Natalie Bradley

A Foundation Dentist

Young Dentists must have an input to the ongoing Debate on Dental Reforms

As a foundation dentist, I am committed to the dental reforms and the profession need to engage and help shape our future

Reporting from Young Dentists Conference 2015, Feb 14th, is part of my commitment to engage and debate. Raj Rattan raised important issues and asked “What treatment should be provided on the NHS?” this is what he said:

All treatments that are proper and necessary to secure and maintain oral health should be provided under the National Health Service. Most NHS dentists will hold General Dental Service contracts, but additional services can be provided if the dentist has been contracted to carry them out. These include:

• Dental Public Health Services

• Domiciliary Services

• Sedation Services

• Orthodontic Services

• Advanced Mandatory Services - What are these Advanced Mandatory services?: A service which provides a high level of expertise and facilities where general practitioners can refer their patients for specialist periodontal or endodontic treatments.

There are several guidelines available that assess the complexity of the treatment required for a patient, which can be used to determine whether a referral to an advanced mandatory service is indicated, and include guidelines from:

• American Association of Endodontics

• NHS Restorative Dentistry: Index of Treatment Need Complexity Assessment

• British Society of Periodontology

The most common treatments that are ‘pushed privately’ by dentists who violate the terms of their NHS contract and do not follow the GDC Standards of Care are:

1. Cobalt chrome dentures

2. Bridgework

3. Periodontal treatment and hygienist referrals

4. Endodontic treatment

As dental professionals, we are trained as clinicians, and not business managers, and this brings me to the issues of: time, quality and money, and how well equipped are we to deliver.

Ideally, we all would like to perform highly in all of the above, but unfortunately this is often not possible. It has been estimated that around £72 million was inappropriately claimed by gaming dentists; 50% of this were treatments claimed which the patient didn’t actually receive. This is not in the interest of the profession or the patients.

Dentists are also under pressure to be transparent in their pricing by the Office of Fair Trading, more recently by Which? and to be CQC compliant. The profession therefore must discuss how best to use their clinical skills and the settings for appropriate and effective dental care services.

This blog discusses some of the issues facing young dentists, for more see http://www.atoothgerm.blogspot.co.uk