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One does not perhaps immediately think of 'Torquay' and 'change' in the same sentence. Sleepy notions of seaside holidays past combine with images of deck chairs and sand castles, fish and chips and guest houses to provide a cosy aura of times at rest. Yet the BDA's 1999 Conference based in and around the Riviera Centre, Torquay could hardly have provided a more stark contrast in its overview of change in the dental profession or, as the title of the Conference had it, 'The Business of Dentistry'.

The harbour in Torquay

The business of ...team work

With time being such a precious commodity there is a tendency to use conferences nowadays as the opportunity to add on extra meetings on the basis that people will either already be at the venue, or can extend their stay if they wish to take in extra sessions. It was just such thinking that prompted the organisers to include a pre-conference symposium on the Thursday, strictly speaking the day prior to the main event, jointly organised by the BDA and the General Dental Council (GDC). Entitled, 'Teams for Tomorrow', it attracted a large audience to consider the future of the dental team in its widest sense. Chaired by BBC Social Affairs Editor, Niall Dickson, the day got off to a cracking start with a presentation by Professor Alan Maynard, Joint Director of the York Health Policy Group.

The Riviera Centre, Torquay which provided excellent facilities for the smooth running of the Conference.
Geoff Garnett (left) retiring President congratulates and welcomes in-coming President Stuart Robson at the Opening Ceremony.

Professor Maynard pointed out that dentistry was characterised by changing working methods whose evidence base was poor due to failure to evaluate practices. He felt that dentistry had three pressing 'needs' before it could start to consider the construction of teams; the need to evaluate, the need for evidence based practice guidelines and the need for better incentives to induce cost effective practice. In a speech, which in many ways set the tone for the day, he asked if by including professionals with different skill mixes, we were merely substituting cheaper personnel or creating truly complementary colleagues.

Chris Stock, one of the main guest speakers

The development of roles within teams in healthcare was further expanded upon by Sarah Waller from the UK Central Council for Nursing, Midwifery and Health Visiting (UKCC). The nursing world holds valuable comparisons with dentistry's likely future situation in which delegation of clinical duties will become far more common place. Sarah therefore considered the personal and professional accountabilities of those now included on the UKCC's register and the consequent responsibilities which such duties placed upon the individuals involved as well as their managers and team members.

Statistical and management consultant Graham Try asked whether we had 'Too few dentists?' Always a very difficult area in which to try and predict future trends, dental staff planning is beset with the problem of how one defines and calculates 'needs' and 'demands'. Explaining his carefully worked through logic, Graham attempted to estimate the supply of dentists over the next 40 years. Using his analysis he revealed the fascinating prospects that by the year 2036 between zero and five per cent of the population would be edentulous and that the profession would be equally composed of men and women.

Professor Brian Edwards, Chairman of the Council for Professions Supplementary to Medicine (CPSM) provided useful background to the medical model, and set the 'cat among the pigeons' by saying that groups who might find themselves excluded from registration with the GDC could well be eligible via the CPSM.

The BDA stand at the exhibition

Other aspects discussed throughout a comprehensive day's examination of the multi-issue topic included the expectations and protection of the public, the legal framework and the training imperatives for all members of the future team, however it is finally constituted.

BDA Chief Executive John Hunt and Victoria Wilson at the launch of the BDA Website - now active on www.bda-dentistry.org.uk and www.bdj.co.uk

The business of ...discipline

Vocational Dental Practitioners are always in abundance and welcome evidence at BDA Conferences being, as they are the future of the profession. Their special occasion, except perhaps arguably for the very well attended and thoroughly enjoyable 'Ball', was a full session devoted to 'The Business of Discipline' which, which was chaired by Dental Protection's Kevin Lewis, took the young practitioners through a mock NHS disciplinary hearing.

The subject of the hearing, a character with the unlikely but ominously far-sighted name of 'Len Dintears', was played superbly by Young Dentist favourite Len D' Cruz who was being accused of over-prescription. A skilfully shot video was used as clips in the form of 'flashbacks' to illustrate how the sorry state of affairs had developed, allowing the audience the insight into some of the ways in which the unwary can easily fall prey to less than ethical practices, in all senses of the word. Judging by the rapt attention from the audience as their hapless, erstwhile colleague faced the music, the lesson was driven home in humorous but unflinching style.

The business of ...the opening ceremony

Opening Ceremonies, like awards presentations, can degenerate into self-satisfying affairs for the great and the good. Not so in Torquay. Skilfully guided by Executive Director John Hunt and clearly, carefully stage-managed in the choreographic sense, the Conference Opening Ceremony provided just the right balance between critical and celebratory self-examination, present successes and optimistic future prospects. The last opening ceremony of the twentieth century it may have been but it was also one from which delegates could not have departed without a sense that the BDA had indeed very obviously got its act together to go forward to the twenty-first century.

The business of ...the trade exhibition

Modern design and construction methods dictate that trade shows are no longer populated by sheepish looking people standing behind uniform rows of display counters. The colourful and lively exhibition in Torquay proved no exception. Proving to be very popular with delegates, the show, consisting of over 80 exhibitors with a huge variety of goods and services on offer, attracted good attendances throughout the three days. With technology and associated services changing and developing so rapidly, trade exhibitions are now more essential than ever before for the purposes of browsing and updating. It is clearly a two way process though, with exhibitors being just as keen to update their knowledge of 'what the customer wants' and whether or not he or she is satisfied. A lesson for us all.

Roll call: BDA branch and group presidents and conference platform party outside the conference centre.

The trade exhibition was also the venue for the successful launch of the BDA and BDJ's new Websites, respectively: www.bda-dentistry.org.uk and www.bdj.co.uk. Also now available and launched the same day are two new BDJ books: very pertinently The Internet Guide for Dentistry and Complete Dentistry - Problem Solving.

The business of ...innovation

It is always refreshing to gain an outside perspective and the keynote speaker in the opening plenary session provided such an opportunity. Geoffrey Nicholson, Staff Vice President of 3M, gave a fascinating presentation entitled 'The Business of Innovation - A Survival Issue' in which he detailed the way in which 3M aims at any given time, to create 30 per cent of sales from products introduced in the previous four years. Listing six imperatives for innovation; vision, foresight, stretch goals (management-speak for challenging goals), empowerment, rewards and recognition, and communication, Mr Nicholson stressed that people need time to think and work on their own projects in order to be innovative.

Within 3M, he described how the 15 per cent rule applies, by which up to 15 per cent of an employee's time may be spent on projects which may ultimately benefit the company but which are of his or her own choosing. Innovations which have resulted from the system include the omni-present and world wide sales phenomenon the 'post-it' note which was developed from an employee's need to mark his place in his hymn book but not to damage the pages as a result.

From left to right: Professor Andrew Rugg-Gunn, Professor C Edward Renson, Dr Sam Barsam, Mrs Rosemary Kahn, Dr Stuart Robson (BDA President), Dr S Prince Akpabio OBE, Dr David Rule, Professor Norman Whitehouse, Dr David Phillips OBE, Mr Len Griggs and Dr Geoffrey Garnett (past President).

BDA Honours awarded at the conference: Roll of Distinction Dr S Prince Akpabio OBE Dr Sam Barsam Mrs Jane Gordon Mr Len Griggs Mrs Rosemarie Khan Dr David Phillips OBE Dr David Rule Honorary Membership Professor Norman Whitehouse Fellowship Professor C Edward Renson Tomes Medal Professor Andrew Rugg-Gunn In summing up the successful requirements for a thriving enterprise in whatever market, Mr Nicholson declared that 'discovering an unarticulated need' was the key element to innovative business.

The business of ...clinical dentistry

For many, the bread and butter business of dentistry is the clinical element and there was plenty of opportunity throughout the conference to catch up on the latest thinking and developments. The business of preventing clinical problems was tackled by three speakers. Professor Bernard Smith from Guy's, King's and St Thomas' Dental Institute concentrated on the fact that conservative dentistry really does live up to its name in modern clinical practice, incorporating techniques of micro-cutting for intra-coronal restorations and resin bonding to reduce removal of tooth tissue to an absolute minimum. Professor John Hobkirk of the Eastman Institute considered the aspects of implant treatment that could give rise to failure, and the ways in which such problems could be prevented. Professor Tony Pogrel, a dental graduate from Liverpool but currently from the University of California, San Francisco described how the restrictions of insurance companies and the results of medico-legal opinions resulting in lawsuits in the USA have altered the philosophy of third molar removal. This has resulted in the need for documented reasons for the removal for each third molar extraction and a complex and far ranging procedure for gaining consent from the patient. By turn, each speaker brought his special knowledge to the subject providing delegates with those all-important 'tips' for success, or at least avoiding pitfalls, which are so valued in busy practice.

The dental exhibition
BDA honours: Professor 'Ted' Renson receiving his fellowship (above); Professor Andrew Rugg-Gunn receiving the Tomes medal (below); and Professor Norman Whitehouse receiving his honorary membership (right).

Dentistry 2000

Next year's BDA Conference will take place at the National Exhibition Centre in Birmingham. It will be a unique event as for the first time the BDA Conference will run in tandem with the BDTA's Showcase Exhibition. in addition, at the time of going to press 27 organisations have already submitted proposals to join the fringe programme of meeting, seminars and workshops. Running from 6-8 April 2000, Dentistry 2000 is expected to be the largest event of its kind in the UK and will be the first meeting this side of the Atlantic to combine a major trade show and a world class scientific meeting.

Pain control is another area of our daily lives which demands particular attention. In the session devoted to this topic, Professor Philip Rood, Chris Bell and Ken Roberts respectively described recent challenges in local anaesthesia, sedation and hypnosis. The recent GDC ruling on the use of general anaesthesia in dentistry has thrown the spotlight back onto consideration of other forms of pain control and patient management and this session unquestionably allowed delegates the opportunity to consider re-assessing their own use of the various options.

In a similar vein, but with updates specifically on the menu, came Chris Stock with endodontics, Callum Youngson with materials, Bernard Keiser with periodontics and Professor Martin Addy with prevention. All of these provided excellent material for the type of continuing professional development fore-shadowed in the GDC's future proposals for reaccreditation and recertification.

Stephen Hancocks, commissioning editor for the BDJ poses between the two new BDJ books.

The business of ...lifelong learning

The future of postgraduate education was the subject of a session of its own, kicking off with Jim Rennie, Director of Postgraduate Dental Education for Scotland and a member of the GDC describing the challenge of recertification for 28,000 dentists. The logistics of such a task are quite enormous and Jim emphasised that any system would be 'only a start' and one which would inevitably require continual monitoring and refinement in the light of experience.

BDJ Editor, Mike Grace followed this up with the ways in which journals can serve both readers and organisers of postgraduate education by providing ease of access, reliability and scientific credibility. Given that so many dentists cite journals as a prime source of material for keeping up to date, the role of published work is likely to increase as we move towards more formalised postgraduate study.

The electronic communication revolution was also discussed in this context with Damien Walmsley speculating on the future use of computer assisted learning. This could be especially valuable as a distance learning tool, while the growth of resources available on the internet as a source of information. This theme was further taken up by Mike Lees, a specialist in health care communication who described the International Association of Dental Research's interactive debating site, The Dental Faculty.

The business of ...capitation

Much excitement has been generated in recent months by the continuing interest of 'big players' in the field of corporate dentistry. Indeed, the topicality of the subject was underlined during the conference itself as rumours that high street optical group Specsavers were also about to enter the market. A session on Saturday morning considered the points of view, not just of the dentist, but also the investor and the entrepreneur. Retiring BDA President Geoff Garnett described the reasons why he decided to take his practice, based on 34 years of experience, under the umbrella of a corporate body, while the session as a whole brought together speakers from Whitecross, Denplan, Dencare, Integrated Dental Holdings and a venture capital company. Whatever conclusions delegates brought away from the morning's session, there was no doubt on one matter; that the corporate influence in dentistry was here to stay.

The business of ...big business

The President's debate took centre stage on the last afternoon of the Conference with the proposition 'This house believes that capitation promotes under-treatment'. Speakers for the proposition were Laurence Lando and Barry McGonigle, and in opposition were John Tiernan and Norman McKenzie. Following the usual rubric of debate, the four speakers each put forward their case before the President opened the subject to the floor. As might be anticipated, the discussion was lively, encompassing the views of those firmly wedded to the principle of capitation as well as those who clearly see it as the devil's work! Anxious at the start of the afternoon to put on record that what ever the result of the eventual vote, it was not to be construed in any way as BDA policy, the President finally declared the proposition lost by 61 votes to 16 with 28 abstentions (presumably those waiting to see if it was just a sticky fissure or a real issue!)

Thanks to the main sponsors 3M Dental Advil - advanced medicine for pain Arm and Hammer Dental Care BDA Insurance Services BDA University Teachers' and Research Workers' Group BDA Yorkshire Branch Denplan Ltd Dentists' Provident Society Dentsply HSA Healthcare KaVo Dental Ltd Kodak Medical Specialty Imaging Group MIA Ltd SmithKline Beecham Stafford-Miller Ltd The MDU Dentist The Tea Council Whitecross Dental Care

The BDA's conference office staff from left to right: Katherine Fort, Katy Clarke and Charlotte Long

Elsewhere, new products were launched, initiatives unveiled, hands shaken, contacts made and traditions founded and extended as the usual panoply of a BDA Conference continued in and out of the glorious sunshine with which the event was blessed. The Business of Dentistry unquestionably received a thorough airing at a Conference that was pleasant, challenging, thought provoking and a credit to the Association.