|Tales of the unexpected|
|Monday, 10 January 2011|
Dental practitioners learned how to avoid a broad range of professional pitfalls at the Faculty’s annual symposium
Sixty delegates from across the UK gathered at the College in October for an event with a twist; Dr Bernadette Hughes of the Nobody Move Theatre Company, enacted the role of ‘Miss Diagnosis’, a disgruntled patient, who interacted with speakers throughout their presentations.
Pictured: Speakers at 2010's Dental Symposium 'Tales of the Unexpected'
First up, Dr Peter Day, Consultant in Paediatric Dentistry from Leeds Dental Institute, outlined the management of a patient presenting with dental trauma, from initial contact with the receptionist to the conclusion of treatment and long-term follow-up. Dr Day stressed the importance of a biological approach to underpin clinical techniques and explained Cochrane Review evidence on the endodontic and pharmacological management of avulsed incisors. Simulated video recordings of how not to do it provided an excellent means of educational interaction and the illustration of a structured trauma sheet highlighted best practice.
The potential consequences for the patient and the practitioner of making a late diagnosis of an impacted maxillary canine was illustrated by Dr Rye Mattick, Consultant Orthodontist from Newcastle Dental Hospital. Her presentation was used to highlight many issues that could affect patient consent and effective clinical practice ranging from religious beliefs, ethnicity, political affiliations, socio-economic class, smoking, substance abuse and dietary habits. Dr Mattick cited examples such as the inadvertent prescription of mouth rinses containing alcohol for Muslim patients, the use of dental products containing glycerine such as toothpastes for vegetarians and the use of clinical products that had been tested on animals.
Dr Alan Mighell, Senior Lecturer at the Leeds Dental Institute, delivered an overview of Oral Medicine, outlining a filtration system of categorising lesions into those that were either a focal or non-focal problem as well as those that were high or low stakes for the patient in relation to a correct diagnosis being made. Dr Mighell emphasised patient-centred treatment in the management of oral medicine disease along with the importance of clinicians undertaking risk-benefit discussions to ensure patients are managed according to their wishes.
A mock solicitor’s interview with Miss Diagnosis was conducted by Mr Andrew Collier, a legal adviser for Dental Protection, which covered a range of potential dento-legal pitfalls. The importance of contemporaneously meticulous recordkeeping was emphasised and the more common omissions were highlighted. Mr Collier impressed upon the delegates that in law, if a written record is not made then legally it is deemed not to have happened.
Senior Clinical Teaching Fellow in Restorative Dentistry, Mr Paul Franklin demonstrated the importance of coordinating centric relation with centric occlusion as well as providing restorations that do not interfere with any aspect of a patient’s functional occlusion. A range of laboratory articulators were illustrated as well as a number of adjunctive clinical techniques that may be used to examine and clinically identify the occlusal contacts made between a patient’s teeth.
Convener for the day, Brian Nattress, Senior Lecturer in Restorative Dentistry and Dental Regional Adviser for Yorkshire, concluded with a presentation on the provision of full dentures from impressiontaking to final fit, which also included the use of copy denture techniques. A wealth of experience was imparted with clarity for a clinical technique that, if carried out with sufficient attention to detail and regard for oral anatomy, still offers a justifiable alternative to more advanced implant borne prosthodontics.