Edinburgh Dental Institute

A Message from Lord Pickles and Lord Blunkett, followed by Edinburgh Dental Institute's best practice article

The ability to listen and learn from one another has always been vital in parliament, in business and in most aspects of daily life. But at this particular moment in time, as national and global events continue to reiterate, it is uncommonly crucial that we forge new channels of communication and reinforce existing ones. The following article from Edinburgh Dental Institute is an attempt to do just that. We would welcome your thoughts on this or any other Parliamentary Review article.

Blunkett signature Rt Hon The Lord David Blunkett
Pickles signature Rt Hon The Lord Eric Pickles

www.ed.ac.uk/dentistry

THE PARLIAMENTARY REVIEW
Highlighting best practice
24 | EDINBURGH DENTAL INSTITUTE
Director Angus Walls
A dedicated postgraduate teaching
space with modern equipment
Edinburgh Dental Institute is part of a global university offering
educational opportunities for dental students and academics.
After the undergraduate dental school in Edinburgh was closed
in 1997, the institute was established to provide specialised and
specialist training to qualified dentists looking to expand their clinical
skills. Director Angus Walls tells
The Parliamentary Review
about
their range of programmes and explains how they are helping to
provide the specialist care that an ageing population requires.
At the Edinburgh Dental Institute, we provide first-class clinical training for dentists
who want to expand their skills and become specialists. All the students we take
on must have completed undergraduate training and need to have been qualified
for at least two years. Our courses host a range of students from the UK, the EU
and overseas. We have three different educational opportunities: three-year full-
time DClinDent qualifications in oral surgery, orthodontics, paediatric dentistry and
prosthodontics (PGT); an online, distance-learning MSc in dental primary care (OLDL);
and PhD and Doctor of Dental Surgery (DDS) programmes for researchstudents.
Specialist offerings
We have 28 full-time PGT students, a further 40 enrolled for the OLDL programme
and nine PhD or DDS students. Planned expansion in September 2019 will allow us
to offer new courses in endodontics, dental sedation and anxiety management and
paediatric dentistry. Every year we welcome a new cohort of students onto all of
our programmes: two or three joining the full-time programmes and up to 20 on
the OLDL programmes.
FACTS ABOUT
EDINBURGH DENTAL INSTITUTE
»Director: Angus Walls
»Founded in 1997
»Based in Edinburgh
»Services: Postgraduate dental
programmes for two-year
qualified dentists
»No. of employees: 130
Edinburgh Dental
Institute
25EDINBURGH DENTAL INSTITUTE |
BEST PRACTICE REPRESENTATIVE 2019
All our full-time programmes are
designed to deliver the curriculum
set by the General Dental Council
for specialty education and allow
graduates to be recognised as
specialists both in the UK and
overseas. Entry standards are similar
to those for a UK-funded trainee,
but for EU and overseas students
the qualifications and experience
required are modified to reflect dental
training in their country of origin.
Each of these programmes is intense,
requiring expensive equipment and
expertise to run. Clinical care is
closely supervised by specialists and
consultants working with small groups
of up to six students at a time. As a
result our fees reflect the intensity
of the clinical education and small
group sizes, within the University’s
fundingmodel.
The students who complete the
specialty programmes become
recognised specialists in their field
and because of the current dearth of
trained specialists in many disciplines,
especially within dental primary care,
our graduates are immediately able
to contribute to oral healthcare.
Currently, half our students are
EU citizens, while many overseas
students receive sponsorship from
their government or employers
to undertake the training. Many
travel from Saudi Arabia and the
Gulf states and some continue with
us to complete a PhD after their
postgraduate course.
The MSc in Primary Care is specifically
designed to enable dentists working
in a primary care environment to
enhance their clinical skills. Learning
is delivered through an innovative
online platform as well as through
one-week summer schools in each of
the three years. The focus is largely
on restorative dentistry for the adult
and there are tailored, alternative
modules for those with an interest in
paediatricdentistry.
Advance through research
There have been substantial changes
in the oral health of populations
worldwide and we have conducted
significant research with the Scottish
Oral Health Research Collaboration
and with Newcastle University into the
effect an ageing population will have
on dentistry.
Historically, ageing has been
associated with loss of teeth and a
reliance on dentures. When chewing
with a denture, your bite is far less
stable and as a result it becomes
much more difficult to chew harder
things, modifying foods choice to
reduce fruit and vegetable intake
and increase intake of carbohydrates
and fats. These dietary choices are
the opposite of what older people
need. Older people have lower energy
requirements because of their more
sedentary lifestyle and lower muscle
mass, but they need to maintain
protein and micronutrient intake
through a nutrient-dense diet. Dentists
can help to achieve this by giving
tailored dietary advice while making
new dentures for people to help
them to make healthy dietary choices.
Contemporary clinical
areas
All our full-time
programmes are
designed to
deliver the
curriculum set
by the General
Dental Council
for specialty
education and
allow graduates
to be recognised
as specialists
both in the UK
and overseas
THE PARLIAMENTARY REVIEW
Highlighting best practice
26 | EDINBURGH DENTAL INSTITUTE
Evidencehas shown that adults with
no natural teeth die younger than
those with teeth, and while there are a
number of variables at play, we believe
the adoption of a healthier diet with
tailored advice and stable dentures
would help older people eat more
healthily and livelonger.
The bigger challenge, however, with
an ageing population is the delivery
of care to an increasingly old and frail
population with teeth that require
regular cleaning and are subject to
both tooth decay and gum disease.
Age changes may result in gum disease
progressing less rapidly, but tooth
decay remains a significant problem
because of more susceptible parts
of the tooth becoming exposed in
the mouth as we get “long in the
tooth”, reduction in salivary function
associated with drugs used to manage
the chronic diseases of ageing and,
again, unhealthy dietary choices with
increased consumption of sugars
in the diet. Our current research
focuses on the impact of oral disease
on an ageing population and on the
difficulty that dentists have in trying
to deliver personal oral healthcare to
older individuals as a result of frailty,
poor vision and alterations in the
architecture of the mouth, which
needs to be cleaned on a regular basis.
Industry challenges
The ageing population poses
challenges to the dental profession
in terms of increasing complexity of
care for people who have their own
teeth, which are often heavily restored
and require enhanced skills in terms
of care delivery. Specialist services to
deliver this complex care are few and
far between in the NHS, particularly in
remote and rural parts of the country,
as there is currently no established
mechanism for delivery of specialised
and specialist care in a primary care
environment and the secondary care
services are not designed or staffed
to meet this need. The focus for
the secondary care service is those
individuals with the most complex care
needs associated with oral cancer,
trauma and congenital facial defects.
There is an urgent need to develop
the pathways for care alongside
mechanisms for remuneration of
dental practitioners to deliver the more
complex care needed by the ageing
population. We can help to deliver
the required training but without
a funding mechanism this care will
not become available within the
constraints of the NHS. There is some
provision through private dental care,
but this is only accessible to those
who can afford to pay, potentially
increasing the social divide in terms
of oral health. The poorest in society
already have the poorest oral health
and the highest rates of edentulism; a
lack of affordable services will simply
make this worse.
Clinical simulation
lab to support skills
development
As the
population
ages their oral
care needs
become more
difficult. The
oral healthcare
system needs
to adapt to the
increasing
demand for
more complex
care in frail
older people

www.ed.ac.uk/dentistry

This article was sponsored by Edinburgh Dental Institute. The Parliamentary Review is wholly funded by the representatives who write for it. The publication in which this article originally appeared contained the following foreword from The Rt Hon Theresa May MP.

The Rt Hon Theresa May MP's Foreword For The Parliamentary Review

By The Rt Hon Theresa May MP

This foreword from the then Prime Minister appeared in the 2018/19 Parliamentary Review.

British politics provides ample material for analysis in the pages of The Parliamentary Review. For Her Majesty’s Government, our task in the year ahead is clear: to achieve the best Brexit deal for Britain and to carry on our work to build a more prosperous and united country – one that truly works for everyone. 

The right Brexit deal will not be sufficient on its own to secure a more prosperous future for Britain. We also need to ensure that our economy is ready for what tomorrow will bring. Our Modern Industrial Strategy is our plan to do that. It means Government stepping up to secure the foundations of our productivity: providing an education system that delivers the skills our economy needs, improving school standards and transforming technical education; delivering infrastructure for growth; ensuring people have the homes they need in the places they want to live. It is all about taking action for the long-term that will pay dividends in the future.

But it also goes beyond that. Government, the private sector and academia working together as strategic partners achieve far more than we could separately. That is why we have set an ambitious goal of lifting UK public and private research and development investment to 2.4 per cent of GDP by 2027. It is why we are developing four Grand Challenges, the big drivers of social and economic change in the world today: harnessing artificial intelligence and the data revolution; leading in changes to the future of mobility; meeting the challenges of our ageing society; and driving ahead the revolution in clean growth. By focusing our efforts on making the most of these areas of enormous potential, we can develop new exports, grow new industries and create more good jobs in every part of our country.

Years of hard work and sacrifice from the British people have got our deficit down by over three quarters. We are building on this success by taking a balanced approach to public spending. We are continuing to deal with our debts, so that our economy can remain strong and we can protect people’s jobs, and at the same time we are investing in vital public services, like our NHS. We have set out plans to increase NHS funding annually by an average by 3.4 percent in real terms: that is £394 million a week more. In return, the NHS will produce a ten-year plan, led by doctors and nurses, to eliminate waste and improve patient care.

I believe that Britain can look to the future with confidence. We are leaving the EU and setting a new course for prosperity as a global trading nation. We have a Modern Industrial Strategy that is strengthening the foundations of our economy and helping us to seize the opportunities of the future. We are investing in the public services we all rely on and helping them to grow and improve. Building on our country’s great strengths – our world-class universities and researchers, our excellent services sector, our cutting edge manufacturers, our vibrant creative industries, our dedicated public servants – we can look towards a new decade that is ripe with possibility. The government I lead is doing all it can to make that brighter future a reality for everyone in our country. 

British politics provides ample material for analysis in the pages of The Parliamentary Review 
The Rt Hon Theresa May MP
Prime Minister