Sarah Garner

Trying to #bemoredog

[Sarah Garner @Buried_Fire17]

https://t.co/8Nz4aziSM8 some excellent advice here

[Sarah Garner @Buried_Fire17]

@CadioArena Yes. Yes I am

[Sarah Garner @Buried_Fire17]

@CadioArena This is absolutely rubbish, brusing your teeth with lemon juice will cause erosion and they will end up yellowed as the enamel gets thinner! Yes this recipe will remove surface staining but it won't "whiten" the base shade of your teeth any more than normal toothpaste would

[BallCarrier @BallCarrier_]

BREAKING: Dan Cole is a surprise late call up to the NFL International Player Pathway program with several teams said to be interested in the veteran prop.

[Sarah Garner @Buried_Fire17]

@debbieh131 thought you'd enjoy this...!

[Adam Sharp @AdamCSharp]

English weather is wet
German weather is Wetter

English kids are kind
German kids are Kinder

English mothers mumble
German mothers Mutter

The English shout the word people
But Germans just quietly Menschen it

And English sausages can be bad
But a German sausage is the Wurst

[Sarah Garner @Buried_Fire17]

@ljmorlewis finally, something dental that may be of interest to you!

[Prof Sarah Baker @sarahRbakerDPH]

This is a really important study. Why?

It is the 1st multi centre RCT of a behaviour change intervention promoting toothbrushing for preventing tooth decay in school children which includes clinical and cost-effectiveness & a child-reported outcome measure (quality of life)

Open access here: https://t.co/Z0mSIR6QA3

Jointly led by @nicolainnes & @zmarshman from @ShefDentistry & @CardiffDental with a dream team of researchers in #dentistry

[Sarah Garner @Buried_Fire17]

Well done @itv @doctor_oxford @jed_mercurio on #BREATHTAKING an excellent representation of the NHS frontline. Chilling to watch, but so so important. Suddenly it feels like yesterday again

[Dr. Helen Wall @DrHelenWall]

Child patient with severe autism undergoing GA for dental decay soon and the dentist wrote to GP to ask if she needs any bloods taking as she knows it’s a struggle otherwise. What a thoroughly refreshing MDT approach. Faith restored. Thank you 🤩 🥰 #teamwork #dentist #TeamGP

[Zoë Paramour @ZoeParamour]

That sounds great, Neil but some of us have jobs and stuff.

[Sarah Garner @Buried_Fire17]

https://t.co/4KRMGiMLJr

[Lauren Harrhy BDS PGDip @Laurenharrhy85]

📖 Story time; A general dentist reflects upon a case of throat cancer

A few years ago, at the practice which I now own, I was making my way down to reception with some papers.

The receptionist was talking to a man at the front desk who was not a current patient. She explained that we didn’t have space for new NHS patients. The gentleman explained that he didn’t necessarily want to see someone about his teeth but about the big lump at the back of his throat. He had been to see the GP over the road who had advised him that “it’s probably a cyst, go and see a dentist” as whatever the problem was it was affecting the fit of his denture - red flag 🚩

I had a spare few minutes so invited the gentleman to come to my surgery so that I could “have a quick look”

It was not a “quick look”

Upon inspection I found that the patient had a firm lump extending down the right hand side of his pharynx from the soft palate. He had no gag reflex to speak of so I was able to palpate quite far down. That was the second red flag 🚩

When discussing the patient’s medical history we talked about his use of alcohol (100+ units per week, possibly more) and his use of tobacco (60 cigarettes per day). Red flag number three 🚩

The patient had also recently lost some weight unintentionally but had, understandably, put it down to the stress of looking after his elderly mother who was terminally ill. Red flag 🚩 4

I had heard enough and put in a call to the local Maxillofacial department and asked for him to be seen urgently. Dentists aren’t able to refer directly into ENT.

Within days the patient called to inform us that it was cancer and to thank me for referring him.

This gentleman wrote me a letter some months later to express his gratitude that I had “saved his life”.

Of course, I had done no such thing, I had merely identified a substantial risk and referred him to the appropriate department. The treatment he received there was what saved him.

There are several things to take away from this story (and absolutely no shade to be thrown on my very busy, capable but overstretched GP colleagues)

1) The GP was not able to identify whether this was a lesion of concern (why would they? They have about a one hour lecture on oral cancer or something, the mouth isn’t specifically their area, like it would be for say; a dentist)

2) The GP advised the patient to go and see a dentist (someone who is used to looking at mouths all day), but this patient did not have access to a dentist. Had he not been in the right place at the right time (the front desk of my practice while I happened to be taking paperwork down and have five mins spare to examine him) he might not have been looked at for much, much longer. He was in no pain and would be unlikely to be triaged as “urgent” when ringing any helplines.

I have been the identifying/referring clinician several times through my career. I have cared for some of those patients when they have been well enough to come back to primary care.

I have even referred some of my patients for skin lesions (on the face & head) which have been malignant.

Oral cancer is often painless, unnoticed by the patient. Yes we must teach the public to self screen but where do they go then?

GP colleagues are overstretched, NHS dental services are at breaking point. Who will direct these patients into the hospital? A&E would be wholly inappropriate.

If you have made it this far, please know that I am not writing this to scare anyone or to virtue signal that I’ve picked up so many of these cases. I work in a deprived area, there is a correlation.

There is so much more awareness that needs to be raised around head and neck cancer. The government, healthcare professionals and the public could all stand to know more.

A good place to start is here:

https://t.co/9PQK14FVDh

November is a month for Mouth Cancer Awareness and blue is the colour we use to signify that

Thank you for reading

@TheBDA @MouthCancerMCF @TheBMA

[Stevie @xxsnzz]

Everyone in healthcare - read this article until the end.

Your comments may not seem relevant but look at it from the patients point of view.

Look at what happens when people don’t get clear communication - which there is no excuse for.

We need to do better.

[Sarah Garner @Buried_Fire17]

@HMHNBandara @BristolUni @superstreps @BrisHealthSci Awesome, congratulations Jane and very well deserved!

[Gus Hamilton @gushamilton]

@Jopo_dr What is crazy, is that I can not think this is at all common. I mean, how often do 7 consultants agree on *anything*, let alone something so controversial. If all consultants in dept say - 'this is really unusual, we are worried', this is already a 1 in a million event..

[Sarah Garner @Buried_Fire17]

@ljmorlewis Congratulations! Hope you had a fabulous day. Love the red gown and hat, very bling, totally what a PhD deserves!

[Academic Chatter™ @AcademicChatter]

Is the paper you need stuck behind a paywall? Here is a list of useful websites to help you access the research you need.

* https://t.co/LNo6dEUv8X
* https://t.co/Anfsq2ONxq
* https://t.co/QwVvkzET2M
* https://t.co/Z2ZUG247no
* https://t.co/bPGp5rPm96

[RS Archer @archer_rs]

First British tourists of the summer season are here. Middle aged couple with a caravan that had a UKIP sticker in the window. Assumed I spoke English, asked for directions, I replied in French. The woman tutted, rolled her eyes and said,
"They don't even try to speak English"

[VeryBritishProblems @SoVeryBritish]

Would you say the North-South divide line is in the right place?

[YoungMinds @YoungMindsUK]

Listening and validating their feelings is one of the most valuable ways to support someone. #MentalHealthAwarenessWeek