Mark Tangri Dental Excellence

A Message from Lord Pickles and Lord Blunkett, followed by Mark Tangri Dental Excellence'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 Mark Tangri Dental Excellence 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.marktangri.com

BEST PRACTICE SPONSOR 2020
THE PARLIAMENTARY REVIEW
Highlighting best practice
34 | COCHRANE DENTAL CARE
Society expects high standards of
ethical professionalism from graduates
to professors, and while experience
does provide a measure of this, the
newly qualified dentist is not afforded
the opportunity to learn ethics from
mistakes. The risks of failure are too
high to be able to do this, and so I
believe educators and dental schools
need to realise that a complete and
overarching ethical curriculum should
be meaningfully inculcated into the
dental undergraduate experience.
For postgraduates, we need to develop
a strong sense of accountability. We
need to be brave in adopting an
inspiring message that will challenge
people to look at how we can change
the fact that poor dental work can
often go unchallenged and we have
a system of dental care that is at best
outdated and at worst failing the
population. The standard of political
support for dental healthcare reform
in Northern Ireland is at a low, and
without a sitting government, we
cannot achieve meaningful progress.
With this backdrop, I am moving
further away from the NHS as a
practice; however, I know I am able
to provide better care for my patients,
and until there is a government that
puts people’s dental care as a priority,
I will hold to this trajectory. We need
good leaders, and at the moment, they
are simply not there.
I am sure the majority of dentists go
to their places of work to care for
patients; however, I would make
a plea to the future governance of
dentistry that they find a better way
to regulate the dentists who can
perform poorly and then simply walk
away from the profession and into
retirement without recrimination. We
need to find a way to change this in
Northern Ireland, where currently, a
dentist can retire themselves away
from fair accountability, and a patient’s
only recourse is to litigate against
them. This is a deeply unsatisfactory
position to find ourselves in. It sends a
wholly demoralising message to active
dentists engaged in the challenges
of everyday dentistry and promotes a
survival mentality in some colleagues
where retirement is imminent. There is
no substitute for great levels of care,
competence and communication.
The demands of dentistry are real,
as are the responsibilities, and the
way to thrive as a professional is to
embracethem.
There is no
substitute for
great levels
ofcare,
competence and
communication
The great team behind
our patients’ care
35MARK TANGRI DENTAL EXCELLENCE |
DENTISTRY
Head of Clinical Operations
DrMarkTangri
Maintaining the highest
standards requires attention to
detail and sheer hard work
Having built up a practice with over 100 staff, in 2017 Mark
Tangri decided that he wanted to step away and change
the way he worked. Looking instead to do something
slightly more niche, he established Birmingham-based Mark
Tangri Dental Excellence. The private referral dental practice, he
tells
The Parliamentary Review
, is an “idea meritocracy”, where
the best wins out. With a team of eight clinicians, Mark focuses
on research and evidence-based clinical practice, driven by an
educational, preventative and patient-focused ethos.
Our clear, clinical and functional governance structure drives what is ultimately a
minimally invasive approach to patient management. It’s not just “my way or the
highway” – if anybody has a good idea, no matter where they are in the practice,
no matter how long they’ve been here, we will use it.
On a day-to-day basis, we deal with the more advanced and technical side of dentistry.
Generally, our patients are more anxious and nervous, and usually we sedate them to
undertake complex dental work. I myself will often sedate as many as 30 people a week.
While we opt first to be preventative and don’t resort to surgery unless absolutely
necessary, many of our patients require serious oral rehabilitation. Some of them
haven’t been in care for years, and require treatments such as teeth removal, bone
and sinus grafts and dental implants. Some of our patients may have experienced
serious trauma in the affected area, perhaps having suffered tumours in the area
where we would operate.
We are specialists and well equipped to carry out such treatments, but our complex
multidisciplinary treatment planning makes prevention the number one priority
FACTS ABOUT
MARK TANGRI DENTAL
EXCELLENCE
»Head of Clinical Operations:
MarkTangri
»Founded in 2003
»Located in Birmingham
»Services: Dentistry
»No. of employees: 68
Mark Tangri Dental
Excellence
THE PARLIAMENTARY REVIEW
Highlighting best practice
THE PARLIAMENTARY REVIEW
Highlighting best practice
36 | MARK TANGRI DENTAL EXCELLENCE
at Mark Tangri Dental Excellence. As
such, we run a teaching programme
for postgraduate dentists, where
we focus on two key areas: dental
implants and conscioussedation.
The changing face of
dentistry: prevention,
prevention, prevention
To discuss how dentistry is changing,
I want to focus on three major
questions:
»How is what we do changing?
»How are we changing?
»How are the patients changing?
How is what we do
changing?
Firstly, the profile of the diseases we
cover are changing dramatically. One
particular example is peri-implantitis.
Around 20 years ago, dental implants
exploded onto the scene. They were a
great replacement for missing teeth,
and a serious push forward in dental
technology. While they did fulfil
an incredibly helpful function, they
were and are not a true replacement
for perfectly healthy, organic teeth.
After some time, peri-implantitis –
an implant-specific inflammatory
condition – started to emerge.
The oral diseases we’re seeing in
people entering our clinic are similar,
but widely different beasts. As such,
dental practice has had to change –
we’re not just making holes in teeth
and filling them any more. Public
health initiatives in decades past
have worked incredibly well, and the
conditions we saw in people 15 years
ago are rarer than they ever have
been. With new dental technology,
however, comes a fresh raft of diseases
and conditions.
How are we changing?
In terms of the dental profession
itself, the changes have been
significant. There has been a boom in
postgraduate dental training, but as
a result, we are seeing something of
a gap with regards to undergraduate
dentistry education. Dentists are
qualifying with excellent theoretical
knowledge but a lack of practicalskills.
We’re seeing a huge drop in the
output of dentistry as a result, and
a lot of the general practice work
is being picked up by qualifying
hygienists instead. I have seen the
number of dentists with appropriate
skills plummet rapidly during my time
in the sector, and it’s for this reason
that we’re starting to see more and
more people go into postgraduate
education. It all comes full circle.
In terms of the sector more widely,
we’re also seeing people shift away
from the NHS. The fact that the NHS
dentistry budget has stayed at £2 or £3
billion for the past 20 years suggests
that primary care dentistry is largely
transitioning to a private system.
How are patients changing?
Finally, how are patients changing?
This is a big question and there’s no
single answer – but let’s start with
dental work undertaken abroad. This
is becoming more and more common,
as is the recovery work we’re seeing
in the wake of it. The NHS continues
We are
specialists and
well equipped
to carry out
such
treatments, but
our complex
multidisciplinary
treatment
planning
makes
prevention the
number one
priority at
Mark Tangri
Dental
Excellence
With Dr Jeanie Suvan
and Professor Klaus
Lang. A real privilege
to work with and learn
from the true giants of
periodontology
BEST PRACTICE SPONSOR 2020
THE PARLIAMENTARY REVIEW
Highlighting best practice
36 | MARK TANGRI DENTAL EXCELLENCE
at Mark Tangri Dental Excellence. As
such, we run a teaching programme
for postgraduate dentists, where
we focus on two key areas: dental
implants and conscioussedation.
The changing face of
dentistry: prevention,
prevention, prevention
To discuss how dentistry is changing,
I want to focus on three major
questions:
»How is what we do changing?
»How are we changing?
»How are the patients changing?
How is what we do
changing?
Firstly, the profile of the diseases we
cover are changing dramatically. One
particular example is peri-implantitis.
Around 20 years ago, dental implants
exploded onto the scene. They were a
great replacement for missing teeth,
and a serious push forward in dental
technology. While they did fulfil
an incredibly helpful function, they
were and are not a true replacement
for perfectly healthy, organic teeth.
After some time, peri-implantitis –
an implant-specific inflammatory
condition – started to emerge.
The oral diseases we’re seeing in
people entering our clinic are similar,
but widely different beasts. As such,
dental practice has had to change –
we’re not just making holes in teeth
and filling them any more. Public
health initiatives in decades past
have worked incredibly well, and the
conditions we saw in people 15 years
ago are rarer than they ever have
been. With new dental technology,
however, comes a fresh raft of diseases
and conditions.
How are we changing?
In terms of the dental profession
itself, the changes have been
significant. There has been a boom in
postgraduate dental training, but as
a result, we are seeing something of
a gap with regards to undergraduate
dentistry education. Dentists are
qualifying with excellent theoretical
knowledge but a lack of practicalskills.
We’re seeing a huge drop in the
output of dentistry as a result, and
a lot of the general practice work
is being picked up by qualifying
hygienists instead. I have seen the
number of dentists with appropriate
skills plummet rapidly during my time
in the sector, and it’s for this reason
that we’re starting to see more and
more people go into postgraduate
education. It all comes full circle.
In terms of the sector more widely,
we’re also seeing people shift away
from the NHS. The fact that the NHS
dentistry budget has stayed at £2 or £3
billion for the past 20 years suggests
that primary care dentistry is largely
transitioning to a private system.
How are patients changing?
Finally, how are patients changing?
This is a big question and there’s no
single answer – but let’s start with
dental work undertaken abroad. This
is becoming more and more common,
as is the recovery work we’re seeing
in the wake of it. The NHS continues
We are
specialists and
well equipped
to carry out
such
treatments, but
our complex
multidisciplinary
treatment
planning
makes
prevention the
number one
priority at
Mark Tangri
Dental
Excellence
With Dr Jeanie Suvan
and Professor Klaus
Lang. A real privilege
to work with and learn
from the true giants of
periodontology
37MARK TANGRI DENTAL EXCELLENCE |
DENTISTRY
to pick up the tab for cheap botched
work and there has to be some
recognition there. I’ve had patients
come to me that have paid something
like 20 or 30 per cent of the standard
cost of, for instance, comprehensive
veneers and expected me to put
itright.
On the domestic stage, we are also
seeing high street stores offering
limited dental services – tooth
whitening, for instance. There needs
to be greater regulation in that regard.
Often these places aren’t licensed
nearly as much as they should be,
and the products they’re using are
potentially catastrophically damaging.
The rising demand for cheaper
procedures, I think, we can blame in
part on social media. Just as it creates
unrealistic ideals with regards to body
image, so does it affect people’s
relationships with how their teeth look.
Undoubtedly the largest concern with
patients of today, however, is just how
few people actually go to the dentist.
In the UK, latest estimates are as low
as 50 per cent. That’s just staggering.
No ifs, ands or buts: that needs to
change if the dental health of our
nation is to improve.
A closer relationship with
medicine
We are working closely with Warwick
University on designing a dental
diagnostic initiative, and we have a
patent pending on a piece of specialist
dental equipment we can’t go into
further detail about. There is no doubt,
however: as technological change
continues to quicken, dentistry and
medicine will be more closely entwined
than ever before.
One thing I hope will change is how
human-centred general dental practice
is. Historically, it’s been about fitting
people into processes – really, that
should be the other way around.
Patients should get dental treatment
at their pace, and their experience
should be an essential part of how the
sectoroperates.
At Mark Tangri Dental Excellence, we
say that we’re “putting the mouth
back in the body”. We’re trying to kill
that old-school “drilling mentality”
and we know that prevention is better
than cure. It saves everyone a great
deal of time and money – and with our
patients alone, we are seeing the state
of things improve rapidly.
Patients should
get dental
treatment at
their pace, and
their experience
should be an
essential part of
how the sector
operates
An example of case
management of
restoration of a failing
dentition with fixed teeth
using dental implants
2019 graduation from
Harvard Medical School
in surgical leadership

www.marktangri.com

This article was sponsored by Mark Tangri Dental Excellence. 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 Rt Hon Elizabeth Truss.

Rt Hon Elizabeth Truss's Foreword For The Parliamentary Review

By Rt Hon Elizabeth Truss

Even by the standards of the day –this has been one of the most exciting and unpredictable years in British politics.

The leadership election we’ve just seen marks a huge moment in our country’s history. This government is taking a decisive new direction, embracing the opportunities of Brexit and preparing our country to flourish outside the EU.

As international trade secretary, I’ll be driving forward work on the free trade agreements that are going to be a priority for the government. Free trade isn’t just an abstract concept bandied around by technocrats. It is crucial for a strong economy and for the ability of families to make ends meet. Free trade benefits people in every part of our country, as British firms export to new markets and people doing the weekly shop have access to a wider choice of goods at lower prices.

The essence of free trade is in the title: freedom. It’s about giving people the power to exchange their goods without heavy government taxation or interference. Commerce and free exchange are the engine room of prosperity and social mobility. I’m determined to tackle the forces who want to hold that back.

One of my priorities is agreeing an exciting new free trade deal with the US, building on the great relationship between our two countries and the Prime Minister and US President. But I’ll also be talking to other partners including New Zealand, Australia and fast-growing Asian markets.

And with the EU too, we want a friendly and constructive relationship, as constitutional equals, and as friends and partners in facing the challenges that lie ahead – a relationship based on a deep free trade agreement. Our country produces some of the world’s most successful exports, and the opportunity to bring these to the rest of the world should make us all excited about the future. It is this excitement, optimism and ambition which I believe will come to define this government.

For too long now, we have been told Britain isn’t big or important enough to survive outside the EU – that we have to accept a deal that reflects our reduced circumstances. I say that’s rubbish. With the right policies in place, we can be the most competitive, free-thinking, prosperous nation on Earth exporting to the world and leading in new developments like AI. To do that, we’ll give the brilliant next generation of entrepreneurs the tools they need to succeed. Since 2015, there has been a staggering 85 per cent rise in the number of businesses set up by 18 to 24 year olds – twice the level set up by the same age group in France and Germany. We’ll help them flourish by championing enterprise, cutting taxes and making regulation flexible and responsive to their needs.

As we do that, we’ll level up and unite all parts of the UK with great transport links, fibre broadband in every home and proper school funding, so everyone shares in our country’s success.

2019 has been the year of brewing economic and political revolution. 2020 will be the year when a revitalised Conservative government turbo charges the economy, boosts prospects for people across the country, and catapults Britain back to the forefront of the world stage.



Rt Hon Elizabeth Truss
Secretary of State for International Development