Realistic Dentistry: the principles in practice series

The Realistic Dentistry Group introduces Principles in Practice, a series of articles covering the principles of Realistic Medicine and how they can benefit patients and your practice

07 October, 2024 / indepth
The Realistic Dentistry Group

A female dentist and patient sit across from each other discussing treatment.

On 21 November 2024, the dental sector will come together in Glasgow for the Annual Dental Conference at the Royal College of Physicians and Surgeons of Glasgow where the spotlight will be on Realistic Dentistry.

Practising Realistic Dentistry, based upon the principles of Realistic Medicine¹, aims to place patients at the centre of their care and do so sustainably and equitably. It is about delivering outcomes that matter most to people whilst allowing dental professionals to provide high-quality care which is valued, professionally fulfilling and sustainable.

To coincide with this event, and by way of introduction to the guiding principles for those wishing to know more, we are publishing a series of articles covering the six principles of Realistic Medicine. Each article will provide scenarios highlighting how a Realistic approach can be adopted, and the positive outcomes it can deliver for patients.

What are the principles of Realistic Dentistry?

A personalised approach to care

Personalising your patients’ oral health care helps us to build the kind of trust with patients that is key to positive experiences and better outcomes. Evidence suggests that people who feel they’ve been listened to in medical consultations are more likely to adhere to treatment and less likely to regret their treatment choices².

Shared decision making

Sharing decisions with patients on their care empowers them, grants them ownership for their oral health, and can reduce waste by avoiding the provision of unwanted interventions. It requires a shift away from “Dentist knows best” to meaningful discussions about treatment options, their benefits, risks, and the alternatives.

Reduce harm and waste

Overuse of investigations and treatments can risk harm to patients and can lead to unwanted outcomes. By seeking out ways in which we can reduce waste, such as being vigilant with prescribing, or following best practice guidance on the management of periodontal disease or recall intervals, we can provide dental care that people value.

Managing risk better

Open conversations with patients about the risks and benefits of care options are integral to best practice. Inadequate consent was the most common recurring issue in complaints investigated by the Scottish Public Services Ombudsman³. More transparency and more meaningful conversations may lead to less litigation, not more⁴.

Reduce unwarranted variation

Unwarranted variation is variation in care unexplainable by need, or by explicit patient or population preferences. Stopping overuse and overtreatment can free up resources currently used and not providing a benefit to patients.

To become improvers and innovators

Being an improver and an innovator is about feeling confident in blending the use of the best available evidence and guidance, your sound clinical judgement, and utilising the rapport you have built to listen to what matters most to them.

We asked Dr Mark Bradley, General Dental Practitioner (GDP) in NHS Ayrshire and Arran, what Realistic Dentistry means to him: “Realistic Dentistry attempts to provide a framework to improve both the patient and the workforce experience within NHS dentistry. As GDPs, we are adept at providing high quality care to a large number of patients. But this can come at the expense of the patient experience; where long waiting times, short appointments or a lack of referral pathways can result in frustration for everyone involved. As we look to new models of care for general practice, leaders and stakeholders have a framework to guide policies which create meaningful change, to benefit, not only the patients we treat within the NHS, but also to provide GDPs and dental care professionals with a more sustainable and fulfilling role in supporting and maintaining the oral health of their patients.”

Look out for the next article in this series which will explore the shared decision-making pillar.