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The King’s College London Dental Institute Student Magazine

January 2017




SMILES ALL ROUND Smile Society fill us in about their latest missions!



Note from the Editors:

2. To floss or not to floss 3. UDA's - Are they really worth it?

Dearest readers,

4. Could tooth infection increase the risk of heart

A very happy new year to everyone and a warm welcome

disease? 4. The latest on E-cigarettes

back into the term! Our new team is so excited to share our latest

5. Women In Dentistry Launches at KCL

issue with you. There have been many socials : Boat Party, KCL

6. An Interview with Dr Nichols

Diwali Show, BDSA you name it! But there have also been lots of

7. Enthusiasm– the forgotten ingredient to success?

developments in research that have shocked us all e.g. flossing!

8. The journey to becoming an OMFS registrar

And this issue especially aims to make you aware of these current

9. Toothwise Wins 11. Rapsoc on top, Wheel it again 11. KCL charity Diwali Show 12. Dentsoc presents 5-a–side football

topics of debate. We are also very excited to announce that another BDJ article

13. Behind the scenes of BDSA sports day

writing competition will be underway so make sure you get your

13. Boat Party 2016

thinking caps on!

14. Smiles all round 15. How can Dentists manage the level of stress they

And on a last note, thank you all for the support. Our magazine is


becoming known over the Dental school and it is thanks to the

16. Pop quiz & Competition announcement

writers and of course the readers! Make sure you follow our Face-

17. Spot the Difference

The King’s Crown Team:

book page and Instagram to keep up to date with us! Love, The King's Crown Team

Shree Patel, Chief Editor Danielle Kelly, News Editor Jessica Hewitt-Dean, Special Features Editor Ash Mohan, Social Editor Rahail Kumar, Publicity Officer

Cover design by Sumaiyah Tabasum Kindly printed by Bryant Dental Kindly sponsored by Dental Protection

Krisanth Ragudhas, Media Officer




As a dental student, friends and

family will often come to me with questions about any and every tooth pain and problem that arises. Even in first year when we had no clinical experience, they seemed to think that simply by enrolling onto the dental course, we can automatically diagnose their conditions. If only it were that easy…

bunjak concluded in 2011 that ‘There is weak, very unreliable evidence … that flossing plus tooth brushing may be associated with a small reduction in plaque’. So has it all been a lie? Ultimate Goal But before I possibly shatter yo -ur world as you know it, let’s bring it all back to the basics – what are we trying to achieve when we spend five minutes staring at ourselves in the mirror while we lose blood flow to our fingertips because a piece of floss is wrapped so tightly around them? We are trying to remove the plaque (a product of the accumulation of bacteria) which sticks to our teeth. Removing this decreases bleeding gums and inflammation which prevents gingivitis and thus periodontitis. This is when the bone resorbs, because our body is trying to kill the bacteria, yet it is the inflammation which also harms us in the process. When we lose bone, we lose tooth support. If our tooth is not supported, it falls out. And then we become like the girl from the Corsodyl advert. So great, we now know what we aim for, but how do we get there? In the past, the answer has been to brush twice a day with a fluoride toothpaste, spit don’t rinse, and floss between our teeth. Has this now changed?

As I progressed and started to learn about the practical side of dentistry, I started to feel more comfortable giving advice, and after our Perio exam in second year, we practically had a certificate allowing us to teach people to brush and floss their teeth. But now comes the question of should we teach patients to floss at all? In August 2016, numerous articles came out questioning the efficacy of flossing, and I was bombarded by questions from my friends asking if this were true. It all began when the Associated Press (a multinational non-profit news agency in New York) asked for evidence from the Health and Human Services and Agriculture if flossing was actually beneficial. Let’s be honest, they weren’t expecting this, and simply shrugged their shoulders in reply. The US Federal Government has now removed flossing from its recommended guidelines as it admits that there has not been sufficient investigations to prove that it is worthwhile. A systematic review in the International Journal of Benefits of Flossing Determined to not have my Dental Hygienists (Nov 2008) said ‘a dental education shattered, I looked for routine instruction to use floss is not supported by scientific evidence.’. Sam- articles and proof that all the Oral Hygiene Instruction I had spent hours giv-

ing to patients was not worthless. It appears many dentists think it is good practice to floss as it is ‘low risk, low cost’ , but the research is leaning towards the recommendation of interdental brushes. An article in the Journal of Clinical Periodontology confirmed that the ‘use of interdental brushes provides higher levels of plaque removal than tooth brushing alone; however, there is a lack of evidence for the efficacy of dental floss for plaque removal or reducing gingivitis’. Another article from the same journal says ‘interdental cleaning with IDBs is the most effective method for inter-dental plaque removal.’ But interdental brushes are impossible to use for people with very tight contact points as their teeth are very close together (like myself) but I don’t want to be fated to have poor oral hygiene… Conclusive Evidence Looking for hard and fast answers is tricky. One of the largest problems with these studies is that flossing is very technique sensitive. It is certainly an art which takes time and skill to learn to do correctly-‘never pull the floss backwards and forwards on the gum’ as this is a common mistake. Also, if you are going to floss, do it thoroughly where you gently move it up and down along the side of the tooth, ‘giving it a C -shaped hug’ next to the gum line. Tim Iafolla from the National Institute of Dental and Craniofacial Research said ‘the problem is you can’t follow people at home and make sure they’re flossing correctly or flossing when they



should be.’ We can give as much OHI as we like with the patient in the dental chair, but if they go home and forget what we’ve said, only YouTube tutorials will be able to help them. And how many times have you turned to your laptop to google flossing techniques? Not only this, but we must re member that studies conducted usually only last a few weeks whereas periodontal disease usually takes decades to develop. Once again, we must take what we see in the media with a pinch of salt.

Conclusion I believe we should not use this an excuse. Many people don’t like flossing – it takes time and effort, and at the beginning of the day when we need to run to catch a train, or at the end of the day when we just want to go to bed, we don’t really feel like spending time fiddling around with floss. I think that this news gave people an excuse. If you were thinking about giving up flossing, these articles allowed you to bin that little box with a slightly cleaner conscious as you could picture a professional in a white

coat backing you up. But I personally wouldn’t act that quickly. We have highlighted that there is almost no harm in flossing and even a slight long term risk reduction is worth it. If you can use an interdental brush, fantastic, keep going. If floss was your plaque fighting weapon of choice, don’t lay down your arms just yet. It only takes five minutes, once a day, and a decrease in plaque and bacteria in your mouth will improve oral health.


nits of Dental Activity (UDA) represent the money paid by the government to Dentists, depending on the complexity of treatment. (Figure 1) The main pitfall of this system is that it groups a relatively simple treatment in the same category as a more difficult one. Whether you do 5 complex extractions or a straightforward one, you’ll be awarded 3 UDAs for that patient, meaning the many hours you could have spent will have little reward. Limits on banding expire after 2 months, at which point further treatment will incur a repeat cost and allocate you more UDAs. One UDA is equivalent to about £10 after your practice owner takes a cut. On average, a dentist will attain 6,600 UDAs per annum. The NHS revealed that from 2015-16, 10 dentists reached over 18,000 UDAs. Longer working


hours and increasing rates of patients should we admit defeat, stop looking for seen by each practice contribute to this, a solution and just find a way to make it meaning appointments are stretched out work? over a few months, increasing the number of UDAs earned. However, it may also be a factor in the rising negligence cases over the last few years. We are taught to focus on upscale preventative treatments, albeit in practice life there is little time for this and no reward. How can we move forward in a profession where there is so much pressure to meet quotas? Should we create more bands, with more points for preventative and more complex treatments at the risk of confusing patients? Or figure 1— showing treatment, costs and UDA equivalence




t has been well publicised that t -he diseases of the oral cavity, such as periodontal disease, links to many systemic health problems such as rheumatoid arthritis and type 2 diabetes. One of these effects is thought to be heart disease such as coronary artery disease (CAD). While it is argued that these conditions shared many of the same risk factors such as smoking, diabetes and nutrition, it is clear that even in the general population there is a link between the state of the oral cavity and heart disease. It has previously been hypothesised that bacteria from the oral cavity travel through the blood and make inflammatory conditions worse. Now a recent study in the Journal of Dental Research has shown that there is a link between infections at the tip of the root, such as in apical periodontitis, and acute coronary

syndrome, which is a collection of conditions that lead to a block in blood flow to the coronary arteries. Apical periodontitis is caused by inflammatory lesions of the pulp, at the base of the root, triggered by bacterial infections. The study involved 508 patients with a mean age of 62, who had experienced heart problems. They all underwent angiographs, which is an x-ray of the blood vessels. The angiographs showed that 36% of patients had stable CAD, 33% had a form of acute coronary syndrome whilst the other 31% had no significant CAD. The patients then underwent panoramic tomography radiographs to assess their teeth and jaws. It was found that in 58% of patients there was at least one apical lesion. From this they found that patients with apical periodontitis were more likely to have CAD or

ACS. The association was greatest in patients whose apical periodontitis was left untreated, leading to root canal, with a 2.7-times greater risk of ACS. With it long being suggested that that health of the oral cavity affects the whole body, this could be one more bit of evidence on why it is so important for us as future dentists, to encourage our patient’s oral health.



eriodontal disease is a multifactorial induced infection of the periodontium. It can lead to chronic inflammation and ultimately lead to irreversible destruction in very severe cases to the supporting periodontal tissues. PD is a largely prevalent disease, (50% of the adult population is affected by gingivitis, with 30% of them developing into periodontitis). An early symptom that can be identified by a GDP is BOP. The ability of the host to respond to the bacteria present within the matured plaque biofilm is the primary causative factor of PD. The bacterial load and the immune response contribute to the breakdown of the supporting tooth tissues via enzymes, toxins and also cytokines. Secondary factors affect the normal host’s defense mechanisms to respond to the pathogenic bacteria present therefore increasing the risk of encountering PD activity. Tobacco is a key example. However it is not tobacco within cigarette smoke that we are concerned about at this present time. The attention has turned to E-cigarettes and whether they are a better alternative compared to smoking. However the effects it has to the gingivae are still under much debate,

cigarette smoke could be the cause of gingival vasoconstriction. The study also saw an increase in GCF. The baseline for this study was using previous studies that assessed the effect of complete smoking cessation to gingival health and that this study showed similar effects seen. Cytokine levels showed no substantial change so conclusions drawn were limited and no control group was used. The authors are aware that further studies need to be carried out but this is an amazing start for further development as vaping is on the rise, and smoking is on the decline. We really need to find out the effects of vaping to periodontal health especially is we are to recommend it to patients as a ‘better’ alternative to smoking.

and whether if we should advise our patients to vape instead of smoking, if they wanted to cut down their smoking habits or stop completely. Most recently, the first ever pilot study by Wadia et al looked at the gingival response and inflammatory biomarkers when smokers switched to vaping. The study consisted of 18 participants (all staff members at Guys’ Hospital) who swapped their day to day cigarettes to E-cigarettes for two weeks. Previous studies that have claimed that it is the nicotine component which causes a reduction in bleeding may be contraindicated, as BOP increased after the 2 weeks of switching to E-Cigs. This could Please go to the KingsCrown website for references therefore mean other components within and link to the full studies mentioned in all articles..




On Friday 18th November we wel-

comed staff, graduated dentists and students to the launch of the Women in Dentistry society. The event included a brief introduction about the society where the main aims were highlighted. Whilst great progress has been made within the dental profession, so that by 2020, over half of dentists in the UK will be female, the temptation to use this as a barometer for measuring gender equality may be misleading. So, what are the Current challenges? Firstly with r egar d to the 13 specialities – women are underrepresented within every field other than four areas (DPH, paediatrics, special care and oral microbiology). Secondly the low level of involvement of women within leadership roles, we perceive, presents a problem when decisions affecting everyone are made at higher levels. Thirdly outside the realm of discussions regarding equality, the feminisation of the future dental workforce also presents its own particular challenges and issues. It is a topic meriting discussion in its own right, which we hope to explore in greater depth. Therefore it is vital to make everyone out there aware, that this is not a female-only issue. The only way that progress can be made is by including all and opening up the topic for discussion for the sake of the whole dental profession. Why aren’t there more females in higher positions? And what can we do about it. What skills can we equip undergraduates with at this level to ensure they can overcome barriers that may have been faced by people before them? Let’s support each other in


making all of our career goals become a reality. While it is helpful to provide a platform within which specific discussions may be held and opportunities created, our intention is to craft a fully inclusive space, welcoming both women and men to join and support us in our endeavour for a more diverse and equal workforce throughout the profession not just on entry. With the hard work of the committee we were so proud to launch on the 18th and delighted to say we are the first current women in dentistry society across all UK universities and hopefully not the last. What’s to come? This year we will be holding several events including a series of lectures focusing on specialties in which successful individuals within their profession can explain their own career pathways, difficulties faced, as well as advice they have for those interested in that field. There will be regular networking events for undergrads to meet each other and create life long contacts

with fellow students, graduate dentists and working professionals; in the hope that this encourages mentoring and

giving back to the younger generation We will be having an event in March coinciding with international women’s day to raise the profile and celebrate the contributions of women within dentistry. The Event We welcomed 3 incredible speakers who each spoke about issues surrounding women in dentistry and their own career pathways. Professor Dianne Rekow kindly started the event off. As Dean of King’s College London’s Dental Institute, the most comprehensive and largest dental school in the UK & Europe, many notable successes have been realised including improvement in its QS World University rankings from 7th in 2015 to 4th in the world and 1st in the UK in 2016. It is with great sadness however, that she will be retiring at the end of this calendar year. Being a great supporter, it was her personal goal to achieve a balanced gender representation at the Faculty which has seen many women move into leadership positions during the last five years, and culminated with the Dental Institute earning Athena SWAN silver on its first application in 2015. It was fascinating to hear about her own personal career pathway. Dr Alison Lockyer was our second speaker. Having graduated from Edinburgh in 1980, within 3 years she bought her own practice and continued to expand her business to a total of 5 practices over the following years. These included providing dental services to the workforce at the BMW minis site in Leicester as well as running some prison contracts for inmate dentistry. In addition she worked for both the BDA locally and nationally and currently sits on its PEC

SPECIAL FEATURE (Principal Executive Committee). She was also elected to the GDC for 12 year from 1997, as a council member and finally as the Chair. Having achieved such high and well respected positons she is a great role model and it was very inspiring to hear her views about mentoring and just how important this is for all of us. Dr Sana Movahedi concluded the speeches. Being a former student of Guy’s, she qualified with distinction in 1992. Having completed hospital jobs in oral surgery and restorative dentistry at Guy's hospital, she moved to work in general practice and has been a GDP since 1994. Being a very inspiring speak-

er it was fascinating to hear how she cur- events and would like to say a huge rently combines roles as a practice own- thank you to everyone that has shown er, specialist dental advisor for CQC huge amounts of support for the society alongside Associate Dean roles for and its aims! Health Education England, as well as a being a mother of three, so successfully. The evening ended with a drinks reception and the well awaited cheese platters! During this meet and greet everyone was able to speak about what they took away from the event and discuss what the future holds. As well as feeling thoroughly inspired, all attendees went away with goody bag kindly provided by Professor Rekow, Dr Alison Lockyer, Dr Sana GSK. We are excited for the next Movahedi and WID Committee.


term that saw the launch of WomIennintheDentistry, we are delighted to speak to a woman who has well and truly beaten her own path. Dr Lucy Nichols, a general and cosmetic dentist and committee member of the British Academy of Cosmetic Dentistry, is here to share some pearls of wisdom from her student days, dental career and beyond. Was there anything that you really struggled with at university? Skills-wise, some students were brilliant artists and some were more scientific, but I think we all have a mixture of both. I had to work really hard on the artistic side – you’ve just got to keep practising and keep practising.

qualifications after one, two or three years, but I ended up doing the full three years and eventually posted off my dissertation just a couple of weeks before giving birth to my third child! After working for a couple more years I started going to BACD events and also tried some shorter courses along the way like in Invisalign and a fixed orthodontic course – there are lots of great ones out there that are very practical and hands on. Who inspired you along the way?

I think the job market has become increasingly competitive. There is a lot more pressure to have post-graduate qualifications and things that make you stand out – even if it’s just a slick website. The corporates are tricky too – fewer people are owning practices and for those that do it's a challenging time financially.

I had no mentor at all – if I could go back and give myself one piece of advice, it Where do you see cosmetic dentistry gowould be GET A MENTOR! Ultimately I ing over the next decade? followed my own path and it’s worked After graduating, what did you do for out okay. I think there's already been a big move the first few years of your career? towards minimally invasive cosmetic What advice would you give to students dentistry, which I am a big believer in. After doing my vocational training in considering a career in cosmetic dentis- Part of the trend is due to having more Sheffield I moved to London and did try? options available, but also part of it is some hospital jobs for the oral surgery because most young adults now have experience. I then went back into NHS I would definitely advise joining the good teeth anyway, and it’s a matter of practice but wasn’t happy with the way it BACD – they are such a fantastic organi- straightening and whitening rather than worked – rush, rush, rush, patient in, pa- sation with warm, friendly and welcom- managing a heavily restored dentition. tient out every day. ing people and great opportunities. Doing I thought long and hard about a postgraduate course is a good idea – not What do you enjoy doing most in your leaving dentistry, and even took some necessarily a masters; there are lots of career and what are you most proud of? careers advice, but eventually I decided to different ways of achieving career develstick with it – I wasn’t sure if the problem opment. At the end of the day patients I really enjoy the variety of work that I do was with the NHS or with dentistry itself. don’t care about whether you have an now. One minute I’m working with the MSc, they care about how you treat hot air blower and wax on some denture How did you get involved with cosmetic them and how you talk to them and work, then it’s Invisalign and then some whether people recommend you. dentistry? implant work. I am most proud for not giving up when I was tempted to give it To be competitive in private practice I Looking to the future, what challenges all up! started a distance-learning masters in do you think current students face that Clinical Restorative Cosmetic Dentistry, are different to when you were a stuand it really reignited my interest. It was a dent? flexible course and you could leave with



ENTHUSIASM — THE FORGOTTEN INGREDIENT TO SUCCESS ? Jasdeep Brar “Nothing great has been achieved without enthusiasm.” – Ralph Waldo Emerson.


t is widely known and accepted that hard work is essential in succeeding in any endeavour we wish to pursue, however little is often mentioned about the merits of enthusiasm. Bringing happiness into the tasks you undertake is described as enthusiasm and also involves deeply expressing to those around you the desires and emotions you feel. [Enthusiasm – the act of bringing happiness in to the tasks you undertake and it also involves deeply expressing the desires and emotions you feel to those around you.] In this article I am going to share some wonderful journeys I have undertaken, thanks both to my inherently low threshold for excitement and its evolution into enthusiasm. How did I become enthusiastic about dentistry? For those that know me personally I am incredibly passionate about oral & maxillofacial surgery (OMFS) and thoroughly enjoy getting involved in anything related to it. In fact, I struggle to talk about anything else, hence I think I fit the description of being enthusiastic (borderline obsessive). My first taste of dentistry arrived through my work experience at the St. George’s Oral & Maxillofacial department, where I was introduced to a wonderful restorative consultant named Dr. Peter Briggs. On my very first day, as soon as the clinic started I heard a sudden shout from across the room – ‘Jasdeep, come over and have a look at this!’. I scurried across with my notepad to find Dr. Briggs examining a patient from the chairside. As he noticed my presence, he grabbed me by the shoulder (after taking his gloves off) and went on to explain “…here we have a lovely gentleman who faced a terrible jaw tumour and subsequently had a hemimandibulectomy procedure to remove it, the surgeons reconstructed the jaw with some fibula and we have now given him some prosthetic teeth – look how great he looks!”- I was genuinely astounded at the outcome of the patient both functionally and aesthetically, especially after seeing the pre-operative DPT illustrating the tumours devastating impact left upon the patient. Many more patients came and went, none quite as impressive as the first, but each were always explained to


me with the same level of enthusiasm and joy as the next. I was awe-struck by Dr. Briggs’ love for what he does, and it felt very special to be sharing in his pleasure. I made the error of not letting Dr. Briggs know how much of an incredible experience the time had been and soon, the work experience was over. I could not apply for work experience at the unit again, but with the passion and enthusiasm instilled within me by Dr. Briggs, I was determined to become a dentist. My enthusiasm led me to the 2013 BDA conference, where I met Dr. Briggs again. Impressed by my willingness and passionate nature, he happily accepted my request to return to the department to spend more time with the team and see other specialities over the summer. My return saw me attend weekly 8:00am journal clubs, present an audit at the department’s clinical governance meeting and also attend the national restorative dentistry and trauma conference with the team. Needless to say, mentioning these at my interviews was always going to be advantageous. With opportunities being presented to me without even needing to show them my grades, my eyes had truly been opened to the power of being enthusiastic. How has enthusiasm benefited my pursuit in a career in OMFS? Due to a myriad of factors during the year I finally submitted my dentistry application, including the meeting of various humanitarian war surgeons, I suspected that there was a high probability that dentistry was not the career for me. This was confirmed upon completing my first day on GPEP course. The discovery enticed me to explore a career in OMFS and implementing the same enthusiasm I did for dentistry, I embarked upon my journey. Through my first year, the attendance to a variety of conferences, lectures and the successful application to the King’s Health Partners summer programme, which allowed me to spend my entire summer in operating theatres observing various surgical specialties, I gained a deeper understanding of what a life in surgery entailed. Days went by and my growing enthusiasm for surgery easily allowed me to arrive at King’s College Hospital (KCH) for a 7:00am start and only leaving once the final patient had been awoken successfully. On one occasion I even waited around to help the anaesthetist

transfer a bariatric patient to ITU at 9:30pm. These actions were often seen as surprising to many of the staff, especially why a student would do this over his summer holidays? My rotations through cardiothoracic, orthopaedics, general and neuro-surgery eventually placed me in the operating room with Miss. Kathy Fan, OMFS consultant. This was quite a moment for me, and upon revealing my ambitions to Miss. Fan, she went on to barrage me with a variety of complex anatomy questions (while she was operating) to which I could only answer a very few. My performance was not impressive, which led to her responding with “What do they even teach you over there?” I was embarrassed yet motivated, and specifically asked my supervisor that my remaining summer rotations be focussed around OMFS. My frequent attendance to the OMFS theatre provided me with the opportunity to build rapport with the team, and eventually they actually allowed me to scrub-up and assist in a bilateral sagittal split osteotomy (a procedure to move the mandible forward or backward).

Figure 1. Myself with Gian-Marco (an Italian OMF surgeon) who during my summer of 2016 would always ask if I wanted to scrub up to assist in surgery. On one occasion we worked together on a Ludwig’s Angina case at 2:00AM.

SPECIAL FEATURE The absence of the senior house officer meant I scrubbed up and stood at the head of the table, given the sole responsibility of retracting. My arms were absolutely shattered by the end of procedure, but I was in a state of euphoria and it was the perfect anaesthetic to the pain. Time went on and I continued my endeavours with intensifying enthusiasm. Though I did struggle to fit in all of my experiences into this single article, I will leave you with the message of what you can achieve with genuine enthusiasm for what you love as a student or even as a working professional. Following a whole summer with the KCH OMFS unit, in September 2016 I was granted free access (as a steward) to attend the European Association of Cranio-Maxillofacial Surgery conference in London, which comprised of four full days of cutting-edge lectures by pioneering surgeons and unlimited barista coffee, followed by drinks and fine food around the corner with people who I

hope are my future colleagues. Perhaps most humbling was the fact I was not only sharing conversations with some of the finest in the UK, but also in the world and being introduced to them by others as ‘one of the fine youngsters in the future of maxfax’ the pressure is well and truly on me to succeed. To conclude, I will mention another quote from Ralph Waldo Emerson – “Shallow men believe in luck. Strong men believe in cause and effect.” Though I pay special attention to enthusiasm in this article, I cannot overstate the importance of marrying enthusiasm and hard work. I am aware that I am still very far away from even entering my dream specialty, but the experiences I have obtained have provided me with an insurmountable level of desire to achieve my goals. On a final note, I can promise that with genuine enthusiasm and hard-work, you can all establish your own path and be the phenomenal successes you deserve to be.

Figure 2. I was invited by a senior registrar to come along and watch some surgery for a tongue cancer. My cons patient cancelled so I popped down to main theatres and observed what turned out to be a hemi-glossectomy and neck dissection


Oral and Maxillofacial surg-

ery (OMFS) remains unique in the world of healthcare in demanding degrees and foundation training from both Medicine and Dentistry. For a dentist after dental school (typically 5 years) they must complete the DF1 year before they are eligible to enter Medical school, which on average ranges from 3-4 years. This is followed by foundation training as a Doctor of which they must complete 2 foundation years and at least 1 of 2 years in core surgical training. For Doctors following medical school (typically 5-6years) and foundation training (2 years as a junior doctor) they are eligible to enter dental school, which on average is 3-4 years followed by core surgical training which is typically 2 years. The average time spent in higher education alone averages 9-10 years with a further combined 4 years working as a Dentist and Doctor before one is able to call themselves OMFS registrars. As a registrar you are a specialist trainee and begin to learn the more complex operations that demand skills from both the Medical and Dental arena, facial skeleton fracture fixation, head and neck cancer dissection, facial skin cancer, cleft lip and palate among many other

life changing operations. Usually 5 years have never quite forgotten just how maglater you emerge as a consultant, a world ical and breath taking it was to see what expert in OMFS. It is here that so much surgery can achieve but also the bravery of the long training, the endless examina- and courage of patients undergoing these tions, the exhausting hours pale in com- procedures. parison to the privilege it is to work on Reading this may seem dauntinthe facial canvas. From curing cancer to g to require an unreasonable level of facial reconstructions there truly is no dedication and commitment to enter the comparison to the finesse, technical world of Oral and Maxillofacial surgery. skills and the emotional impact of work- I would argue it is no more challenging ing on a patients face and endeavouring than the first time you examined a pato treat their pain and pathology. tient and offered a diagnosis or the first As an OMFS trainee I often sta- time you put drill to tooth surface. More rt the day having to check what name often the years it takes to become a Docbadge and job title I am using. On some tor or a Dentist are fast forgotten once days I am a dental student treating a pa- you finally start seeing and treating patient for fillings or dentures whilst others tients and making a real difference to are spent covering the hospital as a surgi- people in need of your care and expercal doctor. The day may start innocently tise. by assessing a patient needing a filling, an afternoon helping to assist with denture creation while the evening is spent performing surgery on a patient with a broken jaw from a car accident. My journey into this specialty began serendipitously by attending an OMFS clinic by accident. I witnessed a child patient who had been orphaned in a car accident and undergoing extensive facial reconstruction. Over the following appointments I saw an incredible team of surgeons, nurses, medical doctors and dentists work together to transform her injuries. I Figure 1. A very rare photo of a serious Sukhpreet!




About Tooth Wise


“ ringing dentistry together” has always been the Tooth Wise mission. Launched earlier this year, Tooth Wise is a news platform for dental professionals created by dental students. Our aim is to help drive innovation and inspire others with the latest findings, all to enhance the care we can provide to our patients. Co-founder Nikunj shares a bit about how we started out: "When creating Tooth Wise, we asked ourselves what impact we wanted to have in Dentistry. From this we crafted our intention and worked meticulously to produce a platform to help supplement more value to our profession." A few months ago, we decided to enter the Dental Industry Awards, which celebrates excellence within the UK dental industry. The awards have various categories including Innovation of the Year and Marketing Campaign of the year. Competing against some incredibly successful companies, including Oral B and Ivoclar Vivadent, we knew it wasn’t going to be easy, so we were shocked to find out we were finalists for Best App of the Year and Best Use of Facebook. On the 18th of November, our co-founders, Nikunj and Sorabh attended the awards ceremony at the Royal Garden Hotel in London. Being able to net-


work and mingle with world renowned companies was an incredible experience, but the team was ultimately there to hopefully win such a prestigious award. The ceremony was underway and one by one the awards were presented, Tooth Wise was named the winner of Best Use of Facebook 2016, making us the youngest team and first ever dental students to have won a Dental Industry Award. Our Content Content is most certainly king when it comes to any marketing strategy, having partnered with publishers and universities across the globe we can keep our users up-to-date with the latest news in dentistry. As well as sharing our partnered content, we have a number of expert writers who create articles on the latest innovation, top tips for professionals and personal thoughts and ideas. Our other content campaigns include Tooth Wise Moments, a series of emotive video interviews sharing stories from celebrated dental professionals and Weekly News videos that compile the top news stories to provide a short outlook for the week. Social Media In the era of the “millennial”, using social media to spread the word about Tooth Wise has been one of our main priorities. With a current Facebook reach of just over 18,000 visitors, we

have seen a huge growth in our audience since we launched in February this year. But it hasn’t been an easy task! Creating emotively captivating social media campaigns and engaging content that portray our ethos of bringing the dentistry together, have been essential in our online success. In doing so, we have worked with some amazing leaders within the field who share our passion of coming together to drive the industry forward. The support we have received over the past year has been phenomenal and we are truly grateful to everyone that has helped us achieve what we have so far. Winning the Awards Co-founder Sorabh Patel is truly "humbled to know that small ideas can make a huge impact, so don't be afraid to pursue them". It has been a challenging time to get Tooth Wise off the ground and provide real value to our peers through the work we do, but it has been an amazing experience which we have all learnt a lot from. We look forward to taking Tooth Wise to a new level and can’t wait for what 2017 has in store for us!




We’ve always felt like hip-hop

The place began to slowly fill from around 10.30pm, and DJs Serotonin & and grime are underrepresented at our Selenga picked up the pace and began a university, especially when considering grittier back-to-back set that would last the fact that hip-hop is the most listened for 2 hours. BPMs increased and so too to genre in the world today. It has been a did the size of the crowd; doors officially dream of ours to bring that music to our closed at 11.30pm but with a queue of 50 very own Guy’s Bar since the society or so people still waiting we finally shut was founded. Thanks to the support the doors at midnight. Sales ended at we’ve received over the last year from over 240 wristbands sold, and with students and KCLSU we finally had the Guy’s Bar nearing capacity, it was one opportunity to bring that dream to frui- of the busier events this year. With the doors shut and everyone tion. On Friday 9th of December, we inside, we turned our attention to the part hosted the All Black Party. The idea was of the night that we had been looking simple enough; fill the bar and play good forward to the most, the live set. Micromusic. What we didn’t realise, however, phones had been sound checked and the was the scale of the task that we had instrumentals had been popped on undertaken. Fortunately, we were sur- a USB and delivered to the rounded by a committee of passionate, DJs. Our fresher MCs hardworking and amazing people who warmed up the crowd made the job that much easier. With 8 before passing the mic weeks of planning and preparation, we to Grayd & Sugz who felt like everything was in order for the performed live verevening. Almost all of our promotion sions of their songs and was done by various methods, but we “Normal” were quietly confident for what would be “Trap No”. In true RapSoc style, the our first ticketed event as a society. The night started early at 9pm, with set finished with a cypher committee members enjoying free drinks grime and an unsurprisingly quiet Guy’s Bar. where everyone got KCL DJ Society graciously span for us involved. We were at the event, and played a sublime mix of pleasantly surprised music we suggested peppered with some to see MCs from the of their favourite songs. The soundtrack crowd jump into the cyfor the early part of the night was smooth pher, and several wheel ups hip-hop with a few tracks from Grayd & later the mood in the room was Sugz’s forthcoming EP premiered too. electric. With the set over and the

equipment put away all that was left to do was party until closing time. By the end we were all tired and sweaty but very pleased with how things went. Thank you to everyone who came down and partied with us, we hope you all enjoyed yourselves. Special mention must be made to the security team and bar staff for their hard work, and thank you to Rhys and Kish for generously giving us the date. Thanks also to Priya Chotai and Shahad Ismail for photographing the night. Love to the committee, and to all our RapSoc family. See you at the next one.


CL Charity Diwali Show 2016. I may not be a veteran of the show like Aarthi Suresh or even the recently graduated Mariyam Khan, but I do love getting on that stage. Whether you’re singing, catwalking or even dancing, there’s always something there for everyone. The adrenaline rush you get as you walk onto a stage, hearing an audience cheer for you, surrounded by a bunch of good and close friends who were but strangers only a short moment ago, these are some of the best aspects about the show. But what a lot of


people forget at times is that as much as the participants who perform during show, a reason why it endeavours for success is those who run everything behind the scenes. The committee. And this year saw currently intercalating student Roshni Sanikop take charge as the head of acts. And although I might not have been a choreographer myself to have direct contact and learn of all the hard work she undoubtedly put in towards the planning and execution of the event, I’ve heard many times from many people how she was simply amazing. Fair, firm, I didn’t meet anyone who couldn’t stop singing her praises about how she worked to make the experience all the more better. This year saw quite a few dental students from different year groups take the lead role as choreographers with their respective co-choreographers for various acts. Including Ravi (BDS2) for bhangra, Mani and Ria (BDS3) for eastern cat-

walk and Kishan (BDS4) for BollyShri, there was no shortage of talent around. Doing a show is not a sprint. It’s a journey. A marathon. You walk into your first rehearsal, surrounded predominantly by strangers. You spend a lot of time together. Lots of fun, lots of banter. A few group socials here and there. And it all leads up to the showday. Practising and getting ready. Until you hear that your team is called ready to go back stage. Waiting in the wings as the host introduce your act. Lights out. You walk onto stage. And to hear the crowd cheer


and scream for you as the lights come on and the music starts playing, the adrenaline rushing through you, its eu-

phoric. Surrounded by people you’ve spent many hours around, all for this one final moment. You enter your first

rehearsal as an individual group of strangers. You leave the stage as a bonded team of friends.


Just as Ronaldo has been awarded

the FIFA Ballon d’Or so has Chat S**t Get Banged the DentSoc 5 a side football trophy. It was a nippy Friday night the 2nd of December and whilst the weather might not have been a surprise, the inhabitants of Tabard Gardens were. After patients on that day, instead of the usual post-clinic sesh at Guys Bar students were forming alliances and talking tactics, all vying to be crowned the best student football team in SE1. Arriving briskly for the 5pm start there was a nervous tension in the air. Everyone likes to think that if the dentistry fails then Dagenham Rovers will accept them with open arms and a back up career as a low league footballer will prove both fruitful and fulfilling. Not performing at this tournament however would prove a fatal blow to those secondary career ambitions. The tournament was preceded by a speech from Ross Hills, DentSoc’s Sports Rep, outlining how the tournament was to be played. Over a backdrop of dirty grime beats pumping from a speaker he explained that there were three groups each consisting of four teams. The winner of each group (see below) progressed, as did the second place with the greatest goal difference. This created two semi finals and consequently a final that would produce the winner, the crème de la crème of Dental Institute footballing, the standard to which others would aspire to and most importantly, the team taking home the trophy. With Ross’ trusty sidekicks in

the form of Tom Hayes-Powell, refereeing the head pitch, and Ravi Kumar, in charge of tournament organisation, giving their approval, the games were ready to begin. The group games came thick and fast with points being dropped mercilessly. Early tournament highlights include Jack McSweeney scoring an absolute belter from nigh on the half way line, only to let a ball travel between his legs when he was in goal. Perhaps the team drawing the largest crowd of supports was the staff team ‘Alumniati’ headed by Tarik Shembesh. Standing out in their own distinctive orange bibs they declined DentSoc’s offering of classic neon yellow stating they ‘don’t want to wear bibs that smell’, well the only thing smelly

about the Alumniati was their performance, they didn’t make it out the group. Unfortunately as the games progressed it was clear some teams just weren’t up to standard and their dreams were crushed. Only The Barracudas, Chat S**t Get Banged, Rolls Reus and Borussia Dental progressed. Whilst the Barracudas played admirably their tactics of doing beer bongs and drinking gin

pitch side didn’t quite equip them with type of shots they needed. Along with the Barracudas getting close but no cigar was Rolls Reus. With just two teams remaining it was time for the final. A final that was fought so bitterly it was akin to seeing 300 Spartans take on an army of Persians. There was passion, there was athleticism, there was to be just one winner. The game flowed back and forth like a pendulum in a physics lecture, neither side willing to concede an inch (or a goal). However as THP exhaled his last breath through the whistle signaling the end of golden goal there was but one team that had scored. Chat S**t Get Banged had done it. Their story mirrored that of their hero Jamie Vardy, a small town boy lifting the trophy, David triumphing over Goliath. A boy and a team telling anyone getting in their way that in life if you chat s**t you get banged, and get banged they did. GROUP 1



Borussia Dental

Rolls Reus

Lads on Toure

Unreal FC

Struck by Whitening

The Barracudas

Chat S**t Get Banged

The Aluminati

GPEP Squad

The Diamond Burs

Brown Beatles

Tartarnham Hotburs





happens when you invite 1400 dental students together for a weekend? The absolute carnage that was BDSA Sports Day. We can confirm the rumours of hotel evictions, police investigations and human excrement are indeed true but believe it or not, 6 months of blood, sweat and other bodily fluids (some more solid than liquid) were required to organise such madness. It was the first time the annual BDSA Sports Day was being hosted in London and with over 1800 registrations, the organising committee were excited to begin. However, we were immediately faced with an uphill battle finding suitable venues for our nights out and sports day. One not so illustrious club in Shoreditch replied to our enquiries with 4 simple words - “£100,000. Kind Regards, Cargo”. Like Sunmeet Khandari’s experience in the bedroom – short and not so sweet. Our hunt for suitable sport grounds was not faring any better where we witnessed a rather dubious transaction take place in one of the venue’s car park. Naturally, this was in Mile End, 5 minutes away from the campus of our loving neighbours Barts, so I guess this was not too much of a surprise. Finding accommodation in central London also proved to be a struggle. Not only did we face the challenge of finding hotels within the price range of broke students; we also had to use every ounce of our limited charm and wit to convince hotels that dental students aren’t as barbaric as they were 1 year ago (Reference to Liverpool Conference 2016 - #Faeces #Corridor #Barts #IAmAgainNotSurprised).

However, like all things in life, if you are truly committed and dedicated to something, you will either have a severe breakdown or you will eventually succeed. In this case, I would like to believe we managed to do both. In securing The Queen Elizabeth Olympic Park as our sporting venue, and Troxy and Piccadilly Institute as our night outs, we had our foundations to begin preparations for the rest of the event. The months building up to this weekend had its headaches. From having to pull £7,000 out of every orifice in our bodies after our food sponsor dropped out to Salman Sheikh stalling a van in the middle of a roundabout, the committee truly had their work cut out (Sal also ran Ben over in said van). Countless trips to our storage warehouse in the vibrant borough of Bow were required, where we genuinely spent more time in a dark metal box than in our flats. We could go on but we won’t bore you anymore since this article’s only here to fill the space. On a serious note, BDSA Sports Day 2016 would have been an absolute tragedy if not for the amazing work put in by everyone in the committee. We’ve been told it was a record breaking Sports Day, with all 16 British Universities in attendance for the first time and as such, a record number of attendees. We also eclipsed the record for the number of

BOAT PARY 2016 Pippa Khan After months of preparation, Ravi and

I were finally able to announce the Annual DentSoc Boat Party 2016, hosted by The Dutchmaster, in September. The best part about this article is that in my first year I wrote about the boat party in the Kings Crown from the perspective of a newly acquainted KCL DentSoc member vaguely remembering what was an amazing night. Now I can write from an organiser's point of view. The moment the guests got into the boat in their fabulous bow ties and dresses was relieving after all the hard work myself and Ravi had put in, with the support of the DentSoc committee. My aim was to create an unforgettable evening for the first years' introduction to King's Dental Institute,


the finest institute in the world, and, to top every other boat party the rest of the school had been to in the past. The photobooth was brought back this year, which was oversubscribed all night, and the DJ played a variety of great songs, smashing it. With the scene set by LED balloons, it was one of those rare nights for years 1 to 5 to mix and celebrate the start of the academic year. What more could you wish for than to sail under Tower Bridge at night, looking up at the stars with your best friends, and would be best friends? I'm glad to say that the 2016 boat party was incredible, with immensely kind feedback given to me and Ravi afterwards, by students from every single year to our delight and surprise. In fact, I remember the boat dock-

KFC hot wings consumed in 2 weeks and the number of condoms ordered in bulk. To summarise, here are the take home tips for those looking to host a large student event in London: 1.Don’t organise it – let someone else stupid enough do it 2.If you choose to ignore No.1, here’s another reminder – let someone else do it 3.If No.1 and No.2 mean nothing to you, ensure you have a fabulous committee to do all the work you don’t want to do 4.Prepare for the worst because the worst will undoubtedly happen 5.Never let Salman Sheikh drive 6.Never put Devinder Manu or Francecsa Siodlak in charge of merchandise personalisation (there’s a reason why your bottle openers are in Comic Sans) 7.Never under order cheese sandwiches – they’re more popular than you think 8.Always sleep in your own bed in a BDSA event due to the recent increase in defecation incidents 9.Ensure your committee are well fuelled by KFC 10.Most importantly, stock up on high quality tissues because you’ll probably be doing a lot of crying

ing, and no one on the boat had even realised the night had ended. I'm happy to say it was a success, and would like to thank the whole of the DentSoc committee for helping Ravi and I to organise and run it. We couldn't have done it without them. Watch out for us in the new year!



According to data collected by the

Child Dental Health Survey (2013), 35% of 12 year olds are embarrassed to smile or laugh due to the condition of their teeth. This should not be a problem for anyone, let alone children! That is why I am so supportive of the aims of Smile Society: to allow everyone to smile confidently by promoting good oral health from an early age. Since the start of the society a few years ago, dental students have been attending local primary schools to deliver oral health workshops to children aged 7-11. In these workshops we teach children about sugars in the diet, tooth anatomy and demonstrate tooth brushing. The children also have a chance to dress up as a dentist in PPE and get messy with purple teeth in the plaque disclosing station. We have our volunteers to thank for the success of our first school visit this year. If you missed out, fear not – we still have many more schools lined up. In addition to schools, we are looking to expand the society and work with other charities in the next year. Potential collaborations include weekend events with a special needs charity, allowing more of our volunteers to get involved outside of clinic hours. Each year our members are trained at an enrolment seminar. This year we saw a fantastic turnout for our first seminar delivered by Dental Public Health

lecturer, Dr Joury. For those who missed out, due to high demand we are offering a second seminar in the New Year so keep your eyes peeled for details! Just recently we held our annual charity pub quiz in Guy’s Bar alongside EDSA. If you came, you will believe me when I say how much fun it was. Some highlights of the night were the press-up challenge and the grape throwing round where participants had to catch grapes in their mouth. Congratulations to the winners and a massive thanks to everyone who came and supported us. We raised just over £100! While half of this is going towards the EDSA’s Pamoja Project, the other half will be used to fund resources for our community events. It is so rewarding working with schools to educate children. Learning about teeth is part of the school curriculum, so many children already have a basic understanding of dental health but it can often get left in the classroom. This is reflected by the statistic constantly thrown at us that more children are admitted to hospital in UK due to dental caries than for any other reason, even though it is a preventable disease. Our goal is to engage children in a fun and interactive way, so they are compelled to go home and share their experience and knowledge with their family; hopefully encouraging a trip to the dentist. Our sponsors provide goody bags for the children to take home with a toothbrush, timer, sticker (of course) and information for parents on oral hygiene and registering with a dentist. These simple visits can make all the difference and schools usually contact us to return again. This helps us reinforce key oral health

messages. Personally, Smile Society has helped me understand attitudes to dental health in the local area and gain valuable experience in delivering OHI targeted at children – good preparation for my first paediatric patients this year. Explaining scientific information in a simple way at the level of primary school children sounded quite straightforward to me but it was not until I was put to the test did I realise how much I had to think before speaking. I am excited for the rest of the year in my role as co-president and I hope to see lots of you smiley people at our upcoming events. Want to get involved? Like our facebook page (KCL Smile Society) for details on our next enrolment seminar. KEY MESSAGES TO REMEMBER WHEN GIVING OHI TO CHILDREN AND PARENTS: Parents should start brushing their baby’s teeth as soon as the first tooth erupts (usually around 6 months). Use a flouridated toothpaste to brush in the morning and last thing before bed: Children up to 6 years old – 1000ppm FChildren over 6 years old – 1350-1500ppm FGolden rule: Spit, don’t rinse Supervised brushing is required until at least 7 years of age. Remind parents that NHS dental care for children is free. Children should visit the dentist when their first teeth erupt so they can get comfortable with the environment and the dentist, and any problems can be identified early. Download the Change4Life Sugar Smart app and have fun scanning!




Even as a fourth year dental stu-

your body would get primed up in order to either run from the tiger or to fight the tiger. In the modern dental setting it is unlikely that you will ever have a tiger running around your clinic, but seemingly harmless stimuli will occur, which will activate the fight or flight response. What happens to you when you are stressed as a dental professional? -increased neck, back, and head aches -increased perspiration which can be uncomfortable for yourself and those around you -quick mood swings which can cause poor relationships with your colleagues -fall in concentration span -less precision with your work leading to a fall in quality

from back, neck and eye problems because of poor posture. Understanding good posture may seem like a basic task, but is absolutely imperative as it maintains good health and professional fulfillment, and improves your efficiency and quality of work. Also, try your best to avoid conflicts and arguments by quickly coming to a resolution of any issue which may arise, delegate effectively so each team member knows their role (which will in turn improve efficiency and reduce the likelihood of conflict occurring in the first place), pre-determine your workload and prevent overload in your professional life. The last point is crucial for achieving stress reduction. As dentistry operates like all other businesses do, you will at times try to do lots of work in unrealistic time limits which will either lead to more financial gain if performed well, or more likely will lead to poor quality procedures and feelings of professional inadequacy, and these procedures will need to be corrected at a later date. So keeping realistic targets and planning well in advance is clearly the way forward. It is also vital to wear comfortable clinical wear when doing dentistry as well. You feeling confident will translate into better quality of work. I hope that implementing the above methods in your day to day routine enables you to feel more confident with your work and excel in your clinical endeavors. Remember that a less stressed dentist is a more successful practitioner!

dent, I have already realised that dentistry is one of the most stressful professions through the clinical work I have undertaken. Stress management is absolutely key to becoming a great professional. However, like many aspects of dentistry, this is a component which no textbook or lecture can teach you. It must be learnt through experience. Modern dentistry demands high levels of quantity and quality to be done in sharp time limits, as well as for patients, staff and finances to be managed effectively. A few of the major stress causing factors in dental pr actice could include: -feeling inadequate for the tasks you are This may ultimately result in bad sleeping patterns, increased alcohol drinking carrying out -boredom since dentistry involves lots of and poor dietary patterns. repetitive movements -too much work to get done in very little So how can I reduce my stress level? It is important to understand that time limits -working long hours leading to poorer each of us are different. On a personal level, we need to pripersonal relationships, nutritional habits oritise our stress-relieving activities and and exercise habits -lack of patient satisfaction for the work hobbies. I ensure that in my personal schedule I always have slots where I can you are providing -financial pressures caused by running a go to the gym and my dance classes. If you don’t have a hobby at present, find business something you are passionate about and -eye strain, back and neck problems However, we must not get carried balance these activities with your work away by thinking that stress is always a life. In the professional setting, you must bad thing. Small stress levels are great efficiency boosters, which increase per- ensure you are sitting comfortably in the formance, however, surplus amounts can correct positioning. Many dentists suffer have dangerous effects on health. Stress has always been a well-known problem in our profession. Throughout history, our colleagues have often resorted to the use of drugs and alcohol to relieve their stress. Thus, this article will try to help you understand the causes of stress in our workplace, and provide you with measures you can implement right now to reduce the amount of stress you experience. Stress is a very complicated concept, which facilitates physiological and emotional responses to the environment when a threatening stimulus occurs. The physiological response is known as ‘fight or flight’. This then has a knock on effect on our rational thoughts. For example, if a Figure 1: Yerkes-Dodson law of anxiety, indicating that the optimal performance level is at a threatening stimulus such as a medium level of stress. Poor performance is caused by either too low or too high stress levels, tiger is running towards you, indicating that some level of stress has positive attributes.



POP QUIZ 1. What is Dr Foxton’s favourite country? a. Japan b. Fusiyama c. New York 2. What colour is 5 day alginate? a. Brown b. White c. Blue 3. KCL DI is number 1 in the UK, who is number 1 in the world? a. America b. Barcelona c. Hong Kong 4. Who is the current Dean of Guy’s Dental Hospital? a. Donald Trump b. Dianne Rekow c. Devi 5. Where are a giraffe's teeth in addition to their mouth? a. Back of their head b. Back of their throat c. On their palate 6. Which animal has the longest teeth? a. Lion b. Rhino c. Elephant 7. In the U.S, February the 28th is National what day? a. St Patrick’s day b. Halloween c. Toothfairy Day 8. Who was the optimist that said? ‘I feel like every year has a new energy. And I feel like this year is really about to like, the year of realising stuff. Everyone around me, we’re all just realising things. 2016, looking good." a. Paul Pogba b. Joe Biden c. Kylie Jenner 9. Which tutor has the most distinct laugh ? a. Dr Ahmed b. Dr Piper c. Dr Hassan 10. How much does a meal deal from luncheonette cost? a. £3.50 b. £4.50 See King’s Crown website for answers! c. £3.00

IT’S COMPETITION TIME! GET PUBLISHED IN THE STUDENT BDJ! As seen before by winner Gian Marco on his article called ‘S.H.E.E.P,’ we are giving writers another chance to win this fantastic opportunity for your article to feature in the BDJ’s Spring issue! It can be as creative as you like and on any topic! For your chance to win this amazing opportunity please email to any members of the committee or to : (notifying a member of the committee to ensure we have received it!)



SPOT THE DIFFERENCE See if you can find the 10 differences between these photos! (Note: don’t point at your patients!)


Kings Crown Jan 2017  
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