Many moons ago I graduated in dentistry, and since that time the training that I received from my dental school (Glasgow) has always been of great value, particularly understanding the principles of clinical areas outside my own speciality. Nevertheless, there have been substantial changes in clinical practice in dentistry and medicine over the past three decades, and it can be challenging to be able to provide effective and safe clinical care.
Opening our mind
There are many examples of change in dental health care provision, but some highlights include the knowledge that restorative (and paediatric) dentistry has been perhaps revolutionised by the availability of many effective plastic materials and the development of a wide range of implant systems. There is now a significant appreciation of the impact of systemic disease upon periodontal health, and a far wider availability of medical and/or surgical interventions to maintain the periodontal tissues. Furthermore, new orthodontic and surgical techniques, together with ever-improving training, have advanced orthognathic surgery, while the realisation that such care should include psychological monitoring and interventions (principally developed in the UK), has created a truly holistic approach to clinical care.
Umbrella of care
Among other changes within the profession, we have seen how health care workers are now significantly protected from harm in the dental clinic by virtue of health screening and immunisation, the availability of occupational health facilities and employment legislation. Patients are indirectly protected by these factors but also by virtue of the work of the Care Quality Commission, Disclosing and Barring Commission (DB), and legislation relating to infection control and disability amongst others.
Rightly, patients with potentially complex social and/or medical histories have ever-increasing expectations and thus dental healthcare providers are seeking to ensure that they can provide the required care in an effective and safe manner. As a consequence of the above, both newly qualified and established dental care workers wish and are required to stay abreast of appropriate knowledge. This can be a notable challenge as often the question of ‘where do I begin?’ comes to mind.
Guidance is, of course, provided by the General Dental Council, NHS Trusts, other legal organisations, and the BDA; and yet it may still be difficult for clinicians to truly address their requirements or wishes. Perhaps there is a need for all of us to consider finding or being a mentor to our colleagues. Mentorship networks often do exist but dental staff who believe that such a network is warranted for them and/or within their place of practice should consider being pro-active in developing such a scheme.
Professor Stephen Porter is director and professor of oral medicine at UCL Eastman Dental Insitute. His clinical interests are the non-surgical management of complex immunologically-mediated and potentially malignant disease of the mouth and salivary glands.
For more details about the UCL Eastman Dental Institute, please visit www.ucl.ac.uk/eastman or telephone 020 3456 1038. director and professor of oral medicine at UCL Eastman Dental Insitute. His clinical interests are the non-surgical management of complex immunologically-mediated and potentially malignant disease of the mouth and salivary glands.