2017 GDPUK Conference Report
Andy Bates
Next up was Laura Gartshore (pictured below) from Liverpool Dental School with a presentation on regenerative endodontics - how to revascularise a traumatized immature tooth.
Having listened to a similar talk a few years ago by a different speaker, I was expecting to hear something interesting but largely theoretical and potentially way beyond the realms of something an ordinary GDP could practically reproduce. How wrong I was, and I'm pretty sure I wasn't alone in that feeling! The technique of persuading the stem cells found at the apex of an immature tooth to enter the devitalised pulp canal and regrow vital pulp tissue, allowing new odontoblasts to not only close the apex, but significantly increase the thickness of dentine at the apex of the tooth is not difficult. The treatment also uses materials easily accessible to the average general practice dentist.
Laura explained that it is a widely held view now that apexification using CaOH is no longer a recommended practice for treating traumatised immature teeth, but the use of MTA has taken over as the 'gold standard' method of closing the apex. To get MTA to the very apex of an immature tooth is incredibly complex though, the materials and equipment needed are very expensive. Getting a patient to a centre where this can be reliably done within the short treatment window that produces the best results is often very difficult.
However, the technique described by Laura requires initial dressing with a di-antibiotic paste, (which can be mixed up in the surgery from antibiotic capsules), followed a couple of weeks later by placing MTA, or, more simply, Biodentine in the coronal aspect of the tooth, after the first important step of inducing apical bleeding in the pulp chamber at the second appointment.
At the coffee break we were all trying to digest what we had heard to that point, there were groups of dentists around the first session speakers eager to learn and grilling them further.
Caffeine fix done, the next session got underway with a talk from Neil Taylor. Neil qualified as a dentist and practised for several years in the hothouse of Scottish NHS dentistry. Looking for something different from life he retrained as a solicitor, then became an Advocate (Scottish Barrister) and now is the founder of the indemnity company Taylor Defence Services. It was a fascinating talk about how the legal system works, and the fact that the advocates 'job' in a courtroom is basically deciding on the strategy of the approach rather than the proof of innocence or guilt, and how that process works in a dental complaint setting. It made us see that there needs to be someone who has a degree of 'detachment' from the emotion of a case that is working towards the best solution for his clients – you and I as dentists. He certainly struck me as someone I'd want on my side!
Our own Tony Jacobs was up next and he gave us a tour through the first 20 years of GDPUK. Although it is a story that I personally know quite well, it was still amazing to run through where it started to what it is today.
To take us to lunch GDPUK dentist member and pianist Richard Franscics entertained us with a selection of relaxing pieces. Although having not played in public for many years Richard overcame his perfomer’s nerves and it really didn't show! Full credit must go to Richard for bringing his rather heavy electronic piano from Crawley. This was then carried up to his hotel room, then back down to the venue and back into his car for the journey home. Gary Neville also lent a hand at one point holding a door open whilst the GDPUK removals team squeezed past, piano in hand.
Richard also settled us into the afternoon session with some more jaunty tunes to wake us up after lunch.
The first session of the afternoon was a talk from another legally qualified dentist, active GDPUK contributor and blogger, Simon Thackeray. Simon gave a very thought-provoking talk on a subject he had written a thesis on for his LLB qualification. The subject being ‘Bias in Expert Witnesses’.
Simon (pictured below) described the various types of bias that could affect experts, and how some were allowable, and others were not. A rather surprising fact to some of us was that an expert witness has a duty to remain impartial, and should not skew their testimony towards the side that has paid them. He also pointed out that expert witnesses don't get to examine the patients, but just have the notes, radiographs and statements to go off. Simon ended by telling us that various ways of minimising such biases were actively being considered. The most sensible of which seemed to be the 'single joint expert'. That is where one expert witness will be commissioned jointly by both sides in a case.
I would urge anyone reading this article to familiarise themselves with this technique as soon as they can. It is genuinely revolutionary, and will certainly alter my treatment of such cases in the future.
Gary Neville also lent a hand at one point holding a door open whilst the GDPUK Pickfords team squeezed past, piano in hand.
Tom's talk (pictured above) was basically mindblowing! The future will be electric. (Strangely enough one of the most viewed and discussed threads on GDPUK over the past 12 months has been on electric cars and issues surrounding electric power) A lot of that electricity will be solar generated, due to the increase in efficiency in both manufacturing and output of solar panels. Advances in battery technology show no signs of slowing down, and the energy density of batteries is now approaching equivalence with petrol and diesel. The advances in AI technology will mean that personal devices will organise our lives for us - right down to having a driverless car turn up at our door when we need it to take us to an appointment that it made for us when it realised we needed a haircut! Of course, the driverless car will not be owned by us - car ownership will be unnecessary when one is just called for us on an as-needed basis.
Just as our minds were getting around these concepts though - he moved on to Graphene. Imagine a bridge to span a river that was light enough to be carried into place by a couple of blokes, although it was pointed out by Simon Thackeray that somebody would steal it. If that wasn't enough, a Graphene cable would be able to solve that science fiction dream of the elevator up to space!
With our heads truly spinning we finished the day with a 'Thank you' from Tony, and the hope that this sort of dental conference would become a regular part of the professional calendar.
Getting back into my car, the first thing it told me was if I wanted to get home, this wasn’t the best place to start! I turned the display off, and using my very own brain turned right out of the car park. It will be a long time before I let this technology actually drive me, never mind arrange my haircuts and shopping!!
Tom's talk was basically mindblowing! The future will be electric. A lot of that electricity will be solar generated, due to the increase in efficiency in both manufacturing and output of solar panels.

Up next was Catherine Rutland of Simply Health Professionals - the organisation formerly known as Denplan. Catherine is the Head of Professional Support Services and was a GDP who required an enforced lay-off due to a past medical condition. Her talk on 'The Risk of the Gatekeeper and the Benefits of Delegation' gave good insight into how sometimes complaints can escalate due to patients getting a poor initial contact at the practice, but how by the same token, the dentist shouldn't take everything upon themselves, as things can also rapidly spiral down if they do. Basically, the importance of having the right people at the right places within your practice to support you.
After the afternoon break and a naughty selection of sweeties from local sweet manufacturers Swizzles Matlow, we returned for the day's final presentation. Tom Cheesewright is often seen and heard on both television and radio. His title is 'Applied Futurist' - a name he freely admits was completely made up by an associate of his at some point in the past, but being a good descriptive term for what he does. He looks at trends and developments within various industries and from that, gives some insight into the 'direction of travel' for those within industries who feel they need to be aware of such things.
At this time twelve months ago I attended the first GDPUK conference to be held in several years, and I came away having thoroughly enjoyed a really thought provoking day. So this year as I drove towards Hotel Football, slap bang next to the iconic Old Trafford football ground, I was again looking forward to a slightly 'off the wall', unconventional dental CPD day. Roadworks around the hotel sent me on a detour that gave my SatNav a nervous breakdown - it eventually gave up on finding the hotel car park, throwing its Teutonic toys out of the pram and wishing it was back in Munich! Luckily having attended last year I knew where it was.
Entering the venue the fact that I'd set off without my breakfast was not a problem. The welcoming spread of bacon, sausage and egg rolls were easily up to last year's standard, and the room was already filling up with faces slightly older, but recognisably similar to the avatar photos seen every day on the pages of GDPUK. It seems that dental chat forums and Tinder follow the same rules. As an acquaintance tells me.
Over coffee and the aforementioned rolls I caught up with friends, both from the online world and those that I'd been at University with and hadn't seen in real life for what is now decades.
For a nice, gentle, uncontroversial start to the proceedings, Tony had invited Kevin O'Brien to open the day's lectures. Kevin is well known for his own online presence, most specifically his blog on orthodontics which is read by over 45,000 people a month and which is available in 7 languages. He was also the last dentally qualified Chair of the GDC. Now retired and off the dental register, he continues his blog which he uses to expose the bad science and quackery within his speciality.

Kevin’s talk on Short-Term Orthodontics was not the complete broadside to the subject that a lot of the audience was expecting. He acknowledged that there was indeed a place for short, simple treatments that just corrected the alignment of the 'Social Six' anterior teeth and that it is not a new concept. Providing that patients realised that the treatment would be a compromise between what was ideal, and what was just attending to a minor aspect of the full picture, then in adult orthodontics the shorter-term treatments have a place. This is especially the case if these treatments help cut down on the inappropriate provision of veneers to correct minimal crowding issues.
What Kevin strongly objected to was some of the marketing techniques, both those that target dentists along with those that were aimed directly at patients with claims that had no basis in the published evidence.
20th Anniversary Magazine