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Dental Tribune United Kingdom Edition

A s we slowly move out of the naughties and into the teens our expecta- tion of change within the world of NHS dentistry is marred by the troubled early years of the 2006 dental contract. Since its dawn, much of the discussion regarding the system has fo- cused on one thing: what will be replacing it? The economic crash has meant that finances to fund this change have been restricted and that any change is most likely to be in the sec- ond half of the teens, as po- litical will is diverted towards fixing broken Britain, both eco- nomically and socially. The teens may end up being a rebellious period for dentistry and we may have to wait until the twenties before we can trust the architects of the new-new dental contract to make sensi- ble decisions. So why the title The Good the Bad and Regulation? Well, as a profession that is constant- ly changing and required to meet the highest of standards, in my opinion the decision making over what regulations are needed should also meet the highest of standards. Good regulation does more than set a benchmark; it drives the profession in a positive di- rection. It is without doubt in everyone’s interest and histori- cally has been embraced well by dental professionals. Ever since Joseph Lister introduced car- bolic acid (phenol) to sterilise instruments and clean wounds, medicine has always looked for evidence that can help save pa- tients’ lives. So when the Scot- tish government announced that primary care dentists in Scotland will not be required to use vacuum sterilisers because there is a lack of evidence that they would increase patient safety, the question that natu- rally arises is: where was the evidence that they were better in the first place? Bad regulation ends up cost- ing more than just money - it instils a great deal of future mis- trust between the government, dentists and patients. We all rec- ognise that the cost of complying with regulations is increasing and as such it is only natural to question their necessity and ef- ficacy. For example, if we look at the regulations which state our need for Legionella testing, to what extent is this actually good for patients? Could the finan- cial and time burden involved in carrying this out be better spent? At what point do we say we shouldn’t do this because the risk of this is so small that we probably expose ourselves to a greater risk by getting up and going to work? Perhaps the question we need to ask is: what level of risk are we prepared to accept? Apart from lining the pock- ets of those with vested inter- ests, with many of the so called ‘best practice’ regulations it is hard to see a decent cost/ben- efit to patients. But bad regula- tion doesn’t just stop with cross infection; within the last couple of months Health Service Om- budsman Ann Abraham pub- licly named and shamed a den- tist for failing to apologise to a patient who claimed that he had been rough and had hurt her The Good, the Bad and Regulation Neel Kothari discusses the thorny issue of regulation in dentistry ‘At what point do we say we shouldn’t do this because the risk of this is so small that we prob- ably expose our- selves to a greater risk by getting up and going to work? September 5-11, 201114 Comment United Kingdom Edition14 Ems-swissqualitY.com Versatility, utmost Swiss precision and “Best interproximal and subgingival access” (CRA – Clinical Research Association, USA): these attributes and characteristics help explain why this forerunner among ultrasonic instruments suits nearly 90% of all scaling applications. 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