Primary dental care : journal of the Faculty of General Dental Practitioners (UK)最新文献

Aim: The aim of this paper is to introduce the reader to personal construct psychology as a theory to help understand the process of change in facilitative and mentoring relationships.

Background: Continuing professional development is critical if practitioners are to keep up to date with new ideas, techniques, and materials. However, is it important not only to consider what is learnt, it is also important to understand the how of learning in order to develop an approach that leads to lifelong learning. Mentoring, coaching, and appraisal are all facilitative processes that aim to encourage professionals to engage with their own development. This leads to differing degrees of both behavioural and attitudinal change. As a result, it is useful to have a theory that can help an individual to understand these changes and to identify any difficulties that are associated with them.

Approach: Personal construct psychology has long been recognised as a potential framework for personal development. It has been used extensively in a broad range of domains, including clinical and educational psychology, management, and psychotherapy.

Conclusion: Personal construct psychology is a useful theory for understanding the facilitative process because it enables the facilitator to form a conceptual framework to comprehend behavioural and attitudinal change. Its underlying philosophical approach also supports lifelong learning, given its emphasis on an enquiring mind and reflection, both of which are key to continuing professional development.

The aim of this paper is to update the reader on the subject of dental neglect in children. Recent national guidelines produced by the National Institute for Health and Clinical Excellence and the British Society of Paediatric Dentistry have raised the profile of this condition by providing specific, evidence-based recommendations for recognition and response to dental neglect. Dental neglect may be a sign of general neglect or may be considered maltreatment in itself. The specific dental and non-dental features are described and actions secondary to a diagnosis of dental neglect are discussed. Three types of intervention are described: preventive dental team management, preventive multi-agency management, and referral to child protection services. With increasing awareness of this condition and through access to the expertise of other specialist agencies in this field, the primary care practitioner can play a key role in safeguarding the welfare of children.

Aim: The aim of this study was to determine the possible effects of the 2006 National Health Service General Dental Services contract changes on the referral pattern to the orthodontic department at St George's Hospital, South West London.

Method: This study was carried out on a retrospective basis. The notes of consecutive patients referred between 1st May and 30th September in 2005 and 2008 were assessed, and the patient's Index of Orthodontic Treatment Need (IOTN) and the source of referral noted.

Results: The total numbers of referrals increased from 260 in 2005 to 405 in 2008. The number of referrals from general dental practitioners decreased slightly from 165 to 156, as did the numbers of referrals from other sources, such as tertiary referrals. The number of referrals made by specialist practitioners increased from 41 in 2005 to 207 in 2008, representing an increase from 16% to 51% of overall referrals. Overall, the number of patients being referred with an IOTN dental health component grade of 5 increased from 27% to 55%.

Conclusion: The increase in referrals from specialist practitioners may be partly due to the changes brought to the commissioning of orthodontic services for specialist practitioners. Overall, the number of cases being referred with IOTN grades 4 and 5 remains high at St George's Hospital, indicating that appropriate referrals are being made.

This paper has been developed from a version originally submitted as an assignment for the Faculty of General Dental Practice (UK) Certificate in Health Services Leadership and Management Course. It has been revised in the light of the independent review led by Professor Jimmy Steele into National Health Service dental services in England (generally referred to as the Steele Report), which has commented on many of the points dealt with here. The paper addresses issues arising from a moral tension often experienced by dentists between the professional desire to serve patients well and the necessity, as practice owners running a business, to survive financially. The need for honest and open recognition of what is truly achievable from the public purse is stressed. Rights and responsibilities are discussed in relation to professional practitioners, their patients, and society in general, in seeking the moral high ground under different funding arrangements. The paper concludes by stressing the need to offer improved health rather than palliation of disease.

Aims: To investigate the motivations for, and perceived benefits of, undertaking senior house officer (SHO) posts, and to explore the career pathways of those who do, examining trends in successive cohorts.

Method: Postal cross-sectional questionnaire survey of all dental and maxillofacial SHOs (DF2s) who had worked for two South London hospitals within the previous nine years (n=137). Respondents were grouped into three cohorts to enable responses to be examined in relation to respondents' entry to their first SHO post.

Results: There were responses from 83 (61%) potential participants. The most frequent motivation for carrying out SHO posts from 79 (95%) of the respondents was the desire to 'learn from experienced clinicians'. The most common perceived benefit reported by those who had completed posts at the time of the survey was 'an improved understanding of the role of the hospital dental service' from 68 (97%) of those who answered this question. Difficulty in securing a job in general dental practice was not reported as a notable motivating factor, either before or after the implementation of the new dental contract. 'Fulfil approved training post requirements for postgraduate examinations' reduced as a motivator from 28 (88%) for the earlier cohort of SHOs to nine (36%) for the more recent cohort. Fifty-four of 78 (69%) respondents declared a definite plan to seek admission to the General Dental Council Specialist Lists in future, 24 (83%) in the first cohort, compared with 11 (46%) in the last (P=0.05). Of the males, 13 (52%) were significantly more likely to report that they were currently working in general practice compared with 15 (27%) females (P=0.028).

Conclusion: The findings suggest that multiple benefits are identified from undertaking SHO posts. However, some of the motivations for undertaking SHO posts may have changed over the nine-year period investigated. Possible influences are discussed. This paper highlights the perceived benefits of junior training posts at a time of significant transition within the profession.

Aim: The aim of the study was to determine the prevalence of dental, orofacial and head injuries and of mouthguard use among schoolboy rugby players.

Materials and methods: All members of the first and second XV rugby squads at three secondary schools (two in England and one in Australia) were included in the study. All participants answered a questionnaire that sought information regarding dental, orofacial and head injuries. Statistical differences between groups were determined using chi-square tests for categorical variables and Kruskal-Wallis tests for discrete (count) variables.

Results: One hundred and seventy-eight completed questionnaires were returned (100% response rate). One hundred and twenty-five (70%) players reported having sustained at least one injury (range 1-4). Facial injuries were common. Dental injuries were the most prevalent injury: 46 (26%) were reported. Fractured teeth were reported by 20 (11%) players, and avulsed teeth by 7 (4%). There was evidence of a difference between schools in the prevalence of injured players (P=0.014), but among those reporting injuries, there was no difference between schools in the number of injuries (P=0.95). All players said that they used a mouthguard regularly.

Conclusions: Dental, orofacial and head injuries were commonly reported. Dental injuries were the most prevalent type of injury. All players used mouthguards regularly.

Aims: This investigation examined the current practice of tooth whitening carried out by a sample of dentists and beauty therapists from Portsmouth in the context of the relevant law.

Methods: A random sample of dentists and all beauty salons in Portsmouth were invited to respond to two postal questionnaires, one for dentists and one for beauty salons. These questionnaires were used to assess whether tooth-whitening services were offered and if so, details of products and techniques employed. The findings were analysed and compared with the current United Kingdom law on tooth whitening.

Results: One hundred and seventy-nine dentists (88%) and 76 (75%) beauty salons responded. One hundred and nineteen (66%) of the responding dentists and eight (11%) responding beauty salons provided in-house and/or take-home tooth-whitening services. The vast majority employed whitening agents containing or releasing hydrogen peroxide at a concentration greater than that permitted by the Cosmetic Products (Safety) Regulations 2008.

Conclusions: The current practice of tooth whitening by the dentists and beauty salons surveyed in this study is at odds with the criminal law that has been developed in order to safeguard consumers in relation to the products employed and the individuals carrying out the practice of dentistry. The practice also raises civil law issues, and compensation may be necessary in the event of injury. A change in the law, based on a scientific background and professional standards of care, is required at both European and domestic levels in order to align reasonable practice with the law, while upholding patient safety.