So now I am a specialist, weeks don't always look the same! I work between the Community Dental Services and the Charitable sector with Dentaid. I also need to balance my roles within the British Dental Association and Managed Clinical Network Deputy Chair - so between patients and lunchtimes there might be meeting or two squeezed in! 

But here is an example week...

I'm at one of the community dental clinics I work at seeing patients referred to me for treatment under IV sedation. This might be because of severe phobia, learning disabilities, limited mouth opening, severe gag reflexes or to control a tremor. 

I will also see any patients for treatment under local anaesthetic - for example people with medical complexities like cardiac issues, dementia, cancer patients or patients taking bisphosphonates.

This is my day dedicated to Dentaid as their Clinical Director. This could be working from home on the guidelines and policies of the service, having meetings, heading down to our HQ in Totton to be in the office with the team, or even doing one of our  mobile clinics. 

Once a month, we have a general anaesthetic list to see patients who cannot have their treatment any other way for example due to severe learning disability. This list is hosted by an external trust so it takes a lot of organisation and communication... and lots of emails! 

Currently, I'm off on maternity leave so my weeks are never the same, with sporadic routine looking after my little one! And certainly when I do go back to working, I am sure that my week will look very different to this! 

Specialists in Special Care Dentistry can work in the CDS like I do, hospital dental services or even in general practice (for example providing sedation or domiciliary visits). I would love to hear from other specialists to hear about how your week goes! Although as those of you who work with Special Care patients will know.... there is never a 'typical' week in Special Care Dentistry!

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday & Sunday

Time to relax with my husband, bake and catch up with friends!

Thanks Simran for a really good description of what your week is like! A very varied and clearly fulfilling week 

I am Malaaika, a Bristol graduate, currently undertaking a split DCT1 post in Paediatric and Restorative Dentistry. My first rotation has been Paediatrics. Why did I choose DCT1? I don’t know about you, but during DFT I was just craving to ask for a specialist opinion on so many patient cases. I have definitely found DCT an opportunity to help clear a lot of my uncertainties. I now feel a lot more confident in my decision making as a dentist.

My passion for Paediatric dentistry continues to grow and I am excited to see what life has in store for me. This is a DCT1 post I would totally recommend as it provides you with options open to specialise in any discipline at this stage.

AM: I am on casuals’ clinic where I see emergency Paediatric patients. I am also responsible for two undergraduate dental students to make sure they maximise their clinical opportunities. At the same time, I triage patients and prioritise them to attend clinic on the same day, the following day or not attend at all. Sometimes, I ask patients to email in photos to supplement their problem/explanation. Balancing all these job roles can be quite overwhelming at times, but it teaches you how to prioritise patients. Also, through adapting and working with the registrars, nurses and students carefully, we always manage.

The patients are either trauma, facial swellings, ongoing pain for 48 hours or more not responsive to maximum pain relief, or medically compromised individuals, such as oncology patients that require dental screening prior to commencing treatment.

Tuesday

Wednesday

Thursday

Friday

PM: Outpatient clinic

Saturday and Sunday

Time off to relax ☺

Hi, I’m Katie and I’m currently a Dental Core Trainee in Oral and Maxillofacial Surgery at Rotherham General Hospital. This post appealed to me for many reasons; first and foremost, the chance to gain a huge amount of clinical experience to stand me in good stead for my future career (although I haven’t yet decided what this will entail!). Secondly, I chose a post in a District General Hospital, in the hope of gaining lots of hands-on experience in extractions and minor oral surgery. Finally, after finishing Dental Foundation Training in a dental practice, I fancied a change of scenery! The chance to be part of a bigger team and learn a whole new set of clinical skills was exactly what I hoped for.

I’m on-call this week, so I arrive in the hospital for an early 8am start. After a quick catch up with the consultants and other DCTs, we start the morning ward round. Next, I complete a couple of admin jobs; discharging inpatients and booking outpatient appointments for A&E attenders are first on the list. However, it isn’t long before the on-call phone rings. There is a patient in A&E with a large submandibular dental abscess who will need to be admitted for treatment. I take some bloods, prescribe intravenous antibiotics and gain consent to drain the abscess and remove the offending tooth in theatre under general anaesthetic!

My main task today is organising the placement of a tracheostomy for a Covid positive patient on a ventilator. I discuss the case with the consultants, book the emergency theatre and complete the consent form. The phone is constantly ringing today, so I only get 5 minutes to grab some lunch – thank goodness for the on-site M&S! Next, I head to theatre to assist with the tracheostomy. This procedure involves surgically creating a hole in the patient’s windpipe, so they can be gradually weaned off the ventilator. After finishing in theatre, I am called to manage a couple of lacerations in A&E, before handing over for the evening.

Wednesday gets off to a pretty quiet start, so I head to clinic with one of the consultants; two-week wait referrals, skin cancers, cysts and troublesome teeth are all on the list today. I am then called to see a two-day old baby on the postnatal ward. He has a mobile neonatal tooth, which I must remove due to the risk of aspiration. Understandably the new Mum is very concerned, but her baby does her proud and doesn’t even cry! I head home after the evening handover and my dinner is already on the table; amazing housemates are essential when you’re a DCT!

Every Thursday starts with an hour of teaching – today we learn about head injuries from one of the A&E consultants. After that the on-call phone stays mysteriously quiet (touch wood!), so I wander down to theatres to see what’s happening. I assist with a coronectomy and the removal of a basal cell carcinoma skin cancer. Later, I handover to the DCT on nightshift. Last on-call shift this week – tick!

This Friday I am on cover, meaning I help the other DCTs with their workload. As the on-call DCT has everything under control, I work on my audit which is looking at how we manage dental trauma in A&E. I also have a much needed catch up with the other DCTs. Later, I assist my registrar with the repair of a fractured mandible in theatre. We reposition the broken fragments and stabilise them with small metal plates. Once we are finished, I head home. I am off this weekend, so it’s time for some rest and relaxation, before it all starts again next week!

Hopefully I have given you an insight into the typical week of an OMFS DCT. As I hoped, this post has already allowed me to hugely improve my clinical skills, but it has also given me so much more… Arguably the most important things I have learnt are actually related to teamworking, communication, leadership, working under pressure, prioritisation and resilience. All of these valuable skills are easily transferable to other roles, hence a DCT in OMFS is often compulsory for entry into specialty training. 

So, if you are even thinking about applying for Dental Core Training, I would say ‘Go for it!’. It definitely feels intimidating and at times overwhelming, as a brand new DCT who has just finished FD, however it becomes much easier once you gain a little confidence. You soon learn that everyone around you is there to help and give advice – you are the trainee, not the trainer! 

There are so many opportunities around, beyond those you would typically expect – for example, observing the vascular access team to improve your cannulation technique or shadowing the medical registrar to learn about a range of medical problems. Even within OMFS you may see conditions and procedures which are rarely encountered, so it’s important to make the most of every opportunity. It’s also a great time to enhance your CV by getting involved in audits, teaching, quality improvement projects and research. But it’s not all work… Luckily there are also lots of opportunities to balance the hard times with lots of socialising with your colleagues and fellow DCTs. Regardless of your long-term career aspirations, you can learn so much from a DCT post – so give it a go!

Each DCT had their own rota which they followed for the whole year, with a mixture between consultant clinics, treatment clinics and a variety of all the specialties. This was a week during my DCT1 job last year (before redeployment sent me to A and E!).

Mondays on my rota were usually quite a relaxed start to the week. The day began with a generalised, restorative consultant clinic. We saw just about every aspect of restorative dentistry during this session, but most patients were complex, and required several restorative elements in their treatment plans.

The afternoons saw oral surgery consultant clinics, involving the initial assessment of patients in order to develop a treatment plan for further appointments.

The paediatric trauma clinic (while busy and slightly nerve-wrecking) was such a fun and interesting learning experience. Dealing with patients is difficult; but when they are 6 years old, crying, and need a complicated root canal, then you have to pull out patient management techniques that would put Welbury to shame.

Tuesday afternoons were also rather challenging. An innocently termed ‘denture clinic’ saw you providing prosthesis for people with more MRONJ than bone, or 1mm of alveolar ridge, using techniques that I’d never even heard of.

The mornings were spent in oral medicine. Not many DCT jobs offer oral med experience and this was one of the main draws of this post for me. This busy clinic was interesting, and really helped me gain confidence with mucosal diseases.

We had the option of an extra clinic on a Wednesday afternoon, and I chose to spend this time in special care. This was a mixed clinic, featuring: sedation (with and without propofol), follow-ups and new patient assessments. No patient or treatment plan was ever the same, and it was heart-warming to provide a service to an often over-looked patient base.

Sedation clinic in special care. You really got to bring together all of your normal dental skills and patient management, as well as having the opportunity to get accredited in sedation.

Afternoons were supervised oral surgery clinics. I found this particularly useful as I wanted to improve my surgical skills, and you don’t always have the opportunity for one on one teaching.

I’m Tejal, a DCT1 in Oral and Maxillofacial Surgery at Worcester Royal Hospital, on the West Midlands scheme. I chose to do DCT because secondary care has been appealing to me since I was in dental school - initially I took this post because it has a 6 month SCD rotation, but that fell through because of the pandemic and so I rolled with it, but I absolutely love the hospital environment and doing DCT is one of the best decisions I have made.

A yoga/meditation session and a very strong breakfast to ensure I have enough energy for the day ahead.

This job is never boring - we have a 12-week rota that takes us to Bedford and Milton Keynes University Hospitals too. With 12.5 hour on calls, weekend theatre & night shifts galore, here’s a glimpse of one week in the life...

I live close to the hospital but somehow still run late every morning, so I eat my toast as I walk to work. I’m on-call from 8am-8pm, so at morning handover I take the dreaded bleep from the night DCT and head to ward round with the consultants. Our patients are stable so I have a relatively chilled day, visiting A&E to suture lacerations on kids, drain dental abscesses and review an elderly lady who fell down the stairs.

Due to the pandemic, elective theatre lists are cancelled so I spend the morning updating my portfolio, which is used to monitor our progress throughout the year. In the afternoon, I help on clinic seeing new patients who have been referred in by dentists and GPs for extractions, soft tissue pathology, and more.

Although elective cases are cancelled, cancer operations are not. I assist a consultant in a partial glossectomy on a patient with Squamous Cell Carcinoma of her tongue - it was gory but fascinating to assist in such an amazing surgery.

Like many other young dentists, I have no idea where I’m heading with my career. I graduated in 2018 from Newcastle University and completed DFT and DCT1 in York. COVID-19 threw a spanner in the works for all of us, and really emphasised how important a work-life balance is to me. I was eager to explore a new part of the country and DCT2 provided a great opportunity for this. Luckily I got somewhere that offered exactly what I was hoping for!

Tuesday

The Head and Neck Multidisciplinary team clinic runs on Tuesdays. This involves new cancer diagnoses, treatment planning and follow-ups. As a DCT it is valuable to see all parts of the patient journey and hear their experiences. We also often undertake pre-radiotherapy dental assessments which keeps your skills in dentistry fresh.

Wednesday 

The start of 24 hours on-call with ward round and clinic. For the other DCTs, this is an admin and teaching day. We provide weekly medical student teaching which is a great experience, plus we have teaching at DCT level. Pre-COVID lock-down, there was an afternoon IV sedation session, but for now we’re using the time to complete projects.

Thursday 

I handover and attend the ward round. As I was well rested, I spent the morning on our outpatient department assisting skin cancer excisions, then went home.

Saturday 

 

Most mornings I arrive at work 7:30am, giving me time to grab a cuppa and bite to eat before ward round at 8am. This is led by the on-call DCT, but everyone helps out to ensure it runs smoothly. Teamwork makes the dream work!

In the morning I have a treatment clinic. This can range from biopsies to surgical extractions. The staff are on hand to help but as the months have progressed, I find myself gaining more confidence. That and knowing I have a team of experts next door to me!

Afternoon is an emergency treatment clinic – essentially A&E dentistry!

Head and neck cancer theatre list all day. Assisting for lifesaving cancer treatment is something I’d never seen before my DCT year. Dodging the blood squirts and directly assisting our fantastic OMFS consultants. There truly is no better way to understand head and neck anatomy, although free flaps and neck dissections are not for the faint hearted. The delicate work undertaken by our OMFS surgeons during the microvascular surgery of radial forearm free flaps is such a fine art and fascinating to watch.

Depending on our rota for the week, there are also paediatric theatre lists running, which includes extracting teeth and exposure and bonding of canines.

Head and Neck MDT and cancer clinics – This is where people from all specialities in the hospital discuss patient treatments and outcomes to ensure the best care is provided to them. This week was particularly emotionally tough as I discovered a patient younger than myself was diagnosed with oral SCC. The clinics can be challenging at times, particularly when witnessing consultants breaking bad news to patients.

Day case theatre lists includes a range of treatments including arthrocentesis, surgical third molar extractions and cyst removals under GA.

Friday mornings consist of a group teaching ward round and study club.

Finishing the week off with face-to-face clinics, where instead of being a DFT referring in patients the role is reversed, and you’re on the receiving end.

1 in 4 weeks I’m on call, which is probably the most challenging yet rewarding experience I’ve had in my career so far. Teenage Mutant Ninja Turtle rucksack on and I’m off! One minute you’re incising and draining a swelling in A&E and the next you’re in theatre stitching up a laceration on a young child. The week is truly a rollercoaster ride.

I’ve learnt so much about how hospitals function and gained so much respect for our medical colleagues. Working in the midst of a global pandemic has shown me the true grit and determination of our NHS staff. I would definitely recommend doing a DCT OMFS post. You will learn a great deal of surgical skills and professionalism. For me this post put things into perspective, as we tend to worry so much about being a heroic saviour of teeth that we forget the bigger picture of life.

Navpreet, DCT1 in CDS/OMFS at Birmingham

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Friday