Editorial Board
Exciting times
What are the most important areas of continued development and training for the 21st century dentist? Today’s dental patient can, quite rightly, expect a vastly different experience from their dental visit than patients of 30 years ago. Today we have potent anaesthetics that work quickly and extremely effectively, we have handpieces capable of 350,000 rpm plus, through handpiece irrigation and effective aspiration systems. All of this combined should result in a visit for the patient that is quicker, painless and with less after effects. We are also blessed with an enviable range of materials and technicians that make works of art by way of ceramic reconstruction in crown and veneer fields. Combine this with the advances in bonding and adhesive dentistry even since I trained (twelve years ago) and we are restoring teeth more beautifully than ever before, more conservatively and with higher
success rates regarding marginal seal and post op sensitivity.
hygiene and their expected lifespan is around double that of a bridge.
CAD/CAM allows for single visit indirect restorative treatments, scans of preps or whole arches with accuracies within microns to ensure crowns and inlays that fit first time and tighter than ever before. We can even manufacture orthodontic appliances from these scans, without the need for the patient to go through the unpleasant experience of impressions, and with greater accuracy to ensure the best possible tooth movement efficiency.
With this in mind, I feel today’s dentist should focus on continued development that they have at their core; at least a knowledge of implantology, an understanding of when and how orthodontics can be utilised to create beautiful smiles, reposition teeth to minimise preparations for veneer treatment, or enhance the restoration of the dentition. A focus on digital advancements, chairside scanning, I feel will become a must have, rather than a preserve of the elite in a very short time frame. In their spare time, after covering all of this, they could develop their skills in the use of composite bonding; there are myriad mentors in this field. What truly exciting times we are working in!
For the patient with a missing tooth, the option of choice is the dental implant. The benefits of the implant versus its predecessor, the bridge, be it fixed-fixed, fixed-moveable, cantilevered or bonded, are so numerous that listing them here would fill the article ten times over. Suffice to say, they do not require heavy tooth removal of two teeth either side of the space, they should always have fewer inaccessible areas for dental
Dr. Richard Brown
Parrys Lane Dental Practice and Bupa Dental Care, Nuvola Speaker for Nuvola courses
Buying a practice?
You may need more than just a valuation Two recent cases have prompted me to comment that there are prospectuses issued by major sales agents in circulation, which make statements that are at best disingenuous, and they certainly contain traps and pitfalls for the unaware. These generally relate to a significant overstatement of the potential profitability of a business. The key is to separate out the true trading expenses from the non-trading expenses. The non-trading expenses generally comprise items such as depreciation, which is a financial adjustment to reflect the fact that things wear out, personal motor and travel costs, personal subscriptions and other. In some cases, items such as repairs and renewals, which are actual expenditure costs that are incurred year in year out by every dental practice, are being added back into calculations. Suddenly you are buying a perfect building that needs no repair and equipment, that does not need to be serviced and that does not break down; a bit far-fetched in my view. There also seems to be a trend to forget upward adjustments where costs are likely to increase, for example, adjustments to rent. In some cases these figures can be significant. A further important consideration is the prospective structure of the dental team; I have had very recent experience of a case where outlandish assumptions were made as to the prospective shift in balance between work carried out by associates and work carried out by the principal, even to the point where you had to consider whether
the assumption was being made by the sales agent, constituted an ethical delivery proposition. In the headlong rush to buy and sell practices, there is a strong temptation for corners to be cut. With at least one major corporate currently offloading practices, it is clear that not every deal makes rational sense, and it is imperative that the practice that you are purchasing works for you on every level and that you have a good understanding as to how it will work for you based on your own needs, objectives and circumstances. Recently we have achieved significant reductions in the price paid against the advertised selling price, which is clearly to the benefit of the purchaser. I firmly believe that the tide is turning and I’m hopeful that equilibrium will return with price paid matching more closely fair value of the practice.
Mike Hughes
Principal Dental Practice Consultancy Service
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Modern Dentist Magazine