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National Smile Month 2024 launches at the Foundling Museum
The Foundling Museum in London set the stage as National Smile Month 2024 was launched amidst an audience of approximately 100 delegates. Running under the theme of ‘Love Your Smile,’ National Smile Month aims to inspire people to prioritise oral health and wellbeing.
The campaign seeks to foster positive habits that promote healthier smiles and happier lives. The initiative encourages everyone to embrace their smiles by taking proactive steps towards better oral health.
Speaking at the event, Dr Nigel Carter, chief executive of the Oral Health Foundation emphasised the importance of the campaign as a vehicle to transform oral health habits.
Dr Carter said: “This is the 48th National Smile Month, making it one of the longest-running oral health campaigns in the world. But it’s more than just a few weeks of dental awareness – it’s a movement. Our aim is to promote good oral hygiene, raise awareness about the importance of healthy teeth and gums, and inspire positive habits that last a lifetime.
“A simple smile can have a profound impact. We know that people who maintain good oral health tend to have better overall health. And the ripple effect extends beyond individuals – healthy smiles contribute to stronger communities and a happier society. So, as we embark on this month-long journey, let’s remember that our smiles are not just expressions; they’re statements of wellbeing.”
Dr Carter went on to express gratitude to the event’s sponsors, including LISTERINE, the Wrigley Oral Healthcare Programme (WOHP), Oral-B, Boots, EMS, and the British Society of Dental Hygiene and Therapy.
The charity boss acknowledged their invaluable support in advancing oral health education initiatives. He highlighted the collaborative efforts of these organisations in driving positive change and fostering a culture of oral health awareness.
The event also featured speeches from Dr Ben Atkins, speaking on behalf of the WOHP, and representatives from NHS Whittington Health Trust.
Dr Atkins highlighted key statistics from the WOHP’s latest Oral Health Index and stressed the need for preventive measures in oral health care, advocating for greater awareness and accessibility to dental services.
The NHS Whittington Health Trust brought the event to a close by addressing the room to share how they use National Smile Month as a driving force
for initiatives aimed at community engagement, with a strong emphasis on promoting oral health education and awareness. A recent toothbrushing event they organised was a testament to their efforts, successfully reaching around 900 local children.
National Smile Month 2024, which is supported by thousands of organisations from various sectors such as dentistry, health, education, and nutrition, will run until 13 June.
Dr Carter added: “In closing, let me say this: Keep smiling, let’s keep working together to improve oral health, and let’s make National Smile Month 2024 a resounding success”.
For more information about National Smile Month and how to support the campaign, visit www.smilemonth.org. n
Aquafresh study finds half of children lack confidence in their smile
Anew study reveals societal pressure affects children’s self-esteem, with half of kids saying they have experienced low confidence due to their teeth’s appearance. A staggering 98% of parents recognise dental health’s impact on their kid’s overall confidence.
New research conducted by Aquafresh has exposed the issues with confidence that British children are feeling, due to the societal pressure of having the “perfect” Hollywood smile. The study has revealed that nearly one in two kids have experienced low confidence because of how their teeth look*.
The study, of 2,000 parents and children aged 4-11 revealed that 84% of those children that feel less confident with their smile credit their insecurity to missing teeth (20%), teeth not being “white” (20%), wonky teeth (19%), and gappy teeth (13%). A further 36% have been embarrassed to smile or laugh due to how they feel about their teeth – a devastating statistic that truly demonstrates the impact of low confidence on the youngest in our society.
It’s not only children that are being impacted by the pressure for perfect teeth, but it’s a worrying time for parents too. Almost half of parents (48%) have noticed their child be self-conscious or lack in confidence due to how their teeth/smile looks. A further 43% say their children are impacted by societies obsession with “picture perfect” teeth, and an astounding 98% of parents believe dental health is an important factor in their child’s overall confidence and self-esteem.
To shine a light on the shocking statistics and encourage children to feel empowered by their healthy teeth, acclaimed British photographer Rankin has partnered with Aquafresh to capture powerful photographs of primary school children proudly showing of their imperfectly perfect teeth. The images were on display to the public at a gallery exhibition in London at Black & White Soho on Saturday 27th and Sunday 28th April.
To celebrate dental diversity, Aquafresh has also crafted toothbrush prototypes for every type of kid’s teeth – whether gappy or snaggly – to foster positive associations with brushing and boost confidence.
On this partnership and exhibition, Rankin said: “Perfection is an attitude – so being able to help kids embrace their wobbly, wonky teeth and realise what is ‘considered’ as perfect teeth doesn’t matter has been brilliant. Who doesn’t love to challenge the status quo –it’s more interesting being different, anyway!”
Dr Saul Konviser, from the Dental Wellness Trust, said: “Whilst Rankin’s moving portraits demonstrate the joy in a child’s proud, toothy smile, it’s also heartbreaking to find out that half of children are feeling low in confidence due to the way their teeth look. We know that if teeth are looked after and healthy, they are perfect! Dental health should be as much a part of a child’s self-care routine as washing their body and getting enough sleep – especially as we navigate the Dental Health crisis in the UK, and it becomes harder than ever to secure a dentist’s appointment. It’s so important for grownups – at home and in schools – to instil good dental hygiene habits in kids – habits will last a lifetime. Aquafresh has kindly supported The Dental Wellness Trust for over 3 years, helping us to promote oral health amongst children and whilst we’re making huge progress, this research proves that there’s still vital work to be done!”
Monica Michalopoulou, spokesperson for Aquafresh, said: “We’re thrilled to unveil these captivating images captured by Rankin, empowering children to take pride in their healthy teeth—because perfect teeth are just HEALTHY teeth! Our longstanding commitment to shedding light on dental care challenges faced by families remains unwavering. We are dedicated to our ‘Shine Bright’ schools’ campaign—a vital initiative that amplifies awareness and enriches dental education for parents, teachers, and children across the UK, that’s in it’s fifth year. This program, accessible to all primary schools, emphasises the importance of early teeth brushing through fun and engaging activities.” n
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ast issue’s news of new powers for dental hygienists and dental therapists has remained a key talking point within the dental community. The topic came up in multiple conversations I had at the British Dental Conference and Dentistry Show in May, and the feedback is extremely positive.
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In this issue, we speak with the pair who made it happen: Fiona Sandom and Michaela O’Neill. They recount their hard work to get the legislation to this point, comprising long hours and missed family events. The work has paid off and we owe a debt of gratitude to them both. You can find the interview on page 12.
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What’s more, we caught up with the duo for a recent edition of The Probe Dental Podcast, sponsored by Oralieve. You can watch or listen to that via The Probe’s Youtube channel or your favourite podcast platform. Or find it at: https://tinyurl.com/GainingNewPowers or by scanning the QR code.
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Denplan launches hygiene plan to boost preventative care options for patients
Denplan has launched a new hygiene plan to support practices to offer affordable hygiene appointments.
Hygiene is an essential part of preventative care, and the new plan enables practices to assist patients in regular hygiene treatment, care and advice by providing a payment plan to spread the cost of hygiene appointments.
The Government’s Dental Recovery Plan (published in February 2024) aimed to make NHS contracts viable for dentists but overlooked critical resources needed for preventative treatments. Denplan seeks to help bridge these gaps, prioritising affordable preventative treatments to tackle issues early on.
The new Denplan Hygiene Plan is a payment plan designed to promote the prevention of oral health intervention for patients in future, by providing an affordable way of accessing regular hygiene treatment, care and advice. Practices can set up to five payment options for patients.
Nearly three in ten (28%) Britons have had to take time off work because of tooth pain according to research from Denplan last year – an equivalent of 11.7 million people of working age. The NHS advises that leaving dental problems untreated could make them more difficult to manage in the future, so it’s best to deal with problems early, or, if possible, prevent them altogether.
The Long Term Workforce Plan (published June 2023) set aims to deliver 15% of dental activity through dental hygienists and therapists, and is also considering exemptions to allow dental hygienists
to supply prescription-only medicines such as highfluoride treatments for children at risk of decay.
Emma Smith, a hygienist from Paul Smith Dental Care, said: “Every day I hear of the barriers to accessing oral health care. My role as a hygienist is primarily involved in the treatment and prevention of gum disease, but it also encompasses prevention of tooth decay and improving overall oral health.
Access to regular high quality care benefits patients, reducing fear, embarrassment, pain and discomfort surrounding their oral health, making Denplan Hygiene Plan a great help to many of my patients.”
Catherine Rutland, dentist and clinical director at Denplan, said: “We know that many of our members face barriers to offering the preventative treatment they would advise on the NHS. The new hygiene plan has a low service fee and acts as a steppingstone for dentists to explore the benefits of a mixed-model practice, all while ensuring patients get the preventative treatment they need.” n
Jason Wong officially named Chief Dental Officer for England Tom Whiting joins the GDC as CEO and Registrar
When Sara Hurley vacated the role of Chief Dental Officer (CDO) for England in June last year, Jason Wong MBE –deputy CDO at the time – stepped up to fill the void at Interim CDO until a new permanent replacement was named by NHS England and the department of health and social care.
On Monday 22nd April, Jason Wong was named as Sara Hurley’s permanent replacement, now officially listed as the Chief Dental Officer for England on the NHS England website.
Jason was awarded his MBE for services to dentistry and oral health in 2020, the same year he became Deputy CDO. He previously chaired local dental networks throughout the Midlands and the East of England, and had served as secretary of the Lincolnshire Local Dental committee for 16 years.
According to NHS England, Jason’s new role as Chief Dental Officer ‘sees him working in collaboration with local and regional teams to deliver improved outcomes for patients, while also championing the role of dentists and dentistry within the health system.
‘The Office of the Chief Dental Officer England represents the head of the dental profession in England, providing system wide professional and clinical leadership, by setting the strategic vision for England’s oral health.’ n
Tom Whiting has joined the General Dental Council (GDC) as its Chief Executive Officer and Registrar.
In his first month, Tom will meet Chief Dental Officers from the four nations and stakeholders from across the dental sector at the Dental Leadership Network on 12 June. He will also start a series of visits to meet dental teams in different settings across the UK, to find out more about where and how they work and provide more opportunities for dental professionals to engage with the GDC.
Tom Whiting, GDC Chief Executive and Registrar, said: “I understand the pressures that the dental sector is under and the hard work that the whole dental team does to ensure that patients have the care they need. Trust between professionals and the regulator is important for patients and public confidence. I will listen to the views and challenges of dental professionals and stakeholders as well as get to know where and how they work.
“Building my own understanding will help me to identify shared goals and how we can work together to make a positive difference to dental professionals and patients. This will take time, but I’m committed to making a start right away.”
Tom joins from the Independent Office for Police Conduct (IOPC) where he was Acting Director General for 17 months, having been Deputy Director General since 2019.
Work on the GDC’s priorities continues while Tom is settling into his new role. These include the annual renewal of registration for around 70,000
dental care professionals, launching the updated scope of practice, and developing a new framework for registration of overseas dentists and dental care professionals.
Lord Toby Harris, GDC Chair, said: “I am delighted that Tom brings a commitment to building effective relationships externally, as I did when I joined the GDC, and I know that listening and engaging is the best way to do this. The Council will support Tom and the Executive Leadership Team to continue to deliver the GDC’s existing priorities and navigate any changes that come our way after the general election.
“I also thank Gurvinder Soomal for stepping into the Interim Chief Executive role and maintaining both continuity and much progress. Gurvinder returns to his role as Chief Operating Officer with responsibility for corporate functions, which means that the GDC continues to benefit from his valuable experience and knowledge.” n
Rise of the Internet dental diagnosis
From the bizarre, and the ridiculous to the positively dangerous, online ‘dentistry’ has been blooming in popularity
As of January 2024, there were 5.35 billion internet users worldwide, which amounted to 66.2% of the global population. Of this total, 5.04 billion, or 62.3% of the world’s population, were social media users.1
It is hard to get an exact number of those who are regularly performing dentistry on themselves. However, in February, polling by the British Dental Association (BDA) revealed that 82% of dentists are treating gruesome cases of DIY dentistry.2
The internet and social media are part of our everyday lives. It is easy to understand why some people are turning to the internet for advice. The ongoing dental access crisis that has been building over the last few years, has left many desperate for dental advice wherever they can get it.
Why not get it at the touch of a phone screen?
Like a lot of the information that can be found on the internet, this advice may not be coming from a dental professional. At best, the advice may be useless. At worse, it could actually damage a patient’s teeth and gums.
What are the biggest internet issues?
Using the internet to impart information can have benefits. For example, you can reach a wide audience, it is quick, and relatively cheap. However, despite sites such as YouTube trying a verification process to ensure that information is coming from a reputable source, some misinformation still slips through.
Reams of misinformation and wrong claims abound on the internet. You can visit sites such as TikTok to investigate all the ways people are putting their smiles in danger.
Influencers are recommending rubbing fruit like strawberries and lemons on their teeth constantly to whiten them. Filing their teeth with a nail file so they look straighter. Using nail glue to fix their loose teeth to the gums.
These examples are certain to send a shudder of horror through any dental professional when their patients admit to attempting them. These types of DIY dentistry can cause permanent damage to patients’ mouths.
More importantly, these practices can cause pain and be costly to correct, putting pressure on the dentist to perform miracles and undo the damage.
What can dental professionals do?
So, what can dental professionals do to help stamp out this problem?
It’s not often our regular patients who are most at risk from these ‘quirky’ recommendations. Those who do not have regular access to dental care in the UK are the most likely to seek dental advice online.
An estimated 10 million people in the UK are currently waiting for a routine NHS dental appointment and 19 million appointments were missed during the pandemic, according to the British Dental Association.3
These are staggering figures and are unlikely to be reducing any time soon. How do we reach out to warn those we don’t see in our dental practices?
We can reach out through our social media to promote better and correct dental advice. Using dental practice websites to put out relevant, safe information will also help stop the potentially permanent damage to teeth and gums.
Preventative care should always be at the forefront of all dental treatment and advice. If patients start using our recommended preventative measures to take care of their teeth, they are less likely to need as much complex dental treatment, leaving more appointment time for new patients.
In the meantime, we must encourage patients to book dental appointments as often as their dental professional recommends, and not skip these regular visits.
References
1. Internet and social media users in the world 2024 | Statista
2. 8 in 10 dentists seeing cases of ‘DIY’ dentistry (bda.org)
3. the-great-british-oral-health-report-2021.pdf (dentistry.co.uk) n
ABOUT THE AUTHOR
KAREN COATES
New powers in the pipeline
Miranda Steeples offers an informed view of the upcoming groundbreaking legislation poised to involve dental hygienists and dental therapists in the UK
Crucial legislative reform is set to improve the functionality and effectiveness of oral healthcare in the UK. This reform will update the Human Medicines Regulations 2012 (HMRs), allowing dental hygienists and dental therapists to supply and administer certain medications without needing direct oversight from a dentist.
This initiative, started by the BSDHT and BADT back in 2013 and developed over the past 11 years, aligns with the broader goals of the NHS Long Term Workforce Plan, which seeks to enhance direct patient care and free up dentists to focus on more complex treatment issues.
The BSDHT is a strong supporter of these changes, recognising the potential for dental professionals to offer more comprehensive care, consequently increasing the operational efficiency of healthcare teams and improving time management across the board.
Providing context
Following on from a public consultation held between 18 August and 15 September 2023, the amendment aims to authorise dental hygienists and dental therapists to administer specific medicines as part of their regular practice.
The consultation was met with enthusiastic participation, drawing 2,743 responses that reflected
a deep engagement within the dental community and among the general public. An overwhelming 97% support rate from respondents across England, Wales, Scotland, and Northern Ireland highlights widespread approval of the initiative.
Many participants also emphasised the importance of Direct Access, noting that the exemptions would enable dental professionals to maximise this approach by providing comprehensive treatment within their scope of practice.
Currently, dental therapists and dental hygienists must obtain prescriptions from dentists to administer certain treatments, which can interrupt both patient care and dentists’ schedules. The proposed exemptions would allow them to administer specified medicines independently, streamlining the treatment process, enhancing practice efficiency, reducing the need for multiple patient visits, and fully utilising their professional skills.
Future directions
While the response to the legislative changes has been largely positive, there are concerns about ensuring sufficient indemnity coverage and the need for practitioners to possess a comprehensive understanding of how to assess patients and select medications. These challenges underscore the importance of
ongoing professional education and potential curriculum adjustments to prepare practitioners for their expanded roles.
These regulatory adjustments are set to broaden the roles of dental hygienists and dental therapists significantly, aligning with the government’s healthcare strategy to make better use of diverse professional skills across the NHS.
This legislative update is anticipated not only to improve patient care and professional satisfaction but also represents a major shift in the delivery of dental services throughout the UK.
A period of transition
The confirmation of exemptions for dental hygienists and dental therapists to administer certain medications signifies a pivotal moment in oral care provision. As these legislative changes approach full implementation, they promise to create a more streamlined, autonomous, and comprehensive oral care system that benefits both patients and dental professionals directly.
Following the consultation, the Department of Health is committed to progressing amendments to the HMRs, aiming to implement these changes by year’s end. The BSDHT will continue to guide its members through these changes and encourages all to stay informed via updates and future communications. n
Middleton, Dental Therapist and Founder of London Hygienist
• A dentolegal advice line, with out-of-hours advice available for emergencies 24/7, 365 days of the year
• A huge range of CPD, including live webinars, online modules, and more
• Help responding to and resolving patient complaints
• Access to our confidential counselling service to support you through stressful situations.
Gaining new powers
Fiona Sandom and Michaela O’Neill explain how new powers for dental hygienists and dental therapists will benefit the profession recount their work on getting the legislation to this point
As announced in March, the Department of Health and Social Care plans to streamline processes within dental settings by granting ‘new powers’ to dental hygienists and dental therapists, which will enable them to supply and administer medicines, including pain relief and fluoride –without sign off from a dentist.
In light of this news, Smile Oral Health Matters caught up with Fiona Sandom, Past President of the British Association of Dental Therapists, and Michaela O’Neill, Past President of the British Society of Dental Hygiene & Therapy, who were instrumental in bringing the legislation to this point.
What do the new powers granted to dental hygienists and therapists mean for the profession?
Fiona: It means that direct access is truly available for patients to see a dental hygienist or dental therapist, something that has not been 100% possible until now. We will have autonomy to treat our patients without them having to see a dentist first. We will be able to supply and administer prescription only medicines. The most important prescription-only medicine we need to use is local anaesthetic so that patients can have treatment pain free. Michaela: Whereas we have been able to use these medicines for many years, the processes in order to do so have been problematic. In my view, these powers have simplified the whole dental team’s working life and added a huge benefit to patients. This legislation is another step to true autonomy as a clinician, which will empower the profession, providing job satisfaction and ultimately benefit our patients.
How will this improve patient access?
Fiona: It will improve patient access considerably as a dentist will not have to see the patient first. Even in practices that have a Patient Group Directive (PGD) in place, it means patients that fall into the exclusion criteria can still be treated by the dental hygienist or dental therapist. It also means that dentists will not
have the administrative burden of writing Patient Specific Directions (PSD).
Michaela: BSDHT carried out a survey of the profession in 2014 and asked how many had turned a patient away because of the lack of an appropriate prescription. The majority of the 400 respondents had.
Asking someone to return to the practice at a later date has an impact on their time, costs and disease levels, and equally on our appointment times and finances. During the process for Exemptions, we had an impact assessment carried out that estimated a saving of £18 million on wasted time for both the profession and patient. The use of the Exemptions mechanism will not only avoid this but will allow for direct access to be finally used to its potential.
How long has this been in the making and how much work have you both put into getting to this point?
Fiona: We began this project in early 2014. There were at least four years of very intense meetings and requests for information and reposts, with some very short deadlines. I remember one Mother’s Day that we both were working on the case of need…
Michaela: I started at 5am that Mother’s Day in order to spend the day with my kids but I was still in my dressing gown at 8pm that evening, with very disappointed children. Fiona and I were writing the document on one screen while FaceTiming on the other.
Part of my ambition as President of BSDHT was to continue to remove the barriers to direct access. I had initial conversations with the Department of Health in 2013, as did Fiona. When we decided to join forces on this project, I didn’t realise what a benefit that would truly be as I couldn’t have completed the workload on my own.
The key piece required to start the legal process was a case of need. This document was extensive and the amount of research, drafting and sheer number of hours that went into it was equivalent to completing a Masters.
We have many people to thank for their help and support. Namely our families. They were so
supportive, and made huge sacrifices in order to support us in this project. On the upside my husband is now a much better cook!
There is no start date yet, do you foresee any stumbling blocks?
Fiona: While there’s no start date yet, and a general election in July, the amendment has been through the required process, so there should be no blocks. This project has kept going through Brexit, several Prime Ministers, a global pandemic, and Northern Ireland without a Government. Although, I won’t believe it until it is finally over the line!
Michaela: I think we have both had so many false starts with this process that we will be cautious until the legislation is finally in our hands.
Why should dentists and all other DCPs be receptive of this news?
Michaela: Honestly, dentists should be delighted that they won’t have me knocking at the door looking for a prescription to carry out treatment. The number of times I have had to do that are innumerable, and I know I wasn’t the only one. This always has such an impact on the patient and the rest of the team.
Would you be happy being sent away without treatment? We have been successful with Exemptions because we could demonstrate how this will benefit patients and happy patients will have a positive effect on the whole team.
Fiona: It will change all our working practices for the better. There will be less administration for the dentists, autonomy for dental hygienists and dental therapists, a safer environment for patients, and cost effectiveness for the practices and the NHS.
What else do all DCPs need to know?
Fiona: Embrace this! Just remember to undergo the education and training and inform indemnifiers.
Michaela: Of course, it isn’t compulsory to use this mechanism but if you want to truly experience your role, make sure you gain the appropriate training and indemnity, as Fiona says, as well as support from your professional body. n
BioMin® F toothpaste increases acid resistance of teeth by 1000%
BioMin® F is the only toothpaste that delivers low level Fluoride with Calcium and Phosphate ions continuously for 12 hours after brushing. These combine to form Fluorapatite on the tooth surface ensuring the teeth are 10 times better protected to survive acid attack and therefore less prone to decay.
Soluble Fluoride, used in all other toothpastes, is rapidly washed away by saliva and has little clinical benefit just over an hour after brushing.
BioMin® F solves the problem of traditional soluble Fluoride toothpastes.
BioMin® F bioglass is the result of 15 years research and development at Queen Mary’s University, London. Uniquely, this slowly dissolving bioactive glass adheres to tooth structure releasing optimal proportions of Calcium, Phosphate and Fluoride ions over a 12 hour period after brushing. In contrast traditional Fluoride toothpastes contain soluble Fluorides which are rapidly washed away by saliva and ingested.
Bioglasses in toothpastes
Developed over 20 years ago, NovaMin® represents the first generation bioglass used in toothpastes though it was not originally developed for this purpose. It had initially been formulated for bone grafting. Only later was it used in toothpastes because of its adherent and slow dissolving capabilities to release Calcium and Phosphate. It does not contain Fluoride nor optimum proportions of Calcium and Phosphate minerals.
First generation NovaMin®, the active ingredient in Sensodyne Repair and Protect, is a bioglass without Fluoride. Repair and Protect incorporates additional soluble Fluoride which rapidly washes away like all other saliva soluble Fluoride toothpastes.
In contrast, BioMin® F represents a more advanced second generation bioglass, which has been specifically developed for dental applications and
is uniquely formulated to slowly release Fluoride, Calcium and Phosphate ions over a 12 hour period after brushing. It facilitates rapid and continual production of stable, acid-resistant Fluorapatite within dentinal tubules and on tooth surfaces.
BioMin® F with controlled release Fluoride facilitates constant Fluorapatite development on the tooth surface, which increases the acidresistance of natural tooth enamel by 1000%. All other toothpastes contain soluble Fluoride salts that are rapidly washed away providing far less protection.
The Fluoride 1350, 1450 and 1500 misconception
Some wrongly believe that the optimal toothpaste should contain 1500ppm of Fluoride. This figure is not based upon optimal clinical benefit, but is simply the legal maximum a toothpaste can contain without having to comply with more onerous product registration requirements. No manufacturer
can add more Fluoride to a toothpaste without a Pharmaceutical Product Licence. Manufacturers add as much soluble Fluoride as they are legally allowed to in order to maximise preventive properties before the Fluoride is washed away. BioMin® F does not have this problem because of its controlled continuous release of Fluoride with Calcium and Phosphate. Brush twice a day with BioMin® F and Fluoride is ever present doing a fine job!
BioMin® F – Safer than high Fluoride toothpastes
The higher the Fluoride content the greater the risk of Fluorosis by accidental imbibition, especially amongst children and people more prone to swallowing their toothpaste.
With its dramatically lower 530ppm Fluoride content this risk is minimised, whilst still delivering 12 hour Fluoride protection!
Brush twice daily for 24-hour Fluoride protection and reduced sensitivity
BioMin® F has been formulated to contain Fluoride, Calcium and Phosphate ions in the optimum proportion for rapid remineralisation. What’s more, as the oral pH decreases after consumption of sugary and acidic food and drink, the bioactive glass dissolves quicker, resulting in even faster release of these minerals, which in turn neutralises acid helping to stabilise the pH further and helping to protect the teeth from decay.
BioMin® F bioglass particles are engineered to be 60% smaller than those found in NovaMin® products, resulting in less abrasivity and deeper penetration of the dentinal tubules with acid resistant Fluorapatite. So, the formation of Fluorapatite is not just on the surface of the teeth, but also deep within the dentinal tubules. The tubular occlusion achieved with BioMin® F is much more resistant to dissolution, providing more effective and longer-lasting relief from dentine hypersensitivity. No other toothpaste can deliver such effective remineralisation of teeth and longterm protection against dentine hypersensitivity, no matter how much they spend on expensive machinery and advertising!
Published research shows that BioMin® F outperforms other sensitivity toothpastes in its ability to block dentinal tubules, resulting in superior and long-lasting sensitivity relief (Studies available upon request).
For further information visit the Trycare website, www.trycare.co.uk/biomin, contact your local Trycare representative or call 01274 885544. n
Take part in National Smile Month
National Smile Month is one of the longest-running oral health campaigns in the UK. The Oral Health Foundation could not have achieved this enormous success every year without your help. National Smile Month offers dental professionals the opportunity to raise awareness about the importance of good oral health, promoting healthy messages to patients and the local community. This year’s campaign theme is “Love Your Smile” – and here are just a few of the ways you can get involved.
Refresh your dental practice!
Join in with thousands of dental practices who revitalise their dental practice during National Smile Month with vibrant displays and informative posters. A strategically placed pop-up stand in your waiting room can serve as a powerful conversation starter.
Make your stand engaging with colourful bunting, a Smiley photo frame, or even one of our comprehensive 2024 campaign packs, equipped with everything you need for a successful display.
Each week of National Smile Month has a unique focus for your team to delve into and they are perfect for tailoring your displays to.
• Week 1: Caring for Your Smile.
Highlight the importance of daily hygiene routines and their benefits for patients’ smiles. Showcase the influential role of the dental team in helping patients achieve good oral health.
• Week 2: Food and Drink. Discuss how diet directly affects oral health. Explain what happens to teeth, tongue, and gums when patients consume certain foods and drinks, distinguishing between the good and the bad.
• Week 3: Confidence and Mental Wellbeing. Explore how a healthy smile can boost selfesteem and confidence. Discuss the mental health benefits of a healthy smile and provide tips on how patients can love their smiles more.
Week 4: Disease and Conditions. Educate about the link between oral health and various physical and mental conditions. Discuss common oral health diseases and preventive measures that patients can take.
Week 5: Oral Health Products. Guide patients on the oral health products they need for a healthy smile. Discuss different products, their usage, and their effectiveness in maintaining oral health. All display resources can be purchased from our online shop at www.dentalhealthshop.org. All proceeds contribute to our charity’s mission of promoting oral health.
Reaching out through social media
As dental professionals, we have a unique opportunity to make a significant impact during National Smile Month. Harnessing the power of social media, we can extend our reach beyond our patient base and into the wider online community. This initiative is not just about promoting oral health, but also about fostering team spirit and unity within our practice. Imagine the entire team coming together, brainstorming creative ideas for posts, and sharing their passion for oral health. It’s a fantastic team-building exercise that also serves a greater purpose. Use the downloadable content available on the National Smile Month website to create engaging and informative posts. This resource is completely free and designed to help us spread positive oral health messages effectively. But why stop there? Let’s make this campaign even more
interactive and fun by incorporating the iconic ‘Smiley’ into your posts. These Smileys, available in the online shop, are perfect for photos and can add a touch of joy and positivity to your messages.
Don’t forget to use #SmileMonth in your posts and let’s make a difference, one smile at a time. Remember, every post we make, every ‘Smiley’ we share, helps to raise awareness of oral health. And who knows? We might even inspire someone who isn’t a patient yet to take that first step towards better oral health.
Practical activities for everyone
There are lots of fun activities that you can take part in the National Smile Month.
One of our most popular activities has always been ‘The Great British Brushathon’. On Monday 13th of May 2024, The Great British Brushathon will connect people from all around the world in one giant communal toothbrushing event.
All you need to do is take a selfie whilst brushing your teeth and post it to social media. Alternatively, if you want to get a bit more creative you can film a video of yourself brushing and you can get your staff and patients involved too.
Do not forget to include the hashtags #SmileMonth and #GreatBritishBrushathon and tag three other people to keep the chain going. Let us know if you are planning to take part and we can look out for and share your post.
During National Smile Month, many dental practices also seize the opportunity to extend their impact beyond their practices by visiting local schools. They deliver
invaluable lessons on dental health, utilising our free Dental Buddy programme (available online). This programme offers a wealth of resources, including lesson plans and activities tailored for Early Years Education, Key Stage One, and Key Stage Two.
No matter how you choose to participate in this year’s National Smile Month, your efforts are greatly appreciated. On behalf of all of us at the Oral Health Foundation, we extend our heartfelt thanks to you. Here’s to making this year’s campaign the most successful one yet!
Revitalising your career as a dental professional
Megan Fairhall shares how she revitalised her career after the dual challenges of Covid-19 and maternity leave
Irevived my own career after some significant life changes. Firstly, the Covid-19 pandemic happened, which impacted all of us in the dental industry. I then had my daughter two years ago. Taking maternity leave can be really daunting and scary, and returning to work when sleep deprived was a challenge. My own self-care became secondary and I had a lot of mum guilt about leaving my child, but I also had to work to earn money to pay for my child - not to mention wanting to resume my career. The majority of clinicians are self-employed and there can be very little support. I felt it was important to maintain my place in the industry, so I looked at how I could work differently.
There’s a very high percentage of burnout within dentistry. We’re working long hours. It can be exhausting being back to back with patients, and taking on their anxieties and stresses all day long, along with running a business and a household. So you might be looking at cutting down your clinical hours, and wondering how you can work smarter and not harder. How can you change things? How can you build on that and create a career that you actually really love?
Teeth whitening has help me revolutionise my career. I offer both 6% hydrogen peroxide in-chair whitening and at-home whitening trays, which uses 6% hydrogen peroxide, 10%
carbamide peroxide or 16% carbamide peroxide. It’s nice to be able to offer different treatment options. I use Philips Zoom whitening, and patients will often seek out the procedure with me from another practice because they want Zoom whitening.
Teeth whitening has helped shape my career and comeback. We know that teeth whitening is the most requested dental treatment. It’s safe, it’s effective and has long lasting results. It really does work. Teeth whitening is minimally invasive, so we’re not destroying or removing any tooth tissue, meaning it’s a positive experience for our patients. The impact it has for patients and their confidence is huge. I feel very lucky
Powder therapy with a difference
NEW SOFTpearl supragingival, glycine-based powder is designed for use with NSK’s ProphyMate neo and Varios Combi Pro powder therapy devices to gently remove moderate supragingival staining.
The reason I love SOFTpearl is because it has a subtle difference to similar supragingival powders - it dissolves in water. This makes clean up faster, helps to make patients feel more comfortable and keeps suction and amalgam separators clean and functional.
Listen to Cat Edney’s review of SOFTpearl
NSK’s compact and portable Prophy-Mate neo makes supragingival powder therapy with SOFTpearl easyquickly and safely removing moderate staining with 360° rotation and 60° and 80° nozzles to gain access to all areas.
NSK
Combi Pro combines ultrasonic scaling and powder therapy for effective and comfortable biofilm control. Its detachable chambers and handpieces make it easy to switch between supragingival and subgingival application without the risk of powder mixing or powder entering the control unit.
Cat Edney DT PgDip (Dist)
The
Varios
Varios Combi Pro
Prophy-Mate neo
that whitening is now the predominant focus of my career.
Offering whitening treatments can vary your day and expand your scope of practice. It’s a really positive treatment, as patients are very excited about it. When your patients are happy, it makes a big difference to your day. Teeth whitening can increase earnings too. It’s a higher priced value treatment, particularly when you’re adding scans to the end of your hygiene appointment and appointments don’t need to be very long. The increase in whitening has helped me cut down my clinical hours but earn more money.
Nurturing our existing patients is key to patient retention. We ask patients what treatments they are interested in having, and it’s a simple way to cross over to teeth whitening. We assess the patient’s tooth colour and advise them of their current shade, diagnose their whitening potential and recommend the products that may fit their lifestyle. Sometimes that might just be an Airflow or Air Polish, but we always
discuss aesthetic treatments. I believe that with every single type of aesthetic dental treatment, from veneers to composite bonding, whitening provides the underlying basis. We take photos of every single patient, and showing what whitening could do for their smile is eyeopening for them.
The first thing I did after returning from maternity leave was work on a big rebrand. I redid my website and social media. I felt like a different person, and I no longer resonated with my previous branding. I took a step back and reflected on who I am now, and what did I want to portray to the world. The process was so cathartic. I worked with my designer to strip back to the values of who I am as a person and as a clinician. I’d really recommend doing something like this if you feel like you’re trying to find yourself again.
I felt nervous when I returned to work from maternity leave, and it’s taken me nearly a year and a half to rebuild things. Things are advancing so quickly, especially with AI in
dentistry. You may feel like you’ve been a bit left behind if you’re not up to date with all the technology. There might be changes in laws and regulations, and there’s the challenge of keeping on top of your CPD and your GDC registration too. I would advise that you keep your registrations, especially if you’re just taking a short period of time out as it’s quite hard to reregister sometimes, and it’s a lot of work. I know it seems like a chore keeping on top of your CPD, but I think it’s good to keep your hand in and keep your brain working. These are all challenges that we face as we enter the next stage in our careers.
Looking at your time management is one way to work more effectively. Can you delegate any tasks? It’s hard to give up control, but once I did I realised it was to my long-term benefit. Clinically, I definitely utilise my nurses more. I have meetings with my treatment coordinators every month, and review our patient plans. All of my teeth whitening patients get put onto a whitening tracker, and we can monitor
them moving forwards, contacting patients for hygiene exams and whitening top up syringes. I’ll message my TCOs in the week and ask them to message patients that need booking in, whereas before I was doing all of that myself.
I also now have a social media agency which I use to run my social media channels for me. I still have control over what I share, and I still post myself, especially on my Instagram Stories. But now I have a schedule and we plan things, there’s more of an agenda to it. Giving that up has given me a lot more freedom and headspace. There is a lot of pressure to post on social media, and it takes a long time. You don’t just put out a quick post, you have to write the copy, create the content. It can take a long time, especially if you’re a bit of a perfectionist like me. But I know when I do it right it helps develop my brand, and brings new patients through the door. It helps grow my whitening courses, which is a real passion of mine. So delegating that task has really given me a lot of headspace back. I would recommend utilising technology to help you use your time more effectively. I try to scan as many patients who are interested in teeth whitening as possible. That way we don’t need to bring them back in for another appointment and to do impressions. My nurses can do the scanning too, which is a great way to delegate. I try and upskill myself all the time. Doing this can help you create a day you love. Is there a treatment you enjoy doing? How can you skill yourself to do more of it? I do training with my team – it’s important to invest in your staff. If a prospective patient phones and enquires about teeth whitening, my team have had teeth whitening themselves so can speak about it on a first-hand basis, and they have done lots of training about whitening too, so they know everything there is to do, and can streamline the booking.
Increasing your free time may also give you the opportunity to explore other options in dentistry. My time isn’t solely spent in clinic, and having a few different strings to my bow allows be to have different income streams as well. It’s important to take time for yourself, and regroup and rejuvenate. It can be very hard to ask for help, but trying to do everything yourself leads to burnout. Lean on people when you need them and focus on your pillars of wellness. n
ABOUT THE AUTHOR
MEGAN FAIRHALL
Megan is a leading dental hygienist and therapist. She has developed her own dental brand #LIVETOSMILE, utilising social media and online marketing to attract new patients, focusing particularly on teeth whitening treatments; an element of dentistry for which she has discovered a real passion.
For dry mouth – when just water is not enough
New
1 in 5 suffer from dry mouth, and water is usually the standard remedy. But for many people, water only provides brief relief.
TePe’s new hydrating mouthwash and mouth gel ease the feeling of dry mouth, provides comfort, and protects teeth. We recommend the gentle, unflavoured products for those with a very dry mouth and mildly flavoured products for those with moderate problems.
TePe® Hydrating Mouthwash - TePe’s mouthwash moistens the mucosa and leaves a pleasant feeling in the mouth. Not only does it help with dry mouth, but the added 0.2 % fluoride also gives that extra protection against caries.
TePe® Hydrating Mouth Gel - TePe mouth gel gives immediate and long-lasting comfort*, moistens and soothes the oral mucosa and is convenient and easy to use whenever needed – great for on-the-go.
Available from dental wholesalers. Find out more at tepe.com.
Building good habits for better dental health
Daily interdental cleaning is recommended by the NHS, as it helps manage the build-up of biofilm, and can reduce the likelihood of developing gingivitis and periodontitis.
However, in a recent UK survey, only 37 percent of those aged 55 and over claimed to floss their teeth daily, and just 18 percent of 18 to 24-yearolds. It seems the interdental cleaning habit isn’t sticking here in the UK.
Dentists know that the best chance of successful oral health in adulthood is given by building up positive dental care habits, including interdental cleaning, in childhood. Even if we were lucky enough to have had this instilled when we were growing up, the challenges around building certain healthy habits is something all of us can relate to.v Maintaining a robust dental care routine, including interdental cleaning, can be even harder for some patients with impaired executive function.
Executive function and oral health
Executive functions are the high-level cognitive processes that govern one’s approach to adapting behaviour beneficially to circumstances. They affect the ability to problem-solve, make decisions or meet goals. A person with impaired executive function will struggle to connect tasks in the shortterm to their longer-term benefits, and so can be at a disadvantage when attempting to form favourable routines.
The causes of executive function disorder (EFD) are not always clear; however, studies show that neurological conditions like Attention Deficit Hyperactivity Disorder (ADHD), and Adverse Childhood Experiences (ACE), as well as mood disorders are factors. It’s no coincidence that patients with these conditions are more likely to suffer from poor dental health.
ADHD is a complex condition, but those with the condition may particularly struggle with forming and maintaining habits, no matter how beneficial. Symptoms are characterised by lack of attention, hyperactivity and impulsiveness, and it is very difficult for patients with the condition to foresee outcomes in any given scenario, both positive and negative. According to some researchers, the ADHD brain is in a state of ‘reward deficiency,’ related partly to differences in dopamine function. As a result, people with ADHD can be focused on short-term sensation rather the benefits of delaying gratification.
Many studies have looked at the connection between ADHD and oral health. Adolescents with ADHD are particularly at risk, as they have a significantly higher incidence of dental caries and gingival bleeding than those without the condition. To maintain gingival health, young patients with ADHD need more attention from dental professionals and those responsible for their diet and oral hygiene.
Oral health suffers where there have been ACEs. Particular connection between poor oral health and childhood neglect and abuse has been noted by researchers. Where there has been neglect of basic care, children can develop a range of
For more information on Waterpik ® Water Flosser products visit www.waterpik.co.uk. Waterpik ® products are available from Amazon, Costco UK, Argos, Boots, Superdrug and Tesco online and in stores across the UK and Ireland.
disorders, many of which affect executive and cognitive functioning. Survivors of ACEs may present with a spectrum of oral health problems including erratic dental hygiene patterns, tooth loss, dental pain, periodontal diseases and dental anxiety in adulthood.
Executive dysfunction can accompany mood disorders as well as other psychiatric conditions. Individuals with mental illnesses are more likely to suffer from poor dental health; many common depressive symptoms, such as anhedonia or a lack of motivation, feelings of worthlessness, and fatigue, may adversely affect an adult’s ability to maintain regular habits around oral hygiene.
Building good habits
It’s never too late to work on improving executive function, even in patients with EFD. In cases of extreme impairments, medication might be considered, with cognitive behavioural therapy recommended to teach behavioural strategies and emotional regulation techniques.
Psychologists advise a gradual approach to building healthier patterns of behaviour, starting with small and simple changes, building new habits into existing routines, and incorporating rewards, making them immediate and pleasurable.
Anyone who has used a Water Flosser can attest to the simplicity – as well as the fun-factor – of incorporating it into a daily routine. The Waterpik® Water Flosser, accredited by the Oral Health Foundation, is also effective in removing up to 99% of plaque from dental areas, and is up to 50% more effective in improving gum health than string floss. The Waterpik® Cordless Advanced Water Flosser comes in an attractive range of lightweight, convenient and easy-to-use units. It is also rapidly rechargeable, ultra-quiet, powerful, portable, and easy to use, making it an easy addition to patients’ daily routines. It even be used it in the shower.
Clinicians may struggle to help patients incorporate regular, interdental cleaning into their daily oral care routines. Anything that helps improve dental health by making good habits easier and more appealing is to be embraced. n References available upon request
ABOUT THE AUTHOR
SUSAN HUTSON
Susan joined Waterpik as a Professional Educator over 4 years ago.
Susan graduated from Eastman Dental Institute School of Dental Hygiene in 1988 and now has over 30 years clinical experience working in Harley Street, specialist and orthodontic practices. Susan has a particular interest in treating periodontal patients and regularly encourages her patients to use the Waterpik water flosser to help maintain their periodontal health.
Susan lives in Buckinghamshire with her husband and 9 year old son. She is a fitness fanatic and keen runner, having completed many marathons and half marathons.
Lupus – an autoimmune disease with profound consequences
Lupus (systemic lupus erythematosus, or SLE), is a chronic autoimmune condition that causes inflammation, and can damage any part of the body. The cause is currently unknown, although research has indicated that genetics, hormones and certain infections, including viruses, may be factors. Symptoms may vary, but patients often experience joint pain, painful facial rashes, hair loss, oedema, pain when breathing deeply or lying down, headaches, depression, abdominal pain, sensitivity to the sun and a high incidence of oral health problems.
Inflammation in the body caused by SLE can have a devastating impact on a patient’s overall health, in severe cases affecting kidney function, damaging the brain and central nervous system and affecting cardiovascular health.
With such a long list of possible symptoms, as well as periods of remission between flare-ups, lupus can be difficult to diagnose. No single test can detect the condition, so a number of blood and kidney function tests are used. There is no cure, but a combination of treatments can be effective in managing many of the symptoms.
SLE commonly affects adult women, more than men by 9 to 1. It is thought that currently up to 50,000 people in the UK have the condition. Lupus affects people of Afro-Caribbean, Asian and Hispanic heritage more than other populations; a study in the US found that African American women had almost twice the prevalence of SLE as white women.
Lupus and oral health
Lupus affects every bodily function, so it’s no surprise that the condition can significantly affect patients’ oral health, greatly impacting their oral health-related quality of life (OHRQoL).
Because of additional risks to oral health, careful dental care routines and frequent dental visits are vital to protect sufferers. However, visits to the dentist can be a challenge for many patients with SLE. The condition is associated with high risk of metal delayed-type hypersensitivity, including nickel, gold and mercury, often present in dental materials. Use of fluorescent light, such as surgical lighting, can also cause flare-ups due to an increased risk of photosensitivity.
Oral lesions occur in more than 40% of people with SLE. In some cases, non-treatment of oral ulcers carries an increased risk for development of cancer. Development of oral shingles is also possible. Shingles (herpes zoster, or HZ) is reported as the most prevalent viral infection in patients with SLE.
Saliva dysfunction and oral microbial changes are a common symptom of lupus, leading to a high incidence of caries development in patients. Studies have shown that about 79% of patients with SLE suffer from hyposalivation, and xerostomia is a common side effect of the condition. The decrease in salivary flow rate in SLE may be the result of secondary Sjogren’s syndrome, a condition affecting saliva production, which often accompanies immune system disorders. Xerostomia carries with it a number of risks to oral health. Saliva supports oral hygiene, providing lubrication to condition teeth and wash away food particles, keeping the oral cavity moist and clean. Salivary amylase helps to initiate the digestive process, and mucin and immunoglobulin in saliva protect the oral mucosa from microbial infection.
When saliva production is affected, gingivitis and periodontitis, dental caries, halitosis, fungal infections (candidiasis), and accelerating enamel erosion can occur.
Inflammation, periodontitis and lupus
Studies have also shown that SLE carries a significantly increased risk of periodontitis. The inflammatory condition is generally preventable through exercising good oral hygiene, however, once inflammation extends to the periodontium, the risk of bone loss, infection and tooth-loss increases.
Studies clearly demonstrate an association with periodontal disease and the development of several autoimmune inflammatory conditions, including SLE. A causal link is difficult to prove, but there is a clear prevalence of poor oral hygiene and periodontal disease in patients presenting with symptoms of lupus.
Managing a complex condition
Lupus is a complex condition to manage. Maintaining periodontal health with increased attention to daily oral hygiene is very important element of this. Frequent tooth-brushing is fundamental for maintaining oral health and reducing the formation of biofilms. However, research has shown that brushing alone may only remove 42% of plaque. Dental professionals are encouraged to educate patients on the added importance of interdental cleansers.
FLEXI interdental brushes, used with PREVENT GEL from TANDEX are an ideal system for maintaining periodontal health. The FLEXI interdental brushes come in 11 different sizes, and the flexible brush can be shaped to reach all the gaps that a toothbrush can’t reach. The addition of PREVENT GEL supports patients who have impaired saliva production, containing chlorhexidine and fluoride to strengthen enamel and protect against bacteria.
Patients with autoimmune diseases like SLE have been shown to suffer disproportionately with poor oral health, and have been shown to have a greater risk of periodontitis. Educating patients with lupus on the importance of interdental cleaning helps them manage the additional risks to their oral health.
For more information on Tandex’s range of products, visit https://tandex.dk/
Our products are also available from CTS Dental Supplies: https://www.cts-dental.com/ n
References available upon request
ABOUT THE AUTHOR
JACOB WATWOOD ON BEHALF OF TANDEX
Jacob Watwood is a registered dentist.
An easier and more sustainable option for all patients
Interdental cleaning is a crucial aspect of every oral hygiene routine. Removing the build-up of bacteria in between the teeth helps patients to keep their mouths healthy, prevent disease, and reduce any bad odours. Consistent motivation and encouragement is key for helping patients to clean interdentally every day, providing them with the knowledge and skills they need to carry out effective cleaning.
Conventional tooth brushing is simply unable to reach the interdental spaces, and is less effective for patients who have orthodontic appliances, for example, so it’s important to provide each patient with the unique recommendations they need to improve their oral hygiene.
Making it easy
Some patients may be put off by the recommendation that they floss, associating the practise with fiddly and time-consuming cleaning, which can be very difficult for many people. As such, it’s important to discuss the various options for interdental cleaning with patients, and find the best solutions for them. While traditional string floss is able to fit in between the teeth and clear away some of the bacteria, it cannot reach every surface of the
interdental space.ii It might remain a good option for the anterior teeth for some patients, as string floss can only clean the surfaces which have a uniform shape. However, this makes much of the bacteria unreachable when cleaning in between the posterior teeth.
Interdental brushes from Curaprox are a fantastic option for many patients, allowing them to easily move the brush in and out of the interdental spaces and thoroughly remove bacteria, plaque, and debris. For the best results, assist patients in finding the right size brush for each interdental space, providing a sizing chart to help them keep track of the best brushes to use in each area of the mouth.
Implants, braces, and oral appliances
Curaprox interdental brushes are also a great choice for patients who are undergoing or have undergone dental treatments. For example, those with fixed orthodontic appliances are likely to find it difficult to clean in between their braces and their teeth, with plaque and debris building up over time. Interdental brushes can allow them to eliminate this, easily cleaning the areas which are traditionally difficult to reach.iii It’s vital to maintain excellent oral hygiene during orthodontic treatment, to help achieve the best possible results, and to reduce the risk of disease in the teeth and gingiva.
Similarly, interdental brushes can be very helpful to clean around dental implants and oral appliances such as bridges. Removing bacteria is essential for reducing the risk of peri-implantitis and periodontitis, respectively, in these cases.
Be kinder to the environment
CPS interdental brushes from Curaprox are the ideal solution for patients looking to improve their oral hygiene. The brushes feature superfine, extra-long, ultra-resilient filaments, which offer effective and gentle cleaning
with a single brush action. Available in a wide range of sizes, the CPS range has the right interdental brushes for everyone – including those with natural teeth, implants, narrow spaces, larger spaces, crowns, and bridges –making interdental cleaning simple. What’s more, the CPS range of interdental brushes uses the Curaprox Click System, which makes daily oral hygiene routines kinder to the planet. Interdental brush heads are available in environmentally friendly refill packs, which work with all Curaprox interdental brush holders. Patients need simply click the old brush head away, and click the new brush head on. This means that the handle can be used again and again – a convenient solution for less waste.
And, as brush head refills are compatible across all Curaprox handles, patients have the freedom to choose the best solution for them. This includes the choice between a long or a short handle, enabling them to access those hard-toreach spots in the mouth.
Effective interdental cleaning for all
Maintaining a clean mouth is essential for staying healthy and preventing dental problems in the long term. As such, it’s important to explain the significance of interdental cleaning to each patient, and ensure they feel comfortable carrying it out daily, as part of their routine. Curaprox interdental brushes are the ideal solution, offering all patients an easier and more sustainable option for interdental cleaning.
For more information, please visit www.curaprox. co.uk and www.curaden.co.uk
References i. https://curaden.com/#studies ii. https://gently.curaden.com/interdentalbrushing-everything-you-need-to-know/ iii. https://curaprox.ch/en/info/interdental/ interdental-brush n
COMPOSITE MAINTENANCE MASTERCLASS
28 JUNE 2024 9:30AM-4PM
Join Teki Sowdani and Laura Bailey for a transformative masterclass in composite maintenance, sponsored by EMS.
WHY ATTEND?
Expert guidance from industry leaders. Practical insights for long-lasting results. Strategies for business growth. Networking opportunities with peers.
Don't miss out! Elevate your practice with Composite Maintenance. Scan the QR code to book your spot.
Sponsored by
Laura Bailey
Teki Sowdani
Plastics and dentistry – what can be done?
Dentistry has become a field dominated by plastics. They are everywhere you turn and are used in hygiene appointments, clinical surgeries, and so much more.
As part of a dental practice’s environmental and disposal responsibilities, plastics are a concern. Taking a wider look at plastic use and disposal in general, the European Environment Agency estimates that only 9% of the plastics ever produced have been recycled, 12% have been incinerated, and the rest are either in use, in landfill, or in the environment.1
Dental professionals should review their daily workflows and find ways to decrease their plastic consumption and potentially damaging disposal methods. The contribution to pollution has been judged by some to be in contention with the philosophy of ‘first, do no harm’.2
Plastic in the practice
It’s important to first assess where plastic appears in the dental workflow. Most often it is through singleuse items. In a routine adult primary care dental procedure in the UK, an average of 21 single-use plastic items are employed. 3 Gloves, masks, wipes, autoclave/sterilisation sleeves, and tray liners are amongst these, and more than one of these items is generally needed for each average procedure. 3 These add up fast. Conservative estimates say 720 million dental single-use plastic items end up as waste in the UK every year.4
Creating environmentally friendly solutions may mean, where possible, substituting single-use plastics for alternatives that are made of sustainable materials. After all, if you cannot continue dentistry without an item – for example, PPE – the only approach is to change the type of product. Some dental-specific, sustainable solutions are already available to clinicians and patients alike, but understanding the disposal process attached to each product that is traditionally made from plastic will allow you to identify where changes can have the greatest impact.
Disposal management
The Health Technical Memorandum 07-01 (HTM 07-01) is an excellent source of advice and information on improving your principles of sustainable waste management. Some of the examples of good practice that it seeks from healthcare teams include: sourcing products derived from recycled materials, prioritising the use of reusable products over single-use products, and, where safe to do so, investing in alternatives to single-use items.5
It also includes instructions on where items can or cannot be directed for disposal. Within the colour coding guide, it states that some domestic waste, recyclable waste, and confidential waste can all be sent to recycling.5 However, other products of the dental workflow, including photo-chemicals from X-rays and some offensive waste, are also listed as recyclable too.5 Dental professionals should consult their waste management service to ensure they can safely manage refuse in this way.
So, what items can be redirected to a recyclable waste stream, rather than destined for incineration
or landfill? One common stumbling block for some practices is the single-use wrapping that protects sterilised equipment before use. Whilst seemingly innocuous and small, it is a case of plastic waste that will add up over time. By recycling these wrappers before they came into contact with a contamination source, one observed practice saved up to 5kg in waste per week.6
Over a year, by just avoiding sending these wrappers to incineration, a practice could create an estimated saving of 0.55 tonnes of CO2 equivalent.6 Apply this further to single-use plastics that create offensive waste, such as PPE, and the savings could only expand. Remember, until such an item is actively contaminated with infectious fluids, chemicals, or radiation, it is considered offensive –and therefore potentially recyclable – rather than hazardous or infectious.5
Alternative solutions
Whilst you work to improve your disposal workflows in the dental practice and identify further opportunities to recycle plastics, you should consider the types of products you use and recommend every day.
In the dental practice itself, HTM 07-01 suggests, where appropriate, that you replace disposable cleaning wipes with handcloths to implement more reusable products.5 You may choose to opt for products made of sustainable materials, and the key place to look may be your disposal solutions. These can often go unnoticed as a potential risk to the environment but are just as important as any other item in your practice.
Choosing an alternative like the new Griff Pac bins from Initial Medical helps you stay green, whilst carrying out effective disposal workflows. Designed to abide by your colour coding waste system, the Griff Pac bins made of corrugated lightweight corrugated polypropylene and are suitable for the disposal of larger volumes of plastics such as suction tips. Choosing the Griff Pac means your practice actively opts into reduced
CO 2 contributions by 25% in production and 40-50% in shipping, thanks to their lightweight and flatpack design. For greener ways to manage your waste, choose Initial Medical.
Some plastic waste in dentistry is unpreventable at this current moment in time. But with the awareness and action taken to improve disposal workflows and choose environmentally friendly alternatives, the dental practice can be a better place for the environment in years to come.
To find out more, get in touch at 0808 304 7411 or visit the website today www.initial.co.uk/medical
References
1. European Environment Agency, (2023). Plastics. (Online) Available at: https://www.eea.europa. eu/en/topics/in-depth/ plastics# [Accessed March 2024]
2. Martin, N., Mulligan, S., Fuzesi, P., & Hatton, P. V. (2022). Quantification of single use plastics waste generated in clinical dental practice and hospital settings. Journal of Dentistry, 118, 103948.
3. Martin, N., Mulligan, S., Fuzesi, P., Webb, T. L., Baired, H., Spain, S., Neal, T. J., Garforth, A. A., Tedstone, A. A., Hatton, P. V., (2020). Waste Plastics in Clinical Environments: A Multi-disciplinary Challenge. Plastics Reseach and Innovation Fund Conference, Creative Circular Economy Approaches to Eliminate Plastic Waste. (Online) Available at: https://www. ukcpn.co.uk/wp-content/ uploads/2020/08/PRIFConference-BrochureFinal-1.pdf [Accessed March 2024]
4. Martin, N., Sheppard, M., Gorasia, G., Arora, P., Cooper, M., & Mulligan, S. (2021). Awareness and barriers to sustainability in dentistry: A scoping review. Journal of Dentistry, 112, 103735.
5. NHS England, (2022). Health Technical Memorandum 07:01 Safe and sustainable management of healthcare waste. (Online) Available at: https://www.england. nhs.uk/wp-content/ uploads/2021/05/B2159iiihealth-technicalmemorandum-07-01.pdf [Accessed March 2024]
6. Richardson, J., Grose, J., Manzi, S., Mills, I., Moles, D. R., Mukonoweshuro, R., ... & Nichols, A. (2016). What’s in a bin: A case study of dental clinical waste composition and potential greenhouse gas emission savings. British dental journal, 220(2), 61-66.
ABOUT THE AUTHOR
REBECCA WATERS
Rebecca is Category Manager at Initial Medical, she has worked in the Healthcare sector for the past 17 years and was a Research Chemist with Bayer Cropscience prior to joining Rentokil Initial in 2003. She keeps up to date on all developments within the clinical waste management industry and is an active member of the CIWM, SMDSA and BDIA.
OOPS!
MY TOOTH FELL OUT!
Single-component, moisture-activated, professionalgrade temporary cement. Available in take-home applicators that are easy for your patients to use.
Prevention and therapy of peri-implant infections
Dr Nadine Strafela-Bastendorf and Dr Klaus-Dieter Bastendorf present an eight-step systematic protocol, from diagnosis to patient-specific recall frequencies, which can also be used successfully as postoperative prophylaxis for supportive implant therapy.
The aim of this article is to present an eight-step systematic protocol, from diagnosis to patient-specific recall frequencies, which can also be used successfully as postoperative prophylaxis for supportive implant therapy
On completing this Enhanced CPD session, the reader will:
• Comprehend the ecological plaque hypothesis according to Marsh and its role in oral diseases, including peri-implant mucositis and peri-implantitis
• Know the eight-step protocol for diagnosing, preventing, and treating peri-implant infections, and know how to apply it in practice
• Understand that the best treatment for plaque-induced peri-implant inflammation is systematic prevention
• Be able to achieve greater proficiency in professional mechanical plaque removal techniques, including the use of various instruments and devices
• Be capable of assessing the effectiveness of postoperative supportive implant therapy (SIT) protocols and understand the role of regular maintenance in preventing peri-implant disease recurrence or progression.
Learning Outcomes: A,C,D
Oral diseases have a multifactorial aetiology, with Marsh’s ‘ecological plaque hypothesis’ widely accepted as the main cause, attributing supraand sub-gingival dysbiotic biofilm as the primary factor. Effective biofilm management both with home care and professional prophylaxis is therefore crucial for preventing and treating peri-implant diseases.
With around 2 million implants placed annually, the incidence of peri-implant diseases has risen. Treatment strategies for peri-implant mucositis and peri-implantitis, adapted from periodontal therapy, emphasise systematic prevention, regular biofilm management, and early detection.
Peri-implant mucositis can be treated nonsurgically, however successful non-surgical treatment of peri-implantitis is more challenging, predominantly because of the difficulty posed by decontamination of the roughened threaded implant surfaces. Nevertheless, like periodontitis therapy, surgical peri-implantitis therapy should be preceded by minimally invasive non-surgical therapy.
When is peri-implant disease present?
Peri-implant mucositis is a biofilm-induced, reversible disease caused by the disruption of host-microbe homeostasis at the implant-mucosa interface, leading to inflammation. Understanding peri-implant mucositis is crucial as it can precede peri-implantitis, a condition marked by inflammation and bone loss around dental implants.
Non-surgical treatment of peri-implant mucositis aims to reduce clinical symptoms of infection, similar to gingivitis treatment, through optimal biofilm management. The goal of non-surgical treatment for peri-implantitis, like periodontitis, is to reduce infection signs using anti-infective therapies. Successful treatments should decrease pocket depth, reduce bleeding on probing (BOP) and suppuration, and stabilise bone levels. While non-surgical methods can improve clinical parameters and help prevent disease progression or recurrence, treated sites often retain residual BOP values and deeper probing depths.
Systematic structured prevention with GBT
In 2015, the EFP’s 11th European Workshop in Periodontology called for increasing importance to be attached to the prevention of periodontitis and peri-implantitis. Answering that call, the Swiss company, EMS, in collaboration with clinicians and academics, adapted and updated the recall session as per Axelsson/Lindhe in accordance with new scientific findings and technical progress.
Guided Biofilm Therapy (GBT) is a risk-oriented, evidence-based, systematic, structured, modular, individual, universally applicable prevention and treatment protocol delivered in eight steps. GBT can also be used for peri-implant infections. Professional tooth cleaning (PTC) or, better put, Professional Mechanical Plaque Removal (PMPR), is a central component of systematic prevention.
Both prevention and therapy of peri-implant infections can only be successful with a systematic, structured protocol. The requirements for systematic protocols (and for peri-implant infections) are:
• Diagnosis (continuous risk factor control)
• Homecare measures (inform, instruct, motivate)
• PMPR/PTC
• Localised subgingival instrumentation at residual pockets
• Regular recall visits.
GBT meets all these requirements and so the following addresses postoperative prevention of SIT (supportive implant therapy) using the GBT protocol. This supportive care for implants is not an isolated individual measure, but rather part of a systematic preventive protocol.
Step 1: infection control / assessment (diagnosis)
Prior to treatment, a mouthrinse with an anti-microbial agent reduces the number of microorganisms released by a patient in the form of aerosols/ backspray mist. These can otherwise contaminate equipment, surgical surfaces, and the dental staff.
Assessment of the findings, diagnosis and resulting disease risk are crucial for successful prevention. Modern digital aids are available for assessment of the findings and documentation of all oral diseases,
including peri-implant infections. These aids not only allow identification and documentation of the current findings and risk factors, but also enable monitoring. To obtain indications of peri-implant infections in good time, the initial situation must be established and documented after insertion of the implant superstructure. Only when compared with the initial values can visual inspection, palpation (secretion or pus discharge), probing depth measurement, BOP (particular prognostic significance for implants), mucosal recessions, and X-ray findings provide the necessary information for timely preventive intervention.
Step 2: disclose
Current literature clearly demonstrates that disclosing biofilm creates more precise plaque indices and achieves better results with homecare and professional biofilm removal.
Step 3: motivate (homecare)
Successful prevention is always made up of the components of at-home and professional biofilm management, the so-called two-pillar model as per Axelsson/Lindhe. An important component of SIT is regular patient motivation and re-instruction by means of informing and instructing, which must be continuously updated and adapted.
The relationship between inadequate oral hygiene and peri-implant bone loss has been described in several studies. The risk of suffering from periimplantitis was considerably increased in patients with poor or very poor oral hygiene.
This means that at-home plaque control around implants is essential, for both primary and secondary prevention, as well as for tertiary prevention of periimplant infections.
Steps 4, 5 and 6: biofilm and calculus management
The removal of inflammatory bacteria (biofilm) is the undisputed goal of SIT. In addition to the mechanical removal of biofilm through homecare measures already mentioned, professional mechanical biofilm management plays a crucial role. Various aids are available for this purpose:
• Special hand instruments
• Brushes and cups in rotary handpieces (rubber cup polishing (RCP))
• Sonic and ultrasonic instruments, and
• Powder-water-jet devices (air polishing).
The goal of the professional procedure is to remove the biofilm completely while being gentle on the tooth substance and maintaining a high level of comfort for patients and clinicians. The terms air polishing and air flowing are often used synonymously, but they differ considerably and must be distinguished from one another.
Both systems work according to the same principle of powder-water-jet technology. Air flowing is a technically, physically and chemically coordinated system (using the Airflow Prophylaxis Master device and Airflow, the Perioflow handpiece, and minimally invasive erythritol-based Airflow Plus powder).
The Airflow Prophylaxis Master is the only device that operates with a constant and regulated powder flow rate and laminar flow, unlike air polishing, which has a turbulent and less regulated powder flow rate.
Step 7: check
Through self-monitoring, the prophylaxis team checks the effectiveness of the treatment performed. This is followed by a checkup by the dentist and documentation of the treatment performed compared to the initial situation.
They evaluate the individual risks of disease, make the final diagnosis, and plan any further necessary therapies. Supervision by the dentist is essential for appropriate delegation in terms of legislative requirements in Germany but may differ in other territories.
At the end of the non-surgical treatment of periimplant mucositis and/or peri-implantitis, local antimicrobial substances (chlorhexidine digluconate (CHX), mouthrinses or sodium hypochlorite) are often used adjunctively.
Step 8: recall
The importance of maintenance therapy for oral health and maintaining the health of peri-implant tissues has long been recognised.
Luengo F et al (2023) found that compliance with a strict SIT protocol keeps the peri-implant tissue healthy after one year, and even improves postoperative results.
Stiesch M et al (2023) impressively pointed out the importance of SIT. The provision of SIT after peri-implantitis therapy can prevent recurrence or progression of the disease. However, there is still insufficient knowledge to determine a specific protocol for the supportive care for tertiary prevention of peri-implantitis, the effect of additional local antiseptic agents, and the impact of the frequency of supportive care measures. The protocols used should be a combination of preventive and therapeutic interventions at regular intervals. They should be matched to the patient's specific needs. GBT offers such a protocol, as all requirements of modern oral medicine are met: GBT is predictive, preventive, personalised, participatory, as well as minimally invasive with maximum effect.
Summary
Derks et al (2015) showed in a systematic review that the prevalence of peri-implant mucositis is 43% and peri-implantitis is 22%. After five years, clinically
CPD Questions
1. According to the article, what is the primary factor in oral diseases, including peri-implant diseases?
a) Poor oral hygiene
b) Dysbiotic biofilm
c) Genetic predisposition
d) Lack of regular dental check-ups
2. What is the primary goal of non-surgical treatment for peri-implant mucositis?
a) Complete removal of the implant
b) Surgical intervention
c) Reduction of clinical symptoms of infection
d) Application of antibiotics
3. What is GBT, as described in the article?
a) General Biofilm Therapy
b) Guided Biofilm Therapy
c) Generic Biofilm Treatment
d) Guided Bacterial Treatment
4. What is the significant difference between air polishing and air flowing in biofilm removal?
a) Air polishing uses a turbulent powder flow, while air flowing uses a laminar flow
b) Air polishing is more effective than air flowing
c) Air flowing is more commonly used than air polishing
d) There is no difference between air polishing and air flowing
5. What was a key finding by Luengo F et al (2023) regarding the SIT protocol?
a) It had no effect on peri-implant tissue health
b) It worsened postoperative results
c) It improved peri-implant tissue health after one year
d) It required more frequent visits than other protocols
manifest peri-implant mucositis without therapy resulted in peri-implantitis in 43.9%.
Costa et al (2012) were able to show the importance of regular preventive therapy. In the control group (with regular preventive measures), the incidence of periimplant mucositis dropped from 43.9% to 18.0%.
Therefore, the absence of preventive therapy (SIT) can result in peri-implant infections. Without SIT, peri-implant mucositis is associated with a high incidence of peri-implantitis. If left untreated, the progression of peri-implantitis leads to implant loss.
In summary, in this article, there is a basic consensus with the current S3 guideline ‘The treatment of periimplant infections on dental implants’ in terms of systematic supportive treatment (SIT).
A discrepancy with the S3 guidelines occurs when assessing which therapy aids (PTC/PMPR) result in an improvement in the clinical parameters for periimplant mucositis.
According to the S3 guideline, alternative methods (glycine powder air-polishing, chitosan brushes) for biofilm removal should not be used for peri-implant mucositis, as alternative methods for biofilm removal did not show any additional clinical effect compared to conventional debridement (ultrasonic scaler with carbon fibre tips, Teflon/titanium curettes, RCP).
This statement in the guidelines is in sharp contrast to a number of scientific papers comparing aids used, and this discrepancy is also evident when comparing the literature on the treatment of gingivitis. It also has to be questioned why three times more biofilm can be removed in terms of subgingival biofilm elimination from natural teeth with air polishing/air
flowing, whereas this is supposedly not the case for peri-implant mucositis. Being gentle on tooth substance and maintaining patient and practitioner comfort are not mentioned in the S3 guidelines. Consensus with the S3 guidelines exists with the literature mentioned above for the non-surgical therapy of peri-implantitis. The S3 guidelines state in this case that alternative methods for biofilm removal (air polishing/air flowing) should be used.
References and a summary comparing aids in literature are available upon request.
First published in ‘Dental Magazin’ 2024; 1: 24-30. n
ABOUT THE AUTHORS
Dr Nadine StrafelaBastendorf
Dr Klaus-Dieter Bastendorf
Spit, don’t rinse - with water
Listerine is delighted to bring you this article, with the aim of supporting the ongoing Enhanced CPD needs of dental healthcare professionals in improving and maintaining the oral health of their patients
The aim of this article is to explore why it is best to spit out toothpaste and not rinse with water, exploring the research on fluoride levels when you rinse with water versus mouthwash straight after brushing
On completing this Enhanced CPD session, the reader will:
• Understand the optimal, twice-daily application of fluoride in toothpaste for caries prevention
• Understand the impact of post-tooth brushing rinsing behaviours on fluoride levels and effectiveness
• Understand the problems associated with rinsing with water after tooth brushing
• Understand the potential role of fluoridated mouthwash in supporting oral health after brushing
• Understand the current evidence base, including the PHE’s toolkit for prevention recommendation on ‘Spit, don’t rinse with water’ after brushing.
Learning Outcomes: A,C,D
This article revisits discussion about why it is best to spit out toothpaste and not rinse with water, exploring the research on fluoride levels when you rinse with water versus mouthwash straight after brushing.
Introducing the issue of fluoridation in at-home oral care products, Pitts and colleagues (2012) wrote: ‘Oral care products for home-use play an important part in the prevention and control of oral diseases such as caries and periodontal disease. Fluoride toothpaste is the most widely used topical fluoride modality for caries prevention and control worldwide. There is a body of high-quality evidence regarding the optimal concentration of fluoride in toothpaste for caries prevention, the frequency of brushing and, to a lesser extent, the amount of toothpaste to be used (particularly in young children).’1
Meanwhile, Parnell and colleagues (2013), stated: ‘The recommendation to brush twice daily with fluoride toothpaste is well established and features in guidelines and in educational literature from professional organisations. It even appears on toothpaste packaging. There is strong evidence to support this recommendation: a Cochrane review by Marinho et al. found that brushing twice a day with fluoride toothpaste increased the caries-preventive effect by 14% compared to brushing once a day.2
Adding to this picture, Pitts and colleagues (2012) went on to state that rinsing with water or mouthwash after brushing teeth is a common habit and that, ideally, oral hygiene routines should work together to improve oral health.1
However, the type of rinse used, such as water, fluoride mouthwash, or antimicrobial mouthwash, can affect how well fluoride toothpaste works. Despite the importance of this interaction, there is limited advice available for both patients and dental professionals.1
Pitts and colleagues (2012) further indicate that: ‘Post-tooth brushing rinsing behaviours have the potential to either reduce or enhance the effectiveness of fluoride toothpaste and show wide variation in the general population. There is a lack of high-quality evidence to support
definitive guidance in this area. However, the currently available international guidelines provide consistent recommendations despite the limited evidence.’1
The problem with water
Public Health England’s most recent evidencebased toolkit for prevention contains a ‘strong’ recommendation (2021) of ‘spitting out after brushing rather than rinsing with water, to avoid diluting the fluoride concentration.’3 Despite this, it has been suggested that many people rinse with water after brushing.2
However, as demonstrated by Chestnutt and colleagues in 1998, whose study supported previous findings, ‘…mouthrinsing with water after brushing should be kept to a minimum in order to reduce rapid intra-oral fluoride clearance and hence achieve the maximum beneficial effect of fluoride exposure with a dentifrice.’ 4
Rinsing with mouthwash
When it comes to using a mouthwash, Duckworth and colleagues (2009) found that adding 100 ppm of fluoride to a mouthwash
could make up for the decrease in oral fluoride levels that occur after brushing with fluoride toothpaste and then rinsing with a mouthwash without fluoride. Their research also indicated that using a mouthwash with fluoride between tooth brushing sessions could more effectively prevent cavities. 5
The researchers concluded that using a mouthwash with 100 ppm fluoride right after brushing with fluoride toothpaste should not disrupt the toothpaste’s caries protection. On the other hand, using a mouthwash without fluoride immediately after brushing might lessen the protective benefits of the fluoride toothpaste. 5
Consequently, as stated within Pitts and colleagues’ (2012) published work: ‘To maintain the anticaries benefit of a standard fluoride toothpaste, a mouth rinse should therefore contain at least 100 ppm fluoride if it is to be used at any time, including soon after brushing. A non-fluoride mouth rinse should preferably be applied at different times of the day to a standard fluoride toothpaste so as to avoid the ‘wash-out phenomenon’ that impacts on the benefit of the fluoride toothpaste.’ 1
A further study carried out by Duckworth and colleagues (2009) looked at the effects of flossing and rinsing with a fluoridated mouthwash after brushing with a fluoridated toothpaste on salivary fluoride clearance, adding to the body of evidence. 6
The findings indicate that using a fluoridated mouthwash after a routine of brushing with standard fluoridated toothpaste and then flossing effectively offsets any reduction in oral fluoride due to flossing. Indeed, the data suggests that an oral hygiene routine incorporating fluoridated mouthwash could offer better protection against cavities compared to routines that rely solely on toothpaste for fluoride. 6
This advantage seems to be contingent on the consistent use, twice daily, of the fluoridated products examined in this study, including that the mouthwash has a fluoride concentration of 226 ppm fluoride. 6
Enhancing daily routines
Offering a succinct overview of the situation, Nelson and Labello (2016) wrote in the BDJ: ‘For the wider population who simply want to control plaque and maintain good oral health, the evidence suggests that rinsing with mouthwash after brushing is effective. This has the additional practical benefit of fitting mouthwash use into most people’s daily routine.
‘Indeed, as caries is a multi-factorial disease, plaque control is one way to help reduce caries risk. In addition, as demonstrated in the scientific literature, using fluoridecontaining mouthwash, rather than rinsing with water after brushing, can help maintain or boost the levels of fluoride exposure, at least during morning and evening oral hygiene routines. 7
CPD Questions
1. What is the most widely used topical fluoride modality for caries prevention and control worldwide?
a) Fluoride mouthwash
b) Fluoride toothpaste
c) Fluoride varnish
d) Fluoride supplements
2. According to Parnell and colleagues (2013), how does brushing twice a day with fluoride toothpaste compare to brushing once a day in terms of caries-preventive effect?
a) No significant difference
b) Increases by 5%
c) Increases by 14%
d) Decreases by 10%
3. What is the ‘strong’ recommendation from Public Health England regarding post-brushing behaviour?
a) Rinse with water vigorously
b) Use a mouthwash immediately
c) Spit out after brushing rather than rinsing with water
d) Drink a glass of water after brushing
4. What did Duckworth and colleagues (2009) suggest about the fluoride concentration in mouthwash used after brushing and flossing to maintain oral fluoride levels?
a) Any fluoride concentration is effective
b) Less than 100 ppm fluoride is sufficient
c) At least 100 ppm fluoride is necessary
d) A concentration of 226 ppm fluoride offers better protection against cavities
5. Back in 1998, what did Chestnutt and colleagues suggest about rinsing with water after brushing with fluoride toothpaste?
a) It should be encouraged to remove toothpaste residue
b) It has no effect on the fluoride’s effectiveness
c) It should be kept to a minimum to avoid reducing intra-oral fluoride clearance
d) It increases the anticaries effect of fluoride
References
1. Pitts N et al. Post-brushing rinsing for the control of dental caries: exploration of the available evidence to establish what advice we should give our patients. BDJ 2012; 212(7): 315-320
2. Parnell C, O’Mullane D. After-brush rinsing protocols, frequency of toothpaste use: fluoride and other active ingredients. In: van Loveren C (ed). Toothpastes. Monogr Oral Sci. Basel, Karger, 2013; 23: 140-153
3. Delivering better oral health: an evidencebased toolkit for prevention. 4th edition, 9 November 2021. Chapter 2: Summary guidance tables for dental teams. Available at: https://www.gov.uk/government/ publications/delivering-better-oral-healthan-evidence-based-toolkit-for-prevention/ chapter-2-summary-guidance-tables-fordental-teams. Accessed 7 March 2024
4. Chestnutt IG et al. The influence of toothbrushing frequency and post-brushing rinsing on caries experience in a caries clinical trial. Community Dent Oral Epidemiol 1998; 26: 406-411
5. Duckworth RM et al. Effect of rinsing with mouthwashes after brushing with a fluoridated toothpaste on salivary fluoride concentration. Caries Research 2009; 43(5): 391-396
6. Duckworth RM et al. Effects of flossing and rinsing with a fluoridated mouthwash after brushing with a fluoridated toothpaste on salivary fluoride clearance. Caries Research 2009; 43(5): 387-390
7. Nelson G, Labella R. Response to a letter by James M. Oral health: an evidence-based approach. BDJ 2016; 221(3): 100 n
Care and maintenance of dental implants
This CPD article from Jenny Walker Dip DH/DT and Kathryn Mayo DipDH, FAETC looks at the care and maintenance of dental implants and methods to prevent and treat peri-implant disease through supportive implant therapy.
Learning aims and objectives
• To inform readers on the principles of preventing peri-implant diseases through supportive implant therapy
• Heighten readers’ awareness of various modalities available for disruption and control of dental plaque biofilm
• Enable readers to recognise the key role of supportive care when managing dental implant patients
Learning Outcomes: C
Thanks to the continuing advances in dental technology and material science, dental implants have become the gold standard for restorations that look, feel, and function like natural teeth. According to a research report from Global Market Insights, the global implant systems market is expected to record over 6.5% CAGR (Compound Annual Growth Rate) from 2023 to 2032.i
While demand for dental implants continues to rise, there is growing evidence of the susceptibility of implant patients to peri-implant diseases, which may result in implant failure.
Peri-implant diseases
Peri-mucositis and peri-implantitis are plaquebiofilm associated diseases of the tissues (and supporting bone in implantitis) around dental implants. Peri-implant mucositis is a reversable condition and thought to be a precursor to peri-implantitis. ii This means, unlike gingivitis, which may never progress to periodontitis, if peri-mucositis is not detected early enough, or treated successfully when detected, it will always progress to peri-implantitis, which is irreversible.
The main clinical characteristic of peri-implant mucositis is bleeding (more than one dot/spot or a line of bleeding) on gentle probing. Erythema, oedema, and loss of contour of the surrounding tissues are likely to be evident. Peri-implantitis generally has the same signs and symptoms as mucositis but loss of crestal bone (outside acceptable parameters) differentiates the two, and implantitis lesions are more likely to suppurate than those in mucositis cases.
The principles of preventing peri-implant diseases are focused on management of risk factors and effective biofilm control, both at home by the patient, and professionally in the dental surgery. Biofilm control around implants can be challenging due to the nature of implant restorative morphology. This, along with certain peri-implant histological and biological features increase implant susceptibility to bacterial challenge. Increasing numbers of hygienists and therapists are seeing implant patients on a regular basis, therefore an awareness of risk factors, and the implementation of processes to facilitate early disease detection are essential for appropriate patient management. A team approach to implant therapy, focussing on educating the patient is paramount from the outset. This should include, but is not limited to, risk assessment, periodontal assessment, and communication with the
patient regarding their individual risk/increased susceptibility to disease, and how they may mitigate these risks, where possible.
The role of supportive care
Patients who have lost teeth prematurely may be ‘periodontally susceptible.’ It is important to establish the patient’s periodontal status prior to placement, ensuring either periodontal health or stability. This diagnosis will enable them to be both managed and supported appropriately.
Research has shown, patients enrolled in a supportive care programme are associated with a lower incidence of peri-implant disease. Patients without regular maintenance might exhibit a 4.25fold increased risk for peri-implantitis, therefore supportive therapy should be considered essential.iii
Fully informing patients of the significance of supportive care, along with the additional time and cost commitment required prior to implant therapy is crucial to the consent process and should increase adherence to post-supportive care appointments.
The importance of monitoring
Monitoring is an essential component to identify the early signs of peri-implant disease. Collecting
baseline data is crucial to managing the implant long-term. This includes:
• A baseline radiograph, ideally a peri-apical showing crestal bone height.
• Six-point pocket depth chart around each implant, approximately three months post final restoration.
• Probe at each visit to check for bleeding.
• Observe how effectively the patient is managing biofilm around the new implant and natural teeth, if present.
• Additional radiograph one year post restoration to assess for bone remodelling. Patients should initially be monitored closely, ideally on a three-monthly basis but this may be reviewed and modified if the patient is low risk and oral hygiene is optimal.
Plaque biofilm removal
Professional mechanical plaque removal (PMPR) is the term that describes ‘in surgery’ control of dental plaque biofilm and plaque retentive factors on natural teeth and dental implants both supra and sub-gingivally/marginally.iv PMPR is essential for plaque control, particularly in patients with fullarch fixed implant-supported prostheses.v Powered instruments, manual instruments, or a blended approach may be used based on clinician
and patient preference, the case presentation, and the goal of treatment.
Air polishing is a highly efficient method of disrupting biofilm and has many applications for use, including (with the correct powder selection) natural teeth, implants, restorative work, orthodontics, and soft tissues. It evokes the least surface alteration of any mode of instrumentation, providing a minimally invasive approach, ideal for access around and underneath prosthesis and implant structures. It is a simple, quick, comfortable treatment, which is tolerated well by patients, and therefore may contribute to recall compliance.
Ultrasonic devices have certain applications for use around implants, particularly in peri-implantitis where the implant surface within the lesion may require debridement. In these circumstances, an angled tip may adapt well to the ‘threads’ on the implant body. It should be noted that any ultrasonic utilising stainless steel tips will significantly alter the implant surface, therefore a ‘benefit versus harm’ approach should be adopted.
The NSK Varios Combi Pro (VCP) is one such device that combines ultrasonic scaling and powder therapy for highly effective, comfortable implant maintenance. The VCP has detachable chambers and handpieces which make it easy to switch between supragingival application to remove staining on sound enamel only, and subgingival application to disrupt biofilm supra and sub gingivally. Only the sub-gingival chamber with compatible powder is indicated for use around dental implants.
Empowering patients
Dysbiosis of oral biofilm is known to trigger an inflammatory response around natural teeth and implants that may affect distal sites in the human body. This is evidenced by a growing number of studies suggesting links between periodontitis, peri-implantitis and systemic diseases including cardiovascular disease, gastrointestinal and colorectal cancer, diabetes, and Alzheimer’s disease, as well as respiratory tract infection and adverse pregnancy outcomes.vi Considering this, it is crucial to treat peri-implant inflammatory lesions appropriately as this may negatively impact not only oral health, but general health.
It is the role of the whole dental team to support their patients throughout the implant journey, encouraging them to maintain optimal home biofilm control and long-term engagement with supportive care programmes. The team should also be prepared to respond to changes in risk factors which may occur with increasing age and adapt their approach accordingly to ensure longevity of the implant work. While retention of natural teeth where possible should be prioritised, dental implants offer a solution for missing teeth which can significantly enhance a patient’s quality of life.
References
i. Dental Implants and Abutment Systems Market Size - By Product (Dental Implants, Abutment Systems), By Material (Titanium, Zirconium), By End-use (Hospitals, Dental Clinics) & Global Forecast 2022- 203. Published June 2023
iii. Frisch E, Vach K, Ratka-Krueger P. Impact of supportive implant therapy on peri-implant diseases: A retrospective 7-year study. J Clin Periodontol. 2020 Jan;47(1):101-109. doi: 10.1111/jcpe.13206. Epub 2019 Nov 6. PMID: 31599464. iv. https://www.periodontalcare.sdcep.org.uk/ guidance/treatment-components/pmpr/
Jenny Walker Dip DH/DT
v. Yang J, et al. BMJ Open 2021;11:e053286. doi:10.1136/bmjopen-2021-053286
vi.Fiona Q. Bui, Cassio Luiz Coutinho Almeidada-Silva, Brandon Huynh, Alston Trinh, Jessica Liu, Jacob Woodward, Homer Asadi, David M. Ojcius, Association between periodontal pathogens and systemic disease, Biomedical Journal, Volume 42, Issue 1,2019, Pages 27-35, ISSN 2319-4170 n
ABOUT THE AUTHORS
Jenny and Kathryn’s subject of interest has led them to present around the UK on implant supportive care and periodontitis
Jenny qualified as a dental therapist from Leeds Dental Institute in 2015. Jenny’s experience working at a peri-implant disease referral centre in the Northwest led her to develop a special interest in both the management of peri-implant disease and periodontitis. She is a past BSP early career group dental therapist and dental hygienist representative (2019-2020) and participated in the adolopment working group panels for the S3 guidelines stage I III, IV and prevention and treatment of peri implant diseases.
Kathryn Mayo DipDH, FAETC
Kathryn graduated from Leeds Dental Institute in 1993, returning soon after to take a teaching post, and completing a teaching qualification. She has worked in various dental setting, currently working in private practice and as a clinical supervisor running an implant maintenance clinic for the Manchester University BSc undergraduate students at ICE Postgraduate Dental Institute and Hospital. Kathryn participated in the BSP adolopment working group panels for the S3 guidelines stage IV and Prevention and treatment of peri implant diseases.
To complete the questions and gain one hour of Enhanced CPD, visit https://the-probe.co.uk/courses/course_category/brush-uplog in and find this course under the title ‘Care and maintenance of dental implants’
The dental implant kaleidoscope
The traditional kaleidoscope is not often used as a metaphor for the dental implantology field. However, it fits well – implantology is a diverse and complex world with many different layers. Finding the right combination of accurate diagnostics, careful treatment planning and excellent surgical and restorative execution is essential for the beautiful, functional and longlasting outcomes that patients deserve. Being able to deliver this depends on a number of factors, one of the most important being clinical education and training.
Impact on success rate
A substantial body of research has demonstrated a range of factors that affect implant success rates. These include patient age, length and diameter of the implant used, bone quality and region of the jaw in which the implant is being placed.
It has also been determined that the level and type of education delivered to clinicians has an impact on the treatment delivered and survival rate they achieve for dental implants. Practitioners with more clinical training and experience have been shown to achieve shorter operating times. In addition, research has found an association between the number of implants a dentist has placed and the success of treatment outcomes.
As such, the quality of education that dentists seek as they begin to provide implants, and as they advance their skills, is critical in their ability to optimise results.
Aesthetics and function
Societal pressures and trends have led to an increase in aesthetic demand among patients seeking any type of dental treatment, including implants. As such, patient satisfaction is often now determined by a combination of functionality, longevity and aesthetics. This means ensuring high survival rates alone is not enough for a happy implant patient.
To optimise aesthetic outcomes, clinicians have to consider a host of elements from implant location to the position of adjacent teeth, the gingival biotype, the smile line and the unique anatomy at the surgical site. To achieve all of this and more, the clinician’s education once again comes to the forefront. It is the dentist’s duty to have undertaken sufficient clinical training to be able to manage cases effectively and facilitate the best possible outcome for the patient.
A broad education
Consequently, it is important that the dental implant training sought incorporates a wide range of relevant topics, from basic oral surgical skills to soft tissue management techniques, bone grafting solutions, sinus lifting procedures, socket preservation and more. Even for clinicians who choose not to perform certain aspects in-house, it remains crucial to have knowledge of all evidencebased and emerging treatment options available in the market. Only then is it possible to discuss all relevant solutions with patients and ensure fully informed consent during the planning process. It is also crucial that dentists obtain a combination of theoretical and hands-on training to enable their skill development. The latter is especially important when learning new techniques or trying new materials, giving the clinician practical knowledge that will allow them to safely perform the treatment in practice.
Completing the puzzle
Finding high-quality education across the range of topics required can be challenging for dentists and
their teams, but there are highly trusted sources available here in the UK.
The Association of Dental Implantology (ADI) is dedicated to supporting professional education across the dental implant field. The highlyanticipated ADI Team Congress is an excellent example of the training and knowledge sharing that is made available to members and non-members alike. Not only does the programme feature worldclass speakers who are keen to share their expertise in a broad range of related subjects, but it also caters to the needs of the entire dental implant team. The 2025 event is set to encapsulate everything that modern dental implantology is today, with both learning and networking opportunities for implant dentists to take advantage of. Entitled “The Implant Aesthetic Kaleidoscope”, the Congress will be held on 1-3 May at the Brighton Centre – it is a not-to-be-missed event for anyone with an interest in dental implants or who is looking to take their skills to new heights.
Whether you are just starting out on your dental implant journey, or you have several years of experience, it is always important to keep your knowledge and skills up-to-date. This is an incredibly multi-faceted field with countless opportunities to improve patient quality of life, but with this power, comes a responsibility to do so in the safest way possible. Ensure your professional training and education is continuous and of adequate quality to enjoy a long and prosperous career in dental implantology.
For more information, visit www.adi.org.uk
References
i. Raikar S, Talukdar P, Kumari S, Panda SK, Oommen VM, Prasad A. Factors Affecting the Survival Rate of Dental Implants: A Retrospective Study. J Int Soc Prev Community Dent. 2017 Nov-Dec;7(6):351-355. doi: 10.4103/jispcd. JISPCD_380_17. Epub 2017 Dec 29. PMID: 29387619; PMCID: PMC5774056.
ii. Sonkar, J., Maney, P., Yu, Q. et al. Retrospective study to identify associations between clinician training and dental implant outcome and to compare the use of MATLAB with SAS. Int J Implant Dent 5, 28 (2019). https://doi.org/10.1186/ s40729-019-0182-6
iii. Sun, TM., Lee, HE. & Lan, TH. The influence of dental experience on a dental implant navigation system. BMC Oral Health 19, 222 (2019). https:// doi.org/10.1186/s12903-019-0914-2
iv. Sendyk, Daniel & Chrcanovic, Bruno & Albrektsson, Tomas & Wennerberg, Ann & Deboni, Maria. (2017). Does Surgical Experience Influence Implant Survival Rate? A Systematic Review and Meta-Analysis. The International Journal of Prosthodontics. 30. 341-347. 10.11607/ ijp.5211.
v. McCrea SJJ. An Analysis of Patient Perceptions and Expectations to Dental Implants: Is There a Significant Effect on Long-Term Satisfaction Levels? Int J Dent. 2017;2017:8230618. doi: 10.1155/2017/8230618. Epub 2017 Aug 8. PMID: 28928771; PMCID: PMC5591937.
vi. Forna N, Agop-Forna D. Esthetic aspects in implant-prosthetic rehabilitation. Med Pharm Rep. 2019 Dec;92(Suppl No 3):S6-S13. doi: 10.15386/ mpr-1515. Epub 2019 Dec 15. PMID: 31989103; PMCID: PMC6978930.
vii. Ferro AS, Nicholson K, Koka S. Innovative Trends in Implant Dentistry Training and Education: A Narrative Review. J Clin Med. 2019 Oct 4;8(10):1618. doi: 10.3390/jcm8101618. PMID: 31590228; PMCID: PMC6832343. n
ABOUT THE AUTHOR
DR ZAKI KANAAN
Dr Kanaan, ADI President, qualified from Guy’s Hospital, London, in 1996. His main interests lie in all aspects of Cosmetic Dentistry with a special interest in Dental Implant Treatment, where he has achieved a Masters Degree from the GKT Dental Institute in 2001.
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The team at the heart of excellent dental care
The delivery of high-quality dentistry today is only possible with input from the entire dental team. Effective collaboration and skill mix utilisation are crucial for the successful delivery of patient care in any situation. This means that all team members must advance their knowledge and skills, using evidence-based products and techniques to support the provision of dental treatment and care.
For those looking to upgrade their materials, systems and oral health solutions, BDIA Dental Showcase afforded the perfect opportunity to see everything in the UK market right now. New products were featured, as were many trusted favourites from decades gone by, allowing the dental team to discover, compare and try various innovations in one place. Professional associations, societies and education providers were also in attendance – including the ADAM, BADN, BADT, BSDHT, and more – allowing individuals to find
out more about membership and start planning for their future.
Though BDIA Dental Showcase is best known for its extensive dental exhibition, the 2024 presented a dynamic educational programme of equal calibre. This meant plenty to see and do for all members of the dental team, with hours of CPD available for dental hygienists/therapist and dental nurses to enjoy.
The Oral Health Theatre, for example, discussed a broad spectrum of relevant topics from improving patient communication to enhancing periodontal management and considering the global landscape of oral health right now. Among the popular sessions was Dr Mahesh Kumar’s lecture providing an update on mouth cancer. He offered a range of tips on how to conduct a thorough examination, considering the impact that HPV has had, and continued to have, on mouth cancer rates.
Dr Celia Burns from Nothing But The Tooth commented: “This was a really helpful talk that was appropriately pitched for GDPs. It was useful to hear the details of the 2-week wait referral guidelines. Time flew by as the talk had plenty of clinical examples, which were also helpful to illustrate what we are looking for.”
For dental nurses, Laura Hardy discussed career pathways into dental implantology, sharing useful advice on how to take those important next steps. Fiona Ellwood’s presentation on “The Business of Dental Therapy” was also well-received, with dental therapists and dentists learning more about how to effectively integrate the dental therapy role within a busy practice.
Louisa Eyeoyibo said about the session: “I liked this presentation; there was some really good information provided in bite-sized chunks that were appropriate for the environment. The use of
surgery pictures was helpful and the session will really help with NHS care.”
A later session on mental health and wellbeing proved insightful for all members of the team, as did a presentation by Dr Kunal Shah on the impact of artificial intelligence in dentistry.
Team members seeking further information and updates in clinical areas such as periodontology, intraoral scanning, patient-centric care and facial aesthetics, had the opportunity to join the Clinical Theatre where more leading speakers covered a wealth of topics. The Dental Update Theatre was equally as popular, with discussions around medico-legal issues in periodontology, mouth cancer prevention and sleep dentistry taking centre stage.
The CDO Theatre was another port of call for any team members with an interest in hearing from the Interim Chief Dental Officer England, Dr Jason Wong, and his team. A session dedicated to skill mix in the dental practice proved popular, with all team members represented by speakers. Debbie Reed presented research into reasons dental nurses may be thinking about leaving the profession, citing pay as a leading factor – although other important considerations were extended sick pay, whether GDC registration was covered and CPD provided. Miranda Steeples highlighted the opportunities afforded by direct access, while Simone Ruzario shared her personal experience as she began to fully use her scope of practice. Bill Sharpling went on to share a clinical dental technician’s perspective and Amy Howard explored the benefit of the orthodontic therapist.
A common theme throughout the session was that practice owners, managers and frontof-house staff need to understand team members’ full scope of practice in order to make the most of their skills.
By covering such hot topics, the programme provided plenty of food for thought and certainly stirred conversation. Dental professionals were able to engage with speakers, share their thoughts with colleagues, seek expert guidance from product experts and carry on the discussion beyond lectures.
No matter what role you fulfil within the dental team, be sure not to miss BDIA Dental Showcase 2025. Save the dates today – 14th-15th March!
THE DENTAL AWARDS 2024
‘And the winners are’ - Part One
The Probe proudly presents The 2024 Dental Awards
The 2024 Dental Awards marks the 26th edition of this prestigious event that, for more than quarter of a century, has sought to recognise the outstanding individuals and teams whose dedication and drive continues to raise standards throughout the UK dentistry profession.
Winning or becoming a finalist in the Dental Awards is a tremendous accolade that provides a significant boost to the profile of a practice. Not only is the event an opportunity to share in the happiness and success of those who win an award, but it offers the chance to see what fellow dental professionals are doing across the United Kingdom.
The Dental Awards presentation, which streamed on the-probe.co.uk, as well
Qualifying in 2010, Rachel aptly demonstrates the importance of combining excellent dentistry with careful attention to the patient journey and experience. Always focusing on the highest levels of patient care and adopting a listening approach that enables patients to feel comfortable, Rachel is keen to foster a personable approach throughout the practice. Taking over Chapel Dental with her husband in 2022, Rachel’s leadership and management skills have set the tone for the practice, engendering an ethos that benefits both staff and patients alike
Highly Commended: Martina Hodgson, The Dental Architect, Leeds
Finalists: Aly Virani, North Cardiff Dental, Cardiff
Deciding to become a dentist aged 14, Chloe’s love of dentistry came through loud and clear to the judges. A committed professional and gifted dentist, Chloe continues to strive to make an impact on the profession, working with the team to develop her own clear aligner training course.
Highly Commended: Dharmesh Mistry, YOR Dental, Salford Quays
as on The Probe’s Youtube channel, is available to watch on-demand now. Scan the QR code (across) to see the winners of The Dental Awards 2024 react to their victories, as well as to discover who was named a finalist in each of the 12 hotly contested categories.
The Dental Awards 202is brought to you by B.A. International, Colosseum Dental, Dental Elite, and Waterpik, in association with The Association of Dental Administrators and Practice Managers, British Association of Dental Nurses, British Association of Dental Therapists, British Society of Dental Hygiene and Therapy, and The Oral Health Foundation.
For more, visit https://the-probe.co.uk/ awards/the-dental-awards-2024/
To see the full list of our winners, highly commended, and finalists, and to watch the 2024 Dental Awards Presentation, scan the QR code or visit: https://the-probe.co.uk/awards/the-dental-awards-2024/
Rachel Derby
Chloe Harrington
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Directa’s ProphyCare, is one of the most well-known brands of prophylaxis paste worldwide, offering reliable results ranging from regular cleaning of the teeth to more complicated implant maintenance procedures.ProphyCare pastes are available in different grits from coarse to extra-fine and are colour coded for easy identification. All ProphyCare pastes have a mild minty taste and do not splatter, it stays in the polishing cup during the treatment.
the dental awards 2024
Dental Therapist of the Year
Winner: Natalie Peary, Smile Together Dental CIC, Bodmin
The judges described Natalie as an inspirational dental therapist working within a supportive setting to reach those who might usually be missed when it comes to dental care, especially in an area where NHS care is difficult to access.
Highly Commended: Kayley McCauley, Dorset Dental Clinic, Poole
Finalists: Victoria Akinfenwa, New Cross Dental Practice, London
Joining the profession as a dental nurse at the age of 19, Amanda believes that Dental Hygiene is the foundation of dentistry. Without health gums and bones there are no teeth.
Educating and enabling patients by giving them their own autonomy and linking any health inequalities they may experience, and/or using conditions, such as inflammation, as a motivational tool to encourage patients to follow their treatment plans.
The Periodontal Therapy Clinic @ 10 Dental, Southport
Sakina Syed, Bupa Dental Care, London Bank
Zara Shirvani, Zara The Hygienist
Dental Nurseof the Year
Winner: Brittany Pittham, Inspired Dental Care, Exeter
Qualifying as a dental nurse in 1993, Janine moved into dental practice management in the early 2000s. Extremely efficient and well organised, Janine ensures the practice always runs smoothly. Understanding the financial picture, she manages the practice diary to improve and stabilise cashflow. Continually developing her skill set, she has a real talent for conflict resolution and attracting exceptional, loyal new team members. Considered by her team as the quintessential Practice Manager, they all hope that she never retires.
HighlyCommended: Shannon Wilkes, Euston Place Dental Practice, Leamington Spa
Finalists: Rebecca Silver (Highly Commended)
Wiktoria Wisniewska, Ridge Dental, Bristol
Natalie Marucci, Clear Dentistry, Southampton
Natalie Peary
Amanda Harbrow-Harris
Brittany Pittham
Maximising oral health, whatever the challenge
Regular interdental cleaning is recommended for maintaining periodontal health, which can be especially compromised by conditions like cardiovascular disease, diabetes, and autoimmune diseases like lupus and rheumatoid arthritis. Special care can be implemented most effectively with FLEXI interdental brushes used with PREVENT GEL from TANDEX.
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Adding PREVENT GEL, containing fluoride and chlorhexidine, to their FLEXI brush, strengthens enamel, and keeps the mouth cleaner for longer.
Find out more about how the FLEXI range and PREVENT GEL from TANDEX can improve the oral health of patients.
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Swiftly alleviate dentin hypersensitivity with Predicta® Bioactive Desensitizer using natural tooth elements.
Predicta® Bioactive Desensitizer by Parkell swiftly alleviates dentin hypersensitivity using natural tooth elements, calcium and phosphate. Upon application, it forms hydroxyapatite plugs in the dentinal tubules and adds a mineralization layer that broadens the seal, protecting pain-sensing A-delta nerve fibers. Ideal to treat sensitivity from exposed roots after perio-surgery, bleaching, scaling, root planing, and gingival recession. Patients report immediate relief from sensitivity lasting up to six months.
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blue®m Oral Health Care
In periodontology, fine, sharp instruments are essential for a successful treatment. With American Eagle patented XP technology, that makes instrument tips significantly more durable, time-consuming sharpening is a thing of the past.
XP instruments have a significantly longer service life and suffer from much less wear than standard instruments. Moreover, the thinner tip design means easy access to the interproximal area and periodontal pockets; achieving better results whilst increasing the patient’s comfort level.
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Professional throughout the entire process
At Dental Elite, we know that finding a new role in dentistry can be stressful, and the last thing you want is to be left in the dark. Our team is always on hand for support and guidance throughout the job searching process, and it reflects in the thoughts of the professionals that use our service.
Tiphanie Jackson said: “Toni (Dental Elite’s Recruitment Consultant) was very professional throughout the entire recruitment process. She was great at communication, through both messages and calls.”
My Sonder felt the same way, saying: “Toni is amazing. She was quick with her responses, and really efficient with the communication between me and the new employer.”
If you’re looking for a new role in dentistry, or looking to hire at your practice, Dental Elite can support you at every step of the process.
To learn more about specialist recruitment that keeps you in the loop, contact the Dental Elite team today!
For more information contact the Dental Elite team on 01788 545900 https://dentalelite.co.uk/ www.dentalelite.co.uk
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Treat Hypersensitivity in Minutes with Predicta® Bioactive Desensitizer
Predicta® Bioactive Desensitizer is Parkell’s solution to dentin hypersensitivity. This highly innovative material is changing the way clinicians treat patients’ discomfort by using the elements that are naturally found in the tooth (calcium and phosphate) and restoring them to the tooth in the form of hydroxyapatite plugs that immediately start forming in the dentinal tubules upon application.
Predicta Bioactive Desensitizer doesn’t stop there. An additional layer of mineralization also forms atop the dentinal tubules as a result of the ongoing release of calcium and phosphate ions. This extra layer broadens the seal that protects the pain-sensing A-delta nerve fibers in the pulp from being stimulated.
Predicta Bioactive Desensitizer treats dentin hypersensitivity due to exposed roots after perio-surgery, bleaching procedures, scaling or root planing, and gingival recession. This syringe-dispensed, ready-to-use gel is considered highly biocompatible as it contains no methacrylate or soft-tissue irritating chemicals. Click on this link for an exclusive trial package offer. https://europe.parkell.com/ predicta-bioactive-desensitizer-uk-probe
Contact info: Parkell Europe AB, Finvids väg 8 SE-194 27 Upplands Väsby, Sweden Tel. +46 708 593 481 infoeurope@parkell.com
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Interdental Brushes
High Quality doesn’t have to mean high price and for ease available from your current Interdental brush supplier.
Free marketing materials available to all stocking practices and a loyalty scheme to claim free brushes. For more information or to request a sample, visit www.optim-idb.uk
