Dental Prof

Dentists campaign against missed appointments

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NHS dentists in Sheffield are taking part in a campaign to raise awareness of the problems caused by missed appointments.
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/>Each year, 54,000 appointments are missed at dental practices in the city, with the average practice having 600 missed appointments a year.
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/>The campaign urges patients to ‘Keep it or cancel it – just don't forget it’ in a bid to highlight the disruption caused when patients fail to attend.
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/>It will involve displaying posters in surgeries, giving patients reminder stickers and using a chart to show the number of missed appointments and time wasted at practices each month.
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/>Richard Taylor, dentist at Taylors Dental Care on Sharrow Vale Road, said: ‘As a Sheffield dentist, my colleagues and I are seriously concerned about the impact that patient non-attendance has on our workload.
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/>‘If a patients fails to return for an hour appointment the dental team – dentist, nurse and receptionist – are totally redundant. If that's not bad enough, the whole team will have to work an extra hour another day to enable the practice to reach their targets.’
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/>In October, Taylors Dental Care had 37 missed appointments – amounting to more than 10 hours of the practice’s time.
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/>All dental surgeries in Sheffield will receive a chart to display the number of missed appointments to help raise awareness of the problem to patients.
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/>“In response to this, many dentists send a written reminder to patients, but if they repeat the non-attendance they may not be offered another appointment,” Richard added. “It’s important to remember that a missed appointment could have been used to see a young child with toothache.”
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/>Dentists have reported that more patients are failing to attend their appointments since April 2006. This date saw the introduction of the new dental contract - making dentists unable to charge patients who miss appointments.
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/>'Failure to Attend' resource packs will be distributed to all Sheffield dental practices in the coming weeks. The packs include: posters, reminder sticker sheets for patients and a chart for displaying the total number of missed appointments and time wasted for each month.
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Make sure you tell the dentist what medication you’re taking!

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Do you regularly take aspirin or antiplatelet medications? Do you know whether or not these drugs should be stopped before dental procedures or surgeries?
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/>According to a study published in the May/June issue of General Dentistry, the clinical, peer-reviewed journal of the Academy of General Dentistry (AGD), stopping antiplatelet medications prior to a surgical procedure places a patient at greater risk of permanent disability or death.
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/>The probability of a patient bleeding depends on the over-the-counter and/or prescribed drug or combinations of drugs.
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/>‘A thorough drug history should be reviewed prior to any procedures,’ notes Mary Aubertin, DMD, lead author of the study.
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/>Dr Aubertin recommends that the dentist and patient start with a simple discussion.
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/>'The dentist and the patient should discuss the risks and benefits of treatment with or without the drugs versus no treatment and include the patient's physician's opinion in the decision making process. This will allow everyone involved to understand and prevent medical risks.'
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/>Fortunately, due to the prevalence of this type of medication, dentists are prepared to treat these situations.
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According to AGD spokesperson Carolyn Taggart-Burns, DDS, ‘excessive bleeding is a major concern with many dental procedures due to the extensive prescribing of blood thinners in America. Heart disease is so prevalent that many patients are on these drugs, which can complicate even the simplest procedure.’
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/>Dr Taggart-Burns reminds patients that it is very important ‘to communicate medical history with your dentist so that they can provide the best care possible.’
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/>What happens after a procedure is also important to the dentist.
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Patients who experience excessive bleeding or bruising after the surgery, in spite of applying pressure to the site with wet gauze or a wet teabag for 20-30 minutes, should contact the dentist for evaluation and treatment.
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/>‘Informing the dentist of medical issues is the first step. Working with the patient's physician and the patient to develop a plan is also important. Last, staying healthy is the best way to have a successful procedure,’ says Dr Taggart-Burns.
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/>What you should do before a dental procedure:
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/> * Schedule a consultation with the dentist
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/> * Disclose all prescribed and over-the-counter medicines to your dentist
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/> * Disclose your medical history and concerns
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/> * Discuss the risks and benefits of treatment with or with out the drugs
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/> * Ask the dentist if they have an office emergency plan.

DDU offers new dates for CPD courses

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The Dental Defence Union (DDU) has joined forces with experts from King’s College London, to offer two further courses for all members of the dental team – worth 12 hours of verifiable CPD.
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The courses will be held in Stratford-upon-Avon on Wednesday 25 February and Thursday 26 February 2009 and will cover topics such as complaints, radiography, medical emergencies and infection control, all part of the GDC’s recommended core CPD subjects.
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Rupert Hoppenbrouwers, head of the DDU, said: ‘We had a great response from delegates who attended this year’s London CPD courses, which were fully subscribed, and we are looking forward to hosting them again in the West Midlands.
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‘The courses are a great opportunity for all members of the dental team to hear leading experts discuss a broad range of important dento-legal issues. All delegates will receive a signed certificate confirming their completed CPD hours.
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‘Now that CPD is compulsory for Dental Care Professional (DCPs), we are also delighted to be able to offer DCP members of the DDU a complimentary place on the course if they are accompanied by a full paying delegate.’
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Good oral health – a must in the fight against AIDS

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A US dental school is leading the effort to raise awareness in the importance of oral health as part of World AIDS Day today (1 December).
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/>Forty million people worldwide are living with HIV/AIDS and from the onset of the epidemic, oral health problems were identified as key indicators of the disease.
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/>There are approximately 80,000 people living with HIV in the UK and about a third of these don't know that they are infected.
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/>The epidemic is still growing in the UK with around 7,000 new diagnoses every year. Even if someone you know is living with HIV, they may not feel able to tell you.
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/>Antiretroviral treatment has reduced both the mortality and the morbidity of HIV infection But according to a professor at the University of Southern California School of Dentistry.
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/>‘Medications are allowing people with HIV/AIDS to live longer, more productive lives, but they also create another set of oral health issues – saliva, the body's natural cleansing process, is disrupted, prompting the development of oral lesions in many of these patients,’ says Dr Mahvash Navazesh, professor with the USC School of Dentistry.
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/>Ninety per cent of people living with HIV have one or more HIV-associated oral lesions over the course of the disease.
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/>‘These lesions are often a harbinger for the disease's progression to full-blown Aids,’ says Dr Veronica Green, assistant professor of Clinical Dentistry with the USC School of Dentistry.
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/>She adds: ‘Access to oral health care, both for the person at risk for HIV infection and the person already living with HIV, is critical.’
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/>For the HIV-positive person who is unaware of his/her condition, lack of access to dental care represents missed opportunities for an early screening, diagnosis and testing for HIV.
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/>Oral symptoms provide dentists with the clues to diagnose the disease before the patient has seen his or her own health care provider or been tested for HIV.
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/>For details, visit www.worldaidsday.org.

Public wades into fluoride debate

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Health officials running the consultation into proposals to fluoridate Southampton’s water supply have reported an ‘unusually’ large response from the public.
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The Strategic Health Authrity (SHA) said it had received 5,000 replies from residents of Southampton and surrounding areas, including letters, emails, forms and postcards sent by campaign groups.
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They included 1,000 responses to a feedback form received just days after it was sent out to more than 110,000 homes.
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The SHA believes it is ‘very possible’ the form, which asks residents to detail their views on fluoridation, will generate a higher number of responses – before the process ends on 19 December – than the usual 2-5% return rate found in typical health consultations.
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The SHA has held eight drop-in events, each lasting eight hours, where local people have been invited to find out more information and ask questions.
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It has organised three question-time debates, all of which were filmed and made available on the SHA’s website for later viewing.
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It is also hiring polling organisation, ICM, to conduct a phone poll of 2,000 randomly selected residents to test the views of people ‘in the middle’ of the two sides.
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Kevin McNamara, who is leading the public consultation for the SHA, said: ‘The consultation is as comprehensive as we can get, and we are doing well over and above what we are required to do by law.’
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The pressure on the SHA to carry out the consultation properly is acute, with strong views on both sides of the debate.
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The SHA, as organiser of the consultation, is expected and determined to remain ‘objective’ on the debate, and has gone to great lengths to head off allegations of bias, including asking an independent analyst to compile a report on the responses to the feedback forms and inviting opponents of fluoridation to debate the proposals at question time events.
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Mr McNamara said: ‘It shows you the importance with which we take the need to make sure the consultation is carried out properly. We have to remain objective.’
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The SHA has stressed the consultation is ‘not a vote’, and it is not bound to follow the majority view. Instead, it hopes to use the results to help establish what the views of the public are to help inform its decision.
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Anyone wishing to respond to the consultation can do so at www.southcentral.nhs.uk/fluoridation by 19 December.

Access to NHS dentistry declines again

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A million fewer adults and more than 200,000 fewer children have been able to access an NHS dentist in England since the Government implemented reforms to dentistry in April 2006, according to official figures published today.
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/>The NHS Information Centre report reveals that 19,348,000 adult patients were seen by an NHS dentist in the 24 months up to 30 June 2008, compared to 20,348,000 in the 24 months up to 31 March 2006.
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/>The same period saw the number of children able to access NHS dental care drop from 7,797,000 to 7,587,000.
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/>Prior to the implementation of the reforms the Government estimated that approximately two million people who wanted access to NHS dental care were unable to get it.
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/>Reacting to the figures, BDA Chief Executive Peter Ward said: 'These figures provide yet more evidence of the problems created by the Government’s 2006 dental reforms. More than 1.2 million fewer people in England are able to access an NHS dentist now than was the case before the reforms were implemented.
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'That means that, according to the government’s own figures, there are more than three million people in England alone who want access to NHS dentistry but can’t get it.
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/>'Patients who are able to access care are confronted with a system driven by targets that discourages modern, preventive care.  That is difficult for dentists, who want to focus on providing the best possible care for their patients.
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/>'Problems with the NHS dental reforms are well documented and have been acknowledged by the Department of Health. For the good of patients and dentists alike, it’s time for them to enter into the long-overdue dialogue necessary to resolve these problems.'

Extra regulation for Wales’ private dentists

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Legislation coming into force next year is to add another level of regulation to Welsh dentists offering private care to their patients.
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/>The Private Dentistry (Wales) Regulations 2008 will take effect from 1 January 2009, requiring practitioners providing any non-NHS dental treatment to register with the Healthcare Inspectorate Wales (HIW).

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The HIW is the healthcare regulator for Wales, under the Care Standards Act 2000.
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Once the legislation comes into effect, it will be responsible for inspecting and regulating private dental provision (both individuals and premises) across the country.
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The act will cover wholly private and mixed practice dentists alike, and comes in addition to any NHS performer list obligations.
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Clinical dental technicians are currently exempt from the legislation.
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Dentists already in practice will be granted a six-month ‘transition period’, needing to submit a completed application form (available from the HIW website, www.hiw.org.uk) by 30 June 2009.
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Any dentists not practising in the country before 1 January, but who wish to offer private dentistry in Wales from next year, will need to register with HIW before they can provide any private treatment at all.
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This applies to all dentists, including non-UK nationals, locums and vocational dental practitioners.
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The Welsh Assembly maintains it has tried to ‘minimise the level of bureaucracy’ in the process for existing private dentists.
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Practitioners offering private work but still on the NHS dental performers list will only need to supply a statement that they are complying with the regulations (and will continue to do so), provide the name and address of the local health board they are listed with, and give details of any conditions imposed on them by the GDC.
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They will also need to supply an enhanced criminal records certificate.
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The chief dental officer for Wales, Dr Paul Langmaid, was positive about the impact of the legislation.
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He said: ‘These regulations will ensure that private dental treatment in Wales is regulated to the same high standard as NHS care. Uniformity of regulation between NHS and private care is important as many patients often choose to supplement their NHS care with private treatment, often from the same dental practice.
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They will provide a mechanism for continuous improvement in both the provision of private dental treatment and clinical governance throughout primary dental care in Wales.’
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He added that registering practitioners will help identify where wholly private care is being offered as well as highlighting the movement of dentists between different dental practices in the country.

Registration at a click

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Dental professionals can now pay their GDC annual retention fee, update their contact details and check the details on their practising certificate before it is printed, all via the web. This is thanks to the GDC’s new self-service website e-GDC at www.gdc-arf.com.
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/>The new website means GDC registrants can keep up to date and take care of their admin at any time, day or night, when it’s convenient for them.
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/>Edward Bannatyne, GDC director of operations said, ‘The launch of e-GDC should make life a lot easier for our registrants. It aims to take the hassle out of simple things like updating your contact details and checking your practising certificate has been sent out. Now you can manage your registration at your convenience, and not just during office hours.
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/>'A range of additional online services are planned for next year too. You will soon be able to submit your annual CPD declarations online as well as set up a paperless direct debit to pay your annual retention fee. Meanwhile, I’d welcome your feedback on e-GDC. Please send your comments and suggestions to our Processing Manager, Anne Gerulat, at agerulat@gdc-uk.org.’
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/>To protect individuals’ personal information, the GDC has built a number of security measures into the new system.
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New e-GDC users will need to create an account. They will then be sent an initial password and PIN, which they will need to use when they first log in. Each time a user logs in they will need to answer a security question.

Action week puts mouth cancer on the agenda

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An emotional and compelling campaign ensured 2008’s Mouth Cancer Action Week increased awareness of the disease both within the dental community and the wider public domain.
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The campaign, organised by the British Dental Health Foundation (BDHF) and launched at the House of Commons last month, saw practices up and down the country play their part in an issue where dentists can make a real difference.
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Mouth cancer claims one life every five hours, with nearly 5,000 cases each year. With more than 40,000 blue ribbon badges distributed throughout the UK, the November campaign week followed in the footsteps of the previous annual events by continuing to raise awareness.
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Sponsored by Denplan, who sent posters to practices across the UK, and Vizilite Plus, this year’s focus took a more positive stance as a newly-named Mouth Cancer Action Week.
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Health professionals across the land helped promote the slogan ‘if in doubt, get checked out’ – stressing the importance of early detection, which boosts chances of surviving the disease to more than nine in 10.
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The Westminster launch provided an ideal platform to kick the week off in a high-profile fashion. A moving speech by cancer survivor and novelist Lia Mills set the tone of determination to beat the disease.
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Shadow health minister Mike Penning MP joined politicians and leading figures in the dental industry at the launch, before filing an Early Day Motion calling for government support in the bid to tackle oral cancer.
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Keynote speaker Professor Saman Warnakulasuriya joined the chorus, seeking legislation to give dentists powers to prescribe stop-smoking treatment, plus compensation for oral screening.
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The risks of smoking and chewing paan, guthka, or areca, which contribute to 80% of oral cancers, were a focus of the week. Alcohol plays its own part in increasing risks amongst frequent drinkers, while more and more cases display none of the routine risks.
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Later in the week the Foundation donned its scientific cap to continue discussions of oral cancer and its links to the human papilloma virus (HPV) via oral sex.
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Support from TV and radio as well as national, local and trade press helped the campaign achieve a circulation of more than 60 million viewers and readers.
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BDHF chief executive Dr Nigel Carter was delighted with the response. He said: ‘What has been really pleasing is the sheer number of surgeries and PCTs taking part, through free screenings, decking the walls with our posters, sporting blue ribbon badges and working hard to highlight the campaign.
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‘We have seen mouth cancer discussed in the corridors of power, and public health can only benefit from these efforts.’
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Visit www.mouthcancer.org.

Drinking green tea protects your teeth

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Many types of beverages can hurt your teeth because they contain sugar and acids, particularly citric acid.
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/>But if you have a habit of drinking beverage, there is one type you can drink safely, that is, home-brewed green tea, a study finds.
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/>According to the study published in the July/August issue of General Dentistry, home-brewed green tea is better than black tea when it comes to tooth protection.
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/>For the study, Mohamed A. Bassiouny, DMD, BDS, MSc, PhD compared green and black tea to soda and orange juice for their effect on human teeth.
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/>They found that tea, just like water does not have an erosive effect.And green tea is better than back tea due to its natural flavonoids and antioxidants.
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/>But if you drink tea, you are advised not to use any additives such as milk, lemon or sugar.
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/>Tea should be home brewed and you should avoid prepackaged iced teas that contain citric acid and high amounts of sugars.
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/>Academy of General Dentistry issued a statement about the study and offered the following tips:
/>• Reduce or eliminate carbonated beverages. Instead, drink water, milk, or tea
/>• Skip the additives such as sugar, lemon, and milk
/>• Drink acidic drinks quickly and through a straw
/>• Chew sugar-free gum to increase saliva flow in your mouth
/>• Rinse with water to neutralise the acids, and wait an hour before brushing
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