MY LIFE IN MEDICINE

Tim Sunnucks, co-founder of Thayer Street Dental Centre

Interview: Viel Rickardson

Ihelped start up the dental practice here at Thayer Street in 1998 as a sister practice to one in Wandsworth. I had already been in practice for several years and was developing a special interest in restorative dentistry – a wide-ranging subject that involves most of the disciplines needed to rebuild and restore teeth. Endodontics is a part of this wider field. Endodontics is concerned with soft tissue inside the tooth: the pulp and the nerve. This includes what a layperson would know as a ‘root canal’ treatment, where the tooth has died, so the nerve needs to be taken out and the root canal system filled in. I’m now on the specialist endodontics register, but I still undertake wider restorative dentistry treatments as the two sit very well together.

I can’t think of a better example of ‘less is more’ than dentistry. If, as a dentist, I can avoid doing a procedure while fixing a problem, I see that as a big win. Often, by having more specialised endodontic knowledge, I can avoid needing to carry out the root canal treatment at all. Often, something much less invasive will solve the problem. If it’s a problem with the pulp, a technique like pulp capping, for example, might be sufficient.

Alongside the practice, I have become increasingly involved in training, which I find extremely rewarding. It really concentrates the mind. An hour-long lecture takes many hours of thought, planning and preparation. If you’re going to stand up in front of a roomful of postgraduates, clinicians and other people with knowledge of the subject, you had better make sure you’re on the ball. You also inevitably analyse your own practices and techniques in relation to the latest knowledge and current thinking. It keeps you thinking deeply about what you do and stops things becoming too routine.

I’m involved with a programme that is helping train some of the dentists within BUPA to be what are called enhanced clinical skills practitioners. There is actually a fairly limited number of fully trained endodontists in the UK – around 250, which is not enough to cover the demand. The idea is to bring dentists to a level where they have better endodontic skills, while not yet being specialists. This allows them to take on more challenging cases, if not the most problematic ones, and thus take some of the strain off the demand for specialist endodontists. I really enjoy the hands-on teaching environment that these relatively small groups create. You can develop a rapport with people that you don’t necessarily get in other areas of the job.

A lovely tangent to the teaching was when a company called John Baines Tours asked me if I would be interested in doing some lecturing. I said yes, assuming this would be in the usual conference centres or hotels, but it turned out to be on a cruise ship in the Mediterranean. These are professional development trips for dentists, and I was to be one of the lecturers. I’ve done several trips around the Med and the Baltic. My wife and I were meant to be doing one around Iceland but that was cancelled due to Covid.

This is a really fascinating time to be involved with restorative dentistry, because while the field has undergone steady but slow progress for many years, that speed is picking up. Technologies are emerging which are having an impact on how we practice. A lot of the new computer-aided manufacturing and 3D printing technology is having a huge impact in the field. Complex restorative structures can now be designed based on highly detailed scans of the tooth or jaw, leading to a much better final result.

In endodontic, a big changes could come from stem cell technology. It raises the possibility of being able to regrow dead tissue. This could mean that if a tooth dies, rather than removing the dead pulp and refilling the tooth, you could potentially put stem cells in and regrow the pulp. I’m really excited about where this technology might take us and the benefits it could have for future patients.

THAYER STREET DENTAL CENTRE

12 Thayer Street, W1U 3JP 020 7486 4866