Continuing on with specific risks to your patient, you need to have a good understanding of Montgomery 2015 and informed consent. This relates to the matter of “whether the information given to a patient is adequate, is judged from the perspective of a reasonable person in the patient’s position” and that “patients are aware of ‘material risks’” (MDU, 2024). We would recommend reading into the case and the issues that were raised, but to explain this simply for us as dental professionals, if there is an issue specific to the patient, and there is a risk with a procedure which can have particular consequences to them, it needs to be explained clearly to them.
For example, if you had a patient who was a chef, and taste is very important in their job, you may wish to warn them of the risk of lingual nerve injury from an inferior alveolar block. You should warn that this risk may result in temporary or permanent changes in their taste. With this risk in mind, you and the patient may decide on alternative ways to achieve analgesia for a dental procedure. This is only one example of the thought process you need to have when consenting a patient to treatment.
The importance of contemporaneous clinical notes
We all hate spending much of our time writing clinical notes, but there are many small details we have seen people miss. As mentioned in GDC Principle 4.1, “you must make and keep contemporaneous, complete and accurate patient records”. You need to ensure whoever is present in the room is recorded. This is particularly important in relation to paediatric patients in case safeguarding issues are being investigated. Any presenting complaints (PC) must be documented, along with the history of presenting complaint (HPC). These must be recorded in the patient’s own words. For example, if the patient says “I feel like ripping my tooth out”, put that in your notes in quotations. This could be important as it gives an idea of the kind of pain a patient might be in.
You should ensure you have clear notes of the patient’s medical history, social history (smoking and alcohol), dental history along with oral hygiene routine, findings in your exam/assessment, intra and extra oral findings, a comment on the oral hygiene, any special investigations taken with their findings including BPE, sensibility/TTP, Radiographs etc, risks level for caries, periodontal disease, oral cancer and tooth wear. You also need to record all your diagnoses (especially for periodontal disease with staging, grading and risk factors) along with treatment options and discussions. It is also great if you can take pre- and post-op photos of your work, or problems the patient is attending with, as this can show how the patient has presented to you – this a form of evidence which is indisputable if there are issues afterwards or concerns about the care you have provided. Top tip – make sure your camera’s date and time settings are correct before taking the photos. Find out about how to pick a good camera set up in the blog ‘How to get the most out of Foundation Training and make the right investments’
Templates can be a great tool, especially when you are seeing many patients. They can help ensure you do not miss anything during your appointments, and you’ll find many of the discussions you have will be the same with a lot of patients, so having quick notes will save you from typing out the same discussion for multiple patients. However, you need to be very careful with how you use these. If you were to be investigated for whatever reason, blank or unfilled areas in your notes would not look very good, and if you have not edited notes to make them specific to each patient’s risks, this could mean some parts of your conversation with the patient may not be there to defend you.
Poor records = poor defence
Something I remember being told when I started working has always stuck with me – Poor records = poor defence. No records = no defence. If you have not written in your clinical notes something you have said, it is essentially assumed the conversation never happened. If you find yourself in the court of law with litigation issues, the only thing there will be to defend you is your clinical notes, or lack thereof, if you are not doing them well.
Further learning
We would really recommend doing some more research and CPD on consent and record-keeping. For good practice guidance, go to the CGDent guidance ‘Clinical Examination and Record-Keeping’ and we’d also recommend the indemnity websites where they discuss cases and there is a lot to be learnt from them.
Authors’ bio
“I Graduated from the University of Manchester in 2023, completed my FD Training in the Greater Manchester North Scheme and am now an Associate Dentist in Greater Manchester. I’m also a NextGen Ambassador for the College of General Dentistry. My clinical interests include Oral Surgery and Prosthodontics. I am currently undertaking a Masters in Prosthodontics at UCLAN and have interests in Implants and also dental education. Outside of work, I enjoy running and 5-a-side football.”
Dr Choudhury Rahman, Associate Member of the College
“I graduated from the University of Manchester in 2005 and am currently an Educational Supervisor in Greater Manchester North Scheme, as well as an expert witness. I spend most of my time carrying out general dentistry, alongside placing implants and running two NHS dental practices. Outside work I enjoy spending time with my two boys and I am also an avid Manchester United fan”
Professor Igor Blum, Editor of the Primary Dental Journal (PDJ), describes the fundamental change in how the dental and medical communities understand and treat temporomandibular disorders – the theme of the upcoming issue.
The history of dentistry is often one of mechanical solutions for biological problems. For decades, the management of temporomandibular disorders (TMDs) was dominated by the search for the “perfect bite”, a quest that frequently led patients down a path of irreversible occlusal adjustments and increasingly complex orthodontic or restorative interventions. However, as we stand in 2026, the paradigm has shifted. We have moved from a focus on gnathology to an era of neurobiology.1 This fundamental paradigm shift in how the dental and medical communities understand and treat TMD marks a transition from viewing the temporomandibular apparatus as a purely mechanical system to viewing it as a complex biological and neurological interface.2
TMD comprises a group of musculoskeletal conditions that affect the muscles of mastication, the temporomandibular joint (TMJ) and associated structures.3,4 The symptoms can include localised or referred tenderness/pain in the TMJ or associated structures, clicking or grating sounds in the TMJs, restricted jaw movements, muscle pain, headache, tinnitus, impaired hearing, and earache.5 These symptoms can cause a wide range of biopsychosocial impacts including impacts on health-related quality of life commensurate with other types of persistent pain.6,7 Therefore, TMD is most accurately viewed through a biopsychosocial lens: an intricate interface where peripheral nociception is modified by masticatory function, sleep hygiene, autonomic stress physiology, and central sensitisation.8
TMDs are the second most common cause of orofacial pain after “toothache” (odontogenic pain).6 They affect up to one in 15 of the UK population and predominantly arise in the 20–40-year age range.6,7 Females more commonly present with symptoms of TMD than males.4,6 Many patients present with a simple concern (“my jaw clicks”; “it hurts to chew”; “I wake with headaches”) but behind this sits a spectrum of conditions ranging from self-limiting myalgia to inflammatory arthropathy, internal derangement, or degenerative joint change. The challenge – and the opportunity – for us as clinicians is to respond with care that is proportionate, evidence-informed, and firmly grounded in the patient’s lived experience. In this framework, “jaw pain” is not a diagnosis – it is a symptom. Our primary clinical mandate is to move beyond mechanical reductionism to identify the predominant pain driver, stratify patient risk, and select interventions that prioritise the prevention of iatrogenic harm while maximising functional recovery and patient comfort.
Two fundamental axioms guide contemporary TMD care. First, most clinical presentations are self-limiting and respond predictably to conservative, non-invasive management. Second, in the minority of cases where symptoms persist, the lack of resolution is rarely the result of a missed occlusal detail or an insufficiently complex appliance design. Instead, persistent pain is seldom explained by a solitary structural finding.
The upcoming themed issue of the Primary Dental Journal aims to highlight the presentation and management of some of the more common and important TMD conditions encountered in dental practice; a core theme in the papers is to highlight the vital role that primary dental care clinicians contribute to the assessment, diagnosis and management of patients with TMDs. The cornerstone remains careful assessment. A structured history is not an administrative formality: it is a diagnostic instrument. Onset and temporal pattern, functional limitation, triggers, parafunctional behaviours, prior interventions, and red flags (trauma, systemic inflammatory disease, progressive neurological symptoms, swelling, fever, unexplained weight loss) shape the differential diagnoses. Equally important are the psychosocial drivers that influence pain persistence – sleep disturbance, anxiety, depression, and the impact on daily roles.5 The clinical examination then adds specificity: localisation of tenderness, pattern of movement, joint sounds, range and deviation, and the relationship between pain and function.9
Standardisation matters because it improves communication and research translation. Diagnostic frameworks such as the recently published brief Diagnostic Criteria for Temporomandibular Disorders (bDC for TMD)10 have moved the field forward by improving reliability and reinforcing the distinction between common muscle-related pain and less frequent joint pathology. Yet even the best taxonomy is only valuable when applied with humility: imaging and joint noises can be compelling, but they are not always causal. A click may reflect disc displacement with reduction in an otherwise stable, asymptomatic joint. Crepitus may indicate degenerative change, but the severity of radiographic findings often correlates poorly with pain intensity. The clinician’s reflex must be to contextualise findings rather than to chase them. After all, TMD care is, at its core, an exercise in clinical judgement and therapeutic restraint. It asks us to be precise in diagnosis, generous in explanation, conservative in intervention, and collaborative in approaches.
The emphasis of modern management is conservative care first – because it works for most patients and because it preserves options. Education is not “reassurance” in the dismissive sense; it is an evidence-based intervention that reduces fear, improves adherence, and supports self-efficacy. Simple explanations about joint function, muscle overload, and the natural history of many TMDs can be transformative. From there, treatment becomes a suite of low-risk strategies: activity modification, soft diet during flare-ups, heat/cold, short courses of anti-inflammatory analgesia where appropriate, and targeted exercises. Physiotherapy approaches (range-of-motion, coordination training, postural strategies, and manual techniques) remain highly relevant, particularly when delivered as part of a broader plan rather than as isolated “sessions”.11
Occlusal splints continue to have a role, especially for symptom modulation and protection in selected patients,12 but the narrative must be updated. Splints are not magic devices that “realign” joints; they are tools to reduce overload, support muscle relaxation, and improve symptom control. Clinicians should be explicit about indications, limits, and follow-up – particularly in patients with sleep bruxism, where the aim may be harm reduction rather than eradication of activity. In persistent cases, behavioural and psychological interventions are not optional add-ons; they are often essential. Cognitive behavioural approaches, stress regulation, and techniques that address hypervigilance to pain can change outcomes.13 Even brief, chairside communication strategies (language that reduces threat, validates experience, and sets realistic expectations) can shift the trajectory from chronicity toward recovery.
I trust that the Temporomandibular Disorder-themed issue of the journal will serve as a tabletop reference in general dental practice. It is hoped that it will help clinicians to integrate the principles of TMD into clinical practice to improve patient-related outcomes. In this token, I would like to express my special thanks to the Guest Editor of the TMD-themed issue, Dr Ziad Al-Ani, and to all contributing authors for crafting this superb issue of the PrimaryDental Journal.
To receive the Temporomandibular Disorder issue of the PDJ, join the College by Thursday 16 April 2026.
The Primary Dental Journal is the College’s quarterly peer-reviewed journal dedicated to general dental practice. 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.
The Temporomandibular Disorder issue will be available online in late April and printed copies should arrive with College members in May.
References
Xue Q, Ming H, Huang Y, et al. Association between temporomandibular disorders and somatization: a narrative review. J Oral Facial Pain Headache. 2026;40(1):42-52.
Dutra Dias H, Botelho AL, Bortoloti R, et al. Neuroscience contributes to the understanding of the neurobiology of temporomandibular disorders associated with stress and anxiety. Cranio. 2024;42(4):439-444.
Beecroft E, Palmer J, Penlington C, et al. Management of painful temporomandibular disorder in adults. [Internet]. London: NHS England Getting It Right First Time (GIRFT) and Royal College of Surgeons of England Faculty of Dental Surgery; 2025. Available at: rcseng.ac.uk/dental-faculties/fds/publications-guidelines/clinical-guidelines [Accessed Feb 2026].
Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992;6(4):301-355.
Einstein A, Hassan S, Ghritlahare H. Understanding Temporomandibular Joint Disorders. In: Bhargava D. (Ed.) Temporomandibular Joint Disorders. Singapore: Springer; 2021. pp29-67.
Slade GD, Bair E, Greenspan JD, et al. Signs and symptoms of first-onset TMD and sociodemographic predictors of its development: the OPPERA prospective cohort study. J Pain. 2013;14(12 Suppl):T20-32.e1-3.
Sharma S, Breckons M, Brönnimann Lambelet B, et al. Challenges in the clinical implementation of a biopsychosocial model for assessment and management of orofacial pain. J Oral Rehabil. 2020;47(1):87-100.
Shaffer SM, Brismée JM, Sizer PS, et al. Temporomandibular disorders. Part 1: anatomy and examination/diagnosis. J Man Manip Ther. 2014;22(1):2-12.
Durham J, Ohrbach R, Baad-Hansen L, et al. Constructing the brief diagnostic criteria for temporomandibular disorders (bDC/TMD) for field testing. J Oral Rehabil. 2024;51(5):785-794.
Skorupa-Strojna A, Kulesa-Mrowiecka M. Effectiveness of physiotherapy for temporomandibular disorders: a systematic review of pain and functional outcomes. Scand J Pain. 2026;26(1):20250073.
Khijmatgar S, Tartaglia GM, Sardella A, et al. Occlusal splint effects on visual capacities in patients with temporomandibular disorders (TMD): a prospective interventional cohort study. BDJ Open. 2025;11(1):56.
Turner JA, Mancl L, Aaron LA. Short- and long-term efficacy of brief cognitive-behavioral therapy for patients with chronic temporomandibular disorder pain: a randomized, controlled trial. Pain. 2006;121(3):181-194.
Dr Mick Horton FCGDent, Chair of Trustees and co-host of the recent Presidential Q&A, reviews the College’s achievements over the past twelve months.
As we look forward to celebrating our fifth anniversary this summer, it’s worth reflecting on our journey in the historic establishment of a College for dentistry, which had been an aspiration for 150 years.
We started with the transfer of an initial, dentist-only membership from the Faculty of General Dental Practice (UK) of the Royal College of Surgeons of England (FGDP(UK)). Since then, we have shaped our own distinct, whole-team approach, opening our arms to those amongst the wider team who have so much to contribute to the intellectual life of the organisation, and bringing their distinct perspectives on the development of our professional community.
FGDP(UK) made an indelible contribution, over thirty years, in postgraduate skills-based qualification, and in setting standards for practice. That legacy has been built upon by the College of General Dentistry, and transformed for a different age.
Our Summer Reception for 2025 was held in the wonderful Sheffield Cutlers Hall, which is a worthy competitor to its London namesake in its historic building and elegant interiors – a fine setting for our key event in the year. 2025 saw the introduction of the College Lecture, the inaugural lecture given by Martin Kelleher FCGDent. His incisive analysis provides a provocative opening salvo for the College’s interests in the philosophy of care – about which our Members and Fellows will be hearing much more.
In January 2026, we opened our long-planned credentialing scheme, Certified Practitioner, in response to an ever-more confusing market for postgraduate training, to give patients and practitioners alike a clear mark of advanced capability. The first credential, for Endodontics, is now open for applications, and others are planned for opening in 2026. It is sad to see the final cohort of our renowned Diploma in Restorative Dentistry completing their programme this year, but we are no less committed to career and skills development for all dental professionals and credentialing provides our way forward.
Credentialing was one focus of a key meeting on Implant Dentistry, at our Fellows Winter Reception this year. It also provided an opportunity to hear about the development of the new edition of Training Standards in Implant Dentistry, now in development. Implant Dentistry is just one of the many fields of practice in which the College is making its mark.
Fellowship of the College remains the ultimate mark of accomplishment for our professional community, and in 2025 we updated our criteria for admission, to reach across a broader range of experience amongst practitioners – whilst holding true to the standard we have set. The new scheme also widens the opportunities for Associate Fellowship, in different Domains of practice, and introduced a new Role Fellow designation for members of the wider team, for whom achievement across two Domains can now be recognised.
Professor Sreenivas Koka FCGDent presenting to participants at the CGDent Leadership Development Masterclass
Leadership is an elusive quality that the College is interested to develop amongst our community of practice. We are delighted to have the opportunity to work with Prof Sreenivas Koka FCGDent, who has Guest Edited our recent thematic issue of the Primary Dental Journal, and ran a Masterclass in Leadership (together with his colleague Dr Elizabeth Carr FCGDent) in the autumn. The popular Masterclass will run again this September.
On a related theme, we were grateful to Prof Avijit Banerjee FCGDent, (now) Dean of the Faculty of Dentists, for his generous contribution to a new Foundation Nakao -CGDent award in mentoring and coaching for the wider dental team. This award further highlights the holistic approach that the College espouses for team development, and we plan a further round of the award in 2026.
In close partnership with the Tom Bereznicki Charitable Educational Foundation, the College’s focus on early careers has continued to expand, with the development of a further clinical award offering fantastic training opportunities, in addition to several one-day symposia around the UK, and more activities in the pipeline.
(l-r): The College’s recently-granted Coat of Arms; Sir Nairn Wilson CBE FCGDent receiving the Grant of Arms at the College of Arms; the College Badge
The end of the year has been marked by the completion of a very successful fundraising campaign, investing the College with its own Coat of Arms and associated branding. As we look forward to the prospect of a Royal Charter – our key aim in consolidating the authority of the College, alongside its Royal College healthcare peers – our Coat of Arms stands out with pride as a marker of our values, commitment and distinct identity. Our thanks are extended to Sir Nairn Wilson CBE FCGDent in leading the campaign, and to the many generous donors who made it possible.
Finally, I’d like to extend my thanks to the small and dedicated College team whodo so much to provide the excellent service for our members and the wider professional community that we support, in the interests of our patients and public.
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