The Technologist, February 2016

volume 9 issue 1 february 2016

issn 1757-4625

the

technologist the official journal of the dental technologists association

Credibility, confidence and knowhow In this issue: Refresh your knowledge of medical emergencies ... p7 Protec temporaries ... p10 Technicians transform lives ... p12

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HOURS OF VERIFIED CPD PLUS 1 HOUR OF UNVERIFIED CPD IN THIS ISSUE!

february 2016 1

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technologist in this issue Editor: Vikki Harper t: 01949 851 723 m: 07932 402 561 e: vikki@goodasmyword.com Advertising: Sue Adams t: 01452 720 413 e: sueadams@dta-uk.org

DTA administration: Sue Adams Chief Executive 2 Wheatstone Court Waterwells Business Park Gloucester GL2 2AQ

news letters to the editor dta column contracts & job descriptions medical emergencies key performance indicators (KPI) fast protec temporaries – fast protec® ‘pull out’ procedures a complete reconstruction that changed lives raising concerns in the right way quality assurance sharing the secrets to business success continuing professional development

t: 01452 720 413 e: sueadams@dta-uk.org DTA Council: Mike McGlynn President James Green Deputy President Tony Griffin Treasurer Gregg Clutton Michael Egerton Darryl Palos Delroy Reeves Nargisa Rikena John Stacey Jack Thurkettle Student representatives: Chris Keating Jelena Greb Editorial team: James Green Tony Griffin Mike McGlynn Darryl Palos Jack Thurkettle Design & production: Kavita Graphics t: 01843 583 084 e: dennis@kavitagraphics.co.uk Publishing: Stephen Hancocks Ltd w: www.shancocksltd.com

www.dta-uk.org the

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The Technologist is published by the Dental Technologists Association and is provided to members as part of a comprehensive membership package.

For details about how to join, please visit: www.dta-uk.org or call 01452 720 413

ISSN: 1757-4625

Find out the 11 reasons to join DTA by visiting:

02 04 05 06 07 08

Views and opinions expressed in the publication are not necessarily those of the Dental Technologists Association.

The DTA’s preferred insurance provider Tel: 01634 662 916

2 february 2016

news&information

■ WORKPLACE PENSIONS IN A NUTSHELL Just in case you are still trying to get to terms with the action you need to take to introduce workplace pensions into your dental laboratory, here is a quick run down of the salient points:

■ THE DIGITAL

REVOLUTION HITS HMRC

Paperless? You will soon need to be! In the autumn statement the Government announced plans to transform HMRC into one of the world’s most digitally advanced tax administrations. Referring to the press release, ‘most businesses, self-employed people and landlords will be required to keep track of their affairs digitally and update HMRC at least quarterly via their digital account, reducing errors through record keeping.’ Probably to be expected as the Government continues with its plans to close HMRC offices and reduce overall staff numbers. Plans will be published shortly and detailed consultation will take place in 2016.

1. Small businesses will begin enrolment in earnest from 2016. It will be a staged process and is based on the last two digits of your PAYE reference.

2. If you haven’t started preparing, you need to! The Pensions Regulator suggests a minimum of 6–9 months is required to select a provider, sort out payroll, test it and communicate the scheme to employees.

3. Regulator fines for lateness to launch the scheme range from £500 per day for those employing 5–49 people and £50 for those employing 1–5.

4. It is up to you, as the business owner, to demonstrate you have selected a compliant scheme and that your payroll/accountancy processes are robust. So do allow time for testing as suggested.

5. There is plenty of help available and you would be wise to seek it out with ample time to spare. Good points of contact include Federation of Small Businesses www.fsb.org.uk; and The Pensions Regulator www.thepensions regulator.gov.uk.

Definition of terms ■ Automatic enrolment is so called

■

■

■

■ ■

■

because it is automatic for employees.

It is not automatic for employers!

Employers with one or members of staff have a duty to enrol employees onto a pension scheme and contribute towards it.

Staging date – this is your date for auto enrolment. You need to find out when it is. You should already know having been contacted 12 months in advance by The Pensions Regulator.

Payroll software – if you don’t use payroll software or your existing software does not have the facility for auto enrolment, you may want to think about updating or changing it – which takes time.

Clean data – make certain all employee data is correct.

Correspondence – you will be writing lots of letters to your staff so it may be worth getting your templates in order now. Failure to complete it within the 5 months can result in a fine.

Declaration of compliance – on receipt of your staging notification you must complete and return this declaration. You have five months to do this but you shouldn’t leave it to the last minute

■ LIVING AND WORKING AS A DENTAL The following press release from the GDC reminds us of our responsibilities as dental professionals. Amongst other things we must work within our scope of practice and be honest in our advertising.

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dental technician from Leyton, Sandy Edward Palmer, has been removed from General Dental Council’s (GDC) list of registered dental professionals following an allegation of dishonest conduct.

Among the allegations he faced were: ■ offering to make a new denture without a prescription from a dentist the

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■ offering to take one or more impression(s) of a patient’s gums ■ making false claims on his website The Committee found that Mr Palmer offered to provide dental services outside of his scope of practice as a dental technician, and that he acted in a misleading and fundamentally dishonest manner.

The Committee found that Mr Palmer’s dishonest conduct was also apparent in the advertising and promotional materials, which made false claims about his qualifications and about services that he was not allowed to do.

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news&information

■ OLD BONES

■ HAMPSHIRE DENTIST

REMOVED FROM THE REGISTER FOR DISHONEST CONDUCT

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ooth morphology, be it human or animal, is often of interest to dental technicians. The immediate thought tends to be about how similar or different the dentition looks when compared to our ‘normal’ 21-century dentitions.

The discovery in Africa of an early human form of some several million years prompted such thoughts. Looking at the dentition, l was firstly reminded of a student quip of some 30 years ago, when on seeing a similar dentate mandible, remarked how lucky that individual was not to have any fillings!

On looking at Figure 1 of this skull fragment we immediately compare it to typical occlusal surfaces of human dentition. Here are my initial thoughts: 1) There appears to be little evidence of caries cavities unlike those associated with our own refined and high sugar diets.

2) An adult dentition, not dissimilar to our own in number, with wisdom teeth probably indicating an ageing of 20+ years?

3) There are some differences e.g. the 36 and 46 occlusal table seems a little smaller than the 21st-century human version. Do they appear to you to be slightly smaller than that of the actual 37 and 47?

4) Might the lower canines look a little smaller than 21-century human counterparts or is it just a photographic distortion?

5) There looks to be considerable incisal and occlusal wear. Is that likely to have come from a coarse diet containing abrasive items (e.g. inclusion of fine grit) or erosion due to other factors?

It all makes for interesting personal reflection.

PROFESSIONAL In reaching their decision, the Committee said: ‘The Committee is mindful that the dishonesty that it has found is an attitudinal problem which is not easily remedied. It has not been provided with any information that might indicate that Mr Palmer has taken steps to remediate the misconduct that this Committee has found.’

‘Indeed, there has been a lack of evidence of any steps taken by Mr Palmer to remediate the shortcomings that have been identified in this case.

“His limited correspondence with the GDC contains no expressions of remorse for or insight into the matters that have

brought him before this Committee, and instead are further suggestive of his disregard for the GDC and its statutory duty to protect patients.’

The Committee added: ‘Mr Palmer’s lack of regard for and insight into his professional responsibilities and scope of his practice suggests that his unremediated misconduct presents a real and ongoing risk for the safety and wellbeing of patients because of the likely prospect of there being a repeat of such behaviour.’

The GDC makes it clear that all dental professionals must have indemnity cover in place so that patients can claim any compensation they may be entitled to. It is the individual’s responsibility to ensure such cover is appropriate and is maintained. As a DTA member you are entitled to great savings on your indemnity cover. Contact us for a quote.

A Hampshire dentist has been removed the General Dental Council’s (GDC) list of registered dental professionals following an allegation of dishonest conduct as he carried out treatment and offered advice while he did not have the appropriate indemnity (insurance).

The Committee found Mr Machita had practised without indemnity on three separate periods between August 2013 and February 2014. He provided dental advice and treatment to patients when he was not in possession of indemnity cover over a long period of time. This was a clear breach of his professional obligations, in which he placed patients at financial risk in the event that a claim was made.

‘In the Committee’s view, Mr Machita appears to have no understanding of the risks involved to patients by practising without indemnity cover. It is concerned that the dishonesty was persistent and involved being dishonest to not just his patients but also to his insurance provider and his contracting body. Such conduct calls into question Mr Machita’s integrity.’

The GDC makes it clear that all dental professionals must have indemnity cover in place so that patients can claim any compensation they may be entitled to. It is the individual’s responsibility to ensure such cover is appropriate and is maintained.

The GDC investigates matters when it is alleged that a dental professional’s ability, behaviour or health may impair their fitness to practise. the

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4 february 2016

news&information

■ GDC GIVEN NEW POWERS TO STREAMLINE INVESTIGATION OF DENTAL COMPLAINTS

letterstotheeditor General Interesting magazine articles. Keep up the good work. We know it’s hard to maintain the standard but you are all doing very well.

P Thwaites Bullying and harassment This article should be kept in your folder containing Standards for the Dental Team and regularly updated with future appropriate articles.

D Masser Taking a leaf out of the anteriors Excellent format for learning and great links from YouTube.

PJ Conlon Pumice This brings up the question is it healthier for the technician to use artificial pumice, which could cause cancer, or use traditional pumice with lower risks?

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ew powers enabling long-awaited changes to the way the General Dental Council (GDC) carries out its Fitness to Practise (FtP) proceedings have been announced by the Department of Health.

The new powers, set out in legislation laid in Parliament, are designed to improve the efficiency of the fitness to practise processes, enabling swifter investigation of complaints, which will improve the system for both patients and dental professionals.

The new arrangements are due to come into effect in April 2016. The GDC will be able to appoint case examiners with powers to decide cases at an earlier stage than at present.

Case examiners will also be able to agree undertakings – effectively imposing conditions on practice – with dental professionals under investigation where that is both proportionate and consistent with public protection.

Other measures include a power to review a closed case where it is in the public interest, where the decision may be flawed or where new information

comes to light, making the system fairer and more transparent.

Commenting on the decision, Evlynne Gilvarry, chief executive and registrar of the GDC, said: ‘This is a milestone for the GDC.’ These long-sought new powers will lead to a more streamlined complaints system with timelier decisions, and with appropriate safeguards for both patients and dental professionals.

‘We welcome these new powers as a first, important step in modernising our fitness to practise processes and we will continue to make the case for more fundamental reforms in the interests of patients and professionals.’

Julia M Kilby Pumice This was an interesting bit of research but it would have had a better result if the test had been done again, this time with the liquids swapped, and then the test run again.

■ CPD meter: Year Three – from 1 August 2015 until 31 July 2016 the

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Disinfection and decontamination

CPD-o-meter

Medical emergencies

required provided in TT

PJB Wilks

Materials and equipment

provided in Articulate

Equality in the workplace Everybody should be treated as you would like to be treated yourself.

Radiography & radiation protection

Other specific verified CPD (including: legal and ethical issues, complaints handling, oral cancer: early detection)

HOURS

Stephen W Carslake

40

30

20

10

0

The requirement is to complete 50 hours of verifiable CPD, 20 hours of which relates to core topics: decontamination, materials & equipment, (or radiography) and medical emergencies. You can use the additional hours provided in the core subjects to fulfil the total verified CPD target.

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february 2016 5

thedtacolumn

■ The DTA Column The first DentaidBox was sent to Uganda in 2012 and they are now being used in countries all over the world.

The DentaidBoxes were soon followed by a DentaidBag, which is a special rucksack that allows dental equipment to be taken by plane as carry-on luggage.

Supporting Dentaid in their 20th anniversary year We are delighted to announce that our nominated charity for 2016 is Dentaid.

Over the last 20 years Dentaid has grown into a global charity that has worked in 70 countries. Its mission is to enable people of disadvantaged communities to achieve an optimal level of oral health by accessing appropriate, sustainable, primary oral healthcare services in their community.

As highlighted in our December issue, DTA member Andrea Johnson is heading out to Uganda with the charity in March. Over the next few months, we will be following Andrea’s story and raising awareness of Dentaid’s fight for world oral health.

Humble beginnings In 1996 Dentaid was formed with one member of staff working from his garage supported by a £10,000 grant.

At first the charity concentrated on refurbishing donated equipment and sending it to charitable dental clinics across the world. But as funding increased, Dentaid started oral health education projects, dental engineer training and volunteering trips.

In addition to providing equipment, volunteers and training, Dentaid has become a respected voice in international dentistry. In 2007 an ongoing action group was set up to study and combat the traditional African practice of tooth gouging, known as infant oral mutilation (IOM).

The charity is also involved in fluoride advocacy and oral health projects in schools, as well as initiatives that provide toothbrushes and toothpaste to deprived

Insert: Andrea Johnson

communities. In the UK, Dentaid developed its Bright Bites education resource for Key Stage 2 pupils, which includes teachers’ packs, an educational game, experiments and lesson plans.

Dentaid boxes and backpacks One problem with sending large pieces of dental equipment around the world was high shipping costs and the length of time it took for chairs to be installed in surgeries.

But Dentaid’s engineers came up with a solution.

In 2009 the charity devised the DentaidBox – a portable dental surgery complete with a chair that can be operated without access to water or electricity. And the whole thing fits into a wheelie bin! Not only did this allow the charity to help more projects around the world, but an entire surgery could be built and sent overseas for £1,500.

This fully portable surgery can be transported easily to outreach clinics in rural areas and to regions affected by natural disasters.

Get involved If you would like to help Dentaid’s fight to eradicate world oral pain, you can do so by: ■ offering your professional services by joining a planned volunteer trip ■ donating unwanted equipment that can help create a portable surgery or provide the resources to fill a DentaidBox or rucksack ■ fundraise for a planned event – or organise one of your own.

Learn more by visiting www.dentaid.org, calling 01794 324249 or emailing info@dentaid.org. If you wish to support Andrea’s efforts and make a donation, please visit her donation page https://mydonate.bt.com/fundraisers/ andreajohnson1

■ DTA COUNCIL

ELECTIONS IN MAY

Would you like to influence the future of the DTA? Do you fancy joining likeminded colleagues on the DTA Council?

Interested but would like to know more?

If you would like to know more, contact Sue Adams about joining the next meeting of the Council on March 12, as an observer. the

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6 february 2016

hrfacts

■ Contracts & Job Descriptions ■ Educational aim: – to provide an overview of contracts of employment ■ CPD outcome: – to get to grips with the legal requirements for contracts of employment

What is a contract of employment?

It’s a collection of terms and rights that relate to a contract or service or apprenticeship. It can be made up of both written and verbal terms. Custom and practice (how work gets done) can also form part of your contract. Their purpose is to introduce clarity into the employment relationship for both parties that can be relied upon in law when disputes occur.

I don’t have a contract: am I entitled to one?

Everyone who is employed for a period of a month or more is entitled to a written statement of terms and conditions. You are entitled to receive this before the end of your second month of employment.

What should it cover?

Your contract should include basic details such as the name of the employer and employee, dates when the employment commenced, the pay and holiday entitlement, the hours of work and a brief description of the work.

the

employers to include a detailed list of the responsibilities for each role. Jobs evolve over time and an employer should review significant changes to ensure the job size is reflected in the reward package.

What else should be included in my contract?

Additional items are normally added in instalments and these should include entitlement to sick pay, pension arrangements, notice and length of contract if not permanent.

What notice period am I entitled to?

There is a minimum statutory notice that you are entitled to receive from your employer. This starts at one week and then after two years’ continuous service equates to one week for each complete year of service up to a maximum of 12 weeks after 12 years’ service.

What should I do if I have a problem with my contract?

How much notice do I have to give?

Speak to your manager in the first instance. Most problems can be resolved quickly and easily. They will normally be able to provide additional information or the explanation you may need. If the problem is not resolved, you may want to call the DTA helpline, which includes access to legal advice.

There is no statutory requirement here. It is specific to your contract of employment.

Typically this will be one to four weeks but may be longer, particularly for more senior roles.

Finally, as part of your contract you will have access to a grievance procedure, which is another effective method of resolving more significant problems.

Is there anything else that I am entitled to by right?

All employees have a statutory right to have access to a disciplinary and grievance procedure. These are often contained in a staff handbook. But not all policies with the handbook will be contractual. This will be made clear within the text. It is normally the case that bonus and commission payments are made at the discretion of the company and are not guaranteed.

Am I entitled to a full job description?

Can my employer make changes to my contract?

Whilst there is no legal entitlement to a full job description, it’s good practice for

Even though your contract may indicate a right to make changes, these cannot be

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made without your employer going through a proper process. The safest way for them to do this is with your agreement. Sometimes an incentive may be offered for you to agree to the changes. At the very least they would have to consult with you over the proposals, explaining the business case and giving you reasonable time and opportunity to respond. As an extreme, an employer may chose to terminate your contract and offer re-employment on new terms, but this is quite rare.

Richard Mander Richard Mander is a freelance HR consultant with over 20 years’ experience in Strategic and Operational HR with companies including the Granada Group and Ecclesiastical Insurance. If you would like to find out more about this topic or advice on other HR matters you can contact him at www.manderhr.com 07715 326 568.

human resources

Most people only study their employment contract when they have a problem. Here’s a list of the most commonly asked questions that should help you to understand what you should find in yours.

Ed’s note: Once you have read this article, visit DTA’s website to access supporting documentation that includes: ■ a standard employment contract based on the current statutory minimum ■ a job description template ■ a set of interview guidance notes

other specific verified CPD

Standards for the Dental Team: Standard 5.4 Find out about laws and regulations that affect your work, premises, equipment and business, and follow them

february 2016 7

medicalemergencies

■ Medical Emergencies – Reference Page The DTA is very much aware that many of its dental technician members find it difficult to access training courses on medical emergencies, and as we had a positive response from many of you last year when we ran a similar CPD feature, we felt it beneficial to run it again.

■ CPD outcomes: – an annual refresher of medical emergency protocols – an awareness of the RESUS online facility

Quality standards for CPR and training.

9. In the CPD section at the back of TT is also a series of ten MCQs that encourage you to reflect on your own learning relating to medical emergencies to further add to your activities in this area.

10. Do keep your knowledge and skills updated by revisiting.

medical emergencies

Activity guidance:

code to log in. Remember, if you have used the site before, just log in again with your code.

7. Now you can explore the site and take the activities for Jake, Rebecca and Peter. You can replay the films and also take the tests. If you do not achieve it the first time, take it again.

It’s about learning from the activities and developing your knowledge of medical emergencies.

8. This link on the Resus website www.resus.org.uk/quality-standards/ primary-dental-care-quality-standards -for-cpr-and-training is where you will find guidance on Primary dental care –

■ Educational aim: – to provide an introduction to medical emergencies

core verified CPD

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or those of you who have access to the Resuscitation Council’s online basic training, this simple exercise will be appreciated. If you would prefer face-to-face training courses, find details at www.resus.org.uk/cpr/cpr-training -resources or search locally in newspapers or on the web for specialist providers.

To undertake this CPD it is essential to follow the guidance below completely and allow yourself time to complete the activity. When you have completed the online activity you will be able to print out your personalised resuscitation certificate.

Standards for the Dental Team: Standard 5.1 Develop and update your knowledge and skills throughout your working life

1. Firstly, sit at your PC with access to the internet and allow yourself at least 1.5 hours. You are learning about how to potentially save a life so do invest time in this.

2. The web link is https://life-saver.org.uk There are other links to different digital services, so if you have problems with this one, search around the topic of ‘Lifesaver’.

3. The page can take a little while to load so be patient. On the Home page you will see a just in front of a reference to having read the terms and conditions.

‘I HAVE READ AND ACCEPTED THE TERMS OF THE LIFESAVER WEB SITE’.

4. Click in the box and then click on ‘ENTER’.

5. If you have not used this site before you need to type in your email address and print your name.

Otherwise you cannot gain a personalised certificate of completion.

The system will send you YOUR CODE by return email. This authorisation code is for you to remember and use.

It’s FREE. 6. Once you have received your code via email, put in your email address and the

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8 february 2016

keyperformanceindicators

■ Key Performance Indicators (KPI) Standards for the Dental Team: Standard 7.3 Update and develop your professional knowledge and skills ■ Educational aim: – to introduce key performance indicators and how they can help improve your business performance ■ CPD outcome: – to have a greater understanding of the kinds of business metrics that could be introduced

By Peter Blake

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anaging your financial performance is therefore vital, and in order to manage effectively, you need to measure effectively. You, your stakeholders, potential investors and customers may use financial and other metrics to assess your business performance and its ongoing viability. The generic term for these is key performance indicators or KPIs. The same indicators are useful to you as the business owner to keep score of how well you are doing. Early warning signs help you to monitor progress and identify problem areas faster.

Whether you are a successful FTSE 100 company or a KPIs can be financial and non-financial: small sole trader just starting they are any business measure that out in business, your success evaluates factors that are crucial to the will depend on your business success of your organisation. generating enough revenue Prominent Financial KPIs to cover all costs and leave There are many different financial KPIs you with enough to live, but I will outline those that are useful no reinvest and pay your taxes. matter what size of business you are.

Gross Profit Margin (GPM)

The gross profit margin measures the amount of profit a business makes on any product it sells before taking account of indirect costs i.e. those costs that are not directly related to the production of

that item or service. For example, if ABC Ltd buys in widgets at £10 and sells them directly on to their customer for £20, then the gross profit is £10 (£20 – £10). The gross profit does not take into account other indirect costs such as rent and rates, travel, administration, etc.

To work out the GPM, you divide the gross profit by the sales figure and multiply by 100.

GP margin = gross profit/sales x 100 The GPM is an indication of how profitable the production side of the business is and will be compared to previous years/months to ensure that the percentage is at best being maintained but certainly not going backwards.

Net Profit Margin (NPM) The net profit of a business is the profit earned after all costs have been deducted: both direct and indirect. It is the measure of overall profitability of the business, sometimes called the ‘bottom line’.

The NPM is a measure of the profitability of the business, expressed as a percentage.

Net Profit Margin = net profit/sales x 100 Again, a useful tool is to compare against historical performance on a monthly/ yearly basis to ensure your business is moving in the right direction.

Current Ratio

About Peter Blake Peter Blake is a chartered accountant, business coach and master practitioner of NLP. He has his own practice based in Wiltshire, lectures on finance and mentors new business start-ups for Gloucestershire Enterprise Ltd. For further details, contact Peter on 07912 343 265 or email peterblake@pbcoachingandtraining.com the

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The current ratio is used to measure a business’ ability to pay off its debts over a given period – normally 12 months. It is calculated by dividing the current assets of a business by the current liabilities of the business.

Current assets might include items such as the value of stock held by the

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keyperformanceindicators business, monies owed to the business by customers and any money held in bank accounts.

Current ratio = Current assets/ Current liabilities

The quick ratio is another measure of how solvent a business is but this ratio looks at the ability of the business to pay off its debts in a much shorter time frame should a crisis occur. It is similar to the current ratio but it would not include items in current assets that may take some time to turn into cash, such as stock. So, for most small businesses, the quick ratio should be 1 or above to show it is healthy enough to cope with a shortterm crisis and is calculated as follows: Quick ratio = Current assets – Stock/current liabilities

Debtor and Creditor Days Trade debtors is the amount owed to us by our customers and trade creditors is the amount we owe our suppliers.

Calculating debtor and creditor days allows us to ensure we are maximising our cashflow position and that we won’t end up with cashflow issues. We are looking for a situation where ideally our debtor days are lower than our creditor days and this basically means we are getting money in from our customers quicker than we have to pay our suppliers.

Non-financial KPIs A KPI can be non-financial but still provide useful feedback as to how effectively the important parts of the business are operating.

Quality of product or service – Analysis of regular customer surveys and feedback could act as early warning signs for any dissatisfaction creeping in. Likewise, customer feedback that an aspect of your service or team has done brilliantly may prompt you to expand that product or service or use that person more. It could help explain why a practice is not using you as frequently as they once did or why another client has decided to use you.

Ensuring you ask, receive and analyse customer feedback is vital to maintaining a happy base of clients.

Success of marketing activities – Do you know where or how your new clients found out about your service? If not, how do you know what marketing to maintain, what to change and what to give up? KPIs in this section of the business might link sales to where they came from such as website/sales reps/existing customer recommendation/sales campaigns, etc.

You can’t influence what you do not know!

Debtor days = Trade debtors/sales x 365

Employee retention – This would look at the ability of the organisation to hold on to its key staff: how often you lose people and how long your team members have been with you. It costs time and money to recruit and train people so the more you find yourself doing it, the more unproductive you are. Reviewing KPIs in this area might provide clues to what you do and don’t do well as an employer.

Creditor days = Trade creditors/cost of sales x 365 (Cost of sales = the direct costs incurred in achieving the sales)

Customer retention – This KPI would look at the ability of the company to hold on to its customers by calculating the

We calculate these ratios as follows:

average time a customer has stayed with the business. Are you continually marketing for new customers? Do your clients go elsewhere within a short space of time, and if so, why? Are you competing on price, service, speed, expertise, etc.? Knowing the answers to these kinds of questions helps you ensure you look for and win customers that appreciate your approach.

key performance indicators

Quick Ratio

other specific verified CPD

Current liabilities might include monies owed by the business to its suppliers and any overdrawn bank accounts.

When we calculate the current ratio we are looking for a ratio of two or better, which shows that our business is in a good position to pay off its debts within a year should it need to.

These six financial ratios are the main KPIs I would recommend for any business, whatever its size, and for the owner of the business it would give a good account of how the business is performing financially.

KPIs can be like corporate fingerprints – you need to choose the ones that reflect the needs and direction of your dental laboratory. If you have no debtors, then there is no point setting that as a KPI. If you are single-handed, there is no need to monitor employee retention. The point is you can only make positive improvements to your business if you know how it is performing right now.

Don’t wait until year-end, when an accountant hands you your draft accounts, to discover your profitability has significantly reduced. Don’t wait until you have no cash to realise that slowly but surely your customers have been leaving because of a member of your team.

Don’t keep paying for an advert in the local press if no one ever responds to it.

Identify five or six critical aspects of your business and implement monthly KPIs that measure how effective you perform across them so you can maximise your business potential. the

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10 february 2016

panadentfeature

■ Fast Protec temporaries – the third of

four Fast Protec® ‘pull out’ procedures

The FastProtec® System

FastProtec® can be used for:

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■ removable full and partial dentures ■ toronto bridges ■ temporary crowns and bridges including those requiring fibre reinforcement ■ occlusal splints ■ OFT gingival masks ■ duplication ■ denture relines ■ ceramic mouldings for pressing ■ high acrylic impact available

n innovative, consistently accurate, plasterless system to make restorative work easier and faster.

Advantages: ■ Modular system – components can be added as and when required ■ Minimal investment – quick return on investment guaranteed ■ Saves 30–40% on material and labour costs compared to conventional methods

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■ Join our YouTube page to discover how to make temporaries the Fast Protec® way: https://youtu.be/chHcbzqQeEo ■ Or go to Panadent Fast Protec® product area on the Panadent website at: www.panadent.co.uk

february 2016 11

panadentfeature

1

Model set on the Articulator

2

Silicone templates on Implant Box

3

Opening of the muffle

4

All-In with the Fast Temp base

5

Check of the stump reduction on the All-In

6

Reduction of the model teeth

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Inspection of uniform spaces between stumps and template

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Preparation of the two holes for the injection

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Resin injection

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Opening of the Implant Box

11

Final result the

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12 february 2016

usingIPS E.Max

■ A complete reconstruction that changed lives Standards for the Dental Team: Standard 7.4 You must update and develop your professional knowledge and skills throughout your working life

By Petr Mysicka Dental Technician www.petrmysicka.com

■ Educational aim: – to provide a personal account of how IPS E.Max was used in a major reconstruction ■ CPD outcome: – to gain an understanding of the technical development of a major reconstruction using IPS E.Max

Introduction

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his 41-year-old female patient was involved in a car accident about 15 years ago. The accident had not only broken several bones in her body, it had literally wiped the smile from her face – almost all her teeth were badly broken.

She visited her dentist to begin what would become a long-term project to rebuild her teeth and return the smile to her face.

This woman had to undergo many treatments that included root canal, fillings, crowns and bridges, in addition to the removal of many of her teeth. The end result, however, was never to her satisfaction.

Subsequently she has felt uncomfortable about her teeth and of smiling in front of people. When I received the first pictures from my dentist colleague I knew straightaway we needed to help her.

Due to the complexity of her case, and because she wanted to improve and change her smile, we decided to choose and follow the Digital Smile Design (DSD) protocol, which begins with an in-depth analysis of the case. In this instance it was evident that her gummy smile would need to be considered along with a shortening and repositioning of the incisor’s edge, if we were to achieve the desired aesthetic result.

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Why did we choose to follow the DSD methodology? DSD helps us to understand the face morphology and guides us towards the right final result. It’s very important to understand and know what we want to achieve in advance in order to have a clear game plan to pursue. As a dental technician, I find it invaluable to have a clear understanding of my dental colleague’s expectation’s and even more importantly, to know what the patient’s desired outcome is.

Firstly, we must agree the aesthetic and function of the DSD protocol. Once achieved, we were ready to transfer it to the initial wax-up. Anatomical wax-up is a very important part of my daily job and it is vital I follow our DSD protocol.

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usingIPS E.Max

For the best aesthetic result I am always confident of using ceramic from Ivoclar – IPS e.max Ceram. It gives me the opportunity to create a lifelike aesthetic result.

In the lower jaw I decided to make the full contour crowns using IPS e.max Multi press. For a long-lasting result, I believe it is crucial to use a strength of 400 mpa.

This material gives me a highly aesthetic result and also saves time, so I can focus on the layering of the ceramic in the

materials and equipment

now was to copy this temporary into the final restoration. I started with the zirconia constructions. Because of the crown lengthening, we decided to keep our incisors joined in the 13–11 and 21–23 area for greater stability and better prognoses in the future. Also, in the posterior upper and lower quadrants I designed four zirconia screw-retained bridges. It’s vital the construction is designed accurately. If the space for the ceramic is more than 2 mm out, it is very likely that chipping of the ceramic will occur.

core verifiable CPD

Why is the wax-up so important? It helps guide the dentist’s technique when it comes to undertaking the implant and crown lengthening processes. I duplicated the model and produced the surgical stent. The surgical stent must be stable as it provides the guide for the length of the future crowns and positions the implants.

The crown lengthening was done during the implant treatment. The dentist placed eight implants in the posterior area. After the preparatory work was undertaken with the placement of the implants and the crown lengthening, our patient received the first temporary bridge made from the initial wax-up.

Following two weeks of healing, our patient returned for a new temporary bridge. I received a new set of impressions, this time already with a final preparation, so I was able to create a very well fitting and aesthetic temporary bridge that would last until the gum and implants healed.

After a few months of healing the patient was ready for the final restoration. For me this stage was fairly simple because I had put so much effort into the initial preparation (see image top right).

Our DSD protocol was successful: the implants had healed, the gummy smile was corrected and all I needed to do

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core verifiable CPD

The patient was delighted with the final result. She said the whole experience had changed her life and put a big smile back on her face.

She rediscovered her confidence. She will never hide her teeth again when she smiles, which is something I am really proud to think about.

This is the reason I love my job so much.

What we do truly changes lives and this particular job didn’t just change her life, it changed mine as well!

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materials and equipment

areas that are more important, such as the upper anteriors. Because of very dark natural dye in areas 41, 42 and 43, I decided to do these crowns with opaque zirconia and layer them with ceramic.

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raisingconcerns

■ Raising concerns in the right way ■ Educational aim: – to gain an understanding of how and why to raise a concern ■ CPD outcomes: – to understand why concerns should be highlighted – to understand the process for raising a concern

Would you do nothing and hope that someone else will notice? Or would you raise your concern?

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aising a concern is not the same as making a complaint – when you raise a concern, you will usually be reporting something that you have witnessed that puts patients or colleagues at risk.

The risk could come from the health, performance or behaviour of a colleague, an aspect of the clinical environment or being asked to do something that might conflict with your duty to put patients’ interests first. For example, a colleague not properly sterilising equipment after each patient or being under the influence of alcohol or drugs.

or colleagues. When we asked a sample of 3,611 dental professionals questions about raising a concern, we found: ■ 46% had come across issues that they felt could be raised as a concern ■ 88% would know where to go if they wanted to raise a concern about poor standards of care, but 12% would not ■ 39% had raised a concern at their work ■ 5% had raised a concern with the GDC ■ 80% agreed that their workplace was one where staff can raise concerns openly, but 9% felt that their workplace was not.

The results show that almost half had come across issues that warranted raising a concern. We know that the decision to speak out is never taken lightly and that deciding what to do when you have concerns about a colleague’s behaviour can be uncomfortable as there may be personal and professional loyalties at play.

Putting loyalties aside, our standards make it very clear that the priority is to patients. The first principle is to put patients’ interests first. The eighth is to raise a concern if patients are at risk.

In his flagship report, Robert Francis talked about the need for an open and

transparent culture. This means that anyone should feel comfortable raising a concern, knowing that appropriate action will be taken, and that they will not suffer personally or professionally as a result.

Knowing who to raise a concern with can also be challenging. While our survey found that 88 per cent knew how to raise a concern, this means that 12 per cent did not.

If you raise a concern, you are protected by the Public Interest Disclosure Act 1998 (PIDA). This gives protection to anyone who raises a genuine concern about potentially illegal or dangerous practices in the workplace. This protection applies as long as you:

raising concerns

If you saw something at work that could put a patient or colleague at risk, what would you do? Let me ask the question again: if you saw the same thing being done to a friend, or family member, would you still act the same?

By Janet Collins, Head of Standards, General Dental Council other specific verified CPD

Standards for the Dental Team: Standard 7.1 Put patients’ interests first

■ are acting in good faith ■ honestly and reasonably believe that the information and any allegation in it are substantially true ■ are not raising concerns mainly for the purpose of personal gain ■ have taken steps to raise concerns first with the employing or contracting authority (unless you reasonably believe that you would be victimised if you did so, or you reasonably believe a coverup is likely or the matter is very serious)

Speaking out may allow poor practice to be identified and tackled before it develops into a serious risk to the safety of patients

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qualityassurance

■ Quality assurance breeds credibility

You do not have to prove your concerns provided you make them in good faith.

The General Dental Council should not normally be your first point of call. However, it might be appropriate – particularly if the concerns are serious or if you have already raised them internally first and no action has been taken.

To complement the advice, we have launched a confidential advice line in partnership with the charity Public Concern at Work, offering impartial advice on how to raise a concern at work. While you won’t be able to raise a concern through this route, the line offers practical advice on how to raise your concern and who to raise it with.

It is important not to ignore issues such as poor performance or a lack of resources that may potentially harm patients. Doing nothing in a situation where you have concerns about the safety of patients or colleagues is not an option.

■ The number of the helpline is 0800 668 1329. The call is free and confidential. The line is open between 9 am and 6 pm, Monday–Friday.

■ Educational aim: – to gain an awareness of quality systems related to manufacturing dental appliances

By Tony Griffin

■ CPD outcomes: – to provided an update on a form of dental laboratory quality kite marks – to provide an outline of the applied QA needs

Abstract Manufacturing of custom-made dental devices, such as removable dentures, fixed prosthodontics and orthodontics, are subject to the requirements of the Medical Devices Directive (MDD). Many dental laboratories often go above and beyond the basic requirements by implementing their own quality assurance procedures that further promote consistency. This paper provides a personal overview of some of the systems being used in dental laboratories to deliver a quality assured product.

raising concerns

It advises, where possible, that you raise the concern internally first following your organisation’s whistleblowing policy. If this is not possible, it gives details of where to seek advice, such as your defence organisation or professional association.

other specific verified CPD

To help overcome some of the barriers to raising concerns, we have published advice about how to raise a concern, which is available on our website.

Standards for the Dental Team: Standard 1.9.1 You must find out about, and follow, laws and regulations affecting your work.

Key words: Medicines and Healthcare products Regulatory Agency (MHRA), Medical Devices Directive (MDD), Duty of Candour, CAD/CAM, Guidance on commissioning and manufacturing dental appliances, GDC Standards for the Dental Team, ISO 9001:2008, DAMAS, Statement of Manufacture

Promoting an improved quality provision

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seem to be spending an increasing amount of time supporting teams, reviewing processes, developing protocols and reflecting on practices in an effort to promote an improved quality provision. In my experience there is a correlation between a high quality provision and the passion of all team members in the organisation for ongoing improvement. In a recent personal review a participant asked: ‘Where should we be going with the Duty of Candour?’1 This always creates some interesting responses such as, ‘We always act in the best interests of our clients’. However, it misses the point, as it is for the patient that the dental team is providing our regulated activities. This often provides a complex set of issues. For example, when things go wrong as part of clinical treatment and a problem occurs, it may still be the patient who is the last person to be informed.

The processes within a dental laboratory are complex and require integration of artistry and skill to ensure that every the

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custom-made dental device is fit for purpose. Even with the introduction of CAD/CAM, the hand and eye coordination of the expert dental technician makes a noticeable difference to the final product outcome. This is the result of the focused skill and aptitude of the individual dental technician, who must also meet the various organisational and national regulations linked directly to the manufacturing of custom-made dental appliances.

Candour and consent Every UK dental laboratory has to maintain its compliance information for the Medical Devices Directive (MDD) to ensure its continued registration with the Medicines and Healthcare Products Regulatory Agency (MHRA).2 Each dental manufacturer registered with the MHRA is provided with a registration number (e.g.

CA000000), which is accessible via the MHRA website3 in a Public Access Database for Medical Device Registration, and can be shared by the dental laboratory and its clients. To further clarify dental appliance manufacturing requirements, the General Dental Council

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qualityassurance

and confidence in your dental laboratory work

Quality management systems The implementation of management systems to ensure a business follows set procedures is especially useful to those who have a number of employees and business consistency is not forthcoming.

Standards pronounced by the International Organization for Standardization (ISO)6 are often seen ‘kite marked’ for a wide range of businesses and activities. For example, the ISO 9001:2008 is a standard that provides a set of requirements for a quality management system regardless of what the user organisation does, its size, or whether it is in the private or public sector.7 The quality assurance of the manufacturing of dental appliances in the UK may be third party accredited by an independent, non-governmental

■ Section 4. Overall requirements for a quality management system ■ Section 5. Requirements for management ■ Section 6. Human resources, facilities and equipment and the manufacturing environment ■ Section 7. Requirements for manufacturing the products or providing services ■ Section 8. Requirements for monitoring, analysis and improvement

Certification Once ISO 9001:2008 is in place within an organisation, it can be externally audited for accreditation by such a body as a representative from the British Standards Institute. Initially auditors asked just to see the manuals and for evidence of how they were used. Now, some years on, auditors use more probing questions to determine how your approach seeks to fulfil its objectives and demanding you reflect on whether processes could be done better.

For instance, questions that ask: ‘Will this procedure help you achieve your stated business objectives?’ or ‘Is it a good process or is there a better way to do this?’

Thus we are encouraged to reflect on something that is being heavily emphasised with regard to our approach to our lifelong learning plans (CPD). The qualified and accredited auditor will, by an analysis of the systems and a range of questions, then determine whether the business satisfies the standards or not. If, during the evidence review, the auditor determines you are fully compliant, he/she

will likely recommend the award of the certificate. However, should they find serious problems, such as deviations from agreed processes, you will be required to correct these and possibly undergo a reaudit before certification is granted. If the auditor only identifies a small number of ‘minor’ problems, you can also be certified but will be required to correct these problems within a specified timeframe and likely be subject to re-audit.

Traceability, confidence and reassurance Once your organisation is compliant, it is awarded a quality kite mark reflecting its status of an ISO 9001:2008 certified company. Those dental laboratories applying the DLA’s version of the quality management system gain a DAMAS certificate and unique number.

Certification bodies are required to revisit registered companies and carry out an audit regularly to make certain that the business is still meeting the requirements of the specific standard.

legal and ethical

Therefore all manufacturers of custommade dental devices in the laboratory or in the clinic must comply with these regulations or face the potential of criminal charges. According to the GDC there is an obligation for dentists to register with MHRA as a provider of custom-made devices if in their clinics they should manufacture such items.

There may be those who avoid complying, although with the two Cs of ‘candour’ and ‘consent’ looming overhead, it might be a weak defence to say, ‘We thought that we were not actually manufacturing’. Standard 1.9 of the GDC’s Standards for the Dental Team requires that all registrants ‘… find out about laws and regulations affecting your work and follow them’.5

organisation, or there is a similar dedicated dental laboratories association8 called the Dental Appliance Manufacturers Audit Scheme (DAMAS). Both these organisations require that quality management systems are put in place and, in particular, the ISO standard has the following main sections:

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(GDC) provides guidance in its document Guidance on commissioning and manufacturing dental appliances.4 Here the GDC indicates that ‘If you commission and manufacture dental appliances you must comply with the Medical Devices Directive 93/42/EC. Compliance with this is a legal requirement and failure to comply fully is a criminal offence.’

These surveillance visits normally take place annually at an agreed date. The benefit of external quality assured dental laboratories is that clinicians know, for example, that should they request data on an appliance’s quality assessments during manufacture or materials authentication, it will be appropriately saved. It’s really about traceability, confidence and reassurance of the product and knowing that appropriate systems are in place to provide authenticity.

Quality systems do not guarantee quality It is worthwhile acknowledging the fact that quality systems do not absolutely guarantee high quality appliances, prostheses or restorations. Whilst management may set the quality level, the technical quality is more often in the hands of the creative dental technician whose practical skills and ability with raw materials determine the final product in accordance with a clinician’s wishes and directive. the

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other specific verified CPD

Fig. 1: Partial denture, designed to a clinician’s prescription by a quality assured process

The statement is like a certificate or warranty The final piece of the custom-made dental appliance puzzle is what the patient receives: the ‘Statement of Manufacture’. A statement of manufacture is a specific legal requirement and should be supplied with every appliance.

It is a certificate indicating for whom the appliance was created, amongst other things. As outlined to patients by the GDC, ‘The person who prescribes your treatment (usually your dentist) must offer you a statement of manufacture with full details of the appliance.

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The UK dental laboratory industry is in a state of transition There is a change in prescription requirements, an increase in complex independent appliance requests, a wave of CAD/CAM technology, digital manufacturing, consolidation of dental practices into corporates and mini corporates to name a few.

The statement is like a certificate or warranty and proves that your device has been made to legal standards especially for you.’9

There is also a clear decline in dental technicians according to the GDC’s annual registration records. While UK dental laboratories still fly the flag of UK manufacturing with pride, putting heart and soul into their manufacturing of dental appliances, there remain challenges from worldwide manufacturing and demands for low cost restorations.

Deciding not to give this to a patient means that a clinician is obliged to keep the Statement of Manufacture for the ‘lifetime’ of the appliance. A rather demanding commitment to archiving, but something that digital scanning may help with.

So, the next time you proudly complete a piece of work, just take a moment to consider the complex manufacturing process that has taken all sorts of raw materials to create a final custom-made dental appliance and appreciate how your dental laboratory is meeting all the legal

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Many thanks to FGDP at the Royal College of Surgeons (Eng) for their permission to reprint this article.

References 1 Care Quality Commission Regulation 20: Duty of candour. Available at www.cqc.org.uk/content/regulation -20-duty-candour accessed May 2015.

2 Medicines & Healthcare products Regulatory Agency.

Available at www.gov.uk/government/organisations/ medicines-and-healthcare-products-regulatory-agency/ about accessed May 2015.

3 Medicines & Healthcare products Regulatory Agency.

Public Access Database for Medical Device Registration. Available at http://aic.mhra.gov.uk/era/ pdr.nsf/name?openpage&start=1&count=200 accessed May 2015.

4 GDC. Guidance on commissioning and manufacturing dental appliances. Available at www.gdc-uk.org/ Dentalprofessionals/Standards/Documents/Guidance%20 on%20commissioning%20and%20manufacturing%20 dental%20appliances%20(Sept%202013).pdf accessed April 2015.

5 GDC. Standards for the Dental Team. Available at www.gdc-uk.org/Newsandpublications/Publications/ Publications/Standards%20for%20the%20Dental%20 Team.pdf accessed May 2015.

6 International Organization for Standardization. ISO 9001:2018 Quality management systems – Requirements. Available at www.iso.org/iso/catalogue _detail?csnumber=46486 accessed May 2015.

7 Newsome PR. Dental technicians regulation and quality assurance. Br Dent J. 2011; 210: 25–9. Available at www.firstlabdirect.co.uk/assets/PDFs/2011/Dental -Technicians-regulation-and-quality-assurance.pdf accessed May 2015.

8 Dental Appliance Manufacturers Audit Scheme.

Available at www.damas.co.uk accessed May 2015.

9 GDC. Crowns, bridges and dentures. Do you know what’s going in your mouth? Guidance for patients.

Available at www.gdc-uk.org/Newsandpublications/ Publications/Publications/Patients%20Med%20 Devices_Layout%203.pdf accessed May 2015.

legal and ethical

requirements to support and reassure the patient and dental team.

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businesssuccess

■ Sharing the secrets to business success As technicians, we are better known for our creative flair than our business acumen.

While many of us dream of opening our own lab, turning a profit in an increasingly competitive market can be tough – and off-putting. We put award-winning technician and business owner, Hit Parmar, under the spotlight to discover how he learned the commercial skills necessary to run a successful and profitable business.

Dental technician, Hit Parmar, award-winning owner of Fine Art Dental Studio

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he vision and desire to one day be his own boss inspired Hit Parmar to open his own lab. In 2008, eleven years after graduating from Matthew Boulton College in Birmingham, his dream became a reality and Fine Art Dental Studio in Moseley was launched.

In any business, ensuring growth is vital to success. Fine Art Dental Studio now employs six technicians and has several awards under its belt. So how does Hit make key decisions, which marketing techniques has he found work best and how does he identify and fill gaps in his knowledge? Let’s start with marketing: for Hit, his top three strategies have been the following:

Networking ‘Word of mouth is still the best recommendation. It takes more time as a marketing strategy but offers enduring success. Personally I get a huge buzz when a patient says we were recommended; however, a referral from a dentist always feels like an endorsement that we’re on the right track.

We’ve found acting as a host for meetings, seminars and training events a brilliant way to network with our peers.’

Stay niche Exposure ‘Publications are excellent for awareness in the industry, and when it comes to public and international awareness we’ve found social media platforms invaluable.

It’s like marketing on steroids! Using Facebook in such a visual and creative industry, it is perfect for showcasing the quality of our work.’

‘Few businesses achieve success by being all things to all people – it’s just too difficult for others to be sure about what you do. By following your true vocation you’ll naturally become highly skilled, confident and the “go to” for this particular service or skill. It takes courage and discipline to remain focused, but the results are definitely worth the effort.’

Know your limits, communicate with dentists – and avoid underselling yourself According to Hit, gaining experience from working in other successful laboratories will provide an insight into what it requires to be successful; however, he stresses it is only an insight. The real learning comes when you open the doors to your own business – and even in the face of adversity, Hit recommends never ever giving up.

‘Knowing when to bring in business specialists at strategic times is another part of the success jigsaw – just because you’re a skilled technician doesn’t automatically mean you’ll be a skilled businessman.

They’re very distinct skills and there is no shame in employing the services of others to help you build your success.

‘My advice for other lab owners or those considering taking the leap is to be open the

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businesssuccess The main laboratory

a discussion of advanced cases at the bench using photographs, wax-ups and mounted models to get the creative and lateral brain fired up!

to the ideas and approaches of others. It’s very easy to imagine our way is the only way, especially in a profession where the work is often a labour of love.

‘Employ people who have skills you haven’t. Employ people who are better than you are. Take the time to learn new techniques and never be afraid to try out new concepts.

‘Communicate with your dentists; mutual respect and understanding requires constant fostering but the effort will have huge benefits for your business. I’ve found being accessible to dentists is critical. By allowing them to discuss and plan cases we can effectively guarantee the desired result is achieved. You’ll not only ensure you’re working well together, it’s having that shared vision and a strong resolve that helps you both progress in unison.

‘Also, avoid devaluing your product by underselling; this is a slippery slope because there will always be another lab prepared to do it cheaper.’

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‘Having excellent in-house training and conference facilities means we can run study groups for dentists and this is where a dental technician’s input has proved so valuable. Alongside this we host and attend CPD courses and various exhibitions to keep up to date with modern dentistry.’

Keeping ahead Under Hit’s leadership, Fine Art Dental Studio has a reputation for constantly researching new techniques and approaches. We asked how he undertakes research and keeps abreast of the latest developments.

‘Reading specialist publications such as The Technologist is the easiest and first part of research – keeping an open mind towards new techniques and innovations is critical. We are prepared to trial new technology and, of course, make mistakes along the way.’

Access techniques through social media ‘It’s amazing how accessible our colleagues are nationally and internationally through social media. We get to see and learn different techniques, materials and ways of thinking. This virtual world can never replace the immediate feedback and ideas from dentists who visit the laboratory, something we positively encourage. There’s nothing like

Die trimming

Stay on your toes Identifying your customer groups and attending to their different needs are fundamental to a successful business and for Fine Art Dental Studio, the majority of their clients are private dentists.

‘My brother, Dr Dipesh Parmar, is an important client for us. As he participates in several professional awards he keeps me on my toes to continuously enhance my skills and achieve perfection. Helping him achieve his vision means we are constantly pushing boundaries to achieve award-winning results.

Perfecting smiles ‘There is an escalating trend toward achieving “the perfect smile”, resulting in increasing numbers of patients becoming interested in how cosmetic dentistry can help them. Bespoke shade matching enables us to effectively customise a restoration to match a patient’s natural tooth. This not only means we can

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businesssuccess

Before

After - full upper rehabilitation

achieve the most aesthetic result possible, it also means we can meet the patient’s expectations. Thankfully, gone are the days when it was obvious you had a “fake tooth” – few things are more embarrassing – bespoke shade matching helps eliminate the likelihood of this happening.

imagination and aesthetics that gives me such a buzz. Engaging with new technology and ever-improving techniques and materials means our output just gets better and better. That’s a win for me, a win for the dentist and obviously a fabulous outcome for the patient.

with technology, and in doing so, will create a foolproof system.

‘The in-depth shade matching we offer not only helps to customise the build-up, it also means we can select the right visual effects at each stage of the process to guarantee a seamlessly natural result for the patient. As you can imagine, the procedure is more complicated and far more comprehensive than a simple shade match taken at chair-side by the dentist.

‘The digital revolution is very exciting, but with any advancement in technology there are concerns. It saddens and frightens me to think that skilled dental technicians will have diminished significance in dentistry in the future. Whilst machines can’t replicate all that technicians do, there will undoubtedly be an impact on new technicians. Who knows what the future holds; I hope that technicians will advance

For more information please contact: ■ Fine Art Dental Studio Rear of 1 Alcester Road Moseley, Birmingham B13 8AR ■ Call: 0121 449 9333 ■ Email: info@fineartdentalstudio.co.uk ■ Social: www.facebook.com/ fineartdentalstudio

Before

After - denture

‘Not every dentist will request a bespoke shade to be taken, in which case we are accustomed to shade matching against the photographs and prescriptions provided. However, if we did not offer the option of bespoke shade taking, unavoidably there may be a chance of an incorrect shade. Together, a thorough evaluation of these parameters can create the most beautiful and natural result.’

‘For now, all we can do is maintain our enthusiasm and desire to continually do and be better than we were yesterday.

That is my intention.’

Before

Loving the job today and tomorrow We spend a lot of our lives working so being able to enjoy what we do is so important. What is it about being a dental technician that is so great?

‘Every day is a challenge and that’s what we thrive on. No two teeth are identical and everyone’s tooth shade is different. I think it’s the combination of creative After - veneers

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22 february 2016

continuingprofessionaldevelopment Continuing Professional Development (CPD) Programme The Technologist is pleased to include a continuing professional development (CPD) programme for DTA members in accordance with the UK General Dental Council’s regulations and the FDI World Dental Federation’s guidelines for CPD programmes worldwide. The UK General Dental Council regulations required that from 1 August 2008 all dental technicians must start documenting their CPD. They are required to complete and record a minimum of 150 hours of CPD every five-year cycle, a third of which should be verifiable CPD (50 hours). This should include verifiable CPD in the following core subjects: ■ medical emergencies (10 hours per cycle) ■ disinfection and decontamination (5 hours per cycle) ■ materials and equipment (5 hours per cycle) The questions in this issue of The Technologist will provide verifiable CPD for those entering the programme. Complete your answers for free online at www.dta-uk.org, or use the answer sheet overleaf.

(Or a photocopy if this is preferred, so as not to remove the page). Return your answer sheet to the DTA Head Office address, with your £5 payment (please note that your CPD won’t be processed without payment) before the 21 March 2016.

Online and paper responses must be received by the deadline. The answers to the questions in this issue will be provided in the April 2016 issue. Dental technicians completing the programme will receive a certificate for the prescribed number of hours of verifiable CPD, together with the answers to the questions either online or by post according to the above guidelines.

Aims and outcomes In accordance with the General Dental Council’s guidance on providing verifiable CPD: ■ The aim of The Technologist CPD Programme is to provide articles and material of relevance to dental technicians and to test their understanding of the contents.

■ The anticipated outcomes are that dental technicians will be better informed about recent advances in dental technology and associated subjects and that they might apply their learning to their practice and ultimately to the care of patients.

December 2015 – CPD Answers Pumice

1. C 2. A 3. C 4. A 5. D 6. A 7. B 8. A 9. D 10. C Fabrication of indirect brackets

1. C 2. D 3. A 4. D 5. D 6. C 7. A 8. B 9. D 10. A Bookkeeping

1. C 2. D 3. A 4. B 5. C Equality in the workplace

1. C 2. A 3. B 4. C 5. B

Please use the space on the answer sheet or online to provide any feedback that you would like us to consider.

Raising concerns in the right way (other specific cpd – 30 minutes) Q1 – Is raising a concern the same as making a complaint?

A – Yes, they are one and the same B – No, a concern is something you have witnessed C – No, a concern is something that puts colleagues or patients at risk and (b) D – Yes, they are the same and both should be avoided

Q2 – Risks can come in many forms. Which of the following is not a risk mentioned in the article?

A – The health, performance or behaviour of a colleague B – A conflict with your duty of care to patients C – A colleague not properly sterilising equipment D – A colleague who is not properly trained to perform their duties

Q3 – What did Robert Francis highlight in his report?

A – That raising concerns was down to the individual B – The need for an open and transparent culture C – The need for everyone to feel comfortable about raising a concern D – The confidence to know that appropriate action will be taken and (b) and (c)

Q4 – Individual protection applies via the Public Interest Disclosure Act 1998 (PIDA) as long as …

A – You act in good faith B – You have raised concerns internally first C – You can prove your concerns D – Your concerns are not based on personal gain

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Q5 – Which of the following statements is best, based on the article’s content?

A – Doing nothing about a concern is not an option and (b) and (c) B – The General Dental Council should not normally be your first point of call C – Public Concern at Work offers impartial advice on how to raise a concern at work and (b) D – You should ignore issues that may potentially harm patients

Life Saver (Medical emergencies cpd – one hour) Q1 – Which of the following is not regarded as a medical emergency?

A – Cardiac arrest B – Choking C – Rhinitis D – Collapse

Q2 – ‘There should be regular practice and teaching using simulation-based cardio respiratory arrest scenarios’ for …

A – Dentists B – Hygienists and therapists C – Dental nurses and CDTs and only the above D – Dental technicians and all the above

Q3 – A cardiac arrest occurs when …

A – The person is in a meditation phase B – The heart stops pumping blood efficiently around the body C – There is a large bleed from the mouth D – The patient is lightly breathing and has a pulse

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continuingprofessionaldevelopment Q4 – How should immediate help be summoned in a medical emergency?

A – Request a local manager to arrange guidance B – Call the local ambulance service C – Dial 999 or 112 on a telephone D – Report the case under RIDDOR by phone

Q5 – Why should all medical emergency training be recorded?

A – It forms part of a GDC registrant’s essential CPD B – Individual registrants are required to record their CPD C – Records should show 10 hours in each CPD cycle D – It is a requirement under CPD and all the above answers

Q6 – How many chest compressions in a minute?

A – 80–90 B – 90–95 C – 100–120 D – 110–128

Q7 – Place the heel of the hand on …

A – The centre of the person’s chest and (b) and (c) B – The centre of the person’s chest and place the other hand on top C – The centre of the person’s chest and press down by 5–6 cm at a steady rate D – The centre of the person’s chest and press down 2–3 cm at a steady rate, and (a) and (b)

Q8 – If rescue breaths are being used they are given every xx compressions A – 10 B – 20 C – 30 D – 40

Q9 – If you decided to give rescue breaths …

A – Tilt the casualty’s head gently and lift the chin up with two fingers B – Pinch the person’s nose and all answers C – Seal your mouth over their mouth and blow steadily and firmly into their mouth and (a) only D – Check that their chest rises. Give two rescue breaths and (c) only

Q10 – If you need to assist in dislodging an item stuck in someone else’s throat …

A – Use fingers to remove the stuck item B – Get the person to keep coughing C – Use two hands over the upper sternum and push repeatedly D – Use the heel of your hand to give up to five sharp back blows between their shoulder blades

Contracts of employment & job descriptions (other specific verified CPD 30 minutes) Q1 – The primary purpose of a contract of employment is to …

A – Protect the rights of the employer B – Protect the rights of the employee C – Provide a legal basis for the relationship between employees and employers D – None of the above

Q2 – When are you entitled to a contract of employment?

A – On the first day of your employment B – Before you start employment C – Before the end of the second month of your employment D – Within 6 months of your start date

Q3 – Your contract has to include …

A – A full job description B – A summary of your main duties C – The staff handbook D – Entitlement to an annual pay review

Q4 – Your employer can only safely change your contract by …

A – Imposing new terms B – Giving you notice of the change C – Consulting with you about the proposed change, obtaining your agreement and giving reasonable notice of the change D – None of the above

Q5 – The best way to deal with any problems in your contract is to …

A – Speak to a colleague B – Speak to your manager C – Contact a solicitor D – Contact ACAS

KPIs (other specific verified CPD one hour) Q1 – KPI stands for …

A – Key performance indices B – Key performance indicators C – Key performance indexes D – Key performance inclinations

Q2 – One important financial KPI is Gross Profit …

A – Multiple B – Deduction C – Margin D – Difference

Q3 – What does the term ‘trade debtors’ mean?

A – How much is owed to us by our customers B – Businesses in the dental sector that have gone bust C – How much we owe to our suppliers D – None of the above

Q4 – Which of the following statements about KPIs is untrue?

A – They can be financial and non financial B – They can act as early warning signs of impending issues C – You should have one for every process in your business D – They are like corporate fingerprints – relevant to your business

Q5 – Customer retention is an example of …

A – Financial KPI B – Negative KPI C – Positive KPI D – Non-financial KPI

Q6 – You calculate current ratio by dividing current assets by …

A – Current liabilities B – Net profit C – Direct costs D – Indirect costs

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24 february 2016

continuingprofessionaldevelopment Q7 – Which of the following statements about gross profit margin are not true?

A – It is a measure of product profitability before accounting for indirect costs B – To calculate you divide the gross profit by the sales figure C – To calculate you divide the sales figure by the net profit D – It is a measure of production profitability

Q8 – Net profit is: A – A useful tool for comparing historical performance B – The profit earned after all costs have been deducted C – A measure of overall business profitability D – Sometimes called the bottom line and (a), (b) and (c)

Q9 – Which of the following best reflects information about customer retention KPIs? A – It measures the average time customers stay with you B – It can help you to identify the customers that like your service best and (a), (c) and (d) C – It may help to determine the basis on which you are competing and (a) D – If you are constantly looking for new clients, it may be a worthwhile measure

Q4 – A ‘statement of manufacture’ is a specific legal requirement to ....

A – Be kept for 11 years by the laboratory B – Only be supplied on the request of the clinic C – Be only required for private work D – Be supplied to the clinic with every appliance

Q5 – To gain a quality management system kite mark, an inspection is made by...

A – Having a discussion over the telephone with the owner of the dental laboratory B – An accredited and qualified auditor who visits and reviews the evidence C – A GDC registered dental technician who visits and looks at the quality of the work D – A member of the group already registered who visits the laboratory and makes a recommendation

A complete reconstruction that changed lives (Materials & equipment cpd – 30 minutes) Q1 – DSD protocol is related to ...

Q10 – Quick ratio is …

A – A measure of your solvency B – Similar to current ratio C – For small businesses, one or above D – Calculated by current assets – stock/current liabilities and all of the above

Quality assurance breeds credibility (Legal and ethical CPD – 30 minutes) Q1 – Every UK commercial dental laboratory must be registered with ...

A – General Dental Council B – Medicines and Healthcare Products Regulatory Agency C – DAMAS D – ISO 9001

Q2 – The GDC ‘Guidance on commissioning and manufacturing dental appliances’ states

A – Dental Systematic Design B – Digital Symmetry Dentistry C – Digital Smile Design D – Dental Smile Development

Q2 – What amount of crown lengthening was indicated by the team for the 23?

A – 1.5 mm B – 2.0 mm C – 4.0 mm D – 4.5 mm

Q3 – An anatomical and functional wax up for this case was then duplicated to enable the ...

A – Dentist to follow the axial inclination of the implants B – Face morphology to be followed C – Clear stent to be manufactured D – Development of the zirconia structure

Q4 – Which statement does NOT relate to this case?

A – Incisors joined in the 13–11 B – There is more than 3mm of unsupported ceramic C – There are four zirconia screw-retained bridges D – 21–23 joined incisors

A – You must comply with Medical Devices Directive 93/42/EC and b) only B – Compliance with Medical Devices Directive 93/42/EC is a legal Q5 – Dark coloured, prepared natural teeth were masked requirement by...

C – Relates to manufacturing in a clinic as well as a dental laboratory A – Opaque cement B – Gold cores on the implants D – Failure to comply with MDD 93/42/EC is a criminal offence and C – Opaque zirconia D – Ceramic core stains all the above

Q3 – A quality management system that includes ‘Requirements for manufacturing the products or providing services’ can be found in...

A – Candour and consent documents B – ISO 9001:2008 C – DAMAS and b D – Medical Devices Directive

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Simply fill in the multiple choice answer sheet on the inside back cover and complete the form ...

february 2016

continuingprofessionaldevelopment

answer sheet the technologist february 2016 Please PRINT your details below: First Name*

Last Name*

GDC no.*

Title

DTA Member: Yes

No

DTA no.*

*Essential information. Certificates cannot be issued without all this information being complete.

Complete free online at <www.dta-uk.org>. First-time users will need to register; those already registered need only log in.

Or, either remove this page, or send a photocopy to: Dental Technologists Association, 2 Wheatstone Court, Waterwells Business Park, Gloucester GL2 2AQ. A £5 payment must be included with your CPD answer sheet – please do not forget!

Please note that you must achieve a score of 50% or more to receive a certificate.

Answer sheets must be returned before 21 March 2016 for CPD responses returned in the post and for online CPD users.

Answer sheets received after this date will be discarded as the answers will be published in the April 2016 issue of The Technologist.

Answers Please tick the answer for each question below Raising concerns in the right way (Other specific CPD – 30 minutes)

Question 1:

A

B

Question 2:

C

D

A

B

Question 3:

C

D

A

B

Question 5:

Question 4:

C

D

A

C

D

A

C

D

A

B

C

D

A

C

D

A

C

D

A

C

D

A

C

D

A

C

D

A

C

D

A

C

D

A

B

C

D

C

D

C

D

C

D

C

D

C

D

C

D

C

D

Life Saver (Medical emergencies cpd – one hour)

Question 1:

A

B

Question 2:

C

D

A

C

D

A

Question 6:

A

B

B

Question 3:

C

D

C

D

Question 7:

B

A

B

Question 8:

A

B

Question 5:

Question 4:

B

Question 10:

Question 9:

B

B B

Contracts of employment & job descriptions (Other specific verified CPD – 30 minutes)

Question 1:

A

B

Question 2:

C

D

A

B

Question 3:

C

D

A

B

Question 5:

Question 4:

C

D

A

C

D

A

C

D

A

D

A

B

B

KPIs (Other specific verified CPD – one hour)

Question 1:

A

B

Question 2:

C

D

A

C

D

A

Question 6:

A

B

B

Question 3:

C

D

C

D

Question 7:

B

A

B

Question 8:

A

B

Question 5:

Question 4:

B

Question 10:

Question 9:

B

B B

Quality assurance breeds credibility (Legal and ethical CPD – 30 minutes)

Question 1:

A

B

Question 2:

C

D

A

B

Question 3:

C

D

A

B

Question 5:

Question 4:

C

B

B

A complete reconstruction that changed lives (Materials & equipment cpd – 30 minutes)

Question 1:

A

B

Question 2:

C

D

A

B

Question 3:

C

D

A

B

Question 5:

Question 4:

C

D

A

B

B

Feedback We wish to monitor the quality and value to readers of The Technologist CPD Programme so as to be able to continually improve it. Please use this space to provide any feedback that you would like us to consider.

An important note for non-DTA members Non-DTA members will incur a £25 fee for undertaking CPD provided through this publication. Cheques made out to DTA should accompany your answer sheet. the

technologist