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Are you attending the Dentistry Show 2012? |
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 Are you attending the Dentistry Show 2012?
The UK’s leading dental conference and exhibition is back this year for more action packed lectures, demonstrations and workshops on all things dental- clinical and business related.
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Diary of a Treatment Coordinator- Series 5 |
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Delivering bad news.....
I had quite a stressful day today. We had two new patients booked in this afternoon, both female, aged 34 and 55. Both had recently had examinations and already had long-term NHS Dentists.
The younger patient, let’s call her Patient A, was concerned about her gums and felt she had some tooth movement, particularly around her front teeth. Her own Dentist had always dismissed this and just encouraged her to keep brushing twice a day. No perio advice or treatment had been suggested. She admitted she smoked and although she knew it wasn’t good for her health, she never felt the need to quit as she was not aware of just how significant the link between smoking and perio disease was. She had decided to see us for a second opinion. As soon as I started talking to her, prior to the examination, my heart sank. I thought to myself, “Oh my God, how are we going to tell her it’s this bad.” It was blatant to me that she had advanced perio disease. From talking to her, I think she thought that we would agree that she has been quite neglected but a few visits with the Hygienist would have her right as rain.
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Make a difference join Mouth Cancer Action Month organised by BDHF |
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?Make a difference join Mouth Cancer Action Month organised by BDHF
Oral cancer incidence in EU countries is about 66,650 cases yearly and it has been rising over the years. Oral mouth cancer if not caught early has high morbidity rate. If discovered in time however it increases the chances of survival of up to 90%. This information made me committed to try and make a difference in the environment I live and work. I have decided to write this article and ask you to join me in this mission as well.
Yes, You and Me! We can make a difference. I'm a dental nurse and I have decided to join BDHF in their November Mouth Cancer Action. This is charity action which consequently year by year helps professional like you and me get involved.
We can help our patients with simply providing them information about the mouth cancer which quite often is a tabu topic within the dental environment. This might be because we do not want to scare our patients who most of the times are scared anyway even on the thought on coming into dental surgery or generally 'hate' coming to the dentist.. The truth is we do not talk and warn our patients about the mouth cancer enough. This is controversially the most important thing in fight with every cancer. 'Raise the awareness' we can read this on cancer research website. We need to provide our patients with information so they can make informed decisions about their actions, which often have impact on the incidence of mouth cancer. If you feel the same as me please join this action. BDF supplies leaflets t-shirts and even little blue ribbons, they are relatively inexpensive. You can also create your own leaflets or even a little display. Our dentists are often too busy to think about this. So this is up to us-competent dental professionals to try help them organise this.
Please refer to BDHf website for any information and resources needed. Trust me, it will be rewarding and will help you get out of your daily routine.
RDN
Agata Ignaszewska
Resources used:
Cancer research uk website: http://info.cancerresearchuk.org/cancerstats/types/oral/incidence/#geog
BDF
website: http://www.mouthcancer.org/
 Oral cancer incidence in EU countries is about 66,650 cases yearly and it has been rising over the years. Oral mouth cancer if not caught early has high morbidity rate. If discovered in time however it increases the chances of survival of up to 90%. This information made me committed to try and make a difference in the environment I live and work. I have decided to write this article and ask you to join me in this mission as well. |
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Boosting your morale in these difficult times |
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Times are difficult for everyone at the moment- every industry, every employer, employee etc. Dentistry is going through a stressful phase what with the recession, difficulties filling the diary, the introduction of the CQC and many other factors. For us Dental Nurses, not only do we have to deal with these issues having an effect on our employers and their practices but we also have to deal with our own issues such as the increase in the ARF fee and indemnity insurance, which we are simply expected to accept.
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Discussing money with patients- the easy way |
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We've all been there haven't we? The Dentist will print a treatment plan for a patient (depending on your practice this could range from anywhere to £100 to £30,000) and give you an uneasy glance as you think 'oh my god they aren't going to want to go for this!'
Why is it in most situations, we are so wary about discussing finance with patients? Aren't we offering them a solution to their problem? Or offering them a service that will make them feel better about themselves? E.g. 'I can see from what you have said that the colour of your teeth bother you, have you ever considered Tooth Whitening?' It is often our body language and the way we present treatment options to patients that determine the outcome.
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The Importance of Behaving Professionally. |
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The Importance of Behaving Professionally.
Following the news of a registered Nurse being struck off the dental register for multiple convictions, it is a good idea to re-evaluate the meaning of 'professionalism' and what it is and isn't we should be doing not only in our working life, but also our personal life. Committing ourselves to our profession involves a standard of behaviour and if we do not follow the standards and guidelines set by the General Dental Council, we will not only lose our job, we will also lose our place on the dental register making it impossible for us to work as Dental Nurses again.
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Mouth Cancer Action Month |
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Mouth Cancer Action Month
If in doubt...get checked out!
So, it is now officially Mouth Cancer Action Month and it is time for us to actively promote awareness and prevention of oral cancer. Did you know that oral cancer is diagnosed in 5000 people every year and kills almost 2000 of them? Shocking figures aren’t they? It actually works out one death every 5 hours.
More facts and figures about oral cancer:
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Diary of a Treatment Co-ordinator Series 4 |
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I have had a very productive day today. I have been revising our Smile Portfolio and Testimonials Books and have had a lot of fun updating them with new “before and after” photos and written testimonials for our patients, particularly new patients to view. One thing I love doing is video testimonials and I am currently in the process of uploading a few onto my new TCO Ipad (thanks boss!) which is going to be absolutely amazing once I start using it with patients.
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Are We Providing A Good Enough Service For Our Patients? |
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A recent Software of Excellence customer satisfaction survey which was conducted by market research company, Converso, has revealed shocking results with regards to patients trying to contact their dental practice. Researchers announced that 44% of the phone calls made to various Dental Practices were not taken. Out of the 3557 phone calls made, 718 went straight to answer-phone, 630 were met with a busy tone and 202 faced a constant ringing with no answer or answer-phone service.
Faith Jenkin, who is the Product Manager at Software of Excellence, has expressed her feelings about these findings- “It is remarkable that in the current economic climate practices still either do not have the resource to answer all their calls, or are closing their practice at lunchtime and consequently turning away prospective business.”
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First Dental Visit Tops The Poll In Earliest Childhood Memories |
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According to a recent poll conducted by the creators of www.MyMemory.com, our first visit to the Dentist has come up top as the most common earliest memory. This study was conducted as part of research into the favourite childhood memories of us Brits. 1671 men and women aged 18 and over took part in the study.
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Smoking Cessation: Helping patients to achieve their goal. |
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Smoking cessation is the process of discontinuing the practice of inhalation of a smoked substance. More and more smokers want to give up their habit and luckily, there is lots of help available. Smoking cessation does not necessarily have to involve the use of medication or professional help- it can be achieved alone. This is personal choice.
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Professionalism- Part 3 of 3 |
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Maintaining professionalism individually.
As we approach the end of this three-part topic, we shall finally cover the element of individually- based professionalism. In other words, the responsibility we have towards ourselves as dental care professionals and also the responsibility we have towards our profession through association. It is important that we continue to assess and monitor our clinical skills and knowledge as well as our behaviour and attitude.
Patients expect a certain standard of care from the dental team and choose to put their trust in us. We must not let them down. The final standard set out by the GDC states very simply that we need to "be trustworthy" and this really does sum up this section perfectly. Professionalism as an individual requires us to be trustworthy in all aspects of our position.
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Treatment Co-ordinator training, London |
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The Dental Nurse Network is organising a Treatment Co-ordinator training day with TCO Emma Lever Pilling.
Emma works as a full time Treatment Co-ordinator at the multi-award winning Cahill Dental Care Centre Ltd. Already a registered Dental Nurse with a passion for people, Emma was offered the role of full-time Treatment Co-ordinator due to her natural and effortless way of bonding with patients and gaining their trust. Emma had been performing the role of TCO/Dental Nurse for years however the patient demand became too great and the Practice decided a full-time TCO was necessary, as most Practices are finding these days. Emma was given free rein to develop and build the role into something special and has achieved amazing results so far. The role has gone from strength to strength resulting in less surgery time being wasted and more profit made. Armed with knowledge and experience from training with big names such as Ashley Latter, Jameson Management Inc, Chris Barrow and Practice Plan, Emma is extremely confident and has been proven successful in the role of Treatment Co-ordinator. Recently, Emma secured a staggering £50,000 worth of treatment in one day and is continuing to sell large treatment plans on a regular basis with a high acceptance rate due to her unique treatment presentation skills.
" To Emma,
Many thanks for helping me overcome a life long fear of dentists. Your kind support and expertise has been invaluable to me. "Thanks again."
Best wishes, Carole "
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Professionalism- Part 2 of 3 |
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Maintaining professionalism within the team.
“Co-ordinated action carried out by two or more individuals jointly, con-currently or sequentially. It implies common agreed goals, clear awareness of and respect for others’ roles and functions.”- The World Health Organization’s definition of teamwork.
It is stressed in most industries that “teamwork” is important for success. For Dentistry however, it is not just success that encourages teamwork but also professionalism, as teamwork is required by the GDC guidelines in order to stay professional. The GDC defines a dental team as “the group of people who together provide care for a patient. Teamwork means working together to provide good-quality dental care.”
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Professionalism- Part 1 of 3 |
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Maintaining professionalism around our patients
Achieving this aim at all times can sometimes be difficult when we have to do it on a daily basis. It is however, absolutely vital that we realise that it is our responsibility as Dental Care Professionals to ensure the highest quality of care and respect and to also make sure that the patients’ best interests are always prioritised above those of our own, our colleagues or even our employer.
We don’t need to look far for guidance on this matter, the General Dental Council (GDC) have set guidelines for us to follow in order to maintain professionalism. There are six principles in total- the first three are most relevant to patient-centred professionalism and they are:
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Diary of a Treatment Co-ordinator- Series 3 |
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 One thing that I always consider to be quite challenging is dealing with objections to treatment and turning things around so that the patient is happy to proceed. However, with a bit of time, patience and clever questioning, it is not a difficult task. I feel fortunate enough to be able to deal with these situations after years of experience and also by attending a course run by Ashley Latter on dental sales and communication. Howevear they can still be tricky.
We had a new patient this morning, a lovely man who had just moved into the area and was looking for an initial consultation. He had not seen a Dentist for about 5 years, had lost a couple of fillings and wanted some thorough hygiene treatment- nothing major really. He informed me that he had dental insurance and that it was the top band and should cover him for the majority of the treatment. After seeing our Dentist, I presented him with a treatment plan consisting of hygiene treatment, a few fillings and a couple of crowns.
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Short Term Orthodontics (STO) |
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Thanks to celebrity culture and dazzling "hollywood smiles" we see everyday in magazines and on television, more and more people are requesting "Cheryl Cole" or "Tom Cruise" smiles when they visit their Dentist. Because traditional orthodontics are unsightly and can take years to achieve optimum results, more and more people are opting for Short Term Orthodontics to get their dream smile. STO can improve the appearance of teeth dramatically and also improve function to a point.
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Diary of a Treatment Co-ordinator- Series 2 |
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 I was quite nervous today as I had a couple of Treatment Presentation appointments. We saw two very different patients last week and they were both coming to see me today. Their personalities were massively different- Patient A was very bubbly and friendly, quite loud and opened up to me immediately. Patient B was pleasant but a lot more reserved and not as warm.
When I create my Treatment Presentations and prepare for the appointment, I have to be very aware of the personality style of the patient. I find that in order to be successful in selling Dentistry and also building excellent patient relationships, it is crucial to adapt yourself to the personality of the patient. For example; my personality matches Patient A very well so I wouldn’t necessarily have to adapt myself in order to communicate well with her but with Patient B, I have to reign in the giggles and touchy-feely side of my personality and channel my serious, “down to business” side in order to communicate well with the patient.
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Interview with Gayna Horridge RDN Cert. DPM |
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On the Spot!
Interview with Gayna Horridge RDN Cert. DPM
 Gayna is the Practice Manager at the award-winning Cahill Dental Care Centre Ltd in Bolton. She started her career in Dentistry way back in 1990 and has had many achievements in her career so far including success in many areas of Dental Nursing and also co-writing a book on Dental Nursing. Gayna has recently been short-listed for "Practice Manager of the Year" at the Dental Awards 2011 which is taking place on May 6th.
Q/ Gayna, how and why did you get into Dentistry?
A/ Well, I began my career as a student dental nurse at Manchester Dental Hospital in 1990 where I completed a 2 year training programme. I found out about the course through my own dentist who my parents had always religiously taken me to every 6 months as a child. I really enjoyed the training course and completed my National and Hospital exams.
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Case of the unfair penalty clause-Justice for Dental Nurses! |
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A nurse came to DNN’s recruitment centre, we will call her Kelly. Kelly was upset after working in extremely stressful working conditions saying she was unable to leave because she had signed a contract which stated that if she was to leave within 12 months she would incur the agency fee.
Unaware of her rights in this position and after many months of anxiety Kelly handed in her resignation and was signed off by her doctor for stress.
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Winner of Dental Nurse Of The Year |
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 DESERVED WINNER OF DENTAL NURSE OF THE YEAR:
- Xyanthe Lambert
Senior Dental Nurse, Radiographer, Oral Health Educator
I am proud to say I am a 41 year old registered Dental Nurse, (well perhaps less of the 41 year old)! I am a Senior Dental Nurse, qualified Radiographer and Oral Health Educator and I have been nursing for almost ten years now. I still have the same passion for the job as I did all those years ago. You could say that once you get me talking about the subject I turn into a bit of an anorak and go into full swing talking about my job, because I love it so much.
Why do I love my job so much?
I like making a difference to patients. I like seeing patients from their initial consultation, until their treatment is complete and than seeing them come back regularly for dental health reviews. Overcoming patient’s fears and previous bad experiences and building their confidence up, so they are actually smiling and laughing with us at the dentists. It is so rewarding making a difference and giving people the confidence to smile again. I wish I could take all the glory but I am only one of a team that achieve this. No one person standing above another as we all work together to achieve the transformation in patients.
How did I end up working in dentistry?
I had previously always worked in an office, so was always highly organised and when I was made redundant I initially thought about becoming a dental or doctor’s receptionist. When I went to the job centre, the guy said you are smartly dressed, why don’t you call round and pick up an application form from this practice and it turned out to be for a position of a dental nurse. My Mum was a dental nurse and I had lost her when I was young and so thought it would be nice to do something that she had also done, and after two interviews the rest is history……the best decision I ever made.
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Annual Appraisals: How to get the best from them. |
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Annual Appraisals: How to get the best from them.
For many people, the mere mention of the term "staff appraisal" fills them with dread. Feelings of worry start to surface at the thought of what could possibly be mentioned and it's funny really because we tend to think about what negatives are going to be brought up about us instead of the positive things we have achieved over the year- the main reason for an appraisal!
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How to stand out in a job interview |
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 A job interview should be seen as the perfect opportunity to show what you can offer to the company you are applying at. Good preparation can make you the candidate that they are looking for.
1/ First impression is important
Research has shown that employers have made their mind up within the first 30 seconds of a job interview. This makes the handshake and the greeting significant. Think about what you would be looking for if you were the interviewer. Find out what the company’s dress code is and research the website to find as much information about them as possible. Look at Facebook or Twitter to discover what the main issues facing the company are at present. If you can find out who will be interviewing you, that would be an advantage as you coud research their career history and interests.
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Employment Rights: Do you really know your rights? |
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 Everybody should know their rights and entitlements in the workplace but unfortunately, many of us don't. In order to feel confident, secure and happy at work, we really need to know all the information, whether it is uncertainty about what to do about a dispute or a maternity issue. Below is some information that is key to know in the workplace.
Discrimination, bullying or harassment/
All employers are responsible for ensuring that all staff know that this kind of behaviour is not tolerated and policies should be in place to protect employees from discrimination. Sexual discrimination, sexual orientation, gender identity, age and race discrimination, religion or belief and disability all fall under this category.
Steps to take if you are a victim of any of the above:
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CRB Confusion! |
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Do we or don’t we need a CRB check? (England only)
That seems to be the burning question on the lips of every Dental Nurse at the moment! Well according to the CQC, yes we certainly do, however a lot of Dental Nurses have had their application forms returned, causing a lot of confusion.
The problem seems to be that Dental Nurses, as well as Dentists and Hygienists, have been sending their CRB application forms through the CQC when in fact they should be applying through an “umbrella body” such as a Primary Care Trust. The only people who should be applying through the CQC are Providers, Nominated Individuals and Registered Managers.
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Tooth Whitening Justice! |
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The GDC have just announced that they have successfully prosecuted a clinic's boss for illegally performing tooth whitening. This has been an issue for quite a while, with individuals claiming to be qualified in the tooth whitening procedure, when in fact they have not been. The GDC rightly classes tooth whitening as "the practice of dentistry" and won its case against Mr. Paul William Hill, the Director of PW Healthcare Consulting Ltd, which trades nationally as Style Smile Clinics. Mr. Hill pleaded guilty to four offences, including practicing dentistry while not being registered as a dentist or dental care professional between 02/10/10 and 11/03/11. As we all know, it is an offence for non-registrants to practise or be prepared to practise dentistry under the Dentists' Act 1984.
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Recruitment Testimonials |
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 It has been just over 3 months since The Dental Nurse Network (DNN) launched their recruitment specialist service and the response has been positively encouraging.
We do our best to place the right dentist and nurse together. We aim to visit 99% of the practices we work with in London and this has made all the difference.
Please see our testimonials below and if you are interested in working with DNN simply phone 020 7720 2492.
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Diary of a Treatment Co-ordinator |
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Another fulfilling day at the practice today! I had three new patients booked in with myself and the Dentist this afternoon and was looking forward to meeting them, particularly the last patient of the day.
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Are you a member?? |
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Sign up today for free membership! Simply go to the website and click the sign up icon.
What do you get when you sign up for free?
Firstly and foremost, you become a unique member of the ultimate dental
nurse society.
...plus, you will be entitled to these fantastic additional extras at no cost!
* Free verifiable CPD - Improve your communication skills.-members only
• Latest hot news and information which you can’t afford to miss out on.
• Free CV template- Every wonder exactly what to write?-members only
• Network and share experiences with other nurses!
Plus a free report- ‘What every dental nurse should know’- members only
We are a registered tax agent for dental nurses:
• Learn how to claim up to £120 in tax refunds on washing your own uniform.- members only
* Claim back for Retention Fees- members only
What do you get when you sign up for free?
Firstly and foremost, you become a unique member of the ultimate dental nurse society.
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Regional Dental Nurse Groups |
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The Dental Nurse Network has decided to orchestrate dental nurses groups across the UK.
The purpose of the groups is to get nurses discussing work place issues, GDC retention fee and pay. The idea is to get together as a uniformed voice and brainstorm solutions/ways forward. So far, we have had interest in the groups but not enough as yet to start grouping the nurses. Below are answers to questions that may concern you, if there is anything else you would be interested to know- simply email us with your queries.
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Governing Bodies, Professional Associations and CPD. |
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An Introduction to: Governing Bodies, Professional Associations and Continuing Professional Development.
As Dental Nurses it is really important that we understand every aspect of our positions and that includes our Governing Body and the Professional Associations of our industry.
Our Governing Body is the General Dental Council (GDC)
An Introduction to the: General Dental Council.
The GDC was created in 1956 and is constituted by the Dentists Act 1984. The GDC protects the public by regulating Dental Care Professionals (DCP’s) in the UK which include Dentists, Hygienists, Therapists, Dental Nurses and Dental Technicians.
The GDC protects patients by:
• Keeping lists of fully qualified DCP’s, constantly updating the lists and making them available for the public to view.
Benefits to the public are:
• The public can check to see if their Dentist is suitably qualified. Also beneficial for patients looking for a new Dentist as they can check to see whether potential new Dentists are qualified.
• Setting the code of conduct and rules/regulations at a very high standard.
Benefits to the public are:
• Registered DCP’s are regulated to perform to the highest standard, providing excellent care and treatment to patients.
• Maintaining high standards of dental education.
Benefits to the public are:
• DCP’s are highly educated and are constantly learning due to CPD.
• Making Continuing Professional Development (CPD) a necessity for DCP’s.
Benefits to the public are:
• DCP’s are always updated with the latest education and developments enabling them to provide the best care for patients.
• Taking appropriate action towards a DCP if there is concern about the way they are practising Dentistry.
Benefits to the public are:
• Any DCP who is unfit to practise will be identified and judged as to whether they should continue practising Dentistry.
To register with the GDC, the annual registration fee is now £120 and needs to be paid in full by the 31st July every year.
For more information, you can visit www.gdc-uk.org.
An Introduction to the: National Examining Board for Dental Nurses.
The National Examining Board for Dental Nurses (NEBDN) was established in 1943 in order to provide Dental Nurses with a National Certificate in Dental Nursing. It consists of Dental Nurses and Dentists. The aim of the NEBDN is to “advance the education of Dental Nurses for the benefit of the public” by:
• Providing qualifications for Dental Nurses
Benefits to the public are:
• Dental Nurses will be suitably qualified and able to give patients the care and attention they need.
• Publishing syllabuses of study.
Benefits to the public are:
• Dental Nurses are more likely to understand and pass the examinations resulting in a healthy amount of Dental Nurses armed with knowledge and ready to work.
• Issuing Certificates and Badges.
Benefits to the public are:
• Patients can clearly identify qualified Dental Nurses and also see what post-graduate qualifications they have taken.
• Setting standards for all qualifications.
Benefits to the public are:
• In order to qualify, Dental Nurses must meet the standards required to deliver excellent care.
• Liaising with other appropriate bodies.
Benefits to the public are:
• Liaising with other appropriate bodies promotes the education and qualification of Dental Nurses resulting in excellent care of patients.
Qualifications that the NEBDN currently provide are:
• National Certificate for Dental Nurses
• NVQ Level 2 Oral Health Support Worker
• NVQ Level 3 Oral Healthcare Dental Nursing
• Certificate in Oral Health Education
• Certificate in Dental Sedation Nursing
• Certificate in Dental Anaesthetic Nursing
• Certificate in Special Care Nursing
• Certificate in Orthodontic Dental Nursing
• Certificate in Dental Implant Nursing.
For more information, you can visit www.nebdn.org.uk.
An Introduction to the: British Association of Dental Nurses.
The British Association of Dental Nurses (BADN) was formed at the same time as the NEBDN and is a professional organization committed to representing all Dental Nurses, qualified, unqualified and working in all areas of employment. The BADN negotiates and represents the interests of all Dental Nurses with regards to working conditions and remuneration. The BADN publishes a journal every 3 months which highlights various topics including issues in the workplace and letters of concern/praise. Reading the BADN journal keeps Dental Nurses up to date with the latest news and developments.
For more information, you can visit www.badn.org.uk.
An Introduction to the: British Dental Association.
The British Dental Association (BDA) is the trade union and national professional association for Dentists. The BDA aims to promote the interests of its members, advance every aspect of Dentistry and improve the oral health of the nation. The BDA follows the following beliefs and principles:
• Oral health is necessary for general health and well-being.
Benefits to the public are:
• Awareness of the links between oral and general health enable patients to receive better care.
Quality oral health should be easily accessible to everyone.
Benefits to the public are:
• The BDA is always pursuing this belief in order to soon make this a reality.
• Quality oral care is best provided by co-ordinated teams led by Dentists and with well-trained support staff.
Benefits to the public are:
• Patients are aware that their care is co-ordinated by a team consisting of qualified, educated DCP’s and well-trained support staff.
• Research into oral health and the delivery of quality oral healthcare is to be actively encouraged.
Benefits to the public are:
• Patients will receive the best treatment available.
• Liaising with other appropriate dental bodies is to be actively pursued.
Benefits to the public are:
• Liaising with other bodies will improve and enhance knowledge and education in order to provide the best possible care for patients.
For more information, you can visit www.bda-dentistry.org.uk.
An Introduction to the: Faculty of General Dental Practice UK.
The Faculty of General Dental Practice (FGDP) was formed in 1992 and has been the academic home of Dentists working in the field of primary dental care. The FGDP recognizes that the care of a patient requires the specialities of the whole dental team and because of this, the FGDP have developed an approach to education and training that increasingly encompasses the whole team. The FGDP (UK) welcomes all DCP’s and offers them membership, including registered Dental Nurses. The FGDP also offers diplomas in Dental Hygiene and Therapy, Orthodontic Therapy and a route to GDC registration for Clinical Dental Technicians.
Continuing Professional Development.
Continuing Professional Development (CPD) is a requirement that all DCP’s must fulfil. CPD is a life-long learning process throughout your working life. CPD is achievable in many different forms and does not necessarily involve formal studies. It is the responsibility of the individual to keep up to date with CPD, as Dental Nurses we must not look to our Dentist or Practice Manager to fulfil this for us- it is completely our responsibility. There are many benefits of CPD including, increased job satisfaction, increased knowledge and experience and greater career prospects.
DCP’s must complete at least 150 hours of CPD over a 5 year cycle and at least 50 hours must be verifiable CPD.
What is the difference between Verifiable and Non-Verifiable CPD?
Verifiable CPD must satisfy the following conditions:
• There must be proof from the activity provider/organizer in the form of a document. For example: a certificate with your name on it signed by the provider.
• The activity must have clearly defined aims and objectives. For example: post-graduate courses such as the Radiography certificate.
• The activity should have clearly defined anticipated outcomes so that it is evident what can be gained by taking part. For example: Again, post-graduate courses have an outcome!
• The activity should have quality controls and there should be an opportunity to provide feedback so that the quality of future activities can be improved. For example: at the end of a course, providers usually ask for feedback sheets to be completed by all participants.
Non-verifiable CPD does not need to satisfy the above conditions but it does need to be recorded. Non-verifiable CPD can include: reading journals, research and private study.
CPD activity needs to be logged and recorded from the time of registration. The GDC provides a GDC booklet which includes a form for logging your CPD. You can also do this online at the GDC website once you have registered your details. CPD can be quite time-consuming but needs to be completed properly. The following needs to be recorded:
• Date, title and venue of the activity.
• The name of the person or organization providing the activity.
• Whether it is verifiable or non-verifiable CPD.
• The number of hours spent.
CPD should be planned out to ensure that the quality and appropriateness of the activities are right for the individual. This can be done at annual appraisals or performance reviews. Short and long term goals and implementation should be discussed.
CPD can be achieved in ways other than formal learning. Some examples are:
• Attending conferences- this will also improve your networking skills and potentially open new doors.
• Reading publications and journals- this will increase your knowledge and confidence.
• Exhibitions and Lectures- this will increase your product knowledge and broaden your interests.
• The Internet- verifiable CPD is available online on a subscription basis and is very convenient.
An Introduction to: Governing Bodies, Professional Associations and Continuing Professional Development.
As Dental Nurses it is really important that we understand every aspect of our positions and that includes our Governing Body and the Professional Associations of our industry.
Our Governing Body is the General Dental Council (GDC)
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What is the Care Quality Commission and why is everybody talking about it? |
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What is the Care Quality Commission and why is everybody talking about it?
With the registration process looming over every dental practice this month, it is essential that we at least know the basics about the latest change to Dentistry- the introduction of the Care Quality Commission. The Care Quality Commission (CQC) is the independent regulator of all health and adult social care in England, also described as the health watchdog. The aim of the CQC is to make sure that better care is provided for everyone in every environment of care including hospitals, care homes and dental practices. The CQC state that they have a vision and that vision is to provide high quality health and social care to everybody in England.
The CQC have announced that all dental practices must be registered before 1st April 2011 if they wish to continue providing dental care. Registration is compulsory to all branches of Dentistry so NHS, Private, Mixed, Orthodontic and Emergency Practices are all more or less in the same boat. There is great concern that the CQC registration combined with the strict new regulations introduced by HTM 01/05 will be too much for some smaller dental practices to handle, resulting in many practices being forced to shut down. The main reasons for this unfortunate prediction being financial and also practical- not many practices have the room for a separate sterilisation room with 3 different sinks- something that all practices must aim for according to HTM 01/05. Dental practices, once registered, must comply with a series of outcomes set by the CQC.
So what are the visions and aims of the CQC?
According to the CQC:
The vision is of high quality health and social care which:
• Supports people to live healthy and independent lives.
• Helps people and their carers make informed choices about care.
• Responds to individual needs.
High quality health and social care is defined as:
• Safe.
• Having the right outcomes, including clinical outcomes (E.g. do people get the right treatment and are they well cared for?)
• A good experience for the people who use it, their carers’ and their families.
• Helping to prevent illness, and promote healthy, independent living.
• Being available to those who need it, when they need it.
• Providing good value for money.
The values of the CQC are to:
• Put the people who use services first, be informed by what the people tell them and to stand up for their rights and dignity.
• Be independent.
• Be expert and authoritative, basing their actions on high quality evidence.
• Be a champion for joined up care across services.
• Work with service providers and the professions to agree definitions of quality.
• Be visible, open, transparent and accountable.
What are their priorities?
The CQC have identified five priorities which they believe they need to focus on to bring about visible change and significantly enhance outcomes for people. They state that they will deliver these priorities by carrying out regulatory activities well.
The priorities are as stated:
1. Making sure that care is centred on people’s needs and protects their rights.
The CQC want people to be able to shape their own care around their needs and to have a voice. To do this, people need up-to-date, relevant and accurate information so that they can make informed choices about their care.
2. Championing joined-up care
The CQC want to see better coordinated and integrated health and social care so that the services people receive are joined up and their experience is a good one. They also want better integration within sectors, e.g. across primary and acute services and when young people move up into adult care. They want commissioners and providers of care to work together, and with people who use services, so that outcomes for people are improved.
3. Acting swiftly to help eliminate poor quality care
The CQC believe that people have a right to expect that and if a service falls below the essential standards expected, this is identified and acted on quickly. They want to have a major impact on these poorer services and state that they will focus particularly on those that fail to improve.
4. Promoting high quality care
The CQC believe that people should be able to access and experience high quality services that put them first and respect their rights. Where they identify care that is improving, they state that they will promote this so that other commissioners and providers can learn from what is working well.
5. Regulating effectively, in partnership
The CQC state that they will be sensitive to the requirements that they put on those they regulate. They also state that they will work to the principles of better regulation and will frequently show their progress in doing so. Additionally, that they will work with other organisations to improve the quality of life for communities and local people, and make sure that the benefits they bring to people significantly outweigh their costs and those incurred by others, in meeting their expectations.
So why is the CQC causing such controversy?
Despite these visions, aims and priorities, most Dentists feel like the CQC is unnecessary in Dentistry as we are already aiming for the highest standards of care and service anyway. We already have existing governance and regulations, so there are a lot of Dentists and DCP's finding this additional body completely unnecessary. Many Dentists have written letters of complaint and expressed their views in journals and on websites. The latest controversy is the CQC announcing that a consultation will take place to discuss the charging structure, which Dentists are invited to contribute to. Seeing as most Dentists completely disagree with having to pay a penny to the CQC, it is unclear as to whether this will help. Dentists have been informed by the CQC that there is no charge to register with them at this moment in time; however charges will be unavoidable from next April. According to the CQC, the fees cover the registration of all service providers and also the overseeing of their compliance with the essential levels of safety and quality.
For more information on the CQC you can visit www.cqc.org.uk.
 With the registration process looming over every dental practice this month, it is essential that we at least know the basics about the latest change to Dentistry- the introduction of the Care Quality Commission. The Care Quality Commission (CQC) is the independent regulator of all health and adult social care in England, also described as the health watchdog. The aim of the CQC is to make sure that better care is provided for everyone in every environment of care including hospitals, care homes and dental practices. The CQC state that they have a vision and that vision is to provide high quality health and social care to everybody in England. |
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Fitness to Practice. |
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Fitness to Practice.
As Dental Care Professionals (DCP’s) registered with the GDC, we each have to follow the “Principles of Practice in Dentistry” as advised by the GDC. These principles are:
Putting patients’ interests first and acting to protect them.
In other words, we have to put the interests of our patients before our own, our colleagues and also employer, e.g. the Dentist. We have to consider this principle when dealing with patient enquiries, concerns and complaints. We have to respect the patient completely despite receiving a complaint- it is our duty to resolve it for the benefit of the patient. DCP’s should make sure that they are protected in the event that a patient makes a claim so the patient can receive adequate compensation if necessary. We should work within our knowledge, professional competence and physical abilities and if we cannot help the patient in a certain situation, then we need to find somebody who can. Patient records should be kept up to date at all times including regular medical history checks. Patients should have easy access to their records if they choose to view them. If you believe that a patient could be at risk due yourself, a colleague or the clinical environment then this needs to resolved quickly by taking necessary action. The practice should also find out about the local procedures for child protection and follow these procedures if there is any suspicion of a child being at risk.
Respecting patients’ dignity and choices.
Patients should be treated kindly and with respect and we should help them make the right decision with regards to their health and promote their responsibility to make these choices. We need to treat each patient equally and not discriminate on any level. Patients should be listened to and offered correct advice. There are boundaries between a patient and a DCP and in no circumstances should a relationship between a patient and DCP be abused.
Protecting the confidentiality of patients’ information.
We should treat patient information as completely confidential and only use it for the purpose in which it was given. Patient information needs to be kept secure and unauthorized access must be prevented so that it is not accidentally revealed. Patient information should only be revealed if it can be justified, for example, if it is in the interest of the patient or the public.
Co-operating with other members of the dental team and other healthcare colleagues in the interests of the patients.
It is important that all team members co-operate with each other and respect everybody’s role in caring for the patient. Knowledge and skills should be shared amongst colleagues in order to provide a better standard of care to the patient.
Maintaining your professional knowledge and competence.
Registering as Dental Nurses is only the first stage in our careers and it is important that we continue to develop ourselves in order to be better Nurses and provide increasingly good standards of care to all patients. Our knowledge and skills should constantly be reviewed and reflected on to see if we can make improvements. We should also keep up to date with the latest advancements in rules and regulations which affect the way we work.
Being trustworthy.
We must justify the trust that our colleagues, patients and the public have in us as DCP’s. We must follow these principles in our professional and personal life and maintain the trust and confidence that we have earned.
GDC Guidelines for dental nurses in training:
‘1 Are employed by a practice and enrolled in a training course but waiting for the course to start or,
2 Are employed by a practice and waiting for enrolment for a training programme to open or,
3 Have passed the National Certificate but are still completing the 24 months’ chairside experience needed to get their certificate.
In all above cases:
A Before a student dental nurse undertakes any duties in the practice he or she must receive an appropriate induction, which must include confidentiality and health and safety in the practice;
B The student dental nurse must keep a log book of the training they received in the practice;
C The student dental nurse must not undertake exposure prone procedures, including cleaning instruments, until they have received their appropriate vaccinations as required in the area where they practice.’
References- The General Dental Council Website.
As Dental Care Professionals (DCP’s) registered with the GDC, we each have to follow the “Principles of Practice in Dentistry” as advised by the GDC. These principles are:
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The role of a dental nurse |
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A Dental Nurse assists the Dentist in all aspects of patient care and also supports other members of the dental team. A Dental Nurse mainly works in surgery assisting the Dentist but can often work on reception and participate in administrative duties too. It is the duty of the Dental Nurse to:
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Dental Nurses: How to write patient notes |
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 Patients’ notes are a legal document. Dental nurses therefore have a responsibility to make these records as accurate and detailed as possible so that all relevant information is present and correct. This includes accurately charting all present teeth and past treatment, all treatment needed, correctly labelling and mounting radiographs, maintaining an updated medical history, keeping a record of all correspondence with specialists etc, retaining consent forms and recording accurate clinical notes every time the patient attends.
It is important to maintain correct records firstly so that all information about the patient is available in order to provide them with the treatment and care most suitable for them, and secondly for legal reasons. If there is any dispute between the patient and dentist it is important that the dentist can provide accurate notes showing any diagnosis, advice or treatment they have given to the patient, and their reasons for doing so. The dentist therefore can provide written evidence justifying any treatment or advice they have given to the patient.
Patient Details
A record should be kept of the patient’s date of birth, current address and telephone number and/or email address. The patient should be routinely asked if there is any change in contact details.
Attendance
Records should be kept of all appointments patients have failed to attend, have cancelled or attended late.
Medical History
Patients’ medical history should be updated every time the patient attends. This is extremely important as certain drugs the patient may be taking, such as anticoagulants, can cause excessive bleeding after extractions, and other medication can react with drugs administered during dental treatment, such as the adrenaline contained in some local anaesthetic solutions.
If medical history is checked verbally a record should be made in the patient’s notes. Ideally the patient should be given a medical history form to complete prior to the appointment which can then be scanned to the patient’s notes if these are computerised, or kept with the patient’s record card.
The following should be recorded:
• The patient’s GP
• any medical conditions such as epilepsy or diabetes
• any allergies such as Asthma or Penicillin allergy
• any infectious diseases such as Hepatitis B or HIV
• if the patient is pregnant
• any medication the patient is currently taking
• if the patient is currently undergoing any treatment or has had any recent operations
• oral cancer risk factors including whether the patient smokes and average weekly alcohol consumption
Charting
Dental charting is a diagrammatic representation of teeth and their surfaces providing a visual note of the patient’s teeth and any treatment they have had on them. Charting is not only important in the respect that it shows the dentist an immediate representation of the patient’s mouth so is an important aid in patient diagnosis and treatment, but it is also an aid in forensic identification of bodies. Correct charting can be the only means of identifying bodies in cases such as burn victims, so it is of vital importance that it is recorded accurately.
At the patient’s first visit a full base chart should be recorded showing all teeth present and any treatment that has been carried out on them. The charting should be checked each time the patient attends and updated if there are any changes.
There are two main systems of tooth notation available when referring to specific teeth in the clinical notes. In the United Kingdom Palmer tooth notation is often used. In handwritten notes it involves using a quadrant symbol and the tooth number:
__ __
| lower left | lower right __| upper right |__ upper left
As demonstrated this does not work well on computerised notes (!) so quadrants are referred to as UL - upper left, UR - upper right, LL - lower left and LR - lower right.
The International Dental Federation two-digit system is a globally recognised form of tooth notation where quadrants are recognised as numbers: 1 - upper left, 2 - upper right, 3 - lower left, 4 - lower right, and for deciduous teeth, 5 - upper left, 6 - upper right, 7 - lower left and 8- lower right.
Both forms of notation are acceptable and the dental nurse should use the system that the dentist prefers.
Other forms of charting may be required such as charting the findings of a Basic Periodontal Exam - this ideally should be carried out at every examination appointment. Pocket, mobility, plaque or surface wear charting may also be required.
Clinical Notes
At an examination or emergency assessment appointment the first thing that should be recorded in the clinical notes is the patient’s chief complaint, followed by anything else the patient complains of or wishes to report. This should be recorded as closely as possible to the patient’s own description of their symptoms.
Any diagnosis or observations the dentist makes should then be recorded along with any charting updates. All discussions regarding treatment options, including costs or any questionable prognosis of any treatment, changes in treatment plans or post-operative warnings should be recorded.
At appointments where patients are undergoing treatment concise details should be made of the treatment being carried out and correct notation of where it is being carried out, along with records of any drugs administered and materials/equipment used. Records should be made of any post-operative advice given.
Notes should always be recorded during and directly after the patient’s visit as it is required that they are contemporaneous. It must also be taken into consideration that patients’ can request to see their clinical notes; therefore they must be written in a professional manner with no derogatory comments made about the patient. For example, if a patient attended complaining of a broken tooth a note should be made of this, including how and when it was broken, what tooth or area of mouth patient describes and any symptoms:
‘Pt c/o broken tooth UR area this morning whilst eating cereal, causing sensitivity to cold.’
The dentist’s diagnosis, any vitality tests or radiographs, and any discussions about treatment plans should then be recorded:
‘O/e: UR5 fractured mesio-buccal cusp, pt has a heavy bite and not much tooth left so advised patient that a crown is the best option. Explained to patient tooth can have a composite restoration but that it may not last long. Explained differences between gold and porcelain bonded crown, advised patient that PBC was the most aesthetic option, but gold is slightly stronger and helps periodontal condition. Patient concerned about crown blending in with existing crowns and veneers, concerned about metal becoming visible due to gingival recession as this has happened to the patient before. Discussed option of Lava crown (metal free), shown patient some photographs of Lava crowns, patient wishes to go ahead. PA taken of UR5 to check suitability of tooth for crowning, PA shows tooth to be suitable .Pt given verabl and written estimates and consent form to sign.’
Although the dental nurse should record as much information as possible in the patient’s clinical notes and write them as accurately as possible, the dentist is ultimately responsible for their content, so before any notes are saved and the patient’s appointment is marked as complete, the dentist should check that the notes are satisfactory and make any necessary additions or ammendments.
Radiographs
If radiographs are processed and mounted digitally then they should be attached to the correct patient’s notes, orientated correctly and labelled accurately recording the type of radiograph and teeth present on radiograph. Reasons for taking radiograph and findings should be recorded in the patient’s clinical notes. Radiographs that are manually processed should also be correctly mounted and labelled and kept with the patient’s record card.
Correspondence
Any correspondence with specialists or hospitals such as letters or emails should be retained and either scanned to the patient’s digital notes or kept with the patient’s record card. Any paper work regarding confidential information about patients should be shredded after scanning to patient’s notes. This also applies to medical history forms.
A record of any correspondence made regarding the patient, or with the patient, over the telephone should be made in the patient’s clinical notes.
Patients’ notes are a legal document. Dental nurses therefore have a responsibility to make these records as accurate and detailed as possible so that all relevant information is present and correct. This includes accurately charting all present teeth and past treatment, all treatment needed, correctly labelling and mounting radiographs, maintaining an updated medical history, keeping a record of all correspondence with specialists etc, retaining consent forms and recording accurate clinical notes every time the patient attends.
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Good Patient Communication and Rapport-Building Skills. |
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Good Patient Communication and Rapport-Building Skills.
Communicating well with patients is vital in Dentistry and benefits both the patient and the Dental Nurse. The patient because they will feel genuinely cared for and understood and the Dental Nurse because she will feel fulfilled and satisfied with her performance.
Examples in which good communications are absolutely necessary:
• Explaining treatment and gaining consent.
• Pre and post-operative instructions.
• New patient exams.
• Discussing payment.
• Gaining consent for using patient photographs.
In order to care for our patients well and in accordance with the rules and regulations, it is important that patients are fully aware and understand the information we relay to them. It is also important that WE understand what patients say to us also and what patients tell us could be interpreted not only by word but also by body language. That is why we need to be able to communicate on many different levels. As a Dental Nurse, we need to monitor the patient and inform the Dentist if at any time we feel there are any concerns with the patient.
Non-verbal communication.
Patients can alert us subconsciously if there is something wrong by using vocal or physiological communication and also by using expressions and posture. A patient may whimper, cry or even scream while having treatment. We do not need them to tell us that they are unhappy, their vocal communication does that instead. A patient may also pull away from the drill, close their mouth or tense up their legs. Again, this indicates they are not comfortable with what is going on. Other things we must notice are physiological changes such as excess sweating or paleness. Lastly, expressions such as grimacing are also ways of non-verbal communication.
Good rapport is so important when caring for a patient .Rapport is an important feature of sub-conscious communication and is often described as being “in sync” or “on the same wavelength” with the person you are communicating with. There are different methods of building rapport, the most common being;
• Mirroring
Mirroring basically means getting into the rhythm of the person you are communicating with on as many levels as possible. There are three types of mirroring; Emotional, Posture and Tone/Tempo. Emotional mirroring basically involves empathizing with the emotional state of the person you are communicating with and letting them know subconsciously that you are “on their side”. Posture mirroring involves matching the body language of the person you are communicating with subtly by mirroring the same message with your energy and attitude. Tone/Tempo mirroring involves matching the tone, tempo and volume of another’s voice.
• Commonality
Commonality is a technique which involves purposely finding something in common with a person in order to build trust and confidence. This can be done through shared interests, hobbies, dislikes etc.
• Reciprocity
Giving someone a gift or doing them a favour triggers feelings of obligation in the person on the receiving end.
Good communication and care can be achieved by:
• Knowing your patient and having your patient know you.
Introduce yourself to your patient and make eye contact. Find out how they preferred to be addressed, e.g. Mrs Smith or more informally, Janet. Once you know their name, make an effort to remember that person so that at their next appointment you can greet them directly by name. The patient will not believe that you remember them from 6 months ago and no doubt feel secure and happy coming to a dental practice that knows them as an individual and not just “another patient”.
Ask how they are and try to find out a bit about them to make them feel more comfortable. Information is a great tool. Find out if the patient has any up and coming events such as a wedding. When they attend for their next appointment, ask them how it went. Again, they will be very surprised that you remembered that they were attending a wedding and feel flattered. Find out if they have any fears or issues and do your best to help them. Let them know a bit about you and try to relate to the patient, e.g. “I’m not keen on injections either, but it’ll be ok.” Treat each patient as an individual and give them the level of care that they require. Some patients need a little bit extra than others if they are nervous or frightened for example.
• Listening.
When the patient is speaking to you, give them your undivided attention to show them that you are genuinely listening to them. Position yourself so you are facing them and look into their eyes. By listening, you are more likely to pick up on matters that could be missed if communication is poor such as previous bad experiences with a Dentist. As a Dental Nurse, patients are more likely to speak to you about delicate matters as it is often difficult for patients to address the Dentist due to nerves or sometimes intimidation.
• Maintaining confidence and professionalism.
Always keep cool and calm and care for the patient adequately despite your surroundings. Working as a Dental Nurse can often be a fraught, “running round like a headless chicken” type experience, especially when the diary becomes double booked and there is an endless run of emergencies, however this does not mean that patient care and attention can be compromised. The patient should not see the madness behind the scenes. If you have to leave the room or are called out to the desk for example, calmly excuse yourself. It is also important that the Dental Nurse stays in control and acts in confidence.
Maintaining good communication with patients.
There are ways that a Dental Practice can maintain good communication with their patients and also please them as individuals. Some of these ways are:
• Sending routine recall/reminder letters.
Some Dental Practices advise patients to pre-book their 6 monthly appointments in advance to guarantee a preferred time and date, other practices simply advise their patients to contact to make an appointment nearer the time they are due. Depending on whether the patient has made their appointment or not, one of these letters should be sent out every 6 or 3 months depending on when they are due to come back for their routine review. More Practices are now confirming appointments in other ways such as email and text reminders, which are very popular and convenient amongst patients.
• Post-treatment courtesy calls.
Imagine this- you have had to endure an Apicectomy the day before and you are feeling a bit sore and sorry for yourself. The phone rings and it is actually the Dental Nurse who assisted through your appointment asking you how you are feeling and asking you to contact the practice if you need to and that the team are there for you if you have any questions. That is bound to make any patient feel better and the benefit to this very simple but effective task is that WE know that the patient is ok after treatment and THEY feel valued and cared for. It is ideal if the Dental Nurse can make the calls however the Receptionist can do this also.
• Birthday cards.
Sending a patient a birthday card is a lovely touch and reinforces the fact that you do care and value them as a patient.
• Thank You cards.
If a patient refers a friend to your practice or writes a nice testimonial then sending them a “thank you” card is a relatively inexpensive and nice thing to do and could very well encourage them to do more for you. Some Practices take this a step further and have referral systems in place. For example; refer 1 person to the practice and receive 10% off your next course of treatment, refer 5 people to the practice and receive £25 gift voucher and 10 off your next course of treatment etc.
 Communicating well with patients is vital in Dentistry and benefits both the patient and the Dental Nurse. The patient because they will feel genuinely cared for and understood and the Dental Nurse because she will feel fulfilled and satisfied with her performance. Examples in which good communications are absolutely necessary:
• Explaining treatment and gaining consent.
• Pre and post-operative instructions.
• New patient exams.
• Discussing payment.
• Gaining consent for using patient photographs.
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What is HTM 01/05 and why is it important? |
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What is HTM 01/05 and why is it important?
HTM 01/05 is a document that has been released by the Department of Health and is to be used as guidance in relation to Decontamination in the Dental Practice.
The aims and objections of HTM 01/05 are:
• Recognition of the difference between cleaning, disinfection and sterilisation.
• Implementation of Practice procedures and policies.
• Understanding of maintenance, testing, storage and disposal.
• Understanding the importance of Personal Protective Equipment.
• Operating safely and practically within the law and the British Dental Association guidelines.
• Recognition and minimization of cross-infection.
Refresher on the basics
Cross-Infection/
Cross infection is the term given to harmful micro-organisms being transmitted from one person to another due to poor or no protection. For example; using the same set of instruments on more than one patient is cross-infection. Cross-infection can occur in a number of ways and take a number of different routes. Recognized routes are;
• Ingestion
• Aerosol
• Inoculation
• Sexual
It is very important that we prevent and minimize cross-infection as much as possible by:
• Wearing and asking the patient to wear PPE.
• Disinfecting worktops and equipment.
• Sterilising instruments correctly.
Disinfection/
Disinfection involves the use of a disinfectant spray or wipes which can be used on all surfaces or equipment that can’t be sterilised. Placing instruments into an ultrasonic bath is also classed as disinfection. Disinfection will kill micro-organisms but not all bacterial spores. Disinfection does however reduce bacteria to low levels which are non-harmful. Disinfection is less effective than sterilisation but unfortunately we cannot put the dental chair in the autoclave!
Sterilisation/
Sterilisation is the process intended to destroy or remove all living organisms from an object. Unlike disinfection, sterilisation completely kills all micro-organisms when done correctly. Instruments need to be sterilised after use and the most common way is by using an autoclave.
HTM 01/05.
Below are the requirements of HMT 01/05. Highlighted in bold are the requirements that must be met within 12 months.
Guidelines with regards to:
Protocol/
• A detailed plan for "best practice" must be written and explain what is going to be done in order to move forward.
• An appointed person should be responsible for decontamination.
• An infection-control policy should be in place that meets the essential requirements and this should be reflected on. Each member of the team needs to read, sign and implement the policy.
• A validated cleaning cycle should be in place and a protocol made explaining this.
• Audits should be made and kept for 2 years.
• Autoclaves should be tested daily and results recorded. A written protocol should be in place.
• Dental unit water supplies (D.U.W.S) should be tested every few months for the quality of the water. The water used at chairside must not be used directly from the mains water supply. A written protocol should be in place.
• All staff should be up to date with immunisations and be able to provide evidence of this.
• Every Dental Practice must have an Accident Report book.
• Every member of staff should have a Personal File which should include a signed copy of the infection-control policy, details of any accidents reported, copies of immunisations and risk assessments.
• A written policy detailing a validation/checklist for Manual Cleaning should be in place. This should include checking the use of the correct detergent, mercury-free thermometer and also an illuminated magnifier to inspect the instruments.
• A written policy detailing a validation/checklist for PPE should be in place. This should include checking the use of safety glasses, gloves, face masks, face visors and disposable aprons.
• A written policy detailing a validation/checklist for the Ultrasonic Bath should be in place. This should include daily checks of the safety, visual effeciency, cleaning and draining. Also weekly protein checks and quarterly activity tests. Lastly, checking the use of the correct detergent and making sure the bath has a lockable lid or clear label.
Disinfection/
• There should be dedicated hand-washing facilities in addition to two seperate sinks- dirty and rinse.
• Instruments must be transported from surgery to sterilisation room in rigid, durable, leak-proof containers with lids on. There must be clean and dirty containers.
• Manual cleaning must be done wearing heavy duty gloves and using a long handled kitchen brush which should be washed in detergent and hot water. The brushes need to be replaced weekly. Instruments must be held with the sharp end facing away and they should be fully immersed in warm water and detergent . PPE should be worn in order to prevent splatter. Instruments should be inspected with an illuminated magnifier before placed in an ultrasonic bath.
• Ultrasonic baths must be filled with warm water and the correct amount of enzyme cleaner.
• The aspirator/suction system must be cleaned with a non-foaming, bio-film contaminant and this should be done at the end of every clinical session. The spittoon needs to be disinfection after every patient.
• Impressions need to be rinsed under running water to remove all debris and then dipped/sprayed with disinfectant or soaked for 3 minutes. Impressions then need to be dried and packaged.
• Uniforms must not be worn outside the surgery or in any eating areas. They should be changed daily, (when visibly contaminated) and washed at 60 degrees celsius.
• Hands should be washed in a 6-8 stage technique and this should last for 15 seconds. All jewellery must be removed and nail varnish must not be worn. Cuts and abrasions need to be covered up. Hands need to be washed using a liquid soap from an automatic, wall-mounted dispenser at the beginning and end of each session. Liquid soap or alcohol gel is fine to use in between changing gloves, alcohol wipes should be avoided. If hand cream is used, it needs to be water based.
Sterilisation/
• Every practice must have a validated steam sterilizer.
• Sterilised instruments must be packaged in sealed plastic packets. Dry, covered instruments can be available to use for a maximum of 21 days before they need to be re-sterilised, non- vacuum sealed instruments can be used up to 21 days and vacuum sealed instruments can be used up to 60 days. The date of sterilisation, expiry date and signature of the person responsible for the sterilisation needs to be documented.
• Autoclaves must not be overloaded and the trays should be perforated in order for optimum sterilisation.
• There should be a central sterilisation room which should contain 3 sinks- dirty, rinse and hand basin and clean/dirty clearly labelled areas. There should be an air flow maintained and no portable fans. The room should contain an ultrasonic bath, washer disinfectant and autoclave. There should be no clutter. Everybody who uses this room must be fully trained on the procedure that needs to be followed.
• Washer disinfectants should be implemented as soon as possible and stored under a bench top.
Disposal/
• Every Dental Practice should have a "single use" policy for the following equipment: Prophy brushes/cups, Endodontic instruments and Matrix bands. Anyone who does not follow this policy will be fully, legally responsible.
• Gloves and face masks must be replaced with every patient.
• Ensure that amalgam waste is not mixed with any other type of waste.
• Keep records of the amount of waste produced and sent for disposal or recovery over a minimum of 3 years.
For more information on HTM 01/05 you can contact the Department of Health.
 HTM 01/05 is a document that has been released by the Department of Health and is to be used as guidance in relation to Decontamination in the Dental Practice. The aims and objections of HTM 01/05 are:
• Recognition of the difference between cleaning, disinfection and sterilisation.
• Implementation of Practice procedures and policies.
• Understanding of maintenance, testing, storage and disposal.
• Understanding the importance of Personal Protective Equipment.
• Operating safely and practically within the law and the British Dental Association guidelines.
• Recognition and minimization of cross-infection.
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The Importance of Enjoying Your Job. |
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The Importance of Enjoying Your Job.
Working as a Dental Nurse can be very difficult. Working in surgery can often be very hectic and running behind can become a regular occurrence in a lot of Practices. The mad dash of sterilising instruments, disinfecting worktops and setting up instruments and equipment in between patients can quickly become frustrating and demoralising. Team this with the odd patient complaining about their wait and another not bothering to acknowledge you because you "are only the Dental Nurse" and it is very easy to spiral into a miserable day in day out mind-set.
But that is not what we as Dental Nurses should be simply accepting as our role- especially in this day of age. The potential to grow and develop our careers has never been higher. We must remember that we are registered Dental Care Professionals and we have a purpose- to give the ultimate in patient care and assist the Dentist in every way we can. The days of sitting aspirating, looking pretty are over. We are capable of doing so much more.
In order to get the most from our jobs we need to make sure we.........
Know our stuff!
In other words, we must know the ins and outs of our profession and keep up to date with all the latest developments. Have you ever been assisting the Dentist or Dental Surgeon and felt nervous because you were unsure of what came next? How much better would you feel, confidently passing them their next instrument without them having to ask? Knowledge and confidence is the key to being happy at work. If you feel like there are areas you can improve on at work or treatments/materials that you could learn more about, then ask your Dentist or Practice Manager for a training session. Not only will you impress them by being proactive but you will also be doing yourself a big favour by developing your skills and knowledge.
There are certain types of Dental Nursing that require complete knowledge and understanding, such as Implant and Orthodontic Nursing. Unfortunately with Implant Nursing there are a lot of Dental Nurses that have not received adequate training and feel out of their depth when assisting the Dentist. There are courses that Nurses can go on in order to work efficiently as an Implant Nurse, basic and advanced. In order to feel as confident as possible when Implant Nursing, there are a few things that you should know:
• The Implant System that is used in your Practice. E.g. Astra Tech, 3i, Straumann. You need to be able to inform and educate your patients on your Implant System. Patients are a lot more knowledgeable these days with so much information readily available on the internet- if they phone up enquiring about Implants or come for a Consultation, they WILL expect you to know. It would also be a poor reflection on your practice if members of the team were uneducated in such a popular treatment.
• How to set up and close the surgery, the procedure from start to finish and the pros and cons of the treatment.
• The type of restorations that can be fixed to the Implants. e.g. Crowns, Bridges, Dentures.
• Basic knowledge of patient criteria. e.g. the success rate of Implants falls if the patient smokes or is diabetic and there needs to be sufficient bone present in order to place the Implant.
Similarly to Implants, Short Term Orthodontics (STO) is now becoming more popular. Invisalign, 6 Month Smiles, Inman Aligner and Clearstep are all examples of STO treatments that are in demand.
Again, if your Dentist offers these treatments and you feel unsure as to what they do and how they work, ask! You must be able to inform patients and explain the treatments if you are asked and if you are promoting these treatments in your Practice, you WILL be asked at some point by at least one patient.
Keep our CPD updated!
There are new developments in Dentistry all the time and in order to be the best we can be, we should all be keeping up to date. Signing up to dental magazines, regularly viewing dental websites/blogs is a great way to keep yourself in the know. We all need to be keeping on top of our Continuing Professional Development (CPD) and by attending courses and undergoing further training, this can be achieved quite easily. You can also count reading educational material as CPD.
Being a Dental Nurse armed with knowledge you are not only empowering yourself, you are making yourself a valued, respected member of the team- which should mean enjoyable, productive and successful job roles.
Respect yourself and speak up!
Most Dental Nurses have experienced some form of verbal abuse whether it be a grumpy Dentist snapping at us in the surgery or maybe a conflict with another team member- even an unpleasant patient giving us a hard time over the phone. Do not accept this. We are all qualified and registered Dental Care Professionals (or training to be) and we deserve respect for what we do. It is very easy to feel intimidated or insignificant at work but we play such an important role in Dentistry and we must remember this. If you feel you are being disrespected in some way, voice your concerns with the person making you feel this way and if that fails, report this to the Practice Manager. If it is the Dentist or Practice Manager causing you to be unhappy, ask for a meeting to be arranged so you can sit down and explain the way they are behaving is making you unhappy at work. By doing this, you are showing that you will not stand for being treated with disrespect and you will instantly win respect and understanding for behaving in such a mature, professional manner. If a patient disrespects you, calmly but firmly explain that you will not tolerate being spoken to in that way.
The steps to take if you are greatly unhappy at work.
• Make a list of everything that is bothering you. This could be conflict with a colleague, an issue with wages, your workload etc. Arrange a meeting and voice your concerns.
• Seek advice. If you feel that speaking to your manager has not worked then there are people you can speak to. If you are a Dental Nurse in training, speak to your tutor/assessor and explain the situation. They will either help you by stepping in and speaking to your manager directly or find you another workplace. If you are a qualified, registered Dental Nurse then the Citizens Advice Bureau may be able to help.
• Look for another job. Send out copies of your CV to Dental Practices that you would be interested in working at. Keep an ear to the ground and browse through recruitment websites and also Dental Nursing websites/magazines. There are always opportunities for Dental Nurses.
Working as a Dental Nurse can be very difficult. Working in surgery can often be very hectic and running behind can become a regular occurrence in a lot of Practices. The mad dash of sterilising instruments, disinfecting worktops and setting up instruments and equipment in between patients can quickly become frustrating and demoralising. Team this with the odd patient complaining about their wait and another not bothering to acknowledge you because you "are only the Dental Nurse" and it is very easy to spiral into a miserable day in day out mind-set.
But that is not what we as Dental Nurses should be simply accepting as our role- especially in this day of age. The potential to grow and develop our careers has never been higher. We must remember that we are registered Dental Care Professionals and we have a purpose- to give the ultimate in patient care and assist the Dentist in every way we can. The days of sitting aspirating, looking pretty are over. We are capable of doing so much more.
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Dental Nurse Indemnity, do i need it? |
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 Do you need indemnity cover?
With all these fees, are you expected to pay for indemnity insurance?
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Dental Nurse Network video news |
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Video news including:
Dental Showcase 2010
Dental Nurse Diary and more ...
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Dentistry and Social Media. |
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Dentistry and Social Media.
Social media has had a massive effect on the world and has recently become an obvious way forward for the promotion of Dentistry. Applications such as Facebook, MySpace and Twitter are being used every single day and Facebook in particular has over 400 million users. With that many people logging on to these sites every day, the likelihood of a fraction of these people wanting either general or cosmetic dentistry is considerably high, so why not promote your Dental Practice through a social networking site?
More and more Dental Practices are creating accounts on Facebook and sending out friend requests to their patients. The benefit of this is not only keeping current patients updated with the latest news and offers but also attracting new patients who see your Dental Practice on their friend/brother/sister’s friend-list, or see an offer that has been posted on that same persons wall and think, “You know what? I think I might check them out”. So by reaching out to your existing patients, you are also advertising yourself to potentially thousands of new patients. Using Facebook is also a great way of advertising new offers, promotions and open-evenings. Facebook has a great feature which allows the user to advertise events and allow friends to confirm whether they are or are not attending. For those who aren’t yet sure, there is also a “maybe” selection. So if your practice is holding an open evening then advertising it on Facebook could get many places filled!
It is even possible to post photo albums of “before and after” photos and Smile Makeovers. That is an exciting prospect and is bound to attract curiosity from potential new patients or existing patients who just need that little push to get them to book that Veneer Prep. Videos can also be uploaded so posting real video testimonials is a great marketing tool. It is important to remember that patient consent must be received to use any photographs or videos.
It is also great to post photographs of the team enjoying team outings and events such as a team-building night out or photographs of the team beaming whilst accepting an award etc. It is a great opportunity to show your patients that you are in fact human as well as Dental Care Professionals and you enjoy what you do. This allows the patients to connect to you and think, “Actually, they are really nice, fun people!” This may well put a potential patient at ease and give them the confidence to come and see you.
Having a Practice Blog via Twitter is also a great way of advertising yourself and also keeping patients and non-patients informed of the latest news. Having a blog is also another great way of reaching out to your patients. Blog about recent team outings and events, blog about successful training sessions, blog about anything that allows the patients to relate to you! You can attract followers who are non-patients but simply want to know what is happening at your practice. Chances are they will join you at some point, when they are ready. In the meantime however it is a good idea to keep them impressed with your practice and possibly giving you a mention to their friends and family. Many Dentists are having their own personal blog now in order to give professional advice and “tips of the day” for their patients and potential patients.
Aside from applications, it is absolutely vital in this day of age that your Dental Practice has a decent website. With most people browsing the net for Dental Practices rather than looking through the phone book, it is crucial that you stand out. A professional, yet different and interesting website is much more appealing for a potential patient than your average generic website. Some of the best websites I have seen have the following features:
• Virtual Tours of the Practice
• Video Testimonials
• Online Shop
• Live Chat Feature or “Ask The Dentist” Feature
• Online Smile Evaluation and Medical History forms
• Press and Media Articles/Video Clippings
So, love it or hate it, Social Media has officially taken over and we need to take full advantage of it in order to stay successful in the ever-progressing world of Dentistry!
Emma Lever-Pilling RDN.
 Social media has had a massive effect on the world and has recently become an obvious way forward for the promotion of Dentistry. Applications such as Facebook, MySpace and Twitter are being used every single day and Facebook in particular has over 400 million users. With that many people logging on to these sites every day, the likelihood of a fraction of these people wanting either general or cosmetic dentistry is considerably high, so why not promote your Dental Practice through a social networking site?
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The GDC has made the decision... |
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The GDC has announced that DCP (Dental Care Professionals) annual retention fee will rise ( as of next due, 31 July 2010).
The new fee will be £120 compared to £96 which will amount to an extra £2.00 per month.
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Career Pathways for Dental Nurses. |
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Qualifying as a Dental Nurse is only potentially the first step in a long and successful career. There are many options for Dental Nurses to take these days and being a Dental Nurse has never been so exciting. Dental Nursing alone has rapidly evolved with Nurses being able to become more involved in treatments by helping the Dentist with impression-taking for example.
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Registering with the CQC... |
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The government plans to register all dental professionals – including dentists, nurses, hygienist, therapists, dental technicians and orthodontic therapists with the Care Quality Commission (CQC) by April 1, 2011.
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Books we recommend |
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Equip and empower yourself with vital information for dental nurses. Advanced Dental Nursing
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Team building and maintaining good working relationships |
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Team building and maintaining good working relationships.
Seeing as most of the population spend more time at work than they do at home, it is vital that we feel happy and confident when we are working. Team building is essential to reach these goals. Team building is a process that involves developing cooperation, motivation, trust and respect among the team members. Team members work well together when everybody is working to achieve a common goal. It is good to make a list of practice goals for which everybody plays a part in achieving, e.g. winning a dental award or reaching targets in order to receive a bonus. Regularly reviewing these goals keeps people motivated and working hard together to achieve them. Employers should encourage team members to make their own personal goals too- this is something that can be discussed in annual appraisals. By having personal goals, we are always working towards something positive.
Some examples of team building are:
• Monthly team meetings.
Having an hour long team meeting once a month allows everybody to sit down together and discuss any issues regarding the practice and team. Regular team meetings enables everybody to feel up to date with the latest news and gives people the chance to voice their opinions/concerns etc. Issues that are often discussed at team meetings are ways in which we can improve our performance and areas that can be improved, upcoming news and events and practice productivity. It is a good idea to have two people taking the position of facilitator and recorder for the duration of the meeting. The person facilitating can lead the meeting whilst the recorder can make notes and then write them all up and hand out minutes to each team member. At the following team meeting, the previous issues can be reviewed and hopefully be identified as resolved. It is a nice idea to have an extended lunch at a team meeting so that lunch can be ordered in, making the meeting an enjoyable experience.
• Morning huddles.
Morning huddles are a great way of preparing and motivating the team for the day ahead. Everybody should have a copy of their diary and can update the team on anything significant, such as, “Mr X has referred his wife for a consultation, we must not forget to thank him when he arrives” or “Mrs Y’s lab work is being delivered this afternoon.” Topics that can be discussed at morning huddles are practice daily productivity, issues with patients, phone calls that need to be made that day etc. If there are any new patients attending the practice then the team can be made aware of this. It is also a good idea to point out any particular patients that could be asked to pass on some referral cards to friends and family, e.g. “Mr X is coming for a review on his new veneers, maybe we could ask him to pass on some of our cards to friends and family who may be wanting a similar service?”.
• Regular training sessions.
It is a good idea to hold regular training sessions to keep everybody up to date and performing to the highest standard. Keeping everybody highly trained maintains confidence in each person, therefore maintaining a confident team. Regular training in the following areas can be beneficial to the team:
• Cross infection
• New treatments and techniques
• Patient communication and phone skills
• Practice promotion
• Team activities.
Team activities help keep relationships strong and build trust among team members. It is good to spend time with each other away from the workplace every so often as people tend to relax more and it is a good opportunity to find out more about each other. Team activities often include:
• Having a nice meal and a few drinks together
• Watching a show
• Going for a day out somewhere, for example, Alton Towers
• Visiting a Comedy Club
• Appraisals.
Having annual appraisals is a great way of the management team and team member communicating to each other about job performance and satisfaction. Appraisals tend to be conducted in a quiet, private, informal environment in order to put team members at ease. It is the duty of the employer to inform the team member on their performance in the last year and discuss possible strengths and weaknesses the person has and how weaknesses can be overcome. Team members need to be made aware of any aspect of their job that they are doing particularly well and also not so well because if their performance could be improved in a certain area then they need to be told in a friendly and constructive manner. Also discussed at appraisals are:
• Aspects of the job that the team member likes.
• Aspects of the job they do not like.
• Ways in which they could possibly improve their role.
• Any concerns or issues they might have.
• Their successes from the past year.
• Any further training or development they would like or feel they require.
• Professional and personal goals.
Strengths and weaknesses.
It is important to remember that everyone has their strengths and their weaknesses. In order to work well as a team it is vital that people are given jobs and responsibilities that they are able to do to a high standard. For example, there is no point in giving Miss X the duty of updating the website weekly if she has little experience with computers. This would make Miss X feel stressed and lacking in confidence. However Miss X is very organized and patient, so she would feel happy and confident doing the weekly filing and scanning of documents instead. When we have stressful days at work it is very easy to see each other’s faults and concentrate on them instead of the good qualities. This does nobody any good, it can make us feel inadequate and stressed if we know that only our faults are being noticed. Try to recognize the positive qualities of your colleagues and you will immediately feel better at work.
Communication.
Communication is the key to maintaining good working relationships. It is important that everybody knows how to communicate with each other effectively so there are never any misunderstandings. There is often hostility between people in working environments and a lot of this hostility can be put down to poor communication. Yes, there are bound to be people that simply do not get on, however with good communication, there is nothing stopping them working together as colleagues and reaching for the same professional goals.
Body language can say a lot when you are speaking to someone. It is important that you are looking into the eyes of the person you are communicating with. This signals to them that you are listening to what they are saying. It is also important that you show you are listening with your body language. If you are speaking to a colleague but have your body turned away and your fingers drumming on the table, the chances are that sub-consciously you are not listening and this really does come across.
If you are talking to somebody and they have said something important, e.g. your Dentist asks you to put something in the order book, and you are not listening effectively, then this could lead to problems. You could forget all about it or get to the order book and forget what product it was that needed ordering. If you know that you can be a bit forgetful then write it down. Writing notes increases our ability to remember things more accurately and reduces the risk of forgetting by 90%. Another way of increasing our ability to remember is by repeating the tasks that we need to do, so when the Dentist asks us to put something in the order book, say aloud, “I need to put that in the order book”.
It is wise to avoid cliques at work as this can cause possible conflict among team members. It can also lead to breakdown in communication. It is better to get on with everybody equally and treat everybody the same in order to prevent any upset or conflict among team members. It is fine to have a chat and a laugh at work but ultimately we are dental professionals and must conduct ourselves in a respectable, professional manner.
 Seeing as most of the population spend more time at work than they do at home, it is vital that we feel happy and confident when we are working. Team building is essential to reach these goals. Team building is a process that involves developing cooperation, motivation, trust and respect among the team members. Team members work well together when everybody is working to achieve a common goal. It is good to make a list of practice goals for which everybody plays a part in achieving, e.g. winning a dental award or reaching targets in order to receive a bonus. Regularly reviewing these goals keeps people motivated and working hard together to achieve them. Employers should encourage team members to make their own personal goals too- this is something that can be discussed in annual appraisals. By having personal goals, we are always working towards something positive.
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What is a Treatment Co-ordinator? |
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What is a Treatment Co-ordinator?
A Treatment Co-ordinator (TCO) is a member of the team who looks after patients with regards to their treatment plans and the fees involved. Basically, a TCO relieves the Dentist of the duty of discussing treatment and the fees involved in order for the Dentist to focus solely on delivering dental treatment. TCO’s are only really necessary in private practices where money is more of a concern to patients.
The job of a TCO involves a lot of responsibility and effort. It often takes a certain character to be a TCO, someone who is naturally good with people and can put them at ease. A TCO also needs to be patient, understanding and empathic as when dealing with patients, especially nervous patients; it is not uncommon for situations to become difficult. For example, a nervous patient comes for a consultation in order to be told that she needs all of her upper teeth taken out and a denture fitted and that if she came 10 years ago then this wouldn’t be necessary. In this sort of situation, the patient could become very upset, cry and need support. A TCO needs to be able to sympathise with the patient and offer them reassurance, whilst focussing on the goal of booking this patient in for the appointment and securing a payment.
Duties of a TCO:
• New patient journey
• Treatment presentation
• Discussing treatment plans with existing patients
• Recording daily diagnosed and accepted figures
• Following up outstanding treatment
• Conducting free smile consultations
• New patient journey:
The TCO should conduct the new patient journey from start to finish. This involves taking the initial phone call to booking appointments and securing payment. The first stage is taking the phone call. Excellent phone manner is essential. Once a patient has expressed interest in joining the practice, it is necessary to explain what kind of practice you are, e.g. denplan, practice plan etc., and the benefits of joining.
It is also a good idea to promote your practice and try and entice the potential patient along. If the patient is unsure as to whether they want to come for a consultation, take their name and address and offer to book them in for a free smile consultation (see section on free smile consultations) or send them an information pack. It is also important to find out about the patient and try to connect with them on a personal level. Ask what their concerns are and what it is they are looking for, be it general dentistry or a smile makeover so that you have a bit of information about them before they attend. Explain the consultation process and the fee. It is always a good idea to take a deposit over the phone or ask the patient to come into the practice with a deposit in order to encourage them to attend as you don’t want to risk the patient changing their mind and wasting an appointment. At the end of the phone call, explain that you will be sending them a welcome pack with their appointment card and receipt (if deposit was taken over the phone) and it is always a nice idea to ask them if they would like a drink on arrival. This makes the patient feel special and is all part of the first class service patients expect with private treatment.
What should I put in a welcome pack?
A welcome pack should include:
• Welcome letter.
• Information about the practice.
• If patient expressed interest in a particular treatment, e.g. Invisalign, put some information about it in the pack.
• Medical history form.
• Smile evaluation form.
• Appointment card.
• Receipt.
• Testimonials.
On arrival, the patient must be greeted warmly by the hand of the TCO or receptionist and either handed their choice of drink or offered a drink. Once the patient has had a few minutes to settle with their drink, the TCO will give them a guided tour of the practice and then escort them to the consultation room. For the first half hour or so, the TCO will discuss with the patient their medical history and smile evaluation forms, find out what the patient’s goals are for their mouth and what it is they would like from your practice. The TCO will make notes of this. At this first stage of the consultation, it is useful for the TCO to take some extra-oral photographs of the patient and their teeth in order to keep on their record. If the Dentist has a camera for cosmetic cases, it is worthwhile he/she training the TCO in photography, as this is yet another job the TCO can relieve the Dentist of. Once all information and photographs have been taken, the TCO can escort the patient into the reception area and ask them to take a seat while the treatment room is being prepared for them. At this stage, the TCO will explain to the Dentist the patient’s situation and dental background so the Dentist is prepared for the patient. It is necessary at a consultation to have the following:
• Mirror, probe, periodontal probe and tweezers.
• Bitewing sensor and holder.
• Intra-oral camera.
• Photographs on the screen that were taken earlier.
The TCO will then escort the patient to the treatment room and introduce them to the Dentist. If the TCO is a Dental Nurse then they can assist during the consultation to chart and assist with the x-rays, if not then another Dental Nurse can be doing this instead. Consultations can include an assessment with a Hygienist. If this is the case then the TCO will escort the patient up to the Hygienist after seeing the Dentist and then collect the patient at the end of the hygiene assessment.
Once the Dentist and Hygienist have both completed their assessments then they can put a treatment plan together for the patient. If the treatment plan is fairly simple and straightforward, then it is absolutely fine to discuss it with the patient there and then. If the patient accepts treatment, then appointments can be booked, payment can be arranged and membership discussed. However if the treatment plan is quite complex, then it is wise to invite the patient back for a treatment presentation.
• Treatment Presentation:
If a treatment plan is particularly complex or expensive then inviting the patient back for a presentation is a great idea because it adds value to the treatment. The patient is made aware that the Dentist has had to take time out of his/her diary to carefully study their x-rays and photographs in order to create a plan just for them.
Before the patient arrives, have their treatment plan(s) ready and any demonstration models, before and after pictures, testimonials etc. ready.
It is also a great idea to present the patient with a computerised presentation that can be burnt onto a CD for them to take away and view at home. Microsoft PowerPoint is a great program for this. You can create slides with descriptions of the treatment you are proposing for the patient and include images of their x-rays and photos highlighting areas of concern. You can also include at the end the stages of treatment and the fees involved.
It is really the TCO’s job to fully explain what the Dentist and Hygienist have recommended for them and the reasons why. Also to be discussed are the fees involved, any discounts that can be offered and payment options etc. If your practice offers finance, then the TCO can set this up at this appointment if the patient wanted finance as their payment method. If the patient accepts treatment then appointments can be made and payment can be arranged. Alternatively, if the patient wants to think about the treatment, then you can arrange a courtesy call a week later to see if they have made a decision. If the patient declines treatment then you can ask them why and see if there are any obstacles that can be overcome- e.g. “I can’t afford that, I can’t proceed with treatment” can sometimes be overcome with, “Well did you know that we can spread the cost over 12 months interest-free?.” If the patient still declines after you have tried to solve any issues they have then you can just update their record and explain that they are welcome to come again if they change their mind.
• Discussing treatment plans with existing patients:
If a regular patient requires treatment after an examination with the Dentist, it is a good idea for the Dentist to request that the TCO come and collect the patient from the treatment room and escort them to the consultation room to discuss the treatment plan in private. The Dentist will inform the TCO, in front of the patient, of the patient’s situation and ask the TCO to look after the patient from that point. The TCO will explain again to the patient the treatment needed (or requested if cosmetic) and the reasons for it. This gives the patient the opportunity to ask questions that may have forgot to ask the Dentist or may have felt too embarrassed to ask. The TCO can inform the patient of the cost of treatment, discuss which payment method would be best for the patient and book an appointment. Similarly with new patients, if the patient needs time to think about it then you can arrange a courtesy call and if they decline then you can try and clear any obstacles that they may have in order for them to book in for their treatment.
• Recording daily and monthly diagnosed and accepted figures:
It is important that as a TCO we keep track of the treatment that has been diagnosed each day and the acceptance rate. An excel spread sheet is the best way to do this and should have the following columns:
• Month treatment was diagnosed.
• Name of patient.
• Treatment provider, e.g. Dentist or Hygienist.
• Treatment diagnosed.
• Cost of treatment.
• Whether it was accepted, left outstanding or abandoned.
At the end of each day, all the treatment plans that were presented to patients (new and existing) should be collected and logged onto the spread sheet. Once this has been done, you can total up the amount diagnosed and come up with a percentage of the accepted treatment. E.g. Treatment diagnosed comes to £2000, £1650 was accepted- unfortunately Mr X declined a crown. To figure out the percentage of accepted treatment, just divide £1650 by £2000 and multiply by 100. This gives a total percentage of 82.5%. This figure should ideally be given in the following morning meeting. If your practice does not have morning meetings then you can give this figure to the Dentist or Practice Manager daily or weekly. In your monthly meeting, it is a good idea to provide monthly diagnosed and accepted figures.
Following up outstanding treatment:
It is important to keep a record of all patients that have been given a treatment plan and not booked an appointment due to wanting to think about it or not booking in straight away as they are going on holiday etc. This can easily be achieved by keeping an outstanding treatment file. This can be made using an excel spread sheet which should have the following columns:
• Date treatment was diagnosed.
• Name of patient.
• Treatment provider.
• Treatment diagnosed.
• Notes (so that you can make relevant notes such as “left voicemail, to call again next week” or “call patient when they get back from holiday next month.”
This file should be referred to regularly so that you know where each patient is up to with regards to their treatment. Ways of contacting patients are a courtesy phone call, letter to remind them of their treatment and reminder email or text. If patients have been on the file for a while, you could think of enticing them back for their treatment by sending them an offer such as “10% off cosmetic treatment only for this month” if the practice has an offer on.
Conducting free Smile Consultations:
A Smile Consultation with a TCO is a great way of allowing a potential patient to decide whether they would like to join the practice and find out whether the practice provides the treatments that they are interested in and whether they are affordable, without wasting theirs and the Dentist’s time. If the patient decides that they are serious about having treatment with you, then you can book an appointment for them with the Dentist, knowing that the chances of treatment acceptance are high. A Smile Consultation with a TCO should be about 30 minutes and involve a guided tour around the practice, a chance to meet the team and a discussion about the kind of treatments we offer and the fees involved with the TCO.
A Treatment Co-ordinator (TCO) is a member of the team who looks after patients with regards to their treatment plans and the fees involved. Basically, a TCO relieves the Dentist of the duty of discussing treatment and the fees involved in order for the Dentist to focus solely on delivering dental treatment. TCO’s are only really necessary in private practices where money is more of a concern to patients.
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Holistic Dentistry |
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Holistic Dentistry
With holistic therapies becoming more and more popular, it was only a matter of time until they reached Dentistry. With certain therapies such as Reiki Healing and Acupuncture being introduced into the NHS, holistic therapy is becoming recognized as a great, non-invasive way to relieve anxiety and improve health.
Many Dentists' are introducing holistic therapies into their dental practice by hiring a therapist or holistic-trained Dental Nurse- some Dentists are even choosing to provide these services themselves and referring to themselves as "Holistic Dentists".
"Holistic Dentistry" basically means that the clinician views the health of the mouth as part of the general health of the patient. Rather than relying on general medicine to cure the problem, it is thought that natural supplements and healing can do this instead. Of course there are certain situations where conventional medicine is needed however.
Holistic therapies that are currently being offered in dentistry are:
Acupuncture:
Acupuncture involves inserting tiny needles into certain points of the body to alleviate pain and sickness and promote good health. It can be used during pregnancy to help ease labour, to help with joint/muscular problems and even help alleviate the unpleasant symptoms of cancer treatments such as chemotherapy. Acupuncture originates from China originally and is now very popular in the west.
Acupuncture can help dental patients by:
• Reducing the pain/swelling from invasive treatment, particularly surgical.
• Easing fear and nerves prior to appointments.
• Helping patients control a particularly strong gag reflex.
• Easing jaw pain.
Homeopathy
Homeopathy involves the use of natural remedies to help the body to naturally heal itself. On visitation to a Homeopath, he/she will take a detailed account of your situation and prescribe you with natural remedies which can come in lots of different forms. Some common remedies include Aloe Vera, Chamomile, Clover and Tea Tree Oil. Homeopathy can help dental patients by:
• Helping with pain relief. A common remedy for pain relief is Clover.
• Soothing inflammation pre or post-treatment. A common remedy for inflammation is Willow Bark.
• Helping to treat oral infections or abrasions. A common remedy for oral infections, e.g. Herpes; is Lysine.
• Helping to alleviate fear/anxiety. A common remedy for anxiety is Phosphorus.
• Aiding the body's natural healing process. A common remedy for the promotion of natural healing is Black Walnut.
Reiki Healing
Reiki is an ancient form of healing which originated in Japan and works by clearing the seven major chakras (energy points) of any blockages that can cause physical, mental or emotional symptoms. Reiki means “universal life force”. Universal life force represents an unlimited supply of energy which once tapped into, flows through the body and cleanses on every level. Reiki helps heal physical illness whether it is acute or chronic and because of this can help dental patients greatly. Having Reiki healing is deeply relaxing and involves being lay down for about an hour whilst the practitioner places their hands on certain energy points in the body. Reiki can help dental patients by:
• Helping put patients at ease and relax them before or after treatment.
• Helping to conquer fear or anxiety of dentistry.
• Encouraging the body’s natural defences to speed up recovery after a treatment which has caused trauma to the mouth such as a difficult extraction or implant placement.
Aromatherapy
Aromatherapy is an alternative therapy that involves the use of oils specifically extracted from plants. These oils are called essential oils and the use of them varies from lifting one’s mood to helping improve one’s health. Aromatherapy works in two ways; the aroma from the essential oils has an influence on the brain, so for example, it can make you feel better if you are down and also because the oils are directly extracted from plants, they can have healing and medicinal properties.
Aromatherapy complements dentistry very well. The last thing a patient wants to smell when they enter a dental practice is disinfectant or the smell of burning acrylic after a denture ease! Having some form of scent machine such as a diffuser would make a big difference to how patients perceive dentistry and would make the practice a much more welcoming place. Gently massaging essential oils into the temples is also another great way of relaxing and easing the patient.
With holistic therapies becoming more and more popular, it was only a matter of time until they reached Dentistry. With certain therapies such as Reiki Healing and Acupuncture being introduced into the NHS, holistic therapy is becoming recognized as a great, non-invasive way to relieve anxiety and improve health.
Many Dentists' are introducing holistic therapies into their dental practice by hiring a therapist or holistic-trained Dental Nurse- some Dentists are even choosing to provide these services themselves and referring to themselves as "Holistic Dentists".
"Holistic Dentistry" basically means that the clinician views the health of the mouth as part of the general health of the patient. Rather than relying on general medicine to cure the problem, it is thought that natural supplements and healing can do this instead. Of course there are certain situations where conventional medicine is needed however.
Holistic therapies that are currently being offered in dentistry are:
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Get your bread, milk and a scale & polish.... |
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Go to tesco to get your bread, milk and a scale & polish....
Following Sainsbury’s example, Tesco is planning to open the first dental surgery, within a supermarket, in Glasgow, Scotland.
Statistics show that Glasgow have one of the worst records of dental health in Scotland.
Approximately three out of four children, below five years of age,undergo dental treatment including dental extractions and treatment for tooth decay.
Sainsbury’s opened their first dental clinic in store in 2008. Open seven days a week, the surgery has been flooded with patients and was said to be "making dental healthcare more accessible and convenient to better meet patients' needs."
David Gilder, of Sainsbury's, said: "There is a shortage of dental practices in the UK and the launch of this new service goes some way to providing local people with greater access to dental advice and a range of procedures."
 Following Sainsbury’s example, Tesco is planning to open the first dental surgery, within a supermarket, in Glasgow, Scotland. Statistics show that Glasgow have one of the worst records of dental health in Scotland.
Approximately three out of four children, below five years of age,undergo dental treatment including dental extractions and treatment for tooth decay.
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Dental nurse receives £200,000... |
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A dental nurse received damages of £200,000 after contracting occupational dermatitis, caused by the gloves she was wearing.
After working for the NHS for over 30 years she was shocked to have to retire at age 50.
The dental nurse wore powdered and non- powered latex gloves in the surgery. In 2004 she was diagnosed with her condition by her doctor. She initially went to see her doctor in 2003, complaining of itchy wrists.
'Caroline Bedale, UNISON Branch Secretary, said: “Latex products are a known danger to dental and other healthcare workers because they are at increased risk of latex allergy. This case demonstrates the critical importance of all employers having proper policies, not only to protect staff from developing latex allergy, but also for the safe handling of patients with known or suspected latex allergy.”¹
'Commenting, the woman’s representative at Thompsons Solicitors, Imogen Wetton, said: “The impact of a latex allergy causes no end of difficulties for sufferers. My client cannot wear jewellery with nickel in it, nor can she wear any clothes with metal zips. She has to avoid any rubber handled items and wear cork inner soles. She has to sleep with cotton gloves on and has to regularly apply steroid creams. She has to avoid washing up and ironing. She can’t even use the TV remote control as it has rubber buttons. The list goes on and on and it’s a living nightmare for sufferers.'²
1http://www.thompsons.law.co.uk/ntext/damages-latex-allergy.htm
2 http://www.thompsons.law.co.uk/ntext/damages-latex-allergy.htm
A dental nurse received damages of £200,000 after contracting occupational dermatitis, caused by the gloves she was wearing.
After working for the NHS for over 30 years she was shocked to have to retire at age 50.
The dental nurse wore powdered and non- powered latex gloves in the surgery. In 2004 she was diagnosed with her condition by her doctor. She initially went to see her doctor in 2003, complaining of itchy wrists.
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DNN Magazine 
Heart your Smile