An excellent template
BRITISH DENTAL JOURNAL |
Letters to the editor
0 P. Ward, London , UK
Send your letters to the Editor, British Dental Journal, 64 Wimpole Street, London, W1G 8YS. Email . Priority will be given to letters less than 500 words long. Authors must sign the letter, which may be edited for reasons of space. Dental careers References 1. Al Hassan A, Nazar S. Dental core training for the future GDP: is it worth it? Br Dent J 2019; 226: 484-485.
An excellent template
Sir, I write to commend the excellent
opinion piece by Hassan and Nazar.1 The
description of such a reasoned approach to
career planning should give younger
colleagues an excellent template as they make
their way into practice. Beyond the clear
benefits described in respect of the
particular experience in this case, the application of
loss aversion reasoning as a process would
serve the wider profession well.
Decisions are seldom clear cut and
there are usually trade-offs to be made.
Consideration of the long-term benefits
and deferred gratification can often help to
prioritise. I would encourage practitioners
young and old to read this piece and
apply the same approach to difficult life
Sir, it was very disappointing to read the
letter from Dr Tajmehr. 1
Firstly, 155 patients referred over a
12-month period equates to just under 13
per month or about 3-4 per week. Having
worked for seven years in various oral and
maxillofacial units, as well as many years in
general practice, I do not think this is putting
a ?significant strain on secondary care services?.
Secondly, it was reported that ?of the
remaining 143 referrals, the majority of
patients were diagnosed with
potentially-malignant and premalignant conditions?.
Thankfully, the primary care practitioners
had the requisite education and training
to refer these patients, who will have been
reassured by the non-cancer diagnosis
and subsequent review and monitoring
of their lesion instigated after histological
Thirdly, it was reported that ?the rest
had no abnormal findings at all?. The word
?abnormal? is poorly used in this context.
Does the author mean that at histology
the oral mucosa was normal in appearance
or that there were no histological signs
of dysplasia? Most experienced clinicians
will have come across clinically suspicious
lesions which turn out to be benign at
histological examination. The point here
is that clinical appearance does not always
correlate with histological examination.
Fourthly, there is extensive postgraduate
training available to dental practitioners,
which most of my colleagues will avail
themselves of, nowadays under the
watchful eye of the GDC. However, I
do not know how much education and
training our hard-pressed medical
colleagues receive either in the undergraduate
or postgraduate field. Perhaps, this is an
area Dr Tajmehr would care to research?
Finally, I would urge all my primary
care colleagues to continue to refer any
suspicious lesions through their
locally-agreed pathway to the appropriate oral
and maxillofacial unit. They will find that
their secondary care colleagues will not
judge them on the ?appropriateness of the
referral? but will be grateful for putting
patients? interests first.
A. J. Wight, Dundee, UK
Sir, one of the problems facing oral and
maxillofacial surgery (OMFS) clinicians
is the inappropriate method of referring
patients by our primary care colleagues via
other members of staff.
Many general dental practitioners (GDPs)
will ask non-clinical members of staff, such
as the practice manager or a receptionist, to
ring the hospital to refer emergency patients.
This is inappropriate for a number of reasons.
First, these individuals do not have the
clinical knowledge or experience to relay the
appropriate information. Second, only the
person who has assessed the patient will be
able to answer key questions on the patient?s
current condition and the seriousness of the
situation. Third, this method of referring often
creates more inefficiency than if the GDP had
called initially. These issues severely
compromise patient care, specifically the ability of the
OMFS team to provide informed advice or
management for these patients.?