November 2017 | volume 4 | issue 6
articulate the bi-monthly e-newsletter of the dental technologists association
This issue contains 30 minutes of CPD for DTA members
www.dta-uk.org PLEASE NOTE OUR NEW CONTACT DETAILS F13a Kestrel Court, Waterwells Drive Waterwells Business Park Gloucester GL2 2AT Telephone: 01452 886366 Email: sueadams@dta-uk.org Web: http://www.dta-uk.org
DTA Nominated Charity of the Year 2017 DTA members have selected Crisis as DTA’s nominated Charity of the Year for 2017. If you’d like to find out more about their work go to www.crisis.org.uk
TALKING ABOUT CANCER: reducing risk, early detection and mythbusting Join Cancer Research UK’s free online cancer awareness course now! Did you know that around 4 in 10 cases of cancer in the UK could be prevented? t Cancer Research UK we think it’s essential for all health workers, including dental staff, to feel confident and well-equipped to talk openly with patients about cancer risk factors, and signs and symptoms. Knowing what to say and how to say it can make a real difference to you and your patients.
A
Our free online course Talking About Cancer: reducing risk, early detection and mythbusting has proved to be a huge success in building health professionals’ confidence and “know-how” to: ■ Separate myths from facts ■ Explore people’s cancer awareness, attitudes, and barriers ■ Encourage those around them to take positive action for their health Over 7500 people worldwide have already taken part – join us to gain practical skills and resources for having conversations that
could help save lives. Watch the course trailer to find out more. Talking About Cancer is led by our expert trainers Gwen Kaplan and Gill Kilgour, drawing on their years of experience as nurses. You’ll learn through quizzes, articles, interactive discussion, and video scenarios demonstrating conversational dos and don’ts.
Here’s what some a couple of previous participants have said about how it’s benefitted them: “ The course has surpassed my expectations not only for the valuable information related to cancer and awareness, also to the transferable ideas and tools provided… I feel much more confident in talking about cancer with others. “ – Debbie, health professional “ I believe passionately that a course like this, that encourages people to be open about health issues and points the way to reliable resources, can save lives” – Barbara, person affected by cancer
HOW TO TAKE PART ■ Sign up now at cruk.org/talkingaboutcancer Takes around 3 hours, at your own pace. Works on mobile, tablet or desktop.
Dental Technologists Association, F13a Kestrel Court, Waterwells Drive, Waterwells Business Park, Gloucester GL2 2AT. call: 01452 886 366 email: sueadams@dta-uk.org web: www.dta-uk.org
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November 2017 | volume 4 | issue 6
Early Cancer Detection Article and CPD by Tony Griffin REF: ● Standards for the Dental Team: 1 & 7
Aim: ● To raise awareness among dental and clinical dental technicians of the benefits of prevention and the early treatment of malignant melanoma.
CPD Outcome(s): ● To outline the risks related to malignant melanoma; ● To review some of the current recommended projection methods; ● To identify the links between changes that can occur in moles and cancer.
INTRODUCTION Please note that this article is compiled and edited from pieces from various sources as indicated in the references to ensure that the facts are appropriate and correct.
M
elanoma is a type of skin cancer related to moles that can spread to other organs in the body. Nearly 90% of melanomas are thought to be caused by exposure to UV light and sunlight. It is believed that one blistering attack of sunburn, especially at a young age, can more than double a person’s chance of developing melanoma later in life.1
There are three main types of skin cancer: (i) basal cell carcinoma (sometimes known as ‘rodent ulcer’) (ii) squamous cell carcinoma (iii) malignant melanoma Authorities consider basal cell and squamous cell cancers as less serious forms of skin cancer. Also referred to as non-melanoma skin cancers, they are highly curable when treated early. Malignant melanoma – made up of abnormal skin pigment cells, called melanocytes – accounts for just 10% of all cases of skin cancer in the UK. ‘However, left untreated, it can spread to other organs and be difficult to control. It is responsible for most of the deaths from skin cancer.’2 There are reports of there being a dramatic increase in this form of cancer e.g. ‘Twice as
many cases in the over 55s in Scotland than there were 20 years ago’.3 An early and relatively simple, local surgical operation is very often successful. But it must be dealt with early; any delay could reduce chances of success. Melanoma is not just skin cancer. It can develop anywhere on the body – eyes, scalp, nails, feet, mouth, etc.4 The first sign of a melanoma is often a new mole or a change in the appearance of an existing mole. Normal moles are usually round or oval, with a smooth edge, and no bigger than 6 mm (1/4 inch) in diameter. These can occur anywhere on the body, but the back, legs, arms, and face are regarded as the areas most commonly affected. A melanoma will often change in size, shape, and colour over time, and may become raised above the skin’s surface. Inflammation or swelling is another sign that you need to see your GP for a check-up immediately. The original mole often remains the same size, while an area around or under it appears to spread or swell. Any new symptoms – such as bleeding, itching, or crusting – may also be caused by melanoma.5 Therefore, if the symptoms of melanoma are found, you should visit your GP immediately. Where a clinical dental technician is treating a patient, he/she needs to appropriately
document concerns regarding a suspicious lesion and refer the patient on to a specialist as appropriate e.g. ‘6.3.3 You should refer patients on if the treatment required is outside your scope of practice or competence. You should be clear about the procedure for doing this.’ 6 Most medical guidance says, ‘See your GP as soon as possible’, if you notice changes in a mole, freckle, or patch of skin, especially if the changes happen over a few weeks or months. In most cases, melanomas have an irregular shape and more than one colour. They may also be larger than normal moles and can sometimes be itchy or bleed. Melanomas often have ragged or blurred borders or edges. Normal, healthy moles tend to be much rounder, with smooth, clearly defined borders. In most cases, melanomas have an irregular shape and more than one colour. They may also be larger than normal moles and can sometimes be itchy or bleed. The signs to look out for include a mole that is: ■ ■ ■ ■ ■
getting bigger changing shape changing colour bleeding or becoming crusty becoming itchy or painful
Dental Technologists Association, F13a Kestrel Court, Waterwells Drive, Waterwells Business Park, Gloucester GL2 2AT. call: 01452 886 366 email: sueadams@dta-uk.org web: www.dta-uk.org
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November 2017 | volume 4 | issue 6 NHS Choices7 provide a helpful checklist if you are concerned about a mole that you have. It provides a helpful way to tell the difference between a normal mole and a melanoma as in this ABCDE checklist shown in Fig. 1.
Fig 1:
■ Asymmetrical – melanomas have two very different halves and are an irregular shape ■ Border – melanomas have a notched or ragged border ■ Colours – melanomas will be a mix of two or more colours ■ Diameter – melanomas are larger than 6 mm (1/4 inch) in diameter ■ Enlargement or elevation – a mole that changes size over time is more likely to be a melanoma
Figure 2 below shows a range of moles as an artist’s impression related to the ABCDE identification in Figure1. So, what’s the hurry about getting treatment? Metastatic melanoma is the least common skin cancer. It’s also the deadliest because it spreads (metastasises) quickly and easily to other parts of the body.8 Metastatic cancer is more likely to be fatal because the cancer cells have already spread, or metastasised, to other parts of the body. This makes treatment complicated, as the cancer is no longer centralised. It is recommended that we all be suspicious of any lesion, particularly on the face, that
fails to heal within 3–4 weeks. We should all use high factor sunscreen, reduce exposure to the sun between 11.00 am and 3:00 pm and be vigilant – check regularly for any changes to those moles. Notes 1 Melanoma Research Foundation USA https://www.melanoma.org/understand-melanoma/ what-melanoma/melanoma-facts-and-stats 2 Web MD Boots http://www.webmd.boots.com/ melanoma-skin-cancer/skin-cancer-guide/ sun-exposure
3 Example: The Times. 5 July 2016. p. 6. 4 Melanoma Research Foundation USA https://www.melanoma.org/understand-melanoma/ what-melanoma/melanoma-facts-and-stats 5 Skin Cancer – NHS Choices at http://www.nhs.uk/ conditions/Malignant-melanoma/Pages/ Introduction.aspx 6 Standards for the Dental Team http://www.gdc-uk.org/ Dentalprofessionals/Standards/Pages/default.aspx 7 NHS Choices http://www.nhs.uk/Conditions/ Malignant-melanoma/Pages/Symptoms.aspx 8 Healthline http://www.healthline.com/health-slide show/metastatic-melanoma-symptoms-treatment -outlook
Fig 2:
CPD Questions Q1 Malignant Melanoma is made of abnormal skin pigment cells called:
Q2 Basel cell cancers and squamous cell cancers are:
Q3 Malignant melanoma can develop in:
a) b) c) d)
a) b) c) d)
a) b) c) d)
Ulcer cells Metacognition Melanocytes Carcinoma
Less serious forms of skin cancer Can be treated at an early stage and a) The most serious form of skin cancer Cannot be treated and b)
Q4 What are some of the signs to look for in moles?
Q5 In what given period should you see a medical practitioner if a lesion fails to heal?
a) A hair in a mole b) Changing colour, bleeding or becoming crusty c) Clear metastatic action of the mole d) Getting bigger or changing shape and a) above
a) b) c) d)
Body skin and scalp Answers a) c) and d) Eyes and nails and a) only In the mouth
3 - 4 months 1 month 3- 4 weeks 1 year
Dental Technologists Association, F13a Kestrel Court, Waterwells Drive, Waterwells Business Park, Gloucester GL2 2AT. call: 01452 886 366 email: sueadams@dta-uk.org web: www.dta-uk.org
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November 2017 | volume 4 | issue 6 CPD Reflection There are no right or wrong answers for these questions – tick only one answer for each question. A. What did you learn from this CPD activity I. Updated my own knowledge on the subject II. Gave me a basic understanding of this area of activity III. Made me consider possibly sharing this information with others IV. Was of no use to me whatsoever
B. How might this CPD help improve your professional working I. It will not, but it has made me aware of potential business opportunities II. Made me aware of other areas of work activity III. Gave me the opportunity to consider other potential learning IV. No help whatsoever.
Feedback Box:
Disclaimer Notice: This publicly available information is provided to members for educational purposes only and DTA accepts no responsibility for any inaccuracies contained therein. Clinical aspects are shown in order to (a) assist members’ understanding (b) promote team working with clinical colleagues and (c) support continuing professional development.
E-NEWS SHOTS
GDC publish Innovation in children’s new enhanced dentistry with Starting Well CPD guidance The General Dental Council has published several enhanced CPD guidance documents. The documents include: ■ Enhanced CPD guidance for dental professionals ■ The GDC’s Personal development plan (PDP) template ■ PDP: examples for using the template ■ The GDC’s activity log template ■ Activity log: examples for using the template ■ Enhanced CPD guidance for CPD providers
The launch of the new Starting Well scheme has been welcomed by the British Society of Paediatric Dentistry (BSPD) as an important step in trying to reduce oral health inequalities in children. Starting Well is to operate in 13 areas of England where children’s oral health is worst. Dental practices will, among other initiatives, hold open days and family events to improve access for young children.
The scheme was announced by then Health Minister Alistair Burt to the BDA conference in 2016 to tackle the high number of GAs for multiple extractions. Since then NHS England has worked with the dental profession, local authorities, and health providers to develop the prevention focused initiative. ● See http://bspd.co.uk/Portals/0/ Statement%20re%20Starting%20Well %20final%20oct%202017.pdf
● Read more @ https://www.gdc-uk.org/ professionals/cpd/enhanced-cpd
Dental Technologists Association, F13a Kestrel Court, Waterwells Drive, Waterwells Business Park, Gloucester GL2 2AT. call: 01452 886 366 email: sueadams@dta-uk.org web: www.dta-uk.org
www.dta-uk.org
November 2017 | volume 4 | issue 6
E-NEWS SHOTS (CONTINUED...)
DenTech fundraising Den-Tech are raising £500 to Support DenTech and enable them to restore the smile, dignity, and quality of life of those less fortunate than ourselves. Everyday there are people both in the UK and abroad that are suffering in great pain, struggling to eat, and feeling that they have lost much of their dignity through dental problems, missing teeth etc.Den-Tech aims to help restore the quality of life in those suffering in this way by providing the dental restorations they very much need. This will be achieved through our network of volunteers and by working alongside other dental teams to provide complete dental care to those most in need.
DTA Fellowship presented to Sue Adams Congratulations to Sue Adams, who was presented with a DTA Fellowship on Saturday 30 September. Presenting the Fellowship, DTA President James Green said ‘Much of the DTA’s success is because of Sue Adams, who has been at the heart of our professional body for 25 years. As Chief Executive, Sue is exceptionally hardworking and driven but is never satisfied with the progress that has been made and never stops pushing the organisation forward’.
We will also be working over the Christmas period to provide dentures and denture repairs for the homeless community in the south of the country, for this we will need further equipment and supplies. Every penny donated will be used to support the ongoing work of Dent-Tech and any donation no matter how large or small will be greatly received. ● To donate go to https://www.justgiving .com/crowdfunding/glenclova2peaks
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Dental Technologists Association, F13a Kestrel Court, Waterwells Drive, Waterwells Business Park, Gloucester GL2 2AT. call: 01452 886 366 email: sueadams@dta-uk.org web: www.dta-uk.org