Sir, whilst reading my wife's copy of the BDJ I came across J. White's letter (BDJ 2018; 225: 93) regarding dental core trainees (DCTs) and out of hours (OOH) cover. The tone of the letter and its content were concerning to me as an anaesthetist.

I agree that nobody wants a return to the days of 1:2 cover and 100-hour weeks, but there is a need to balance training and service provision. And, whilst true that nights may be harmful to health in the long term, someone has to do them.

The patients don't stop getting unwell just because it's an anti-social hour. Whilst there may be issues with covering medical complaints, trained dental senior house officers (SHOs) are best placed to provide immediate care for those with dental/maxillofacial trauma and disease OOH.

Nights gave me some of the best experience during my training. I was able to take what I had been taught under direct supervision and apply it without someone standing over my shoulder. I was able to find my own way of doing things but safe in the knowledge that I had senior support as needed. This experience would be essential for those considering a career in OMFS, as many DCTs may be.

Just because someone is not there teaching you, it doesn't mean you're not learning. Developing autonomous practice is vital for any doctor or dentist, especially those that find themselves working the majority of their career alone in practice.

With specific regard to the NG tube call; I hope that the author attended promptly to the ward nurse's concerns and assessed the patient because the 'intra-oesophageal somersaults' referred to in the letter are certainly possible.

I have seen two patients with aspiration pneumonitis because their NG tubes had migrated up the oesophagus after vomiting but appeared unchanged from the outside and feeding had continued. A misplaced NG tube is a Never Event1 and strict guidelines must exist for the insertion, checking and monitoring of patients with NG tubes.