BOS News Magazine 12/2024 by Christopher Baker

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WELCOME TO THE WINTER BOSNEWS

Celebrating 30 Years of the British Orthodontic Society: Embracing Change for a Bright Future

As we mark the 30th anniversary of the British Orthodontic Society (BOS), we celebrate not only a remarkable journey of growth and transformation but also the start of an exciting new chapter. From its inception, the BOS has championed the cause of orthodontic care in the UK, supporting its professionals, advancing its science, with members enhancing the lives of countless patients. As we look ahead to the next 30 years, it is clear that change is on the horizon.

The past three decades have seen the BOS grow from a fledgling organisation into a cornerstone of British dentistry. This growth has not come without challenges, yet the Society’s commitment to fostering community, education, and innovation has been unwavering.

This year’s reimagined conference, tailored to reflect the needs of a new era, demonstrates that BOS is not only keeping pace with the changes around us but is eager to lead them.

“Change is the only constant in life,” the Greek philosopher Heraclitus once said, and this sentiment couldn’t be more relevant as the BOS enters its next chapter. Change is not something to be feared but rather to be embraced.

With rapid advancements in orthodontic technology—such as AI-assisted treatment planning, 3D printing, and rapidly expanding skeletal anchorage options—the orthodontic landscape of the future promises to look very different from the one we know today.

Looking back on the Society's achievements, one might recall the words of Maya Angelou: “If you don’t like something, change it. If you can’t change it, change your attitude.” For thirty years, BOS has adapted to meet the needs of its members and the public. The organisation has expanded its resources, diversified its training programs, and created networks for collaboration and support and will continue to do so.

This new chapter demands a willingness to innovate and a readiness to embrace the unknown. As we look ahead, BOS is poised to lead discussions on sustainable practices, advocate for digital transformation, and address the growing need for inclusive care.

The future may be uncertain, but with the BOS at the helm, we can be confident that our profession will continue to flourish. I am proud to be a part of it.

Here’s to another thirty years of excellence, growth, and, above all, smiles.

Arti Hindocha BOSNews Editor bosnewseditor@bos.org.uk

Orthodontic Society Registered Charity No 1073464

Royal College of Surgeons of England 38-43 Lincoln’s Inn Fields London WC2A 3PE Tel: 020 7353 8680

Email: ann.wright@bos.org.uk Website: www.bos.org.uk

BOS is a Company Limited by Guarantee Registered in England and Wales, Company No. 03695486

The British Orthodontic Society is a charity and our objectives include promoting education and research in orthodontics. As part of our duties, we will notify our members about upcoming external courses from time to time. The Society cannot be held responsible for the content of thirdparty advertisements or the quality of external courses. The accuracy of the information in the advertisement has not been verified by the Society. Should any member have queries about the content of a third-party advertisement or course, you should contact the course provider directly. The Society does not recommend, endorse or support any external product, course or service and it is a decision for members whether or not to attend such a course and to check whether the advertised information is accurate.

Copy date for the Spring edition is 10th March 2025.

NB. Those of you who didn’t attend BOC2024 will find your BOS@30 enamel badge enclosed.

BOS at 30

PRESIDENT’S REPORT

It has been a very busy time for the Society in its 30th year. I write this report on my return from a very successful BOC in Birmingham – my thanks go to Guy Deeming and the organising team as well as the BOS Office staff who worked tirelessly to make the conference a huge success.

Head Office Changes

This issue of the BOS News focuses on the conference but also is the opportunity to reflect on our 30th year as a unified Society. The BOS came into being on the 1st July 1994 with the unification of the five existing national orthodontic organisations. By uniting the national orthodontic voice we became stronger as a specialty giving us the ability to represent UK orthodontics as a whole.

There are so many members who have played their part in driving the Society forward and I would like to recognize and thank all of them. However, in all successful organisations, there is a team of dedicated people behind the scenes who oil the cogs and keep us on the straight and narrow. I would like to mention one individual in particular, who has also been on this 30 year journey with us. We aren’t able to make anyone an ‘honorary orthodontist’, however if the Society could I’m sure we would endorse Ann Wright in that role –she has been the glue that has held us together and our thanks at this special time of celebration go to Ann as well as all those who have worked for the BOS over the years. Without them we would not be here.

Over the six months celebration period, we have looked to recognise and highlight the milestones along our 30 year journey so far, as well as also looking to the future. My thanks to Sue Cunningham as the lead of the organising group co-ordinating the events.

A number of matters have come up over the year of which I wanted to give an update to members. I’ve termed this, a year of change for the Society:

Board of Trustees Changes

In June Sally Walker stepped down as Director of Education. I would like to thank Sally for all the hard work she undertook over her three years in this role. Hemendra Shah replaced Sally as Director and I know Hemendra has some interesting ideas for future courses and will continue to develop the educational content that the Society provides for members.

September brought the biggest change for the HQ Office staff with the re-location to offices within the Royal College of Surgeons, Lincolns Inn Fields, London. Currently there are a number of construction projects being undertaken in the area surrounding Bridewell Place. This and the under-utilisation of our office space led the Execs and Board making the decision to move to more practical workspaces. We looked for opportunities to sub-lease our offices in Bridewell Place and were able to secure a contract with the firm of lawyers who were already in the building and looking for additional space. This was a financially beneficial move and enabled the Society to reduce office costs. My thanks go to all the office staff who put in a tremendous effort to sort out and pack up over 18 years’ worth of the Society’s stuff and organise an almost seamless transition to the RCS office in a very short period of time.

Talking of BOS Staff, we said goodbye to Denise and Malcolm as we moved from Bridewell to the Royal College. They both helped with the move and transition and without them it would not have gone as smoothly as it did. In April we welcomed a new member of staff, Claire Joffe, who joined the Society as Events and Commercial manager. Claire brings with her a wealth of knowledge and provides well needed support for members organising Society events. We recently appointed a new Executive Secretary for the Society who will work alongside our current staff to come up to speed with the finer workings of the BOS.

I’m aware that it may look that, on one hand, we are telling members of our challenges with the budget and financial situation whilst, on the other, appointing new staff to HQ and ‘moving house’. The Board and Execs are conscious of this optic. It is important to reflect and appreciate the loyal dedicated staff that have worked for the Society over many years whilst looking to secure the BOS’s future as work practice and members’ needs change. This is a time of transition and there needs to be cross-over and a ‘passing-on’ of corporate memory and values.

Financial Position

Over the last 2 years, the team in the Office, Execs and Board have been working hard with our Auditors to gain a clearer understanding of the Society’s financial structure and position. Although this is always going to be a ‘changing picture’ this work is now completed and Grant will be updating the Society in his report. We are coming towards the end of our review and transition, and in this year of our 30th Anniversary, the changes that have been implemented will establish a secure stable base for the Society to last us the next 30 years and beyond.

GDC Curriculum Review

Since my last report there has been further developments on the approved GDC Specialty curriculum. Last September I reported that the GDC finally approved the ST 1-3 orthodontic curriculum and that the issues of deliverability were being addressed. The Orthodontic SAC worked hard to find a wording that would satisfy all parties around the research element of the curriculum and an acceptable solution to this tricky issue was finally agreed in September.

The orthodontic trainees still have the opportunity to undertake a higher degree maintaining the parity with our international colleagues and our thanks go to the SAC under the leadership of Martyn Cobourne for their perseverance on this issue.

Political Agenda

Following the change in government we wrote to the Secretary of State for Health and Social Care to highlight the challenges that the profession is facing and recommending 4 core orthodontic principles for the Government to address:

1. Improve access to NHS orthodontic care

2. Dental Contract reform

3. Developing and retaining the orthodontic workforce

4. Improving UK oral health

We have not received a reply from the Government but a meeting with the CDO was held in August to discuss our concerns further. The message from the CDO is that the Government is focused only on delivering on its pledges, there is no extra money from Dentistry and we have to feed into the oral

health programme. We continue to push our agenda, particularly over workforce numbers and distribution.

GDC Consultations

As a Society we have responded to a number of consultations over the year including the Scope of Practice, Routes for Assessed Applications on the Specialist Lists, Overseas Dentists registration, Dental Graduate ‘tie-in’ and Fluoridation. The discussions are still on-going with respect to the Scope of Practice. This current draft document may have a significant impact on our nursing and therapy colleagues as the wording is open to wider interpretation.

Thanks

This is my final report as President as I demit at the end of December. It has been a huge honour to serve as President over the last three years. As I write, I’m in a reflective mood. It is useful to look back to learn and, of course, consider the highs and lows over my journey. It has been a time of huge change for the Society but it is on a steady secure footing and the future is bright.

In this role I have seen the range of work that is undertaken by the Society and this is done by volunteers who give up their time – so for my final time I would like to record my thanks to everyone who volunteers and gives their time to the Society – it is truly appreciated. But, of course, we could not do this alone and we have the support and backing of all who work in the BOS office and the partners we work with providing legal, financial, HR, marketing and PR services.

My personal thanks go to all those I have had the pleasure of working with on the Board and in the Society, past and present, but specifically Simon, Grant and Nigel who have supported me as Co-Execs over the last 3 years and, of course, Ann and Rupert in the office. As BOS volunteers we come and go but it is the permanent members of staff that help keep the BOS ‘supertanker’ moving forward in the right direction.

I will hand over to Robbie Lawson, your incoming President, at the end December and I wish Robbie and the team best wishes and good luck for the next 3 years. I know I will leave the Society in safe hands.

Nikki Atack President of BOS

TREASURER’S REPORT

In 2023, total income for the BOS was £1,754,598 and total expenditure £1,909,024 resulting in a structural financial deficit for the year of £154,426. Whilst this is lower than in 2022 (£395,801), work continues to be undertaken by the BOS Finance team (Finance Manager, Sarah Uttridge-Everett, Chief Operating Officer, Rupert Marks and I) to put in place various controls and changes to help improve the Society’s overall position. The majority of the detailed work particularly for the charity audit, a statutory responsibility, is undertaken by Sarah and Rupert Marks for which I am grateful.

Expenditure for the accounting and bookkeeping functions is kept under close scrutiny. We have now made an appointment for a part-time bookkeeper who will start in November. The transfer from Sage to Xero as the accounting system for the Society permitted much of the manual input work to be automated and this has been a key part of underpinning the BOS finance systems and processes for the future. Payment by cheques and purchase orders have also been phased out and online payments are now the way forward for the BOS.

In relation to our investment portfolio, whilst global markets confounded gloomy expectations for 2023 helping the BOS investment portfolio with a gain of £92,659 (as opposed to a loss of £269,931 in 2022), the Society needed to withdraw £200,000 in December 2023 to partly cover BOS and BOSF running costs, cash flow and working capital to ensure the Society remained a going concern until the inflow of membership fees in March 2024. This means that the BOS has withdrawn a total of £850K from the investment portfolio since 2021.

Research is one of the Society’s principle objectives. We currently have £424,174 pledged to support the brightest and best orthodontic research in the UK and the Society is now well placed to increase donations and subsequent research funding through BOSF. I would encourage everyone to donate to this most worthwhile cause at www.bos.org.uk/bosf-donations/

In 2021 The Trustees agreed that unrestricted funds not committed or invested in tangible fixed assets ("the free reserves") should not fall below £500,000. The Trustees determined in 2023 that this should be maintained to enable the current activities of the charity to continue, even in the case of a further global financial ‘shock’. The Society has free reserves of £1,076,276, which is £576,276 more than the reserves policy. In addition to unrestricted funds, the charitable company also holds restricted reserves of £71,384.

The Society continues to place a high value on risk management, with a focus on identifying potential risks that may compromise the ability to fulfil our charitable objectives. Risks continue to be monitored via the risk register at Board meetings and an overall annual risk assessment. No new financial risks were added in 2023. With the move to the new website provider in 2023, costs were greater than planned, but the Board were pleased to note that costs have subsequently stabilised.

Various membership fee models were discussed by the Board of Trustees in June and the AGM supported the model whereby full members will shoulder a proportionately greater increase at £445 for 2025, with postgraduates at £231 and retired members paying £147.

As reported elsewhere, the ongoing costs and projected repair costs for the BOS headquarters in Bridewell Place continue to beleaguer the Society. Following a full review of the property portfolio with expert advice from external agencies in 2023, the decision was taken in 2024 to lease the building while significant redevelopment work is undertaken in several nearby buildings. The reduced costs of the move to the Royal College of Surgeons of England and the lease income will be shown in the 2024 accounts.

I am grateful to everyone for their work in understanding, reviewing and planning the BOS finances for the future. The Finance Team will present a balanced budget for 2025 to the Board of Trustees in December as part of the ongoing financial management of the Society and will continue to actively support education and research in orthodontics, our key charitable objectives.

Grant McIntyre Honorary Treasurer

HONORARY PATRON’S REPORT

I’m now almost at the end of my tenure as Patron of the BOS and have been privileged to be able to attend almost all the group meetings this year, including the most recent BOC in Birmingham.

The annual conference was once again a triumph, organised by Guy Deeming and his team. The venue was great, and the centre of Birmingham has certainly changed over the past few years! There were lots of new innovations within the format of the conference, but for me it still retained the familiarity and reassuring feel of being the meeting to go to in the orthodontic education calendar. The OTTG session was as ever a highlight, and as I said in my first report as Patron, I hope we can encourage our trainees to continue to enrol for a higher degree during their orthodontic specialist training. They learn a number of additional, translational skills by participating in such research, as evidenced by the calibre of the research and the presentations submitted for the OTTG session. Well done to all the participants and in particular the award winners! Another highlight was this year’s Northcroft Memorial Lecture given by Prof Tim Newton, entitled Doing Good, Being Good and Feeling Good. Tim highlighted mental health and wellbeing, not only within the dental team, but also our patients, and why orthodontics is so valued by the public.

As well as celebrating 30 years of the BOC, this year we celebrated 25 years of the BOSF. By my very rough calculations the BOSF has allocated research funding of over £1.4m pounds in that time, with £800k so far spent and a further £600k allocated to ongoing research. In terms of outputs from this BOSF grant funding, 35 research papers have to date been published, 2 PhDs completed and with a further 3PhDs underway.

Using a very crude metric this equates to around £23k for each paper published, something that many large grant funding bodies would struggle to match. Research topics have included hypodontia, wellbeing, pain, the value of orthodontics, quality of life, dental materials and basic science research. It is therefore a very diverse portfolio of research. Some of the grants are relatively small, but this can lead to spin offs, with one research project being awarded just over £32k by the BOSF, but which attracted concurrent funding from the NIHR (National Institute of Health Research) of £1.5m. BOSF funding helped establish the National VLE (virtual learning environment), which is used extensively by our postgraduate trainees, our higher trainees, dentists with a special interest in orthodontics and orthodontic therapists. The BOSF relies entirely on donations, including regular monthly contributions by members, one off donations, waivers of speaker’s fees which are then donated to the BOSF, sponsored events such as the BOS fun run and finally as legacies in wills. If you feel you are able to donate, then please do so by contacting the BOS office. The future of the BOSF lies in the hands of the BOS members, without whose support it cannot function.

As Patron I hosted the annual Patron’s lunch at the BOC this year. It was great to see so many of our retired members including friends, colleagues, ex teachers and even ex examiners! In the case of the latter, it was a very long time ago that I last sat directly opposite them, namely during M.Orth, and at that time it was definitely a less convivial atmosphere. For those retired members who might be reading this I would recommend attending next year if you can.

Finally, I would like to welcome Roz McMullen, who I have known for many years, as the incoming BOS Honorary Patron for 2025. More recently Roz has been President of the BDA and so will bring a wealth of knowledge about UK dentistry to her new role as BOS Honorary Patron.

Tony Ireland Honorary Patron

Honorary Patron's Lunch BOC 2024

COO’S REPORT

I write this having just returned from BOC2024 in Birmingham. As a non-clinician the conference seemed a great success, and it was heartening to witness the strong camaraderie, fun and sense of community the Society fosters amongst its members, trade partners and other interested attendees.

It has been a busy few months at head office and I am sure it’s not gone unnoticed by many of you that the BOS has relocated to new offices at the Royal College of Surgeons (RCS) in Lincoln’s Inn Fields. It’s about a 15 minute walk from Bridewell Place. The move to this prestigious address brings a number of key benefits; both tangible and intangible. Primarily, it will help project even more the professional image we strive for, aligning with our values and charitable aims.

The transition also allows the office based team to work in more collegiate (pun intended) surroundings and a more collaborative style. Working in a more concentrated open office environment at the RCS will hopefully encourage even better communication and the sharing of ideas. The RCS is already home to more than 20 medical charities/not for profits which gives the BOS great potential to mix and cross fertilise with other like-minded organisations. We believe that working within this dynamic and vibrant community will be a boon for the Society, its staff and the members.

As I mentioned in my last update, there have been a number of potential issues with our home at the Grade II listed building at Bridewell Place in Blackfriars. BOS owns a 980-year leasehold on almost 3,000 square feet spread across part of the ground and all of the first floor. As with most old buildings the need for regular upkeep and maintenance is a constant; but even so an independent surveyor’s report from 2022 estimated that the more fundamental restorations required could exceed £300,000. Furthermore, there are approved plans for large-scale commercial development all around 12 Bridewell Place: one next door at No 9 Bridewell Place, turning the current site into a hotel; Fleet House opposite at 8-12 New Bridge Street and the Baker & McKenzie office at 100 New Bridge Street. All are large-scale developments which would each take in the region of 3 years to complete and involve a large amount of destruction and construction; with all the noise and disruption this would bring if the BOS remained in situ.

On this basis it made commercial sense to leave 12 Bridewell Place - this move may or may not be permanent but it will certainly serve as a first step. We have sublet our space on the ground and first floors

to a sitting tenant – a law firm - already occupying the second floor. This generates an income stream and positive yield for the BOS.

Overall, this relocation represents an exciting opportunity for the BOS to reimagine how we operate in the longer-term, allowing us to review our processes and adapt to a more conducive, forward-thinking environment. It goes without saying the charity’s best interests will always be paramount in the decisionmaking process.

I would like to take this opportunity to extend my sincere thanks to the entire BOS Head Office team for their support and cooperation throughout the move. Having been based at Bridewell Place since 2006, the relocation required careful planning and organisation, and their understanding and assistance have been invaluable.

Do remember, if there is anything you would like to discuss with me, please email me on coo@bos.org.uk and I’d be delighted to answer any queries you might have. And of course do pop by and see us in our new home!

Rupert Marks Chief Operating Officer

END OF AN ERA

It is with a mix of gratitude and resignation that we announce the retirement of Ann Wright at the end of 2024. For many members of the British Orthodontic Society, Ann has become synonymous with the organisation itself. Her dedication and contributions have been invaluable, and while we celebrate this well-deserved milestone, we will deeply miss her presence.

Ann joined one of the forerunners to the BOS - the BSSO (British Society for the Study of Orthodontics) - in 1986 and has been ever present, ever since. Since then, she has been a steadfast figure, adeptly managing inquiries and ensuring the seamless operation of all BOS functions.

What is there to say about Ann? We are not sure that words, even superlatives, can sum up what she has meant to the Society - indeed she seems part of the very essence of the BOS.

“Many of us thought this day would never come! I cannot articulate what Ann means to me personally or the Society as a whole in a few words – quite literally, she has been the glue that has held us together over

the years. She provides the support, wise counsel and keeps us on the straight and narrow. The Society is truly indebted to her loyalty and commitment over the last 30 years.” Nikki Atack, BOS President

“Not having Ann at the BOS, in the office, at committee meetings, or at Society events, will be a new experience for us all, and will take some getting used to. Ann has provided us with consistency, a familiar friendly face and is always on hand to help and advise. She will be sorely missed” Tony Ireland BOS Honorary Patron

We know that whatever the future holds, Ann will stay busy and bring the same dedication to her activities as she always has at BOS. We wish her a fulfilling and joyful retirement—she truly deserves it.

WE COULDN’T HAVE DONE IT WITHOUT YOU!

As we celebrate our 30th anniversary, it is important to recognise the huge support that the British Orthodontic Society has had from a dedicated head office team.

Over the years they have been the glue that has held the society together. Whether it be assisting with BOC, answering membership queries, running courses or any number of other tasks, they have been unswerving in their dedication to our members.

The Head Office was initially at the Eastman, then Grays Inn Road, then Bridewell Place and just recently we moved to our new home at the Royal College of Surgeons. We would like to say a hearty thank you to those who have been integral to the success of the BOS over the last 30 years:

Ann Wright

Ann Humphrys

Tony Kearney

Denise Rayner

Malcolm Lee

Rupert Marks

Claire Joffe

Louise Woodhams

THE PORTMEIRION STUDY DAY

Croesoi Portmeirion! The annual Portmeirion Orthodontic Study Day was held in the picturesque Portmeirion village on June 28, 2024. Mr. Stephen Chadwick, consultant orthodontist at the Countess of Chester Hospital and Chair of the Meeting Organising Committee, welcomed attendees and introduced Dr. Orla Carty, fellow consultant at the Countess of Chester, who explored work-life balance. Dr. Carty's quote, “You cannot pour from an empty cup,” highlighted the importance of self-care for optimal patient care. Dr. Carty addressed job satisfaction concerns and advocated for strategies to combat burnout and stress. She shared her experience balancing motherhood and professional responsibilities, and discussed support available for trainees.

Continuing with the wellbeing theme was Professor Tim Newton, Professor in Psychology applied to dentistry and Honorary Consultant Health Psychologist at King’s College London. He discussed stressors in clinical practice and administrative burdens, emphasising the impact of patient-related stress, litigation pressures, and the pursuit of perfection on mental health. He offered practical strategies and advice for building mental resilience and improving professional life and wellbeing.

Following a coffee break, Mrs. Madhavi Seshu, Consultant Orthodontist at Alder Hey and Arrowe Park Hospitals and NIHR ARC NWC intern, shared her recent research findings on parents’ experiences on accessing dental care for children with clefts. This revealed challenges in communication, access, and financial strain, highlighting the need for improved accessibility and patient involvement in healthcare.

Mr Gavin Barry on the saxophone

Mr John Scholey and Mrs Vanessa Parsonage

Mr Steve Chadwick and Dr Orla Carty

Mr. John Scholey, Consultant Orthodontist, and Mrs. Vanessa Parsonage, Orthodontic Therapist from Royal Stoke University Hospital presented digital indirect bonding - a method improving efficiency in fixed appliance bonding. They demonstrated the benefits of digital planning and custom trays, which reduce chairside time and support complex case management.

Then it was time for lunch which was provided with musical accompaniment by Mr. Gavin Barry, consultant orthodontist at Arrowe Park Hospital, adding to the day’s ambiance. Mr. Chadwick kicked off the afternoon session with a presentation on Temporary Anchorage Devices (TADs) in Mr. Simon Watkinson’s absence, covering practical considerations, failure rates, and successful placement techniques.

Dr. Helen Al-Nakashbandi, specialty doctor at Alder Hey Hospital, presented her service evaluation findings on the management of impacted canines. Her project covered an impressive 375 referrals with 431 canine teeth requiring intervention. There was a low (4%) post-operative complication rate with infections, mobility of lateral incisors, haematoma, and gold chain detachments.

Dr. Badri Thiruvenkatachari, Research Director and Professor in Orthodontics at Sree Balaji Dental College and Hospital, and Bharath University in India, closed the meeting with insights on cleft care in the largest lower middle-income country. He presented his research on the custom nasoalveolar molding (NAM) appliances in babies to reduce clefts prior to surgery. He shared outcomes of the pre-artificial bone graft (ABG) orthodontics in older children as well as the method of anterior maxillary distraction highlighting benefits to children’s psychological wellbeing.

Huge congratulations to Mr Chadwick for organising this fantastic programme, tan y tro nesaf!

Melissa Sin, Neda Jajeh and Nathan Nagar

Neda Jajeh

ST1 Orthodontics at Wirral University Teaching Hospital

NHS Foundation Trust and Countess of Chester Hospital

NHS Foundation Trust

Melissa Sin

ST1 Orthodontics at Liverpool University Hospitals

NHS Foundation Trust and Warrington and Halton Hospitals NHS Trust

Portmeirion group

FACIAL GRADING

Facial nerve palsy significantly impacts physical and emotional well-being, causing symptoms like dysarthria and motor function loss. The SunnyBrook Facial Grading System (SBFGS) is more effective than other scales for assessing severity. Although advances in 3D motion capture technology have enhanced facial movement assessment, the reproducibility of SBFGS facial expressions needs further investigation for accurate treatment evaluation. No studies have assessed the reproducibility of these facial expressions.

Aim

To evaluate the reproducibility of SBFGS facial expressions over six months using 4D motion capture technology.

Method

A prospective longitudinal cohort study was conducted at Birmingham Dental Hospital with 20 healthy volunteers (10 males and 10 females). Participants were evaluated at baseline (T1) and six months later (T2). The study assessed the reproducibility of six facial expressions using 4D stereophotogrammetry.

Results

Reliability coefficients exceeded 90%. Snarl, pucker, maximum smile, and eyebrow lift were reproducible based on Euclidean distances. Eye closed gentle and lower teeth show had significant differences but remained within 2.0mm. Decomposition into x, y, and z components showed no significant differences over 2.0mm. Lower teeth show and lip pucker were least reproducible, exceeding a 95% confidence interval of 3.0mm.

Conclusion

SBFGS facial expressions are reproducible within 2.0mm to 3.0mm over six months. Clinically, changes in facial movement must exceed 3.0mm to be considered significant. This study provides baseline data for assessing patients with facial palsy.

Anant Bakshi

A Study To Assess the Reproducibility Of Facial Expressions Used In The Sunnybrook Facial Grading Scale Using 4D Motion Capture Technology

A. Bakshi1,2, B.S. Khambay2 1Kings College London, 2University of Birmingham

• Facial nerve palsy impacts both physical and emotional well-being, leading to dysarthria, motor function loss, and drooling.1 The SunnyBrook Facial Grading System (SBFGS) is a superior tool for assessing the severity of facial palsy compared to other scales, e.g., the House-Brackmann Scale, as it considers synkinesis.2 It is valid and reliable, even for less experienced clinicians.3,4

• Accurate diagnosis, and severity classification, of facial nerve palsy guides treatment plans, ranging from monitoring to surgical intervention.

• Advancements in technology, including 3D motion capture (4D) stereophotogrammetry (Figure 1), have improved the assessment of facial anatomy and movement, aiding in treatment planning and monitoring. However, the reproducibility of facial expressions in the SBFGS warrants further study to ensure accurate evaluation of treatment outcomes.

• Currently no study has been carried out assessing the reproducibility of the facial expressions used in the SBFGS.

There is no statistically significant difference (p<0.05) in the Euclidian distance of each landmark for each facial expression between T1 and T2 Any differences of 2.0mm or above would be deemed clinically significant.

Method

Prospective Longitudinal Cohort Study

20 fit & Well volunteers (10 Male & 10 Female), recruited from January 2021-April 2021

Time points, T1 (baseline) and T2 (6 months later)

Five SBFGS expressions were analysed in conjunction with an additional facial expression:

1.Eyebrow raise

2.Lip pucker

3.Snarl

4.Eyes closed gentle

5.Maximum smile with teeth together

6.Lower teeth show (additional facial expression)

The images were captured using a Di4DTM Pro (Figure 1). Landmarks were then placed and tracked using Di4DView (Figure 2)

Assess the reproducibility of facial expressions, 6 months apart (T1 and T2), used in the Sunnybrook Facial Grading System based on 4D facial motion capture technology. Inclusion

oro-facial palsy Can provide written consent Diagnosed with craniofacial syndromes Diagnosed with neurological condition affecting oro-facial movement Have undergone cosmetic adjunctive procedures such as Botox or fillers.

Results An error study showed coefficients of reliability over 90% with no systematic errors. Snarl, pucker, maximum smile, and eyebrow lift were reproducible, whilst eye closed gentle and lower teeth show exhibited statistically significant differences in Euclidean distances between T1 and T2 None of the differences in Euclidian distances were statistically significantly greater than 2.0mm for any facial expressions. Decomposition of Euclidean distances into x, y, and z components indicated no statistically significant mean absolute differences greater than 2.0mm.

• Lower teeth show and lip pucker displaying the least reproducibility. Both expressions exceeded a 95% confidence interval of 3.0mm.

Conclusions

This novel study examined the reproducibility of facial expressions over six months, rather than the four weeks of previous studies. This extended duration reduced memory bias.

The study has shown that with an interval of 6 months, the facial expressions used in the SunnyBrook Scale are reproducible to within 2.0mm - 3.0mm. Based on the Euclidian distances, the null hypothesis was rejected for eye closed gentle and lower teeth show. When looking at the x, y and z components, all of the facial expressions were reproducible.

Clinically, changes in facial movement must exceed 3.0mm to be considered significant rather than attributable to reproducibility variation.

This study also provides clinicians with baseline data of a control group for comparison, aiding in the assessment of patients with facial palsy.

I graduated from Cardiff University with an Honours degree. After carrying out various DCT jobs, I completed my competitive three-year orthodontic specialty training at Birmingham Dental Hospital and Royal Stoke University Hospital. During this period, I earned a Master's in Research from the University of Birmingham and was awarded the Intercollegiate Membership in Orthodontics from the Royal College of Surgeons of Edinburgh.

Currently, I am undergoing Consultant training at King’s College Hospital and Royal Surrey County Hospital, where I am gaining extensive experience in treating complex cases, including orthognathic surgery and cleft lip and palate.

Figure 1 Di4DTM Pro capture system.

2024 SIDCUP ISFE REVISION COURSE FOR POST-CCST TRAINEES

To support the Post-CCST trainees’ preparation for their Intercollegiate Specialty Fellowship Examination (ISFE), the annual Sidcup ISFE Revision Course was held at the Gillies Unit, Queen Mary’s Hospital Sidcup on 14th March 2024.

In the morning, the attendees were rotated around six clinical scenario stations. A broad range of clinical topics were covered, mainly cleft lip and palate, obstructive sleep apnoea, hypodontia, orthognathic surgery and complex medical conditions. For each station, a 15-minute viva was followed by examiners’ feedback.

After lunch break, the attendees were given three management scenarios which involved discussion of job planning, appraisals, medico-legal and staff management. As the course progressed, the attendees began to realise not only the level of knowledge and problem-solving skills required to tackle scenarios, but also the difficulty to keep focused concentration throughout the day.

The feedback from attendees has been overwhelmingly positive, and this would not have been possible without the hard work of the consultant co-organisers Lynsey Tabrett, Mariam Shahid-Noorani and Stuart Yeaton.

Thank you to all the consultants who kindly volunteered as examiners: Lucy Davenport-Jones, Farhad Naini, Sameer Patel, Golfam Khoshkhunejad, Mary-Kate Kearney, Geraldine Brown, Monika Cedro, Arti Hindocha, Suhaym Mubeen and Norman Hay.

For those who are due to sit the ISFE next year… make sure to mark Thursday 27th February 2025 in your calendar for the next running of this course!

Ohsun Kwon, Post-CCST in Orthodontics

The Gillies Unit, Queen Mary’s Hospital Sidcup

BRITISH ORTHODONTIC CONFERENCE 2024 – BIRMINGHAM ICC

Returning to Birmingham for this year’s reimagined conference was a profoundly reflective experience. As Simran and I attended as new Orthodontic Registrars, George poignantly reminded us of our previous stewarding experiences at the ICC in 2022, underscoring our journeys into this esteemed profession. Engaging with peers and colleagues from diverse training units was truly invigorating.

This year’s conference not only showcased an exceptional line-up of international speakers but also introduced a dynamic collection of digital posters, aligning with our commitment to sustainability. The exhibition space was meticulously redesigned, incorporating smaller studios and trade-supported theatres to enhance the delegate experience and offer greater choices. Furthermore, the hybrid format ensured accessibility for online participants, with our dedicated stewards and IT team facilitating a seamless experience across both platforms.

WEDNESDAY

Our first day commenced at midday with a warm welcome from Dr. Guy Deeming, who inaugurated the main scientific program. Dr. Justin Durham delivered an insightful and thought-provoking lecture on the biopsychosocial aetiology of temporomandibular disorders (TMD), emphasizing the critical need for a pre-treatment screening from an orthodontic perspective. Following this, Dr. Naeem Adam presented an exceptional talk that underscored the significance of temporary anchorage devices (TADs) and the importance of close collaboration with dental laboratories when exploring innovative approaches. He adeptly illustrated how TADs can facilitate molar distalization and expansion in secondary care, encouraging attendees to think creatively about their application in specialist training. Dr. Marissa Bell then captivated us with her refreshing presentation on interceptive treatment utilizing an Invisalign First approach. Her case studies, including her son’s perspective on how this treatment has positively influenced his quality of life, provided compelling evidence of its benefits. Subsequently, Dr. Carlos Flores Mir discussed the current evidence surrounding the management of Class II malocclusions, emphasizing the vital role of research and evidencebased practice in orthodontics.

As the afternoon progressed, the prize session was held to recognize various members of our profession for their exemplary contributions. The day's proceedings concluded with an outstanding presentation by our Chapman Prize winner, Dr. Jadbinder Seehra, who examined the current evidence regarding the periodontal outcomes of impacted maxillary central incisors and canines, as well as the implications of surgical-orthodontic treatments on the periodontal health of these teeth.

- Fiona Lourenco

THURSDAY

Thursday saw a mix of clinical insights and the latest innovations in orthodontic care with main lectures and a series of break-out groups for the Training Grades Group (TGG) and aspiring orthodontists. One noteworthy talk included a lecture on multi-disciplinary treatment planning from Dr Aws Alani, Restorative Consultant in London, which highlighted sustainable treatment provision. Dr Benedict Wilmes, Professor of Orthodontics at the University of Dusseldorf, later gave an eye-opening lecture on the use of temporary anchorage devices (TADs) for molar distalisation with integration of digital treatment planning for accurate and successful placement in class II cases. In the afternoon, Dr Simon Harvey, a dental and maxillofacial radiology consultant in London, gave a lecture on the use and benefits of cone-beam computed tomography (CBCT) in orthodontic patients. A main takeaway message from this was the relatively low radiation dose compared to medical CTs and the advantage of viewing structures in 3-dimensions. Thursday’s programme wrapped up with a welcome reception which was enjoyed by all.

- Simran Kumar

From the perspective of a Dental Core Trainee, steward for the BOC and aspiring Orthodontist, the conference felt both inspiring and essential. In my role, I had the privilege to interact with numerous members of the orthodontic community, including esteemed orthodontists and fellow trainees, and appreciate the knowledge and insight from their respective careers. Personally, this was one of the main highlights of the conference, and many of whom I spoke to also deeply valued the opportunity to reconnect with friends and peers, and make new connections with colleagues from all over the world. In addition to this, the BOC offered a comprehensive programme which included a variety of fascinating lectures that clearly illustrated the breadth of the specialty. Perhaps the most directly relevant lectures for postgraduate trainees like myself were those from the ‘So You Want To Know About Orthodontics’ series. These lectures were tailored to aspiring orthodontic applicants to provide an understanding of what a career in orthodontics would entail.

The first lecture, ‘1826 days – The Orthodontic Specialist Training Journey’, delivered by Mr Robert Conville and Mr Naeem Adam, outlined the orthodontic specialty training pathway. The speakers provided a detailed explanation of the responsibilities, expectations and challenges trainees will likely face in each year of their specialty training from pre-CCST to consultant level. We heard various do’s and don’ts and ways in which the turbulent transition into specialty training can be eased, for example, by revising key orthodontic principles and terminology, assisting or shadowing on orthodontic clinics where possible, and by becoming familiar with clinical photography. Ultimately, we learned that trainees will need to go into specialty training with a malleable mindset and embrace the challenge that the training post will deliver.

Following this, Dr Hanieh Javidi delivered the lecture ‘Is Academia the Key to Variety’, which explored the considerations for an academic career in orthodontics. From the speaker’s personal experiences, we heard

about the various benefits that involvement in academia can provide, including a diverse working week, opportunities for clinical teaching and increased job satisfaction.

The final two lectures in this series, delivered by Dr Hayley Llandro and Mr Tom Frawley, then focused on how to overcome the ultimate challenge for aspiring orthodontic applicants - national recruitment. We learned how the self-assessment process is examined, and how applicants can maximise their chances of success by presenting clear, accurate and relevant evidence to support their self-assessed score. We then heard about how the interview process is structured and the key skills that interviewers will assess for, such as organisation and planning, situational awareness and professional integrity. Mock-interview scenarios were also discussed to highlight how these skills can be applied and demonstrated, which was extremely valuable.

- George Emms

FRIDAY

Friday’s festivities commenced with an invigorating BOS fun run along the canal, enhanced by surprisingly agreeable British weather. This energizing start set the stage for an excellent lecture by Dr. Benedict Wilmes, who discussed strategies to transcend the limitations of aligners through the use of temporary anchorage devices (TADs).

In addition to a diverse array of lectures in the main hall, parallel Cleft sessions were held, featuring presentations tailored for dental care professionals (DCPs). Dr. Sophie Acker delivered an insightful talk on fostering happiness within the dental practice, while Diane McAllister addressed the critical issue of identifying signs of domestic violence.

Fiona Lourenco

George Emms

Simran Kumar

Returning to the main hall, Dr. Jörg Glockengießer presented the latest scientific findings on fixed orthodontic retention, juxtaposing these results with seminal works by Bjørn Zachrisson on direct-bonded fixed retainers. His presentation also explored innovative strategies for the fabrication of fixed orthodontic retainers utilizing computer-aided design (CAD) and computer-aided manufacturing (CAM) technologies. The latter part of the afternoon featured compelling UTG research presentations and an awards ceremony, followed by the thought-provoking Northcroft Lecture delivered by Tim Newton. His presentation, titled "Doing Good, Being Good, and Feeling Good," illuminated the prevalence of mental health and wellbeing challenges within the dental team, supported by key insights from the MINDSET Project 2024. He emphasized the necessity for interventions at individual, organizational, and sectoral levels to effectively address these challenges, reinforcing our dual responsibility— upholding our obligations to our patients (Doing Good and Being Good) while also caring for our own wellbeing (Feeling Good).

The afternoon continued with an inspiring lecture by Dr. Kevin Fong OBE, an anaesthetist, broadcaster, and Royal Institution Lecturer, who shared his experiences as a doctor for NASA. Paula Timms highlighted the importance of identifying and supporting young patients at risk of bullying due to malocclusion, followed by a motivational talk from Dr. Houghton

on her journey from nurse to consultant orthodontist. The day culminated with an engaging presentation by Dr. Waddah Sabouni, who discussed a systematic approach to treating complex extraction cases with clear aligners. Friday’s events concluded with a celebratory 30th Anniversary gathering at Birmingham Town Hall, marking a fitting end to an inspiring day.

- Fiona Lourenco

We would like to take a moment to sincerely thank our sponsors; without your generous contributions, this conference and all the great giveaways – it would not have been possible. Additionally, our deepest appreciation goes to the BOS Conference Committee for their exceptional enthusiasm, commitment, and meticulous effort in creating such a remarkable event this year. The entire experience flowed effortlessly. Thank you all! We look forward to the next conference at the ICC Wales in 2025.

Fiona Lourenco

Specialty Registrar (ST1) Sheffield/ Kettering

Simran Kumar

Specialty Registrar (ST1) Sheffield/ Mexborough

George Emms

Dental Core Trainee in Paediatric Dentistry, Charles Clifford Dental Hospital

Member Benefit

BOC2024

BIRMINGHAM SOCIALS

Do you remember your 30th Birthday party? You may have had it whilst undertaking your orthodontic training just like the BOS who celebrated this anniversary on the Friday at Birmingham BOC. In a move away from the Black tie ball there was a 30th party held at the town hall for all delegates – and wow do some people know how to dress up!

Navigating the Christmas market which had sprung up during conference (blocking the main thoroughfare from the ICC) those with the stamina (or their phone maps) managed to get to the town hall just fine. You may have been ably assisted by our stewards who sent delegates via the shortest possible detour with the type of smiles you only get with orthodontic trainees. Thank you to Sarah, Sadie and Ambica who were there to guide you through the huts, Santas and (rather oddly) mushrooms to the venue.

A slide show of the good, the bad and the beautiful had been collated by Sue Cunningham and it was great to see colleagues pointing out their friends up on the big screen - just as people were getting their own memento of the night at the photo booth. I hope some of these photographs get used in future BOS celebratory

events. There was of course music dating back over the 30 years and a band who made us all forget about the effects of ageing – at least until the next morning.

Thank you for coming to celebrate the BOS’s 30th anniversary – I wonder how we’ll celebrate our 40th, 50th and even our centenary? Will there be hologram lecturers, flying cars or space food at these future events? I’m not going to make a call on that.

What I will say is that while virtual attendance proves useful for some delegates, there is nothing like meeting in real time with your colleagues and friends to really benefit from conference. I hope you enjoyed yourselves, you are after all only 30 once.

Jamie Gwilliam

THE 2024 BRITISH ORTHODONTIC CONFERENCE PRIZES & AWARDS

BOS Life Membership and Honorary Patron’s Cup - Professor Martyn Cobourne

BOS Distinction Award - Karen Juggins

Professor Martyn Cobourne

Karen Juggins

BOS Special Service Award

- Liz Roberts, Trevor Hodge, Claire Bates, Padhraig Fleming, Catherine Brierley

BOS Award to a Dental Care Professional for Distinguished Service - Janet Gray

BOS Award to an Orthodontic Technician for Distinguished Service - James Green

Chapman Prize - Jadbinder Seehra

Liz Roberts

Claire Bates

Trevor Hodge

Janet Gray

James Green

Jadbinder Seehra

BOC2024

BOS OTTG Prize

BOS

Clinical Audit Prize 2024

1st Mohammed Lone collecting prize (Catherine Tothill, Elinor Chalmers)

2nd Nathan Nagar, Sing-Yee Chan, Sarah Germain

3rd Beth Jones collecting prize (and Katherine Davies)

(Peter Boyd) and Paul Scott collecting prize

Mohammed Lone collecting prize (Catherine Tothill, Elinor Chalmers)

Beth Jones collecting prize (and Katherine Davies)

Against the Odds Prize

Trevor Hodge

JO Sage Scientific Paper of the Year 2024

Nicky Mandall

Orthodontic Update Prize

Aliya Hasan

JK Williams (Morth) Medal

Yana Sabbagh

William Houston (RCSEd) Medal

Christopher Wright

Honorary Patron

Tony Ireland, Honorary Patron for 2024, handing over to Roz McMullan, Honorary Patron for 2025

Tony Ireland and Roz McMullan

BOC 2024 ORGANISING COMMITTEE

Chairperson

Guy Deeming

Scientific Advisor

Martyn Cobourne

Treasurer

Faiza Lewis

Social Events

Jamie Gwilliam

Saturday Sessions

Anshu Sood

Studio Theatre

Sarah Merrett

Audio Visual

Cian Lowney

Trade Sponsors & Exhibitors

Paul Scott

Stewards

Hayley Llandro

Front of House

Robbie Lawson

CPD

Julie Williams

Posters

Sheena Kotecha

Prizes

Suzi Caldwell

Sustainability

Anshu Sood

Marketing

Chris Baker & Neil Hillyard

REFLECTING ON BOC2024: A JOURNEY OF PRIDE, INNOVATION, AND GRATITUDE

As I head home from Birmingham on the train, I find myself reflecting on BOC2024 with a mix of emotions—mostly pride, excitement, and a touch of that unique exhaustion that only a successful conference with friends, colleagues, and countless conversations can bring.

First and foremost, I feel immense pride. It’s been a privilege to bring BOC2024 to life in the city of my youth (and how it has changed!), but what makes me most proud is the orthodontic profession itself. Once again, our community has come together to share, celebrate, and explore the endless potential of our unique specialty. I am also deeply grateful to the BOC and BOS office teams, whose tireless efforts behind the scenes—both during the event and in the months (and years) leading up to it—have made these three days possible. A special thanks to the conference organising committee who helped make the BOC a fantastic event. Their hard work, professionalism, and good humour often went above and beyond expectations, and for that, they deserve the utmost thanks.

I am thrilled to report that the innovations introduced this year landed even better than I had hoped. The redesigned program and exhibition, trade and studio theatres, and post-conference sessions were all wellreceived. Of course, there are always lessons to be learned, and we look forward to reviewing delegate feedback to refine and improve these features for **BOC Wales 2025**. Your input is invaluable, so please share your thoughts, both positive and constructive, through the feedback form.

I am also deeply humbled by the incredible quality of the speakers who graced our stages. Their generosity in sharing their knowledge and expertise, each in their own unique style, was nothing short of inspiring. The feedback from attendees was unanimous: the presentations were exceptional, and I couldn’t agree more. A heartfelt thank you to all our presenters, especially those who travelled great distances to be with us.

So, where next? Wales! For the first time, BOC will be hosted in Wales, at the ICC Wales/Celtic Manor. We are

already deep into planning, and I can’t wait to share more details with you soon (assuming my train ever makes it home!).

In summary, I leave BOC2024 feeling proud, thrilled, humbled, and excited for the future. For those who attended, I hope you feel the same sense of accomplishment and camaraderie. For those who couldn’t make it, there’s only one thing you’ll be feeling: FOMO for BOC Wales 2025! You will not want to miss out two years in a row.

Guy Deeming Chair, British Orthodontic Conference 2024

www.bos.org.uk

BRITISH ORTHODONTIC SOCIETY AT 30

2024 is an extremely important year – it marks 30 years since the orthodontic societies in the UK unified to form the British Orthodontic Society (BOS) and this was the starting point for the BOS being recognised nationally and internationally as the voice of orthodontics in the UK.

The timeline illustrates the important events for the Society itself (in purple) and other important events in orthodontics generally (in blue) over the last 30 years. As you look at this timeline, please also spend some time thinking about what the next 30 years may hold for orthodontics and for the BOS. If you have ideas, then please contact the BOS office – all members play an important role in the BOS and it is the members’ ideas which continue to enhance the quality of care for our patients.

As we celebrate this great achievement it is also important to reflect on some words by C. D. Stephens

OBE (BOS President 2001) “While it is very appropriate that we celebrate 30 years of a united Society it is sobering, for those of us who were there at the time, to recall when hostility existed between the then 5 UK orthodontic societies………it took twenty years of patient negotiation to accomplish unification. This achievement must continue to be prized and preserved. There will always be differences of opinion within our all-embracing dental membership but is crucial that within an ever-changing political landscape any major sectional differences that we may have within the Society are resolved within its democratic structure and that British orthodontics continues to speak with one voice.”

THOUGHTS AND OBSERVATIONS ON BOS AT 30

Chris Baker speaks to members of the British Orthodontic Society about what the Society means to them.

1994 may seem like last week to some of us but it is a lifetime for others. Perhaps some of the key events from the year might put things in perspective:

• Nelson Mandela becomes President of South Africa

• The first episode of Friends is broadcast

• The Channel Tunnel opens

• Formula One driver Ayrton Senna dies in an accident at Imola, Italy

• Tony Blair becomes leader of the Labour Party

REFLECTIONS

• Harry Styles, Saoirse Ronan and Tom Daley all born

• Whigfield No 1 with Saturday Night

As the British Orthodontic Society celebrates its 30th anniversary, we took the opportunity to speak to three BOS members about the past, present and future of the BOS.

The British Orthodontic Society (BOS) has been instrumental in shaping orthodontic practice and education in the UK. As a body that represents orthodontists across various areas of practice, BOS has played a crucial role in the growth and development of the field. My own career as an orthodontist has been greatly influenced by the resources and opportunities that BOS provides, from networking and education to clinical guidelines and support for patient communication. Reflecting on my journey through orthodontics, it is clear that the BOS has not only helped me navigate a competitive job market but also contributed significantly to the advancement of orthodontics as a specialty.

My Journey in Orthodontics

I graduated from Glasgow Dental School in 1988, with my interest in orthodontics piquing during my elective study in the fourth year. After completing a junior house job in oral medicine, I spent a year working in Reading, gaining further experience in maxillofacial surgery with an orthodontic component under Keith Isaacson. This experience deepened my interest in orthodontics and strengthened my intention to pursue specialist training.

In 1990, I moved to Bristol as a Senior House Officer (SHO), where I rotated between oral medicine and periodontology. During that year I applied for the

three-year specialty training program in orthodontics at the Eastman Dental Institute, which I completed in 1994. My time at the Eastman was transformative, allowing me to develop a solid foundation in orthodontics and fostering valuable professional relationships. I stayed on for an additional year, gaining further clinical experience as a locum lecturer.

During this year, I applied for Senior Registrar posts, but the job market was very competitive at that time, and it was in November 1995 that I was appointed to my final training post back in Glasgow for a further three years. This provided an excellent platform for professional growth, and experience in multidisciplinary care, leading to my eventual appointment

as a Consultant in Glasgow, which I held for 20 years. In 2019, I transitioned into my current university post, following the retirement of a colleague. My role as a Clinical Academic has allowed me to contribute to clinical practice, orthodontic education at both undergraduate and postgraduate level, as well as research.

The Role of the BOS in My Career

The BOS has been a constant throughout my career. I vividly recall attending British Society for the Study of Orthodontics (BSSO) and British Association of Orthodontists (BAO) meetings during my trainee years in London. The eventual amalgamation of these organisations to form BOS gave the orthodontic specialty a much stronger voice and a unified platform. This unification was vital for the advancement of the field, allowing for a coordinated effort in education, professional development and patient care. The BOS provided a single organisation that could advocate for orthodontists, ensuring that the specialty could thrive.

The British Orthodontic Conference (BOC) has always held an important place in my professional calendar. Attending these events has allowed me to not only stay up-to-date on the latest advances in orthodontics but also to network with colleagues and mentors. The Consultant Orthodontist Group (COG) meetings were similarly valuable, offering a platform for more focused discussions on clinical challenges and innovations.

The BOS has played a pivotal role in standardising orthodontic education, providing access to research, and offering guidance on patient communication. The society’s focus on providing continuing education opportunities has been instrumental in ensuring that orthodontists remain at the forefront of their profession. Regular participation in BOS events and engagement with their resources has helped me maintain my practice standards, as well as providing networking opportunities.

The Next 10 Years?

The future of orthodontics is undoubtedly tied to technological advancements, with digital dentistry already revolutionising the way we approach both diagnosis and treatment. Over the past decade, the introduction of 3D technology and digital workflows has enhanced the precision and efficiency of orthodontic care. Looking ahead, I anticipate a progressive shift

towards digital orthodontics, where 3D digital design and printing of appliances becomes more routine.

Artificial intelligence (AI) will likely play an increasingly important role in the areas of diagnosis and treatment planning but, while technology will enhance our capabilities, it will never replace the need for a patientcentred approach that prioritises individual care and clinical expertise.

In terms of access to care, orthodontic services could be more widely and uniformly available across the UK. Currently, full NHS funding for primary care orthodontics in Scotland is available until 26 years of age, but there are ongoing challenges with the provision of care in remote and rural communities due to difficulties in attracting specialists to these areas. Improving this may require a greater emphasis on remote monitoring and mentoring of general dental practitioners to manage straightforward cases more locally. This already happens to some extent.

BOS: Making a Difference

The British Orthodontic Society has a critical role to play in guiding the future of orthodontics. One area where the BOS could potentially make a significant impact is by helping to draw up guidelines to address key challenges within the profession. For example, in Glasgow we have developed an interest in the “surgery-first” approach to orthognathic treatment, and the BOS could help with organising groups to share knowledge and best practices around this and other areas of innovation.

The BOS has already made great strides in creating educational resources, such as orthognathic surgery videos and the Patient Information Leaflets, with QR codes available on the website. Moving forward, the society can further support its members through hybrid events like the BOC, ensuring that orthodontists can engage with the latest developments, whether in person or remotely. The BOS could also foster more collaboration across the UK’s different regions by facilitating attendance at events in Scotland, Wales, and beyond.

My own career has benefited immensely from the BOS’s resources, and I look forward to seeing how the society continues to lead the profession forward into a new era of digital dentistry, interdisciplinary care, and patient-centred treatment.

Philip Benington

BOS - MY EXPERIENCE

How has BOS helped you in your career to date?

Being a member of the BOS and getting involved in the events, courses, and conferences every year has been a great influence on my career to date. In particular, attending the ‘so you want to be an orthodontist’ course when I was applying for orthodontic specialty training helped me meet others in the profession, become more involved and develop my passion for orthodontics. I also attended the BOS Conference in London last year; the lecture programme and speakers were very inspiring and current. The conference was also a great opportunity to socialise with colleagues.

What would you like to see happen in orthodontics in the next 10 years?

Technology has advanced so much over the last 10 years and has already impacted dentistry and orthodontics through the introduction of digital dentistry. Over the next 10 years, I would like to see everyone in orthodontics becoming completely digital giving us more scope for being creative and designing appliances through 3D printing.

I’d also love to see artificial intelligence being integrated into the profession and orthodontics. Despite these changes there will always be a need for understanding the fundamentals of orthodontics and to adopt a patient centred approach. Technology will enhance this but does not replace it.

What do you feel that BOS should be focussing on to further the benefits of orthodontics?

Orthodontics has become increasingly popular especially with the introduction of clear aligner systems and with more GDPs carrying out orthodontics. The BOS should continue to ensure the public are aware of the risks of clear aligner systems which do not involve the input or minimal input from a dentist or orthodontist. Furthermore, there should be increased support for GDPs who carry out orthodontic treatment.

What changes do you expect to see in the hospital setting over the next decade?

I expect to see a greater integration of digital orthodontics such as with the introduction of scanners across all hospitals. In addition, being able to offer a wider range of treatment modalities such as clear aligner therapy and lingual orthodontics and specifically being able to gain experience in these during specialty training.

Rana Fard

A PERSONAL VIEW ABOUT THE BOS AT 30 FROM SOMEONE WHO WAS THERE AT THE BEGINNING

My orthodontic training started as a two-year MDSc training programme in Leeds in 1987, sharing a salary with the other postgraduate, paying a University bench fee and University Master’s fees. However, in our first year a new exam was discussed called the MOrth which would have 3 parts. Following completion of MDSc, MOrth Section 1 part 2 and DOrth I was now eligible to sit the first diet of the Edinburgh MOrth part 2. With no national recruitment and only 3 posts available I accepted a Senior Registrar post at St George’s and Kings which was quite a change as I had only visited London previously for a four day school trip. One of the first people to contact me when I arrived in London was Jonathan Sandler, who chaired the Senior Registrar Orthodontic Group (SROG) and invited me to join them for their annual meeting at the old University College Hospital which is now housing and office space. This would be my introduction to the predecessor of the TGG.

BOS and My Career

The BOS has been a consistent and invaluable presence throughout my career. When I started my orthodontic training, the landscape was very different. In the mid-1980s, orthodontics in the UK faced considerable scrutiny, following reports like a television documentary called Digging for Gold and the subsequent Schanschieff Report, which criticised aspects of the dental profession. Unexpectedly there were claims about the quality of orthodontic care and unnecessary treatment in practice which spurred a greater need for professional unity between orthodontists from all areas of practice and led to the first BOC.

My first BOC was in Birmingham in 1989 when I presented my project delivered using 35mm slides with triple projection, an essential skill for an orthodontic trainee and very scary for the uninitiated. This was my first big meeting with various orthodontic groups with a common lecture programme and groups also having separate meetings during the conference. I became involved in organising meetings in SROG and, in 1993, I was elected Chairman of the group. The SROG had been set up in 1981 to support further education of Senior Registrars (today’s ST4-5s and improve training opportunities. These meetings were relatively small, twice yearly with only about 40 members with equal male and female trainees. Communication was by land line and Fax. Senior Registrar training was on average 3.5 years with no exit fellowship to mark the end of training. However, there was an annual assessment of

training. I was very fortunate to have very supportive trainers, but training could be variable and the time increased if the trainer thought it appropriate. A certificate of accreditation was awarded following advice from your trainers to allow application for consultant posts. The SROG always had a very close relationship with the Consultant Orthodontist Group (COG), with the SROG chair invited to COG meetings and the membership invited to attend COG study days. Consultant colleagues such as Ray Reed the chair of COG at the time, Austin Banner, David Birnie and Stephen Powell were always generous with their time and advice. This relationship has continued with the TGG.

On 1st July 1994, six societies joined to become the BOS - including SROG as the sixth member in the working party, The SROG subsequently became the Training Grades Group which represents orthodontic trainees. I was very privileged to chair SROG and then be the first chair of TGG in 1994.

BOS is an incredible success story for dentistry which brought together 6 groups, who from the view of the SROG chair at the time all had very different agendas. 30 years later it is as if BOS has always been the voice of Orthodontics in the UK. Orthodontic specialists represent about a third of all dental specialists but only 3% of the profession, however BOS is the best-known specialty organisation. Just ask any dentist!

One of the major achievements of BOS has been its ability to foster collaboration across different sectors of orthodontics, support education at scale and deliver

an outstanding annual conference while maintaining the identity of individual groups. Prior to unification there were some divisions between the various groups and the merged BOS helped unite orthodontists under a common goal of improving patient care. The late David DiBiase was the first chair of the new society and one of the most skilful chairs I have ever observed, fantastic at getting people around the table to resolve differences. The late John Williams commented about the unification of six societies that “Some of us may be wondering what all the fuss is about! I expect that quite soon it will be impossible to understand why it took so long to achieve what was so obviously required.” How true that comment is today. It is very important to mention Ann Wright who has always offered amazing service behind the scenes managing challenging situations with her unique charm and I will always be grateful for her advice to one new very inexperienced member of BOS.

Unification has benefited trainees very much. As the BOS has developed into a much larger organisation the TGG has developed and expanded with representatives on various boards such as the Specialist Advisory Committee (SAC), Core Training Group, Consultants Group (COG) and Specialists Group (OSG).

BOS has also played a key role in supporting orthodontists through significant changes, such as the introduction of specialist registration, introduction of dental therapists, curriculum changes and the Intercollegiate Specialty Fellowship Examination (ISFE) which replaced the less transparent accreditation process 30 years ago. My generation were barred from sitting the new ISFE via an agreement with the surgical colleges. But that is another story.

The Role of BOS in the Future

Looking ahead, the future of orthodontics is bright, and I remain optimistic despite the challenges we face. Over the years I have seen trainees at my own unit in Guildford occupy a variety of roles in TGG, including a few as chair. The TGG has embraced its educational role and with the support of the BOS can deliver courses at scale for not only current members but supporting aspiring orthodontists. These opportunities would have been impossible without a large parent organisation. We are fortunate to now have colleagues who were themselves once aspiring specialists and are now either in training or have become Specialist Orthodontists due to the support of the TGG.

Advances in digital technology have already transformed many aspects of our work and no doubt will continue. Artificial intelligence (AI) will likely play a growing role in orthodontics, particularly in case selection and monitoring, potentially improving efficiency and outcomes. I have no doubt that BOS will be there to provide advice to support best practice. The greater focus on minimising waste and corporate

social responsibility within the profession was already evident with presentations at the BOC 2024.

I am sure BOS will continue to play a central role in guiding the profession through future changes. It is vital that the Society maintains its non-partisan approach, providing gold-standard governance and resources that serve the best interests of patients and practitioners alike. I have no doubt that it will maintain and improve professional standards and continue to encourage research and education. BOS is not a union, nor should it ever become one, but it must remain a strong advocate for the profession in its role as a charitable organisation.

On a more practical note, public funding for orthodontic treatments is likely to face further constraints. This will require a more strategic use of resources, with orthodontic therapists playing a larger role in delivering care. At the same time, patient awareness of treatment costs and outcomes will continue to grow, necessitating clear communication and transparency from practitioners. The BOS demonstrates skilful public relations, discrediting false claims and providing accurate information to members and patients. The awards and prizes that BOS bestows are of great value as we showcase the best that the specialty can offer and allow us to reward clinical excellence.

The social aspect of BOS events, particularly the BOC, is very important. These gatherings have become more impressive over the years and allow for an exchange of ideas and the fostering of relationships, helping orthodontists across the UK stay connected and informed. The informal conversations that happen at these events can be just as valuable as the formal sessions, offering new perspectives and insights in an informal setting. Without the early conferences and social events, I wonder if unification would have ever occurred. It should be remembered that the conference was one of the catalysts that moved unification forward.

Looking back over 30 years, BOS has played a crucial role in shaping modern orthodontics, and its influence will be even more important as we navigate the technological, ecological, and financial challenges of the future. I have no doubt that the Society will continue to provide the guidance and support necessary to keep orthodontics at the forefront of dental care, ensuring the best outcomes for patients and professionals alike.

John Williams wrote in the BJO in August 1994 “The expectations we have of the new Society are considerable. I have every confidence in what we have achieved, and the British Orthodontic Society has my very best wishes”. It is sad that he is not here for his prediction to become more than fulfilled.

Nigel Taylor

THE PAST IS ANOTHER COUNTRY1 - OR IS IT?

The historian GM Trevelyan believed that “what distinguished civilised man from the semisavage was his wish to understand the past as it really was”. 2 It was for that reason that since 1908 Britain’s orthodontists have maintained both a Library and a Museum and why one of the first achievements of our unified Society BOS was to publish an account of its 87 year history.3

While it is very appropriate that today we celebrate 30 years of a united Society it is sobering, for those of us who were there at the time, to reflect that from 1907 until 1960 we had such a society - The British Society for the Study of Orthodontics. However, the inclusion of orthodontics within the dental NHS in 1948 raised many issues which the BSSO could have helped to resolve but sadly it clung to the misguided view that as a “Learned Society” it should not become involved in issues of treatment provision, even when asked to do so by such bodies as the Royal Colleges and the Department of Health. A direct consequence of this attitude meant that by the 1970s there were four societies representing and voicing the sectional interests of members of our disunited specialty.4 As recorded succinctly by Chris Kettler, the first Honorary Secretary of the BOS, “It is difficult now to recall the antipathy that existed in the late 1960s and early 1970s between the factions of the UK orthodontic specialty as well as the barely-concealed hostility between the various orthodontic societies and between these and the BDA” 5 Matters had to change.

The German physicist Max Planck believed that science advances one funeral at a time, or more precisely: “A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it” 6 So it proved to be for orthodontics and by the late 1960s many of those who had been appointed as NHS Consultants in Orthodontics in 1948 were retiring and lead by Steve Gould, Chris Kettler, David DiBiase and others the 19 year progress to unification began.7

In the late 1960s, the widely held belief was that “...cases requiring active treatment can satisfactorily accomplished by a system of efficient but simple removable appliances”. 8 For those of us who were recent postgraduates or were occupying junior hospital posts the revelation came with the World Orthodontic Congress held in London in 1973, where having been constantly told by our BSSO leaders that NHS orthodontic treatment was “the best in the world”, it became abundantly clear that this was untrue.

At that time the orthodontic fee structure was determined by the BDA Dental Rates Study Group into which our Society had no input and NHS orthodontic fees were biased in favour of encouraging simple one arch removable appliance treatment which could be carried by the general dental practitioner. Multibanded two arch fixed appliance treatment in the GDS, when it was approved by the Dental Estimates Board, was given an NHS fee which meant treatment could only be undertaken at a financial loss. It followed that by the 1960s there was increasing frustration by those working in the GDS who held postgraduate orthodontic qualifications who rightly felt they were being discouraged from providing treatment of an acceptable contemporary standard.

Since unification there have been a number of highly significant achievements which have directly come from our ability to speak with one voice. As a result the treatment of cleft lip and palate has been rationalised, the standard of our orthodontic qualification has been raised to one gaining international respect, more realistic GDS fees for fixed appliance treatment have been negotiated, and we have secured the establishment of a specialist register and seen the introduction of orthodontic therapists.

There will always be differences of opinion within our now all-embracing dental membership but it is crucial that within an ever-changing political landscape any major sectional differences that we might have within the Society in the future must continue be resolved internally by full participation of the membership using its democratic processes so that British orthodontics continues to speak with one voice. In connection with this fundamental principle, I was concerned to note that the number of ordinary members attending the recent AGM at Birmingham was just 36, whereas 20 years ago it would have been several hundred.

The English philosopher and statesman Francis Bacon once stated “I hold every man a debtor to his profession from which as men of course do seek countenance and profit so ought they of duty to endeavour themselves by way of amends to be a help

and ornament thereunto” 9 This long held belief was echoed by the late President John F. Kennedy in his presidential address in 1961.10 I believe my generation has carried out this obligation. It is now up to the present membership, and those recently retired, to continue to do so. At the very least every BOS member should maintain an informed knowledge of current Society issues and where necessary make their views known to the Board. In addition, we should all support the recent appeal by the Board for contributions to British Orthodontic Society Foundation for without research there can be no meaningful progress.

Emeritus Professor C.D. Stephens OBE

Member of the Unification Working Party 1990-1993 BOS President 2001-2

The English College, having recently agreed to include dental fellows, is looking for obituaries from current orthodontists for those of our colleagues who died between 1990-2023.

Guidelines are on the Plarrs website (www.livesonline.rcseng.ac.uk).

1. L.P. Hartley The Go-Between. Hamish Hamilton, London, 1953.

2. GM Trevelyan An English Social History. (Introduction). Longman Green and Co, London, 1942.

3. Rose JS et al. A history of the British Orthodontic Societies (1907-1994). The British Orthodontic Society, London, 2002.

4. Hospital Consultants (COG, 1961), GDS specialist practitioners (BAO, 1965), Community Orthodontists (ComOG, 1974), University Teachers (AUTO, 1978).

5. Stephens CD. The Unification of UK Orthodontic Societies 1970-1994. Dental Historian, 2021; 66(1): 17-24.

6. Plank, MK. Scientific Autobiography and other papers. (Translated from the Germans by Gaynor, F) Williams and Norgate. London, 1950.

7. Gould MSE. Some observations on the British Society for the Study of Orthodontics and suggestions concerning its future. A discussion paper presented to BSSO Council, October 1975.

8. Dixon DA. The evolution of the fixed appliance in orthodontic treatment. Trans BSSO 1970/1, 158-166.

9. Bacon F. Maxims of the Law, in The Works of Francis Bacon. Cambridge University Press, 2011. pp. 307 – 308.

10. Kennedy JF. “And so my fellow Americans : ask not what your country can do for you -ask what you can do for your country”. Presidential Inaugural address, January 20th 1961.

The inaugural Council Meeting of the BOS 2nd October 1994 at the BOC Harrogate

Sitting from left to right: Professor Jim Moss, Professor Chris Stephens, Chris Kettler, David DiBiase, Jeffrey Rose, Allan Thom, Peter Gordon, Keith Isaacson

Standing from left to right: Robert Kirschen, Ray Edler, Jeremy Moore, Liz Jones, David Lawton, Stewart Hawthorn, Nick Mitchell, Ann Wright, David Williams, Ken Lumsden, Helen Knight, David Birnie, Nigel Taylor, Chris Wright, Cindy Brown, John Alper

CYCLING ON COBBLES TO RAISE AWARENESS OF SUICIDE PREVENTION

Everyday, 17 people in the UK tragically die by suicide. It’s shocking to note that suicide is the leading cause of death for men under the age of 50 and women under the age of 35. Despite this, it’s rarely talked about and those affected are often isolated and stigmatised. I lost my brother Andy to suicide and it had a devastating effect on our family, Andy’s friends and colleagues.

However, there is hope. If more people talk openly about mental health and suicide, spot the signs, ask the right questions and listen without judgement, we can make a difference. I’ve been involved in mental health awareness and suicide prevention for some time and wanted to take on a cycle challenge to help to raise awareness on this critically important issue.

I’ve been fortunate enough to have undertaken numerous cycle races and challenges, however none quite like the Flandrien Cycle Challenge in Belgium. The Flandrien cycle challenge is over 400km in length with over 5000m of climbing on the famous steep cobbled roads of Belgium. Much like our mental health, there was no official start or finish line, we just had to complete 59 sectors within a time period. My friend Rob, and I, are experienced cyclists, however neither of us have much experience of riding cobbled roads. We decided to undertake the challenge over 3 days in July (thinking we might have nice weather!).

Our first day we were based in Ypres and was relatively short at 75km, which we thought would be a good warm up. Our first taste of cobbles was on the famous Kemmelberg climb. The cobbles appeared to have been laid in a random haphazard pattern and we were bounced around and our tyres were sliding underneath us as we negotiated the steep climb. Once at the top of the climb we were both shell shocked as we realised how difficult this challenge was going to be. After the last cobbled climb of the morning, I realised something was not right with my bike. My back wheel had buckled under the stress of riding over the cobbles. This led to an unplanned visit to a bike shop to buy some new wheels. This was just the start of the challenge and we had sudden realisation this was going to be much tougher both mentally and physically than we’d anticipated.

We transferred to Oudenaarde for the next two days. Day two was an epic day in the saddle at 189km with numerous famous cobbled climbs to negotiate. The day started off with steady rain and made for fairly miserable riding. Another unexpected challenge was riding on wet and slippery cobbles on flat roads and downhill. We were both losing confidence as our tyres were sliding on the slippery cobbles and we really had to dig deep in our mental fitness locker to keep going. The kms slowly ticked over and the weather slowly improved but were getting more physically and

mentally fatigued. We were relieved to have finished day two in one piece.

Day three was slightly shorter at 135km however the most difficult cobbled climbs were planned for the afternoon. Soon after we started riding we had to deal with heavy rain and treacherous riding on the cobbled roads. Whilst descending a rough cobbled road I had a puncture on my front tyre which wasn’t pleasant to say the least, thankfully I stayed upright and managed to keep going. By lunchtime Rob and I were both feeling very mentally and physically fatigued and were dreading the afternoons challenging route. Thankfully the rain stopped after lunch and we battled over the cobbles supporting one another. Both of us reached our mental limits from dealing with the stress of the repeated efforts of steep cobbled climbs and slippery riding. We hung on and completed the challenge. As we came back to Oudenaarde we stopped at the Centrum de Ronde van Vlaanderen to receive our commemorative cobble for completing the challenge.

However, this challenge was never about the bike… It was about raising awareness of mental health and

suicide prevention. We documented our journey on social media to share our ups and numerous downs. Showing that it’s ok to show emotion, ask for help and share the psychology for managing mental health in stressful situations. Creating hope for others that things can and do get better. Hold On Pain Ends…

We were delighted to have raised over £10,000 which was shared equally between The Baton of Hope and The Canmore Trust, two charities which are close to my heart. The money will assist The Baton of Hope with the creation of gold standard policies for suicide prevention in the workplace. The Canmore Trust will use the money to train Experience Friends in suicide prevention and suicide postvention.

I’m deeply passionate about raising awareness of mental health and suicide prevention. However I can’t do this alone, we all can make an difference improving mental health in society and open up conversations which can save lives.

Angus Pringle

BOSF CELEBRATING 25 YEARS OF SUPPORT FOR RESEARCH AT BOC

The British Orthodontic Society (BOS) in its current format celebrated 30 years at this year’s BOC in Birmingham. The tremendous benefits of BOS Membership include access to educational resources (VLE), preferential rates for conferences and courses, subscription to the JO, proximity to equipment and materials suppliers, helpline for clinical and business advice, and of course access to research grant funding.

The day-to-day business of the BOS, in large part, revolves around educational and research activities. The Research Directorate is a major pillar of the Society which drives innovation in Orthodontics, excites interest among members and students, and informs, evidences and underpins improvement in our clinical practice. The BOSF is the instrument that drives the advancement of orthodontic knowledge by funding orthodontic research for the improvement of patient care, supported by the BOS Awards programmes and the Journal of Orthodontics.

There is of course a cost for research activity and publishing which accounts for a significant portion of our finances, with an investment of £1.5M over the 25 years the BOSF has been in existence. We are currently investing around £600,000 in ongoing research projects. Current BOS membership income just about covers our operating costs, and so we are continuing to raise revenue to enable the BOSF to continue funding research projects and issue new calls.

The celebrations at our BOS 30 year anniversary and 25 years of BOSF (tagged as the BOS@30) was a timely and unprecedented opportunity to publicise what we do in BOSF and showcase some of our exciting and impactful research over that time. We are indebted to BOSF for the incredible contribution to research both in terms of the education of our trainees to be better professionals and the clinical legacy that Orthodontics can bring in transforming lives. BOSF is a flagship for BOS and an attractive brand in the world of Orthodontics and oral health and wellbeing.

At the conference, there were many innovations in the style as well as the content of the presentations and the opportunities for engagement with speakers, the trade and with each other – and hopefully you will have noticed the BOSF more prominently. Testimonials from BOSF grant awardees about how BOSF funding has supported their research were shown and the

inaugural BOSF Fun Run was introduced to the BOC programme with great success. It was fantastic to see runners of all abilities enjoy the social atmosphere on the 1 mile and 5k runs.

Thanks to Dental Monitoring as the sponsor with a DM thermal cup for all participants

Further BOSF highlights from the conference included:

• The Chapman prize winner, Jad Seehra, whose research on the “Management of impacted maxillary central incisors - a multicentre RCT” has been funded by the BOSF, updated the audience on “Periodontal outcomes for impacted maxillary incisors and canines: What do we know?”

• Trishna Patel won 1st prize at the OTTG presentation session with her BOSF funded research on “Orthodontic Patient Experience of Intraoral Scanners Versus Alginate Impressions (UK)”.

• Research led by Amaar Hassan and funded by a joint FDS – BOS pump priming grant, won the Research Poster Prize. Their poster summarised “My PPI experience: How young people influenced research on WSL”.

• Meanwhile the latest (September 2024) issue of the Journal of Orthodontics carries 2 significant research papers by Mandall et al (an RCT on bone anchored maxillary protraction) and DiBiase et al (on the links between malocclusion and bullying), both made possible thanks to BOSF funding.

Going forward, we plan to:

• Tailor activities to the needs of our members in the various BOS sub-groups which means encouraging feedback from BOS Members as we seek to

ensure that our package appeals to not only current members but also specialist and general practitioners with an interest in orthodontics.

• Encompass the interests of the wider orthodontic team who are engaged in the provision of orthodontics and ensure they are adequately supported – this includes our nurses, therapists, hygienists and technicians as well as the dentists who would like better access to Consultant orthodontic advice.

• Optimise communication and collaborative activities with our corporate members and sponsors –publicise their support for our work, and they may be interested in our research expertise, and we will be delighted to help!

• Engage the public more, raising their awareness of the benefits of orthodontics, inviting feedback from those who have received orthodontic treatment and make it attractive and easy for members of the public to make donations to the BOSF.

• Welcome our international members and expand the geographic boundaries in research collaborations, in conjunction with BOS at a time when nominations are being invited for a BOS International Liaison Lead.

• Acknowledge our Scholarship and Award winners in the public advertising screens at future BOC events, celebrate their successes and the ongoing success of our acclaimed international journal – the Journal of Orthodontics. Show case ongoing BOSF funded research with presentations from researchers completing projects currently funded by the BOSF.

Through all the above we aim to keep you entertained, interested and smiling at the premier event in the BOS Annual calendar as we “Keep Britain Smiling”, –which is a reference to the tremendous Karen Juggins' initiative to optimise the impact of Orthodontics on improving health and wellbeing of our target population throughout the UK.

Your donations to the BOSF directly support research across the UK and without these, many of the projects aiming to improve Orthodontic care would not be possible.

To those that have supported the BOSF before - thank you for your continued support. And to those that are donating for the first time – thank you. We look forward to working with you all to fund projects that help to improve patient care both in the UK and across the world.

This QR code will direct you to the donation page.

EMBRACING SOCIAL RESPONSIBILITY IN PRACTICE

In recent years, the concept of Corporate Social Responsibility (CSR) has evolved in our practice. We realised that we could engage in social responsibility initiatives to create a positive impact on our patients, team members and ourselves. It has not happened overnight and has taken time to evolve. The pandemic helped propagate some of the changes.

Accessible Orthodontic Care

Since 2020 we have offered a combination of remote and in-house consultations. This gives the patient more choice on what they would like to do. In addition, when patients call up with an emergency we ask them to send in photos either via WhatsApp or email to give us a chance to triage their problem. This saves them time if they don’t have to come to the practice and could either resolve the issue at home or wait till they are next in. Some people love it, others simply want to be seen to miss school!

Educational Outreach Programs

As the pandemic is a distant memory, we have stepped up our CSR efforts by becoming educators within our community. We offer to hold oral health workshops in schools, nursing homes, and for Scout groups and the Girl Guides.

We host teaching evenings for our local dentists and their teams. The last one was in November where we gave them tips on taking good photographs and a seminar on orthodontic referral guidelines. I am afraid I only have photos of the food available as it was the day after we had a CQC inspection and we were exhausted!

We also regularly post oral health awareness social media posts.

Both Anjli and Anne-Marie attend careers fairs at the local schools. This provides the opportunity to inspire and mentor aspiring professionals, while also fostering connections within the community and promoting the growth of future talent. We offer work experience days to our patients who may wish to consider a career in orthodontics.

Eco-Friendly Practices

Sustainability is a growing concern for us and we have reduced our paper usage by using digital records and try and email any correspondence. Since 2020, medical history forms and consent forms are completed and stored electronically.

We have started to adopt eco-friendly practices. Simple measures like reducing paper usage through digital records, using autoclavable suction tips and 3 in 1 tips, using glass cups not disposable plastic cups and recycling programs has reduced our environmental waste.

Community Initiative

Involvement in charitable activities fosters a sense of goodwill and community engagement among staff and patients alike, enhancing the practice's reputation and strengthening patient loyalty. At No 1, we held a raffle in aid of Ben’s Den a charity that helps support the families of children fighting leukaemia or cancer, by giving them a free holiday. This allows the family to spend quality family time together away from the overwhelming hospital environment. The local businesses donated prizes and together we raised over £600.

Each year we support a local U10 football team and provide them with much needed sports kit. Sponsoring the local junior football team not only demonstrates a commitment to community support but also enhances brand visibility, fosters positive relationships with families, and promotes healthy lifestyles among young athletes.

Conclusion

Embracing Corporate Social Responsibility is not just a trend; it's a commitment to creating a positive impact beyond the clinic walls. As an orthodontic practice, we can contribute to the improvement of society by implementing thoughtful CSR initiatives. By fostering accessible care, engaging in educational programs, adopting eco-friendly practices, and supporting community causes, we can build a legacy that goes beyond crafting beautiful smiles to creating healthier and more vibrant communities. As the saying goes, a healthy community begins with a healthy smile.

Anjli Patel

ARCHIVE AND MUSEUM COMMITTEE REPORT

In 2022 the Archive and Museum Committee collaborated with the NHS at 70: Voices of Covid-19 group in Manchester (www.nhs70.org.uk) to capture the experiences of some orthodontists during the pandemic (see BOSNews Summer 2023).

This involved the technique of oral history, which is probably the oldest form of historical inquiry. It involves the ‘gathering, preserving and interpreting the voices and memories of people, communities, and participants in past events’ (www.oralhistory.org). Following the success of the Voices of Covid-19 project the Archive and Museum Committee is planning to use the technique again to preserve the memories of individuals involved in other significant orthodontic events and experiences in the recent past, including the Clinical Standards Advisory Group on Cleft Lip and/or Palate. Prior to the start of data collection, we present here a brief history of the CSAG report written by Michael Trenouth, a retired Consultant Orthodontist from Preston and member of the BOS Archive and Museum Committee.

The Clinical Standards Advisory Group (CSAG) was established in April 1991, under Section 62 of the National Health Service (NHS) and Community Care Act 1990, as an independent source of expert advice to the UK Health Ministers and to the NHS on standards on clinical care for, and access to and availability of services to, NHS patients. There had been 16 previous CSAG reports prior to the report on Cleft Lip and/or Palate, most notably Dental General Anaesthesia.

A previous comparison of treatment outcomes between 6 European Centres (Amsterdam, Copenhagen, Great Ormond Street, London, Manchester, Oslo and Stockholm) concluded that the centres where surgeons performed a high number of operations had better treatment outcomes for patients than either of the two UK centres, where surgeons performed a low number of operations (Shaw et al., 1992). As a result the CSAG on Cleft Lip and/or Palate was commissioned.

The group outlined 12 objectives at the start, with the main purposes to “To advise on standards of clinical care for people with congenital cleft lip and/or palate’ and ‘report on current levels of access to units that would be expected to achieve good outcomes and suggest any changes to existing clinical standards considered necessary in the light of your findings.”

Two research teams were established comprising a Northern section based at the University of Manchester,

with David Bearn and Professor William (Bill) Shaw and a Southern section based at the University of Bristol with Alison Williams and Professor Jonathan Sandy. A research strategy was adopted to limit the outcome audit to complete bony unilateral cleft lip and palate only, as this was considered a reasonably homogeneous subgroup, involving the whole multidisciplinary clinical team. It was also decided to extend the project to include speech. The study was undertaken over a 15-month period beginning on 1 March 1996 (Sandy et al., 1998). A questionnaire was sent to all 57 UK hospitals identified as treating patients with a cleft of the lip and/or palate and 48 responded (84%). The information was used to select hospital units to visit, based on a geographical spread and number of patients treated per year (i.e. 1-10, 11- 20, 21+). Units chosen were visited to identify the number of 5-yearolds born between April 1989 and March 1991 and 12-year-olds born between April 1982 & March 1984. The 12-year-olds were included to assess the outcomes from alveolar bone grafting. The number of children identified was 647 (326 5-year-olds & 321 12-year-olds), under the care of 50 cleft teams. Of these 601 children were invited to attend data collection days and 457 attended (76%; 239 5-year-olds and 218 12-year-olds). There were also written submissions, oral presentations and survey data from the Cleft Lip and Palate Association (CLAPA). A protocol was used to assess Purchasers (4 indicators) and Providers (14 indicators) and overseas visits were undertaken to Oslo and Nantes.

The summary findings of the study and conclusions were published in 2001 (Bearn et al., 2001). The conclusions and implementation of the report proved to some extent controversial. It resulted in a major reorganization of treatment services for patients with clefts of the lip and/or palate, involving the whole of the UK and multiple specialties. A low volume dispersed model of care ceased and was replaced by a centralized high-volume model of care, with the number of units providing primary cleft surgery being reduced from 57 to 11.

I was responsible for organizing the data collection for the Preston centre and compared the Preston results to the National ones. I also played a role in the

implementation of the CSAG findings in the Northwest working with the first Clinical Director, Joyce Russell.

The rearrangement of services provided to patients with clefts of the lip and/or palate has subsequently been evaluated by Cleft Care UK (CCUK) in 2013 (Dudding et al., 2023).

Michael Trenouth

If you were involved in the Clinical Standards Advisory Group on Cleft Lip and/or Palate and would like to take part in our oral histories project please contact the committee using the e-mail address: archiveandmuseumcommittee@bos.org.uk.

The committee would also like to record the experiences of anyone involved in the Community Orthodontic Service. If anyone would like to be involved in this project please contact us: archiveandmuseumcommittee@bos.org.uk.

Philip Benson Chair A&M

References

Bearn D, Mildinhall S, Murphy T, Murray JJ, Sell D, Shaw WC, et al. Cleft lip and palate care in the United Kingdom--the Clinical Standards Advisory Group (CSAG) Study. Part 4: outcome comparisons, training, and conclusions. Cleft Palate Craniofac J 2001; 38: 38-43. https://doi.org/10.1597/1545-1569_2001_038_0038_ clapci_2.0.co_2

Dudding T, Martin S, Popat S. An introduction to the UK care pathway for children born with a cleft of the lip and/or palate. Br Dent J 2023; 234: 943-946. https://doi. org/10.1038/s41415-023-5998-z

Sandy J, Williams A, Mildinhall S, Murphy T, Bearn D, Shaw B, et al. The Clinical Standards Advisory Group (CSAG) Cleft Lip and Palate Study. Br J Orthod 1998; 25: 21-30. https://doi.org/10.1093/ortho/25.1.21

Shaw WC, Dahl E, Asher-McDade C, Brattstrom V, Mars M, McWilliam J, et al. A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 5. General discussion and conclusions. Cleft Palate Craniofac J 1992; 29: 413-418. https://doi. org/10.1597/1545-1569_1992_029_0413_asciso_2.3.co_2

Supporters of the BOS Museum

If you are interested in assisting the museum and helping to preserve orthodontic heritage then please consider joining our team of Supporters of the Museum, who are a vital support to the work of the museum. Some examples of the work carried out by the Supporters include:

• Providing orthodontic knowledge to the curator

• Donating and identifying objects

• Writing articles

• Researching orthodontic history

• Assisting the curator with enquiries.

To register your interest, please contact the Chair of A&M archiveandmuseumcommittee@bos.org.uk

www.bos.org.uk

DIRECTORATES

EDUCATION

This is my first report for BOS News as Director of Education. I look forward to managing the portfolio of this Directorate’s activities and serving the members of our Society during my tenure in this role over the next 3 years. I would like to begin by offering a gratitude of thanks to my predecessor, Sally Walker, for her energetic leadership of the Directorate over the past 3 years.

In April, the BOS offices at Bridewell Place hosted a dento-legal and risk management study day. This was a well-received and lively day with Alison Williams, Giles Kidner and, from the Dental Defence Union, John Makin and Tamsin Thomas as speakers. The interactive day stimulated discussion around orthodontics and understanding how to manage risk in practice, the root cause of many dento-legal matters and understanding the roles of the expert witness and the GDC clinical dental advisor. The day was concluded by describing the legal process of a dental negligence claim from the perspective of an experienced solicitor in this field.

The ever-popular annual Orthodontic Therapists national training day held in May was delivered using a hybrid method of face-to-face and online delivery. Amy Gallacher, David Waring, Steve Chadwick, Pam Gill and Julie Williams facilitated this day. A range of topics were delivered to the orthodontic therapist delegation including an update on orthodontics and periodontal disease, working with the oral surgery team, tips and tricks of aligning impacted teeth, finishing and detailing of cases, methods of space closure and imposter syndrome in dentistry. Planning is already underway for the Orthodontic Therapist’s National training day in Spring 2025. Further details will be circulated in due course.

During the summer, two asynchronous level 2B CBCT orthodontic specific courses were delivered in conjunction with the British Society of Dental and Maxillo-facial Radiology. This bespoke virtual training programme equips the clinician with the training required in dental CBCT interpretation and reporting. A key feature of this training is the development of the extremely useful skill of image manipulation to orientate the images which is invaluable in the clinical setting to inform, orientate and educate patients and carers

about their condition. The training which delegates have received whilst undertaking this programme has generated extremely positive feedback. This course is designed to enable the delegate to pace their training at a time of their choosing which is facilitated by a Dental and Maxillo-facial radiologist.

The Education Directorate of the Society is composed of the Education Committee and its activities of providing a portfolio of educational content and courses and the Archives and Museums committee whose aim is to foster and promote interest in the history of orthodontics. This includes the responsibility for the care of the BOS museum and its collection, with the objective of preserving documents of historic, political and scientific significance. During the summer the BOS offices at Bridewell Place moved to the Royal College of Surgeons of England. The museum at the BOS offices which has been curated over many years was delicately packed by Sophie Riches and placed into a bespoke storage site which carefully preserves artefacts of historical interest. As part of this process, Neil Hillyard photographed each piece within the museum collection.

Please see the upcoming BOS Courses and Educational Events Calander for those courses which shall be delivered in the next few months, with the Education Committee in the process of planning further courses for 2025.

If you have any queries about education matters or have suggestions for future courses that could be delivered by the committee, please email on education@bos.org.uk.

Hemendra Shah Director, Education

Inter Artem et Scientiam Concordia Art and Science in Harmony

Upcoming BOS Courses and Educational Events

Please visit www.bos.org.uk for more information or to book a place on one of our courses

14 November 2024 New specialty training curriculum and assessment methods webinar

This webinar is for anyone with an interest in training, but especially relevant for TPDs, Educational Supervisors, Clinical Supervisors and Specialty trainees, who have begun their training in October 2024 and will provide further details on the newly introduced orthodontic curriculum.

Virtual 18:00-19:30

5 December 2024 PAR Training Course

This hands-on training course will teach participants to accurately apply the PAR tool in the clinical setting. This course includes a formal assessment which, if successfully passed, will lead to participants being recognised as being fully-trained in the use of the PAR tool This course is suitable for all members of the clinical team.

Face-to-face: Royal College of Surgeons of England, London.

6 December 2024 IOTN Training Course

This hands-on training course will teach participants to accurately use the Index of Orthodontic Treatment Need in the clinical setting. This course includes a formal assessment which, if successfully passed, will lead to participants being recognised as being fully-trained in the use of the index This course is suitable for all members of the clinical team.

Face-to-face: Royal College of Surgeons of England, London.

1 January –

31 January 2025

31 January 2025 & 1 February 2025

28 February 2025 & 1

March 2025

Dentoalveolar CBCT Course Level 1 (Core training and referral)

A virtual theoretical course delivered by members of the BSDMFR. Registered participants will be sent a link to the material and can complete the course at their own pace during the viewing window. Participants are also invited to attend a virtual live Q&A session with the speakers, date and time to be confirmed. Virtual.

Dentoalveolar CBCT Course Level 2A (Interpretation)

A hands-on training course developed specifically for orthodontists and delivered for BOS by BSDMFR, involving manipulation of anonymised CBCT scans. Participants must have completed a Level 1 course run by the BSDMFR before attending.

Face-to-face: Edwardian Hotel, Manchester

Dentoalveolar CBCT Course Level 2A (Interpretation)

Face-to-face: Royal College of Surgeons of England, London

Online CPD and educational resources from BOS

CPD on the BOS VLE for all members

• NEW! Shared decision-making module – 2 hours of CPD available

• Risk management situational judgement tests – 4 hours of CPD available Login to www.bosvle.org.uk to complete the learning packages and obtain your CPD

National Orthodontic Programme for specialty trainees

Please contact your Training Programme Director to gain access to this valuable resource available at www.bosvle.org.uk, which includes full coverage of the ST1-3 curriculum.

Fluoride varnish application training on the BOS VLE

A virtual training package for DCPs who wish to extend their scope of practice to include application of fluoride varnish to patients undergoing orthodontic treatment. Log in to www.bosvle.org.uk to view the training video and download the training materials.

CPD

for DCPs

There are four CPD modules available online for orthodontic therapists:

• Cephalometry (3 hours CPD)

• Management of orthodontic emergencies (2 hours CPD)

• Brackets and bracket prescriptions (2 hours CPD)

• Assessment of the orthodontic patient (2 hours CPD) Log in to www.bosvle.org.uk to undertake the CPD

Prodental CPD

Complete all your core CPD online for FREE! Available free of charge to all BOS and ONG members

To request access, please email ann.wright@bos.org.uk

Digitutor

An online package designed to help develop skills in identification of common cephalometric points. A great resource for those learning the practical skills of cephalometric assessment. Available at www.bos.org.uk

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The Voice of Orthodontics

Ensure that you don't miss out on all the benefits that being a member of the British Orthodontic Society brings. As well as being part of the largest specialist dental group in the UK and the opportunity to network with like-minded colleagues, you can also take advantage of:

• Membership tailored for you whether you’re a Consultant, Specialist, Dentist, Academic or Post Graduate – there’s a group for you

• Access to BOS members' area of website and Virtual Learning Environment (VLE)

• FREE Subscription to Orthodontic Update - worth £92.00

• FREE ProDental CPD access to mandatory topics

• Discounted rates for British Orthodontic Conference and BOS group meetings

• Legal Helpline with 30 minutes of free legal advice

• A wide variety of educational courses

• Journal of Orthodontics

• Clinical Effectiveness Bulletin

• BOS News

British Orthodontic Society, Royal College of Surgeons of England

38-43 Lincoln’s Inn Fields, London WC2A 3PE

Tel: 020 7353 8680

EXTERNAL RELATIONS

The External Relations team at the British Orthodontic Society (BOS) is excited to share some fantastic highlights as we celebrate our 30th anniversary! This milestone is not just a reflection of our history; it's a moment to look forward to our future in advancing orthodontic care and supporting the communities we serve.

Celebrating Our 30th Anniversary

As we mark 30 years of the BOS, we have so much to celebrate! From our humble beginnings to becoming a leading voice in orthodontics, this anniversary is a tribute to the dedication of our members, partners, and the entire orthodontic community. Throughout those 30 years, BOS has remained committed to fostering professional development, enhancing patient care, and advocating for the needs of our members.

This year’s BOC 2024 was a wonderful occasion not only for learning but also for reflecting on our journey. It was heartwarming to see so many familiar faces, alongside new members who are joining us in our mission to improve orthodontic care.

Collaboration with Kidscape to Combat Bullying

One of our proudest initiatives during BOC2024, has been our collaboration with Kidscape to tackle bullying. Kidscape’s CEO, Paula Simms, joined us this year to highlight the positive impact we can have together. Her insights into the challenges faced by young people today were both eye-opening and inspiring. Andrew DiBiase, Consultant Orthodontist at Kent and Canterbury, shared alarming findings from his research which received BOSF funding. A survey of 700 school children aged 10-14 years old, revealed that children are bullied because of their teeth – particularly due to them sticking out. This is mainly name calling, mean comments and teasing. In addition, children with an

aesthetically handicapping malocclusion are more likely to feel lonely at school and this is especially prevalent in girls.

The voices of our Patient Panel, including Ryan Hughes and Kathryn Hames, added a personal touch that resonated with everyone. Their stories of the difference orthodontic treatment made to their own lives serve as a reminder of why our work matters. We were also privileged to hear from Kidscape ambassador Olga Thompson, known as @big_fat_greekmother who shared her powerful experiences with bullying and encouraged us all to foster empathy and support in our communities.

New Anti-Bullying Resources on the BOS Website

We are proud to announce new resources on our website dedicated to supporting individuals facing bullying. You can find practical guidance and tools on our BOS Bullying Support page. These resources are designed to empower patients, families, and professionals in addressing bullying effectively.

Press Coverage on BOS Anti-Bullying Efforts

Our efforts to draw attention to the effects of bullying have caught the attention of the media, with articles highlighting our partnership with Kidscape. Coverage in The Probe and Dental Review amongst others, showcases our commitment to creating safe environments for young people:

- The Probe: BOS Teams Up with Kidscape to Tackle Bullying

- Dental Review: Kids, Teeth, and Bullying

Strengthening Partnerships and Supporting Trade

BOS’s 30-year journey wouldn’t have been possible without our incredible trade partners and sponsors. Their unwavering support has been vital in helping us deliver valuable resources and events to our members. This anniversary serves as a reminder of the strength of

our collaborations, which allow us to bring cutting-edge technology and insights to the orthodontic field.

At BOC 2024, our exhibitors showcased innovative products and services, reflecting the vibrant and dynamic nature of our industry. We are grateful to our partners for their commitment to enhancing patient care and advancing the practice of orthodontics.

Fundraising with the BOSF Fun Run

A fun and meaningful addition to this year’s celebrations was the BOS Foundation (BOSF) Fun Run! This event brought together members, partners, and supporters for an early morning session of fitness and fun while raising funds for important research and educational initiatives. It’s a fantastic way to foster camaraderie within our community while supporting causes that matter to us all. The Comms team were out in full force!

Looking Ahead

I am pleased to hand over the role of Director of External Relations to Hayley Llandro, Consultant Orthodontist at Newcastle and Sunderland. She is part of the BOC committee and has been in charge of organising the stewards over the past two years. I am confident that Hayley will continue to champion the mission of the British Orthodontic Society with dedication and vision. Her expertise and commitment to our goals make her exceptionally suited to lead our external relations forward. It’s been a privilege working in this role and thank you to everyone who has been a part of this incredible journey. This role has given me the invaluable opportunity to grow as a professional and, most importantly, to build lasting friendships with so many wonderful colleagues.

Anjli Patel Director, External Relations

CLINICAL PRACTICE

I would like to take this opportunity to thank Ann Wright for her wisdom and support in my first year as Director of Clinical Practice and for her expertise in responding to queries and concerns from patients and BOS members. Enjoy your well-earned retirement, Ann!

VAT on orthodontic appliances

On 15th February, HMRC updated the guidance document “Health professionals and pharmaceutical products (VAT notice 701/57)”. This document was first published in July 2014 and provided information on how to account for VAT on goods and services provided by registered health professionals, including dentists.

The amendment removed a reference to orthodontic appliances from the following paragraph:

10.1 Liability of services and goods

If you’re a dentist, a dental care professional or a dental technician you may exempt your supplies of:

• Dental care and treatment

• Drugs or appliances provided in the course of dental care and treatment

• Dental prostheses (including dentures, artificial teeth, crowns, bridges and plates)

The BOS, the BDA and the BDIA will work together to seek clarification from HMRC as to why this change was made and whether it will affect the VAT exemption on orthodontic appliances.

Procurement

There has been very little change since the last edition of BOS News!

In areas where 7 + 3 PDS contracts were issued in 2018, Integrated Care Boards (ICBs) appear keen to apply the three year extension to the contract, provided the Key Performance Indicators (KPIs) have been met. It is important that providers check their contracts and

Inter

ensure they know what KPIs have been included in the terms of their PDS agreement.

ICBs have had time to familiarise themselves with the Provider Selection Regime (PSR) which came into effect on 1st January. Early indications are that they are keen to use the “Direct Award Process C” where possible, provided there aren’t significant changes to the orthodontic contract.

Hertfordshire and West Essex have issued a guidance letter to existing providers to update them on the progress of their plans for the long-term provision of orthodontic services. They wish to procure 10 year contracts but in order to satisfy the requirements set out in the PSR document, they cannot start the direct award process until June 2025. They have produced a timetable with key dates for the orthodontic providers.

In any areas where new contracts are being offered, or where the ICB does not wish to award the contract to the existing provider, the competitive process will be used again. NHS Devon ICB have commenced the procurement process for orthodontic services (approx. 6500 UOAs) in North Devon and Torridge and will do so through the competitive tender process as this is a new contract. The information regarding this contract is available on the “Gov.uk” Contracts Finder website.

Managed Clinical Networks (MCNs)

The national MCN Chairs network continues to share information across MCNs. Any new MCN Chairs are encouraged to get involved with this network. Details can be requested from the BOS office.

Matt Clover Director, Clinical Practice

CLINICAL GOVERNANCE

The BOS governance team have been working on behalf of the Society in a number of areas of clinical practice. In order to support members and their care for patients. This has included meetings with the General Dental Council.

Audits and service reviews continue to be published in our Clinical Effectiveness Bulletin under the Editor Robert Smyth and his team. This produces an excellent resource for the Society and is now in a searchable format as part of our new website design. Our Publications Committee led by Sameer Patel includes patient information leaflets. These are available in a modern media format via our recently updated QR codes and also in the traditional printed format. BOS advice sheets also fall under Sameer’s team and we are hopeful these may become a feature within the BOS News in order to try and make sure advice is readily available for members before problems occur rather than our advice sheet being something only accessed after the event. These advice sheets have been written by members of the BOS, on behalf of the Society, for members of the Society. They offer friendly advice, not legal advice and should not be seen as prescriptive.

Mariyah Nazir continues to provide support as Chair of Audit for all those who aim to survey the Society. We aim to support all our TGG members who wish to survey the BOS as part of their research but remain aware the frequency and topics of these surveys must not exhaust the co-operation of the target audience. The BOS office team control the number of surveys to try to ensure we have a good return rate. I would encourage you all to please take the time to complete these survey requests. The strength of our Society to the support we give to each other.

Can I take this opportunity to thank Nicky Stanford our Chair of Ethics, Mariyah Nazir, Chair of Audit, Sameer Patel, Chair of Publications, Robert Smyth, Editor of the Clinical Effectiveness Bulletin and all of the Governance team who continue to work on behalf of the Society to support the care of our patients.

Member Benefit

To register

Please email ann.wright@bos.org.uk and enter ‘BOS CPD’ in the subject line. Please provide your name and GDC number and you will be sent an invitation link.

www.bos.org.uk

British Orthodontic Society PG

Autumn, cooler weather, and the falling leaves mean it’s time for another BOS News article. This will be my final round-up as I step down as PG Chair and hand over to Adey Bennett. Obviously, this has brought back memories of my time as a BOS member. Many new concepts/techniques learned, ideas forged, and much understanding deepened. But that is only part of the equation. BOS has also given me friendship and support during the hard times, and like-minded people with whom to celebrate during the better times.

I would like to point members to our next Study Day in early February. I’m sure you have all seen Ann’s reminders. If you haven’t you soon will. We have a great clinically based day planned with subjects ranging from composite bonding and polishing protocols to snoring cessation (I may have to pay particular attention to that one!) We also plan to introduce an element of audience participation with ‘Cases Cafe’ and ‘What Can Go Wrong?’ presentations.

Well hopefully I have whet your appetite a little. Before I sign off I would like to give thanks to all those who have helped me and the Practitioner Group over my last four years in post. There really are too many of you to name but I think you all know who you are. I owe you all a beer (or a chilled white wine as appropriate). See you all in February.

Sean Masterson Chair, PG

British Orthodontic Society COG

In the past year, the Consultant Orthodontic Committee (COG) have supported our members in a number of ways in order to provide guidance on national topics and issues.

ST1-3 Curriculum

The update of the curriculum has been…. complex. The COG, BOS and SAC representatives have endeavoured to convey your feelings and concerns, at national level. At the time of writing this report, the curriculum has now been approved and the October ’24 intake will adopt this new framework. The main changes to the curriculum centred around the ‘research component’, namely there are now 3 routes through this aspect of the curriculum;

• Route 1: Taught Clinical Masters, MRes, doctorate or equivalent university higher degree in Orthodontics that involves an original research project undertaken within the training period.

• Route 2: An authored contribution normally, but not exclusively, within the specialty of orthodontics based on original research accepted for publication in a PubMed journal and undertaken during the specialty training programme.

• Route 3: An appropriate alternative deemed acceptable by the postgraduate deanery and assessed through the Annual Review of Competency Progression process.

All new 2024 posts in England will be run through training. Whilst trainees can still choose to exit at 3 years, having funding in place for 5 years, may help trainees stay on for consultant training, possibly moving units but staying within the region. This may assist with increasing the ST4-5 recruitment numbers which have dipped in recent years.

As a committee, we are well aware of the concerns members still have about some aspects of these changes. For now, it would be up to all of us to collect meaningful data, highlighting areas of success and problems with the new curriculum. This will create an evidence base to better inform stakeholders the next time the curriculum is reviewed in 2028.

Consultant Strike Resolution

COG supported members by making members aware of the voting timetables of any ballots in the past year. The pay dispute has now been resolved, hopefully with better oversight of pay reviews moving forwards. Of note, Local Excellence Awards (LEAs) have now been removed from the consultant contract. This may have unforeseen consequences, in the coming years, across health service administration, training and support offered by consultants in the future.

Patient Information Support

Yourjawsurgery.com has been updated with more patient and parent stories. This content now provides a greater depth of diversity in terms of age, ethnicity and malocclusion treated. Work is ongoing within the BOS to create a similar website, aiding information delivery for patients with hypodontia.

BAOMS/BOS Project

A National Project for orthognathic patients, focussing on Patient PROMS is due to start imminently. Please

In Memoriam

check your inbox, or get in touch, if you would like to be part of this national data collection project.

Dental and Orthodontic Access Issues

We are aware of these issues and the COG are assisting the BOS in collecting and presenting data, for national level discussion to highlight our concerns. In the past year we have now mapped our UK consultant network, to improve connectivity between our regions. We have also established a new mentorship programme, for consultants within the 1st 5 years of ISFE, to better assist them in their early years.

COG Symposium 2025

Next year’s Symposium will be at the East Midland’s Conference Centre in Nottingham. We have secured a number of rooms at the Orchid Hotel next door. It is hoped this location and set up will mean delegates only have to make their way to one location to the 1.5 day event.

Fly throughs of the venues can be viewed below; www.youtube.com/watch?v=DCkG9l1rhCI www.youtube.com/watch?v=H9sw52CF_I4&t=1s

A number of Keynotes speakers have already been secured, including Jason Wong, CDO England, Ian Dunn, Specialist Periodontist and Prof. John Gibson, Emeritus Professor in Oral Medicine. Please put the 20th and 21st of March 2025 in your diary for this fantastic annual event!

If you need to get in touch, please email chair-COG@bos.org.uk or contact the BOS office.

Andrew Flett Chair, COG

The British Orthodontic Society is saddened to report the death of David Morris on 14 October 2024.

David was Consultant Orthodontist at Leeds Dental Institute and previously of Seacroft Hospital. He was the chairman of the BOS Clinical Standards Committee from 2006-2011.

Our thoughts are with his wife Alison and his children Elliot and Kate.

To notify the Society of a death of a member then please email: ann.wright@bos.org.uk

British Orthodontic Society OTTG

The 2024 OTTG AGM was held on Thursday 17th October at the British Orthodontic Conference (BOC) in Birmingham. Thank you to all those who attended and contributed. Following the name change and renewal of membership to make the group more inclusive, there were some exciting discussions about future plans for the group. These include a Spring Study Day, refreshing the academic mentoring programme, mapping academic training in the UK to establish a subgroup for Early Career Academics (ECA) and exploring avenues for further supporting undergraduate, postgraduate and specialty training.

It was agreed that a priority for the group going forward will be to expand the committee to provide support for these activities so anyone who may be interested in joining OTTG, please do look out for an email about committee positions.

OTTG session at BOC

The annual OTTG session at the BOC was a great success, with presentations on patient and clinician opinions on intraoral scanning, opinions on how well orthodontists and orthodontic therapists work together, patient reported outcomes in cleft care, social media in orthodontics, interproximal reduction, and the hidden curriculum in orthodontics.

The standard of both the research and presentations was very high, and we would like to congratulate all presenters. Many thanks to the short-listing judges, Dr Caryl Nagrani and Dr Aliki Tsichlaki and the presentation judges, Professor Sue Cunningham and Professor Jayne Harrison.

The winners were:

1st place: Trishna Patel – “Orthodontic Patient Experience of Intraoral Scanners Versus Alginate Impressions (UK)”

2nd place: Jonathan Shelswell – “Orthodontic therapists and orthodontists: do they work well together?”

3rd place: Hannah Batsford – “The ‘hidden curriculum’ and decisions to specialise in orthodontics”

Recordings of the presentations are available on the BOC app, and for the first time this year, a further two pre-recorded presentations are available from trainees discussing their research on shared decision-making in

orthodontics and occlusal relationships in orthodontic camouflage cases.

To reflect the changes in specialty training, the eligibility for abstracts was extended this year to include all research completed as part of specialist training. We recognise that as oral presentation at national level is now one route by which to fulfil the research component of specialty trainee, the OTTG session will become even more important to trainees. We are working with the BOC Chair to finalise the format for the OTTG session at BOC 2025 and we will provide details in the next edition of BOS News.

Sophy Barber Chair, OTTG

Jenny Galloway Secretary, OTTG

www.bos.org.uk/Who-We-Are/Shop

British Orthodontic Society TGG

The 30th year of the BOS has been another typically busy year for the TGG and the committee. We have, once again, advocated for our members, mediated for trainees experiencing challenges, and delivered a thorough and varied programme of study days covering all aspects of the orthodontic training curriculum and beyond.

The MOrth and ISFE days were run earlier in the year and assisted trainees in preparing for these high stakes examinations. Particular thanks to Robert Conville, Ohsun Kwon, and Aoibh Wall for their contributions to the organisation and delivery of these days. The ‘So, You Are Now an Orthodontist?’ study day was organised and delivered by Maha Aljefri in inimitable style. This was aimed at ST3s making their first forays into specialist practice, and an excellent panel of presenters gave attendees an overview of the myriad roads an orthodontic career may take.

The BOS Post-CCST National Teaching Programme continues to receive excellent feedback and has been extremely helpful to those preparing for ISFE. These study days cover multiple facets of the post-CCST curriculum and beyond, and I would like to extend my gratitude to the consultants whose generosity and expertise make it possible, as well as Ohsun Kwon for being indispensable in their organisation.

A parallel session at this year’s BOC, aimed at aspiring orthodontists, attracted a multitude of highly motivated attendees, and from impressions gleaned in the brief conversations I had with several of them, we will no doubt see many join our ranks soon. The TGG also regularly runs popular study days directed at dentists interested in formal orthodontic specialty training. This year’s ‘So You Want To Be An Orthodontist?’ study days are to be held in Edinburgh and London. The London day is scheduled for November 13th and the Edinburgh day November 22nd. As ever, there has been substantial interest, and one readily sees a bright future for our specialty with such enthusiastic and capable aspirants.

We received an unprecedented number of applications to join next year’s TGG committee, underlining the impressive appetite amongst our members to step-up and shoulder leadership responsibilities. So numerous

were the applications that, had it not been for the excellent pre-recorded presentations applicants kindly submitted for the hustings, we would have undoubtedly set a new record for the duration of a TGG AGM! My congratulations to the incoming Chair, Georgie Kane, who I am certain will take the TGG to new heights.

As I come to the end of my tenure and as the BOS celebrates its 30th year, I would like to express my heartfelt gratitude to my fellow committee members, the BOS, and orthodontic colleagues across the UK. Their hard work and generosity are what facilitate every endeavour of the TGG. I feel fortunate to be part of a specialty that supports the next generation and leads by example. Long may it continue.

Naeem Adam Chair, TGG

TGG Committee 2024

British Orthodontic Society OSG

Group Meetings 2024 and 2025

Once again, our Group Clinical meeting was held at the fabulous venue that is 30 Euston Square. The meeting, held on Saturday June 15th, was enjoyed by delegates and provided a varied programme covering clinical, business and political topics as well as personal development, supported by a vibrant exhibition. Dr Lars Christensen opened the day sharing his 10-year experience of working with 3D metal printed appliances. Lars always brings a wealth of experience and a very practical approach to his presentations, and he was swiftly followed by the returning Dr Sophie Acker. Sophie is a dentist with huge experience in the orthodontic and aligner industry who has now set up a coaching business, helping orthodontists and their teams reach their full potential. After a welcome coffee break, we were delighted to welcome Dr Waddah Sabbouni who showed some truly outstanding aligner cases and shared many practical tips. The afternoon saw us joined virtually by Prof Ravi Nanda, a giant of the profession for his first presentation to a BOS meeting for many years. The final session switched to political and business topics with an update from our new Clinical Practice Director, Dr Matt Clover and a really insightful lecture on financial management by Chartered Accountant, Bilal Ahmed.

A huge thanks to all the contributors, the exhibitors and the organising/ HQ team and especially our Hon. Meetings Secretary, Roopa Kukadia. For 2025, we have decided to revert to a spring slot with a planned date of Saturday 29th March. Details will follow soon but please save the date.

Against the Odds

Trevor Hodge was the deserved winner of last year’s award, and this was presented to him at the OSG meeting. This year’s edition of the competition is now open with entry open until the end of the year. Thanks to Jon Machell who is now overseeing this award.

Mentorship Scheme

We continue to promote the relaunched mentorship scheme for newly qualified specialists. A recent call

for mentors met with enthusiasm and we now have a good core of mentors to pair with mentees. Many thanks to all who came forward. Being a mentor can be really rewarding and if you are keen to get involved then please get in touch via mentoring-osg@bos.org.uk. Thanks to Aliya Hasan who has overseen this project over the last 12 months.

VAT on Orthodontic Appliances

With the current debate around the proposed application of VAT to medical devices, some accountancy advice is being sought to give to members surrounding this issue. Our understanding is that even though VAT may be applicable, as health care providers, registered practices may be exempt and thus be able to make a VAT claim. There is very real potential for this issue to compromise NHS care and even make some NHS services non-viable. Representations have already been made to HMRC on this issue, led by Clinical Practice Director, Matt Clover.

Private Practice and Business Development: Orthobytes

Quarterly editions of “Orthobytes”, our popular digital publication designed to help members with business, team and personal development continue to be circulated. Thanks again to Jiten Vadukul for leading on this. He has plenty of content planned for future editions and thanks also to all the contributors.

Committee Meetings and Committee Membership

By the time you read this, the election process for a new Chair, Treasurer and a number of committee members will have taken place. Good luck to those elected.

I would encourage anyone to consider getting involved in the BOS. It is both enormously rewarding and a welcome distraction from the day-to-day clinic. Thanks to outgoing Treasurer, Simon Jackson and our GDPC rep Damian Bourke.

Thank you as ever to the whole of the OSG committee and to Ann and the team at HQ for their hard work and support.

Richard Jones Chair, OSG

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The Voice of Orthodontics

• Membership tailored for you whether you’re a Consultant, Specialist, Dentist, Academic or Post Graduate – there’s a group for you

• Access to BOS members' area of website and Virtual Learning Environment (VLE)

• FREE Subscription to Orthodontic Update - worth £92.00

• FREE ProDental CPD access to mandatory topics

Together we are advancing patient care, research and education

• Discounted rates for British Orthodontic Conference and BOS group meetings

• Legal Helpline with 30 minutes of free legal advice

• A wide variety of educational courses

• Journal of Orthodontics

• Clinical Effectiveness Bulletin

• BOS News

British Orthodontic Society, 12 Bridewell Place, London EC4V 6AP

Royal College of Surgeons of England 38-43 Lincoln’s Inn Fields, London WC2A 3PE

Tel: 020 7353 8680

E C +

BLOS

BLOS now boasts a large collection of cutting edge webinars!

BLOS is delighted to report that it has amassed an amazing range of webinars from some of the best speakers in the world. Cutting edge topics can be viewed and is a must for serious practitioners who wish to distinguish themselves in private practice.

Anytime on-demand viewing is available to its members and the subjects range from:

1) TADS and Aligners: Overcoming limitations by their synergistic application

2) Biomechanics of space closure with aligners

3) Aligners 2024-where are they at?

4) Clinical implication of skeletal anchorage in maxillary constriction and vertical control

5) Customised lingual orthodontics in daily practice

6) Limits of Class II correction with lingual orthodontics in daily practice

7) Vision: Treatment planning in action

8) An evidence based perspective on the efficacy of clear aligner therapy

9) Aligning to finishing-tips and tricks in lingual orthodontics

10) When do you waste unused aligners and how to avoid it?

11) Class III Non-surgical management

12) Missing lateral incisors: beyond space closure

13) The deep bite challenge

14) Airway changes in posterior crossbite cases

15) Considerations in lingual extraction cases

16) Non-surgical Class II lingual treatment

17) Protocol for space management with the lingual technique

18) Clear aligner therapy: First principles

19) Lingual, aligners and TADS-Paradigm shifts in orthodontics

20) Finishing is making the difference

21) Biomechanics of lingual orthodontics and TADS

22) Conventional and Miniscrew Assisted Rapid Palatal Expansion (MARPE)

23) SARME: the patient journey, mechanics and future promises

24) Efficient alignment: an important step in lingual orthodontics

25) Troubleshooting lingual biomechanics

There are many more webinars still to view and future forthcoming subjects will be on interdisciplinary orthodontics, when is MSE, MARPE and SARPE indicated, management of TMJ patients, vertical dimensions challenges etc.

BLOS members are advised to regularly check the website: www.blos.co.uk for the past recorded webinars and upcoming webinars involving clear aligners, skeletal anchorage and lingual fixed appliances. The website is comprehensive and we welcome new members who wish to push themselves clinically especially with complex malocclusions.

Dr Sunil Hirani BLOS Chairman

Dr Sunil Hirani

ONG NEWS

As we are coming to the end of 2024 ONG has celebrated its 30th Anniversary at this year's BOC. We have attracted many new sponsors to our group and held two webinars this year.

We would like to thank all the members that attended our anniversary lunch and made the journey to Birmingham to celebrate with us, also a special thank you to Wrights the Dental Supply Co especially Gail Protherough who supported the 30th Anniversary DCP Award presented to Julie Rubery, by Gemma and Tony.

Julie was nominated by her colleague Sarah Llewellin. Sarah explained her immense respect for Julie who showed extraordinary resilience and unwavering determination during marked ill health caused by long covid and the temporary loss of her sight. She had repeated medical appointments and operations and continued her professional responsibilities at Lincoln Orthodontics. Her determination has made a lasting impact on the full team, with her profound positive influence on her colleagues and patients during a very difficult phase in her life. Her human spirit showed through, and she is an extraordinary example of someone who has gone above and beyond in her dedication to her role as a DCP. It was an honour to select Julie as our prize winner!

Janet Gray, Orthodontic Therapist, was the BOS Award winner for her distinguished services to Orthodontics, Janet has been a tutor at Leeds Pinderfields General Hospital. She was a founding member of the ONG and continues to teach on the Yorkshire OT Course. She is known for her enthusiasm and dedication to teaching and is hardworking and very popular with the students. Janet has played an important role developing and delivering the Orthodontic Post Qualification for Dental Nurses and many nurses have benefited over the years from Janet's support and teaching. Janet is a very worthy winner of this award for all her hard work, during her wonderful career as a DCP in orthodontics.

We would like to thank all the members who took the time to nominate their colleagues!

This year we have a new committee role as Honorary Patron and this has been given to Debra Worthington. Debra has been an inspiration to many, she has been a member of ONG for 27 years! Debra has completed roles of Chairman & The first Dental Nurse President. She has worked at local and national levels supporting DCP’s and has received two national awards by the BOS & BDA for her services to Orthodontics.

We have elected Joycee Robelo to the committee. She has been representing ONG at the Faculty of Dental Surgery and she is keen in improving the recognition of DCPs at all levels. Joycee qualified at the University of Bristol and has a particular interest in neurodivergent patients helping them build confident smiles. Joycee is our current social media representative Check out her posts!

If you are a keen, hardworking DCP and love orthodontics we are looking for new committee members to join us. We meet via zoom quarterly for meetings and we plan study days and DCP programmes at the conferences, webinars, standing at a stand or chairing a session. Once you have been elected to the committee you can accept a role.

If you would like to become more involved, please contact us via ongteam25@mail.com.

Look out for our social media posts via LinkedIn, Facebook and Instagram. Tickets will soon be available for the 8th of March 2025 Study Day in Mandec Manchester. Discounted Rates for early bird bookings for members only!

Julie Rubery

WHO’S WHO AT THE BOS?

Honorary Patron Tony Ireland

President Nikki Atack

Honorary Secretary Simon Littlewood

Treasurer Grant McIntyre

Groups

Consultant Orthodontists Andrew Flett Group Sujata Sharma

Practitioner Group Adey Bennett

Orthodontic Specialists Richard Jones Group Nadia Ahmed

Training Grades Group Naeem Adam Tara Maroke

Orthodontic Teachers Sophy Barber and Trainers Group Jennifer Galloway

Directorates

Clinical Governance Steve Chadwick

Audit Mariyah Nazir

Ethics Nicky Stanford

Publications Sameer Patel

Clinical Practice Matt Clover

Education Hemendra Shah

Archive and Museum Philip Benson

External Relations Anjli Patel

BOSNews Editor Arti Hindocha

Professional Development Guy Deeming

Research Peter Mossey

BOSF Fiona Ryan

Journal Editor Jayne Harrison

Scholarship and Awards Susi Caldwell

Head Office

Chief Operating Officer Rupert Marks

Executive Secretary Ann Wright

Membership Secretary Ann Humphrys

BOS ADVICE & GUIDANCE SHEETS

BOS Committees regularly produce guidance on various matters. To help keep track of what advice is available to the membership, this and future issues of the BOS News will also provide an up-to-date list of the Advice and Guidance leaflets available and how these can be obtained. Dates indicate when these were last updated/created.

PLEASE ensure you are using the most up-to-date advice sheets.

Advice Sheets/Booklets Year of Publication/Revision

Advice for orthodontists providing treatment for 2018 wind instrument players

Child safeguarding guidelines for orthodontic practitioners 2020

Communications and how to handle complaints 2022

Consent in orthodontics 2023

Dental nurse competencies in orthodontic practice 2023

Duties and responsibilities of expert witnesses 2022

Duty of candour 2022

Ethical management of patient compliance 2023

Guidelines for the management of aspirated or 2022 ingested foreign bodies

Guidelines for the management of the traumatised tooth 2020

Latex allergy in orthodontics 2019

Medical emergencies in orthodontic practice 2017

Mouthguards 2023

Nickel allergy in orthodontics

Non-Nutritive Sucking Habits (Dummy & Digit Sucking) 2023

Oral piercings and orthodontics

Orthodontic extractions risk management guidelines 2022

Orthodontics in patients with significant medical comorbidities 2021

Orthodontic records: collection and management 2022

Orthodontic records: collection and management 2022 guidelines for 3D rendered orthodontic digital study models

Practice advertising, leaflets and websites 2023

Professional standards for orthodontic practice 2019

Raising concerns and whistleblowing 2020

Risks of orthodontic treatment – 2023

Running a mixed practice and maintaining 2023 ethical standards

Supervision of qualified Orthodontic Therapists 2023

Temporomandibular disorders (TMDS) 2023 and the orthodontic patient

The role of the Orthodontist in maintaining oral health 2022 Tooth autotransplantation 2022

Use of images by the British Orthodontic Society 2018

Use of retraction headgear and facebows 2023 Miscellaneous Managing

DB Orthodontics wishes the British Orthodontic Society a huge congratulations on their 30th year Anniversary!

To celebrate, all members can enjoy a special offer the Ixion Instrument range*

Please quote “IXION30” to receive this offer

*Limited to one order per practice, offer expires 31st January 2025. Discount only applies to RRP.

Freephone: 0800 7833 552

sales@dbortho.com | www.dbortho.com