Looking back on almost 20 years’ experience as a Practice Manager, never before has there been as much responsibility on the shoulders of Practice Managers, and now more than ever, they are finally getting the acknowledgment they deserve. When I began as a PM back in 1998 at the age of 19, the role could be quite basic and there was not the level of compliance or responsibility that comes with it now. In those days I learnt as I went along, and quite frankly, from the many mistakes that I made.

There cannot be too many careers in which one is expected to be an HR Manager, Marketing Manager, Compliance Manager, Business Manager, to name just a few, whilst also being an approachable, occasional shoulder-to-cry-on and not forgetting referee! The role needs to be carried out to the highest of standards, often without any formalised, additional training, other than Core CPD.

However, it would be fair to say that the role has evolved at different rates in different practices. Following ADAM’s 2017 Salary Survey, it demonstrated that there was a huge range of pay disparity that was often (although not always) dependent or linked to the scale of responsibility the PM was working at. So, is this the fault of practice owners not understanding, or PM’s not asserting themselves and demanding the credit and pay that is due to them? Part of the problem for PMs is not being aware of what they don’t know, and then finding out where they can gain the training and skills to equip them in their roles. There are often no allowances for error, and certainly not in areas such as HR and Compliance where there are legal implications.

In my experience, the majority of PM’s are happy to take on a huge workload, but too often are also expected to be a receptionist one day and maybe a dental nurse the next in addition to their PM roles and often without the reflection in remuneration. Many dentists are so busy treating patients (which is as it should be) that they sometimes don’t realise the extent of the workload or the systems that are in place and being used by the whole team, to ensure the smooth running and success of their practice.

I would like to say that I don’t believe there is a vast swathe of PM’s that are being undervalued, but for those grafting away and feeling overworked, underappreciated and underpaid, the quote “You get what you pay for” springs to mind.

Many of you may not know that Chris Barrow was involved with the BDPMA in the 1990s. I caught up with him and asked for his take on the massive changes in the role of a dental practice manager over the last 20 years.

“Back in 1997, when the BDPMA was representing the profession, I wonder what the reaction would have been if I had predicted that 20 years later:

• Qualification courses all the way up to MBA standard would be offered by academic institutions;
• The fully-functioning Practice Manager would have to demonstrate leadership and management skills in key business functions, including financial monitoring and analysis; branding; patient relationship management; post-treatment follow-up; and clinical governance.

A good practice manager is integral to the running of a successful practice. Indeed, John Milne, CQC’s Senior National Dental Adviser, recently said at a CQC Reference Group Meeting: “The CQC inspection programme, to date, has found that a delegated and empowered practice manager is a key component of a well led practice.”

Considering that the majority of failed CQC inspections are in the area of the “well led” outcome, surely there is no better reason, to not only look after your Practice Manager, but delegate, empower and reflect this in their salaries based on responsibilities.

Would anyone like to predict where we will be in 2037?!

The Dental Defence Union has said there should be clearer guidance for Coroners, the police and the Crown Prosecution Service to prevent dentists being needlessly put through a gross negligence manslaughter investigation.

In its written submission to the rapid review by Sir Norman Williams into gross negligence manslaughter (GNM) in healthcare, the MDU, the parent company of the DDU, explained that while manslaughter investigations more commonly involve doctors, the DDU has also supported dentists with investigations.
John Makin, Head of the DDU, said:

“There should be far fewer investigations and prosecutions of healthcare practitioners for GNM. It should be about identifying and prosecuting only those cases that are the dental equivalent of deliberately driving down the motorway on the wrong side.

“Coroners are currently responsible for passing most cases to the police for investigation and they should get greater support and clearer guidance about the law. There should be a far more robust referral process, to help to achieve greater consistency and clarity and ensure only appropriate cases are investigated.

“In Scotland we are not aware of a case where a clinician has been successfully prosecuted for the similar offence of culpable homicide. We believe the same approach should apply in England and that investigation and prosecution of healthcare practitioners should be reserved for only the worst cases.

“We are advocating straightforward changes that can be made quickly without practical difficulty. Given the clear distress that investigations cause for dentists involved and the fear and concern this generates more widely among healthcare practitioners, we urge swift and decisive action.”

The Oral Health Foundation has reported that new research has revealed that non-smokers face a substantially higher risk of developing mouth cancer than smokers if they have precancerous lesions in their mouth.

450 patients with precancerous lesions were assessed by researchers from the University of British Columbia and they were able to conclude that non-smokers were more than twice as likely to see them develop into mouth cancer than smokers.

The study found that the different between smokers and non-smokers was due to a difference in the root causes of the lesions. In smokers, they were likely the result of environmental factors, whereas in non-smokers, genetic susceptibility or mutations were the probable cause.

The Oral Health Foundation is calling on everybody to be alert to the early signs of mouth cancer, as the earlier the cancer is caught, the higher the chance is of beating it.

Chief Executive of the Oral Health Foundation, Dr Nigel Carter said: “Smoking may be the leading cause of mouth cancer, linked to around three in every four cases, but non-smokers need to be just as vigilant in spotting and acting on any changes to the mouth.

Catching mouth cancer early can dramatically increase your chances of beating the disease so it is vitally important to check regularly for the early warning.

Everybody should be alert to mouth ulcers which do not heal within three weeks, red or white patches in the mouth and any unusual lumps in the head and neck area. If anybody has any of these signs, you should visit your dentist or doctor straight away.

Mouth cancer is beatable, but you must act quickly. The key to this is being alert to the early warning signs and seeking immediate help when you notice anything suspicious.

In addition to conducting self-checks at home, the more regularly you pay visits to the dentist, the better chance you have to spot anything unusual at an earlier stage.”

Dentsply Sirona has announced that it signed an agreement to acquire OraMetrix, an industry provider of 3D technology solutions designed to improve the predictability and efficiency of orthodontic care. This will further enable Dentsply Sirona to provide a total orthodontic solution, to include full arch clear aligners for our customers.

OraMetrix offers an advanced CAD platform developed for dental professionals to deliver consistently predictable orthodontic outcomes. The acquisition, in combination with GAC’s bracket expertise and Dentsply Sirona’s digital technologies, will enable Dentsply Sirona to provide a comprehensive orthodontic offering that will include a full arch clear aligner solution.

Brad Clatt, Group Vice President, Dentsply Sirona Orthodontics, commented: “Dentsply Sirona’s mission is to empower dental professionals to provide better, safer, faster dental care. OraMetrix has spent over a decade committed to that same clinical approach. This acquisition brings an advanced digital diagnostic and treatment planning system, that will provide clinicians the flexibility, speed, and control they need to treat their patients with multiple modalities on a single platform. We believe this platform positions us very well for the future as an end-to-end total orthodontic solution provider.”

OraMetrix offers a powerful software platform that integrates multiple diagnostic media, including CBCT, Cephalometric, Panoramic, Optical, and Facial data. The company, founded in 1998, has approximately 130 employees in the United States, Germany, and Australia.

Following the acquisition, Dentsply Sirona will be able to provide an end-to-end digital workflow with a comprehensive range of devices to enable dental professionals to match their patient’s growing demands for aesthetics and speed of treatment.

The BDA is standing with tens of thousands of primary care professionals to call for urgent amendments to the Data Protection Bill to prevent huge and needless burdens being heaped on high street providers.

In an open message to Minister Margot James, copied to all opposition opposite numbers, the BDA and partners at the Optical Confederation, the National Pharmacy Association and the Pharmaceutical Services Negotiating Committee have called for simple amendments to be tabled as the Bill makes its way through Parliament.

Primary care leaders believe the Bill goes beyond the requirements of the General Data Protection Regulation (GDPR), which does not require health providers to appoint a Data Protection Officer (DPO) unless they process healthcare data “on a large scale”. Most high street NHS primary care providers do not process data on a large scale, but are set to be covered by this onerous new requirement by virtue of being defined by UK legislation as “public bodies”. BDA’s market research suggests that outsourcing this service may well cost even the smallest practices in excess of £5,000, with some members reporting quotes from potential contractors of over £10,000 a year.

The DPO requirement will not automatically apply to private health providers in the same way, putting NHS providers at a distinct disadvantage, and further deterring dentists from delivering NHS services.

This new requirement is also unlikely to provide any practical benefit for patients as dentists and all other NHS providers are obliged to meet strict requirements on data protection and patient confidentiality.

BDA Chair, Mick Armstrong, said: “We’ve been shocked by the quotes our members have received to meet the requirements spelled out in this broken bill. A single medium-sized practice has been quoted over £11,000 for start-up costs, and a rolling annual fee of over £8,500 to comply.

“Primary care is under huge pressure. These additional costs and red tape are a hammer blow to family dentists, opticians and pharmacists already facing tight regulation and eye watering compliance costs.

“We look to Government and Opposition to urgently table these amendments, and lift this needless burden from small high street providers.”

A BDA member, who is an owner and principal dentist of a small NHS dental practice in the North East, said: “The Government’s Data Protection Bill has chosen to put small dental practices in the same basket as large hospital trusts. By wrongly defining us as a ‘public body’, it goes well beyond the intentions of GDPR, and the net result is we will be required to recruit a Data Protection Officer from May this year.

“Not only will this be another costly overhead on top of ever-increasing cost of compliance heaped on us, but it also puts us at a distinct disadvantage compared with private practices – some of whom will be far bigger than mine – but are not required to appoint a DPO. There is no additional funding being made available to cover this extra cost by the NHS.

“I entered the profession 14 years ago committed to a career in NHS general practice, where I expected to work until I retired. I now feel on the cusp of leaving the NHS altogether. I feel thoroughly disillusioned and disheartened and I am sure I’m not alone. The Government must sit up and listen or face losing experienced dentists from the NHS for good.”

Optical Confederation Chair, Fiona Anderson, added: “As we keep pointing out, a requirement to appoint a DPO would not provide any practical benefit for patients, or anyone else, but would impose costs. We are extremely disappointed that the Government has not listened to our concerns about the unnecessary burden this will place on small businesses, which are key to keeping communities healthy. They were also explicitly intended to be excluded under the GDPR itself. This is pointless gold plating. We hope the Government will act before it is too late.”

Dentaid have provided dental treatment and oral health education programmes for refugees from South Sudan, living on the northern Ugandan border.

Due to the money raised as part of it’s Christmas fundraising appeal, Dentaid was able to travel, alongside Ugandan associates, to Mijale in Yumbe District. The 10 camps the refugees are housed in have basic medical facilities but no access to dental care.

Oral health education sessions and screening and treatment clinics were ran by Dentaid’s Ugandan associate, Angel Nsubuga.

“The district has no dental facility at all which means that there is no dentist in the whole area,” said Dr Nsubuga. “People have a series of dental problems that means they resort to traditional healers and as a result there’s chronic pain and complications. We offered different treatments to the community – teeth that could still be saved were conserved with ART and grossly carious teeth were extracted under local anaesthesia.”

The refugees also had the opportunity to learn about tooth brushing, dental diseases and causes of tooth decay.

Further dental services in the refugee camps are in the pipeline and Dentaid will continue fundraising to continue helping.

To support Dentaid please visit www.dentaid.org/donate

Right from a baby’s very first breath, parents, guardians, family and healthcare professionals should be working together to maintain that child’s health. It’s important that dental health is recognised as part of this, but while we understand that the mouth is the gateway to the body, not all members of the public appreciate the impact it can have on general well-being.

This has become glaringly obvious in the last couple of years by the state of children’s dental health across the UK. The figures, quite frankly, are disgusting and they are showing no signs of improvement.

The Royal College of Paediatrics and Child Health, the British Society for Paediatric Dentistry and the office of the Chief Dental Officer put on a joint event in January this year entitled, ‘Insights: Why Children’s Oral Health is Everybody’s Business’. Its aim was to bring together a multi-disciplinary audience to update everyone on the facts and figures, and encourage us all to work together for the benefit of our young generation and those to come. Presented by highly prominent speakers from each field, sessions considered the current state of and inequalities in children’s oral health, as well as suggesting ways in which we can meet the existing challenges.

This collaborative approach involving different professional sectors is a positive approach to finding solutions. As with public awareness in other health matters, only by working together can we improve widespread understanding of the importance of oral health from a young age and therefore affect behavioural change throughout society.

First Smiles campaign

This aligns well with the BSDHT’s own ethos – we are constantly encouraging dental hygienists and dental therapists to do what they can in areas such as children’s dental health. We strive to give our members the support they need to make a real difference to the lives of their patients.

Our First Smiles campaign is a great example. It is designed to encourage dental professionals to go out into their local communities and interact with young people and their parents on a more personal level. It offers an ideal opportunity to get to know local people and to help them improve their dental health through bespoke advice and check-ups. It is also a good chance to educate people on the importance of effective oral health routines at home.

Last year, many professionals taking part in the First Smiles initiative worked with local schools. They spoke to children about diet and oral hygiene, including dental health habits, brushing technique, ‘good’ and ‘bad’ food and drink, the dangers of sugar and why you should visit the dental practice for regular check-ups.

Forming good habits

Once again this year, First Smiles is all about instilling good habits from an early age and giving children the information and tools they need to enjoy the benefits of good dental health as they grow up. The BSDHT will be supporting those who participate with template letters for local schools, nurseries or community dental teams. Our sponsors – Oral-B and Brushlink – will kindly be donating some goodies as well. Oral B toothbrushes and toothpaste will be provided to leave behind with the children participating and there will be a Brushlink device available on a first-come, first-serve basis for successful applicants. The Dental Buddy downloads are also available for free, offering further information for children of different ages and showing them what they need to know.

The official First Smiles day is Friday 15 June 2018, but it’s no problem for professionals to arrange events or activities around this, as the objective is simply to raise awareness and help the young generation grow up healthier. It’s easy to get involved and I would encourage you all to make this another successful Frist Smiles campaign by building partnerships with your local schools and nurseries.

Tackling child dental health problems must be a priority for the dental and healthcare professions. By working together and participating in the various programmes and initiatives run throughout the year, we really could make a difference.