DentalSASH welcomes Dental Core Trainees, Dental Paediatric Trainees and Special Care Dentistry Trainees. This section covers Training information for both trainees and established Consultants. Training Programmes Home
The Dental service at SASH has a strong multidisciplinary focus, with both Level 2 (enhanced primary care) and Level 3a/b (specialist and consultant led care) services hosted within the department.
Trainees will gain experience/exposure to specialities including oral surgery, orthodontics, paediatric dentistry, restorative and special care dentistry. Trainees will gain experience of treating patients under local anaesthesia, conscious sedation and general anaesthesia.
Education and Clinical Teams
Mili Doshi is a Consultant in Special Care Dentistry and has worked at SaSH since 2014.
Mili has always been very committed to improving oral health services for adults with special care needs and integrating oral health into general health. Mili has a special interest in behavioral management and has established a dental conscious sedation service for special care patients. Together with her team she has developed several pathways for hospitalised patients to improve access to dental care.
Mili is leading on a Health Education England initiative, working to improve oral health for vulnerable adults, called ‘Mouth Care Matters’. After a successful pilot at East Surrey Hospital this initiative has been rolled out across 13 trusts in Kent, Surrey and Sussex and is currently being rolled out nationally.
Shrina Nathwani is a Consultant in Oral Surgery and has worked at SaSH since 2019. Ms Nathwani is also a senior clinical tutor in Oral Surgery at Kings College London. She has a Masters in Health and Medical Education with distinction and is a fellow of the higher education academy.
Her specialist interests include management of the medically compromised patient in oral surgery and dental education. She has a number of publications in peer reviewed journals including ‘Education in the Workplace’ and evidence based management of anticoagulated patients for dental procedures in primary care.
Sophie is a GDC registered specialist in paediatric dentistry and is a Consultant in Paediatric Dentistry at Surrey and Sussex Healthcare NHS Trust.
Sophie completed her dental undergraduate training at Bart’s and the London School of Medicine and Dentistry and has held dental core training posts in oral and maxillofacial surgery and paediatric dentistry across London and the South East.
She completed her speciality training in 2017 whilst working at East Surrey Hospital, Redhill, and her special interests include; dental trauma, dental management of medically compromised children and child safeguarding.
The Dental Core Trainees are expected to see ward patients with urgent dental care needs and support the Mouth Care Matters initiative.
The Trainee Experience
Dr Istapraq Hashem
As a DCT 1 in a multidisciplinary role, my week is very interesting, and I am always doing something different.
On a Monday morning, I have an outpatient minor oral surgery session, where I work closely with oral surgery staff grade, treating patients under local anaesthetics for surgical extractions and biopsies and those that are medically compromised. In the afternoon, I am in the outpatient maxillofacial clinic, where I see patients alongside a Maxillofacial Consultant. It is an interesting clinic, where I assess patients for all sorts of oral conditions, I review patients with trauma and I treatment plan. Mondays have prepared and allowed me to pick up various surgical skills and improve my suturing. It has permitted me to treat and assess complex patients, which would routinely be referred out of practice. I have also learnt how to appropriately refer patients in the future if need be.
In the morning, I am involved in seeing newly referred orthodontic patients in the assessment clinic. However, like everything at this unit, nothing is the same or boring as once a month, there is a joint paediatric/orthodontic clinic – this involves treatment planning for complex cases. Furthermore, once a month the department runs a joint orthognathic clinic with a Maxillofacial Consultant Surgeon. In the afternoon, it is Mouth Care Matters ward work and this is one of my favourite perks of working at SaSH. The Dental/Maxillofacial department works closely with the medical team receiving ward referrals. Lorraine the Mouth Care Matters Lead Nurse has been an eye opener as she is very experienced and can support you in navigating the hospital wards and examining patients.
Midweek, you start the day with an oral surgery clinic, working directly with the Consultant to assess patients with a variety of conditions who have been referred from different General Dental Practitioners. This involves triaging the cases and allocating patients to appropriate treatment clinics such as local, IV sedation or general anaesthetics. The afternoon is spent in an orthodontic treatment clinic, seeing patients alongside the Consultant. Due to this opportunity I am now able to treat and advise on aspects such as bonding up and debonding patients, reviewing, undertaking new patient records and much more. This has been a valuable addition to my skills.
At the start of the year, a Thursday morning was dedicated to a rapid 2-week referral maxillofacial clinic assessment of urgent patients. During the latter half of the year, I was given the opportunity to participate in paediatric inhalation sedation clinics and treating children with anxiety and behaviour problems, under the supervision of a Dental Officer. This has allowed me to build my confidence in teaching children and gain inhalation sedation accreditation.
The afternoon is for admin, which is used to prepare GA lists and e-approve letters. I have also taken the opportunity to do a few hours of work with Lorraine reviewing patients and chasing up clinic, patient and ward referrals.
We call Fun Friday special care day – the day is split alternating weeks with all day special care assessment clinics and special care treatment clinics, treating patients under inhalation or intravenous sedation. This is one of my favourite days at SaSH, as the Special Care Consultant (Mili Doshi) gives you the opportunity to treat patients with complex learning difficulties or those that are medically compromised, as well as patients suffering from mental health problems. It is a challenging and rewarding day being able to assess the patients and book them into a treatment clinic that then gives me the opportunity to follow up on them. 1 in 4 Fridays I go to Crawley hospital, which is linked to East Surrey. I get to treat patients under general anaesthetic on an oral surgery list, alongside the Consultant. This gives you the opportunity to develop your surgical skills and it has helped me immensely build my confidence in treating patients under local anaesthetics as I have been able to practice under GA.
For the last 6 months of the training programme, every other Saturday is dedicated to a paediatric treatment general anaesthetic list, which is a long, productive and thoroughly interesting day. Working alongside the Paediatric Consultant gives you the chance to pick up valuable skills about treatment planning, extraction patterns and restorative treatment on children.
While the week is hectic with a lot of change, after a few weeks I found my feet and was able to concentrate on improving a wide variety of skills. I have thoroughly enjoyed the year and highly recommend the post.
Dr Amrisha Ondhia
As a DCT2, my role is predominantly in the Paediatric Dentistry department with a small amount of oral surgery. The timetable will allow the DCT to gain a wide variety of skills and experience within different areas of Paediatric Dentistry.
A typical week will include….
When I have worked on a Saturday Paediatric Dental GA list, a Monday morning is time off in lieu. If not, this time can be used to carry out administration tasks or to attend other clinics in order to enhance our skills, such as intravenous sedation in Special Care Dentistry. In the afternoon, I am involved in the Oral Surgery clinic – in this session I will carry out simple extractions on complex patients, surgical extractions and biopsies under local anaesthesia, with supervision from a Speciality Dentist.
On a Tuesday morning, there is a Paediatric Consultant Clinic (New Patient) – this session is run with our Consultant Paediatric Dentist and Speciality Trainee Registrar. It is a busy clinic mainly consisting of new patient referrals and a few review appointments. Children are referred for a variety of reasons, most commonly due to caries, complex medical history, trauma and dental anomalies. In the afternoon, it is administration time, which is used to approve letters, carry out audits and projects and prepare the notes for general anaesthesia lists. As the DCT, it is my responsibility to ensure the notes have been adequately prepared for the weekly GA lists. I am involved in liaising for safeguarding cases, several of the children we see require communication with local authorities and social workers, in order to ensure that they receive the dental treatment they require. Approximately once a month there are all-day joint paediatric-orthodontic clinics and as a DCT we may be involved in assisting in the examination and consenting process, in order to aid in the running of the clinics.
On a Wednesday morning, there is a Paediatric Consultant Clinic (New Patient) – as before, this is a clinic mainly consisting of new patient referrals. In the afternoon, there is a Paediatric Inhalation Sedation Clinic and this involves carrying out treatment using inhalation sedation. This mainly includes fillings, sealants, stainless steel crowns and extractions.
Thursday morning is administration time. In the afternoon, there is Paediatric Treatment under Local Anaesthesia/Reviews – this time is for treatment under local anaesthesia. Reviews may include trauma testing, monitoring children with complex medical histories and children with high caries risks.
There is a Paediatric Dental General Anaesthesia list (3 out of 4) – this is an all-day list where we will see approximately 10-12 patients per day for comprehensive dental care under general anaesthesia. This includes surgical cases such as the removal of impacted/supernumerary teeth and expose and bond procedures. There is a large amount of hands on experience on this day as well as being involved in the consenting process, theatre team and carrying out paperwork and discharge summaries. There is an Oral Surgery General Anaesthesia list (1 out of 4) – it is an all-day list with the Oral Surgery Consultant carrying out treatment under GA. This includes the extraction of wisdom teeth, more complex dental anomalies and dental clearances.
There is a Paediatric Dental General Anaesthesia list (1 in 2 Saturdays for 6 months).