Dental Tribune United Kingdom Edition

About the author Neel Kothari quali- fied as a dentist from Bristol Uni- versity Dental School in 2005, and currently works in Sawston, Cam- bridge as a princi- pal dentist at High Street Dental Prac- tice. He has completed a year-long postgraduate certificate in implantol- ogy and is currently undertaking the Diploma in Implantology at UCL’s Eastman Dental Institute. D espite the many re- wards of being a den- tist I have always felt that, overall, ours is a lonely profession. The stress of day to day decision making, potential litigation and the practice of defensive dentistry is enough to keep anyone busy, but add on the stress of complying with non clinical organisations such as the CQC and having to nod politely with the sheer mass of risk assessments, practice policies and legislation, this is simply enough to suck the soul out of any person. Fellow editorial board member Stephen Hudson once told me that all you re- ally need with your patients is rapport, “no one sues you if you have rapport with them”. At the time I politely nod- ded and pretended to agree, however as time went on I found myself strangely drawn to that statement and have tried to improve my rapport with patients ever since. I don’t know if this will reduce the future risk of complaints or litigation, but I can certainly say it has made day to day working a slightly happier en- vironment. Since entering dental school I was always told that dentists have the highest suicide rates amongst all professions. I’m not completely sure whether this is in fact true, however a number of authors have raised the issue of suicide and have highlighted its prevalence. A literature review published in the International Dental Jour- nal by Sancho and Ruiz (2010) looking at whether the risk of suicide amongst dentists is a myth or a reality came to the conclusion: ‘In the litera- ture we find systematically a suicide rate among dentists higher than those of other oc- cupations. These studies lack the correct scientific weight and new studies are required that introduce the demograph- ic variables, the psiquiatric morbidity previous to the de- velopment of the profession, the opportunity factor, the stressors not related to work and the relative emphasis to these are necessary to for the profession to decrease the risk of suicide.’ Last December dentist Dr Kamath committed suicide after feeling “harassed and bullied” by health chiefs over standards of record keeping at his practice in Leeds. Dr Kamath was under investiga- tion by NHS, Airedale, Bradford and Leeds over the keeping of his records and his suicide prompted calls for an imme- diate inquest. The inquest at Wakefield heard father-of- three Dr Kamath feared for his career and that the trust had threatened to refer the practice to regulatory body the General Dental Council. The inquest also heard how fol- lowing two minor complaints about the dental practice, the primary care trust decided to conduct an audit of 30 of the practice’s patients and how Dr Kamath committed suicide just five days after a meeting with PCT officials. In a statement read to the court, wife Dr Rajni Prasad de- scribed how the couple felt af- ter their last meeting with the trust: “My husband and I were both very stressed by this and both felt very vulnerable and harassed and bullied with no support offered.” The need for support is an absolutely essential part of our profession and I for one am sick and tired of gov- ernment officials telling us how intelligent dentists are every time they want to en- force a new change. Our den- tal school training doesn’t teach us why or how to do a legionella risk assessment or why I find it easier to access my bank account online rather than the NHSBSA website to update and verify my pension contributions! It teaches us the foundations of clinical dentist- ry instead. It really bugs me when dentists are asked to put their professional integrity above all other incentives but are not supported in doing so. For in- stance, in 2011 the House of Commons Health Select Com- mittee suggested that whistle- blowing should be a statutory duty for all NHS employees. The proposal was to make it a ‘professional obligation’ upon all healthcare workers to re- port colleagues they suspect of poor practice or miscon- duct - and if they failed to do so, they would themselves face disciplinary action. However at the same time the Committee said they were well aware that some doctors and nurses who have blown the whistle have ‘sometimes been subject to suspension, dismissal or other sanctions’. Over the course of our professional careers we will all encounter situations out- side of our control that must make us question whether or not we should raise our con- cerns to higher powers. Whilst on face value it may seem that this decision should be an easy one, in reality very few people actually do whistle blow and those who do are not always met with welcoming arms. At the risk of stating the obvious it is clear that the business of dentistry is a very stressful one and it probably always has been. It’s diffi- cult to point the finger at one specific part of the job that brings rise to such stress, but in my opinion dealing with the non clinical business side of things brings rise to many more problems than the healthcare side we were taught at dental school. For most of us, creating happiness within a workplace clearly involves more than just a monetary reward and unfor- tunately having to comply with the raft of legislation imposed upon the profession such as HTM01-05 and CQC in- spections simply claws away just that little bit more happi- ness from our day to day work- ing lives. Stress in the dental profession Neel Kothari discusses the stress that comes with practising dentistry ‘It really bugs me when dentists are asked to put their professional integ- rity above all other incentives but are not supported in doing so’ The University Hospital in Copenhagen offers a 2 days course in: RESTORATIVE TREATMENT AFTER SEVERE DENTAL TRAUMA AN EVIDENCE BASED APPROACH 4th copenhagen trauma symposium U. PALLESENJ. ANDREASEN E. LAURIDSEN L. BAKLAND L. ANDERSSON K. GOTFREDSEN O. MALMGRENT. KOFODS. JENSEN Registration fee: DKK 2850,- (€ 380) www.dentaltraumaguide.org/registration.aspx It is a fact that approximately half of all traumas affecting the permanent dentition requires a restorative treatment, including various crown restorations or tooth replacement procedures. It is also known that many of these treatments have a very doubtful long- term prognosis. During this symposium 6 different restorative treatments, such as composite restorations, porcelain laminates, crowns and conventional bridges, implants and autotransplanted premolars used in the treatment after tooth loss, will be analyzed in detail and the most reliable treatments will be presented by 9 experts. September 19th - 20th 2014 Copenhagen, Denmark 10 Comment United Kingdom Edition May 2014