Dental

Introduction

Guy’s and St Thomas’ NHS Foundation Trust Dental Programme provides international visiting professionals with the opportunity to experience our highly acclaimed dental service. The programme provides international dentists with the opportunity to gain first hand insight into our dental hospital and school, which together are ranked one of the top five dental training organisations worldwide, with the aim of providing a unique development experience which broadens visiting professionals’ clinical education. The programme will also enable visiting professionals to learn new skills that can be transferred back to their work place.

The programme offers an unrivalled opportunity to benefit from world class dental knowledge in our London Dental Hospital in the heart of London.

Programme aims

The programme is aimed at registered dentists who wish to extend their expertise in dental treatment and management, and who wish to learn more about Guy’ and St Thomas’.

The programme aims to include:

• Direct experience of consultations and follow up appointments
• Exposure of paediatric and adult treatment clinics
• Opportunities to participate in internal department meetings
• Insight into the diagnostic pathway
• Involvement in care planning for patients
• The chance to undertake research projects
• First hand insight into NHS services and the largest dental hospital in Europe
• The opportunity to create networks and links for future learning and development

A Certificate of Attendance will be awarded to visitors upon the end of their programme.

Format

The programme is delivered within the hospital work place and it includes exposure to treatment clinics, paediatric and adult inpatients and outpatients, the laboratory, and internal teaching.

If a visiting professional chooses to apply for an observational programme they will be aligned with a supervisor from within the clinical team. The supervisor will ensure that all of the learning and development needs and expectations are met.

The programme gives the opportunity for participants to be totally integrated with the day to day service within our dental team.

Who can apply

This programme is intended for non-U.K. qualified dentists. Visitors have the choice of applying for a practical attachment or an observership programme.

All practical attachment visitors must have GDC registration. You can apply for GDC registration directly through the main General Dental Council website: General Dental Council website.

Programme duration

The dental programme is designed to run for an eight week period. The programme’s duration can be extended upon request to meet the specific learning requirements of those visiting the Trust.

Dental service

King’s College Dental Institute at Guy’s Hospital, King’s College Hospital and St Thomas’ Hospital, is the largest dental school in Europe with over 700 undergraduate students and 200 postgraduate students at any one time, with 80 per cent of those studying at Guy’s Hospital. They also train 20 per cent of all dentists that qualify in England and are ranked in the top five dental schools worldwide. It is the only institute to teach all dental specialities at post graduate level and its dental services are world leading in many areas of dental research. 

The Dental Hospital is based at Guy’s Hospital where it occupies floors 20 – 26 of the Tower Wing. There are 250 dental chairs and two dental day case theatres, with the majority of the chairs being used in large open clinics and are for teaching purposes. 

There is also the St Thomas’ Dental Centre, where paediatric dental is hosted, which has 19 chairs, mainly based in individual surgeries. 

Dental Departments

Oral Surgery

The Oral Surgery department works with both routine and complex surgical cases that may be carried out under sedation or general anaesthesia. These cases include simple extractions of erupted teeth and roots including orthodontic extractions, uncomplicated buried roots, simple impacted teeth and MDT jaw necrosis clinic. 

Our Oral Surgery team also accept referrals for the following conditions: 

• impacted and ectopic teeth 
• apical surgery 
• dental and jaw cysts 
• soft and hard tissue swellings of the mouth, jaws, neck and salivary glands 
• oral mucosal ulceration, white and red patches of the mucosa 
• suspected malignancy of the mouth, jaws and salivary glands
• salivary gland disorders (lumps, obstructive salivary disease, chronic salivary disease, mucoceles, swellings of unknown origin) 
• facial and jaw trauma 
• craniofacial and jaw deformities 
• facial and dental pain 
• Patients requiring oral and facial implant rehabilitation. 

Oral Medicine

Our Oral Medicine department provides clinical activities at both hospital sites for referral patients; new referrals can receive multiple assessments and investigations upon their first appointment. We accept a range of referral conditions, including persistent oral ulceration, lymphadenopathy, lichen planus and oral submucous fibrosis, stomatitis and cheilistis, and muscosal manifestations of HIV. 

The oral medicine department also runs a specialist combined clinic of oral medicine and gasteroenterology. This clinic provides an integrated care pathway for the management of orofacial granulomatosis and two multi-disciplinary clinics are run per month, staffed by a gastroenterologist, an allergist and a dietitian in addition to the oral medicine team support a patient base of over 200 people. The collaborative group have an active clinical research program which currently focuses on the aetiology and clinical phenotyping of the condition as well as dietary manipulation and other management strategies. 

Orthodontics

Our orthodontic department will see patients that fall within grades 4 or 5 of the Index of Orthodontic Treatment Need (IOTN). 

IOTN Grade 4 

• Increased overjet greater than 6mm but less than or equal to 9mm. 
• Reverse overjet greater than 3.5mm with no masticatory or speech difficulties. 
• Severe displacements of teeth greater than 4mm. 
• Extreme lateral or anterior openbites greater than 4mm. 
• Increased and complete overbite with gingival or palatal trauma.
• Less extensive hypodontia requiring prerestorative orthodontics or orthodontic space closure. 
• Posterior lingual crossbite with no functional occlusal contact in one or both buccal segments. 
• Reverse overjet greater than 1mm but less than 5mm with recorded masticatory and speech difficulties. 
• Partially erupted teeth, tipped and impacted against other teeth. 

IOTN Grade 5 

• Increased overjet greater than 9mm. 
• Extensive hypodontia with restorative implications. 
• Impeded eruption of teeth due to crowding, displacement, the presence of supernumerary teeth, retained deciduous teeth and any pathological cause. 
• Reverse overjet greater than 5mm with reported masticatory and speech difficulties. 
• Defects of cleft lip and palate. 
• Submerged deciduous teeth.

Restorative dentistry

We offer a comprehensive range of restorative advice and diagnostic services, including periodontology, endodontics and surgical endodontics. 

The majority of our restorative services only provide treatment if referrals are oncology patients, those with developmental defects, trauma patients and patients that are medically compromised. Other services that we offer within this department are prosthetics, which includes treatment for patients who have had several previous unsuccessful attempts to construct dentures, crown and bridgework, and implant dentistry. The implant dentistry team see patients that are edentulous in one or both jaws, partially dentate, that have maxillofacial and craniofacial defects or extraoral implants. 

Sedation and special care dentistry

We provide short term treatment for patients with conditions that preclude treatment in general dental practice. These conditions comprise of complex medical problems, a history of infective endocarditis, severe bleeding disorders, psychological problems, confirmed allergy to anaesthetic agents or latex, profound immunosuppression and severe dental phobia.

Paediatric Department Dental Care

We are a regional centre for children and young people who require specialist oral healthcare and our paediatric department provides outpatient and treatment clinics, an A&E service for dental emergencies, inpatient treatments, and general anaesthetic day surgery. 

Common conditions that our paediatric team treat are: 

• soft tissue conditions 
• special needs 
• dental anomalies 
• complex dental injuries 
• periodontal problems 
• extensive tooth erosion and decay 
• phobias 
• surgical removal of teeth that have failed to erupt 
• investigation of disorders of tooth eruption and loss. 

The paediatric dental team run a variety of inpatient and outpatient treatment clinics, many of which operate jointly with other dental teams. 

Hypodontia Clinic

This weekly clinic plans the dental care for children with hypodontia and consists of dentists, orthodontists, restorative dentists and oral surgeons. The aim of the clinic is to provide the best possible appearance of the smile through childhood and adolescence. 

Clinic of Dentistry and Orthodontics

The joint clinic operates on a bimonthly basis at the dental centre at St Thomas’ Hospital and it serves to manage patients who have both dental and orthodontic needs. It is run by both children’s dental and orthodontic consultants. 

Oral Medicine

This is a joint dental and oral medicine clinic that treats conditions affecting both the head and neck and that are connected with medical conditions.

Dental Genetics Clinic

This specialist clinic runs approximately four times a year and includes a clinical geneticist, a dentist and an orthodontist. Children and young adults with undiagnosed conditions involving the teeth, mouth and face are seen with a view to finding an underlying diagnosis. A particular group of patients seen are those with skeletal disorders which also affect the teeth.

Fees

A course fee per week will be applied; this fee excludes accommodation and travelling expenses. To find out the fee amount please email vpp@gstt.nhs.uk.

Please note

Clinicians are able to offer bursaries or discounted placements on an individual basis. This is at the discretion of the Directorates of GSTT and does not affect the terms and conditions of the Visiting Professional Programme agreements.