Specialist subjects?

I tried, I really did, I blocked my ears, turned my phone and other distractions off, reduced the sceptic factor setting as low as it would go and concentrated. The I came to some of the language used and the “mummy knows best” tone. 

  • HEE (NHS Leadership Academy) to develop and pilot a self-help, team building pack, specifically designed to help dental teams assess their current level of efficient and effective working practices and support the design of development plans for further strengthening team performance.
  • HEE (NHS Leadership Academy) to develop system leadership from within primary care, identifying and supporting high-calibre individuals to maximise their potential.
  • The causes of oral diseases are well understood, they are almost entirely preventable and many people now experience good oral health.
  • To reduce health inequalities, it will be important to take an approach of “proportionate universalism”,

By page 8 was floundering, tutting, shaking my head and then it dawned on me, these are the same people or rather people with the same backgrounds in academia, the armed forces and educationalists whose predecessors got us into this position, whose thinking is decades behind where it ought to be. They live their lives through reports, committees, papers and meetings and rarely, if ever, immerse themselves in the existence that the 80-90% of their profession actually live.

Thirty years ago their predecessors were similarly out of date, I was castigated and warned off for allowing my “team members”, a dental hygienist and two dental nurses, to visit a couple of primary schools that had never had any formal (or informal) dental health education. Apparently that was the role of the “community” dentists who rarely, if ever, visited and then to “do” things.

During National Smile Week I held a regular open house and (thanks to the BDHF) attracted a lot of media interest, the result a public put down in the letters page of the city newspaper from the LDC chairman.

The fact that I employed a full time hygienist in a one dentist practice provoked suspicion and comments from FPC/PCTs and the RDO. (ask your favourite ageing dentist to explain the acronyms)

Yes, everyone knows things must change but why does change have to be so far behind the curve? 

Please do take the time and read the report, HERE, it could be that as I have decided that life is too short for this stuff I am missing something, but after 40 years with a BDS I really don’t have the time to invest. 

  • It is clear that the DCP cadre is an essential element in the delivery of care and prevention. 

 

BPP shuts dental course as regulator raises safety concerns – Laurie Taylor’s take.

Students on course forced to find alternative programmes, as government plans to open English sector further to new providers.

First, the truth:

BPP University has shut a dentistry course after it failed to meet General Dental Council standards, leaving new students unable to start and existing undergraduates facing an uncertain future.

Events at BPP, which is owned by a for-profit private equity group, come as the government prepares to open the English sector further to new providers by allowing them to award degrees from the start of their operations on a probationary basis. Critics warn that if new providers subsequently fail, or do not gain full degree-awarding powers, it could mean more students being left unable to complete their courses.

The mess we’re in – full storyvia THE

and now: The Spoof

Laurie Taylor’s take – 12 October 2017

Pull the other one!

“One only hopes it doesn’t prompt an outbreak of bad dentistry jokes.”

That was the reaction of Poppleton’s own Head of Dentistry, Professor Phil McCavity, to the news that BPP University, which is owned by a for-profit private equity group, had shut down a dentistry course after it failed to meet General Dental Council standards.

Professor McCavity told ThePoppletonian that he had already encountered one report of the closure that was headlined “Painful cavity as BPP pulls course”.

Such glib recourse to puns threatened to obscure the emotional issues raised by the closure. “It’s important to remember”, said Professor McCavity, “that dentists also have fillings.”

He hoped that the BPP tutors would not feel too down in the mouth about the closure and would brace themselves for the challenges that lay ahead.

A spokesperson for BPP said that he was “bewildered” by the sudden closure. “As a for-profit provider, we’ve been happily making successful extractions from public funds for many years.”

(On other pages: Buddhism and Dentistry: how a belief in a higher power might allow one to transcend dental medication.)

Word of the day – Mediocracy & a video to match….

MEANING: noun: Rule by the mediocre.

ETYMOLOGY: A blend of mediocre + -ocracy (rule). Earliest documented use: 1845.

USAGE: “Why are gifted individuals always forced out by the mediocracy?” Christopher Fowler; The Victoria Vanishes; Bantam; 2008.

IDEAS: 

(I notice that comments are now disabled for the video, a shame because I would like to see if there was anybody who had anything positive to say.)

It reminds me of this:

The new reformation or just a course adjustment?

The university must be the site of the next Reformation – here’s why.

“Nevertheless, both students and their potential employers are led to believe that academic credentials confer on students that what they have learned at university constitutes knowledge that is more durable than it really is. And all of this is made possible simply because self-certifying “knowledgeable” people – in other words, academics – have said so…”

.”..The financial interest of academics in continuing to promote this idea – from the beleaguered lecturer to the over-remunerated vice chancellor – should be obvious. Perhaps only slightly less obvious is why students continue to believe it.”

This piece from “The Conversation” made me wonder (even more) about the role of universities now and in the future. Referring to universities as businesses and education as an industry as has happened over the past couple of decades has made me question the fundamentals of the need for universities in general and in particular in what I know best.

Should they be a “right of passage” or an extension of school or just a way of increasing the indebtedness of the individual and the country as a whole? Is the whole thing with massively expanding campuses, huge competition for students and vice-chancellors being feted with large salaries just an edifice waiting to implode? Has the expansion really improved the education of our young people or is it a way of moving them from 18 to 21 to keep them out of unemployment?

Only some of this is covered in Steve Fuller’s piece but it’s worth a read.

 

Education, education, education or have I missed the point?

From The Times via BDA, the words of another one of those Johnson boys.

Universities urged to make more money from research

Universities are to be measured on how well they work with business, collaborate on research and development and sell their intellectual property. Jo Johnson, the universities minister, will say today that a “knowledge exchange framework” will be developed to analyse how good a job universities do at putting their research to commercial use. In Britain, more research takes place in universities than in comparable countries, at 26 per cent compared with 17 per cent in Germany and 13 per cent in the US. British university revenues from engagement with businesses are growing slowly, at only 1 per cent a year. American universities earn almost 40 per cent more from intellectual property licences as a percentage of their overall research resources than those in the UK. The University of Queensland in Australia earns more than any Russell Group university from this source. The Higher Education Innovation Fund, which helps universities to sell their intellectual property, is to be given £40 million by the government, taking it to £200 million in 2018-19.

No doubt there will be “World Class” hyperbole/BS that goes along with this. Remind me what is the primary function of a university?

Should you lie in the sun?

I periodically share information gleaned from a well know dermatologist.

This time there’s also a video where, to celebrate an auspicious birthday, my little brother shows the results of his experiments in cloning.

It is well worth a watch, or two.

Dental Sedation Adult and Paediatric Immediate Life Support course

Lynn Fox has asked me to promote her course on Dental Sedation Adult and Paediatric Immediate Life Support. As someone who practiced sedation I believe that on going training and updates on sedation techniques and particularly Life Support are essential.

Details:

For clinical dental staff who wish to provide / assist with conscious Inhalation Sedation or both Inhalation and IV sedation for adults and children. The Dental Sedation Immediate Life Support course fully complies with IACSD standards for Conscious Sedation in the Provision of Dental Care 2015 who state “Practitioners must be able to provide age-appropriate immediate life support as defined by the main elements of the Resuscitation Council (UK) ILS and PILS training programmes. It is not essential to undertake a Resuscitation Council (UK) accredited ILS/PILS course. Alternative courses with equivalent content which are adapted to the needs of dental practice are acceptable: these might also include the management of common sedation, medical and dental emergencies.”

We are responding positively to this by offering these main Resuscitation Council elements on a non Resuscitation Council, tailor made, one day Dental Sedation Immediate Life Support course which has been developed specifically for the Dental team. This Dental Sedation Immediate Life Support course clearly combines the main elements from the RC Immediate Life Support Course (ILS) and Paediatric Immediate Life Support Course (PILS) in one day.

The course developer and lead instructor is Lynn Fox, a Resuscitation Council accredited instructor in ALS/ILS/EPLS/GIC. Lynn has 11 years of experience in teaching to hospital cardiac arrest teams and has previously lectured on anaphylaxis for the British Dental Association which is now a BDA online lecture. Lynn also teaches Dental Medical Emergencies to in-house dental practices and groups including The Oxford Post Graduate Dental School at Thames Valley Health Education.

Next open course date:

26th October 2017 in Oxfordshire.

Dental Sedation Immediate Life Support course content includes:

  • Causes and prevention of cardiorespiratory arrest in the adult and child
  • ABCDE approach including the management of dental, medical and common sedation emergencies in the adult and child including respiratory depression, aspiration, anaphylaxis and other associated emergencies
  • Basic Life Support and Automated External Defibrillation scenarios for adult and child
  • Adult and child airway management using basic maneuvers & airway adjuncts: BVM, OPA, NPA and supraglottic airway (i-gel)
  • Team roles and responsibilities
  • Assessment will focus on the compromised airway both for the respiratory and airway compromised patient and during cardiac arrest.

Certificate will show 7 hours verifiable CPD as per GDC requirements.

Link to the course website for more information and to book your place  HERE

 

If you’re in London on Thursday evening head for Kings.

image

A smorgasbord of Dental talent.

Kishan Sheth and the KCL Dental Society join forces to bring you one of the most anticipated dental events of the year. Chaired by Dr Lewis-Greene, supported by Prof Dunne and sponsored by Henry Schein.

www.facebook.com/kcl.dentalsociety/

5.30-8.30pm

Thursday 8th December 2016

New Hunt’s House Lecture Theatre 1, Guy’s Campus, King’s College,  London

Speakers:

  • Dr Raj Ahlowalia
  • Dr Subir Banerji
  • Dr Anoop Maini
  • Dr Alun Rees
  • Dr Nilesh Parmar
  • Mr Kishan Sheth

Attendees receive 2.5 hours CPD certificates or certificates of attendance for students.

£3 donation upon entry for Evelina Children’s Hospital.

By the end of the evening we would like to have raised £1000 for this amazing cause.

Seats allocated on first come first served basis.

What’s not to like?

Ten Year Anniversary of Child Protection and The Dental Team

41u5Cb15IrL._SX392_BO1,204,203,200_I was pleasantly surprised to bump into my old friend Richard Welbury at the BDA conference 10 years ago, I hadn’t realised at the time what a milestone he and his colleagues were making. Richard was the first person I knew who shared the facts around oral signs of child abuse, his memorable talks produced a determination from everyone who heard them to do everything they could to ensure that children would stay safe. Their work is worth remembering and continues.

From The British Society of Paediatric Dentistry via Dentinal Tubules

A decade ago, dental neglect in children was a neglected issue. But this is no longer the case thanks to the guidance Child Protection and the Dental Team (CPDT) which was launched at the BDA conference in 2006 by the then Health Minister Rosie Winterton.

The document and its associated website (http://www.cpdt.org.uk/index.aspx) came about after Jenny Harris, a paediatric dentist in Rotherham, wrote to the Chief Dental Officer, Raman Bedi, to raise her concerns. This was in the aftermath of the death of Victoria Climbié in 2000 and Lord Laming’s Inquiry report in 2003.

Said Jenny: “I asked myself: If a child like Victoria walked into my surgery, would I recognize her. Would I know what to do and would I have done it? For months I checked the dental press but there was nothing new to educate us about child protection.”

Jenny had already set up a dental neglect working group in Rotherham.  Her job was to define best practice so that children in her area would not slip through the net. But she still felt the dental profession needed expert national guidance.

After receiving her letter Professor Bedi met Jenny and invited her to chair an expert group to produce an educational resource. She was given a generous budget but just a year to complete the project.

The input of Jenny’s paediatric colleagues proved invaluable. She sent out a questionnaire (1) to BSPD members who were asked about their knowledge and experience of safeguarding as well as to share examples of good practice.  This research is being repeated for the 10th anniversary to see how much has changed.

In the decade since its launch, CPDT has been highly influential. In 2008, a survey of GDPs (2) showed that dentists had taken on board the new guidance and it was influencing knowledge, training and policies in the practice.

And there has been extensive involvement with other bodies, both in and outside dentistry. Jenny has become:
• BSPD’s representative on the NSPCC’s Health Liaison Committee  – she presented a paper on dental neglect in children as recently as September 2015
• A contributor to the development of a NICE clinical guideline: When to suspect child maltreatment
• Lead author of the first BSPD policy document on dental neglect in children
• Initiator of a working group bringing BSPD together with the Royal College of Paediatrics and Child Health (RCPCH), the NSPCC and the Advanced Life Support Group (ALSG) to adapt standardized child protection training – a recognition and response course – for the paediatric dentistry specialty trainees

The May anniversary is also an opportunity to celebrate the valuable contribution of the rest of the expert group: Professor Richard Welbury, an early champion of child protection in dentistry, Peter Sidebotham, a leading community paediatrician, Ranee Townsend, a CDS clinical director, Martyn Green, a dentist and vocational trainer in Devon, Janet Goodwin, a dental nurse representative and Chris Franklin, postgraduate Dean.

Now working as a community-based consultant in paediatric dentistry in Sheffield, hardly a week goes by without someone somewhere in the world contacting Jenny for information or advice and she helps where she can. Child protection and the dental team has already been translated into Croatian and Greek, with work on Spanish and Arabic versions now in the hands of enthusiastic teams of paediatric dentists.

Jenny believes there is still some way to go: “We have got better at recognizing signs of child maltreatment and at referring it but it does make a huge extra workload for clinicians and that hasn’t yet been recognized.” Jenny also believes the dental profession needs to have someone in every region who is identified as being responsible for safeguarding children leadership. Currently too much is down to the goodwill and enthusiasm of individuals.

Said Jenny: “I am grateful to BSPD Council for encouraging me to forge links and raise awareness of dental health among other professions involved in safeguarding. There is much more interest in children’s teeth than when we started a decade ago.”

(1) http://www.nature.com/bdj/journal/v206/n8/full/sj.bdj.2009.307.html and http://www.nature.com/bdj/journal/v206/n9/full/sj.bdj.2009.356.html

(2)  http://www.nature.com/bdj/journal/v210/n2/full/sj.bdj.2011.3.html

Note to editors:
For more information, contact Caroline Holland on 020 8679 9595/07974 731396

A couple of Orthodontic posts from Kevin O’Brien

Orthodontics can be a hidden art and it’s often perceived by non-orthodontists as a secret language. Most undergraduates know a something about it, but not much, similar to knowing a few key phrases. “good morning”, “where is the bus stop?” and “two beers please”. That’s where it ends. After graduation it used to be kept (mostly) to the confines of those who had been through, what the New Scientist once called, “the years of crawling subservience under the gaze of the white coated moguls that control our great teaching hospitals”. Then, when deemed to be fluent in the language, the specialists with their M.Orths, headed off to their own planet in the Orthodontic universe to fiercely guard their patch and occasionally share a few simple phrases of ortho speak with their referring dentists.

Times have changed and with the relentless march of a thousand aligner systems everyone has a phrase book – or at least they think they do. Or could it be that they have the dodgy Hungarian Phrase Books?

I am not looking to fan the flames of the GDP v Specialist debate, there’s way too much of that about, rather to present Professor O’Brien’s last two blog posts for your consideration because I think they are both worth a read. I find him to be readable, thought provoking and that sometimes rare thing someone constantly questions what he does and WHY he does it.

First up:

A thinking about Orthodontics blogpost. In its entirety.

This is a short blog post to read just before the weekend, or just after if you are in Australia!  I have just attended a major symposium in the UK and I was asked to give a major lecture.  The preparation of this took some thought. During the meeting I listened to some great presentations and this got me thinking about orthodontics.  I have been working as an academic orthodontist and research since 1986, spent a large amount of time researching clinical matters, I have trained too many people for me to remember and spoken at many major orthodontic conferences.  But what do I know about orthodontics?  Here is a list of my academic knowledge and opinion.

This is a precursor to a more thoughtful blog post that I am going to post next week, so here we go. You may not agree with me..

  • Malocclusion is caused by a combination of genetic and environmental factors
  • There are many ways to treat particular malocclusions.
  • Evidence based orthodontics is a combination of clinical experience, patient opinion and scientific research.  The proportions of influence of these factors varies according to our level of scientific evidence.
  • Arch form and dimensions should generally be accepted
  • Functional appliances and other bits of plastic, pistons and springs do not change or influence facial growth. They tip teeth.
  • To my knowledge there is no high quality scientific proof that orthodontics, extractions, appliances, expansion, myofunctional orthodontics influence breathing, posture, academic attainment, sleep disordered breathing etc
  • Class I molar non extraction treatment is very easy
  • I wish that I knew how to intercept malocclusion…
  • Extraction of permanent teeth is required for the treatment of some malocclusion..but treatment mechanics are as important as the extraction decision
  • You can only “drive” upper molars 2 mm distally
  • Temporary Anchorage devices are better than other anchorage reinforcement method by about 2mm
  • Wire and bracket properties do not influence the efficiency of alignment
  • None of the new developments that are supposed to speed up orthodontic treatment seem to work; according to new trials..
  • There is no such thing as non-compliance treatment
  • I simply do not understand clear aligner systems
  • Self Ligating brackets do not have any advantages over conventional brackets.  The self ligating practitioner should explain this to their patients.
  • The alternative orthodontist should explain to their patients that there treatment is not mainstream.
  • The General Dental Practitioner who has been on a short  course to learn speedy orthodontics should explain to their patients the limitations of their training and knowledge
  • There has been and there continues to be great high quality research being done in orthodontics and don’t tell me that our evidence base is weak!
  • Nearly all orthodontic treatment relapses to a degree and this is probably caused by ageing and we cannot stop time…………….

That’s about it, does anyone want to add to the list?

Now here’s the second one:

Evidence based orthodontics is not as straightforward as it seems…

Should we practice evidence-based orthodontics?

This is a basic point and a good place to start.  It has been pointed out to me several times that orthodontics is different to other part of dentistry because it is more of an art than a science. Furthermore, it is difficult for us to do harm because the harms that we may cause are usually minor, for example, decalcification and root resorption. It is, therefore, not necessary for us to practice evidence based care.

I must disagree with this sentiment.  This is because we need to practice ethically by ensuring that our treatment is based on evidence, when it is available.  We also need to inform our patients of all the potential risks and benefits of treatment.  To this end we should be particularly careful of making statements that are not based on good research evidence.  I can think of the following examples, the proposed benefits of non-extraction treatment, methods of speeding up treatment and orthodontics that is provided to reduce sleep disordered breathing in children.

Continues here

%d bloggers like this: