Author:- Chris Groombridge Managing Director 543 Dental Centre Ltd a member of the Association of Dental Groups (ADG)

The greater and more flexible use of skills mix is steadily becoming one of the most efficient and effective ways of improving treatment outcomes in the dental practice. Some of the dental practices making the most of this approach are ADG members (Association of Dental Groups) 543 Dental Centre, Alpha Dental Care and MyDentist, who are currently involved in the first wave of the In Practice Prevention (IPP) pilot programme. Oasis will also be taking part when the second wave commences in October.

Part of a regional programme developed by the Local Dental Network for North Yorkshire and the Humber in partnership with Local Dental Committees, Public Health England and Health Education England on behalf of NHSE, IPP’s aim is to help reduce dental decay in children aged between 3 and 16. So how does it work?

The programme requires general dental practitioners (GDPs) to signpost children identified as having decay or requiring a GA extraction to dental care professional led prevention clinics, where evidence based prevention is delivered over a defined number of appointments with prescribed evidence based interventions and messages. All pathways are delivered in parallel with the restorative work undertaken by the signposting GDP and the GA extractions provided by the community dental services, and uses flexible commissioning targeting existing contract value to deliver the programme in primary care.

Once a dentist has identified dental decay in a child aged 3-16, the patient is referred via one of four care pathways. These are divided into:

•     Children aged 3-6 with dental decay

•     Children aged 7-16 with dental decay

•     Children aged 3-6 requiring a general anaesthetic

•     Children aged 7-16 requiring a general anaesthetic  

Through their participation in this pilot, 543 Dental Centre, Alpha Dental Care and MyDentist (along with other dental practices and groups) will have the opportunity to maximise their full skills mix potential, helping to reduce the prevalence of dental decay at the same time. Oral health sessions include providing sugar and diet information in line with the ‘eat well plate’, offering healthy swap alternatives, as well as giving oral care advice and relevant oral hygiene instructions to both child and parent. The programme also involves the issuing of fluoride mouthwash to children over 8 years and the prescribing of high fluoride toothpaste to children over 10 years, with fluoride varnish applied every three months in high-risk cases.

It’s early days yet, but if implemented well there is no doubt that there is huge potential for the IPP to alter the behaviour and cooperation of children and improve the state of children’s oral health in Yorkshire and the Humber. As for dental teams, the initiative presents an unmissable opportunity to capitalise on the benefits of a multidisciplinary approach and effective use of skills mix.

The feedback has already been very positive from participating groups, particularly from nurses who have undergone additional training via Health Education England and Local Dental Network organised courses to deliver this evidence based prevention pathway to patients. “The IPP initiative is a team effort that gives dental nurses like me more responsibility,” says Julie Fountain, head nurse and lead oral health educator for 543 Dental Centre. “This has enabled me to extend my scope of practice and help even more patients.”

For the ADG and its members, this is good news – the Association has, after all, keenly championed the use of skills mix in the dental practice for some time now.

To find out more about the programme visit inpracticeprevention.org.uk

For more information about the ADG visit www.dentalgroups.co.uk

Sarah Weston (pictured above) has been working for {my}dentist – a member of the Association of the Dental Groups (ADG) – since 2013 and currently works in Woodbridge, Suffolk. Here, she explores what a normal day entails…

I qualified from Guy’s hospital in 1996 and have worked in Australia, New Zealand and the UK. I have worked across most sectors of the profession – as a house officer in New Zealand, in NHS and private practices and as a partner and an associate.

At my current practice in Woodbridge, we are predominately NHS in a small market town, but do offer a range of private services. With an interesting demographic of patients we get the chance to utilise all our skills. It is a busy practice as we routinely see 25-30 patients a day. I am lucky that I work with a really great team and most of us have worked together for a while now. It’s good to be with other people who understand the stress and strains of the job and can have a good laugh together at times.

I work full time so my days tend to be fairly similar. I start with a coffee then move on to checking day-lists, patient records and lab work etc. I hate surprises so I like to know what’s coming. I spend my day performing a mix of examinations and treatments with the odd interesting case thrown in.

I also offer facial aesthetic procedures and have recently been on the denture excellence course. It is great to be able to offer such a wide choice of treatment options to patients and the denture excellence has really taken off. It’s an area I really enjoy as a good denture can make so much difference to someone’s quality of life. I am hoping to undertake an implant restoration course soon as well, so I will be able to restore the implants placed by colleagues at local practices in the group.

Since working for the corporate I have also become a mentor, which has definitely been a highlight for me. It is a role I really enjoy, as after 20 years in the job it is nice to pass on some of my experience to the younger generation. I had a great VT instructor when I started and I hope I can be as good to new associates as he was to me. It’s a job that is mutually beneficial – it is extremely rewarding to see a mentee improve and gain in confidence and it does the same for the mentor.

Within the corporate we are so lucky to have a high level of support from practice and area managers through to clinical support managers (CSM) and clinical directors. They are there to help prevent small problems becoming larger ones. I know that the ‘red flags’ and KPIs can feel intrusive at times, but I do feel they are there to help clinicians above everything else. A visit from the CSM should be seen as a positive thing and I am lucky to have a great CSM in my area. One thing I have learned is that it can be lonely in the independent sector and there is no-one looking out for you in the same way. I think the support network available is the real strength of corporate dentistry.

We are also incredibly lucky to have the online academy and the reminder to complete CPD when it is required. This can be a burden for dentists and if there is any way to make it easier then we should be grateful! My practice manager keeps us in check with when our CPD is due and the opportunity to complete it online is a great help, especially when I am busy in practice five days a week. Overall, I feel that my move to {my}dentist was the best thing I could have done for my career. The opportunities are there to further my career in ways that I didn’t feel existed in the independent sector.

Having worked for most of my career in the independent sector I was aware of the negative press surrounding corporate dentistry before I joined the group, but I have to say that those rumours were all unfounded. In fact, I feel quite passionately that new graduates are still being given that negative message and as a company we should try to give the next generation the facts and talk to them directly.

I enjoy my job enormously but I would relish the chance to move out of the surgery environment a little in the coming years. I would like to expand on my mentoring role and continue with more training and support of new dentists and I hope I can achieve this within the company.

For more information about the ADG visit www.dentalgroups.co.uk