Get Consent For Disposing Of Teeth
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- Published: Friday, 05 February 2021 07:51
- Written by Chris Tapper
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After today’s alarming story about the illegal online trade in human teeth, GDPUK has been looking at the correct way for dentists to supply students with the specimens they need in order to effectively carry out their phantom head exercises.
In the story on GDPUK: “Horrific Tooth Trade Is Alive,” we report online companies are selling seemingly limitless virgin teeth to dental students, with no indication as to where they were sourced. The trade in human teeth was outlawed decades ago, but these companies seem to be flouting the law. The practice appears to centre around India and China.
The problem for dental students generally, is that extracted teeth that are available for phantom head exercises, are in short supply.
This problem is particularly acute in the United States but is a difficulty dental students in the UK also face. The short supply of human teeth, seems to be because of the reduction in the number of teeth which need to be removed these days because of the development and increased availability of advanced restorative techniques.
Following the enactment of the current Human Tissues legislation passed in 2004, dentists were required to gain consent of patients in order to dispose of extracted teeth.
Some dental practitioners are thought to have become relaxed in their approach to the law after an ambiguous statement in The Department of Health’s Health Technical Memorandum 07-01 said in 2013: "As the disposal of teeth from dental premises is unlikely to cause offence, dental practitioners may treat this as non-anatomical infectious waste."
The wording was seen as a green light for practitioners to be able to dispose of teeth as they wished, without consent, providing they adhered to the regulations surrounding the disposal of amalgam filled teeth.
But Keith Hayes, who has extensive knowledge of regulatory matters and has experience as a Practice Supervisor and a Clinical Mentor for both the NHS and the GDC, advises practitioners exercising caution.
“If advising colleagues, I usually suggest they get consent. It doesn’t do any harm, covers all bases - and I’ve never heard of a patient refusing!”
Keith said “I feel the main factor is consent, because you have been able to establish where the extracted tooth came from and you are confident it was with informed consent,” adding, “This is something you couldn’t do from another source or country.”
Dental tutors and academics agree that the use of human teeth in training is important and that the use of plastic teeth has some disadvantages, although candidates in the Overseas Registration Examination currently perform cavity and crown procedures on plastic teeth in the dental manikin exam.
Outgoing Scientific Advisor for the British Dental Association, Professor Damien Walmsley acknowledges the importance of using human teeth in dental training, but says “Yes, it is important but there have been developments in haptic technologies which have been well researched and have their advocates. The other area that is becoming more and more a reality is the use of printed teeth. I know research is ongoing in several places such as Plymouth.”
Haptic dental training simulators which work in a similar way to flight simulators used to train pilots, have been taken up by some training centres in the UK. The Moog Simodont Dental Trainer is one such unit. Students can be observed during training exercises in real time during cavity preparation, rather than judging the student based on final results.
Chair of the British Association of Dental Therapists Debbie Hemington also stressed the critical importance of dentists and therapists gaining consent from patients before collecting and donating extracted teeth to students.
A clinical tutor to dental therapists in training, Debbie feels that it is important that therapists and dentists practice on human teeth.
“Students can learn cavity design on plastic teeth, but you don’t get the same tactile feedback as when working on real teeth. You really need to be able to feel that sensation of dropping into dentine from enamel.
She adds “The main problem with plastic teeth is the texture. You can’t reproduce the phenomenon of enamel flying off the walls of a cavity, or the appearance of cracks in enamel during cavity preparation.”
Shaun Howe, an experienced dental therapist who works for NHS Scotland, does see one advantage to students working on plastic teeth. He said “It’s really easy to see iatrogenic damage on adjacent teeth.”
GDPUK also investigated the Illegal Trade in Extracted Teeth
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