Thursday, 24 September 2026

Good morning.

This week: someone finally tried to put a number on the value of a clinical dental hour, a new endo trial produced a surprisingly useful result, and “regrowing enamel” just attracted £3 million.

Also, a deadline worth forwarding to the newest associate in your practice.

Let’s get into it.

THE DRILL

A new Department of Health review estimates the economic cost of providing dental care at around £145 per clinical hour, with different methods converging around £145–£150.

That isn't simply the cash cost of a surgery.

The calculation includes opportunity cost: what a dentist could reasonably earn by allocating that clinical time elsewhere, particularly towards private care.

The same review records more than 389,000 fewer publicly funded patient registrations since 2022, despite no clear corresponding fall in the number of licensed dentists.

The Department says fully addressing the findings isn't currently affordable. Instead, officials will begin an options appraisal for payment reform and fee rebasing, followed by a future public consultation.

For dentists outside Northern Ireland, the interesting bit is the method.

For once, someone has tried to put a number on what a dentist's clinical time is actually worth when there is somewhere else that time can go.

The GDC received 138 whistleblowing disclosures last year, up 74%.

All opened an FtP case. But 39 were closed at assessment because there wasn't enough information to progress them, and 82 of the 99 continuing cases are still at assessment.

The GDC also says easier identification of whistleblowers and a 26% rise in concerns overall may partly explain the increase.

So:

74% more whistleblowing disclosures does not mean 74% more misconduct.

Worth remembering when the headline inevitably travels further than the footnotes.

QUESTION OF THE WEEK

Researchers performed partial pulpotomies on 139 mature mandibular molars with deep caries.

At two years, overall success was just over 91%.

Which variable was significantly associated with treatment outcome?

A) MTA vs premixed calcium-silicate putty

B) Pre-operative pulpitis classification

C) Haemostasis time

D) Patient age

Have a think.

Answer near the bottom.

DENTAL TECH

A King’s College London spinout has secured new investment to take its keratin-based enamel technology towards market.

The science is more interesting than the headline.

Published laboratory research found that keratin could guide organised apatite growth on damaged enamel and form a new enamel-like mineralised layer, with recovery of optical and mechanical properties in early lesions.

The company is now working towards consumer and professionally applied products.

But don't bin the composite yet.

The evidence behind this remains laboratory-based, not a clinical trial showing lost enamel being regenerated in patients.

Interesting? Definitely.

Ready to rewrite restorative dentistry? Not from the evidence we have yet.

MONEY IN DENTISTRY

If you became self-employed during 6 April 2025 to 5 April 2026, check whether HMRC knows about you.

If you're a sole trader and earned more than £1,000 gross from self-employment, you're among those who may need to submit a Self Assessment return. New filers who need one must tell HMRC by 5 October 2026.

And an easily confused point:

5 October isn't when your tax is due.

For online returns, the filing and payment deadline is 31 January 2027.

If your first associate job started last year, this is worth checking now rather than on 6 October.

BREAK THE ICE

Try:

“Before I have a look, what's the one thing you'd most like me to understand about your teeth today?”

It tends to get you more than “any problems?”

And sometimes the answer isn't the thing written in the appointment book.

THE ANSWER

The trial followed all 139 treated molars for 24 months.

Success was 90.6% with MTA and 92.0% with NeoPutty. No meaningful difference between them.

More interestingly, the patient's pre-operative Wolters pulpitis category was not significantly associated with outcome.

Haemostasis time was.

That doesn't prove haemostasis time causes success or failure. It's an association within one trial.

But it does suggest that what the pulp does once you're actually in there may provide useful information alongside what it was called beforehand.

A good result, and a good reason not to reduce vital-pulp decisions to the material in the tub.

THE LAST RINSE

Perfect rubber dam.

Clamp secure.

Everything finally dry.

“Sorry… can I use the toilet?”

Some failures are not adhesive.