A Week In The Life of a Specialist Registrar in Special Care Dentistry

So following my recent DCT series of A Week In The Life of... I thought it should me my turn as a registrar in Special Care Dentistry!

Striking a pose in our bariatric dental chair!

Special Care Dentistry speciality training is usually a 3 year long training programme (although my training is extended as I was doing an OCDO fellowship part time last year). The newest dental speciality has a huge curriculum, but training generally needs to cover seeing patients both in hospital settings and in the community.

Let's go through a typical week of mine...

Mondays I spend seeing patients at Guy's Hospital in the Sedation and Special Care Dentistry department under the supervision of the Consultants there. I treat a lot of these patients under sedation which can be Inhalation, Intravenous, Oral or Intranasal (or a combination). This may be because of dental phobia, learning disability, hypersensitive gag reflexes or in conditions such as Parkinson's, to control tremors. I also see patients who have very complex and rare medical conditions, such as Haemophilia, Epidermalysis Bullosa who may have very specific oral health issues surrounding their condition. 

Sometimes I also supervise the undergraduate dental students seeing patients on clinic which is always interesting... often many haven't experienced seeing special care patients before or worry a lot about cannulation. So it's always a good feeling helping to teach them and enhance their skills in seeing these patients. 

Tuesdays are the days on my MSc in Special Care dentistry where we have didactic teaching and lectures about topics surrounding Special Care; from managing patients with autism, to Cognitive Behaviour Therapy for dental phobics. This will also be the day I will dedicate to research later on in my MSc. 

Wednesday is my favourite day of the week! I spend it in theatres at East Surrey Hospital treating special care patients under day case or inpatient general anaesthesia or sedation. I work in a great team: recovery, anaesthetics, learning disability nurses and often visiting clinicians from other specialities when we arrange joint cases for our learning disability patients. For example, recently, we saw a patient who as well as dental examination and treatment, required blood tests and the replacement of her contraceptive coil - which of course we asked a very kind gynaecologist to come to theatres to replace!

If there is time, we might be asked to squeeze in a ward referral for a patient just about to go for their cardiac surgery for example, or a patient with sepsis from a dental infection or to see a patients for dental assessment from the myeloma clinic before they start their IV bisphosphonates. 

Thursday I either spent seeing patients on my own community dental list, or I spend my time at the Royal Hospital for Neuro-disability in Putney, seeing their residents who have brain injuries. We see patients on their wards, treat them in the surgery where the first wheelchair tipper in the UK was installed and provide sedation when needed. Hearing the stories behind how these patients have ended up where they are can be very difficult to hear: from suicide attempts, to road traffic accidents, to alleged assaults. The work we do is very fulfilling in patients who can be very unwell, but it does take some resilience to keep smiling! 

Friday is another MSc day where I spend time in lectures with other postgraduate dental students in KCL. We have core topics to learn, such as research methods, biometry (basically stats!) and recently we have started our Journal Club. This is a good day to network and learn from other specialities in the hospital.

During the week I will have to make time to record my activity for my portfolio (we use the convoluted system of ISCP), complete audits, take time to do publications and fit in general patient admin! 

This is just what life is like for me at the moment! My rota may chop and change depending on the learning needs me and my Educational Supervisor identify. I love my job and how varied my week is... one of the reasons I chose to specialise in Special Care is because how varied the patient groups we see can be. No patient is the same and often we have to think outside the box and use our problem solving skills to work out what is best for our patients!

Do you have any questions about Speciality training or special care? Let me know in the comments below. 

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  1. Really a very helpful article thanks for sharing and keep on sharing!
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