Welcome to another packed issue of Vital. We hope that you will find this issue as useful and interesting as ever. We have fitted a lot in, so make time between your busy appointment schedule and your Christmas shopping to sit down with a cup of coffee and have a flick through. Here is a taster of what's in store.

Mabel Slater leads by example (page 16), showing what kind of career can be built on the foundations of being an enthusiastic and committed member of the dental team; and with the GDC in a position to make a dental career even more flexible, Mabel explains that why now more then ever, the sky really is the limit.

For dental nurses, there are two articles this issue which show the interesting ways that careers can develop. The first of these is to become indispensable to the dentist by becoming more involved in the delivery of the dental operation – otherwise known as four-handed dentistry (page 19). Keith Marshall describes in detail how this can be achieved and gives us an example of it working in his practice.

The second career development angle is that of specialising in orthodontic dental nursing (page 26) where relationships with patients are given time and opportunity to develop in many ways. The highs and lows of orthodontic nursing are described by Julie Ferry.

Child abuse is a sad fact of today's society. A staggering statistic is that 59% of the physical signs of child abuse are on the head, face or neck: and therefore as members of the dental team we are well placed to alert child protection agencies of concerns over a child's welfare. Two paediatric dental specialists from Glasgow Dental Hospital sensitively explain what to look for and what to do should you suspect abuse of some kind (page 23).

We tackle another sensitive subject in our advice section this issue, although it is something we all have to deal with from time to time; that is dealing with complaints (page 37). Gordon Miles explains that complaints don't necessarily need to be the negative encounter we often dread them to be, but properly handled, could have a positive influence on the practice and the services provided.

Along these lines, our perspectives topic for this issue is about irritating patients (page 14), and the team members we spoke to didn't hold back on their comments. It seems being late or not turning up for an appointment is one of the biggest sins as far as the dental team are concerned, but don't let it get you too cross, Anthony Asquith describes how self hypnotism may just be the skill you need to get you through the day (page 29).