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There are often moments in life when you can pinpoint exactly where you were, what you were doing and how you felt. From the ecstasy of your wedding to the moment you found out about a family bereavement, those feelings stay with you for the rest of your life. As dental professionals, it is understandable that, given the pressures exerted by UDAs and the way the contracts are, many patients will be treated and forgotten about by the time the next person is in the chair. [ABSTRACT FROM AUTHOR]

This series of papers will examine how the Anglo-American dental profession was established in the eighteenth century, examining its need for a name and identity, public recognition and official status. This paper outlines the evolution of the names of the profession, from tooth-drawer to dentist, and notes the importance of the name to the profession. [ABSTRACT FROM AUTHOR]

There has been a reported increase in the incidence of self-harm within the United Kingdom. This is of great concern, as a number of studies have shown self-harm to be a major risk factor to completed suicide. However, the identification of self-harm provides an opportunity for support and treatment. Mental health is an area that often receives little attention in the undergraduate dental curriculum. Yet dental practitioners, as healthcare professionals, need to be vigilant for any risk factors or signs of mental illness among their patients and make appropriate onward referrals. The purpose of this article is to examine the current evidence and aspects of self-harm, particularly in young adults and adolescents that are relevant within a dental settling. [ABSTRACT FROM AUTHOR]

Skin cancer is common and an increasing problem in the UK. It frequently occurs on the head and neck skin. A significant proportion of the adult population in the UK visits the dentist each year, thus making dental practitioners ideally placed to identify suspicious lesions, which could be skin cancer, as part of their routine extra-oral examination. These patients can then be referred on to hospital or their GP for further management. The dentist can also give advice on risk factors and self-monitoring to patients. This paper aims to describe the risk factors, pathology, presentation and treatments for the three most common forms of skin cancer - basal and squamous cell carcinomas, and malignant melanoma, to give the dental practitioner the knowledge and confidence to examine for and identify these skin cancers. [ABSTRACT FROM AUTHOR]

Ever-increasing needs and demands by dentists and all other members of the dental team for education and training at all levels – undergraduate, postgraduate and continuing – are straining the resources of existing providers of such education. At the same time, there are ever-increasing opportunities to develop online delivery and the use of a range of information and communication technology (ICT) systems and services further, in all aspects of dental education. This paper reviews recent developments that have led to an increased demand for dental postgraduate programmes and continuing professional development (CPD) courses in the United Kingdom and then discusses how ICT has and will impact on teaching practice. Examples include the use of teaching and learning resources in a virtual learning environment (VLE) and the increasing use of blended learning. The paper then explores the need for both teachers and students to adapt to the new environment to ensure they can benefit to the maximum and that teaching and learning practices are changed accordingly. [ABSTRACT FROM AUTHOR]

Aims The aims of the study were two fold: to determine the influence of trainer expertise on the Vocational Training (VT) experience, particularly in terms of providing Vocational Dental Practitioners (VDPs) with positive role models; and to ascertain if it is possible to identify attributes of expertise that can signpost a successful path for new/less expert trainers.Participants Thirty-five VDPs and each of their Vocational Trainers participated in the study. All training took place in the South East of England.Design The participants were followed through the 12 months of their VT year. Semi-structured interviews were conducted with both trainers and VDPs on two occasions, during the year and once VT had been completed. It was also possible to observe practice sessions and VT Study Day teaching. The descriptive analysis of the training partnerships has been previously described.1 The original data were revisited through a constant comparative analysis of the interview transcripts and observation notes.Results The influence of training expertise is identified and discussed as is the VDP view of the trainer as a role model. Attributes of training expertise are highlighted and presented as a guiding path for new/inexpert trainers.Conclusion The training expertise of a trainer has a significant influence on the VT experience for both trainer and VDP. Expertise has the potential to be harnessed and used to good effect in VT. [ABSTRACT FROM AUTHOR]

Introduction: An evaluation of a pilot scheme offering temporary registration with the General Dental Council (GDC) for up to six months in primary care for overseas-qualified (non-EU) dentists studying for the International Qualifying Examination (IQE) Part C. Methods: In all five pilot sites dental attachments and supervisors were interviewed at the start (n = 10) in 2005. At six months, supervisors were interviewed again (n = 4), and dental attachments were surveyed (n = 5). Patient (n = 15) and staff (n = 27) views were elicited through questionnaires. Results: Hands-on clinical practice was the prime motive for involvement. Patient safety was safeguarded through close supervision of attachments' dental treatment. The value of clinical experience, development of patient management skills, work in a dental team, and familiarity of NHS procedures was highlighted. Feedback from patients and staff was positive: attachments' enthusiasm, approach, willingness to take responsibility, and follow protocols were rated highly. The National Advice Centre for Postgraduate Dental Education (NACPDE), England coordinated the pilot (including selection and matching of candidates to supervisors). They established good links with pilot sites and maintained training standards. Conclusion: Temporary registration with the GDC provided valuable educational opportunities, specifically hands-on experience in primary care beneficial in preparing for IQE Part C. The evaluation demonstrated scope to consolidate the pilot and its expansion has been approved by the GDC. [ABSTRACT FROM AUTHOR]

Complaints or claims against dentists by dissatisfied patients usually consist of three parts: the dentist did not perform the treatment as s/he should have done; the dentist did not inform the patient properly about the risks involved with the treatment; the dentist did not keep records. In most cases it is not too difficult for a judge or dental board member, if necessary with the aid of an expert witness, to decide whether the treatment was indeed below standard. The same applies to dentist's record keeping. The recrimination concerning the information given is something else. This deals with the extent of the duty to inform a patient as well as the proof that sufficient information was given. These difficulties do not only appear in court, but also in dental surgeries. This article will focus on the evolution in the jurisprudence concerning the duty to inform patients about risks as well as on the recently changed guidelines of the General Dental Council (GDC) regarding informed consent. Finally some simple tests will show that informing patients about risks does not have to be a risky and time consuming business for the dentist. [ABSTRACT FROM AUTHOR]

Objectives To investigate if dental nurses perceive gender differences in the communication and interaction style used by their dentist in general practice.Methods Data were collected from 64 Northern Irish dental nurses (70% response), and from 549 Dutch nurses (41% response). Respondents completed the Communication and Working Styles Questionnaire (CWSQ), a self-report questionnaire with 20 items on staff communication and working styles. Using principal component analysis, six distinguishable factors could be extracted: [1] gender-related (four items, Cronbach's α = 0.78), [2] friendly relation (four items, α = 0.66), [3] teamwork (four items, α = 0.44), [4] playfulness (two items, α = 0.69), [5] personal attention (three items, α = 0.60), and [6] business-like (two items, α = 0.32). Factors [3] and [6] were additionally analysed at item level given their low internal consistencies.Results MANOVA indicated a main effect for dentist's gender [F(6,541) = 4.649, p < 0.001], and for country [F(6,541) = 37.601, p < 0.001] on the communication style scales. No interaction effect of gender with country was found. Nurses working with a male dentist had higher scores for the 'gender-related' communications styles, whereas those working with a female dentist had higher scores for 'friendly-relation' and 'personal attention' communication styles. Dutch nurses had higher scores on 'playfulness', whereas Northern Irish nurses had higher scores on 'friendly relation' and 'personal attention' communication styles. Some additional differences were found at item level. The age of the dental nurse explained some differences in communication and working styles [F(6,541) = 2.341, p = 0.031); younger dental nurses scored significantly higher for 'gender- related' communication and working style.Conclusion Gender of the dentist does influence dental nurses' perceptions of the communication styles used in the primary dental care setting. Dental nurses working with female dentists report a style predominantly characterised by 'friendly-relation' and 'personal attention', whereas those working with a male dentist report 'gender-related' communication and working styles. Given the steadily growing percentage of females entering the dental profession, it is recommended to raise both dentists' and nurses' awareness on gender influences in professional communication by introducing these topics in their respective education. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to give an insight into the unique health issues faced by the indigenous population of Australia and their direct relationship to oral health, to help overseas dentists wishing to work in Australia to treat these groups of patients successfully and effectively. This applies equally to indigenous Australians living in remote Australia as well as to those living in general suburbia. Data Sources: A Medline search was carried out for any articles in dental and medical journals pertaining to Australian indigenous health and Australian oral health. Data Selection: Wherever possible, articles cited were obtained in full and where this was not possible, abstracts were obtained. Where no abstract was available, the article was not considered for evaluation. Data Extraction: Articles were reviewed by a single observer and were subject to meeting inclusion criteria indicated in the review. Data Synthesis: Articles were divided into historical, diet, oral health and general health categories. Subjective descriptions were then made. Conclusions: The adoption of a 'westernised' diet by the Australian indigenous community has placed them as a high risk population for dental caries and periodontal disease. They also show some of the highest rates in the world for Non-Insulin Dependent Diabetes Mellitus (NIDDM) and Rheumatic Fever. The UK dentist should be aware of these health issues and their relationship to indigenous oral health before embarking on work within Australia. [ABSTRACT FROM AUTHOR]

While the practice of dentistry has been demonstrated to be significantly stressful, there have been few published studies describing interventions to reduce the stress of dental practitioners. This article describes research into the prevention and alleviation of stress amongst a variety of healthcare professionals, including dental practitioners, and describes the findings from a small scale study of an intervention aimed at general dental practitioners who reported high levels of work related stress. It is argued that to be effective, interventions should be tailored to the individual needs of the practitioner, within a structured intervention framework. Further research into the effectiveness and cost-effectiveness of stress management for dental practitioners is required. [ABSTRACT FROM AUTHOR]

Objective: There is little information available on journal based verifiable continuing professional development (CPD). The aim of this study was to survey those dentists who have undertaken this form of CPD and elicit their views. Design: A questionnaire survey. Method: Four hundred dentists who had registered to undertake CPD with the British Dental Journal (BDJ) were randomly selected and sent a questionnaire. Results: Three hundred and twelve questionnaires were returned (78%) of these 181 (58%) were male and 131 (42%) were female. Of the 312, 307 had undertaken the BDJ CPD initiative. Two hundred and sixty eight respondents (87.3%) agreed/strongly agreed that the BDJ CPD satisfied their personal CPD needs. Two hundred and eighty three (92.2%) agreed/strongly agreed that their knowledge has been increased as a result of undertaking the BDJ CPD initiative. Two hundred and twenty agreed/strongly agreed (71.7%) that an element of their clinical practice had changed as a result of undertaking the BDJ CPD initiative. Conclusion: Journal based learning appears to be an effective way of undertaking verifiable CPD. [ABSTRACT FROM AUTHOR]

This series provides an overview of current thinking in the more relevant areas of oral medicine for primary care practitioners, written by the authors while they were holding the Presidencies of the European Association for Oral Medicine and the British Society for Oral Medicine, respectively. A book containing additional material will be published. The series gives the detail necessary to assist the primary dental clinical team caring for patients with oral complaints that may be seen in general dental practice. Space precludes inclusion of illustrations of uncommon or rare disorders, or discussion of disorders affecting the hard tissues. Approaching the subject mainly by the symptomatic approach — as it largely relates to the presenting complaint — was considered to be a more helpful approach for GDPs rather than taking a diagnostic category approach. The clinical aspects of the relevant disorders are discussed, including a brief overview of the aetiology, detail on the clinical features and how the diagnosis is made. Guidance on management and when to refer is also provided, along with relevant websites which offer further detail. [ABSTRACT FROM AUTHOR]

Objective To provide reliability and validity data on a computerised dental anxiety scale (the Smiley Faces Program or SFP) for children using faces as a response set.Setting Five schools across Derby, Newcastle-upon-Tyne and Shropshire.Subjects and method The SFP was completed by 464 children (mean age 10.8 years). For validity purposes, 241 children also completed two other children's dental anxiety measures (the Modified Child Dental Anxiety Scale and the Dental Fear Survey). For test-retest purposes 100 of the children completed the SFP two weeks later.Results The SFP demonstrated good internal consistency (α = 0.8), test-retest reliability was good and significant correlations were found between the SFP and the other measures. The children rated the local anaesthetic and drill as the most anxiety-provoking items.Conclusion This study suggests that the SFP is a valid and reliable measure for assessing children's trait dental anxiety and may help encourage dentists to formally assess dental anxiety. [ABSTRACT FROM AUTHOR]

Shares the author's view on how dental personnel behave to provide treatment for patients. Provision of changes to improve the patients' self-esteem; Need to reflect and evaluate on past performance as dentists; Citations of the factors that dominate the working lives of the dentists.

Background: Atraumatic Restorative Treatment (ART) was introduced a decade ago as a minimal intervention treatment for caries in unindustrialised countries, but UK general dental practitioners (GDPs) may also be using this technique. Objective: This study aimed to determine the materials and techniques used by a group of UK GDPs to treat caries in primary teeth. Method: A questionnaire, designed to determine GDPs' use of materials and techniques in the restoration of caries in primary teeth, was distributed to 600 GDPs in Scotland and England, with an explanatory letter and reply-paid envelope. The questionnaire included colour illustrations of two carious cavities in primary molar teeth and a request that respondents draw the cavity outline that they would use on the illustrations. The cavity outlines were assessed independently by two examiners. All other data were collated and analysed. Results: 390 usable replies were received, a response rate of 65%. Of the respondents, 99% treated child patients and 42% of respondents were aware of ART. For treatment of a small Class II cavity, 37% drew a cavity outline without extension beyond removal of caries and a majority suggested use of an adhesive material (51% glass ionomer, 13% compomer). For cavity preparation, 47% of respondents used a drill, 10% an excavator and 41% used both. For treatment of a large occluso-lingual cavity, again most used an adhesive technique (44% glass ionomer, 12% compomer) for its restoration, while 50% used a drill, 7% an excavator and 42% used both for cavity preparation. Conclusion: Most respondents used adhesive materials for restoration of caries in primary molars, but, despite 42% of respondents stating that they were aware of the treatment, "true" ART was adopted by fewer than 10% of respondents. [ABSTRACT FROM AUTHOR]

This series provides an overview of current thinking in the more relevant areas of oral medicine for primary care practitioners, written by the authors while they were holding the Presidencies of the European Association for Oral Medicine and the British Society for Oral Medicine, respectively. A book containing additional material will be published. The series gives the detail necessary to assist the primary dental clinical team caring for patients with oral complaints that may be seen in general dental practice. Space precludes inclusion of illustrations of uncommon or rare disorders, or discussion of disorders affecting the hard tissues. Approaching the subject mainly by the symptomatic approach — as it largely relates to the presenting complaint — was considered to be a more helpful approach for GDPs rather than taking a diagnostic category approach. The clinical aspects of the relevant disorders are discussed, including a brief overview of the aetiology, detail on the clinical features and how the diagnosis is made. Guidance on management and when to refer is also provided, along with relevant websites which offer further detail. [ABSTRACT FROM AUTHOR]

Objectives: On graduation, UK dentists wishing to advance their career enter two years of general professional training aimed at consolidating their undergraduate experience. The Membership of the Faculty of Dental Surgery examination (MFDS) attests to its successful completion and is a pre-requisite for entry into training programmes which lead to specialist status. Most MFDS candidates prepare for the examination on their own while in full-time employment and many reinforce this self-directed learning with participation in short revision courses or through distance learning. Here we seek to obtain data on the specific educational needs of these individuals.Methods: Questionnaires were used to interrogate 92 UK graduates attending short MFDS revision courses of up to 1 week's duration to identify which topic areas were perceived as particular areas of weakness. To gain greater insight into the responses obtained, 18/92 respondents were selected at random and followed up with semi-structured interviews informed by the questionnaires.Results: Basic medical science, human diseases, law and ethics and health and safety regulations were the areas of weakness most frequently highlighted by the respondents. Most had undergone comprehensive courses in the first two topics; however, the interviews suggested that this was generally in the early stages of undergraduate training when they had difficulty in contextualising large quantities of new information. In the case of the latter two, teaching had been very varied and several interviewees felt that it had been inadequate.Conclusion: Recent graduates preparing for MFDS have clear educational needs. These data have begun to characterise the requirements of this group and may inform the planning of short revision courses designed to assist them. [ABSTRACT FROM AUTHOR]

Objectives To assess the level of job satisfaction among general dental practitioners from one area of England, and to assess the association of various personal and work related factors with job satisfaction.Design Postal questionnaire survey.Setting General dental practices in South Staffordshire, Wolverhampton and Dudley, England.Method An anonymous questionnaire posted to all 396 registered dentists in the above areas.Results A 75% response rate was achieved. Data were analysed using non–parametric statistics for any significant differences in the scores for stress, respect, overall professional satisfaction, quality of life and overall job satisfaction according to the different demographic groupings of the dentists (alpha =0.05). Dentists with an area of special interest had higher scores in all categories except quality of life. Overall job satisfaction was higher among private dentists, and those in group practices and in non-rural locations. The highest bi-variate correlation occurred between overall job satisfaction and overall professional satisfaction, delivery of care, income, respect and professional time.Conclusions Job satisfaction was judged to be good among this group. Stress was the factor associated with the greatest dissatisfaction. This survey produced similar results to preceding US studies, and suggests ways of improving job satisfaction. [ABSTRACT FROM AUTHOR]

Turner's painting of a dental surgeon's rooms, discussed in the first of these two papers,1 is a very satisfying work of art, successful in its relaying of a domestic drama, and also fulfilling Payne Knight's commission to produce a work to equal that of the older masters. It cannot, though, be relied upon to show us what a late Georgian dentist's rooms actually looked like. For this we are very fortunate to have Turner's sketchbook, with its preparatory drawings for the painting. [ABSTRACT FROM AUTHOR]

Introduction This paper reports an evaluation of the West Midlands Key Skills initiative that provides a framework for learning during vocational training (VT).Method The 48 vocational dental practitioners (VDPs) who began their VT in August 2001 in the West Midlands were surveyed at the start and end of training (45 completed both surveys). They rated their confidence and experience in the 31 components of the Six Key Skills on visual analogue scales. Views were elicited in a survey of both VDPs (47 returns) and their general practice trainers (44 returns). Semi-structured interviews were also held with a stratified sample of 9 trainers and all four VT advisors.Results In terms of VDP progress, a statistically significant increase in confidence and experience was found in each of the 31 components. Six themes were identified in the views data. (i) Supporting the development of Key Skills; (ii) workload implications; (iii) the 'right' six? (iv) links with the advanced diploma (MFGDP(UK)); (v) assessment of VT; and, (vi) consistency and quality assurance.Conclusion VT successfully develops the confidence and experience of newly qualified dentists in the Six Key Skills and has been well received by the majority of VDPs, trainers and advisors in the West Midlands. [ABSTRACT FROM AUTHOR]

Objective: To investigate the career development, perception of status within the dental team, and level of job satisfaction of dental technicians in the United Kingdom. Design: Cross-sectional postal questionnaire survey of 1,650 dental technicians registered with the Dental Technicians Association. Replies were received from 996 (60%). Results: Eighty two per cent respondents had a qualification in dental technology and 21% also had an advanced level qualification. Almost two thirds of the respondents had undertaken no verifiable continuing professional development in the previous year. Only 27% of respondents expected to develop their career over the next five years. Less than 50% of the respondents felt adequately valued as individuals and as a professional group in the dental team. Job satisfaction was significantly related to age, attendance at one or more courses in the last year, working shorter hours, feeling valued in the dental team, and future career plans. Conclusions: Plans for the registration and role expansion of dental technicians provide opportunities for career development which have yet to be realised. The low levels of continuing professional development currently undertaken indicate the need for a review of the provision and funding of training at a strategic level. Whilst levels of job satisfaction are satisfactory, many dental technicians feel insufficiently valued in the dental team. [ABSTRACT FROM AUTHOR]

Objective The aim of the study was to investigate overall stress, work-stress and health in general dental practitioners (GDPs).Design, setting and subjects A nationwide anonymous cross-sectional survey was undertaken using stratified random sampling of 2,441 GDPs in the UK.Main outcome measures Measures included perceived stress, Work Stress Inventory for Dentists, job dissatisfaction, measures of health symptoms and health behaviour, dental and demographic information.Results The main findings were that perceived stress was significantly correlated with measures of dental stress. Work-related factors: fragility of dentist-patient relationship, time and scheduling pressures, staff and technical problems, job dissatisfaction, percentage NHS, and number of hours worked per week together explained nearly a half of GDPs overall stress in their life (linear multiple regression, adjusted r2 = 0.48, F (2, 2404) = 509.68, P < 0.0001). Health behaviours such as alcohol use was associated with work stress (r = 0.18, P < 0.001) and over a third of GDPs were overweight or obese. Sixty per cent of GDPs reported being nervy, tense or depressed, 58.3% reported headache, 60% reported difficulty in sleeping and 48.2% reported feeling tired for no apparent reason. These were all related to work stress (one way analysis of variance, F (1,2211) = 241.53 P < 0.0001, F (1,2214) = 86.17 P < 0.0001; F (1, 2215) = 125.55 P < 0.0001; F (1,2211) = 209.67 P < 0.0001 respectively). Levels of minor psychiatric symptoms were high, with 32.0% of cases identified. The amount of backache was also high (reported by 68.3% of GDPs).Conclusion A high percentage of NHS dentistry was associated with high levels of overall stress in GDPs' lives, indicating that the nature of NHS dentistry should be carefully investigated to try to improve GDPs working conditions. A comparatively large number of dentists reported high levels of psychological stress symptoms, such as being nervy, tense and depressed, showing minor psychiatric symptoms, with alcohol use being related to stress. Other factors reported which were not related to stress but may be related to the actual practice of dentistry were that a third of dentists were overweight or obese and over 60% reported backache. Overall, these findings indicate the stressful nature of dentistry and difficulties in working conditions. The next step should be to develop interventions to help dentists to reduce stress in the dental surgery. [ABSTRACT FROM AUTHOR]

Aim To assess the quality improvement of new patient referrals to a restorative department comparing a standard referral proforma and a normal referral letter.Design A prospective analysis of a consecutive sample of all referral letters and replied proforma until a total of 100 had been achieved.Method The study covered the period from November 2000 to June 2001. Once the letters and corresponding proforma were matched, they were compared for data capture and hence quality.Results There was an increase in 29.3% of information provided. Specific categories of data showed high increases such as patient's telephone number, relevant medical history, treatment already given, recorded signs and symptoms, urgency of the referral and whether treatment or advice was requested.Conclusions In this study, the quality of restorative referral increased with the use of a referral proforma. [ABSTRACT FROM AUTHOR]

This paper expands upon a previous quantitative study which measured dentists' knowledge, attitudes and practices towards patients carrying blood-borne viruses in order to identify potential barriers to the provision of adequate dental treatment. Although some useful findings were obtained in that study, it was suggested that further qualitative work needed to be conducted in order to provide the opportunity for dental practitioners' to expand, reflect and justify their opinions and beliefs in more detail. The aim of this study is to present the results of such a qualitative investigation. [ABSTRACT FROM AUTHOR]

Introduction: Little is known about how effective general dental practitioners (GDPs) are in treating temporomandibular disorders (TMD). The overall aim of this study was to compare the lower stabilising splint (SS) with a non-occluding control (CS) for the management of TMD in general dental practice. Method: A total of 93 TMD patients attending 11 GDPs were randomly allocated to SS or CS. Diagnosis was according to International Headache Society Criteria. Outcome criteria included pain visual analogue scale (VAS), number of tender muscles, aggregate joint tenderness, inter-incisal opening, TMJ clicks and headaches. Splints were fitted one week after baseline and patients were followed-up every three weeks to three months; those not responding to CS after six weeks (< 50% VAS reduction) were crossed over to SS for a further three months. Results: Documentation was returned from nine GDPs for 72 patients (38 for SS, 34 for CS). At six weeks, mean improvements were noted for all outcome criteria, but less so for clicking. There were no significant differences between splints [chi(2)]. Seventeen CS patients had < 50% VAS reduction and were provided with SS in the cross-over group. CS patients with >50% VAS reduction were significantly younger than CS patients who crossed-over (ANOVA, p=0.009) and had significantly less diagnoses of TMJ clicking (chi(2), p<0.05). At the conclusion of the trial 16 patients were referred for specialist management: 11 non-responders (< 50% VAS reduction), one of whom needed occlusal adjustment and five responders also needing occlusal adjustment. Conclusions: At six weeks SS gave similar relief to CS for all outcome criteria. Patients who crossed-over from CS to SS were more likely to be older and have clicking TMJs. At the end of treatment nine of 11 non-responders to SS had a diagnosis of disc displacement with reduction. However, 80% TMD patients were managed effectively by GDPs using splints for periods of up to five months. [ABSTRACT FROM AUTHOR]

Introduction: This paper reports the impact of course attendance on the practice of dentists. Method: Phase One: A survey sent to all general dental practitioners (GDPs) in three deaneries in England. The survey included self-ratings of the impact of course attendance on practice. Phase Two: Interviews with 20 dentists before and two to three months after they had participated in a self-selected course. The response rate to the survey was 54% (n = 2082). Comparisons with national data showed no notable bias in the sample for gender, owners/partners and age/experience. An ordered logit model was used to explore the net effect of factors (including years' experience in general dental practice and gender) on dentists' ratings of course impact. Results: Course attendance was judged to impact on practice. Impact rating was affected by participation rate and years' experience. Barriers to implementation included cost, time, NHS constraints and personal or staff issues. Impact was enhanced when selection of courses was based on learning needs although courses may also serve usefully to confirm current practice. Conclusion: There is much that dentists themselves can do to enhance the impact of courses, principally by reflecting on learning needs. They should be supported in the development of personal learning plans. [ABSTRACT FROM AUTHOR]

ObjectiveA peer review study was carried out to assess the written communication between consultants and specialist registrars in restorative dentistry with the referring general dental practitioners.MethodsSeven people took part in the study and each presented referral and reply letters for five patients whom they had seen for consultation. The referral letters were used for information only and were not used in the peer review process. Each participant inspected the referral and reply letters from the other six participants. The reply letters were anonymously peer reviewed by using a proforma containing agreed criteria in relation to appropriate factors to include in the reply letter. The reviewer also ranked the letter in relation to overall quality on a 1-10 point scale.ResultsIt was found that the participants' letters generally conformed positively with the agreed criteria although there were some differences between individuals. There were particular problems identified in relation to tooth notation. Reply letters commonly used different forms of tooth notation to the referring practitioners.ConclusionsThe ranking of the letters generally indicated that the participants' replies were judged to be favourable by their peers. There may be scope for continuing this study in relation to peer review by other groups of professionals, in particular practitioners in primary dental care. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to determine differences between male and female dental practitioners in the positions they occupy within their employment, and to analyse the correlates of such differences.Method: Postal questionnaire survey of a 1 in 10 sample of individuals taken from the General Dental Council register.Results: Female dental practitioners occupy lower positions in the employment hierarchies of the Community Dental Service and the Hospital Dental Service. Women general dental practitioners are significantly less likely to be sole proprietor of, or a partner in, a general practice. Ownership of a general practice is related to: sex, age, number of years qualified, number of children, and hours worked. Consultants in the Hospital Dental Service are more likely to be male, older, to have been qualified longer and (obviously) to hold more additional qualifications than their non-consultant colleagues. Senior Dental Officers and Directors of the Community Dental Service are more likely to be male, work longer hours and (again obviously) to hold more additional qualifications than Community Dental Officers.Conclusions: Differences exist between male and female dental practitioners in the positions they occupy within employment hierarchies. Age, length of time since qualification and the acquisition of additional qualifications are consistently found to differentiate dental practitioners' status. [ABSTRACT FROM AUTHOR]

This series of papers examines how the Anglo-American dental profession was established in the eighteenth century, examining its need for a name and identity, public recognition and official status. This third paper describes the introduction of the title dentist as the preferred one when used officially and politically. [ABSTRACT FROM AUTHOR]

Tim Newton, leader of King's Health Psychology Service, talks to the BDJ about his views on UK health policy and tells us why a dentist's visit can still cause a lot of anxiety for patients. [ABSTRACT FROM AUTHOR]

It was almost four years ago that information about medicines for oral conditions was integrated into the British National Formulary (BNF) proper. The intention was to prepare dentists to prescribe on terms similar to those of their medical colleagues and to make the information on dental and oral conditions accessible to all healthcare professionals who use the BNF. In the first of a two-part series, we describe how dentists can find significant changes in a new edition of the BNF and navigate to the dental information in it. [ABSTRACT FROM AUTHOR]

Objectives To discover what dentists require of a hospital response letter with regards to content and timeliness.Design Postal survey.Setting South Wales.Subjects and methods A postal questionnaire was issued to all dentists (n = 256) who had referred a patient to the dental hospital between 1 January 2003 and 1 March 2003.Results The response rate was 60.2% (154). The preferred time frame for the receipt of a letter following a patient's appointment was one to three weeks for 96.4% (n = 133) of respondents, but 58.4% believed that they currently do not receive responses within this time frame. The preferred method of communication remained the letter (n = 82, 53%), followed by the telephone (n = 58, 38%). E-mail accounted for eight percent (n = 12) of communication. Most respondents (70%, n = 107) were satisfied with the letters' content. Eight of the ten items of information suggested as being appropriate in a response letter were considered essential by 53.2% of dentists (n = 82), and 55.8% (n = 76) believed the remaining two items to be desirable.Conclusions Dentists agree closely on the information required in a response letter and most are satisfied with the content of current response letters. However, many dentists believe response letters arrive later than three weeks after their patient's appointment. [ABSTRACT FROM AUTHOR]

In 2001, research was carried out to investigate the views of dentists and professionals complementary to dentistry on their experiences as part of the personal dental services pilots. This article outlines the main messages from the survey. Before 1997, NHS general dental services could only be delivered by general dental practitioners via a national contract with a nationally negotiated scale of fees. The NHS (Primary Care) Act 1997 allowed for the voluntary establishment of personal dental services (PDS) pilot schemes to test alternative ways of delivering dental services, in particular general dental services, through local contracting arrangements. In the PDS scheme, the contract for dental services was agreed between the commissioners (health authority or primary care trust) and one or more providers of dental services. Since then, the involvement of professionals complementary to dentistry (PCDs) has become an increasingly important issue. This investigation seeks to shed some light on the effectiveness of attempts to integrate the dental team and improve the contribution made by PCDs. [ABSTRACT FROM AUTHOR]

Background In April 2011 the Scottish Dental Clinical Effectiveness Programme published the Oral health management of patients prescribed bisphosphonates guidance document. The aims of this study were to examine whether dentists' practice and beliefs changed after guidance publication to determine whether a knowledge translation intervention was required, and to inform its development.Methods Three postal surveys sent to three independent, random samples of dentists throughout Scotland pre- and post-guidance publication. The questionnaire, framed using the theoretical domains framework (TDF), assessed current practice and beliefs relating to recommended management of patients on bisphosphonates.Results The results (N = 420) suggest that any significant impact the guidance may have had on the recommended management of patients on bisphosphonates by primary care dentists, had reached its peak ten months post publication. A more positive attitude, greater perceived ability, and greater motivation were all associated with significantly more performing of all recommended behaviours at every time point.Conclusions Prior to this study, there was little available information about how patients on bisphosphonates were being managed in primary dental care, or what beliefs may be influencing management decisions. This study was able to identify levels of compliance pre- and post-guidance publication and determine that further intervention was necessary to enable sustained uptake of recommendations. Using the TDF to identify beliefs associated with best practice made it possible to suggest theoretically informed strategies for service improvement. The next step is to test the intervention(s) in a randomised controlled trial. [ABSTRACT FROM AUTHOR]

Objective To investigate the impact of General Dental Council (GDC) registration and mandatory CPD on dental technicians' views, job satisfaction and intention to leave the profession.Design Postal/online survey, conducted in parallel with a survey of dental nurses.Setting UK private and NHS practices, community services, dental hospitals.Subjects and methods Representative sample of GDC registrants. Main outcome measures: job satisfaction; intention to leave profession (dependent variable in regression analysis).Results 605 were sampled: 40 were ineligible (left the register in July 2011, re-qualified in another dental care profession, shared a practice address with another selected DT); 193 responded (response rate 34%). 22% were female (mean age 38.2 years) and 78% male (mean age 49.4 years). The general principle of registration was endorsed by 52%, and compulsory registration by 54%, but the fee level by only 13%. Most technicians felt that registration had had either no effect or a negative effect on their view of their career (80%), role (78%) or status within the dental team (85%), and 66% did not agree that training helped them to do their job better. Fifty-one percent were not satisfied with their job and 20% intended to leave the profession. Intention to leave was predicted by greater dissatisfaction with remuneration.Conclusions Criticisms regarding the cost and relevance of registration and the cost, relevance and accessibility of CPD, coupled with potentially high level of attrition from the profession, suggest a review of the fee and salary structure and greater support for CPD is warranted. [ABSTRACT FROM AUTHOR]

Background In April 2006, fundamental changes were made to the arrangements for commissioning state funded (National Health Service, NHS) dental care in England and Wales. These involved the dissolution of a universal national contract and the introduction of locally commissioned primary dental care services. Suggested advantages included the elimination of a fee-for-item 'treadmill', an increased emphasis on prevention and improved patient access. This change came at a time when many practitioners were opting to provide care outside the NHS.Objectives This study investigated dentists' experience of the new contract and compared this with attitudes determined in a previous survey of the same cohort of dentists conducted immediately before the changed commissioning arrangements.Methods Data were collected via a postal questionnaire, comprising a combination of 60 open and closed questions, mailed to 608 general dental practitioners in Wales.Results Four hundred and ninety-six (77%) questionnaires were returned. Four hundred and seventeen practitioners continued to provide NHS dental care. Only 46 (11%) of the 417 practitioners agreed that they liked the new method of remuneration and the majority (362 [86.8%]) perceived that they still delivered state-funded care in a 'treadmill' environment. This compares with 34.9% of dentists who perceived the new system as a 'treadmill' immediately before its implementation. Three hundred and forty-eight (83.4%) disagreed that they were able to spend more time on prevention and 356 (85.3%) did not feel they had more time to spend with patients – key objectives of the reforms. Two hundred and seventy-five (65.9%) respondents agreed that local NHS commissioners were controlling their business.Conclusion This survey, conducted 18 months after the implementation of the new commissioning arrangements, suggests that practitioners are deeply unhappy with local commissioning. It raises questions as to whether the changes have achieved the Government's stated objectives in reforming state-funded primary dental care. [ABSTRACT FROM AUTHOR]

Introduction Before April 2006, English dentists were either working as an NHS general dental service (GDS) practitioner (fee-per-item, no local contractual obligations); an NHS personal dental service (PDS) practitioner (block contract with the primary care trust (PCT)); a private practitioner (either fee-per-item or capitation-based, independent of the PCT); or in a situation where they were mixing their NHS work (either under the GDS or PDS arrangements) with private work.Objectives To a) investigate the extent of the mix of NHS and private work in English dentists working in the GDS and PDS, b) to compare global job satisfaction, and c) to compare facets of job satisfaction for practitioners working in the different organisational settings of PDS practices, GDS practices and practices where there is a mix of NHS and private provision.Method A questionnaire was sent to 684 practitioners, containing 83 attitudinal statements relating to job facets, a global job satisfaction score and questions concerning workload.Results Response rate was 65.2%. More PDS than GDS dentists were found to treat the majority of their patients under the NHS. GDS dentists working fully in the NHS were least likely to be satisfied with their job, followed by PDS practitioners and then GDS dentists working in mixed NHS/private practices. Private practitioners were the most satisfied.Conclusion Differences between GDS, PDS and private practitioners were found in global job satisfaction and in the facets of job satisfaction related to restriction in being able to provide quality care, control of work and developing clinical skills. [ABSTRACT FROM AUTHOR]

ObjectivesTo determine knowledge and educational needs of dental practitioners in Wales regarding congenital or acquired cardiac disease and the provision of antibiotic prophylaxis.DesignSelf-administered postal questionnaire.SettingsCardiff University Dental Hospital, district general hospitals (HDS), all general dental practices (GDP) and community dental service (CDS) clinics throughout Wales.MethodsA questionnaire sent to 1,182 dentists in Wales in 2004-5.Results528 questionnaires were returned (a response rate of 45%). These were analysed using one-way analysis of variance to compare summary scores between the occupation groups. Significant differences in knowledge of cardiac risk factors for infective endocarditis and for dental procedures requiring cover were observed between the occupation groups. The majority of dentists (92% GDPs, 94% CDS and 77% HDS) requested postgraduate education in cardiac risk factors and laminated flow diagrams for their surgeries as the preferred educational format.ConclusionThe knowledge of Welsh dentists regarding cardiac conditions or procedures which are risk factors for paediatric and adult patients varied according to place of work. The study identified potential for under- and over-prescription of antibiotic prophylaxis within the current guidance. There was confusion as to which patient groups and cardiac conditions required prophylaxis and for which particular dental procedures. Postgraduate education detailing advances in cardiology practice is necessary for dentists. [ABSTRACT FROM AUTHOR]

AimTo determine aspects of the 'lived experience' of dental vocational training (VT) for vocational dental practitioners (VDPs) and their trainers.DesignA qualitative study: semi-structured interviews were conducted with the participants halfway through VT and once the VT year had been completed.ParticipantsTwo consecutive cohorts of 13 and 22 VDPs and their trainers.ResultsThe experience of VT for the VDPs and their trainers is presented together with a model of VDP progression through the VT year.ConclusionVT is a success for VDPs and their trainers. Not one VDP would have wanted to enter general practice without VT. With very few exceptions the trainers considered VDPs capable of independent practice, post VT. Trainers were considered as positive role models by their VDPs. VT facilitates the transition of novice dentists into competent practitioners. [ABSTRACT FROM AUTHOR]

For the past decade the phrase '80% of caries experience is found in 20% of the population' has been repeated so frequently, including by respected academics, that it has become accepted as fact by many in the dental profession. But is it a true representation of the state of dental health in the UK population, or an unsubstantiated convenient statement? Epidemiological data do not support the assertion. [ABSTRACT FROM AUTHOR]

Provides information on the advantages of e-learning to practicing dentists in Great Britain. Use of online media effectively in virtual learning environment; Development of innovatory online teaching materials; Provision of quality dental training.

Presents an overview on the history of dental education in Europe since the inception of the European Union. Formation of the European Economic Community; Existence of Dental Directives; Freedom of movement enjoyed by the dentists.

The internet is becoming a more and more powerful tool and many dental practitioners use it to advertise their dental service; some dental practices even offer on-line appointment booking! It is not unreasonable to surmise that use of the internet is likely to become increasingly common practice by dentists in the future. This is not surprising as the World Wide Web (WWW) provides an opportunity for dentists to advertise themselves and their practices to a wide audience in a relatively economical manner. [ABSTRACT FROM AUTHOR]

The article provides an overview of the different ways in which overseas dentists can be employed. Since the expansion of the European Union on May 1, 2004 the interest in recruiting dentists from outside Great Britain has intensified. Additionally the Department of Health's announcement in July about the modernisation of NHS dentistry included the promise to recruit 1000 extra NHS dentists by October 2005' and speed up the process for overseas dentists to register to work in Great Britain adding to this interest.

The article focuses on help available for underperforming students. The issue of underperforming health professionals and how to deal with them is a very prominent subject In the last decade, several new legal and advisory framework initiatives, recommended the creation of local procedures to deal with underperforming practitioners before referral to the regulatory authority. A number of schemes for doctors were established as a result. The first Practice Advice and Support Scheme for dentists was established in East Lancashire in 1999 following the Department's publication of "Modernising Dentistry-Implementing the NHS Plan."

This case report describes the initial presentation of variant CJD to a general dental practitioner. The case highlights the importance of prompt referral of patients presenting with a history of atypical facial symptoms. [ABSTRACT FROM AUTHOR]

Background The 'high-speed' (air turbine) handpiece is used extensively across many dental disciplines and the ability of clinicians to detect faulty handpieces is essential.Aim The primary aim of this audit was to determine the proportion of participants who could correctly identify unsafe handpieces. Secondary aims were to determine the proportion that had previous training on the topic and determine whether an educational video could improve scores.Method Eighty participants completed the first round of audit. They were asked to inspect seven handpieces, five of which were faulty, with three being classed as unsafe. After the intervention (educational sessions and distribution of a video) a second round of audit was completed on 69 participants.Results The ability to detect the three unsafe handpieces increased from 10% to 44% over the two rounds of audit. In the second round the highest score obtained was by those who had received the intervention, 77%. The lowest score, 14%, was by those who had not received the intervention. Nine percent of participants in the first round stated they had previously had training on handpiece inspection and none of these participants identified the three unsafe handpieces.Conclusion This audit has highlighted that there is a knowledge deficiency with regards to air turbine handpiece safety and inspection. We have shown that introduction of a simple education video can have an impact on dentists and students abilities to detect unsafe faults. We have already introduced this into the undergraduate curriculum in our school and we aim to also raise awareness within the dental community. [ABSTRACT FROM AUTHOR]