Local Dental Committees Research Articles

Engagement with the North Wales Local Dental Committee - part 2: communication preferences.

Aims To gather the views of dentists practising within North Wales on their preferences as to how they would prefer to interact with the North Wales Local Dental Committee (LDC) (NWLDC).Design Descriptive cross-sectional survey.Setting Online electronic questionnaire.Materials and methods Survey circulated via the NWLDC's current communication channels, local professional groups, the local health board and Health Education and Improvement Wales' MaxCourse email distribution.Results A total of 167 unique responses were received from across North Wales, which included 132 responses from primary care dentists, yielding a response rate of 40.6%. Respondents would prefer to interact with the NWLDC via email notifications (88%), virtual meetings (52.1%) and via the LDC website (41.9%). Furthermore, 31.1% wanted a combination of both physical and virtual attendance at an LDC meeting to be an option and 43.7% of respondents did not want to attend LDC meetings as a preferred method of engaging with the LDC. The survey indicated that holding an educational event just before the LDC meeting will not have a positive impact on subsequent participation in the LDC meeting for 91.6% of respondents. The survey revealed that 70% had never visited the NWLDC's website, with only 20.4% of people visiting it more than once a year. Also, 83.8% stated that the pandemic had made no difference on them accessing the NWLDC website. The results allowed the identification of the top five 'core elements' for an ideal LDC website and which elements should have their access restricted only to LDC members.Conclusions The survey revealed that the respondents want greater communication from the NWLDC and that this is best achieved over a variety of different communication platforms, using the NWLDC website as a primary information resource to which the other communication methods are tethered. It is recognised that only a minority will want to, or be able to, attend the quarterly LDC meetings and so it is imperative that the NWLDC's communication strategy accommodates these individuals, both proactively and passively, by effective use of digital media and to continuously monitor its effectiveness so that it can adapt its strategy to maximise engagement and information delivery. There is a need to expand the representation of the LDC committee to encompass those who have newly entered the profession or are new to the area. The NWLDC recognises the need to reach out to dentists across North Wales who many feel isolated and disenfranchised to establish a constructive, mutually beneficial relationship.

Engagement with the North Wales Local Dental Committee - part 1: current participation and opinions of its communication methods.

Aims To gather the views of North Wales dentists on the current communication methods of the North Wales Local Dental Committee (LDC) (NWLDC) and how this could be optimised to improve engagement from members.Design Descriptive cross-sectional survey.Setting Online electronic questionnaire.Materials and methods Survey circulated via the NWLDC's current communication channels, local professional groups, the local health board and Health Education and Improvement Wales' Maxcourse distribution list.Results A total of 167 unique responses were received from across North Wales. In total, 79.1% were from dentists, of which most were working in the general dental services (63.6%) on a mixed practice basis (61.9%). Furthermore, 69.5% of respondents felt they received too little information from the LDC, 71.3% never attended LDC meetings and only 15.6% attended more than one meeting a year. The pandemic has had no impact for 82.6% in increasing their engagement with the LDC.Conclusions Communication between the LDC and the dental community within an area is crucial. This survey has shown that, despite the best of intentions, the current communication methods utilised by the NWLDC are not effective at maximising the inclusiveness and participation with the LDC. The survey revealed that there is a lack of clarity over the LDC's role and who is 'allowed' to attend LDC meetings. It showed that although the dental practitioners practising within North Wales want to receive information and updates from the NWLDC, the communication methods which are currently being used are not reaching the majority of them.

Paediatric dentistry provision in the North East of England: workforce confidence and attitudes.

Background Exploration of workforce confidence and attitudes towards the provision of paediatric dental care has the potential to inform targeted workforce development to address the oral health needs of children.Aims To explore: workforce confidence in providing paediatric dentistry; attitudes towards existing paediatric dental service provision; and perceived capacity and willingness to deliver Level 2 paediatric dental services.Methods An anonymous online survey was distributed to regional primary care and early-career dentists. It was distributed via Local Dental Committee Chairs, Community Dental Service Clinical Directors, a regional research collaborative and social media for a six-week period.Results Eighty-eight respondents self-reported confidence in 28 paediatric dental skills/competencies. Overall, 64% of respondents rated themselves as confident or very confident, with the least confidence reported in endodontic treatment of immature teeth and prescribing removable orthodontic appliances. In addition, 66% of respondents felt that the current provision of paediatric dental services was inadequate and 44% expressed willingness to provide Level 2 paediatric dental services.Conclusion High levels of confidence were reported in most paediatric dental skills/competencies. Current regional provision of paediatric dental services was described as inadequate. There is willingness and capacity within the existing workforce to provide Level 2 paediatric dental services.

How is carious pulp exposure and symptomatic irreversible pulpitis managed in UK primary dental care?

To investigate attitudes and approaches of UK primary care dentists to carrying out vital pulp treatment (VPT) after carious exposure and with additional signs and symptoms indicative of irreversible pulpitis. An electronic questionnaire was openly distributed via publicly funded (NHS) local dental committees, corporate dental service-providers, professional societies and social media. Principally NHS practitioners and those from mixed and private practice were targeted, in addition to community and military dental officers, and dental therapists. Participants were asked questions relating to several clinical scenarios, with responses analysed using descriptive statistics. χ2 tests with sequential Bonferroni correction were used to explore variables including the method of remuneration, practitioner type (dentist/therapist), postgraduate qualification(s), place of graduation and years since qualification. Variables with a relationship p≤.2 were selected for backwards likelihood ratio logistic modelling. In total, 648 primary care practitioners were included for analysis. Calcium hydroxide (CH) was most frequently used for direct pulp caps (DPCs) (398/600; 66.3%) with calcium silicate cements (CSCs) less frequently used (119/600; 19.8%). Rubber dam was used by 222/599 (37.1%) practitioners. A definitive pulpotomy for the management of teeth with signs and symptoms indicative of irreversible pulpitis was selected by 65/613 (10.6%) dentists. The principal barrier for the provision of definitive pulpotomies was a lack of training (602/612; 98.4%). Regression analysis identified NHS practitioners as a good predictor for using CH for DPCs, having shorter emergency appointments, limited access to magnification and not using rubber dam. Non-UK graduates were more likely to select CSCs, appropriately control pulpal haemorrhage, undertake appropriate postoperative evaluation and use rubber dam. Practitioners deviated from evidence-based guidelines in a number of aspects including material selection, asepsis and case selection. A number of other challenges exist in primary care in providing predictable VPTs, including lack of time and access to magnification. These were most evident in NHS practice, potentially exacerbating existing social health inequalities. Possible inconsistencies in the UK undergraduate curriculum were supported by a lack of association between years since qualification and technique employed as well as the fact that non-UK graduates and dentists with postgraduate qualifications adhered more to evidence-based VPT guidelines.

Knowledge of sepsis risk and management among dental professionals in Wales: a service evaluation.

Aims Sepsis is a significant medical condition. This service evaluation aimed to investigate the current level of knowledge, confidence and educational requirements regarding sepsis among dental professionals in Wales.Design A convenience-sampled, self-administered electronic questionnaire.Setting All chairside dental professionals registered with Health Education and Improvement Wales, all Local Dental Committees, district general hospitals, Cardiff University Dental Hospital and Community Dental Services throughout Wales.Materials and methods A questionnaire was distributed electronically to an estimated 3,716 dental professionals working in Wales in late 2019. Responses were descriptively and statistically analysed.Results In total, 357 responses were received (9.6%), which achieves a 95% confidence interval (CI) with a 5% margin of error. The majority of respondents reported lack of knowledge or confidence in sepsis recognition and management. Approximately two-fifths of respondents did not access equipment to measure oximetry, temperature or blood pressure. More than three-quarters of respondents had not been trained in sepsis recognition and management. The majority of respondents requested online/distance training (42%), local/national conferences (27%) and local study days (16%) as postgraduate educational format.Conclusion There is a clear need for postgraduate education for dental teams regarding the identification and management of individuals with potential sepsis in Wales.Introduction.

Rapid response: activity from a hospital based Urgent Dental Care Centre during the COVID-19 pandemic.

On 23rd March, the UK Government announced a nationwide lockdown in response to the COVID-19 pandemic, resulting in the unequivocal and absolute cessation of all elective dental treatment. With much conflicting evidence on best practice to deliver safe treatment comprising of emergency dento-alveolar surgery, this paper describes the protocols which were undertaken to successfully set up a novel Urgent Dental Care Centre (UDCC) service within a short timeframe. We present patient data from referral through to treatment for the entire ten-week period of operation. A UDCC was established at Queen Mary’s Hospital, Sidcup within 10 days of this announcement. Through an iterative process with minor stakeholders and in collaboration with our Local Dental Committee, a comprehensive urgent dental service was established. Our UDCC received 1,311 referrals within a 10-week period, with 884 patients being accepted for treatment. The majority of treatment delivered in this emergency setting was surgical dento-alveolar procedures (84%). Sixteen per cent of patients attended for trauma, first stage restorative treatment for teeth and postoperative complications. Both aerosol and non-aerosol generating procedures were available to patients. Preventing acute hospital admissions relies on the ability to provide safe dento-alveolar surgery. Our results advocate that our unique UDCC is efficient and provides appropriate patient access and outcomes for those most in need of urgent dental treatment in the face of a pandemic.

Mentoring: are you being or doing? That is the question.

Mentoring is finally coming into its own. The signs are good: the General Dental Council thinks it's important; the British Dental Association thinks it's important; and the royal colleges, Health Education England and local dental committees have all stated that they support mentoring and mentors as beneficial and important. Confidence levels are rising that mentoring is something all dental professionals would benefit from. In this piece I would like to encourage all dental professionals not to view mentoring as something that needs to be an 'add on' or something extra but something that is intrinsic to what and who we are. If we can move away from 'doing' mentoring to 'being' mentors, we will all gain and all aspects of our professional life can be enriched.

Local Dental Committees' annual conference

Local Dental Committees' annual conference

Mick Horton: 'Empathy for your patients is the most important trait a GDP needs'

Dr Mick Horton is the outgoing Dean of the Faculty of General Dental Practice (FGDP[UK]), the ninth Dean since its founding in 1992. In his time as Dean, Mick presided over the decision to establish FGDP(UK) as an independent college for general dental practice. The new organisation aims to provide a collegiate home and professional standing for GDPs and all members of the general dental team. Mick qualified from Manchester University in 1986. In 1992, he purchased a mixed NHS/private practice in Caergwrle, north Wales. His experience includes being a member of the Welsh Dental Committee, 19 years as the chair of his local dental committee and 10 years as the vice chair of his local health board.

Summary of : piloting a local dental network across Hampshire and Isle of Wight Primary Care Trusts.

To pilot a local dental network (LDN) within the Hampshire and Isle of Wight region. An LDN Coordinating Group was set up, which was chaired by the local consultant in dental public health and included representatives from dental commissioning and performance management teams, dental practice advisory team, finance, Oxford and Wessex Dental Deanery and the Hampshire and Isle of Wight Local Dental Committee. The LDN successfully led the organisation of a leadership training course for local dentists, and produced recommendations for local oral surgery and orthodontics care pathways. Key to the success was the collaboration achieved between the commissioners, local postgraduate dental deanery and local dental committee. There were challenges associated with involving non-salaried dental practitioners without a source of funding, and with communicating with the wider dental community. The new Wessex LDN needs to be adequately resourced and integrated into the local commissioning structure, as well as the wider health system, to function effectively. Most importantly, the LDN needs local dental professionals to embrace the opportunities for leadership and use their skills to inform and influence local dental commissioning for the benefit of the local population.

Piloting a local dental network across Hampshire and Isle of Wight Primary Care Trusts

To pilot a local dental network (LDN) within the Hampshire and Isle of Wight region. An LDN Coordinating Group was set up, which was chaired by the local consultant in dental public health and included representatives from dental commissioning and performance management teams, dental practice advisory team, finance, Oxford and Wessex Dental Deanery and the Hampshire and Isle of Wight Local Dental Committee. The LDN successfully led the organisation of a leadership training course for local dentists, and produced recommendations for local oral surgery and orthodontics care pathways. Key to the success was the collaboration achieved between the commissioners, local postgraduate dental deanery and local dental committee. There were challenges associated with involving non-salaried dental practitioners without a source of funding, and with communicating with the wider dental community. The new Wessex LDN needs to be adequately resourced and integrated into the local commissioning structure, as well as the wider health system, to function effectively. Most importantly, the LDN needs local dental professionals to embrace the opportunities for leadership and use their skills to inform and influence local dental commissioning for the benefit of the local population.

An audit investigating outcomes of referrals rejected from Surrey PCT (now NHS England)'s oral surgery triage service

Aim To conduct an audit investigating the treatment outcomes of patients whose referrals were rejected from Surrey Primary Care Trust [now National Health Service (NHS) England]'s Dento-Alveolar Referral Service (DARS – an oral surgery triage service) in order to ensure that the system is safe and effective for patients and dentists. Methods Data about referrals rejected by DARS between September 2011 and February 2012 were collected from the referral management centre. A short questionnaire was sent to the dentists of the patients rejected, requesting details of treatment outcomes for the patients involved. Results Two per cent of all referrals received were rejected during this period. Ninety-one per cent of questionnaires sent out were returned. The majority of dentists (87%) had only one referral rejected. The most frequently rejected teeth were upper third molars. More than half of rejected referrals (55%) were subsequently treated within the patient's own dental practice. Seven per cent of rejections were re-referred to DARS and accepted when extra information was provided. The remaining 38% either did not return (16%), were kept under review (14%), or were treated in other locations (8%). Of 23 extractions attempted by the referring dentist, only two (9%) involved minor complications. Conclusions Patients rejected from DARS are generally being treated successfully elsewhere. This small study suggests that DARS does not put patients at risk. The Local Dental Committee agreed that dentists were not being forced to work outside their competencies. The referral criteria and rejection process should remain the same. NHS England must continue to identify and support training needs amongst referring dentists.

George Sherwood Hobson

George Sherwood Hobson, known as Sherwood to his many friends and colleagues, passed away after a short illness in hospital on 4 November 2011. Born in Belfast in 1930, Sherwood attended Wallace High School and Methodist College, excelling both academically and on the sports field, before going to Queen’s University where he gained his BDS in 1953. Married to Muriel in 1957 theirs was a formidable, loving partnership, each encouraging the other in their endeavours and those of their family, Ross, Leigh and Barry. After qualifying Sherwood worked in general dentistry in the Downshire Hospital and in the School of Dentistry Belfast, where he developed an interest in orthodontics. Sherwood set up the first solely orthodontic practice in Northern Ireland in 1959, and continued with his teaching appointment sharing his practical approach and enthusiasm with those in the Orthodontic Department. He attended both British and European Orthodontic Society meetings to become familiar with the Begg techniques which he then used to create the ‘Hobson smile’. Various local dental committees and the BDA benefited from his insight and input, and the profession is indebted to him for his negotiating skills. In 1976 Sherwood was Northern Ireland Branch President of the BDA. In 1981 he was elected Fellow of the International College of Dentistry and after retiring from practice in 2000 he was honoured with BDA life membership. Outside dentistry, Sherwood played an active and prominent role for many years with Larne Golf Club. He was a member of Malone Golf Club and the University Golfing Society. This interest in golf helped fill a little of the tremendous gap left by Muriel’s death in 2007. Local dramatic societies involved Sherwood as a director or producer. He travelled throughout the province in the 1970s and 1980s and could recount many amusing stories of being stopped at police and army checkpoints in a car filled with disguises, props and wiring. Sherwood enjoyed life and helping wherever he could. He will be missed by his many friends and colleagues. To his family we offer our sincere condolences. D. McLeod, R. Hobson

Local dental committees back BDA red tape campaign

Local dental committees back BDA red tape campaign

The issue of costs

Every year many hundreds of dentists gather at the annual conference of Local Dental Committees (LDCs) to debate the issues they feel most passionate about. The LDCs are the grass roots of the dental profession. They are not strictly part of the British Dental Association (BDA) but the association is very much involved in the conference and has the job of deciding how to act on the issues that are raised.

Maintaining good dental practice: the East Lancashire approach to dentists whose performance gives cause for concern.

The Consultant in Dental Public Health and the Local Dental Committee in East Lancashire have developed a local system, similar to that being set up for general medical practitioners, to help general dental practitioners whose performance is causing concern. GDPs approved it at an open meeting of practitioners. A Dental Performance and Assessment Group has been set up and one problem has already been resolved to everyone's satisfaction. The model is recommended to dentists in other areas.

Badges of the dental profession. The Annual Conference of Local Dental Committees.

Badges of the dental profession. The Annual Conference of Local Dental Committees.

Patients' attitudes to dental charges in Barnet. A survey by Barnet Local Dental Committee

Patients' attitudes to dental charges in Barnet. A survey by Barnet Local Dental Committee