J’aime les dents
This week, our man from Anfield asks, ‘how involved are you?’

With the best will in the world, certain people struggle to look after their teeth. For some, it is lack of motivation. Others consider brushing their teeth to be at the bottom of a very long list of priorities, below walking the dog and watching the grass grow. However, most people are victims of being misinformed. I defy any dental student to claim they haven't changed their own oral hygiene regime even slightly while at dental school, even if it's just the direction in which they move their toothbrush or switching to alcohol-free mouthwash. Equally, it seems that the public are fed a lot of lies, as far as we tooth enthusiasts are concerned.

Having a clean mouth is boss. Do you know why that is? No plaque equals no decay. No plaque equals no gum disease. No volatile sulphur compounds equals no bad breath; hence a higher chance of a bit of club necking in Guy's Bar after clinics on a Friday.

It is our job, as dental professionals, to ensure that our patients are exposed to best practice when training them to look after their own oral and dental health. The number of times I've faced raised eyebrows when advising patients not to use mouthwash after brushing, for example, really does make you think. Even when people set out with the best intentions, they sometimes are doing the exact opposite of what we'd like them to do! Of course this isn't too much of a problem, as we are educators and we shall set all of our patients on the path to oral health perfection!

The main topic of conversation is therefore a question of how 'involved' my fellow students become when educating people about oral hygiene practices. 

For me, it's an absolute necessity for the patient to bring whatever accoutrements they use to keep their mouth clean so that we can inspect their technique and then modify it appropriately. Nor am I averse to throwing a pulp tray under the patient's chin, getting them to hold a mirror in front of their face, and giving their toothy pegs a good clean with their own brush and toothpaste, there and then!

Even more important, as far as I'm concerned, is the matter of flossing. I find it pointless to use those models we find on clinic more than once; it almost seems like insulting the intelligence of the patient by pulling the model out at every visit. Instead, what I would suggest is that you throw on a pair of gloves, snap off a good length of floss, give the patient the trusty mirror once again, and you (yes, YOU) floss their teeth, before their very eyes. Why? It's certainly going to be memorable for the patient; they'll know how it feels when it's done 'correctly’; and they've then got the perfect opportunity to mimic exactly what you've just shown them.

For me, this makes the oral health education a much more enjoyable and immersive experience, with a positive effect on patient compliance.


'Only floss the ones you want to keep'
Garry Wilson

The first two major events of the Dental Society calendar have passed and succeeded in bringing the five years of dental students together. First off we had the dental society boat party. The desire to be pent up for four hours on a boat on the Thames hit sky high when the early bird tickets for the boat party sold out within 30 seconds. The fear of not being able to grasp a ticket was further shown where at the meet and greet, a queue of freshers developed, eager for a taste of the London nighttime skyline (but mostly for the bouncy castle). The evening of the Dental Society Boat Party started off with a drinks reception at the colonnade, which then proceeded to Tower Bridge, now filled with students dressed to the nines. Once aboard, the boat set off and the music started, filled with requests (something DJs usually don’t do! But DJ Shraii did! Kudos.) The rest of the evening was wonderful and ended at midnight.

The infamous pulp crawl was the next item on the agenda, and this year the word for the fancy dress was MOLAR, with each year being assigned a letter from the word so that their costume would start with that letter. The crawl started at Cargo, went onwards to Bedroom Bar, Floripa and finally Roadtrip & the work. The bars in Shoreditch that night were filled with the likes of Super Mario, a Mexican, soldiers, athletes, oompa loompas, a lettuce-man, penguins, an artist, and so many more confusing characters to see outside an establishment at night. The event was well set up by the Dental Society Committee who on the night were dressed up as Wally from Where’s Wally! They also kindly got us sorted with a free £20 Uber voucher so everyone could make it back home for a good night’s sleep before their 8.30am clinics! Overall it was a fun night, roll on next year!

Pippasha Khan, BDS1 

IT IS BACK. It's that time of year we all look forward to. And we invite you to join us on our journey.

Since 1993 KCL Diwali Show has been the proud organiser of the one of the largest student run charity shows in the country. It is a show that celebrates the culture, talent and creativity of our students and has gained a reputation amongst London students for its unprecedented level of flair.

This year we have chosen to support Evelina’s Children Hospital, CAREducation and SHINE mentoring. So you can all do your bit by helping to promote and by coming to support your peers!

So right now make sure you keep Sunday 16th November 2014 free in your patient appointment filled diaries. Because even though we love increasing our number of Youtube views online, the real thing is never worth missing!

The tickets are limited so…
DMFT - Dont Miss out, Fight for those Tickets!


Hope to see you there,

Harshini Pindolia

General Dental Council set to raise Annual Retention Fee (full article)

Overloaded, pressurised and sluggishly-paced  (no, not the lifts at Guy's every morning!): dentistry has changed remarkably over the past decade. With GDC fee hikes among various rising costs to practice, uncertainty is understandable amongst professionals and dental students alike.

Registration with the GDC is a lawful requirement for dental professionals. However, from 2015, the independent body has planned to increase their ARF from £576 to £945: a 64% rise.

Undoubtedly, this increase has been met with fierce opposition. The profession appears to have fallen out with its regulator, whilst defence organisations and even the Department of Health (who typically has little involvement with such bodies) have all queried the GDC's justification.

Allegedly these fees must meet rising operating costs incurred from Fitness to Practice hearings, with ever-growing numbers of complaints made against registrants since 2010. This, hand-in-hand with the emergent litigation culture in the British dental industry, directly affects students. Representation by defence unions is a more worthwhile investment than ever.

The BDA, our professional association, have called into question the GDC's integrity. Legal proceedings were pursued and followed by commisioning of a major accountancy firm to review the case for rising fees. The ultimate decision can be expected on 30 October 2014.

As young, ambitious dentists, these matters concern us greatly. There is an essential requirement for unity and strong advocacy amongst the profession. Here are some action points to consider:

-        Greater involvement with the BDA, unions and other dental organisations will not only give you a voice, but also address your worries

-        Support petitions or campaigns you feel strongly about

-        Develop yourself - network and enhance your profile

-        Prepare yourself for the reality of dentistry - increase your awareness of current affairs


Anish Patel


Editor's note: on 30/10/14 the GDC elected to proceed with a 55% hike in fees, causing widespread consternation; simultaneously the BDA announced that its push for a fast-track judicial review of the decision has been successful, and shall take place before fees are due on 31/12/14.

J'aime les Dents
This week, our man from Anfield ponders the reformed NHS Dental Contract

I love the NHS. The NHS is a boss idea. If you're not well, you go to see someone who knows how to fix you. They do their thing and away you go, all better. And you don't part with a penny. That's great news. Now, NHS dentistry is a wee bit different, in that you have to pay a little bit towards your treatment, but still, your fillings and crowns and whatnot are all very reasonably priced.

The current NHS dental contract is not without its critics. The current UDA (Unit of Dental Activity) system doesn't necessarily result in the best possible care for patients, as dentists aren't paid suitably for the treatment that they carry out, which can lead to corners being cut as dentists struggle to make ends meet, just like anyone else. The Department of Health have acknowledged this fact and are looking to tweak the current system to ensure that prevention is king, that there is suitable recompense for dentists doing the right thing by their patients and by measuring the quality of work provided, so that the patient (and the taxpayer) get their money's worth.

Of course, there was a need for a period of due diligence prior to the implementation of a new contract, so a pilot of the new contract was conducted in seventy practices across England to see how well the new system will work out in the big, bad world. There were 3 different types of pilot and for details of these, I refer you to the full report on the pilots, as the details are beyond the scope of this lovely article.

Changes

Being the riveting and captivating dental writer that I am, I shall use all the erudition and elegance that I can call upon to distill the 87-page review on the pilot into a few key points:

• The care pathway starts with an Oral Health Assessment which (surprise, surprise) assesses the patient's oral health and any systemic or external factors which may impact on the patient's disease risk in the future
• The patient's risk status will be categorised as Red, Amber or Green, depending on whether they are high, medium or low risk; though I'm sure that bit's quite self-explanatory
• As well as having appointments for any treatment that they require, the patients will have appointments that are used for prevention, such as oral health education, or having a scale and polish and fluoride varnish application. These preventative appointments have been given the very official title of 'Interim Care Appointments'. Fancy eh?
• The patients will be advised when they should return for their next Oral Health Review, based on their risk status and NICE guidelines

Consequences

It's difficult to summarise an 87-page document with such brevity and wit, but having read the report, I would consider these to be the salient points:

• For the patients who were regular attenders and were motivated, there were clear findings of an improvement in their risk status, i.e. moving from Red to Amber, or Amber to Green
• Periodontal care is much more widespread; thanks to increased patient motivation and education, periodontal health generally improved
• Risks are being managed and reduced using the new care pathway
• Auxiliary members of the dental team are playing a greater role in patient care

This has been a very quick overview of the contract pilots, which I hope has proved useful. For further details please see the various publications of the Department of Health.


'People ask me why, as a trainee dentist, I always seem to be in a bad mood. I tell them that I always look down in the mouth'
Garry Wilson