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All that's new in the world of dentistry
  Dentist Gone Badd was born in Birmingham but was raised by a family of three-toed sloths at Dudley Zoo. After dabbling in journalism for a decade, he decided to 'help mankind' and study dentistry. He qualified at Dewhursts, but don't hold that against them. Has been practising for 25 years and likes to keep one step ahead of the GDC by refusing t...o leave a forwarding address. He has progeny.  Follow his twitter feed at https://twitter.com/DentistGoneBadd More
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Simpler Times

Simpler Times

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A can of worms

A can of worms

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Only Dentistry Can Save the Earth

Carbon Footprint

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Pump up the Volume by @DentistGoneBadd

Pump up the Volume, a plea to the Chief Dental Officer (England) by @DentistGoneBadd

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JUL
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The New Health Secretary by @DentistGoneBadd

The new health secretary

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JUN
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Increased Dental Litigation

Increased Dental Litigation

(Is It ALL Down To Patient/Lawyer Greed?)

By DentistGoneBadd

“This theory which belongs to me is as follows. Ahem. Ahem. This is how it goes. Ahem. The next thing that I am about to say is my theory. Ahem. Ready?”

Anne Elk (1973) Monty Python’s Flying Circus


It was a glorious September afternoon in 1966. The sun was streaming through gleaming windows. England had won the World Cup, and I had just moved to an exciting and brand new senior school. The classroom had spanking new desks with inkwells, filled with free ink you could draw up into your refillable Parker fountain pen. All was well with the world.

Mrs Wojciechowski, who was also our form teacher, was beginning our first ever French language lesson. I was trying hard to concentrate and confess I missed the meaning of ‘je m’appelle,’ because Peter Hadley who was sitting next to me, was crushing and drowning wasps in his inkwell, with what I regarded as an inferior fountain pen – the sort that scratched, rather than flowed Quink luxuriantly on to the page. Another failing of his pen was that as a tool for Vespidacide, it was failing miserably, one poor creature valiantly struggling to get itself out of the inky torture chamber. Not knowing at that point that Peter Hadley was a distant relative of a notorious Birmingham crime family and was destined to become the school’s head ‘hard-knock,’ I nudged him out the way and offered the tip of my pen to the bedraggled Hymenoptera, so that it had a means of escape from an indelibly inky death.

I suddenly heard a scream that sounded like a French woman shouting ‘murderer,’ but later realised I was in fact witnessing my first ever French swear-word - ‘merde,’ to be precise. I looked up to see Mrs Wojciechowski (French-born, despite her name) bearing down on our twin desk with a wooden ruler in her hand, and quicker than one of my Maryland bridges falls off, she had whacked the back my hand with the EDGE of the ruler, with all the might that her 4ft 6in frame could muster.

This episode was not only painful and a miscarriage of justice, but humiliating to boot and for the rest of that year, Mrs Wojciechowski looked at me with a deep loathing, like I had presented my dentist with the post-crown for recementing after I had retrieved it from the bottom of the Armitage Shanks two days after swallowing it. Upon realising I was under constant surveillance by Mrs Wojciechowski, I made sure I was never near a wasp, bee or inkwell ever again in that school.

I switched to a BIC not long after.

“My theory is along the following lines. Ahem."

We all know inherently, that it is becoming more and more difficult to avoid complaints these days, bombarded as the public is, with targeted Internet adverts and radio advertising. Even looking up and typing ‘dental complaints’ in Google as research for this article, brought up a host of dental litigation firm’s adverts on my Facebook page and various online news sites I read regularly, within an hour.

I strolled into a colleague’s surgery the other day to catch the end of a radio advert by ‘THEM’ – you know, the Cheshire-based mob, enticing dental patients to use them for all their dental litigation needs. I was appalled – I never listen to radio in the surgery – I just inflict my old-bloke’s iTunes playlist – from the Bee Gees to The Eagles to Snoop Dogg on my nurses day in, day out. It’s the reason I oppose permanent nurses, it means they don’t fatigue and burn out on my repetitious Barbara Streisand and Pussy Riot.

I couldn’t believe that these litigation firms were so ‘in-your-face’ with their radio ads, but my colleague confirmed that she heard them at least a couple of times a day and she often talks loudly over them to distract the patient in the chair from memorising the phone number.

Not only are civil claims mediated by the specialist dental litigation firms rising at a seemingly exponential rate (if you don’t believe me, look at your indemnity organisation’s annual subscriptions year-on-year), but cases brought to the GDC’s Fitness to Practice (FtP) process are also rising faster than caseworkers can write ‘dishonest’ on a charge sheet even if you haven’t been charged with dishonesty. From 2010 to 2014, FtP cases rose by 110 per cent. What the rise in civil and GDC cases is now, in the four years since 2014, is difficult to ascertain, but I feel it’s not outlandish to bet that the same rate of rise is probably not far out.

Most of us will know someone who is currently experiencing a spot of bother with the NHS Area Team, the GDC, or more likely, some chancer who has been taken in by a law firm who has found their supply of whiplash clients has suddenly dried up. A colleague of mine has recently been pursued by a patient claiming damages for a dry socket. Sheesh.

But, is the increase in patient expectations, fuelled by the easy access to no-win-no fee legal services, the only reason for the large rise in dental patient complaints?

“Ahem. This theory which belongs to me, is as follows. Ahem. Ahem. This is how it goes. Ahem. The next thing that I am about to say is my theory. Ahem. Ready?”

Well, here goes.

We all know nowadays, that the most important issue surrounding litigation is the paperwork. Have you recorded the BPE? Have you recorded why you are taking radiographs? Have you recorded why you aren’t taking radiographs? That’s what we’re obsessed with – getting the paperwork right so the statistical algorithms down at the NHSBSA don’t flag us up, or so we have a nice neat piece of work to show your defence organisation when they summon you for a day long grilling at a plush lawyer’s office in Lincoln’s Inn Fields.

But the whole reason you have ended up in trouble is that the patient wasn’t happy with your treatment (or some pig of a dentist who never liked you dropped you in it, but that’s another matter).

Have we taken our eye off the ball?

<

So. I would ask the question: Have we taken our eye off the ball?

“My theory is along the following lines. All brontosauruses are thin at one end, much MUCH thicker in the middle, and then thin again at the far end. That is the theory that I have and which is mine, and what it is too.”

Before 2006 and the introduction of the UDA-based ‘new’ contract, we all had, every few weeks, a sample of completed patients pulled by the Dental Reference Service and dragged into some God-forsaken community dental clinic, to have their work checked. The Dental Reference Officer (DRO) would check that you had a) carried out what you had claimed for, and b) done it nicely and hadn’t missed anything.

Admittedly, quite a few patients didn’t attend as requested (despite the fact they had consented to do so in the small print), but as a recent graduate, I was always quite on edge knowing that my work was going to be scrutinised by dentists that I considered by be my elders and betters. Dentists had the option of attending the DRO’s examination. In the main, I chose not to go. On one occasion, I did go.

And frankly, these checks focussed the mind. I was never accused of missing perio during that time, though I was once criticised for leaving a sub-gingival ledge the size of Chiswick on the distal of an upper six. Knowing that ANY patient could be pulled in for post-op examination by a DRO meant you left nothing to chance, even if you did note it. The DRO’s rebuke over the ledge, to my FACE, was like Mrs Wojciechowski’s ruler across the back of the hand. I have been very wary of ledges ever since. They have a nasty sting. I've missed LOADS of other stuff, but ledges are at a minimum.

I have no evidence for my theory, but I do wonder if the increasing litigation, particularly with regard to periodontal problems, could be as a result of there being no, what I would call ‘proper,’ check on the work carried out by dentists. (And this is by no means confined to NHS dentists). Even when cases against dentists go forward, patients are RARELY actually examined.

Anyway. That is my theory. That is what it is. Do we need to go back to DRO checks?

I would frankly, welcome them.

Epilogue

In 1983, after I had been at dental school for a year – some ten years after leaving school, I attended a summer garden party with my wife. Across the garden, I noticed a pair of latecomers. An elderly, tall, burly, Eastern European looking man with a shock of white hair, and a petite little lady of similar vintage, hanging off his arm. I instantly recognised Mrs Wojciechowski.

Encouraged by my wife, I approached her. My former teacher clearly didn’t recognise me ( l like to think I had by that time turned into a swan), so I introduced myself as one of her former pupils.

She said three words to me (this is absolutely true) and walked away:

“Oh **** off!”

And it wasn’t in French.

Quotations from Episode 31 Monty Python's Flying Circus BBC 1973
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JUN
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Dental Irritations by @DentistGoneBadd

Dental Irritants

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JUN
04
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I’m Sorry, But I Think You Need Therapy

europe

By @DentistGoneBadd


This is where I stand.

A few years ago, before David Cameron adopted the foetal position and waved the white flag to the advancing UKIPS, giving them the Brexit referendum, I was stopped by a ‘kipper’ in the high street of my adopted home city. I was asked if I wanted to forever remain ‘dominated’ by some ‘faceless European bureaucrat who would force us to consume straight bananas and live in dimly lit buildings powered by puny Dutch lightbulbs, or put the ‘Great’ back in Britain.

I answered thus:

“If I were the Prime Minister and had unlimited funds, I’d build a motorway bridge from here (the Midlands) directly to Paris.”

It was a nonsense answer – the sort that Donald Trump would have given – but I thought it got my point across. I am, and always will be, a European - a citizen of the world. I think Brexit is madness, and at a time when the world is becoming more and more fragmented, I strongly feel we need unity.

I’m Sorry, But I Think You Need Therapy

In the past couple of weeks, two of my closest dental friends – both from the EU, have indicated that they are thinking of returning to their countries of origin, having worked in UK dentistry for several years. Both were worried about the uncertainty surrounding their rights to residency – an issue still not absolutely clarified by the UK Government.

Another East European friend has recently left my corporate practice to go into independent dentistry, unable to cope with the madness of the NHS, UDA system. This has left the corporate practice critically short of clinicians and attempts to bring in either a permanent dentist or long-term locum has failed. (OK, fair enough, it IS a corporate after all). Many foreign dentists I have met have all been working for a UDA rate much lower than their home-grown counterparts and it is them in the main (it appears to me) that are prepared to work at a rate UK-born dentists would turn their noses up at.

One former corporate practice manager told me recently that she was told to offer prospective dental associates different UDA rates – foreign nationals being offered two pounds per UDA less than their UK counterparts.

Associate Shortages

I know of a number of NHS practices locally, which are currently struggling to find fully qualified associates of either UK, EU or other origin and this of course contributes to the lengthening of waiting lists and reception desk grumbling. With unattractive salaries on offer, particularly from the corporates, it is no wonder some practices are struggling to recruit. I once put myself on a few dental jobs websites and despite pleading to be taken off, am daily bombarded with all manner of associate jobs, from part-time to ‘whatever you can manage.’

Besides EU nationals going home as a result of Jacob Rees-Mogg, in 2017, a private Freedom Of Information request obtained from the General Dental Council showed that foreign dentist numbers dwindled in 2016, since nearly 40% of dentists who were found to have impairment of their fitness to practice originated from the EU or outside the UK and EU. This represented just over 3.7% of the total ‘foreign’ dentist workforce as contrasted to the 0.2% of naughty UK dentists based on 2018 registrant figures.

A search of the number of dental therapists in trouble with the GDC finds no such comparable statistics. Apart from one therapist in 2005 who was erased for performing a filling without a dentist prescription and one in 2013 who forgot to pay her Annual Retention Fee, there has been an exceptionally low rate of fitness to practice cases brought against therapists.

These days, since I work in a corporate, I meet very few therapists, but I have a very high opinion of them from personal experience. I will admit, I was forced into it because I couldn’t find an associate to move out into the sticks where my practice was located, but I employed a dental therapist in my own practice for a while a few years ago and her work was very good - providing a top-notch client service as well as taking patient appointment pressures off me. Her employment was also economically, a ‘no-brainer,’ being cheaper than employing an associate at 50% renumeration. I also trained with a mature dental therapist in the early 80’s. She flew through the dental course with ease, knocking spots of her classmates.

A Solution?

With many practices searching fruitlessly for fully-qualified post-vocational training dentists to replace fleeing dentists (for whatever reason), I wonder if we are missing a trick? Why not put these underutilised dental professionals to full use? Even the corporates haven’t caught on to this yet – presumably because they haven’t done the sums fully. Dental therapists can perform a wide range of tasks that can leave the corporate associates more time for searching for materials or stabbing the practice manager in the back. The only fly-in-the-ointment would be the stroppy associate who resents writing a prescription, but they can always be blackmailed with ‘OK. Do you want to do a radiograph audit after 5.00pm?”

In independent/NHS practice, remuneration would be a simple matter of a salary or hourly rate. In corporates, a nod to the associate’s prescription input would have to be acknowledged, so that he can get on to providing Band 3 mouthguards for someone who may have heard a vague click in their left TMJ in 1998.

Having said all that, I WILL miss my European colleagues if they do decide to go.

When I first met her, one of my EU friends was trying to pick up some British colloquialisms, mainly taught to her by her dental nurse, a girl with a mischievous sense of humour.

I arrived with my wife at the new house she was occupying with her now (British) husband. We had a lovely traditional meal from her home country, but then she apologised for the lack of furniture, and although we were perfectly comfortable at the dining table, she pointed to a couple of ample beanie’s in the lounge area and asked “Or would you prefer sitting on the douche-bags?”

David Cameron, what did you do?

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MAY
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Elf & Safety

Dental Elf & Safety

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More Post It Notes

More Post-it Notes

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MAY
07
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Dental Royalty

Dental Royalty

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GDPR reviewed by @DentistGoneBadd

GDPR in Dentistry

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Robots in Dentistry by @DentistGoneBadd

Robots in Dentistry

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Dental School Prospectus

Dental School Prospectus

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MAR
25
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Dental Tales from the Mall online

Dental Tales from the Mall Online

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FEB
05
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The Tale of a Dental Tyrant by @DentistGoneBadd

Safe air and fury

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JAN
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Enhanced CPD by @DentistGoneBadd

Enhanced CPD

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JAN
22
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Child Caries

Child Caries

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Recent comment in this post
Marian Greally

Loving your humour!

...sometimes there is a very fine line between laughing and crying or perhaps you could cry with laughter? Brush-Baby is a prov... Read More
Monday, 29 January 2018 10:15
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JAN
14
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Horrorscope 2018

Dental horrorscope 2018

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JAN
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Learn the Lingo

Learn the Lingo

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DEC
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Follow the ARF Money by @DentistGoneBadd

Follow the ARF Money

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DEC
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The TRUE Dental meaning of Christmas by @DentistGoneBadd

The TRUE Dental meaning of Christmas

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DEC
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CQC Latest Policies - In Pictures

CQC Policies in pictures

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DEC
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Notes - Post It?

Notes - post it?

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NOV
26
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12 Days by @DentistGoneBadd

The twelve days of Practice

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Perceptions

Dental Perceptions

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Dental Karma

Dental Karma

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NOV
06
1

Dentistry Is Not Immune From Harbouring Sexual Abuse. We Must Be Vigilant Too.

Dentistry Is Not Immune From Harbouring Sexual Abuse. We Must Be Vigilant Too.

As a Brit, I was both ashamed and proud of the revelations coming out of Westminster this week - ashamed that a small number of our elected representatives could act in such a grubby and misogynistic manner, but also proud of the way that the whole decades-long business is being exposed and acted on in an open way, even if it has been fuelled and inspired by our free press.  There was something typically British and admirable in Sir Michael Fallon’s quick decision to resign from his post as defence minister, as opposed to my disdain for the USA’s Orang-Utan in Chief who has a considerable number of accusations of sexual assault outstanding against him and is a self-confessed and unashamed “pussy-grabber.”

It’s become obvious from the ubiquity of the ‘metoo’ hashtag (#metoo) 

this week, that few walks of work life are free from sexual innuendo, threats and frank abuse and I have been wondering at what point the medical and dental professions will stand accused of similar behaviour either in the present or the past.  What follows, has bothered me for years. There was nothing I could do about it at the time, and nothing I can do about it now, but I felt it was time to at least illuminate the fact that dentistry is not immune from the abuse of women.

I trained in the eighties in a fairly well-known dental school. There was a reasonably affable relationship between the students and lecturers – there were some lecturers who were frankly, evil bastards and there were some who treated you as sentient adults and although you wouldn’t go out for a pint with them, you would say “Good morning” to them in a corridor without ducking into the nearest toilet facility.

Some lecturers (and yes, it IS males) however, had a closer than affable relationship with female students and it is one that I need to focus on.  This married lecturer was a reader in restorative dentistry and was a phantom head instructor.  He always seemed to have a pally relationship with the female students and before long it was rumoured that he was having an extra-marital affair with a young student in the year below me.  The affair became quite open within the dental school and he would often turn up at finals nights and exam celebration nights at Med Club.  I didn’t follow that closely, the ins and outs of the relationship, but since it was so well-known, I assume that the dental school authorities turned a blind eye to it since the female hadn’t protested.

A few months after I qualified and left the dental school, friends of mine who were still at the dental school separately told me that the lecturer and been frequently ‘bothering’ a new and attractive dental student in a sexual manner, to the point where the young woman went to the head of the restorative department to report it. 

She was later called to the Professor of the department where she found herself confronted by the Prof and the lecturer in question with the threat that if she were to take her complaint any further, they would ensure that she would fail finals.

I was told a few months later, that the young woman managed to find herself  a place at another university and transferred.  She apparently took her complaint no further.

I believe the head of the department is long retired (or hopefully dead), but the lecturer in question has risen to the heights, is nationally known, and is in active charge of students.

I didn’t know the victim, or even if she would have wanted to have taken this incident further.  The fact that I didn’t?  I am ashamed. 

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Don Gibson

Abuse

Wow. Unbelievable. I noticed an attempted close relationship between one of our female students and one of the prosthetic techni... Read More
Monday, 13 November 2017 19:08
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Personal Development Plan by @DentistGoneBadd

Personal Developent Plan

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OCT
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Dental Body Language

Dental Body Language

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OCT
10
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Fraud

Description goes Fraud - don`t be caught red handed.

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OCT
02
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CPR Training by @DentistGoneBadd

Hoe to survive CPR Training

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Dental Software by @DentistGoneBadd

Dental Software

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Breaking the News

Breaking the News

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Complete Dentures for Dummys by @DentistGoneBadd

Complete Dentures by @DentistGoneBadd

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More Danger than Prosecco? by @DentistGoneBadd

Prosecco

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Being a Dental Nurse for Dummys

Being a Dental Nurse for Dummys

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Dental Confidence Survey by @DentistGoneBadd

Dental Confidence Survey

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Crowns for Dummys

Crowns for Dummys

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Evil Genius - a guide to not being sued.

A guide to not being sued

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JUL
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Perio for Dummys

Periodontology for Dummys

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JUL
24
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Diary of a Wimpy Dentist (2)

Diary of a Wimpy Dentist (2)

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JUL
17
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Avoiding the Dental Police - for Dummys

Avoiding the Dental Police for Dummys

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JUL
10
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Confusion

Confusion

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JUL
03
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XLA for Dummys

Exodontia for Dummys

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JUN
26
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Patient Leaflet by @DentistGoneBadd

Patient Leaflet by @DentistGoneBadd

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JUN
12
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How to be a Patient

How to be a patient for Dummys

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Dental Body Language

Dental Body Language

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Ortho for Dummys

Orthodontics for Dummies

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Zany Principals

Bosses

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Endowontics made simple

Endodontics for Dummies

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08
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Believe

Believe

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MAY
01
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Dental Conspiracies

Dental Conspiracies by @DentistGoneBadd

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5455 Hits
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White fillings - - for Dummys

White Fillings - Theory & Practice

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Ask Auntie

Ask Auntie

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Labelling Patients

Labelling Patients

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Recent comment in this post
Julia Easton

Labels

Couldn't find these on SOE! My favourite in the days of paper notes was CPITN (complete pain in the neck)
Monday, 17 April 2017 08:41
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Final Exam MCQ by @DentistGoneBadd

Final Exam MCQ by @DentistGoneBadd

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MAR
27
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Liar Liar

Liar Liar

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MAR
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Dentistry - The Thief of Time

Getting Your Timing Right

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MAR
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Dental Occupational Health Risks

Occupational health

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Train Your Dentist

Train Your Dentist

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Room 101

Room 101

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4566 Hits
FEB
13
0

Dentist Stuff for Dummies

Everyfing

  7079 Hits

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7079 Hits
FEB
06
0

Patientspotting

Patientspotting

  6270 Hits

Copyright

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6270 Hits
JAN
31
0

GDC- Time for change

The GDC - Time for change

  5924 Hits

Copyright

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5924 Hits
JAN
23
0

The Only Way is Ethics

The Only way is ethics (2)

  5277 Hits

Copyright

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5277 Hits
JAN
15
0

Crisis? What Crisis?

Crisis what crisis?

  5566 Hits

Copyright

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5566 Hits
JAN
08
0

Going Rogue

Going Rogue

  5147 Hits

Copyright

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5147 Hits
JAN
02
0

Dental Wishlist for 2017 by @DentistGoneBadd

2017 - A Dental Wishlist

  5235 Hits

Copyright

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5235 Hits
DEC
19
0

All I Want...

All I want for Christmas.

  5408 Hits

Copyright

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5408 Hits
DEC
12
0

Weasel words by @DentistGoneBadd

Weasel Words by @DentistGoneBadd

  5163 Hits

Copyright

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5163 Hits
DEC
06
0

Tweets

Don't Tweet & sniff the hand rub

  6350 Hits

Copyright

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6350 Hits
NOV
28
0

12 days

the 12 days of Christmas

  5648 Hits

Copyright

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5648 Hits
NOV
22
0

Update your team with mobile software by @DentistGoneBadd

If you could fix dental staff with mobile software

  7474 Hits

Copyright

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7474 Hits
NOV
14
0

Mysteries of The Prototypes Explained

The New Contract

  6164 Hits

Copyright

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6164 Hits
NOV
07
0

Unreasonable behaviour - dental students in the 80s

How did we survive without GDC guidance

  6551 Hits

Copyright

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6551 Hits
OCT
31
1

How The Other Half Live

How the other half lives

  6366 Hits

Copyright

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Recent comment in this post
Graham John Nichols

This is so true

An amusing blog except it is so true. I also work for a corporate and recognise the scenarios. I wonder how they get away with it.... Read More
Sunday, 06 November 2016 07:42
6366 Hits
OCT
25
0

Caring for the Dental Team

 If You Find An Injured Co-Worker, Ring 011 456 5674

  6321 Hits

Copyright

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6321 Hits
OCT
14
0

NHS Dental Stats made simple

Statistics

  5884 Hits

Copyright

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5884 Hits
OCT
09
0

Balancing Probability

Case Examiners

  10749 Hits

Copyright

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10749 Hits
SEP
25
0

Its OK, I'm listening

What we say, what the patient hears

  7235 Hits

Copyright

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7235 Hits
SEP
19
0

Those were the days

Fings ain't what they used to be.

  7948 Hits

Copyright

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7948 Hits
SEP
12
0

The CDO Speaks

The CDO Speaks

  5561 Hits

Copyright

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5561 Hits
SEP
06
0

Strike!

Strike!

  5451 Hits

Copyright

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5451 Hits
AUG
21
0

Dental Apps for your phone

Dental Apps for your phone

  8794 Hits

Copyright

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8794 Hits
AUG
14
0

Toothpaste is Dead

Toothpaste is dead

  6638 Hits

Copyright

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6638 Hits
AUG
09
0

Dental Drama

Dental Drama

Continue reading
  7976 Hits
7976 Hits
JUL
31
0

Holidays

Holidays

Continue reading
  5225 Hits
5225 Hits
JUL
25
0

The Art of Dentistry

The Art of Dentistry

  4761 Hits
4761 Hits
JUL
18
0

Politics

Politics

  5762 Hits

Copyright

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5762 Hits
JUL
11
0

Homeopathy

Homeopathy

  7266 Hits

Copyright

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7266 Hits
JUL
03
0

The Mail

if the mail online produced your practice newsletters

  6740 Hits

Copyright

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6740 Hits
JUN
27
0

Denxit by @DentistGoneBadd

Denxit by @DentistGoneBadd

  9432 Hits

Copyright

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9432 Hits
JUN
21
0

Calm Down

Calm Down Dear

  6031 Hits

Copyright

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6031 Hits
JUN
13
0

Surviving

General Dental practice - The Survival Rules

  5820 Hits

Copyright

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5820 Hits
JUN
06
0

No Waffle

Sorry. The waffles are off.

  5700 Hits

Copyright

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5700 Hits
MAY
30
0

Risk Assessing your Dental Nurse

Risk Assessment

  7125 Hits

Copyright

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7125 Hits
MAY
23
0

Dental Research

Dental Research

  6150 Hits
6150 Hits
MAY
16
0

Great Expectations

Great Expectations

  5931 Hits

Copyright

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5931 Hits
MAY
08
0

Halitosis

Halitosis - Its not to be sniffed at.

  7288 Hits

Copyright

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7288 Hits

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