Table Of ContentA Guide to
General Dental
Practice
Edited by
Nick Priest
Hardev Seehra
and
Murray Wallace
Foreword by
Hew Mathewson
General Dental Practitioner
President of the General Dental Council
Boca Raton London New York
CRC Press is an imprint of the
Taylor & Francis Group, an informa business
First published 2006 by Radcliffe Publishing
Published 2018 by CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2006 Nick Priest, Hardev Seehra and Murray Wallace
CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
ISBN-13: 978-1-84619-087-2 (pbk)
This book contains information obtained from authentic and highly regarded sources. While all
reasonable efforts have been made to publish reliable data and information, neither the author[s]
nor the publisher can accept any legal responsibility or liability for any errors or omissions that
may be made. The publishers wish to make clear that any views or opinions expressed in this book
by individual editors, authors or contributors are personal to them and do not necessarily reflect
the views/opinions of the publishers. The information or guidance contained in this book is
intended for use by medical, scientific or health-care professionals and is provided strictly as a
supplement to the medical or other professional's own judgement, their knowledge of the
patient's medical history, relevant manufacturer's instructions and the appropriate best practice
guidelines. Because of the rapid advances in medical science, any information or advice on
dosages, procedures or diagnoses should be independently verified. The reader is strongly urged
to consult the relevant national drug formulary and the drug companies' and device or material
manufacturers' printed instructions, and their websites, before administering or utilizing any of
the drugs, devices or materials mentioned in this book. This book does not indicate whether a
particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole
responsibility of the medical professional to make his or her own professional judgements, so as
to advise and treat patients appropriately. The authors and publishers have also attempted to trace
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Nick Priest, Hardev Seehra and Murray Wallace have asserted their right
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British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library.
Typeset by Anne Joshua & Associates, Oxford
Contents
Foreword vi
Preface vii
About the editors ix
List of contributors xi
Section 1 1
1 Law and ethics 3
The General Dental Council (GDC) 3
The National Clinical Assessment Service (NCAS) 4
Complaints 5
Communication 6
Confidentiality 7
Consent 8
Treatment 9
Infection control 9
Records 10
Complaints, discipline, appeals 11
The coroner 13
2 Clinical governance 16
Raj Rattan
Introduction 16
Definition 18
Aims 20
Government agencies 21
The seven-domain framework 24
References 26
iv Contents
Section 2 29
3 Medical histories 31
Suggested medical history form 31
Assessment of the patient's medical history 35
Implications of common medical problems 37
Oral manifestations of drugs 45
Blood values 50
High-risk patients 51
Accidental spillage of blood or pus 53
Procedure in the event of needle-stick injury 54
Section 3 55
4 Orthodontics in general practice 57
Introduction 57
Tooth development milestones 58
Patient assessment 59
Orthodontic indices 62
Referring a patient to a specialist 65
Appliance design and prescription 65
References and further reading 66
Section 4 67
5 Prescribing in practice 69
Responsibilities 69
Practical prescribing in practice 69
Essential information 70
Private/NHS interface 72
Referring 73
Section 5 79
6 Pain, trauma and emergencies 81
Differential diagnosis of toothache 81
Trauma and avulsion 81
The avulsed tooth 84
Contents v
Splinting times 86
Non-accidental injury 87
Emergencies: the basic procedure 95
Equipment and drugs required for managing
emergencies 101
Section 6 103
7 Oral cancer 105
Oral cancer screening 105
What to do if you find a suspicious lesion 110
You, your practice and oral cancer screening 112
Section 7 115
8 Your practice 117
Introduction 117
The role of the accountant 125
Introduction to personal and practice insurance and
investment 129
Look after your dental rep 133
Dental surgery design 134
Section 8 137
Further information 139
Directory of major dental supply companies 139
Useful addresses 145
British Dental Association publications 150
Your details 154
Index 155
Foreword
The move into general practice is an exciting and challenging
step and this guide is one of those things you will never know
you needed until you cannot find it. Do keep it safe; it is an
incredibly useful collection of information produced by a small
group of your colleagues and which thousands of practitioners
like you have appreciated time and again. Until such time as
you really need it, why not look through it? You will find it
helpful and reassuring.
General practice can be the most rewarding of careers, and
the more you put into it the more you will enjoy it.
Hew Mathewson
General Dental Practitioner and President of the
General Dental Council
May 2006
Preface
The intention of this Guide to General Dental Practice is to assist
your start to an enjoyable and fulfilling general dental practice
career within the United Kingdom. Primary dental care is a
dynamic field and continues to change at a swift pace.
There will be areas within this book which may not have kept
pace with all the many rapid changes, particularly the transi
tion from old general dental service contracts to new-style
contracts. Users of the book need to be aware that this is
intended as a guide and it is recommended to be used in
conjunction with other reference books and scientific journals
where there may be any doubts about 'current' guidelines.
However, I feel that the independent and impartial style of the
book, together with a supportive content, will more than
compensate.
The Guide to General Dental Practice would not exist had it
not been for the vision of Richard Gorham. He aimed to
produce 'a concise and relevant handbook for . . . practi
tioners, struggling to make sense of general practice . . .' Sean
Gibbs industriously continued the good work of Richard and
that of the original ten Wessex-based vocational dental practi
tioners. Hardev and I are very grateful to the contributors who
worked extremely hard to rewrite sections of the book in order
to bring it up to date.
I hope that you will keep this book readily available while
you are working in general dental practice and use it regularly.
Understanding the many areas required for sound patient care
viii Preface
and learning the required professional responsibilities will help
you to enhance the very important ability to reflect on your
professional development.
I wish you every success.
Nick Priest
May 2006
About the editors
Nick Priest is a general dental practitioner, Regional Dental
Adviser in Vocational Training, and Dental Adviser for the
National Clinical Assessment Service. Having graduated from
University College London Dental School in 1981, Nick has
over 12 years' experience in vocational training. He set up two
dental practices in Cornwall; one was featured as a 'Pride of
Practice' in Dental Practice magazine. He won the Marsh Midda
Prize on completion of Bristol University's Open Learning for
Dentists (BUOLD). Nick is studying for a Master's in science in
medical education at Bristol University and wishes to encour
age newcomers into dental practice to look for new challenges.
Hardev Singh Seehra graduated from King's College London
in 2004. He was a vocational dental practitioner between 2004
and 2005 and is currently working in general dental practice in
Aldershot. In his spare time, Hardev has been involved in
charity work in Vietnam and with Dentaid, offers careers
advice in schools, and has designed the website for his dental
practice. He aims to broaden his skills with a clinical attach
ment in hospital. Hardev wishes the very best of luck to new
dental graduates and for those joining general dental practice
for the first time.
Murray Wallace (Wal) graduated in 1972 at Otago University
(New Zealand) and experienced dental practice in New Zeal
and, Australia and Fiji before settling in England where he
owns two practices employing 35 members of staff. His long
association with Vocational Training since 1979 sees him
