Project Tooth Fairy: a pan-London initiative from conception to delivery to patient-reported experience measures.

Pressure on paediatric dental general anaesthetic (GA) waiting lists has recently been at its highest, further compounded by the COVID-19 pandemic. Project Tooth Fairy (PTF), a pan-London collaborative project, was conceived in response to this backlog. A dedicated day case GA suite was established within The Royal London Dental Hospital (Barts Health NHS Trust) for use by multiple trusts to enhance elective recovery.Over ten months, 895 patients were treated and discharged by PTF, averaging 101 patients per month. The majority required simple exodontia and comprehensive care and some patients were treated for surgery related to orthodontic treatment. Patient-reported experience measures highlighted an overall positive experience and appreciation for the service.Several governance domains were considered in the service development, including risk management, workforce recruitment and information governance. Training opportunities have arisen for team members to develop their skills. Patient-reported experience measures have guided the provision of service focusing on paediatric dentistry and paediatric GA.PTF has demonstrated the creation of a service centred around collaboration to successfully reduce GA waiting lists and therefore improving patient outcomes. The development of this service can be used as a template for the establishment of similar regional collaborative projects.

Thalassaemia - part 2: the patient perspective.

This is the second part of the thalassaemia update series which focuses on the dental journey of thalassaemia patients and the challenges encountered. This paper is a guide for recently qualified dentists who may not be experienced in the clinical implications of thalassaemia. A patient focus group was carried out with the UK Thalassaemia Society (UKTS) using a semi-structured interview format. All participants suffered from beta-major thalassaemia. The interview was conducted at the UKTS head office in London, UK. Participants consented for this interview and written consent forms were reviewed and completed by the author. The objectives were to: 1) review feedback from thalassaemia patients on the quality of dental care they receive in primary dental services; 2) evaluate the influence of social media in the thalassaemia community and how this has affected the self-confidence of thalassaemia patients; and 3) identify protocols that can be implemented for the primary care management and criteria for secondary care referral of thalassaemia patients.

Thalassaemia - part 1: a clinical update for the dental team.

Thalassaemia is a genetic disorder that affects haemoglobin function. It is an abnormality of haemoglobin caused by mutation of genes related to alpha or beta globin chains that can be further subdivided into categories. These haematological conditions can vary from mild forms, which present as mild anaemia, to severe forms, that can become life-threatening. The window for dental treatment is often limited by several factors involving medical management, such as the need for antibiotic cover or blood transfusions. The lifetime management of the medical conditions are onerous and can place significant physical and psychological burden on the patient. This paper is part of a two-part series on thalassaemia. Part one focuses on the clinical manifestations patients may present with, treatment regimens and dental implications of such presentations. Part two explores the perspectives of thalassaemia patients on their dental experience.

Dentistry and aviation engineering - behind the scenes at operations in a UK-based airline.

The healthcare industry is commonly compared to the aviation industry with emphasis on human factors and the decision-making processes undertaken by pilots and clinicians alike. The authors have been given exclusive access to meet the head of the maintenance team behind one of the UK's most popular airlines. An open-ended interview took place which was audio-transcribed for thematic analysis. Data were initially coded to identify basic patterns in the transcript. Once this was completed, themes were identified and agreed between the authors which could be compared to healthcare and dentistry. These themes were: regulation, occupational health, maintenance of equipment, use of checklists, reporting, just culture, burnout and disturbances.The aviation engineering industry requires the combination of a skilled workforce working under time pressure often in a financially restricted environment in a similar way to healthcare, especially dentistry. The two industries share common risks, although introduction of risk management tools such as checklists have been prevalent in aviation since the 1930s. Recognition of said risks and themes can lead to shared learning opportunities to benefit both sectors.

Developing a Patient Safety Culture in Primary Dental Care.

Patient safety should be at the heart of any healthcare service. Systems, teams, individuals and environments must work in tandem to strive for safety and quality. Research into patient safety in dentistry is still in the early stages. The vast majority of the research in this area has originated from the secondary care and academic fields. Approximately 95% of dental care is provided in the primary care sector. In this paper, we provide an overview of the evidence base for patient safety in dentistry and discuss the following aspects of patient safety: human factors; best practice; the second victim concept; potential for over-regulation and creating a patient safety culture. Through discussion of these concepts, we hope to provide the reader with the necessary tools to develop a patient safety culture in their practice.

#Wisdomteeth: an analysis of 100 social media posts and a survey on patient perception.

Background The use of social media to broadcast healthcare-related communications continues to increase in popularity, with dentistry being no exception. Method We have analysed, in real-time over a period of six months, 100 posts on the social media platform Instagram which have used the hashtag '#wisdomteeth'.Results Fifty-one posts were posted by dentists/professional accounts. Sixty-four percent depicted removal of third molars and 12% included images related to third molar eruption or surgery for entertainment purposes. Eight percent featured advice related to complications of retaining third molars. Forty-nine posts collected were posted by patients or members of the public. Fifty-nine percent consisted of images showing patients recovering from third molar removal under a form of sedation and 21% with no indication of sedation being used. Four percent showed patients prior to third molar removal surgery. Imagery inferred for entertainment purposes made up 8%. In our patient survey, 68% of those asked claimed they used social media; however, only 32% had viewed oral surgery-related images on these platforms. The most popular site to view such images was Instagram. Of the ten patients who viewed such images, five had a positive reaction, while two had a negative reaction and three had a neutral reaction.Conclusions Our analysis shows multiple posts of invasive surgery without an advisory warning, which may be unsettling for viewers. There seems to be little regard for patient confidentiality with no mention of consent. Posts from patients mainly focus on the recovery from sedation with honest references to pain, swelling and altered sensation. This all plays a role in the public perception of third molar surgery and can impact on the way that the public views the profession.

Patient-reported experience and outcome measures in oral surgery: a dental hospital experience.

Introduction Patient-reported experience and outcome measures (PREMs and PROMs) are useful tools in assessing the quality of a service and the care it provides. We present our findings from the collection and analysis of PREMs and PROMs at the Royal London Dental Hospital Oral Surgery Department and discuss implications for future practice.Methods PREMs questionnaires exploring peri-operative aspects of care were distributed to patients having dental extractions under local anaesthetic. Patients were later invited to complete a PROMs questionnaire to gather information about their post-operative experience.Results One hundred and fifty-five PREMs questionnaires were completed. Over 98% of patients reported that they felt involved in their treatment, their pain and anxiety was well managed, they received information in a suitable language, and they felt able to ask questions. Eighty-seven (56%) patients subsequently completed the PROMs questionnaire. Twelve (14%) reported that they required assistance following treatment and two (2%) required further surgery. Sixty-three (72%) patients reported that they achieved normal function/appearance within two weeks.Conclusion The majority of patients reported a positive experience throughout their patient journey. We conclude that PREMs and PROMs may be used for benchmarking and managing service provision. There is scope for developing comprehensive measures for use in dental settings.

Assessment and Management of Lumps on the Face: a Guide for the General Dental Practitioner.

There are a number of conditions that can present as a lump on the face. The general dental practitioner is uniquely trained in head and neck anatomy and pathology and should be able to identify these important conditions and consider appropriate investigations. Understanding what requires urgent specialist assessment and what can be referred routinely can be difficult, but is crucial to high quality patient outcomes. This article aims to simplify common conditions that may present as a lump on the face or be an incidental finding within the primary dental care setting. It is by no means an exhaustive description of all the pathology that may be encountered within this anatomical region, however it should form a useful and practical framework for common presentations.