So those of you whose DF1 interviews are swiftly approaching may want to know what topics are popular to discuss recently and may come up in one of the stations.

Here is an overview of some of the hot topics in dentistry at the moment:

A very contentious issue at the moment. A proposed 64% increase to £945 annual fee to maintain your registration with the GDC; their reasoning being the increased litigation they have to deal with recently pushing up their own costs.

The decision will be taken on October the 30th and there are currently 3 fee levels proposed ranging from £850 to £945.
As a young dentist, this issue really concerns me as I have just come out of university with a backlog of debt weighing me down and now I need to find at least another £300 to be able to practise as a dentist just before Christmas!

There's a lot of negativity towards the GDC from dentists at the moment, not only do some dentists feel like our regulator is out of touch with the profession, but a recent Daily Telegraph advertisement by the GDC, which advised patient's to complain directly to them if they had a problem with their dentist, has caused outrage.

The infamous Telegraph Ad

The BDA's lawyers are fighting hard to prevent an illegal increase in retention fees. Hopefully they will be as successful as they were with DF1 places for UK graduates and the abandonment of the DF1 pay cut this August.

See my recent post about how Young Dentists feel about this fee increase.

Dental Care Professionals (DCPs), specifically dental hygienists and therapists can now see patients without a prescription from a dentist.
This came into force summer 2013 and has caused some confusion amongst the profession and the public alike.

Dental therapists and hygienists can now work within their scope of practice as long as they are appropriately trained and indemnified to do so although this is not compulsory - DCPs can still work with a prescription of dentist if they prefer and a DCP must have consent from their practice owner to see patients under direct access.

This is currently only relevant in private practice at the moment as under the current NHS contract, a full examination by a dentist is required, although this may be subject to change under the new contract (see below).
DCPs are also limited as they cannot use local anaesthetic (a prescription only medicine), take radiographs or carry out tooth whitening without the prescription from a dentist.
These barriers are currently being discussed and debated, so it is likely direct access will change in the near future.

See this BDA article to learn more about Direct Access.

Having graduated from Newcastle Dental School, I've heard no end about the proposed new NHS contract and the current piloting being trialled around the country.

After Jimmy Steele's 2009 review of the current NHS system, dental professionals together with the government have been trying to come up with a fairer more efficient system.

The main issue with the current contract is that there is no incentive for dentists to prevent disease, only to treat it.

During the past 2 years, the new pilots have been running throughout the country, emphasising the 'traffic-lighting' risk assessment of patients for the 4 domains of oral health: caries, periodontal disease, tooth wear and oral cancer.
There is also an emphasis of the skill set of dentistry and utilising DCPs as well as patient care pathways.

This has manifested in levels of carers:
Level 1 is a safe beginner with no higher accreditation e.g. a GDP
Level 2 are those practioners with additional skills (these are not specialists, but perhaps those with 'special interests')
Level 3 are high street specialists
Level 4 would be a consultant, who would plan and oversee treatment

Having experienced a pilot practice on outreach last year I found the system was much more time consuming than the current system I now use in practice and there is a lot more paperwork for the patient to help educate them about their oral health.
There's still a way to go with the new contract, but with the elections coming up this summer, I doubt it will be addressed before then.

Filling Children's Teeth, Indicated Or Not?


Another project you hear a lot about in Newcastle, but also involving other dental schools (pioneered in Dundee) and practices around the country.

The trial aims to explore the clinical and cost effectiveness of fillings in children's teeth, comparing 3 different ways of managing childhood caries: conventional fillings, prevention alone and biological methods of managing decay e.g. Hall crowns.

To read more about the FiCTION trial, see their website, or see my summary of the London Paediatric Dentistry conference here.

Like the FiCTION trial, there is a move in dentistry away from conventional destructive fillings and more towards a minimal intervention (MI) approach.

See my previous post about MI dentistry here.

Public awareness about implant dentistry is ever increasing and more and more dentists are taking up more training and qualifications in order to provide implants for their patients.

A topic that is often overlooked at dental school, I have been exposed to countless patients in practice who either have implants or are interested in having them.

See my previous post about a #Tubuleslive event discussing implants here.

Something that will definitely kick off in practices in the next decade or so, Computer Aided Design and Computer Aided Manufacture (CAD/CAM) in dentistry could mean that restorations could be make chair side in under an hour, the most popular system being Cerac at the moment.

Instead of taking impressions for veneers, crowns, bridges, implants etc, a scanner can take an image of the prep and use this to mill a restoration directly from ceramic, composite or metal.

This takes out the delay from making a restoration in a lab and the scanning of the prep can be more efficient than taking impressions.
At the moment, the use of CAD/CAM is quite limited as costs for scanners and especially 3D printers (or millers) are very high.

Scanners at the moment are more commonly used to scan poured up models rather than scanning preps directly in the patient's mouth.

See more about CAD/CAM in dentistry here.

It is becoming very popular for GDPs to start offering simple orthodontic treatment in practice rather than refer all cases to specialists.
Companies such as Invisalign, Smilelign, In-Line, Six Month Smiles etc offer comprehensive packages for GDPs to learn how to assess and treatment plan for these cases, and the results can be very rewarding.

See my previous post about the BDIA showcase which summarises a couple of the orthodontic systems here.

I hope that this helps in your preparation for the interviews! 

Is there any other topics that are popular in Dentistry today? Please comment in the section below!