The Monday Morning Quote #356

“Consult not your fears but your hopes and your dreams.

Think not about your frustrations, but about your unfulfilled potential.

Concern yourself not with what you tried and failed, but with what it is still possible for you to do.”

 Pope John XXIII

via Philip Humbert

Modern? Yes. Better? I don’t think so.

Red No Button As Symbol For Danger Or Negativity

I had a great day with the dentists from Edinburgh Dental Studio on Monday. This story was told to me by one of principal Graeme Smart’s associates.

She and her partner are looking to buy a house at the moment and had been looking on a particular estate agent’s website at properties in their price range and the locality they sought.

Having found just such a place they rang to book an appointment to view the house only to be told, “we can’t make an appointment for you to view over the phone. We’re a modern estate agent you can only book on-line.”

I do wonder if the client realises what the benefits of using such a “modern estate agent” are to their potential purchasers?

Good luck with the house hunting Phoebe.



The Monday Morning Quote #355

“Don’t ask what the world needs.

Ask what makes you come alive, and go do it.

Because what the world needs is people who have come alive.”

Howard Thurman




I love Dog Savage’s “Savage Chickens” cartoons. I saw this one on the day after Simon Tucker’s excellent presentation at The BDA Western Counties Young Dentists Conference where he referenced Simon Sinek’s “Start With Why”.

This came at the end of a week where I had insisted/suggested that three of my clients watch Sinek’s presentation.

Makes sense to share it here then, you shouldn’t ignore synchronicity.


PrintMy friend and student contemporary Professor Richard Welbury was the first person to present the full horror of child abuse and neglect to me. It is good to see that the British Society for Paediatric Dentistry is getting behind the NSPCC’s “It’s time” campaign.

The full article was on Dentinal Tubules.

Here it is with a link to the NSPCC site.


A campaign launched by the NSPCC calling for better mental health support for abused and neglected children and young people is supported by BSPD. Jenny Harris,  a  specialist paediatric dentist who has done so much to raise awareness of child protection issues among the dental profession was at the launch.

The aim of the “It’s Time” campaign is to help abused or neglected young people access the support they need to recover from the trauma they have experienced. Minister of State for Community and Social Care, Alistair Burt MP, launched the campaign at the Houses of Parliament this month (February  10th 2016).Nspcc_logo_2

He introduced an NSPCC young ambassador who told guests at the launch why the campaign was so important.  His call for “constant support, not just crisis support” silenced his audience as he told of young people who resorted to self-harm or threats of suicide before they could get help.

Jenny said afterwards: “At the launch I met more NSPCC young ambassadors with direct experience of these issues. They told us that children and young people who have been victims of abuse or neglect currently face long waiting lists for counselling or mental health services.”

“This is the most compelling campaign I remember,” she said. “It seems we have come so far – to get better at recognising signs of abuse and neglect and refer children for help – yet it is scandalous to hear that those same children can’t get the support they then need to rebuild their lives.”

“I want the very best outcome for any of my patients who are affected by this so that’s why I am happy to support the NSPCC’s ‘It’s Time’ campaign.”

To find out how to support the campaign, go to:

Chasing the silver pound.

An article in The Economist, “Shades of grey” (it doesn’t say how many) examines the lot of today’s pensioners with their predecessors and, possibly, their successors.

A few highlights:

  • In 2000-2014 spending on restaurants by the over 75s rose twice as fast as the under 30s.
  • For cinema & theatre tickets it rose five times as fast.
  • Within 2 decades over 65s will be responsible for 25% of consumer spending.
  • Over 65s own 60% of mortgage paid-off property.
  • Poverty amongst pensioners is below that of working-age people without children.

Nor are “pensioners” idle.

  • Someone over the state pension age but under 70 who has a degree is now more likely to be in the labour force than a 16-25 year old with no qualifications.
  • 27% of 65-69 year olds with degrees are employed.
  • Bank of England surveys say this will increase.

What has this to do with dentistry?

This group is the so called heavy metal generation. Many, if not most of them, have kept their teeth and want to keep their teeth. Because of the ravages of caries in their younger years and also perhaps because many dentists were reactive rather than proactive (ask me what I mean by that if you can’t work it out) they need and want high quality dental care.

Yet it’s market sector that doesn’t seem to be popular with many dentists. I can’t work out why. Perhaps it’s a generational thing with many young dentists being told that they should be selling whitening, short term ortho and quick fixes they don’t consider that this group are worth considering.

It’s not easy dentistry much of the time, and probably does not suit UDA accumulation. Knowledge, experience, a certain amount of gravitas and good communication skills are at a premium. Often the patients have medical and physical considerations but the rewards can be great, the patients grateful and most have established networks for referrals.

Why not shift your focus to be truly inclusive? This could be a golden age for treating the silver-haired.


NICE two-week cancer advice ‘is delaying diagnoses’, claim Oral Surgeons

Fast-tracking GP cancer referrals through the two-week wait pathway has overloaded clinics and caused delays in diagnosis of head and neck cancers, a group of surgeons have warned.

The article is here – the comments make interesting reading, but leaves me wondering what the person at the coal face of primary care supposed to do.

Experts from the British Association of Oral and Maxillofacial Surgeons (BAOMS) said the recently updated NICE guidelines – which lowered the risk threshold for referral – had ‘tipped the balance’ too far in favour of GP referrals for investigations, and called for an ‘urgent review’ of the referral criteria.

NICE denied the claims, arguing that its guidelines are supported by the latest evidence, while GP leaders said an increase in the number of referrals was ‘unavoidable’ under current guidelines supplied to GPs.

It comes as a study in the British Journal of Oral and Maxillofacial Surgery showed that the proportion of people who end up with a diagnosis of head and neck cancer has fallen markedly over the years since the introduction of the two-week wait pathway in 2008 – from around 11% to just 7%.

Although more cancers are being diagnosed via the two-week wait, as more people are referred, the experts said that half of cancers are still diagnosed through ‘conventional’ pathways, and that overall, the increasing number of people in the system was delaying the diagnosis and treatment of those patients who really need to be seen.

David Mitchell, a consultant oral and maxillofacial surgeon at Mid-Yorkshire Hospitals and editor of the journal, said: ‘An urgent review is needed now to stop this target-driven system delaying the treatment of patients who actually have mouth cancer.’

Former BAOMS president and consultant surgeon at Sunderland NHS Foundation Trust, Mr Ian Martin, told Pulse there ‘has been a big increase in referrals where there isn’t cancer’ and that ‘this latest change to the guidelines has tipped the balance too far’.

He added: ‘You have to question whether this is the right approach because it has the potential to actually, paradoxically, mean those who actually have cancer are going to be treated more slowly.’

Mr Martin said there ‘already huge pressure in the system, the 62-day treatment targets are already being missed in a lot of places’ and that ‘resources have to be diverted to dealing with people, who are understandably worried because they have been sent in on the two-week wait pathway… rather than getting on and treating those who do actually have cancer.’

Professor Willie Hamilton, clinical chair on the guidelines, said the BAOMS had presented ‘no evidence’ that the guidelines had introduced a delay for patients and defended the referral criteria.

He said: ‘The simple truth is that with patients and symptoms it is impossible to investigate “smarter”, giving surgeons their desired high conversion rate. We have to investigate “more” (but within reason).’

He added that the review showed ‘more patients are being seen, and the “new” patients are at slightly lower risk, but overall more patients are being diagnosed’.

Dr Andrew Green, chair of the GPC’s clinical and prescribing subcommittee, said: ‘Individual generalists will come across a new specialist case so rarely that it must be accepted that there will be a large non-conversion rate. This is not due to a deficiency in the guidance or in the knowledge of the referrer, but is an unavoidable consequence of policies designed to avoid diagnostic delay.’

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