Promote Public Prevention in Health

My vision some time ago was to promote public prevention in oral health. More recently, following the experience of Covid and the opportunity and time to look into health in general, I think we drop the word oral.


We work in the health business, and health should be our priority. More and more, the emphasis is business first, and health second as applied by many dental corporates. One could argue the biggest one is the NHS system. Despite the phrase you will have heard, "I hate the dentist", the public trust us. We can utilise our circle of trust by nudging the general public into better health habits as well as interdental cleaning. The idea is for the simple App to provide preventive and specific marketing advice that promotes you, as you can customise the App yourself. It's what Stephen Covey would call a win-win. It saves us time by supporting our oral health advice the public needs and earns money by explaining your recommended services, which the public generally wants. It saves time and money for the public also.


The BPE is related to general health, and the BEWE is associated with the high volume of UPDs, the resulting obesity and type 2 diabetes epidemic, and the increase in UPFs more readily available and affordable from when I qualified in 1982. Why not include some of these details in a simple format, or include links to trustworthy sites other than the "Fake news" that has paralysed water fluoridation. We can be central to health delivery, as the NHS system is overwhelmed by the six million plus backlog of treatment. We can help.


Teeth4life also encourages the public to set reminders for screening themselves. It is not a diagnostic device but a tool to help raise public awareness and access a developing triage process. As with all cancers, early diagnosis improves outcomes. I have engaged the NHS, and specifically, help with funding to help add Teledentistry and a language option that the NHS want. We need an RCT for evidence and demonstrate a profit before they consider supporting it. The Dahl technique in orthodontics and the Hall technique in paediatrics originated from single cases. The proof came later. Clayton Christensen stated years ago regarding disruptive innovation in health delivery that you can't have historical data on innovation. The NHS framework has neglected the public and ourselves in delivering a model for prevention in health for decades. Why not promote ourselves centrally in promoting health rather than being sidelined by this overwhelmed bureaucracy?


The fixed prevention videos follow the government's evidence-based "Delivering Better Oral Health" toolkit. For the App to continue, it needs funding, as outlined elsewhere on this website, with supporting videos for all the dental team. It needs funding to maintain it as a free resource for the public and the majority of DCPs. It would take 0.25% of registered dentists paying £10 a month to keep the current version of the App, or 1% to improve it. Some contributions by peer review study groups would be more helpful to collaborate and help develop the content and functionality iteratively as with most Apps. Banking Apps have resulted in the high street changing significantly. Why not with health delivery? It would be our dental profession taking the lead in our nation's health, rather than the usual spin by the government on greedy dentists. Want to help?


In her lifelong work, Marion Nestle is looking for advocates to reduce the negative influence of the food industry on our health. We need to be able to provide a health service for the general public. The dental team have that position at zero cost on our time as we can include minor incremental changes or nudges within the video content, which we know work, as with Team GB in the 2012 Olympics. We also need to address the long-term issue where most of the population will not be able to afford our services, as outlined by Michael Sandel, and the legal system has crept into the profession, as outlined by Johnathon Sumption. We need to look outside our business to provide a fair solution for us and the public.


Don't hesitate to contact me if you are interested in a bespoke version for your dental business. Please register on care4teeth.co.uk and look at how the App can market you.
If you want us to register you or if you want to take part in a webinar for further information.

"I WILL NOT SUE THE NHS". -Kevin Lewis NEC May 13, 2022.


If you get the chance, see Kevin Lewis. He is a great speaker, and I first listened to him in the 80's explaining how we could provide prevention on the NHS by exploiting the grey areas. Like me, he is no longer worried about getting off by the GDC. Those still working in practice aren't so fortunate, but perhaps those of us retired or about to retire can at least express our opinions and help the profession.
The statement " I will not sue the NHS" was the final slide of his presentation "Outside the Box". It's safe to presume he was referring to dentistry. But ?. It's interesting how dentists working in the NHS can get sued as individuals, whereas if a hospital has a problem, the NHS gets sued. If a dentist working for a corporate gets sued................ It is a minefield out there.


And talking of mines, the NHS was set up by a miner. Nye Bevan, who left school aged 14 to work in a coal mine. It would be interesting to speculate on what he thinks of our NHS now. One principle was the NHS is free at the point of delivery, so the principle of the NHS has not applied to dentistry for some time. I remember my first boss telling me dentistry was doomed as the fees went up to just over £10, covering all treatment in a system that paid on the item of service. He also advised that I buy added years for the excellent NHS pension. It's why like doctors, I could retire early. It was a long time ago. Back in the 70's our NHS started to be questioned, as in this audiobook.

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Accidents do happen, or in legal speak, poor outcomes. As you will know we need to point out that we learn from mistakes, as shown by the airline industry and the black box. If an error occurs, it's a learning process. While immediately after a plane crash, human error is deemed responsible, just as with the Boing 737 Max. The company tries to blame the pilot. Humans don't have a black box, and often the maintenance of the body isn't great, and we all respond differently to different assaults to our fuselage, which is why some procedures have poor outcomes. But it isn't always a mistake. Few sue a good outcome following a poor procedure. If we kept having excessive poor outcomes in the past, an RDO could intervene, ideally before the lawyers and the GDC. As outlined in "The Design of Everday Things" by Don Norman, humans often make mistakes and errors due to the working environment, materials, training, and equipment. We aren't brain surgeons, but we try to "Do no Harm", as discussed by Henry Marsh. 


An interesting observation of the air industry development was that the Wright brothers started it with limited resources and education, unlike Samuel Pierpont Langley, who had both. The plane got off the ground by trial and error from a passionate, enthusiastic group, not by the top academics with massive funding. 


Many dentists went down the private route around 2006 with a negative misleading media spin. Most dentists I know went private years ago to provide a better service for their patients. Often for less money. The high earners that everybody heard about were working mainly in the NHS at the time. We could get the media on our side by using existing technology to deliver prevention through our Dental Health Service, provided by general dentists from a bottom-up business model rather than a beurocratic top-down one. We can deliver some basic oral health advice using the technology the public carry with them 24/7. 

If we collaborate, we can distribute a free trustworthy resource for the general public. It will cost us buttons as a group. Raising the bar, however slightly, will positively influence the public's general health. That will help reduce the burden on the resources of our NHS. It will also help change the usual hostile media we used to get, which finally seems to be landing with the politicians, not the profession.
No matter which practice you work at good oral hygiene is the basis of good outcomes. The teeth4life App has a traffic light system to engage the user to take ownership of their health. It also help highlight oral and skin cancer awareness. We don't have to work in the NHS system, but we can all support it.


General dentists are nervous about carrying out relatively straightforward procedures because of the potential poor outcomes. As dentistry has "progressed" it has become more specialised so that certain incremental changes in treatment produce minor improvement in outcomes at a much greater cost. Does this serve the general good of the nation? Can we change the perception?


As general dentists working to provide an excellent service, we should not be stressed by the worry of litigation. Invariably there will be occasions when things do not go as either the dentist or the patient would like. If there was a ceiling in the cost of litigation dependent on the service provided. The more you pay for a procedure, the greater the compensation in the rare instance you get a poor outcome. If you are seen on the NHS, that bar should start as low as Kevin suggests. 
All evidence shows you get better outcomes when none of you are stressed; this applies to the dentist and the patient. Spending five minutes talking to your patients, rather than ten, writing up the notes will reduce litigation. There was a case recently where a patient complained six times to the dentist about a persistent ulcer. She mentioned it to the hygienist, who referred her to the hospital. After treatment of the SCC, the upset patient complained. No action was taken against the dentist, as he hadn't written up the notes. 
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This video I made before I retired, it was a bit controversial, so I used the software to change the language to Spanish using the AI in the software. A future version of a teeth4life App could be available in multiple languages utilising pre-existing AI, or even with your authentic, trusted voice in the videos.

I saw Elvis yesterday, and it was well worth seeing. This isn't a spoiler, but at the end it shows the last performance Elvis carried out a week before he died. The current view is addiction to drugs, one of which is Amphetamines which were given in the 60's for weight loss. While product placement occurs in many movies, I'm not sure if this is one Coca-Cola would have liked highlighted in this film. Perhaps as advocated for health we should?

This is the full video.
https://youtu.be/4svkR46CesI
​ He never lost his voice.