Dealing with the issue of ‘quality’

The current trend in television programmes like Desperate Housewives where a character voices over the opening scenes with a series of questions and observations is very similar to the construction of an article for publication!

At last month’s vocational trainers’ meeting in St James’ Hospital, Frank Ormsby, our co-ordinator, posed to us the question as to where we are going as a cohort of GDPs. He was concerned with the continuing lack of a Chief Dental Officer to provide direction and the vista of the proposed appointment of a part-time Chief Dental Officer position allied to academia.

The abolition of the Postgraduate Medical and Dental Board and its role being subsumed into the bowels of the HSE without any dentist being involved now or in the foreseeable future is also of concern.

Personally, the news in a recent issue of the Irish Examiner that Minister Harney was at the University of Arizona Dental School to examine aspects of dentistry leaves me baffled. We’ve been neglected, ignored and treated shabbily by her department for the past few years and she now seeks wisdom in America and, worse still, from academia.

Frank proposed the idea of setting up an Irish chapter allied to the UK’s Faculty of General Dental Practice (FGDP UK) ( I believe he has touched on an idea with great promise for us GDPs.

Why, you may ask, do we need this when we have the IDA? I believe if we look at our medical colleagues, who have both the ICGP at Lincoln Place in Dublin, set up in 1984, and their representative IMO, we can see the benefits.

The IDA has successfully carried out its aims of being a professional, representative, scientific and service organisation in its 86 years. We will continue to need its bargaining power, as it is effectively our union. However it does not solely serve GDPs and in today’s world with increasing legislation, standards and restrictions being introduced in all areas of our practices, we can’t expect it to be a panacea for all of our ills.

The FGDP was set up in London in 1992 to be a home for GDPs. Its aims are to improve the standards of care delivered to patients through standard setting, postgraduate training and assessment, education and research. This provides the necessary continuing professional development and training in relation to dentists and dental care in the GDP field.

The FGDP has developed a career pathway that can lead to Membership of the Joint Dental Faculties (MJDF), which will replace the MFGDP (Membership of the Faculty of General Dental Practice) and MFDS (Membership of the Faculty of Dental Surgeons). It also offers diplomas in implant and restorative dentistry.

As GDPs we know that our practices are built upon the relationships we develop with our patients and the trust they develop in us. The recent past in medicine has been clouded with the cancer misdiagnoses and the Neary Scandal, to name just two.

I recently had a new patient who had undergone extensive replacement of posterior fillings with composite. My hygienist called me in to check what she felt were poor quality restorations. They had all been placed within the last two months and on bitewing X-ray most showed recurrent decay; two have since fallen out, requiring replacement. The dentist who carried out the original work is one I would rate highly.

This is not a condemnation of a colleague, as for all I know my patients may similarly have ended up under critical eyes, but rather a demonstration that the ‘quality’ roll-out in response to cross-border and Eastern European dentistry may come back to haunt us.

We are regularly fed the party line of ‘quality’ and it may be that we are paying lip service to it. How many are still using Tofflemire or Siqveland matrix systems for posterior composite restorations when the V-ring matrix is now the gold standard? How many of us know of it or even possess or use it?

It is better now for us to be proactive and investigate the possibility of setting up a chapter of the FGDP for Ireland and dealing with the issues of ‘quality’ before it is forced on us.

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