content Flashcards
utilitarianism
action that benefits the greatest amt of ppl
NHS runs of utilitarian principles
promote oral health education
following infection control measures during covid
prioritising emergency care
duty of candour
be honest and transparent ab mistakes
corrective actions and support to rectify issue and prevent reccurance
document in patient records
report if significant
helps foster trust
breaking bad news
Setting the scene
* R u happy for the discussion to take place here
* Introduce urself
* Explain ur position or role
* Confirm patients identity
* Ask patient if they have any relatives/ loved ones w them to participate in discussion
Perception
* What is ur understanding of why we are meeting today
* (Minimise any shock from recieving the news)
Invitation
* Explain that u have bad news to tell them
* Ask permission to proceed
* (Gives them a warning that there’s difficult news, gives them time to prepare)
* Eg. Im afraid I have some bad news pause is this an appropriate time to discuss something w u
Knowledge
* Explain what happened
* No jargon, simplify info
* Allow patient to process info
Emotion
* Listen to patients concerns
* Let them process info- silence is okay
* Ask open qs about their feelings- what r ur thoughts
* Let them vent
* Apologise
Summary
* Reiterate info
* Suggest plan for future
* Is there anything I can do to help?
* Do u have any further questions or concerns?
* Thank u for ur time
NHS values
- WORKING TOGETHER FOR PATIENTS
- RESPECT AND DIGNITY
- Value every person
- Respect their aspirations and commitments in life
- Seek to understand their priorities, needs, abilities, limits
- COMMITMENT TO QUALITY OF CARE
- COMPASSION
- IMPROVING LIVES
- EVERYONE COUNTS
- Maximise resources for benefit of whole community
- Nobody is excluded, discriminated against
NHS 6 C’s
care
compassion
communication
courage
competence
commitment
define professionalism
how u respond to the GDC principles that r expected of u, and how u take responsibility for meeting them
appropriate attitudes and behaviours w patients and colleagues
why are children more compliant
cost- adults have to pay, more extensive treatment more expensive
patients care ab kids health
greater availability- long holidays, can be excused from school
what could be done to help encourage patients to visit their dentist
lower cost- increase awareness that this is possible eg uni students via HC1 and HC2 forms
weekend appts- ppl w regular commitments can attend dentist
letters and text reminders- many patients forget ab appts
when can disclosure of patient info be justified
insurance companies
court- ppl can be identified by dental records
dental emergency- life or death and patient cant consent, breaking confidentiality is in their best interest
what is primary care
patients have direct access to a dentist in the community
can contact dental practice and book appts without needing to be referred by a healthcare professional
NHS traffic light system
aim is a more preventative approach
patients given red/ amber/ green rating
used to produce a personalised plan of prevention
rating results discussed w patient- explain any risks around caner, periodontal disease, tooth decay
ratings reviewed at timely intervals
What are the negatives of a dentist and patient having a romantic relationship
Treat patient differently
Overlook aspects of patients oral health
Receive greater attention than other patients
GDC principles
put patients interests first
communicate effectively w patients
obtain valid consent
work w colleagues in a way that is in patients best interests
have a clear and effective complaints procedure
maintain and protect patients info
maintain, develop and work within ur professional knowledge and skills
make sure ur personal behaviour maintains patients confidence and trust in u and the dental profession
raise concerns if patients are at risk
role of dental nurse
- Prepare and maintain dental environment
- Sterilise instruments using autoclave, package them up
- Prepare for each patient
- Clean environment between patients
- During procedures
- Provide chair side support- handing dentist things
- Using suction
- 4handed dentistry, dentist and dental nurse have to work together to create a good effect
- Prepare mic handle dental mats
- Mix alginate- requires skill and knowledge
- Dangerous- skin dermatosis or reactions to mats
- Record dental charting
- Radiographs
- Prepare and process
- Can do extra courses to widen skill set
- Oral health education
- Assisting in treating diff patients
- Orthodontic
- Special needs
- Patients under conscious sedation
- Can train to do things w a dentist prescription
- Taking radiographs
- Using topical anaesthetic
- Placing rubber damns
- Taking impressions
- Apply fluoride varnish
- Only cant diagnose and treatment plan
understanding of the GDC
- Stands for the general dental council
- Governing body for all dental professionals in the UK
- Not j dentists, includes hygienists, students and so on
- Set a standard of conduct and ensure that all dentists follow the standards so that all UK dentistry is the same quality
- So they can protect the public and ensure they have confidence in dental healthcare professionals
- They set 9 main principles eg
- Put patients interests first
- Obtain valid consent
What’s the diff between empathy and sympathy and which is more important in dent?
- Empathy- putting yourself in someone else’s shoes and understanding how they feel
- Sympathy- feeling sorry for someone
- Imo empathy is more important
- Resonate w patients and provide a better level of treatment
- Sympathy only cld annoy patient if ur not being understanding
- Patients r often anxious and in pain so empathy cld help calm them down
- Build a stronger patient dentist relationship and deeper trust from the patient- procedures run more smoothly
- In conc both r important to show but empathy can be more impactful in making the patient feel as comfortable as poss
what do u understand ab NHS dent?
- Treatment is free for some
- Preggo
- Low income benefits
- Under 18
- Others pay w bands system
- 1- basic check-ups, xrays
- 2- fillings, root canals, extractions
- 3- bridges, crowns, dentures
- Price increases and band increases
- Relatively cheap compared to private so accessible
- But not so accessible as there are a lack of NHS dentists so long waiting lists for appts
- Dentists paid in UDAs- units of dental activity
- Amt of udas depend on band of treatment
- Have to reach a UDA target- have to work long hours for this
- Unrepresentative of how much treatment costs so dentists leaving NHS- dental deserts
- Despite this, still provide high standard of care for patients
consent
- Consent is the agreement or permission given by an individual for something to happen or be done
- In dental terms: when a Patient agrees to a procedure or treatment having given and considered all the facts necessary
- GDC principle obtain valid consent
- To Make sure consent is informed consent, dentist has to first explain and ensure the patient understands things such as
- Options for treatment, including no treatment
- Aims of procedure
- Side effects
- Benefits, risks, chances of success
- Consequences of treatment vs no treatment
- Cost
- Remind patient they have the right to change their mind at any time
- 2 types: explicit and implied
- Explicit
- Verbally say yes
- Sign a form
- Implied
- Consent inferred from patients actions and non verbal cues
- Eg in a medical setting, patient extending arm for a blood test
- Sometimes consent isn’t needed
- Emergency life saving treatment, patient unconcious
- Additional emergency procedures during an operation
- If theres a wider risk to public health if patient isnt treated
- Someone is extremely ill, unhygienic, living in poor conditions
- Ppl over 16 can consent
- Children under 16 checked to see if theyre gillick competent if a parent or legal guardian isn’t consenting for them
- Retain info
- Weigh pros and cons
- Make a decision
- Verbalise info back
- Children under 16 checked to see if theyre gillick competent if a parent or legal guardian isn’t consenting for them
- Consent only taken from ppl competent
- Capacity assessed by dentist/ nurses
- Patients may lack capacity if deemed medically incompetent under Mental Capacity Act
- GDC principle put patients interest first
- Beneficence
- In conclusion very important
- ensure ethical practice,
- Respect patients autonomy
- and foster trust between the dentist and the patient
NHS funding and budgeting
- NHS dentistry operates on a fixed budget allocated by the government.
- This budget is distributed to NHS dental practices to deliver services based on contractual agreements.
- NHS dentists are paid based on Units of Dental Activity (UDAs), which categorize treatments into bands
- Dentists are contracted to provide a set number of UDAs annually, limiting the amount of treatment they can offer under the NHS.
Problems
* The fixed budget often struggles to meet the rising demand for NHS dental services, leading to shortages in appointments.
* Access to NHS dental care varies significantly by region, with rural and deprived areas often facing greater challenges.
* The UDA payment system is criticized for focusing on quantity over quality, discouraging complex treatments and preventive care.
* Rising costs for dental materials, equipment, and workforce pay put additional pressure on the budget.
Dental recover plan
* Released feb 2024
* Published under previous conservative government
* £200 million plan
* Aimed to deliver 2.5 million additional NHS dental appointments delivered for patients over the next 12 months, including up to 1.5 million extra treatments being delivered.
* Launching Smile for Life, a focus on prevention and good oral health in young children
* Dental vans sent to rural areas to help reach the most isolated communities.
patient centered care
prioritizes the individual needs, preferences, and values of the patient
involving patients in decision-making about their treatment.
Pros
* Enhances patient trust and satisfaction.
* Improves compliance to treatment plans.
* Reduces dental anxiety
* Leads to better long-term oral health outcomes.
How to provide it
* Effective communication
* Explain diagnoses and treatment options in clear, non-technical language.
* Actively listen to patient concerns
* Shared decision making
* Autonomy
* Gain informed consent
* Preventative care
* Oral health education
* Personalised advice- lifestyle factors, general health conditions
* Accessibility
* translation services/ interpreters
* accommodations for patients with special needs,
* such as wheelchair access
* extra time for appointments.
* Continuity of care
* Check on recovery and satisfaction
* Accurate up to date patient records
Improves patient satisfaction
And overall health outcomes
confidentiality and data protection
fundamental in NHS dentistry to ensure patient trust, legal compliance, and ethical practice
Importance
* Ensures patients feel safe sharing medical history and personal details.
* Dentists have a professional obligation to maintain confidentiality
* GDC principle: maintain and protect patients info
* Prevents data misuse
Key aspects
* Info not shared without patient consent unless specific scenarios:
* Required by court or law enforcement
* Patient is at risk of harming themselves, others
* Only authorised staff have access to info
Consequences of breaching confidentiality
* Could result in suspension or removal from the register.
* Legal penalties
* Loss of patient trust
how to actively listen
nod head
eye contact
speak at their level
filling procedure
decay
local anaesthetic
remove decay w a drill
cavity cleaned
fill w amalgam/ composite
shaped and polished
crown procedure
cap placed over a weakened tooth
impression taken
temp crown if not cad cam
root canal procedure
local anaesthetic
small hole drilled to reach pulp
infected pulp and bac removed, canal cleaned
canal filled
extraction procedure
local anaesthetic
elevator to gently loosen tooth
forceps to carefully extract
gauze over socked to control bleeding
bands prices
1: 26.80
1: 73.50
3: 319.10
things to mention in data interpretation q
title
source
type of graph
axises
key
trends- figures, comparisons
