Fundamental training

Sir, in the third edition of The first five years the General Dental Council stipulates that newly qualified UK trained dentists should be competent at extraction of teeth, removal of roots and undertaking minor soft tissue surgery.¹ We wished to determine whether recently qualified dentists felt properly prepared to perform such procedures, so an email questionnaire was circulated to 150 UK vocational trainees via the postgraduate dental dean or local vocation training coordinator. Trainees were asked to rate their confidence in five key aspects of oral surgery: raising of a mucoperiosteal flap; use of elevators; bone removal; sectioning of teeth and intraoral suturing.² Trainees were asked to rate their confidence with regard to each procedure as either: 'very confident'; 'confident'; 'not confident' or 'not done before'. Sixty-eight trainees responded to the questionnaire (45%) (see Table 1). Fifty percent of trainees felt they were not confident at intraoral suturing and 17% felt they were not confident using elevators, but there were no trainees who had not done these procedures before. Forty-two percent of trainees felt they were not confident at raising mucoperiosteal flaps and a further 9% had no previous experience. Thirty-two percent of trainees were not confident with bone removal and a further 25% had no previous experience. Thirty-three percent of trainees felt they were not confident to section roots and a further 25% had no previous experience.

Table 1 Responses to the questionnaire. Figures are percentage response rate for each questionnaire domain. Total number of questionnaires completed = 68

These procedures are all integral components of surgical tooth removal. The results presented suggest that UK dental graduates do not currently feel they meet the criteria set out in The first five years. The pattern of referrals to our department supports this suggestion. As a consequence of this lack of confidence in minor oral surgery, it will be difficult for many vocational or foundation trainees to achieve the more ambitious aims set out for competence in oral surgery in the Curriculum for Dental Foundation Programme Training.³

We believe that there is a need for further fundamental training in minor oral surgery, either within the undergraduate curriculum or within dental vocational/foundation training. This should target specifically the trainee's ability to perform surgical tooth removal.