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A Review of the Young Dentist Conference 2015

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A Review of the Young Dentist Conference 2015

Natalie Bradley qualified in June 2014 from Newcastle dental school. Natalie has written this article to provide a summary of the talks given at the Young Dentist Conference on 14 February 2015. I found the Young Dentist Conference this year was a really informative day with lectures that were highly topical for young dentists like me!

This year's Young Dentist Conference was held on Valentine's Day. There was a great turnout despite this, and missing out on any festivities was well worth it, with talks from some big names in dentistry.

Not only were there highly topical talks throughout the day, but a number of stands were set up during the breaks such as the Armed Forces, My Dentist and the Dental Property Club. A great opportunity to meet and network with dentists both more experienced and young!

Here is a brief summary of each of the talks that were held on the day:

Are you referring to me? Endodontics with Dr Simon Stone

Root canal treatment often strikes fear into the heart of young dentists and recognising which cases are suitable for us to treat is a skill, which we all need to know, so that patients are able to have realistic expectations in terms of whether their tooth can be saved or not.

The predictability of root canal treatment is determined by the pre-treatment assessment, the preparation, irrigation, disinfection, instrumentation and sealing of the pulp space and the coronal restoration.

Difficulties young dentists may face include, deciding whether the tooth is restorable and managing patient's expectations.

Beware if a patient presents with an odd history e.g. changing nature of pain, abnormal radiation. In these cases you should consider other possible diagnoses such as TMD, phantom tooth pain, trigeminal neuralgia, cracked tooth syndrome.

When should I refer?

Sometimes, things do go wrong. If you have trouble providing effective treatment, or even if you'd like a second opinion then referral is a sensible option.

So what sorts of things are commonly referred?

● Patients with a medical risk for XLA e.g. bisphosphonates, post radiotherapy

● Anterior/premolar teeth are prioritised (often 7s are not accepted)

● Important teeth with strong long term prognosis (>2mm ferrule, prognosis of endodontics better than prosthetic replacement)

● Trauma and its sequelae including root resorption

● Atypical pain

● Suspicious pathology

● Surgical endodontics

Remember to always send a good quality radiograph when referring a case - either an original film, a copy printed on photography paper, or a CD ROM copy.

The NHS/Private Interface with Raj Rattan

Raj addressed that question that many dentists in the UK have difficulty answering: "What treatment should be provided on the NHS?"

All treatments that are proper and necessary to secure and maintain oral health should be provided under the National Health Service.

Most NHS dentists will hold General Dental Service contracts, but additional services can be provided if the dentist has been contracted to carry them out. These include dental public health, sedation, domiciliary and orthodontic services as well as advanced mandatory services.

What are Advanced Mandatory services?

A service which provides a high level of expertise and facilities, where general practitioners can refer their patients for specialist periodontal or endodontic treatments.

There are several guidelines available that assess the complexity of the treatment required for a patient, which can be used to determine whether a referral to an advanced mandatory service is indicated.

The most common treatments that are 'pushed privately' by dentists who violate the terms of their NHS contract and do not follow the GDC Standards of Care include cobalt chrome dentures, periodontal treatment and referrals to hygienists, bridgework and endodontics.

As professionals, we are trained as clinicians, and not business managers, and this brings me to the issues of: time, quality and money, and how well equipped are we to deliver them.

Ideally, we all would like to perform highly in all of the above, but unfortunately this is often not possible.

Dentists are also under pressure to be transparent in their pricing by the Office of Fair Trading, more recently by 'Which?' and to be CQC compliant. The profession therefore needs to have a conversation on how best to use their clinical skills and the settings to deliver dental care.

Are you referring to me? Oral Surgery with Julie Cross

Like endodontics, oral surgery can be a source of anxiety for young dentists. It can be difficult to assess what treatments you are competent to perform in practice, and those which should be referred to secondary care.

Common pitfalls in oral surgery in practice

1. Fractured teeth

2. Soft tissue damage

3. Root in the antrum/oroantral communication

4. Haemorrhage

5. Fractured tuberosity

Simple extractions such as periodontally involved teeth or orthodontic extractions shouldn't be a problem for general practitioners; however, teeth which are heavily broken down with deep caries, bulbous or divergent roots which have been endodontically treated may prove more difficult.

So when should I refer?

Where most likely, a surgical approach is required and you do not feel confident doing this

Ultimately, you shouldn't take on treatments that you don't feel confident with! Always refer for a second opinion if you are unsure as complications with oral surgery can be serious!

How to survive as a young dentist with Reena Wadia

What environment are young dentists graduating into?

After five years of hard studying and training, newly qualified dentists are spat back out into the real world where there are uncertain job prospects, increased litigation and less NHS funding.

On top of this, we are now graduating with much less experience than our more senior counterparts - I could count the number of root canals I did in dental school on one hand! With so much competition how are we supposed to get good jobs?

Reena shared her top tips with us to thrive as young dentists.

Reena's Top Tips

1. Be confident

2. Maintain your record keeping skills and be a good communicator

3. Invest in Loupes with illumination

4. Save up for a camera

5. Secure the job you want

6. Network and find a mentor

7. Get published

8. Enjoy yourself!

The thing that gets you up in the morning should be something you enjoy doing! Yes we have our ups and downs, but if your career in dentistry is going to last thirty or forty years, you must enjoy what you're doing!

Patients will notice it too! Dentistry may seem a bit doomy and gloomy at the moment but there are so many opportunities out there for young dentists with some exciting developments coming up in the next few years!

Do you see what I see? with James Foster

There are lots of challenges for dentists in today's environment, not just dento-legal challenges of course. Some of these challenges include:

● Complaints

● Negligence claims

● Regulatory investigations (GDC, CQC)

● Disciplinary procedures

● Criminal investigations e.g. fraud

In a dentist's career, there are around 250,000 interactions with patients (on average). During your career, you will have around 1-2 GDC cases, and 3-4 negligence claims.

Therefore, to reduce your risk of a complaint you must learn how to communicate effectively with patients. Also be aware of what you post online on social media - closed groups and forums are not as safe as you may think!

How to respond to a complaint effectively

1. Acknowledge the complaint

2. Express meaningful regret

3. Tell the patient that you are sorry - this is not an admission of fault

4. Discuss possible solutions

5. Do not abandon the patient

The important message wasn't to scare us off practising dentistry, but to prepare us for when things go wrong and how to explain risks and adverse situations to patients.

Summary

Overall the day was a good combination of the topical issues in dentistry for the younger generation of professionals. Sometimes it can be hard to find positivity in our profession especially since the ARF hike earlier on this year, but there's still plenty of opportunities out there particularly for newly qualified dentists.

I can't wait to see what next year's conference has to offer!

See more on Natalie's website here

Natalie Bradley
natb990@hotmail.com
For more images from The Young Dentist Conference 2015 click here

 

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