Effective prevention for patients at increased caries risk*
• 5000 ppm Fluoride Toothpaste prevents cavities by arresting and reversing primary root and early fissure caries lesions2-5
Prescribe Duraphat 5000 ppm Fluoride Toothpaste and support patient adherence:
• 89% of consumers agree that taste is an important factor when using a toothpaste**
• Prescribing a product with a preferred taste may be important to enhance patient adherence
Be confident prescribing Colgate® Duraphat®, the brand your patients know and trust
# Compared to generic 5000 ppm high fluoride toothpaste. * Patients ≥ 16 years at increased caries risk. ** Colgate UK Consumer Survey on Cosmetic Toothpaste. 504 participants. Feb 2020. † YouGov Omnibus for Colgate® UK, data on file June 2015. Claim applies only to the Colgate® brand.
References: 1. Data on file. Preference Survey. January 2020 (n=82). 2. Baysan A et al. Caries Res 2001;35:41-46. 3. Schirrmeister JF et al. Am J Dent 2007;20. 212-216. 4. Ekstrand et al. Geodent 2008;25:67-75. 5. Ekstrand et al. Caries Res 2013;47:391–8. Colgate® Duraphat® 5000 ppm Fluoride Toothpaste - Name of the medicinal product: Duraphat® 5000 ppm Fluoride Toothpaste. Active ingredient: Sodium Fluoride 1.1%w/w (5000 ppm F-). 1g of toothpaste contains 5mg fluoride (as sodium fluoride), corresponding to 5000ppm fluoride. Indications: For the prevention of dental caries in adolescents and adults 16 years of age and over, particularly amongst patients at risk from multiple caries (coronal and/or root caries). Dosage and administration: Brush carefully on a daily basis applying a 2cm ribbon onto the toothbrush for each brushing. 3 times daily, after each meal. Contraindications: This medicinal product must not be used in cases of hypersensitivity to the active substance or to any of the excipients. Special warnings and precautions for use: An increased number of potential fluoride sources may lead to fluorosis. Before using fluoride medicines such as Duraphat, an assessment of overall fluoride intake (i.e. drinking water, fluoridated salt, other fluoride medicines - tablets, drops, gum or toothpaste) should be done. Fluoride tablets, drops, chewing gum, gels or varnishes and fluoridated water or salt should be avoided during use of Duraphat Toothpaste. When carrying out overall calculations of the recommended fluoride ion intake, which is 0.05mg/kg per day from all sources, not exceeding 1mg per
SmileDirectClub collapse: “It shouldn’t have taken a bankruptcy to protect patients”
The British Dental Association has told dental regulators that urgent reform is needed to stop the next SmileDirectClub putting patients at risk.
The Association understands the remote orthodontic giant had just five UK-registered dentists overseeing cases. It is unknown if these clinicians were UK-based or covered by appropriate professional indemnity. The professional body has now asked both the General Dental Council and Care Quality Commission what expectations are on them to finish incomplete courses of treatment.
While SmileDirectClub reportedly had just a handful of registered dentists, the BBC reported that the company had 65,000 patients. As SmileDirectClub only launched in the UK in 2019, the BDA has expressed fundamental concern over its ability to maintain basic clinical standards based on these numbers – five dentists overseeing 65,000 patients.
SmileDirectClub has signed off telling its patients not only to maintain payment plans, but to find a ‘local dentist’ to take responsibility for future treatment. The BDA warns this could prove a minefield given potential cases of inappropriate treatment. The professional body has urged the dental regulator to ensure any dentists who step in to correct damage or complete treatments will not be liable for mistakes made by the company.
The Oral Health Foundation has also raised alarms over SmileDirectClub’s closure for leaving a significant number of patients in a precarious position.
The charity believes the abrupt closure of the direct-to-consumer aligner company has left patients uncertain about the continuity of their dental care and orthodontic treatments, and is concerned by the potential consequences of patients being left without proper guidance and support midway through treatment plans. The charity is also deeply troubled by the financial impact of patients being abandoned, with many having paid out thousands of pounds.
Dr Nigel Carter, chief executive of the Oral Health Foundation, says: “The closure of SmileDirectClub has created an upsetting situation for many patients who were undergoing dental treatments. We are extremely worried about what impact this will have on the oral health
and mental wellbeing of thousands of people currently undergoing treatment.
“Our hearts go out to the patients who placed their trust in SmileDirectClub. The sense of abandonment they now face is truly distressing.
“It is infuriating to see patients left out in the cold, ripped off, and left out of pocket. The financial losses some patients might now incur are inexcusable, and it’s a stark reminder of the consequences when companies prioritise profits over the wellbeing of those they serve.”
The BDA stressed that historic guidance from regulators must reflect good practice – requiring a full assessment by a dentist working within their competence, informed consent, continuing care and putting patients’ interests first.
Dentist leaders have warned the GDC that the profession and patients rely on it to prosecute the illegal practice of dentistry and that it must now investigate the business practices of any providers operating under similar business models currently or in the future.
BDA Chair Eddie Crouch said: “It beggars belief that five dentists would be enough to provide continuing care for the company’s reported 65,000 UK patients. It shows why change is needed, so that the public are protected, and corners are not cut. This could prove a minefield for any dentist stepping up to help. We need assurances that any clinicians attempting to undo damage will not be liable for mistakes made by this company.
“A full clinical assessment isn’t a nice to have or an optional extra – it should
be required no matter what. If we’re going to protect patients, the basics of decent care must be in place for all.”
SmileDirectClub initiated Chapter 11 bankruptcy proceedings in September, citing a substantial debt of more than £700 million.
Despite an extensive search spanning several months, the company disclosed that it was unsuccessful in securing a partner willing to inject sufficient capital to sustain its operations.
Upon its initial public offering in 2019, SmileDirectClub commanded a valuation of approximately £7 billion. However, the company experienced a significant decline in stock value over subsequent years, grappling with persistent financial losses and grappling with legal challenges.
In the fiscal year 2022, SmileDirectClub reported a notable loss of almost £70 million.
“It all leaves a very bitter taste,” adds Dr Carter. “Patients have been left in the lurch and it will now no doubt fall on orthodontists to rescue the situation for those SmileDirectClub customers who remain unhappy with their smile.
“Patients who are already rightly feeling let down, angry and frustrated will now be in a position where their treatment will not be completed as quickly as they thought. They are also facing further costs. Patient expectations will need to be delicately managed.”
The Oral Health Foundation has previously expressed concerns about the remote provision of plastic aligners, citing concerns about the potential risks of misdiagnosis. These concerns were communicated to the regulatory authorities.
In 2021, the charity launched Safe Smiles, a campaign to help patients make safer choices when it comes to their dental treatment. The campaign stresses the importance of having dental treatment in dental practices and the benefits of it being carried out by trained and registered professionals.
Receiving overwhelming endorsement across the dental industry, the campaign was a response to concerns about the growth of direct-to-consumer alternatives, with the charity worried about more patients potentially being in danger.
Read more on the situation from Dr Nigel Carter on page 12. ■
recipe for success, page 19
kicks, page 32
A welcome from the editor
I hope this issue finds you all in good stead after a well-earned and deserved festive break – and if there was no time for a rest in December, be sure to have some downtime on your calendar in the coming months. On page 38, Alun Rees discusses how important it is to avoid becoming overwhelmed, while Dr Dhiraj Arora explores the power of a reset.
The major news in December was of course the collapse of SmileDirectClub, which I’d seen advertisements for on a major television channel just weeks prior. It is believed that only five UK-registered dentists were overseeing the care of more than 65,000 patients at the remote orthodontics business. It’s our lead story on the previous page, and is discussed further by Dr Nigel Carter of the Oral Health Foundation on page 12, as well as Leo Briggs of the DDU on page 13, who explains how to care for patients affected by the SmileDirectClub closure.
The Dental Awards 2024 are still open for entries until 23rd February at the-probe.co.uk/awards – and if you’re reading this before 12th January, you still have time to register your entry at the early bird rate. Best of luck to everyone who enters.
And here’s to a happy and healthy 2024 for us all!
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Editorial Advisory Board: Dr Barry Oulton, B.Ch.D. DPDS MNLP; Dr Graham Barnby, BDS, DGDP RCS; Dr Ewa Rozwadowska, BDS; Dr Yogi Savania BChD, MFGDP; Dr Ashok Sethi, BDS, DGDP (UK), MGDS RCS; Dr Paroo Mistry BDS MFDS MSc MOrth FDS (orth); Dr Tim Sunnucks, BDS DRDP; Dr Jason Burns, BDS, LDS, DGDP (UK), DFO, MSc; Prof Phillip Dowell, BDS, MScD, DGDP RCS, FICD; Dr Nigel Taylor MDSc, BDS, FDS RCS(Eng), M’Orth
Alex Harden Portfolio Director CloserStill Media
Lau Berraondo Clinical Director Enhance Dental Care
Steve Wright CEO G.B. Kent & Sons
Dr Céline Higton Leading expert in cosmetic and restorative dentistry
Dr Annalene Weston Senior Dentolegal Consultant Dental Protection
Abby Leach Content Creation Mgr Connect My Marketing
Alun Rees Dental Business Coach
Dr Dhiraj Arora Owner evo endo
EthOss® is a 100% synthetic bone graft material for dental implant surgery. With no risk of cross-contamination, EthOss® works with the body’s healing process by creating a calcium-rich environment and is completely absorbed.
New research reveals the missed opportunity of preventative oral care in UK dentistry
Haleon, together with the College of General Dentistry, has launched the Dental Health Barometer, which provides deep insights into the role of preventative oral healthcare in the UK. Preventative care is defined as proactive dental care and advice that helps a patient to take action to maintain a healthy mouth, protecting against tooth decay, gum disease and more serious issues such as tooth loss and negative impacts on general health.
Yet, the survey of UK consumers and dental health professionals reveals that preventative oral care advice is not being offered consistently to patients. That’s despite a high incidence of tooth decay – with 70,000 people treated in UK emergency departments for the disease last year alone1. Just one third (34%) of oral health professionals said they always offer preventative care advice to patients, while one in four (25%) patients said they weren’t given preventative advice during their last dental appointment. Over half (59%) of oral health professionals said that they are more likely to offer preventative advice for private patients than NHS patients, and over a third (37%) of NHS oral health professionals cited time constraints as the top reason for not being able to routinely offer preventative care advice, as opposed to just 15% of private oral health professionals. Though we know oral health professionals are working hard during a time of unprecedented pressure on the UK dental landscape, these figures come as little surprise given the widely reported ‘dental deserts’ where some areas of the UK have over 3,000 patients for every NHS dentist2
Additionally, oral health professionals differed on the preventative advice they would recommend to patients. While half (50%) said advice on additional oral hygiene products and brushing techniques were key, only 2 in 5 (41%) pointed to advice on diet as preventative care and just over a third (34%) would consider advice on caring for gums to be preventative advice.
There is a lack of understanding across consumers and oral health professionals over whether preventative care is routinely available on the NHS. Almost half (48%) of consumers said preventative oral healthcare advice is offered on the NHS, and over a third (34%) were unsure. Oral health professionals were more aware, with 74% saying preventative oral healthcare advice is offered on the NHS. Once again, younger dentists are more aware that preventative care advice should be routinely available on the NHS.
The study found patients have a strong level of trust in advice given by their dentist. Where it is offered, 9 in 10 (88%) found the advice helpful. The study found that NHS patients, younger people and men were less likely to proactive ask for preventative care advice.
Regional split
The Barometer also found that there were regional discrepancies between both patients and oral health professionals. It was found that:
• Only 40% of consumer respondents from Greater London think that preventative care is very important for oral health compared to over half (55%) in Northern Ireland and South West England.
• Respondents from Greater London also were less likely to have received advice, with only 37% having encountered preventative care advice compared to over half of respondents (55%) in the South East and nearly half (47%) in the North East.
• Over half (55%) of respondents in Wales said thinking back to their most recent trip to an oral health professional, they received preventative care advice verbally from them, compared to 50% of those in Scotland, 48% of those in England, and 37% in Northern Ireland
• Northern Ireland have recalled a particularly low level of preventative care during dentist visits – with only slightly over a third of respondents (37%) having received advise at their last appointment. Despite this, the respondents from the region were some of the most interested in learning about preventative advice (53%) compared to (36%) of East England, West Midlands and Yorkshire and Humber who were less interested.
• The East of England saw the lowest level of detail from their oral health professional on preventative care advice, with only 30% feeling their dentist provided a lot of detail.
References:
1. www.telegraph.co.uk/news/2023/10/23/ tooth-decay-patients-ae-nhs-dentistshortage/ 2. www.libdems.org.uk/press/release/rise-indental-deserts-leaves-millions-struggling-toget-nhs-dentist-appointment n
Professional Standards Authority publishes 2022/23 GDC performance review
The Professional Standards Authority (PSA) has published its report on the GDC’s performance for the period 2022/23, which concluded we met 16 of the 18 Standards of Good Regulation. There was positive recognition for the GDC’s engagement with stakeholders and response to the backlog of applications from overseas dental professionals. The GDC tripled the number of places for Part 1 of the Overseas Registration Exam from this year and has increased the number of Part 2 sittings from three to four in 2024.
The PSA found that Standards 11 and 15 were not met, specifically the parts of those standards relating to the respective timely resolution of registration and fitness to practise cases.
The changes to legislation to register dental professionals who qualify overseas prompted a surge of applications and the GDC recruited
a large team of additional people and external associates to process and assess applications, and the backlog is now starting to reduce.
The PSA noted that registration applications for UK-qualified dental professionals showed recent improvement. As an indication of the increased workload, the GDC is on course to register more new dental professionals this year than ever before, with 117,983 professionals on the register (as of 30 September 2023).
There has been a long-term issue that GDC fitness to practise cases often take too long to resolve. The GDC has increased the size of the casework team, streamlined processes, improved guidance to reduce delays and, with support from stakeholders, is undertaking a pilot to enable single clinical issues to be resolved more quickly, while continuing to effectively maintain public safety and confidence in the dental profession.
These reforms reflect the GDC’s determination to make improvements to the fitness to practise process where it can, ahead of any potential regulatory reform. It is also hoped that improved timeliness and proportionality will reduce the impact of fitness to practise investigations on the health and wellbeing of those involved.
Gurvinder Soomal, Interim Chief Executive Officer and Registrar, said: “We are making very real improvements to the fitness to practise process. It is disappointing that the effects are not yet visible in the performance data, although this is an inevitable consequence of managing down a backlog of old cases with the measure of timeliness only crystallising at the point of completion. For registration, UK applications are now being processed within the target time and the backlog of international applications is falling steadily as a result of increasing processing capacity.” n
Patients show appreciation with chocolates, flowers and home grown veg
Despite the pressures currently facing dentistry, patients have shown their appreciation for individual dental professionals over the past year with small gifts and thank you messages, according to a survey by the Dental Defence Union (DDU).
The DDU survey of 460 dental professionals found that 90% had received a gift or thank you message from patients over the past year. The most common gifts were chocolates which 70% of respondents had
received followed by flowers which a third had been gifted (33%) and alcohol which a quarter received (28%). The more unusual presents included a home grown cabbage, a back scratcher, dog toys, and a sheep (which was declined).
John Makin, Head of the DDU said:
“It’s heartening to know that patients are choosing to show appreciation for the care they’ve received from dental professionals. While appreciated, colleagues don’t expect to receive gifts, especially given the rising
costs of living. Most explained they get as much satisfaction from doing a good job.”
Guidance from the GDC on receiving gifts advises dental professionals to refuse any gifts if they could affect or be seen to affect your professional judgement.
John continued: “It is important to ensure gifts don’t raise ethical issues. We recommend members don’t accept expensive gifts and keep a register of all gifts received in case they need to justify them at a later date.” n
BITES
Karen Miller named as Dental Protection CeO
Medical Protection Society (MPS) – of which Dental Protection is part – has announced the appointment of Karen Miller as its next Chief Executive Officer (CEO). Karen – MPS’s first female CEO – will join MPS in February 2024, taking over from Simon Kayll who will retire at the end of 2023 having been at MPS for 30 years, 12 years as CEO. n
Changes to rules for international registrants
The General Dental Council (GDC) has today announced that changes to the rules for the registration of internationally qualified dental professionals will come into effect on 9 March 2024.
The rules are being introduced following a consultation on routes to registration for internationally qualified dentists and dental care professionals held earlier this year.
The new rules provide the basis for the GDC to introduce an ORE application processing fee and to increase examination fees to ensure associated cost are recovered and fees are allocated fairly. These initial changes mean that the GDC can now take further steps to deliver additional ORE capacity while it modernises its international registration framework. n
BADn welcomes executive committee and honorary president
At the British Association of Dental Nurses’ (BADN) recent AGM, Joan Hatchard became Honorary President, welcoming President-elect Preetee Hylton and Treasurer Ruth Garrity to the BADN Executive Committee, as well as former Treasurer Michelle Brand to the role of Chairman. n
CGDent Trustee Board changes
Marie Parker and Jane Clarke have been appointed as Trustees of the College of General Dentistry. They are the third and fourth new Trustees appointed since the College opened its doors to members in 2021, with Fred Thomson and Onkar Dhanoya having been appointed in 2022.n
Dentsply sirona partners with iADH
Dentsply Sirona, the world’s largest manufacturer of professional dental products and technologies, has entered a four-year partnership with the International Association for Disability & Oral Health (iADH) to advance access to oral care and improve oral health for patients with disabilities. This initiative advances the company’s sustainability strategy “BEYOND: Taking Action for a Brighter World” in the field of diversity, equity and inclusion. Dentsply Sirona is also a sponsor of the upcoming iADH conference in Seoul in September 2024 which brings together experts from around the globe to share experiences and expertise on Special Care Dentistry.n
SEE BETTER, FEEL BETTER
New Year’s resolution? Be careful!
We ALL make mistakes
Iread a 2022 online article by a firm of solicitors recently, entitled ‘A guide to suing a dentist in small claims court’. It made me lament a missed golden opportunity. The article stated, quite boldly, “anyone who makes a mistake and causes injury is liable to be taken to small claims court.” Had I known that as a 2nd year BDS student, I could have made my passage through dental school in a financially, very comfortable manner.
To keep a long story short, but making it long anyway, on my first night at dental school, I got stuck in the loo.
It was about 8.00pm in the hall of residence, located on the edge of the vast city hospital campus. I seemed to be the first student on the ninth floor. I hadn’t met a soul the whole evening. I later discovered that all of the male dental students in the building resided on the ninth floor. The university appeared to be determined to contain the problem.
Straining every muscle and sinew in my body for five minutes or so, I couldn’t turn the lock on the cubicle door. Such is my lifelong obsession with not causing a fuss for fear of embarrassing myself, there was no way on this Earth that I was going to shout out for help, even if there WAS someone with patience and understanding at the other end of the corridor. It was a no-brainer (in MY brain anyway). I had no choice other than to climb over the top of the cubicle in order to get out. Being a mature student, having left behind a career in provincial journalism, headlines kept flashing into my head: ‘Dental Student Found Dead In Toilet Prison’ and ‘Dentist Starves To Death In Cubicle Hell.’ (That would have been The Mail.)
After a 10-minute struggle accompanied by profanity that would have made even 50 Cent blush, I reached the summit of the cubicle and landed on my back on the freedom side, with a dislocated arm. I didn’t need to go to A&E because, by that time, after many previous dislocations, I was pretty adept at reducing them myself. A couple of days later, after reporting the defective lock to the warden of the hall, I learned from the maintenance man sent to fix it that his colleague had originally replaced the lock with the wrong part – hence the reason for my inadvertent false imprisonment. Since this occurred in 1983, the thought never occurred to me that I should have sought a legal remedy. In those heady days, like everyone else, I hadn’t up to that point been constantly fed the notion by medical/dental litigation lawyers that ‘somebody should pay’ for my shoulder injury. It WAS pretty bad though. I had to take two paracetamols.
I was reminded of this incident when, a few weeks, ago I read that Head of the Dental Defence Union, Dr John Makin, told attendees at a Westminster Health Forum event on priorities for dentistry in England that ‘too often he witnessed dedicated dental professionals undergo the stress of a protracted investigation needlessly because of a groundless complaint.’ (I won’t go into details but I can attest that the process is EXTREMELY stressful. Just to add to the stress, a GDC caseworker threw
in a charge of ‘dishonesty’ just to grind my face in the dirt – apparently, according to my defence organisation advisor at the time, the GDC ‘does that a lot’).
Dr Makin said, “We see a number of cases in which the concerns being raised have no foundation.” Calling on bodies which investigate complaints against dental professionals to “have the courage to firmly and robustly close down cases quickly where concerns have no foundation,” he pointed out that “the whole process can be extremely stressful and protracted, especially in cases where there are several investigations into the same incident. We have reached a situation where the process in and of itself is a sanction regardless of the eventual outcome.”
And there you have it: the investigation is a punishment in itself. I would wholeheartedly agree. The dentists I have spoken to over the years have been more fearful of the process of going through an investigation and possible hearings – with all of the accompanying publicity – than the fear of actually being erased or suspended.
We all make mistakes, not necessarily because we are being negligent. Should you be dragged through a full-on incredibly protracted and stressful investigation for a trivial complaint that has no merit? As an example, I became involved in helping a former colleague a couple of years ago, who received a solicitor’s letter after a patient my friend had carried out an extraction on developed a dry socket. The solicitor accused my former colleague of being negligent. My European friend didn’t want to involve her indemnity organisation
and so I wrote to the solicitor on her behalf, pointing out that a dry socket is a well-recognised complication after some extractions. After empty threats of taking ‘further action through a regulatory body,’ we heard no more, but that patient could have potentially caused the dentist to undergo an unnecessary FtP investigation - although I would have hoped that an investigating committee would have tossed the complaint out.
One glaring mistake I admit I did make in the 90s was making an entirely inappropriate Maryland bridge for an elderly lady. I overestimated the might of Panavia and the skill of my technician colleagues in being able to resist the overwhelming force of an Olympic bruxing habit that not only caused abfractions (which I hadn’t taken into account), but caused her impressive TMJs to sound like anti-aircraft fire whenever she opened her mouth. After about 10 recements, we gave up, with me reimbursing her for her NHS bridge and repairing the minimal occlusal rest for free.
Another time – again, in the 90s - I was about to start drilling into the distal aspect of a lower five when I suddenly received a painful kick in my shin, delivered by my very experienced nurse. She mouthed ‘wrong tooth’. Even though I’d checked the first premolar on the bitewing before the patient came in, I’d still somehow managed to almost damage a virgin tooth catastrophically. In my defence, I had only just returned to practice after taking two weeks off to bury my wife, but that would have been a negligent mistake, which I would have had to hold my hands up to and say, ‘fair do’s’.
Not clinical mistakes, but mistakes nevertheless, I twice managed to fail to secure prophy cups properly in slow handpieces. My nurse retrieved one with an aspirator, while the other patient retrieved and delivered his prophy cup with a justifiably sarcastic, “Yours, I believe.”
On another occasion, I was working on an upper incisor with the turbine, and the poorly secured bur flew out. The patient immediately started coughing profusely and I thought it had flown up her nose. I was about to march to the phone to arrange a chest x-ray when she started mooching around in her cleavage area and she delivered the missing bur with a smile, saying, “It’s where I normally keep my tissues.”
A couple of years before I retired, I dropped a veneer as I was about to fit it, and then drove straight over it with a wheel on my operator’s stool. The patient wasn’t happy because she had lost time from work, and I really couldn’t avoid the embarrassment on that occasion. Naturally, her wedding was coming up soon. Mercifully, my lab was on-the-ball and saved the day in the nick of time. But what if it hadn’t gone right and she claimed I ruined her special day?
I’d have been really miffed if I’d been locked up for that – especially if it was in a cubicle. n
About the author ollie Jupes is the pseudonym of a former nHs dentist. He monitors dentistry on twitter X as @DentistGoneBadd
The power of civility
Research tells us that team-targeted rudeness likely underpins many adverse outcomes. Dr Annalene weston, Senior Dentolegal Consultant at Dental Protection, argues that, if this is true, kindness is the simplest form of risk management we have
We teach our children that ‘kindness counts’ but is this truth or fairytale?
Kindness is not a new concept. It features in Aesop’s fables, which teach us that ‘no act of kindness, no matter how small, is ever wasted.’ As a parent, I have read out loud countless hours of Dr Seuss – from ‘Fox in Sox’ to ‘Sam I Am’. Aesop, Dr Seuss, and countless authors between tell our children to be honest and true, to themselves and to others.
Fast forward an undetermined period of time and I find myself reviewing claim after claim where not a trace of kindness can be found. Is it that we should be kind unless we are at the dentist, or is it something else? And are we always kind to our patients? Should we be? Critically, are we kind to each other within our teams, or too tired, too jaded, and too (post) Covidexhausted to care?
Civility as a risk management strategy
Simply put, there is strong evidence that rudeness and incivility between healthcare workers impacts negatively on patient safety, as it leads to an increase in error rates, emotional exhaustion and depersonalisation (two of the three factors of burnout), and it effects our cognition and decision making 1-4 . This makes sense, as how can you think clearly and confidently if you don’t feel safe in your environment because you are awaiting a rebuttal, mockery, criticism, or blame?
Conversely, the Civility Saves Lives Campaign 5 seeks to promote positive behaviours in healthcare, and shares the evidence that supports why civility is so critical in patient safety.
people do not sue their friends
Studies have overwhelmingly demonstrated that patients are less likely to sue healthcare providers whom they like. That’s not to say it can never happen, but the research reveals that patients are far less likely to complain about practitioners
they like, and, whom they think like them. This relationship of mutual respect and trust is built on the foundation of rapport.
A deep dive into the basis of legal claims often uncovers a disconnect between the patient and the practitioner. Some people never really ‘hit it off’ and they experience a pervasive sense of awkwardness throughout every interaction. Others have a seemingly solid series of interactions right up until something within the treatment does not go to plan. At that moment in time, just when the patient needs support and reassurance the most, the practitioner turns their back and withdraws their support, leaving the patient frightened and confused. For many, this confusion quickly turns to anger and resentment. The reason for this perceived rejection or dismissal by the practitioner is often as simple as fear and distress. Both experience and studies tell us that remaining connected to a patient who has suffered an adverse outcome under your care significantly decreases the likelihood that they are going to move forwards and make a formal complaint about you. Being kind is the best course of action. Many practitioners are, however, hijacked into placing a defensive barrier between themselves and their patient. Some are advised that ignoring kindness is best but, rest assured, it is not.
sorry seems to be the hardest word
One of the most human reactions when we make a mistake or harm another person is to say sorry. This simple expression of regret can vary from an utterance when you bump into someone at the supermarket to a formal, televised, (and in the case of Johnny Depp and Amber Heard) scripted apology. Regretfully, at some point in time, this most human of reactions to distress caused to others was cast in some arenas to be an admission of liability. This precedent is both dangerous and unnecessary. Firstly, fear of apologising is unnecessary. An apology given to a patient after something goes wrong during their care is not considered to be an admission of liability and, as such, cannot be used against you in a court of law. This is set out in legislation in England, Wales, and Scotland. Certain behaviours are expected by the regulator when something goes wrong, with the General Dental Council (GDC) duty of candour guidance stating that dental professionals must be open and honest with patients when something goes wrong with their treatment or care which causes, or has the potential to cause, harm or distress. This includes explaining when something has gone
wrong, and apologising to the patient or their relatives 6 It isn’t just about expectation though, as the research demonstrates apologies are protective for the wellbeing of the person receiving the apology with measurable impact on their blood pressure, heart rate and breathing. Perhaps more surprisingly, the research also demonstrates apologising is beneficial to the mental and emotional wellbeing of the person giving the apology too.
Humility
Humility is not necessarily a characteristic demonstrated by many healthcare providers. While the rhetoric may suggest this can be factored back to strongly type A-centred personalities, a far simpler view is probably a more meaningful one in this case. In order to gain patient trust, practitioners project confidence, and rightly so, as modesty could easily be misconceived as lack of training or knowledge. So, confidence is a must, with humility becoming more of a relevant factor in two specific circumstances. The first is when a health provider knows in their heart that they are uncertain about the treatment they are about the embark on, and the second is after an adverse event.
Critically, practitioners need to recognise the edge of their envelope of capability to know when it is appropriate to seek guidance or support from a peer. This simple step serves to increase both patient confidence and patient safety. Next, humility is an essential mindset in the event of an adverse outcome. While professionalism,
and the facilitation of continuity of care for the patient is critical, big-noting yourself and your skills and down-playing your contribution to the failure of care, perhaps blaming others or even the patient themselves, is the first stop on a short trip to a complaint. Civility, transparency in communication, apology, and humility – could this be the new foundation to your success? Or perhaps if you simply relied on humanity, brushing away defensive practices and going with your gut human empathetic reaction or kindness over self-concern, this will achieve the same. Critically, kindness counts, and the simple step of being kind to a patient in adversity will help you both to heal. n
References
1. Katz D, Blasius K, Isaak R et al. Exposure to incivility hinders clinical performance in a simulated operative crisis, BMJ Quality and Safety. 2019; 28:750-757
2. Liu Y, Vashdi DR, Cross T, Bamberger P, Erez A. Exploring the puzzle of civility: Whether and when team civil communication influences team members’ role performance. Human Relations. 2020;73(2):215-241
3. Porath, Christine L, Foulk, Trevor, and Erez, Amir. How incivility hijacks performance. Organizational Dynamics. 2015;44(4), 258-265
4. Porath, Christine Lynne. Mastering Civility: A Manifesto for the Workplace. New York, NY: Grand Central Publishing 2016
Transition from the NHS and run your practice in a way that suits you, with the UK’s leading dental payment plan specialist.
Nuffield Trust report indicates the danger NHS dentistry is in
The Department’s response to the Select Committee suggests they are just keen not to take the blame
If you have been following the statements made in the Houses of Parliament over the last couple of years then this will come as no surprise. The Prime Minister has repeatedly referred to the spend on NHS dentistry being “over 3 billion pounds” as a sort of indication of their commitment! Somebody in Parliament ought to point out to the PM that spending on NHS dentistry reached £3 billion in 2008/9, having risen from £2.1billion in 2002/3. The statements about spend are even more disingenuous when you analyse the proportion of the current spend, which is raised from patient charges. Since the last election, patient charges have risen far more than contract values, so the proportion funded by the NHS has fallen. Having advised ministers a long time ago, I have been appalled by the quality of the advice given to this government and the stupid statements around dentistry made and reported in Hansard. At one point, the then Secretary of State said that “two thirds of dental graduates never work in the NHS.” Where did he get this line from? It was corrected very quietly later but who on earth told him this was correct?
The two things that make a service work are money and workforce. Even with a contract that is widely disliked, access improved after local commissioning was introduced and dentists were tendering for new contracts. At one point in 2009, I opened five new practices in one day across Dorset and Hampshire and, by 2015, about 2 million more people were seeing a dentist than were in 2006. All that has changed now, as even practices that wish to grow cannot recruit outside of the big cities. At the moment, the dental budget is underspent by about half a billion pounds, so just putting more money in would not seem to be a short-term solution – though increasing contract values would help. Like the rest of the NHS, the dental service needs to look beyond more dentists and utilise the skills of other members of the team. In 2005 we increased the number of dental graduates; opened two new dental schools, with the clinical training based in primary care, and also opened a school for therapists. We spent a lot of time and effort working with stakeholders to expand the scope of practice of Dental Care Professionals (DCPs) and that has the potential to rapidly improve the workforce situation.
Therapists working in the salaried services are eligible to be members of the NHS pension scheme, so why not those working in general practice, helping providers deliver on their contracts? Some will clearly want to carry on working as hygienists in private practice, but
I am sure a significant proportion would like to use the full range of their skills. There is a major barrier to increasing the number of DCPs in training as the tariff paid to the dental schools is less than £10,000 per year compared to the close to £40,000 per year for dental students. Speaking as a taxpayer rather than a dentist, this seems absurd. However, like all the other issues that need tackling, the current policy seems to be “do nothing and let it wither away”. The BDA is fixated by contract reform but there are thousands of dentists out there providing a really good standard of care for their patients on the NHS who seem to be portrayed as providing a poorer quality of service than those providing private care. I, my wife, my children and grandchildren all get great care from our NHS practice. All the grandchildren get their fluoride varnish applied as recommended in Delivering Better Oral Health but, as costs rise and contract values fail to keep pace, I am sure it is getting more difficult.
There are some tools within the current legislative framework that could be used to ease the current access issues but there seems to be a lack of commissioning expertise at ICB level (or centrally for that matter) to take advantage. PDS contracts could be established in existing practices to focus on improving access without the currency being UDAs. This has been tried in some areas and seen to deliver but, for some reason, not supported. I rather suspect that those in charge are quite happy for NHS dentistry to fade away and be able to blame the dentists.
In the buildup to the introduction of local commissioning in 2006, we included a statutory responsibility on the NHS, set out in primary legislation, to “provide or commission NHS dentistry to the extent they considered necessary to meet the need”. I wonder if that is still there…
As chair of the British Fluoridation Society, it would be great if, this year, they make good on their commitment to start the expansion of water fluoridation in more areas where there is a demonstrable need. This would at least show they have some interest in oral health.
The even more worrying thing for the future is that the scope of NHS care in other areas might also come under the spotlight. n
About the author
Dr Barry Cockcroft
CBe is the former Chief Dental officer for england and current chair of the British Fluoridation society.
The rise and fall of SmileDirectClub
In a surprising turn of events, SmileDirectClub, once a promising disruptor in the orthodontic industry, has recently announced its closure and filing for bankruptcy. This unexpected development raises critical concerns about the repercussions for the countless individuals who entrusted their orthodontic care to the company.
As the dust settles on SmileDirectClub’s downfall, the fallout is expected to include both financial implications, as well as potential concerns around disruption of treatment for patients.
SmileDirectClub built a powerful brand around delivering effective orthodontic treatment at low cost, with quick results. They also claimed to do this without the patient stepping foot in a dental practice.
And it seemed to be successful, certainly in the minds of consumers. In 2019, when it first began trading, SmileDirectClub commanded a valuation of approximately £7 billion. However, the company’s financial struggles and legal challenges caused a significant decline in stock value over subsequent years.
Despite an extensive search spanning several months, it was unsuccessful in securing a partner willing to inject sufficient capital to sustain its operations.
SmileDirectClub initiated Chapter 11 bankruptcy proceedings in September, citing a substantial debt of over £700 million. This included a notable loss of almost £70 million in 2022.
Disruption of treatment
Although there are no official figures, it has been cited that SmileDirectClub was providing services to around 65,000 people in the UK.
There is a concerning prospect that a significant portion of its patients, initially drawn by factors such as cost-effectiveness, expediency, and convenience, may face challenges in maintaining their orthodontic care. Given the reasons why individuals initially opted for SmileDirectClub, the likelihood of these patients seamlessly transitioning to traditional dental care appears low. Instead, it seems plausible that a considerable number may discontinue their aligner usage altogether, risking regression to pretreatment alignment.
While some dissatisfied patients may opt for consultation with local orthodontists, there exists a more probable scenario where individuals seek alternative online solutions, potentially from companies mirroring SmileDirectClub’s model. This trend poses inherent risks to patients, as anecdotal reports suggest potential issues ranging from inaccuracies in the initial impressions to the absence of adequate support throughout the treatment process. These concerns highlight the urgent need for comprehensive oversight and guidance in the evolving landscape of remote orthodontic solutions.
Financial impact
It’s undoubtedly distressing for patients to witness their teeth alignment reverting, assuming their treatment is ongoing, and they haven’t received a retainer. However, the financial strain resulting from SmileDirectClub’s bankruptcy could be equally challenging to bear. The allure of direct-to-consumer orthodontic solutions lies in their promise of affordability, yet the financial stakes for patients could still amount to thousands of pounds. The unsettling reality faced by those invested in SmileDirectClub’s treatment plans is the uncertainty surrounding refunds in the wake of the company’s demise. In a challenging predicament, SmileDirectClub has advised its consumers to persist with their ongoing payment commitments for their treatment plans (the treatment they no longer have access to). However, the implications of the company’s insolvency have raised concerns about the viability of such advice. According to Which? , customers may find themselves relegated to the end of a lengthy line of creditors, diminishing the likelihood of substantial refunds. This could mean that even if refunds are granted, they will be managed by liquidators and may amount to little, if anything at all.
Patients who paid with a credit card, could try using Section 75 of the Consumer Credit Act to get their money back. This rule makes the credit card company responsible for problems, just like the company they bought from. If patients paid with a credit card, it’s a good idea to talk to their credit card provider for advice on getting their money back safely.
Final thoughts
The problems with direct-to-consumer orthodontics are alarming. The closure of SmileDirectClub, which allegedly had as few as five dentists for 65,000 patients, highlights the risks of this streamlined approach. While the demise of one company might seem like a resolution, the continued presence of similar services raises concerns, especially with inadequate regulations. The shift toward these suppliers is worrying, demanding urgent attention. Anger and frustration stem not just from one company’s closure but from systemic flaws enabling such models. Swift legislative action is crucial to eliminate the dangers of direct-to-consumer orthodontics. The safest dental treatments occur in a traditional practice, led by qualified professionals. Prioritising patient safety over profit and convenience is essential, ensuring orthodontic care remains in capable hands. n
About the author
Dr nigel Carter oBe is the Chief executive of the oral Health Foundation.
Kent Brushes: from royal roots to oral care
Steve Wright explores the fascinating evolution of Kent Brushes, from its royal connections in the world of haircare to its entry into preventive oral care, including the launch of the innovative SONIK range of toothbrushes
Recognised globally for its exceptional craftsmanship in hairbrushes and a history of supplying the British royal family for nine consecutive reigns to date, Kent Brushes has recently broadened its horizons into the world of oral care.
It is a brand name synonymous with quality and tradition and has a rich heritage that stretches back over two centuries. Indeed, Kent Brushes traces its origins back to the late 18th century, when William Kent founded the company.
This incredible legacy not only underscores Kent Brushes’ commitment to excellence but also forms the foundation for its expansion into the newest product line - oral care.
A royal legacy
Initially, the company specialised in producing high-quality hairbrushes, setting the gold standard for craftsmanship and developing a legacy of excellence that has shaped Kent Brushes’ identity.
With a commitment to using the finest materials and traditional techniques, Kent Brushes quickly gained recognition for its exceptional products.
As was briefly touched upon earlier, one of the most noteworthy milestones in Kent Brushes’ history is its association with the British royal family. Since the reign of George III, Kent Brushes has proudly held the Royal Warrant, a mark of recognition for supplying premium hairbrushes to the royal household.
This endorsement from the British monarchy speaks volumes about the brand’s dedication to quality and excellence.
Over the years, the brand has seamlessly blended tradition with innovation, continuously evolving to meet the changing demands of the market, while maintaining its commitment to craftsmanship.
Today, Kent Brushes’ products can be found in over 100 countries around the world.
Expanding the brush empire to oral care
While Kent Brushes’ expertise in hairbrushes has solidified its reputation, more recently the company saw an opportunity to make use of its craftsmanship and knowledge in an exciting, new market - oral care.
When Kent Brushes recognised the importance of oral hygiene, the company wanted to offer customers a toothbrush that not only worked effectively but also felt comfortable to use and looked good.
The transition to producing toothbrushes was a natural evolution, given Kent Brushes’ dedication to
using high-quality materials and maintaining meticulous standards.
In fact, it’s a transition that has been taking place internationally over several years. To offer one nugget of fascinating insight into its evolution, Kent Oral Care has become one of the top selling toothbrush brands in South Korea.
Now coming to the UK, the new SONIK range means Kent Brushes stays true to its legacy of excellence at home.
These toothbrushes have been designed with the same attention to detail and precision that makes the hairbrushes so highly regarded.
Introducing the SONIK range
Kent Brushes is proud to launch its groundbreaking SONIK toothbrushes. By leveraging Kent Brushes’ heritage and expertise in brush making, the company can offer a unique and premium, yet affordable solution to the oral care market.
SONIK toothbrushes offer 36,000 sonic pulses for a deeper clean, a smart 2-minute timer and 3 bespoke brush modes, high-quality, individually rounded bristles for optimal performance, 45 days of battery life with super-fast charging in 2 hours, and an ultra-slim, lightweight, waterproof design.
These features not only leverage advanced fluid dynamics sonic pulse technology, which sets SONIK apart
from traditional toothbrushes, they also allow users to customise their brushing experience according to their preference and needs.
Furthermore, the SONIK features an ergonomic handle for a comfortable grip, ensuring that users can maintain proper brushing techniques in comfort. They also look great in the bathroom!
Alongside the toothbrushes, Kent Oral Care includes a subscription service, which enables users to sign up to receive replacement brush heads through the post at a frequency that suits them. Subscribing to the replenishment programme offers a range of benefits, including convenience, cost savings, customisation, regular replacements, quality assurance, sustainability, and flexibility.
A
future of excellence
Kent Oral Care doesn’t end with its SONIK toothbrushes. There is a whole range of oral care products available, including:
• SMILE charcoal and silver-infused, super soft manual toothbrush
• SMILE silver infused, super soft manual toothbrushes
• BRILLIANT whitening toothpaste
• BRILLIANT toothpaste tablets and refill packs
• BRILLIANT mouthwash concentrate
• Mouthwash glass
• SMILE interdental brushes.
Listen to The Probe’s exclusive interview with Steve Wright on The Probe Dental Podcast or watch via our Youtube channel at tinyurl.com/ GBKent - scan the QR code below
With the introduction of the SONIK range of toothbrushes and associated products, Kent Brushes has demonstrated its ability to adapt to the latest advancements in dental hygiene while staying true to its core values.
The brand’s reputation for crafting products fit for royalty has extended into the realm of oral care, ensuring that customers receive the best of both style and functionality. Indeed, Kent Brushes’ commitment to quality and innovation is evident in the SONIK range, making it a standout choice for dental professionals and individuals alike.
An enduring spirit of excellence
Kent Brushes’ journey from its royal roots in hairbrushes to its venture into oral care is a testament to the enduring spirit of craftsmanship and innovation. Whether it’s a regal hairbrush or a cutting-edge toothbrush, Kent Brushes remains a trusted name that signifies excellence in personal care. For further information, please visit www.kentbrushes.com/oral-care
About the author Steve Wright, CEO of G.B. Kent & Sons.
Keeping out of harm’s way
The importance of automated and validated infection control protocols
Who can forget ‘Hands, Face, Space’? The coronavirus pandemic has given the entire population a crash-course in epidemiology. And still today, a greater awareness of the need and responsibility around ‘spreading germs’ persists. That’s why even in a highly sanitised environment like a dental practice, infection control remains top of everyone’s mind.
There are two possible ways of patients acquiring a blood-borne virus during a visit to the dentist: one, a minor cut through a protective glove could lead to direct exposure of the patient’s blood with that of the dentist; and two, exposure of the patient’s blood to instruments that have been contaminated with blood from a previous patient and not decontaminated correctly before re-use.
Look sharp
For practice staff, there is the added hazard of a potential sharps injury (and eye splash incidents) particularly for those involved in the decontamination of the surgery’s instruments. Also known as reprocessing, it can be a complex operation that involves several stages including cleaning, disinfection, inspection and sterilisation.
As you know, there are various routes to cleaning instruments: manual cleaning, manual cleaning combined with ultrasonic cleaning and the use of a washer disinfector.
According to HTM 01-05, best practice cleaning should be undertaken using an automated and validated process. This means that the entire cleaning and disinfection process is verified, tested and documented, as well as consistently reproducible. Something of an impossibility when it comes to manual cleaning. Washer disinfectors from leading manufacturers, on the other hand, have a cycle validation feature which can give dental professionals peace of mind that instruments have been thoroughly processed.
While not mandatory in England and Wales, but in pursuit of best practice, HTM 01-05 recommends the installation of a washer disinfector to remove the need for manual washing. It also suggests the separation of decontamination processes from other activities to enhance the distinction between clean and dirty workflows.
process progress
So, what does a washer disinfector offer? Apart from the benefits of being validated and more time-efficient than manual cleaning, the machine itself features a fivestage cycle: flush, wash, rinse, thermal disinfection and drying. Firstly, cold water is used to remove contaminants (such as blood, proteins and fluids); then a detergent temperature wash loosens up and breaks down any remaining
contamination; this is followed by a detergent rinse and then a thermal disinfection (whereby the temperature of the load rises and is held for the required time, for example, 90oC for one minute). Finally, the load is dried to remove any residual moisture. It is then ready for inspection prior to sterilisation.
HTM 01-05 emphasises the need for the machines to be loaded correctly, as incorrectly loaded instruments will not be cleaned effectively. It is also crucial not to overload or overlap instruments.
Accurate records of the process must be kept so that they can be produced during an audit. Certain washer disinfectors are able to keep precise processing and validation records with the use of data logging devices. Again, HTM 01-05 recommends their use as a way to demonstrate best practice. Not only does this give an additional level of security but also saves the dental team time by not having to manually transfer data.
North of the border
In Scotland washer disinfectors are mandatory.
At Gunning Dental in Annan, South West Scotland, lead dentist Andrew Gunning recently replaced his old washer disinfector with the Miele Professional PG8581 under bench washer disinfector from Eschmann. “The Miele Professional washer disinfectors are not only cost effective and easy-to-use, but they also give staff the peace of mind
Working in perfect harmony
How instrument synergy enhances the efficacy of dental implant procedures
Synergy, as defined by the Cambridge Dictionary, is ‘the combined power of a group of things when they are working together that is greater than the total power achieved by each working separately’. For example, when you are listening to your favourite band, it’s the sum of all the individual group members you’re enjoying. The instruments work in harmony to produce a unique sound.
When it comes to synergy in dental implant procedures, such an approach often enables dental professionals to achieve better accuracy during the surgical phase. For instance, guided implant surgery utilises computer-generated surgical guides to enhance the precision of implant placement. By combining 3D imaging technology with specialised surgical instruments, dental clinicians are able to carefully plan the position, angle, and depth of the dental implant prior to the actual surgery. This collaborative effort between advanced imaging software and specialised instruments ensures that the implant is placed precisely in the desired location, leading to better aesthetic outcomes and increased patient satisfaction.
Seamless integration
Another advantage of instrument synergy in dental implant procedures is the reduced risk of surgical complications. Through the use of specially designed surgical kits, dentists can ensure that all necessary instruments are readily available during the procedure. These kits typically include a range of drills,
depth gauges, and implant drivers that are specifically designed for use with dental implants. The standardised nature of these kits allows dentists to work efficiently and effectively, minimising the risk of instrumentrelated errors and complications. Additionally, the interoperability of these instruments ensures that they can be seamlessly integrated into the surgical workflow, further reducing the time required for the procedure.
Synergy of instruments in dental implant procedures can also improve patient comfort and reduce recovery time. Advanced technology, such as piezoelectric instruments, offers precise and controlled cutting of bone, minimising trauma to the surrounding tissues. This means that patients experience less pain, swelling and bruising post-surgery, leading to a quicker and more comfortable recovery. Additionally, the combined use of specialised instruments, such as tissue punches and implant placement tools, allows for minimally invasive techniques that preserve the integrity of soft tissues. By reducing damage to the surrounding structures, patients experience less post-operative discomfort and achieve quicker healing.
avoiding complications
Instrument synergy also plays a crucial role in the long-term success of dental implant procedures. As you know, proper maintenance and care of dental implants are essential for their longevity. Dental professionals rely on a multitude of specialised instruments, such as periodontal probes and implant scalers, to monitor and clean the
that instruments are thoroughly cleaned and disinfected,” he says.
“We have been working with Eschmann for decades and the ongoing support they provide makes life easier. The installation process went ahead without any issues and Eschmann also delivered ECPD User training to staff, meaning the machines were ready to use in no time at all.”
Infection prevention is a critical aspect for the dental practice and the effective cleaning of instruments and equipment plays a key role in infection control to help prevent pathogens and microorganisms being transferred to patients and staff. Washer disinfectors give dental practitioners peace of mind that their instruments have been cleaned and thermally disinfected in a validated and automated process. They help to protect patients as well as staff, ultimately safeguarding the provision of quality dental care.
For more information on the highly effective and affordable range of decontamination equipment and products from Eschmann, please visit www.eschmann.co.uk or call 01903 875787 n
about the author Nicky Varney, Senior Marketing Manager at eschmann.
implants and surrounding tissues. Key to this process is the use of instruments specifically designed for implants. These instruments allow for effective plaque removal, without damaging the implant surface or surrounding structures. By utilising the correct instruments for implant maintenance, dental professionals can ensure that the implants remain in optimal condition, reducing the risk of complications such as peri-implantitis and implant failure.
Instruments from W&H offer a highly synergistic approach based on many years of research, development and surgical know-how. The Piezomed provides dental professionals with the benefits of innovative piezosurgery. By using the high-quality system, clinicians can remove only the targeted bone with precision, leaving the surrounding soft tissue and bone undamaged. The Piezomed module integrates seamlessly with the Implantmed Plus surgical unit. The synergy between Implantmed creates a superior workflowdriven solution for oral surgery, guiding the clinician through the cycle from implementation to evaluation. With W&H’s synergistic approach, the Implantmed and Piezomed is incredibly versatile, improving procedures and results for patients as it is gentle on soft tissue ensuring reduced patient discomfort and quicker healing. The measurement of osseointegration is crucial when monitoring dental implants to inform loading and ensure success. Utilising the Osstell Beacon from W&H, the only product backed by over 1,400 studies, dental professionals can measure
and evaluate the stability of the implant ensuring full osseointegration. It helps to reduce treatment times and avoid rejection in high-risk patients.
Overall, a synergistic solution to dental implant procedures offers numerous advantages that enhance the overall success of these procedures. The precise and accurate placement of implants, facilitated by guided implant surgery systems, ensures excellent aesthetic outcomes. The reduced risk of surgical complications, thanks to specialised equipment and surgical kits, promotes efficient and error-free procedures. Patient comfort is improved through the use of advanced instruments that minimise trauma and promote faster healing. Finally, the long-term success of dental implant procedures is ensured through the use of specially designed implant maintenance products. With these advantages in mind, it becomes clear that dental implant procedures require well-thought through planning. This helps to develop a solution which allows the clinician to provide high-quality treatment enabling them to deliver patients with effective, efficient, and long-lasting solutions for missing teeth.
To find out more visit wh.com, call 01727 874990 or email office.uk@wh.com n
about the author Kate Scheer, Marketing executive, W&H (UK) Ltd
Mastering dental social media
Key elements for engaging patients
In an era where social media reigns supreme, dental practices are recognising the pivotal role these platforms play in connecting with patients. A well-crafted social media presence isn’t merely about showcasing services; it’s about engaging and educating patients while fostering a sense of trust and comfort. To achieve this, several key elements come into play to transform a dental social media page from a mere online presence to an interactive and informative hub for patients.
Visual appeal: High-quality before and after photos
Visuals are a powerful tool for capturing attention and conveying a message. In dentistry, showcasing before and after photos of treatments is a compelling way to exhibit expertise and results. However, the key lies not just in the content but in the presentation. Highquality imagery is crucial but equally important is steering clear of an overly clinical aesthetic. Patients seek reassurance and relatability, not sterile medical visuals. The focus should be on warmth and authenticity in these images, underlining transformation and the human side of dentistry. While before and after photos are a staple in dental social media, the emphasis should not solely be on the clinical precision but on the emotional impact. It’s not just about showcasing a perfect smile; it’s about telling the story of a patient’s journey and the positive impact on their life. Including personal anecdotes, with the patient’s consent, can add a human touch to these visual narratives.
personal touch: From team to patient
Behind every successful dental practice is a team of professionals dedicated to patient care. Introducing the team through social media humanises the practice, making it more relatable. Sharing team stories, accomplishments, and even behind-the-scenes moments resonates with patients, helping them feel more familiar and comfortable with your practice before even setting foot in the clinic.
In addition, personal content – stories, anecdotes, or shared experiences – can significantly alleviate patient anxiety. A casual conversation about dental myths or a team member sharing their personal dental care routine can go a long way in breaking down barriers between the practice and patients.
Dental anxiety is a common concern, often stemming from fear of the unknown or past negative experiences. Here, personal content becomes a powerful tool in alleviating these anxieties. It’s about going beyond clinical information and sharing relatable stories and experiences that connect with the audience on a personal level.
These seemingly simple gestures humanise the dental experience, reassuring patients that they are understood and cared for. It breaks down the barriers between patient and dentist, fostering a sense of trust and comfort.
Likewise, personal content prompts engagement. Encouraging patients to share their experiences or ask questions through comments or direct messages creates a two-way conversation. This interaction isn’t just about providing information; it’s about building relationships.
Responding to queries or feedback in a prompt and friendly manner further reinforces the practice’s commitment to patient care. It demonstrates attentiveness, empathy, and a genuine interest in addressing patients’ concerns beyond the confines of the dental practice.
educational Videos: informative content for engagement
In the digital age, video content is king. For dentists, using this medium to provide informative and educational content is invaluable. Creating videos discussing various dental procedures, oral hygiene tips, or even debunking common dental misconceptions not only educates patients but also establishes the practice as a credible source of information.
The key to successful videos lies in their relevance, clarity, and concise delivery. Bite-sized, informative snippets are more likely to capture and retain audience interest than lengthy, complex explanations.
Creating engaging educational content requires striking a balance between relevance and value. Dental practices can focus on topics that resonate with their audience’s interests and concerns such as providing stepby-step guides on proper brushing techniques or the benefits of specific dental treatments.
The aim is not just to disseminate information but to captivate and retain attention. Ensuring that the content is engaging, concise, and visually appealing enhances its effectiveness. Real-life scenarios, patient testimonials, or even incorporating humour can make posts more enjoyable and memorable.
Educational videos serve as a tool for building trust and by providing accurate and reliable information the dental practice can be seen as an authority in the field. Viewers perceive the practice as a trustworthy source, not just for promotional content, but as a place to seek guidance and information regarding any oral health concerns.
testimonials and smile reveal videos
Testimonials stand as a beacon of authenticity in the realm of dental practice marketing. They encapsulate the genuine experiences of patients, resonating profoundly with both existing and potential patients. They represent a tangible connection between the practice and those it serves. The power of testimonials lies in their ability to humanise the practice, offering a glimpse into the lives changed by dental care or treatment.
A video testimonial serves as a foundational element in establishing trust. It’s the patient’s voice,
sharing their journey, and affirming the positive impact of their dental experience. Imagine the story of a patient, apprehensive and uncertain about their dental concerns, and through the progression of a smile reveal video, viewers can see not just a dental transformation but a deeply emotional journey. From the moment they walk through the practice doors to the unveiling of their new smile a video can capture the nuances of a patient’s initial worries and the transformative journey toward a confident, radiant smile.
The authenticity of smile reveal videos lies in their rawness. They are not scripted advertisements but genuine portrayals of a life-changing experience. As the patient’s story unfolds on screen, it leaves an indelible mark on viewers, instilling a sense of confidence and trust in the practice’s capabilities.
Prospective patients watching these videos find themselves immersed in a real-life narrative and they can relate to the initial apprehensions, connect with the emotions, and witness firsthand the positive outcome quality dentistry can achieve. This emotional connection goes beyond mere marketing; it cultivates a profound sense of trust and reassurance, driving potential patients to choose a practice they perceive as empathetic, skilled, and capable of transforming lives. n
about the author abby Leach, content creation Manager and Social Media Specialist at connectmymarketing.com
Classic elegance at the cutting-edge
Equipment is everything when it comes to delivering exceptional standards of dental care and wellbeing for patients. At DRMR, we strive to be a world-class clinic offering the highest level of services and clinical procedures. As a professional team we are always developing our knowledge and optimising our skills – but we still need state-of-the-art technologies to perform at our best and provide efficient patient journeys. This is even more important in cosmetic dentistry. People are not coming in for a routine check-up; they have made a conscious, life-changing decision to improve the way they look. They’re willing to invest in themselves and they want an entire experience. The better you can provide this, the happier your patients will be.
When I started building my squat practice, I had a very strong vision for what I wanted to create – a spacious surgery with large windows and a calm but luxurious feel. The goal was to balance classic elegance with cuttingedge innovation – more like a boutique 5* hotel than a traditional dental practice. I was also keen to find a chair that could rotate, but there were few on the market. After researching available solutions, the Stern Weber seemed best for me. The entire surgery space is designed to feel comfortable and lavish, right down to the smallest details. For instance, the cabinets feature rounded edges and are
wall-mounted to give a very clean aesthetic. The chair is very much a focal point in the surgery – it’s the first thing patients see when they enter the room and it looks very impressive. The water bowl moves out so patients don’t have to lean over to reach it. The automated functionality of the chair also means that I can quickly swap between seated and laying down positions during an appointment. Plus, I am proud to have the only Stern Weber chair in the world to be custom wrapped in our brand’s gold colour, which really sets the tone for patients seeking a premium service during their cosmetic dental journey.
The aesthetic of the practice elevates the quality of dentistry provided. The stunning space is home to state-of-the-art dental imaging equipment and all the latest modcons. For example, nearly everything is voice-activated – inspired by the ‘privacy mode’ featured in Marvel films! – from the blinds to the lights and music speakers in the ceiling. My chair was further customised to facilitate videoing from the light which I use when live streaming or recording as part of the veneer training course I present. This programme is designed to help colleagues provide predictable porcelain veneers using evidence-based techniques and technologies, so it’s essential that I have the facilities to deliver thorough and accessible teaching.
Of course, the process has not been easy and there have been challenges along the way. The decision-making when building a squat practice puts a lot of pressure on your
shoulders. Should you finish one surgery at a time so you can stage the investment?
Is it viable to purchase top-of-the-range equipment before you have established your income? Is that extra £5,000 worth it to get exactly what you want or should you wait to upgrade your technologies?
I worked with some excellent people and organisations throughout this project, who provided valuable advice and ensured I knew all my options, which was very helpful. In the end, I chose to go for it and start as I meant to go on – I wanted to deliver an exceptional patient experience with the latest technologies, so I needed to have this equipment from the beginning. I also decided to invest in all the extras that I desired and trusted that the services I could provide would distinguish the business in the way that I hoped. The
result was that I didn’t compromise on anything and I am so glad I didn’t.
The project was the start of a prosperous working relationship with RPA Dental. As soon as I met Pete Higson [Managing Director] I knew he would understand what I wanted to achieve. He and his team did everything they said they would and so much more, they really went beyond the call of duty – their customer service was, without a doubt, exceptional. They have the same ethos as we do at DRMR – nothing is too much and they’re always available to help. Pete remained accessible and personal throughout; even if I called at 9pm with questions, he was willing and able to help. In fact, Pete still checks in on me now with phone calls and sends engineers to service the equipment without me asking to ensure everything continues to run efficiently.
For colleagues looking to build their own squat practice, it is essential to find your tribe – if you work with the right people who share your vision, you will succeed. You need to collaborate with organisations that can meet your expectations and your budget. When you find your kind of people, the process of building and growing your business is made that much easier!
For more detail about the solutions and services available from RPA Dental, please visit www.dental-equipment.co.uk, call 08000 933 975 or email info@rpadental.net
For more details about the Designing Smiles Veneer Course, please visit drmrlondon.co.uk/designing-smiles n
Specialist dental waste management services that help to protect the environment
Dental waste isn’t always the easiest to organise. Many products can’t be sent to the same site, like a landfill. This means dental professionals must pay great attention to their practice’s waste streams.
Sometimes regulations require practices to defer their waste products to specialised waste management facilities. This is often to protect the environment around us from physical or chemical pollution risks. It’s important to understand when these bodies should be contacted, or more specifically, for which products.
Wasting water
Of course, in the practice there are a variety of elements that can’t be disposed of down the sink. These products will commonly contain chemicals which can impact water systems.
For example, dental X-ray fixer is a hazardous material, containing approximately 4000 mg of silver per litre after it has been used. Pouring it down the sink could let it enter water systems, with serious consequences. It could harm fish and other aquatic life, and it may even damage crop fields. The presence of silver could also make water unfit to drink, and it may speed up corrosion and damage equipment that it makes contact with.
HTM 07-01 states X-ray fixer should be kept in a sealed container, separate from X-ray developer, and sent to either the supplier or a specialised, licensed treatment facility. The silver might be recovered from the solution, or it could be sufficiently disposed of as hazardous waste.
Specialised landfill
Similarly to the waste liquid dilemma, there are some dental specific products that can’t be sent to landfill. One prominent item is gypsum waste.
This is used to create 3D models for orthodontic, restorative and prosthetic treatments. It cannot be simply sent to landfill, especially one that accepts biodegradable waste. The Environment Agency requires gypsum-based waste to be separated for re-use or recovery, or sent to a landfill with a separate cell that doesn’t accept biodegradable waste.
This is because of gypsum’s sulphur content. When it interacts with sulphate reducing bacteria, which thrives in a landfill’s wet, anaerobic environment, it gets broken down, and eventually, hydrogen sulphide is produced.
This can be harmful for anyone who inhales the gas. It has a distinct rotten egg odour, and it can be irritable to the eyes, nose and throat, making breathing difficult. Neurological issues like headaches, poor memory and impacted motor function are also possible. A specialised waste management outlet can control and minimise these risks.
take the pressure off
Navigating waste management can often feel complex, but dental professionals don’t have to complete the task alone.
Initial Medical provides legally abiding containers, such as the Eco Gypsum Waste Containers, which are manufactured from 100% recycled polymers to further help the environment. The collected gypsum is segregated and disposed of at a specialist landfill site, to give you peace of mind. Initial Medical is also on hand to answer any queries around waste disposal, from gypsum waste, to X-ray solutions, and even amalgam compliance.
Organising dental waste is essential. Not only does it keep clinicians and patients safe, but the larger world around us, too.
To find out more, get in touch at 0808 304 7411 or visit www.initial.co.uk/medical. n
about the author rebecca Waters, category Manager at initial Medical.
Support, passion and innovative equipment – the recipe for success
Dr Lau Berraondo reflects on the massive accomplishment that was designing and building a
multi-surgery
practice in Cambridgeshire
My motivation for building a new 9-surgery practice, Enhance Dental Centre, was to provide top-quality dental care and a comprehensive range of services to our patients. I wanted to create a state-of-the-art facility that would not only cater to our patients’ oral health needs, but also offer a welcoming and comfortable environment that supported and enhanced their overall wellbeing.
the vision
The vision for the practice revolved around offering a wide variety of dental services, from general check-ups and preventive care to advanced restorative and cosmetic treatments. I aimed to create a patientcentric practice, where the emphasis would be on personalised care and building lasting relationships with our patients. In terms of the design of the premises, I envisioned a modern and sleek ambiance that exuded professionalism and relaxation, making our patients feel at ease during their visits.
a trusted partner in design and equipment
I chose to work with Clark Dental on this project due to their reputable track record and the excellent service and products they provide. Their expertise and dedication to dental equipment and technology made them an obvious choice to help bring my vision to life. I have had the privilege of working closely with Clark Dental over the course of my dental career – which spans over two decades – building a partnership that has proven invaluable to the success of Enhance Dental Centre. Having installed over 25 surgeries with them to date, I can attest to the exceptional quality of their products and the unmatched expertise of their engineers.
Stuart Clark and Matt Rowlingson, in particular, played a pivotal role in the dental design aspect of this practice. Their keen understanding of dental workflows and their ability to translate our vision into practical solutions were instrumental in creating a functional and aesthetically pleasing environment for our patients and staff.
The collaboration with Clark Dental extended beyond the selection and installation of equipment. Stuart and Matt worked closely with our team of builders and architects throughout the entire process, ensuring a seamless integration of the dental equipment and technology with the overall design of the premises. Their
hands-on approach and attention to detail ensured that every element of the practice was meticulously planned and executed, resulting in a state-of-the-art facility that exceeded our expectations.
equipment selection
Selecting the equipment was a scrupulous process. I wanted to ensure that we had cutting-edge technology to deliver the highest quality of patient care. Among the stand-out pieces, I was particularly impressed with the advanced treatment centres and CAD/CAM solutions. These technologies have not only improved efficiency and precision during treatment, but also allowed for more streamlined patient experiences.
Our dedication to providing the highest standard of dental care is reflected in our choice to utilise Dentsply Sirona dental equipment. This is a leading name in the dental industry, renowned for its innovative technology and solutions. The exceptional quality and reliability of Dentsply Sirona’s Axano and Intego Pro treatment centre solutions have revolutionised our practice, allowing us to deliver precise and efficient treatments with utmost comfort for our patients. The introduction of the Primemill and Primeprint 3D units have also facilitated a comprehensive digital workflow in our practice, allowing us to fabricate everything from trays to implant guides and splints in-house, further enhancing our patient services.
In addition, we invested in leading brands for our new handheld x-ray equipment, Axeos CBCT machine and various decontamination technologies. The integration of these solutions elevates our capabilities as dental professionals and also enhances the overall patient experience.
Minor bumps in the road
Throughout the process, we faced several challenges, such as coordinating construction timelines and ensuring all regulatory requirements were met. However, the highlights far outweighed these difficulties. Witnessing the transformation of the practice into a modern, cuttingedge dental centre and receiving positive feedback from our patients were truly rewarding moments.
plan ahead
For other professionals approaching a project of this scale, my advice would be to plan meticulously and surround yourself with a reliable team of professionals who share your vision. Open communication and collaboration with everyone from
the designers to the architects, and equipment suppliers is crucial for a successful outcome. Embrace innovation and technology to elevate patient care and experience, and always keep the patient’s wellbeing at the forefront of every decision made along the journey.
Support is crucial
The final result of Enhance Dental Centre exceeded my expectations and closely aligned with my initial vision. The design of the premises was stylish and welcoming, creating a positive and calming atmosphere for both patients and staff. The stateof-the-art equipment and technology we integrated into our practice have significantly enhanced the level of care we can provide to our patients.
The consistent support and guidance from Clark Dental have been unmatched, and their dedication to delivering exceptional service has solidified our longstanding partnership. With their assistance, we were able to create a dental practice that not only embodies the latest advancements in dentistry, but also fosters a welcoming and
comfortable atmosphere for our patients. I am incredibly grateful for the collaboration with Clark Dental and their unwavering commitment to elevating the standards of dental care at Enhance Dental Centre.
For more information call Clark Dental on 01268 733 146, email info@clarkdental.co.uk or visit www.clarkdental.co.uk n
about the author Lau Berraondo, clinical Director of enhance Dental care,
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The bigger picture
Why the sky’s the limit for dental images and cloud storage
The average patient record contains a vast amount of data – charts, referral letters, consultant reports, prescriptions and billing information are just the tip of the iceberg. And with the major advances in digital imaging, dental practitioners are also now dealing with thousands upon thousands of image files. As you know, dental practices are directly responsible for the data held on patients, and those who are data controllers in the practice must be registered with the Information Commissioner’s Office. The GDC’s Standard 4.5 states that dental professionals must “keep patients’ information secure at all times, whether records are held on paper or electronically.” It also says that dental professionals must “make sure that patients’ information is not revealed accidentally and that no one has unauthorised access to it by storing it securely at all times.” Indeed, all data and images gathered are subject to the Data Protection Act 1998 and therefore dental professionals must follow its guidance to ensure that data is stored safely and securely.
hard times
Up until recently, the most common approach for storage has been the use of external hard drives. Images can be stored on a personal computer and further backed-up to an external hard drive. While the ease and relative cost-effectiveness of this approach may seem attractive, there are fundamental flaws in this approach that risk the loss of data. This is because the data is stored in a
single place and therefore an event such as a fire or a robbery could risk the loss of all data.
Another factor to be aware of is the annualised failure rate (AFR) for hard drives, which has increased over the last three years. For example, Backblaze, the American cloud storage company, recorded an AFR of 0.93% in 2020 and 1.10% in 2021. The AFR for 2022 was up to 1.37%. The main reason for the increase is due to the age of the drives. Like any other hardware, hard drives are more prone to failure as they age.
Given that Dental Protection data in the UK states that records need to be kept for 11 years for an adult, the advent of cloud-based storage systems presents an attractive option. It also chimes with the government’s Cloud First policy for healthcare providers.
There are several reasons why using cloud storage for images in a dental practice can be beneficial. Firstly, it’s a costeffective option. Cloud storage eliminates the need for expensive on-site servers and equipment, saving the practice money on hardware and maintenance costs.
It also offers scalability. Cloud storage can easily adapt to the changing storage needs of a dental practice. As the number of images and files increase, the cloud storage can be easily expanded to accommodate the growing data.
cloud collaboration
Then there’s the benefit of accessibility. With cloud storage, dental professionals can access patient images from anywhere
at any time, as long as they have an internet connection. This allows for increased mobility and flexibility, enabling dentists to access and share images with specialists or colleagues for consultations or second opinions. Dentists, hygienists and specialists can securely share and work on images simultaneously, leading to improved communication and coordination within the dental team. And with digital imaging increasingly being used as a patient information tool to allow patients to be more involved in shared decision making, easy accessibility is key.
Cloud storage can offer peace of mind on the data backup and recovery front. It typically includes data backup and recovery features, which can help protect against data loss due to hardware failures, natural disasters, or other unforeseen events. This ensures that valuable patient images are safe and can be easily recovered if needed. Similarly, trusted cloud storage providers implement robust security measures
to protect stored data. This includes encryption, user access controls and constant monitoring, ensuring that patient images remain private and secure.
Sensei Imaging is part of Sensei Cloud, the Software-as-a-Service platform from Sensei. It is a dental imaging software solution to safely and securely store patient images, allowing dental professionals to access records at their convenience. It works with existing technology, so practices don’t have to interrupt their workflow for an upgrade. It encompasses a whole suite of diagnostic, browser-based dental imaging software tools, enabling dental professionals to grow their business and focus on what’s most important – their patients.
Overall, cloud storage offers dental professionals a convenient, cost-effective, and secure solution for storing and accessing patient images, enhancing efficiency and collaboration within the practice. And with its additional scalability benefit, dental professionals really can shoot for the sky!
For more information on Sensei Cloud visit gosensei.co.uk. For the latest news and updates, follow us on Facebook and Instagram @carestreamdental.uk n
about the author nina gilbert, Senior global product line Manager, carestream Dental.
Intelligence is the future – artificial or not
The field of artificial intelligence (AI) is in constant flux. The technology is being developed rapidly and its applications are broadening by the day. However, there are some valid concerns with regards to how we as a society manage the massive changes that AI could initiate. Right now, the intelligence behind the AI – i.e. the people writing programmes, managing the growth of the technology and using the end product – is what determines its effectiveness and ethics.
here to stay
Although we’re talking about AI being the future, it’s important to acknowledge that it is already here. Indeed, the software has been integrated into various areas of our everyday lives, from the smart phones in our hands to the automatic features in our cars, the smart speakers in our homes and the robotic manufacturing process employed by various industries worldwide. In healthcare, AI is changing the way that patients interact with service providers, with a level of automation now available to help individuals identify basic health issues quickly and easily. As we have seen in dentistry, AI-driven software is also enhancing diagnostic processes with the ability to detect and highlight abnormalities from radiographs and other
imaging media. This particular feature is serving a useful function as a double check or as an objective report that supports the professional’s recommendations. In a profession like dentistry where we commonly have to work hard to earn the trust of our patients, this is advantageous in increasing treatment acceptance. There is also merit in utilising AI-generated reports to enhance patient communication and education, encouraging their engagement in their dental and health care, and compliance with clinical advice. Though the technology is still being developed, there are clearly already massive implications for AI technology in the dental and health sectors today.
Managing development
In light of the vast inroads made so far, there are some – seemingly quite valid –concerns about how AI is developed from now on. For example, there are ethical implications at play. Some people have questioned whether issues of accountability and transparency my arise by using AI in healthcare – and whether the human opinion or AI-generated report would ultimately hold greater stead in a courtroom. There are also potential problems with data privacy where generative AI programs access personal information in order to identify patterns and predict future risks or events.
One of the biggest worries regarding AI right now and for the immediate future, is how to avoid and manage misuse of the technology. The more powerful the algorithms get, the more opportunity there will be for the malicious use of AI. Beyond privacy breaches, this might involve deepfake technology, autonomous weapons, job displacement, cybersecurity threats and widespread social manipulation. Even something as simple as bias in the information presented could impact society as we know it.
That’s why there have been calls for strict regulation of AI development, with recommendations for researchers and engineers to accept a responsibility for actively preventing the misuse of AI. There was even an AI Summit in London in November which, interestingly was held at Bletchley Park – where Alan Turing cracked the Nazi World War II Enigma code. This event brought together experts in the field to discuss the prevention of spreading misinformation by AI technology during elections, as well as the threat of technology warfare.
While all of this is well outside the remit of dental professionals, it’s important that we understand equipment in our practices and how it integrates with the rest of the world. Even a simple data breach could have a detrimental impact on our patients, on the professional team and on our businesses.
humans still run the world
Ultimately, we need to be smart about what we use, when and how. A person could have access to the most powerful equipment in the world but if they don’t know how to use it then it’s useless to them. Similar principles apply to AI in dentistry – if we are to maximise the opportunities available, in a safe and ethical way, then we must first understand what we are dealing with. Right now, as long as the AI-assisted software is used in an ethical way, then the equipment is ethical. The onus is on the operator. Whether this remains the case in the future is yet to be seen, but for now, we are very much still in control of our patients’ care, even if utilising AI-assisted solutions!
For further information please call EndoCare on 020 7224 0999 or visit www.endocare.co.uk n
about the author endocare, led by Dr Michael Sultan, is one of the UK’s most trusted Specialist endodontist practices. endocare is a dependable referral centre, to which dentists from across the country send their patients for the best in specialist endodontic treatment.
Step-by-step – protocols for posterior composite placement
Céline Higton, a leading expert in cosmetic and restorative dentistry, discusses her four-step methodology for the placement of high quality, durable posterior restorations
How has restorative dentistry changed in the past 20 years and what does this mean to today’s restorative dentists?
Most dentists would agree that restorative dentistry has changed beyond all recognition, especially in the last decade, in which there has been a seismic shift from mechanically retentive dentistry to chemically adhesive dentistry.
The moment dentists realised we could effectively and consistently bond to dentine, everything changed. Until then, the only way to predictably place both direct and indirect restorations was using mechanical retention.
As a result of this shift, restorative success now relies heavily on the bond between dentine and composite, meaning it’s vital to follow every step of preparation and execution to the letter.
How important is the external environment in terms of preparation?
It’s fundamental. The external environment in which dentists work is the mouth, which is wet, dark and mobile. Chemically adhesive dentistry relies on having a clean, dry bonding surface. If any biofilm, plaque, bacteria or moisture is present, the bond will eventually fail. The oral environment isn’t conducive to this type of modern dentistry so we have to adjust our processes to eliminate these variables.
Can you explain your 4-step methodology?
The placement of high quality and durable posterior composite restorations relies heavily upon a well-executed sequence. I use a fourstep process which I compare to a building:
1. The foundation: rubber dam isolation
2. The walls: cavity preparation
3. The floors: matrixing
4. The roof: final composite placement Composite placement is the final step but if the initial steps are not completed correctly, the restoration is certain to fail prematurely. If you place a roof on a building with poor foundations; it will eventually collapse.
Why is rubber dam so important?
I am probably the world’s biggest fan of rubber dam! And the main reason I use it
is to simplify the working environment and eliminate external variables. When placing a direct restoration I expose multiple teeth to improve access and vision and to use the adjacent teeth as reference points.
What are some of the protocols for maximising bond strength that chemically adhesive dentistry relies on?
You must first provide a dry and clean area to work in. When placing rubber dam I remove any saliva and use air abrasion to remove any biofilm, which is one of the biggest causes of bond failure.
The choice of clamp shape and fit is crucial for correct isolation. The role of the clamp is to stabilise and anchor the rubber dam in the mouth and having a range of different sized clamps is essential. If the clamp is the wrong shape for the tooth, it will fly off as soon as it is put under any tension.
Open cavity preparation is key to facilitating better matrix and composite placement. One important step is to bevel the enamel surface – this increases the surface area of enamel to which we are bonding, which in turn increases the bond strength. It is also important to have a good understanding of the difference between various matrixing systems and how they are best used, depending on the size and location of the cavity.
Another key protocol in my methodology is dentine sealing, which is crucial because the bond between composite and dentine matures overs time. During the immediate dentine sealing process I prime, bond, cure, resin coat with a layer of flowable composite, cure again and leave for 5 minutes. The bond between the dentine and composite will then be strong enough to withstand any shrinkage stress from the composite and it will be less likely to pull up the dentine from the cavity floor. These factors are key in helping to reduce the risk of post-op sensitivity.
What are your stressreducing protocols when placing composite?
Shrinkage stress is a real issue. You can reduce the C-factor of composite by opening up wider preps and placing composite in increments rather than in bulk.
Material choice also matters, for example, in large cavities by using a fibre-reinforced composite such as everX Posterior (GC). When the composite shrinks the fibres work to dissipate the shrinkage stress.
everX Posterior is also an ideal material for root-treated teeth where you want a material with the least shrinkage stress and good translucency.
What are your considerations when choosing a material for the final occlusal layer?
I always want a material that doesn’t slump, that polishes well, wears well and has very high fracture resistance. My preference is to use everX Flow (GC), a short-fibre reinforced flowable composite indicated for dentine replacement and for core build-up preparations.
You have mentioned using G-ænial Universal Injectable composite. What procedures can this be used for?
This is quickly becoming one of my favourite composites to work with. The shade choice is phenomenal with dentine shades, enamel shades and even a bleach shade. As a flowable its properties are incredible in terms of fracture resistance, wear resistance and polishability; I find it actually maintains its polish better than most paste composites do.
G-ænial Universal Injectable is also the go-to for many clinicians for injection moulding because of its strength and aesthetics. It can be used as a long-term temporary material because it wears very well and is so easy to place. It is also quite flexible so it’s very good for buccal cervical restorations. Its applications continue to widen and improve.
Posterior Composites with Dr Céline Higton is a two-day course being held on 5th – 6th July 2024 at GC UK’s Head Office near Milton Keynes. The course is designed to teach the skills required to place high quality, predictable and durable posterior composite restorations. For further course information and to book your place please visit gcuk-education.co.uk/clinical or email info.uk@gc.dental.
For further information on GC’s full range of restorative products contact GC UK on 01908 218999, email info.uk@gc.dental or visit gc.dental/europe/en-GB
About the author Dr Céline Higton is a leading expert in cosmetic and restorative dentistry.
Empower implant patients to optimise oral hygiene
Thousands of people are now seeking out dental implant treatment every year. Patients are understanding the many benefits of associated therapies, and how a dental implant can look and function similar to a natural tooth. They are also finding out how these treatments can be delivered with minimal chair-time, and are often more affordable than many think.
For patients, one advantage of choosing a dental implant is knowing that, with correct maintenance, they can last for many years. It is crucial, therefore, that they understand how important their own role is in ensuring treatment stability and are willing to commit to all the behaviours required.
Success starts from the planning stage
Although success rates are high for implant therapies – a one-year follow-up study reported a survival rate of 95.5% – there has to be on-going vigilance for all potential complications that could compromise the outcome.
The most common reason for implant complication and failure is infection. Careful monitoring and management of anything that could indicate the inflammatory and destructive condition peri-implantitis, must be conducted by the dental team. Regular appointments, to check all is well, can minimise the threat, as can smoking cessation along with making other lifestyle changes.
Poor plaque control is another factor, which is where the patient’s willingness to adopt an elevated dental cleaning routine is fundamental.
Helping patients choose
Comprehensive home care can help keep a dental implant beautifully maintained, and help patients avoid peri-implant infection. It is their responsibility to keep up the deepclean habit, but professionals must engage them via education, so they truly understand the reasons behind their actions.
With your help, they will feel more confident that they are doing all they can to keep their implant(s) stable. An implant care routine will start with the basics of toothbrushing. Then, cleaning interdentally, which is something every patient should be doing – looking after the interproximal areas has enormous benefits for all-round oral and general health. And, with the right tools, it is perfectly safe for implant patients to do. Cleaning between
will disrupt the deposits of calculus that, if left untouched, can lead to an increased risk of peri-implant disease.
For some patients, they will need to adopt new or update their current at-home routines. The field of behavioural science is an entity to itself, but for dental professionals, having a basic understanding of what drives patient habits can be useful in helping them to make changes. This means ensuring that a patient has the capability (physical or psychological ability), opportunity (with regards to their home environment or access to products) and motivation (desire) to implement positive adjustments to their oral hygiene routine. The dental team should be educating patients and providing reliable information on the benefit of any recommended changes to their habits in order to help understand the importance of following advice. This should be backed up with continuous encouragement and practical support where appropriate, for example, when it comes to practising techniques or selecting products.
making the job a pleasure
To make the job of deep, comfortable everyday cleaning easy for implant patients, premium Swiss oral care brand, Curaprox, has produced an Implant Care Kit, with everything needed in one handy pack. Excellent as a teaching aid too, it contains a toothbrush, interdental tools also toothpaste and mouth rinse, so they know exactly what to reach for, every day.
All Curaprox toothbrushes are designed to remove plaque gently, without scrubbing. That is thanks to the ultra-fine Curen® filaments, which are densely packed yet can move around the teeth easily and efficiently. Once they have brushed, patients can clean between with a CPS Prime interdental brush for implants, which only need a single movement, once a day, to get between the hard-to-reach spaces. Also included is a Perio Plus+ Regenerate mouthwash, containing Citrox®, a natural bioflavonoid extracted from bitter oranges. Adhering well to the teeth, gums and oral mucosa, this completes the Kit.
It is good to remind implant patients that, for the most part, their implant-retained crown is just like a ‘normal’ tooth – and so it requires the same level of TLC. This means attention to scrupulous daily cleaning and oral hygiene practises. But to keep their treatment results beautifully maintained for as long as possible, they should elevate their routine using highquality products that are proven to work. With your help, they can enjoy their new smile for many years to come.
For more information, please visit www.curaprox.co.uk n
about the author tom alcraft, Curaden UK Commercial Director, UK & Ireland.
The dentist will see you now, and again, and again
Adental implant should last a lifetime, serving as a brilliant restoration that can save a smile or functionally help patients in everyday life. As such, the journey of care doesn’t only last from the planning to placement, but includes years of successful implant health checkups. These appointments are essential to maximising the quality and longevity of implant treatment outcomes, ensuring that the appropriate maintenance is in place.
Preferential treatment
Dental implants have become renowned as an increasingly reliable treatment solution for partially or fully edentulous patients. When placed successfully they are aesthetically brilliant, with functionality akin to the natural dentition, and can provide an improved quality of life compared to alternative prostheses, such as conventional dentures. However, I won’t be the first to tell you that they need to be treated slightly differently from the natural dentition that they mimic so well. A patient’s permanent teeth are anchored into place via a periodontal ligament, which also accommodates for natural protective defence mechanisms. The localised cells can produce proinflammatory cytokines when stimulated by bacterial endotoxins, creating a local immune response. In the natural dentition, this plays an essential role in the control of the periodontal pathophysiology. When a dental implant comes into play, clinicians place it directly into the jaw
bone and rely on osseointegration for the stability that the periodontal ligament would generally provide. However, in its absence, the implant is not as well protected. Clinicians familiar with the construction of an implant will know its susceptibility to infection. Studies of peri-implant microflora reveal bacteria such as Staphylococcus aureus – which is not common around teeth – has an affinity for the titanium structure, and is associated with bleeding on probing and suppuration, and more importantly implant failure.
With regards to the physical build of an implant, two-piece implants unavoidably present a micro-gap between the implant and abutment, creating the potential for bacterial colonisation. This presents the chance for interference with peri-implant tissue health, leading to potential bone loss, which will of course risk treatment failure.
Defensive actions
Since the risks associated with a dental implant are different to that of a natural tooth, there must also be a change in approach to care, from both the patient and the clinician. Daily implant maintenance is of upmost importance, and can only be carried out by the individual themself. However, dental professionals must inform patients of the most viable routines that can set them up for success. In the day-to-day, this would require consistent toothbrushing, with a variety of manual, powered and sonic brushes proven effective. Stressing the importance of interdental cleaning is also crucial to shift the bacteria-heavy debris
that can build up and threaten potential implant failure: conventional toothbrushes cannot access proximal surfaces in the same manner as an interdental brush.
The impact of the clinician appears most notably in the all-important check-ups and dental hygienist appointments that patients should attend. The latter are best every six months, perhaps more often for those at a greater risk of oral health problems, but a regular yearly appointment to focus on the implant itself should also be encouraged.
a keen, clinical eye
An annual implant-focused visit could address issues in the greater dentition, but clinicians should prioritise this time to address the healing and patient-led maintenance of the restoration and, most importantly, identify and act on any signs of peri-implant complications. But just as the natural dentition and dental implants react differently to the oral microbiome, clinicians should react differently to each structure.
For example, periodontal indices are viewed by many as inappropriate indicators for treatment needs around dental implants, arguing it is no more effective than the visual inspection of mucosa redness. The risk of damaging fragile peri-implant scar tissue is another significant concern. Bleeding on probing and periodontal pocket depth measurements need to be associated with radiographic assessments of crestal bone loss for confident diagnosis and treatment plans – some would argue it is as effective, and safer, to avoid probing entirely and instead use visual cues, palpation
and radiography as the basis for postplacement assessments. To be able to effectively manage patients in their implant durability, dental professionals must, above all else, be appropriately trained and knowledgeable about these care provisions, from planning and placement to long-term assessments. Clinicians could choose to grow their skillset, and provide exceptionally informed patient care, with the Postgraduate Diploma in Implant Dentistry from One To One Implant Education. The course covers the entirety of the treatment journey, transforming budding implantologists into confident clinicians. Delegates learn from dedicated tutors in a peer mentor system, for ease of communication and exceptional guidance throughout the process. With the right knowledge in place, clinicians can achieve long-lasting restorations that receive brilliant upkeep. Implants must be thought of differently from the natural dentition, but by establishing regular patient visits, the dental team has the greatest opportunity to cease and prevent the common soft-tissue challenges that have long plagued survival rates. To reserve your place or to find out more, please visit 121implanteducation.co.uk or call 020 7486 0000. n
about the author
Dr Fazeela Khan-Osborne is the Founding Course Lead for the One to One education Programme.
Adapting to the challenge
Tooth loss can be stressful for patients, with a change to their dentition potentially affecting function and aesthetics, and in turn, their confidence. They may seek a dental implant for a long-lasting, stable restoration, which can restore a naturallooking and feeling smile.
Clinicians may encounter a range of issues – lost anterior teeth, decaying pre-molars –but some of the most difficult cases may involve offering posterior implants.
Patients are demanding modern and streamlined solutions, so it’s important for clinicians to consider how this affects the types of treatments that they offer – and what it means for the equipment and techniques they use.
A modern treatment
Immediate implant placement is quickly becoming a treatment option preferred by patients. When successfully carried out, an immediately placed implant can restore the dentition with a reduced treatment time, without compromising on aesthetics, function and longevity.
Following the removal of a tooth, the alveolar bone will undergo atrophic change that reduces the available bone volume for implant placement. This can be a functional and aesthetic issue when using delayed placement protocols. In contrast, placing an implant directly after an extraction, particularly in the posterior region, offers a number of benefits for the clinician. Firstly, immediate placement can help to preserve
the extraction site, maximising the volume of bone that is available to work with.
The extraction site may also act as a partial surgical guide. A clinician could follow the extracted roots to ensure that the ideal positioning and orientation of the implant is achieved.
Immediately placed implants have an equally high survival rate when compared to delayed placement in a molar postextraction site. However, to maximise the clinical and aesthetic outcomes of each unique case, clinicians must ensure they are using the appropriate equipment as well as an effective technique.
The difference a component makes
Achieving primary stability, especially in immediate implant placement, is essential to facilitate successful osseointegration in the long term. When a molar is extracted, the fresh socket may have no remaining
bone to support the implant and achieve this stability. However, immediate placement could still take advantage of the limited bone in the surrounding structures. Acting quickly following an extraction could allow a clinician to utilise the nearby bone before atrophy takes place, and use this to attain primary stability.
Clinicians should utilise the widest implant diameter necessary and, where appropriate, consider the use of bone augmentation procedures to provide a sufficient bone density for success. A wider implant can offer an improved chance of achieving primary stability by making contact with the walls of the post-extraction socket. The introduction of a biomaterial can help to narrow the alveolar gap, where a wider implant cannot suffice.
In the posterior region, the human bite force is triple that of the anterior: occlusal overload is an important failure factor, so mitigating this power through the implant structure itself must be considered. It has been reported that increasing the implant diameter can reduce the intensity of stresses along its length, as well as lower stress values in the bone. Increasing the load-bearing capacity is therefore possible with a wider implant, making it an increasingly appropriate option in this region of the mouth.
Bones and all
Alongside the implant’s relationship with the bone, with stability and occlusal forces considered, a clinician should also think about care for the soft tissue. A healing abutment is generally the option of choice to maximise health and aesthetics.
This key component is used to recover or modify the soft tissue following implant placement, for clinical and aesthetic purposes. Healing abutments may be customised for the individual patient, but wider solutions can generally be used in the posterior, given the size of the implant and the surrounding site. Overall, they are essential in modern dentistry for the control of the soft-tissue emergence profile. The ideal outcome is a natural-looking profile that also protects the health of the soft tissue and the underlying bone. A healing abutment does this by preventing the formation of food traps. If debris builds up around the implant and soft tissue, a patient could develop peri-implantitis – with potential for implant failure.
When using the right components, difficult cases in the posterior can become manageable and successful. Neodent®, a Straumann Group brand, offers exceptional posterior solutions within their Grand Morse® range. The Grand Morse® Helix® implants are available with Ø 6.0 mm and Ø 7.0 mm diameters, to maximise primary stability in multi-rooted extraction sockets. Wide healing abutments are also available, for options that provide a naturallooking emergence profile in a healthy site.
Posterior implants place unique demands upon the clinician – less bone in the extraction socket, high occlusal load, and aesthetic molar restoration. Immediate implant treatment is more than possible, though, and where appropriate it can restore a patient’s confidence in excellent time.
For more information, please visit www.neodent-uk.co/portal
The effect of malocclusion on restorative success
Patients’ occlusion should be considered in every aspect of dentistry. It is a key factor in the planning of any dental treatment, be it orthodontic, cosmetic, or restorative. Malocclusion can also have a significant impact on patients’ oral health. It can increase the prevalence of caries and periodontitis, and the risk of trauma. Patients with a malocclusion may also feel self-conscious about the appearance of their teeth, causing them to seek treatment which improves the aesthetics. When providing restorative treatment, special care should be taken in the planning stages to assess patients’ occlusion and provide them with the most appropriate solutions.
Occlusion and restorative design
Occlusion influences every area of dentistry, including restorative. When recommending restorative treatments to patients, it’s vital to consider their occlusal situation and take a prosthetically-driven approach to treatment. For example, when providing a patient with a dental bridge, it’s crucial to take a highly accurate bite registration because the supporting teeth will be required to absorb any occlusal forces to protect the longevity of the restoration. Similar considerations must be made when providing dental implant supported prostheses. While this depends on its location, the design of the prosthesis may mean that it is load bearing, so special measures must be taken to avoid this where possible. Recontouring the opposing tooth, for example, or adjusting the prosthesis
design may help to reduce the load on the implant system and minimise occlusal contact. In doing so, the implant structure is protected against excessive force and patients are able to chew comfortably, and as they normally would.
Any restoration will be exposed to a certain level of force, depending on its location. Small forces exerted during chewing, for example, have the potential to lead to fatigue failure of the restoration over time. If the restorative design does not accurately account for malocclusion, it is likely to be subjected to excessive forces.
the limits of traditional techniques
Inadequate impression taking can have a significant impact on the success of restorative treatment. If an impression has been taken of a prepared tooth which has not accurately captured the situation, restoration failure is more likely, with poor results both aesthetically and functionally. It is important to identify areas which bear the most stress as, if not located and the pressure relieved, restorations placed in these areas will become stress bearing zones.
Traditionally, recording areas of contact is completed using bite articulating paper. The patient bites down on the paper, which marks areas that come into contact with opposing teeth. However, it doesn’t take into account each patient’s unique chewing motion, and the level of force exerted on
these areas. This does allow clinicians to make adjustments to prostheses, but does not provide additional information which could help inform treatment plans, and allow clinicians to adjust the prosthetic accordingly.
are current digital solutions enough?
While intraoral scanners are fast becoming a popular option for recording dental impressions, they are often not sufficient for accurate bite registration. The software used to process intraoral scans may allow the clinician to simulate the teeth meeting, but this cannot replicate force or chewing cycles. This factor is key when providing restorative treatment, as it can have a significant impact on longterm success. Intraoral scanners are also currently unable to record and simulate patients’ chewing patterns, meaning that clinicians are missing crucial information about their bite which would allow them to provide restorations which perform better, and for longer.
Digital
revolutions for enhanced accuracy
As the technology to produce this recording is not currently available, many clinicians are continuing to use traditional methods to record occlusion and bite registration, creating physical models of the teeth to ensure accuracy. Digital dental solutions are being adopted in many other areas of dentistry, and a
Diagnosing and managing dry mouth
Any dental pain or discomfort has a significant impact on a person’s quality of life. In particular, it has been linked with several mental health concerns, including anxiety and depression, stress and even suicidal thoughts. Xerostomia is one condition that can have a substantial impact on the sufferer’s health and wellbeing, so it’s important that dental teams can help patients manage the symptoms effectively.
a widespread condition Xerostomia, or dry mouth, is estimated to affect 40% of people over the age of 55. This is particularly relevant given the physical and mental health concerns that already exist for the older population. A Swedish study also found that women had a higher incidence of xerostomia than men. It can be a chronic issue for suffers, which impacts every aspect of their lives, from speech to chewing and swallowing. It also increases the risk of tooth decay and dental infection. A leading cause of xerostomia is that it’s an adverse side effect of medication, so it is not always possible for dental professionals to eliminate the source of the issue directly.
For all these reasons and more, it is essential that dental professionals have the skills and confidence to effectively diagnose xerostomia and help patients manage the symptoms on daily basis.
assessment of dry mouth
A comprehensive assessment with a thorough medical history is crucial. If a patient regularly takes xerogenic medication, this can be a major indication of dry mouth risk. The patient should also be screened for other conditions associated with dry mouth side effects, such as radiation for head and neck cancer, Sjögren’s syndrome and other systemic diseases like asthma, diabetes, rheumatic diseases, thyroid diseases and eating disorders.
More tailored questionnaires have then been suggested in order to ascertain the severity of dry mouth symptoms experienced by the patient. An intraoral examination is, of course, useful, during which the practitioner should look for specific signs of xerostomia. These may include:
• Where the mirror sticks to the buccal mucosa or tongue
• Frothy saliva
• A lack of saliva pooling in the floor of the mouth
• Loss of papillae of the tongue dorsum
• Smooth gingiva
• A glossy appearance of the oral mucosa
• Cervical caries on more than two teeth
It is also prudent to measure salivary flow rates. Normal stimulated flow rates average at around 1.5-2.0 ml/min, while unstimulated salivary flow rates should be around 0.3-0.4 ml/min. Hyposalivation is typically diagnosed at stimulated and unstimulated salivary flow rates of <0.50.7ml/min and ≤0.1ml/min, respectively.
management techniques
For many patients who are suffering, there is light at the end of the tunnel. Research demonstrates that xerostomia treatment improves the feeling of dry mouth in over 75% of patients receiving xerogenic medications. This, in turn, greatly enhances their quality of life without discontinuing medication use. For others who may be able to tackle the cause of their dry mouth, improvement rates may be much higher. Management techniques may either focus on alleviating symptoms or increasing salivary flow – or both in some cases. Pharmacological treatment often involves the use of sialagogue medications, which stimulate muscarinic receptors and salivation. These are usually only indicated where some salivary gland function remains. They can also cause an array of side effects which must be monitored carefully, including sweating, nausea and rhinitis. Electrical stimulation has also been shown to boost salivary flow rates. However, the related technology is not widely accessible in the dental practice.
Simpler solutions that patients can implement immediately include staying hydrated, sucking on ice cubes or sugarfree ice lollies, using lip balm for dry lips, and using sugar-free chewing gum, while also avoiding alcohol-based dentifrices, coffee, acidic foods and smoking.
Specialised oral care can offer further daily discomfort relief. Various products in the form of sprays, lozenges or gels may be utilised before meals or as needed
system which adequately replaces this would revolutionise bite registration and the way that restorations are designed. For the future, there is a clear need for digital solutions that record patients’ unique chewing patterns, and the force exerted on any areas of contact to allow clinicians to produce restorations which limit occlusal forces and protect the lifespan of the finished product.
Investing in new digital solutions is a big decision for any dental practice. The opportunity to improve workflows and record information that enables the dental team to produce long-lasting restorations is exciting, so it’s important to understand the technology, and use it effectively. Even though digital dental solutions still have a way to go, progress is being made. Many clinicians understand the importance of providing their patients with holistic, personalised care which takes into account every aspect of their oral health and dental anatomy. By designing restorations that accommodate occlusion, many patients will get the most out of the investment they’ve made in their long-term oral health.
https://mimetrik.co.uk n
about the author Stephen Claffey, managing Director of Dental Pathway and the Independent Dental advisory Board.
throughout the day to stimulate salivary flow or even temporarily substitute saliva. A trusted provider of such products is Oraldent, who offers the innovative Xerostom range of dry mouth solutions to cater to various patient needs and preferences. The portfolio consists of a toothpaste, mouthwash, saliva replacement and mucosa gels, mouth spray and pastilles, all of which contain natural ingredients to deliver daily effective relief from dry mouth discomfort, while helping to ensure proper oral care. They have also been shown to increase salivary flow by up to 200% with appropriate use.
restoring quality of life
No matter which discipline they focus on, or how many years they have worked in dentistry, the goal of every dental professional is to help patients improve their health and wellbeing. Dry mouth can have a significant impact on a sufferer every single day. By helping them to alleviate daily discomfort, practitioners can help improve their quality of life.
For more details, please visit Oraldent.co.uk, call 01480 862080 or email info@oraldent.co.uk n
about the author richard thomas, Director, Oraldent Ltd.
Living in a material world
Advances in impression materials take dental mould accuracy to a new level
Advances in flexible and elastomeric dental impression materials have revolutionised the field of dentistry in recent years. These materials have become increasingly popular due to their ability to capture accurate and detailed tooth and gum impressions, leading to improved patient outcomes and greater comfort during the dental impression process.
Traditional dental impression materials, such as alginate and silicone, have long been used in dentistry to create moulds of the teeth and surrounding tissues. However, these materials often lack flexibility and elasticity, making it difficult to accurately capture the complex contours of the oral cavity. Furthermore, they can cause discomfort and gagging sensations in patients, leading to an unpleasant dental experience.
Flexible and elastomeric dental impression materials offer a solution to these limitations. These materials are typically made from a combination of silicone, polyether, and other polymers that provide high elasticity and flexibility. This allows them to easily adapt to the oral tissues, capturing precise impressions even in hard-to-reach areas.
One of the key advancements in flexible and elastomeric dental impression materials
is the development of improved viscosity control. In the past, some flexible materials were too runny, causing them to flow excessively and compromise the accuracy of the impression. Today, manufacturers have optimised the viscosity of these materials, allowing for better flow control and reduced slump during the impressiontaking process. This ensures that the material stays in place and accurately captures the desired impression.
Another important advancement is the introduction of new materials with enhanced tear strength. Tear strength refers to the resistance of the material to tearing when removing it from the mouth. In the past, some flexible materials would tear easily, necessitating costly and timeconsuming re-impressions. However, modern elastomeric materials have been designed with improved tear strength, reducing the need for re-impressions and improving the overall efficiency of the dental procedure.
Flexible and elastomeric dental impression materials now come in a variety of viscosities, allowing dentists to choose the most suitable consistency for each specific dental procedure. For example, a lower viscosity material may be used for capturing fine details, while a higher
viscosity material may be preferred for creating impression trays. This versatility provides dental professionals with greater control and precision in their practice.
In addition to improved performance, flexible and elastomeric dental impression materials have also enhanced patient comfort. The elasticity and flexibility of these materials allow for easier removal from the mouth, minimising the risk of discomfort and gag reflex. Patients no longer have to endure the discomfort associated with traditional impression materials, making the entire dental experience more pleasant and less anxiety-inducing. Indeed, despite the industry noise around the advent of digital scans, one study found that there was no statistical difference between the two impression techniques (digital vs conventional) in terms of time or with regard to patient anxiety levels.
The flexibility of these materials also allows for easier pouring of dental gypsum or other materials into the impressions. The flexible material can be gently manipulated to facilitate the pouring process, resulting in more accurate and well-fitting dental restorations.
AFFINIS™ is a silicone-based impression material from COLTENE. AFFINIS™ wash materials wet the tooth and gingiva extremely
quickly and effectively. Its distinct surface affinity and flowability virtually eliminates the risk of air voids and distortions. With the AFFINIS™ product range, dental professionals are well prepared for any patient situation, no matter how complex. Advances in flexible and elastomeric dental impression materials have transformed the field of dentistry. These materials offer improved accuracy, tear strength, and comfort, leading to better patient outcomes and overall satisfaction. Dentists now have more control and precision in their practice, while patients can experience a more pleasant and comfortable dental visit. Material gains indeed! For more information: info.uk@coltene.com and 0800 254 5115. COLTENE loyalty scheme: https://rewards.coltene.com n
about the author nicolas Coomber, COLtene national account & marketing manager.
A modern approach to tooth decay
Minimally invasive dentistry isn’t out to reinvent the wheel. It is close to a clinical philosophy, believing that, where at all possible, acting to maximise the preservation of the natural dentition is extremely beneficial.
It’s been defined by some as a biological or medical approach to dentistry, notably that of caries treatment, as opposed to traditional surgical or mechanical principles. Now a popular approach carried out by many clinicians in their daily work, it’s important to consider what sets it apart from the established norm, and how it could tackle the largest challenge to modern oral health – tooth decay.
Simple steps
Minimally invasive (MI) dentistry is a practice that many clinicians may unconsciously implement every day. It demands a preventative and risk-management focused approach to care, with the conservation of healthy tissue a high priority. Conventional care may include removing carious dentine and implementing restorative fillings after disease has set in. On the other hand, a
MI approach seeks to prevent and identify issues early, long before cavitation begins and, where appropriate, employ minor surgical intervention.
It is a more holistic take on dental care and patient interactions. In a way, the least invasive treatment of all is simply effective communication with patients, instilling a well-kept oral care routine. Both patient and professional must realise that dental caries are a result of simple cause and effect. It is a lifestyle-related disease, and taking preventative actions such as regular brushing or cutting down on sugars can be beneficial.
However, some patients will, inevitably, present with a form of caries progression. For the best outcomes, catching the disease early is key. From there, the least invasive approach can be considered.
adapting a skillset
A misconception that the uninitiated may arrive at is that MI dentistry simply means doing less, and requires less skill than a conventional, often complicated, surgical approach. The reality is, both require their own set of unique expertise – and MI techniques require just as much skill.
Dentists must have the clinical ability required to accurately risk assess and judge the need for operative intervention only when lesions are actively progressing, without non-operative success; and the technical skill and material knowledge required to act upon a proposed treatment plan. Where the early detection of caries is successful, approaches to minimise the spread of decay may not require comprehensive dentine removal.
Differentiating between dentine that is caries-infected and caries-affected is a task in itself. The former is sticky and soft, whereas caries-affected dentine is a little ‘tackier’ and blends better with the harder, scratchy consistency of sound dentine. Where there is the opportunity to only remove minimal caries-infected dentine, there is the chance to retain sufficient natural tooth structure to support the next key step: a sealed restoration.
Closing off the caries
Since the MI philosophy calls to retain as much of the natural dentition as possible, the caries-affected dentine may actually be left behind, sealed off – rather than removed entirely – to prevent the spread of disease. By creating a physical barrier, dental professionals can effectively arrest caries whilst also creating a favourable environment for patients to clean.
This has proven to be an effective resolution in a number of studies, reducing the likelihood of caries progression by 70% – one 10-year study even showed that bonded and sealed restorations arrested caries progression and had greater longevity and clinical outcomes than unsealed amalgam restorations, where caries were completely excavated before placement.
For patients, achieving consistent results in this manner reduces the future time, money and headaches spent on retreatment of caries. However, alongside the clinical skill needed, dental professionals must be able to employ materials that they can rely upon. When practicing MI dentistry, the preservation of caries-affected dentine presents the challenge of effective
adhesion. Bond-strength, regardless of material and technique used, has found to be consistently higher for sound dentine than caries-affected dentine.
As a result, choosing the right adhesive solution is essential for maximising longterm success, especially where MI dentistry may preserve a significant level of cariesaffected dentine, when the circumstance allows. Clinicians could benefit from employing the 3M Scotchbond Universal Plus Adhesive from 3M Oral Care. The award-winning* adhesive seals cariesaffected dentine by creating a welldefined, void-free hybrid layer,** making it an essential for MI treatments. It is radiopaque to reduce the chance of future misdiagnoses and subsequent invasive overtreatment.** With virtually no postoperative sensitivity,** it’s a fantastic choice for a variety of indications.
Minimally invasive dentistry may be the standard workflow of the future for many clinicians. With tooth decay presenting as an issue of overwhelming magnitude – the World Health Organisation calls untreated caries the most common health condition – it’s important to understand what can be done to effectively provide treatment, whilst also ensuring healthy tissue can survive for a very, very long time.
For more information, call 08705 360 036 or visit www.go.3M.com/ocsdpr 3M and Scotchbond are trademarks of the 3M Company. n
*Dental Advisor award-winning product: https://www.dentaladvisor.com/ evaluations/3m-scotchbond-universalplus-adhesive/ ** 3M Internal data
X-Smart Pro+ endodontic motor with integrated apex locator from Dentsply Sirona: the best partner for the files
Dentsply Sirona launches the new X-Smart Pro+ endodontic motor that will eventually replace X-Smart Plus and VDW.Gold motors. The powerful X-Smart Pro+ portable motor is designed to optimize the performances of both Dentsply Sirona and VDW’s endodontic file systems, including ProTaper Ultimate, WaveOne Gold, TruNatomy as well as VDW.ROTATE and RECIPROC. With an integrated apex locator and Dynamic Accuracy technology, the motor delivers optimal performance in both rotary and reciprocating modes – delivering up to 7.5 Ncm and 3,000 rpm. Users of Maillefer’s X-Smart motor line, as well as VDW.Gold users will both find X-Smart Pro+ familiar thanks to some specific elements inspired by both Maillefer and VDW motors. The X-Smart Pro+ Motor will be available from 15th January 2024
The X-Smart Pro+ is a reliable and robust motor that has portable convenience with the power and functions of a tabletop unit. The motor is designed to streamline workflows, with enough battery power to support a full day of endodontic work.
responsive control and efficient precision
Unlike the periodic feedback of brush and sensor-based motor control, the X-Smart Pro+ features a patented sensorless system for 360° speed and torque feedback, enabling quicker reaction times for stable file settings.
X-Smart Pro+ reaches the apex in reciprocating motion an average of 21% faster than its competitors and 14% faster in continuous rotary motion 1 . The more stable file control provides a more predictable shaping experience.
Dynamic Accuracy™ technology enables direct length measurement during active shaping with the automatic auto-reverse function to keep the file on the desired target. The same accuracy 2 is achieved in length measurement during reprocessing as with a conventional manual measurement method with the hand file.
“The X-Smart Pro+ with integrated apex locator helps me organize my table and simplify my workflow,” said
Dr. Laura Andriukaitiene, endodontist from Lithuania. “It makes my workflow smoother with less transitions. And when I pair it with my preferred sequence, ProTaper Ultimate, I can use the slider for the initial route, canal scouting and gain working length, creating a glide path. It is optimal that the apex locator is integrated and we can use the slider directly.”
The X-Smart Pro+ provides superior visibility and access, with a 10-lumen integrated LED, a mini contra-angle with a 360° adjustable position, and a fully autoclavable handpiece sheath. The large 7-inch easy-toclean touchscreen interface includes a full file library of preset settings for Dentsply Sirona and VDW files, and up to 30 customizable file sequences. The file library can be easily upgraded to accommodate future file systems. Meanwhile, the ergonomic design allows for enhanced comfort, while the removable and autoclavable handpiece metal sheath reduces waste and complies with the latest infection control guidelines.
Better together
Dentsply Sirona and VDW’s endodontic file systems perform significantly better 3 when paired with the X-Smart Pro+ motor:
• For our reciprocating file systems WaveOne Gold, Reciproc Blue and Reciproc: X-Smart Pro+ delivers
the genuine and fine-tuned reciprocating motion, with precise angulation, acceleration, and speed for simplicity, safety, and reliability.
• For our continuous rotation files systems: X-Smart Pro+ delivers dedicated power and torque for optimal performance across a full range of anatomies with ProTaper Ultimate and VDW.ROTATE files.
• For TruNatomy: X-Smart Pro+ delivers constant, stable speed control at low torque to improve procedural control, supporting structural dentin preservation. With TruNatomy Large coming soon, this family is growing to include a new file to preserve dentin even in larger anatomies.
the perfect partner for the file
“Dentsply Sirona and VDW have always gone above and beyond to address the needs of customers, with simple and effective solutions that dental professionals can rely on,” said Mathias Kraus, Vice President Global Endodontics Solutions at Dentsply Sirona. “With the X-Smart Pro+ motor, dental professionals can focus on the procedure, not the tool, with full confidence that both performance and safety are optimized when paired with our endo files. We are committed to deliver solutions for best clinical results and maximized patient safety.”
a move towards a more integrated offer
X-Smart Pro+ is the first device of the Dentsply Sirona endodontic range that is common for both DS and VDW. Synergies between the two brands will continue as VDW will progressively integrate the Dentsply Sirona Endodontic offering as had Maillefer in the past. With the support of Maillefer and VDW, DS combines the endodontic experience of two trusted and leading brands, so clinicians can advance their endodontic performances with confidence. n r eferences
1. Internal data on file, contact: consumables-data-requests@ dentsplysirona.com
2. Variation less than 1%
3. Compared to most leading competitor motors using ProTaper Ultimate and WaveOne Gold files. Internal data on file, contact details: consumables-datarequests@dentsplysirona.com about dentsply sirona
Dentsply Sirona is the world’s largest manufacturer of professional dental products and technologies, with over a century of innovation and service to the dental industry and patients worldwide. Dentsply Sirona develops, manufactures, and markets a comprehensive solutions offering including dental and oral health products. n
Flying high with ClearPilot
ClearPilot 7.0 can give you even greater control over your ClearCorrect® aligner treatment plans
In the world of orthodontics, clear aligners have rapidly become the preferred choice for those seeking to straighten their teeth discreetly and comfortably. Among the various clear aligner solutions available in the market, ClearCorrect®, a Straumann Group brand, stands out as a leader in providing effective and predictable treatment.
ClearPilot™ is the digital treatment planning tool that gives dental clinicians enhanced visibility, and responsive control as they review and approve their ClearCorrect® clear aligner cases. It provides users with easy-to-access comments and technician notes, prescription details all in one place for side-by-side comparison, treatment overview, occlusal heatmapping, superimposition and millimetre grids.
The web-based platform was developed based on feedback from clinicians and enables dental professionals to evaluate and edit their treatment set-ups.
Cutting-edge
One of the standout features of ClearPilot™ is its cutting-edge technology which enables clinicians to create highly accurate and precise treatment plans tailored to each patient’s treatment goals. With ClearPilot, dental clinicians can visualise the final outcome before treatment even begins, providing patients with realistic expectations and greater confidence in the process.
ClearPilot produces robust 3D visualisations. You can easily rotate and zoom the model from all perspectives. It really can help with patient engagement too, as it can explain which teeth are being moved in each aligner step.
This level of visualisation enables the clinician to monitor the force of the aligners and complex movements can be slowed to give a more predictable outcome. It enables the dentist to add Clinical Control™ features like anterior or posterior bite ramps, add cut-outs for buttons and slits for elastics if needs be and the movement visualised with the new bite jump feature.
User friendly
Another key advantage of ClearPilot lies in its intuitive and user-friendly interface. The platform allows dental clinicians to seamlessly navigate through the treatment planning process, empowering them to make adjustments and modifications with ease. With just a few clicks, dental clinicians can fine-tune
treatment plans, ensuring optimal results and maximum patient satisfaction. With ClearPilot, communication between you and the technician, and you and the patient is enhanced.
The platform’s ClearPilot analysis tools include point-to-point measurement Bolton tables, step by step Tooth Movement charts, and Collision monitoring. Bolton analysis determines the ratio of the mesiodistal widths of the maxillary teeth to the mandibular teeth. It shows whether there is any tooth size discrepancy between the upper and lower teeth.
The movement chart tool details how every tooth has moved, giving the dental clinician detailed and accurate information. Users can customise the treatment plan by modifying the final desired tooth position. They can control intrusion/extrusion, translation, crown tipping, crown torque, and rotations directly on the 3D model and also customise the engagers being used, choosing between 2mm, 3mm and 4mm engagers.
Platform upgrade
The advent of ClearPilot 7.0 boasts an improved user interface, with tooth transparency feature, toggling options and colour setting preferences. It also gives you:
• Enhanced editing
• Enhanced visualisation
• Bite jump visualisation – you can show patients the anticipated change in occlusion
• Arch editing – for easier expansion or contraction of the arches
• An intuitive interface for placing engagers, cut-outs, and more
• A customisable sidebar – showing the tools that you use most frequently
• A collapsible right panel for a more efficient treatment experience.
By choosing ClearPilot 7.0, dental professionals can benefit from an intuitive web-based software that makes treatment set-ups easy to review, approve and share. Its robust 3D controls create effective and customised treatment plans that offer a variety of 3D editing tools including predictable tooth movement, ancillary procedure controls and aligner customisation capabilities. Its optimised visual interface supports clinical evaluation, digital treatment planning and increased patient engagement. The platform’s enhanced analysis tools perform deeper analysis and more accurate treatment assessments.
With ClearPilot and ClearCorrect®, dental professionals and their patients are sure to come through aligner treatments with flying colours!
For more details, please visit www.clearcorrect-uk.com n
Full streamlining ahead!
With Kiroku Docs you can generate dental documents from clinical notes in just one click
Have you worked out just how much time you spend every day writing patient letters, referrals and pre-treatment consent forms? We have! You spend about 35% of your time, or roughly 14 hours a week, generating clinical documentation. And around three of those precious hours occur outside your regular working hours.
Time for a change
Dental professionals can save valuable time and streamline their documentation processes by using Kiroku Docs. This latest feature from Kiroku, the digital AI assisted note taking platform, enables dental professionals to generate dental documents such as patient letters, clinician referral letters, and pre-treatment consent documents from their clinical notes in just one click. This transforms a task which would ordinarily take hours into a few short minutes. Each document template pulls in the relevant information from the clinical notes so that nothing has to be written twice. The system helps reduce the risk of errors when copying and pasting, and rewriting information, from your notes into documents. You can also add pictures, links to websites or videos. Even if you don’t write your own documents, it saves your dental nurse time and effort too.
Kiroku has created ready-made templates – which adhere to communication and record-keeping best practice – for you to amend, with the ability to set up your own templates to adapt to your individual needs. These templates only need to be set up once and can be shared within your practice to ensure consistency too. Coherence is key in creating professional and visually appealing documents. Using templates ensures the same format, fonts and styles are used which helps to maintain a unified and joined up brand image. Having pre-designed templates for various types of documents can be a huge time and effort saver. Using templates can streamline the document creation process.
While there’s usually never one size that fits all, Kiroku Docs is different. Just one set of notes can create multiple documents! That’s right! Whether you’re writing to a patient about their proposed endodontic work or referring them on, Kiroku Docs can generate the appropriate letter using the information documented in your notes. So, one set of notes can generate any combination of documents.
Mind your language
Because you communicate with a wide range of people, Kiroku Docs can translate dental terms into patient-friendly language, helping you to improve communication with your patients. For example, the notes might say ‘Caries: UR4 DO’ but the patient letter will interpret that as ‘There is decay affecting your upper right, first premolar tooth.’ And for other parties, might read ‘The patient has decay affecting their upper right, first premolar tooth.’ Kiroku Docs really is that clever.
Good communication with patients helps build a stronger relationship, so the ability to send them tailored follow-up documentation after a visit is a real boon. You often relay a lot of information during an appointment and some patients might find it hard to remember. From the clinical notes taken, Kiroku Docs enables you to send a variety of helpful documents:
• A letter explaining the findings of the appointment
• A letter detailing treatment options
• An information leaflet about the treatment/ condition and how to manage it Documentation sent to patients matches what’s in their clinical record, so this reduces the chance of complaints or litigation too.
The documents you create can be shared easily as well – emailed or printed out. Saved as a PDF or as a Word doc. It’s up to you. If you send a document via Kiroku as a tracked Doc, you’ll be able to see when it’s been read. You are also able to share Docs directly with your patients, other clinicians, or your wider practice team from within the Kiroku platform.
Kiroku Docs helps to reclaim your time and streamlines your documentation processes – all at the click of a button. Effective, efficient and expert. For more information about how Kiroku can help you in your practice, get in touch with the team today. To start your free trial, please visit trykiroku.com n
About the author Hannah Burrow, CEO of Kiroku
You snooze, you lose?
Not according to science
How many of us acknowledge the true importance of a good night’s sleep? Sleep and health are closely correlated and fortunately our understanding of this has deepened over the decades. When sleep is poor, our health can deteriorate – when our health is poor, our sleep can deteriorate. Much of the population is stuck within this vicious cycle, and the impact it can have on not only systemic but also oral health is alarming.
The dental team are not sleep professionals, but if your patient is suffering from poor oral health that is impacting their sleep, or vice versa, it’s vital to be well-informed and provide relevant guidance.
the latest on sleep
The importance of a good night’s sleep really can’t be overstated and interestingly, recent findings suggest that even regular daytime naps can be beneficial. Researchers found a ‘causual link between habitual napping and larger total brain volume’, and postulated that napping appears beneficial when performing certain cognitive tasks. Further studies have assessed the impact of naps on cognitive function, finding links between short naps and memory consolidation and improvement.
Putting the research aside for a moment, many of us can simply feel the benefits that a good snooze can provide: we may feel more alert, refreshed and revitalised. Despite this, sleep is much harder to achieve for certain individuals. It’s believed that around 16 million UK adults struggle to sleep at night, with approximately 31% saying they have insomnia. But, of course, the true figure could be much higher as many individuals may not seek a formal diagnosis or even a medical opinion. Poor sleep, short sleep duration and early rising can contribute to a myriad of daytime complaints, such as fatigue, low mood, poor cognitive function and reduced attention. Interestingly, women seem to be more predisposed to insomnia compared to men, with several theories ranging from hormones to social expectations, care duties and a higher predisposition to mood disorders.
Sleep and oral health
As you well know, there is a wide range of sleep disorders which affect the population. The linking symptom across them all – poor sleep – can have a drastic impact on a person’s oral health. Intriguing research concluded that mammalian sleep evolved to protect the animal from parasitic infection, and further studies postulate that sleep is a vital component which can modulate various physiological functions. It’s therefore believed that sleep can impact our immune response: a patient who is suffering from sleep deprivation may be at a high risk of developing gingival inflammation. Together, poor sleep and gingival inflammation can also increase the risk of cardiovascular diseases.
Oral health complications can, in turn, cause poor sleep. Temporomandibular disorders (TMDs) can impair sleep, while pain associated with gingivitis and periodontitis can also cause sleepless nights. For parents whose child is suffering from poor oral health, research suggests that this can not only disrupt the child’s sleep, but also that of their parents. Sleep-disordered breathing can also massively impact the quality of one’s sleep, and dental sleep medicine is a rapidly-emerging field that is equipping professionals with the skills and knowledge needed to diagnose and treat such conditions.
Your patients may not be aware that their oral hygiene can affect the duration and quality of their sleep, and vice versa. In our busy, modern world, poor sleep can be an impediment to good health, and as a dental professional it’s important to provide patients with the right guidance. If your patient reports that they are experiencing sleepless nights due to oral pain, resulting from gingival disease for example, you can provide a tailored treatment plan to rectify the issue. To help patients maintain good oral hygiene practises while at home, you could consider recommending easy-touse tools, like a Waterpik® Water Flosser, which is clinically-proven to be twice as effective as string floss for reducing gingival bleeding. The solution is also an effective alternative to subgingival antibiotics for periodontal maintenance. Needed for only one minute a day in order to feel the benefits, your patients will appreciate this effective oral hygiene tool that fits seamlessly in their at-home oral hygiene routines.
Promoting a good night’s sleep
The causes of a poor night’s sleep are manifold, but if it’s dental-related, the dental team is in a prime position to provide the right guidance and support. All patients deserve the benefits that come with good oral hygiene, which includes a night of undisturbed slumber.
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.
Join the 3,000+ dental teams who have already benefitted from a professional Waterpik Lunch & Learn. Book your free session for 1 hour of verifiable CPD and a free Waterpik Water Flosser – available either face to face or as a webinar – at waterpik.co.uk/professional/lunch-learn/ n
about the author
alison reid rDh
GDC 5615
Qualified from Dundee dental hospital with dip
dental hygiene, 1999
Qualified dental nurse, NeBN
Teenage kicks
Oral piercings – an appealing form of self-expression or a dental nightmare?
During the teen years, rebellion against adult rules and expectations is developmentally normative to some degree. Whether it’s neglecting schoolwork or sneaking a cigarette, an important aspect of being a teenager is the process of developing a sense of personal identity.
One of the ways that is growing in popularity is the prevalence of oral piercings. If the piercing is carried out by a professional and is kept clean, then all should be well. However, the Royal College of Surgeons and the British Association of Plastic Reconstructive and Aesthetic Surgeons find that half of tongue piercings result in complications. Similarly, one in five cases of lip piercings lead to problems.
The appeal of the mouth piercing lies in its ability to enhance the appearance and express individuality. However, young patients need to be advised that there can be risks with this practice if not carried out professionally.
risk awareness
One of the most significant dangers of mouth piercing is the risk of infection. The mouth is a breeding ground for bacteria, and any break in the skin, such as a piercing, greatly increases the likelihood of infection. Improper sterilisation techniques or the use of contaminated jewellery can introduce harmful pathogens into the piercing site. Infections can lead to pain, swelling, and unpleasant discharges. In severe cases, they may even require surgical intervention and intravenous antibiotics.
Oral piercings can cause damage to the teeth and gums. The constant contact between the jewellery and the soft tissues of the mouth can result in gingival recession, tooth erosion, and even tooth loss. The metal can cause friction against the teeth, leading to enamel wear and eventual decay. In addition, regular contact with hard jewellery can traumatise the gums, increasing the risk of gingival disease.
such as specific metals used in jewellery. Allergic reactions can range from mild skin irritations to severe swelling and difficulty breathing. It is crucial to be aware of any allergies before getting a mouth piercing and to select hypoallergenic materials to minimise the risk.
Apart from these physical hazards, there are also social and professional implications of mouth piercings to consider. Some schools have strict policies against visible piercings, including those in the mouth. Having a visible oral piercing may require removal during school hours.
Scotvec assessor for dental nurses
Professional educator for WaterPik
Another potential danger of a mouth piercing is the interference it can have with oral function. The placement of piercings on the tongue, lip, or cheek can affect speech patterns and articulation. The presence of jewellery can alter the normal tongue movement required for clear speech, resulting in lisps, slurred speech, or difficulties pronouncing certain sounds. Additionally, oral piercings can interfere with eating and swallowing, making it uncomfortable and challenging to consume certain types of food or drink.
allergic reaction
In some cases, mouth piercings can also lead to allergic reactions. Many people are unaware of their allergic sensitivities until they are exposed to certain substances,
While not so popular, the Oral Health Foundation also points out the hazards of tooth jewellery. This involves sticking small jewels onto the teeth using dental cement. Young patients should be advised that the area around the jewel needs to be kept very clean, as plaque can easily build up around it. Proper brushing technique is vital for effective plaque removal. Dental professionals should recommend the use of a soft-bristled toothbrush and fluoride toothpaste. Teenagers may overlook the importance of interdental cleaning too, but it is essential for removing plaque and food particles from between the teeth and along the gum line. They should be reminded to clean interdentally at least once a day, ideally before brushing their teeth. The FLEXI range of interdental brushes from TANDEX can help young patients remove more plaque than brushing alone. Each product’s handle is flexible, and the brush can be bent into the perfect shape to clean in between the teeth. Available in 11 different sizes, the line presents a solution for each individual patient, for a comfortable and effective clean. They can be used to easily apply PREVENT GEL too, a product which contains 0.12% chlorhexidine and 900ppm fluoride known for their antibacterial and enamel strengthening properties. While an oral piercing may seem like an appealing form of self-expression, it is essential young patients are aware of the dangers associated with it. Infections, dental problems, speech difficulties, allergic reactions, and social implications are all significant concerns to consider before getting an oral piercing. Young patients should be advised that regular dental checkups and proper oral hygiene practices are crucial to minimising the associated risks. For more information on Tandex’s range of products, visit https://tandex.dk/ or visit https://www.facebook.com/TandexUK
Our products are also available from CTS Dental Supplies www.cts-dental.com/ and DHB Oral Healthcare https://dhb.co.uk/ n
about the author
Kimberley lloydrees, on behalf of tandex, graduated from the University of Sheffield in 2010, where she now works as a clinical tutor in Dental hygiene and therapy as well as working in practice. She has spent her career working across a variety of specialist private and mixed dental practices, for the MoD and volunteering her time to a dental charity in Nepal.
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Raise awareness of oral cancer risk factors in your practice
While awareness of mouth cancer in the UK is improving, with 88% of British adults having heard of the disease compared to 65% ten years ago, there is still a long way to go. Within the dental practice, it’s important to offer patients education about mouth cancer and its main risk factors, as this can help patients make informed lifestyle decisions, and monitor their own health more effectively in between appointments. Equally, practices should regularly reinforce education about oral cancer within the dental team, and the importance of checking every single patient for signs and symptoms.
What are the risk factors?
Research suggests that patients who smoke or use smokeless tobacco products, drink alcohol to excess, or have HPV are at higher risk for developing mouth cancer. By discussing these factors with every new patient, you are able to establish whether they might be at higher risk of disease, and provide them with smoking cessation advice, for example. Generally, in the UK, awareness of the main risk factors associated with mouth cancer is poor, with 65% knowing that smoking can cause mouth cancer, but only 35% identifying excessive alcohol intake as a risk.
As many patients will be aware, smoking can have a significant impact on oral and overall health. However, smoking is thought to cause around 25% of oral cancers. If your patient is a smoker, it’s important to offer them smoking cessation advice, and direct them to services which may be able to help them quit. Drinking excessive alcohol is thought to increase the risk of mouth cancer too, causing around 35% of cases in the UK. Currently, UK guidelines recommend a maximum of 14 units of alcohol per week.
Patients who have HPV may also be at heightened risk of mouth cancer. The virus effects the moist areas of the body, and is a major cause of cervical cancer. HPV vaccinations are now given to both girls and boys at ages 12-13, with the aim of preventing cervical cancer, but it’s likely to also help reduce the rates of mouth cancer.
What if my patient is high risk?
Regardless of whether a patient is high risk or not, monitoring their oral health is essential. This means checking every patient for any abnormalities and referring them if you think they may have symptoms of mouth cancer. In a recent article, the Daily Mail highlighted a number of the main signs and symptoms of mouth cancer, discussing the importance of regular dental check-ups for monitoring abnormalities
and catching the disease early. Between appointments, patients should be able to recognise symptoms, monitoring their own oral health on a regular basis, and seek the advice of their dentist or GP if they notice anything unusual.
In order to do this effectively, it’s important to educate patients on the risks. This is key both during appointments, and in between by featuring informative pages on the practice website, and posting important information on social media platforms. This can help make reliable information accessible for your patients.
Screening every patient
Oral cancer screening is essential for monitoring the health of every patient, and helping to catch any signs of disease as early as possible. New cases of mouth cancer have increased by 34% in the last ten years, with deaths increasing by 46% in the same time frame. A recent article from the BBC found that, as many people across the UK struggle to access regular check-up appointments with a dentist, oral cancer is not being noticed early enough, with later stage diagnoses having detrimental consequences for patients’ health.
Routine dental check-ups are the ideal time to assess if your patients are showing signs of oral cancer. Carrying out a visual examination is essential and, for your peace of mind,
Tucking into occlusion
It’s no surprise that the dentition has an intimate relationship with the food we eat. In everyday life, we may take it for granted that we can delve into a snack or meal on a whim, and enjoy it without a second thought. For many patients with malocclusions, however, this isn’t the case. It’s important to understand the impact occlusion has on our eating experiences, and how it could severely affect a patient’s overall health. With this knowledge, clinicians can aid patients that hold these concerns, or identify and correct issues before they take effect.
Failure in function
A patient’s dentition plays a key role in the mastication process, being essential for chewing and breaking down solid foods. Malocclusions can significantly impair the performance of these actions, especially when occlusal contacts are reduced. If and when a patient raises their concerns, there is no telling the cause without a comprehensive assessment. Chewing difficulties are common ground for a variety of malocclusions, after all. They may be present in occlusal issues ranging from an overjet or an overbite, to an underbite or a crossbite. The trouble caused by a malocclusion does not stop at chewing pain. Ineffective mastication could have knock-on effects throughout the entire digestive system. Masticatory function is essential for the proper intake of nutrients, breaking down food into a manageable bolus that can be swallowed without difficulty, and from which the body can receive adequate nourishment.
Malocclusion, food and the body
Should a patient present with a malocclusion that affects their chewing, it’s likely that they will have altered some behaviours in order to cope. They may chew for longer in order to adequately break down food and compensate for their difficulties; change their diet to accommodate more manageable foods; or simply not have changed a thing, instead bearing the brunt of any subsequent digestive issues. Without a change, these problems could make everyday life uncomfortable. One study found that a group of women with malocclusions faced a slower gastric emptying rate than a control group with normal occlusion. This follows along with similar research surrounding ineffective chewing and the digestive process, potentially resulting in digestive distresses. By interfering with the gastric emptying rate, for example, patients may succumb to nausea, stomach pains, and bloating, under the medical condition gastroparesis. Connections have been made between orthodontic treatment and temporomandibular disorders (TMDs). Commonly associated with a variety of malocclusions, TMDs are characterised by pain in the temporomandibular joints and facial muscles. This can contribute to the immense discomfort felt when chewing. When this becomes too overwhelming, patients may adjust their diet as a compromise. The danger is that these accommodations could be detrimental to their general health. If masticatory problems
mean patients avoid harder foods such as raw vegetables and fruit, tough fibrous meats, or dry hard foods such as whole grains and nuts, they may be missing out on nutritionally dense sources of proteins, carbohydrates, vitamins and minerals.
It’s important to carefully consider care for individuals with malocclusions that have a severely disordered relationship with food, and are, for example, anorexic or bulimic. There is a significant association between the presence of eating disorders and a dissatisfaction with chewing ability. For the appropriate patients, restoring optimal occlusion not only has the potential to improve a patient’s self-perceived image, but may enormously benefit their nutritional rehabilitation. Using orthodontics as part of an empathetic, multidisciplinary solution may be ideal.
a clinical approach
The relationship between malocclusions and food is deeply intertwined. A complete understanding of occlusion is vital when providing effective care, demanding an awareness of how malocclusions can develop, be identified, and subsequently treated. Optimal treatments could improve patients’ lives from their ability to chew, to aesthetic outcomes that can boost their confidence and self-image.
Malocclusions that affect masticatory functions, and ultimately a patient’s general health, may be rectified with appropriate orthodontic solutions. These include clear aligner therapy and the use of fixed braces,
the BeVigilant™ OraFusion™ System from Vigilant Biosciences® enables you to undertake a quick, non-invasive test in each appointment. The system analyses the saliva to easily identify the presence of biomarkers associated with oral cancer. In 15 minutes or less, it produces a report of either low, moderate, or elevated results. By utilising this easy test in each appointment, clinicians are able to establish every patient’s level of risk, and use this to inform decisions surrounding referral, and motivate behaviour changes. Ultimately, screening every patient for signs and symptoms of oral cancer is essential for catching the disease in its early stages, and preventing further harm to patients. It is vital to ensure everybody in the practice, patients and staff included, are aware of the risk factors associated with mouth cancer, and offer advice on reducing this risk.
For more information, please visit www.vigilantbiosciences.com or email info@vigilantbiosciences.com n
about the author Phillip Silver, founder of total tMJ, a specialist provider of medical devices.
however the GDC demands only adequately trained and competent clinicians provide these. Clinicians should first ensure they have a complete grasp on occlusion before they tackle these challenges, though.
Dental professionals looking to have an impact that extends past the dental chair should seek exceptional training that improves their overall skillset. The Occlusion: Basics & Beyond course from the IAS Academy is the most tangible, comprehensive occlusion training in the world. Across 34 hours of CPD accredited modules, clinicians can develop their understanding of occlusion in a manner that is not offered anywhere else, improving their clinical offering for each and every patient.
Oral health has long been known to have a complex relationship with general health, and it has an ever-increasing impact on the way patients interact with food. By developing a clinical understanding of occlusion, and how it can be improved, dental professionals have the ability to improve patient health in a manner that reinvigorates everyday life.
For more information on upcoming IAS Academy training courses, please visit www.iasortho.com or call 01932 336470 (Press 1) n
about the author Dr tif Qureshi, founder and a clinical director of IaS academy.
BACD welcomes new President
The British Academy of Cosmetic Dentistry (BACD) is recognised across the globe as a leading organisation in the field of cosmetic and restorative dentistry. Taking the helm of the Academy as of November 2023, Dr Luke Hutchings will be building upon the work achieved so far.
Luke first joined the BACD in 2011, after attending a yearlong training course with BACD co-founder, Chris Orr. Luke says: “A comment from Chris about how we could continue to improve our education and skill set further at the BACD caught my attention. I attended the next BACD Annual Conference a few months later and thoroughly enjoyed both the education and social side, hence, I decided to join the following Recommended Meeting too. These provided opportunities to meet various people throughout the organisation. Finding everyone so welcoming and genuine quickly inspired me to become involved at committee level for the Academy. I had the chance to take on several roles on the Education Committee, before being elected as a member of the BACD board, a position I have held for the past 8 years. Colleagues kindly thought me a good fit for Presidency so I had no choice but to humbly accept.”
There are many benefits to being a member of the BACD, not least of which is access to the various educational events on offer. The Annual Conference is a highlight of the calendar for many
cosmetic dentists in the UK and abroad, with an array of specialists and worldclass speakers presenting seminars and hands-on workshops each year.
However, this is just one side of the Academy. The other side is very much one of community and support, with a network of likeminded clinicians and team members coming together to share ideas, experiences and best practice.
“For me, world class education is a given, but the networking opportunities provide one of the greatest benefits of being involved with the BACD,” Luke continues. “I have always valued finding my work family of like-minded colleagues within the BACD, for both professional and personal reasons. Many of the people I socialise with outside of work, I originally met through the BACD – including several of my closest friends. In work, being able to connect with a vast range of colleagues offers a level of support you can’t achieve on your own. Dentistry can be a very insular profession, so being able to step out of the surgery and see how other people think can be very valuable. Whether I have had the same opinion as others or not, discussions had during or after events – including at the bar in the evening – have often taught me as much as the lectures or training courses themselves.
“In addition, I am a firm believer that we should all celebrate each other’s successes and help to raise and elevate each other to better and brighter things. I am always happy to hear that a friend
or colleague has done well and having a network of professionals who share this ethos is important to me.”
As the new President of the BACD, Luke is looking to build on what has been started by those that came before him. He will be continuing to drive the organisation forwards, following the 5-year strategic plan set out by many of the incumbent board. He comments:
“I’m not looking to reinvent the wheel. We have already identified how we want the BACD to grow – such as providing more free education for members by reinvesting in this area, for example. My goal remains the same as Simon before me and Sam after me – to increase the number and quality of member benefits available in a way that is most useful to our members. I also hope to help expand the social activities alongside our educational events like Recommended Meetings so there is always a social element to bolster that community feel throughout the Academy.
“Personally, I want to act reflectively in my role as BACD President. I am grateful for the people that stood before me and appreciative of the opportunity to help further grow an Academy that so many have already worked so hard for. Our collective goal is to keep the BACD as one of the strongest Academies in Europe, respecting what we have achieved so far and driving further success.”
For anyone not yet a member of the BACD, these are just some of
the reasons to join what has become a thriving community of dental professionals. Upcoming events that are already proving popular include the inaugural ski trip ‘BA-Ski-D’ being held in Davos Switzerland from 31st Jan-4th Feb 2024. What could be better than a few days in the company of Walter Devoto from Style Italiano talking all things composite combined with sliding on snow and eating strudel?
For further enquiries about the British Academy of Cosmetic Dentistry visit www.bacd.com n
Solid foundations for a prosperous career
There are many challenges for clinicians in their first few years post-qualification. Not only is it a busy time consolidating and developing clinical skills, but there is also much to learn about how a practice operates and how to manage patients. Though the VT training year introduces newly qualified dentists to the practice environment, the pressure can certainly increase once working more independently as an associate. In order to navigate these early years successfully and lay solid foundations for a long and prosperous career, it is important that newly qualified clinicians have access to support. This may take many different forms, but essentially there should be on-going training available, as well as people to turn to with questions or queries. The result is more capable and confident practitioners, who are able to deliver higher quality dentistry to their patients.
Clyde Munro – the leading dental group in Scotland – understands just how much difference the right support can make to dentists when they’re just starting out. That’s why we provide the Flying Start Programme; a year-long initiative that offers educational and networking benefits to dentists who have qualified in the past few years.
It includes carefully tailored training days that give clinicians an opportunity to advance their skills with leading names in the field, to ask questions and seek bespoke advice from experienced dentists. There is also an important social element to these events, as individuals are able to connect with others in a similar position to them, to share concerns and achievements, and learn from each other.
As a clinician in the early years of his career, Dr James Campbell reflects on some of the aspects he found most difficult as he adjusted to life in the practice:
“The biggest challenge has been maintaining and improving clinical skills against the backdrop of time pressures,
various relationships to manage, and different financial systems to work with. It has been a process to adapt to the juggling act of primary care dentistry!
Doing all this in the context of a pandemic and without the mentoring support that was available as a student and vocational trainee made it particularly tricky.”
James is currently participating in Clyde Munro’s Flying Start Programme as a way to seek a little extra support. So far, professionals have had access to a session with renowned ethical sales coach, Ashley Latter, as well as covering tooth wear with Dr Andrew Paterson, digital workflows with Dr Callum Graham and sustainability with the Haleon team. Other events explored smile design with Dr Josh Rowey and managing trauma in practice with Dr Beth Burns.
Considering the advantages he has enjoyed to date, James says: “The Flying Start Programme has been integral to my personal and professional development during this difficult period. It means that there is a network of peers and more experienced colleagues to turn to for support whenever I need it.
“The practical advice, help and training received from experts on aesthetic treatment plans and patient communication has been most helpful for me. I also appreciate the very pragmatic
approach and readily applicable content that has been shared.
“The Programme has been expertly conceived, organised and delivered. I am extremely grateful to be part of an organisation that is dedicated to supporting colleagues at all stages of their careers in this way.
“It is my hope that the Programme will help me to improve my confidence and capability in addressing patient needs and delivering the treatment they require. I couldn’t recommend this opportunity more highly to any colleagues out there who may be at a similar stage of their career.”
For any clinicians who are in their early years of dentistry and want to make sure they get the very best start, consider speaking to Clyde Munro. We appreciate the importance of supporting all of our colleagues with training and guidance, especially in those crucial first few years. We also endeavour to create the best working environments, with cutting-edge technologies, high-quality materials and the flexibility to achieve a good work/life balance.
Find out more about the career opportunities and vacancies available with Clyde Munro at careers.clydemunrodental.com. n
In private sites turning over more than £850,000 per year the average income per employed head is £202,561. Compared to £169,554 in a smaller practice.
- Comparison data from the Dental Elite Benchmarking Report 2023 For a free valuation of your practice get in touch.
Scan the QR code to download the full Benchmarking Report.
The power of a reset
You may be forgiven for thinking that resetting is an intentional topic for January, traditionally the month of good intentions, but the reset works perfectly at any time of the year – and at any time of the day for that matter.
A reset, to me, is a few things. It’s an adjustment. It’s a way of returning to and reassessing your baseline. It can involve or invoke change but not necessarily. It helps
calm the chaos. It is always about setting things in order.
You can reset small things like your workspace, surgical instruments, bookshelf, filing systems, shoe rack… Instead of looking at your life and environment as a whole, you can simply reset some areas. You can reset whatever you need to, when you need to, and not get overwhelmed or distracted by the bigger picture.
Kaizen theory is based on incremental change for the better. Resetting fits in with this concept as it’s not all about making wholesale differences. Its joy is in improving things little by little. Each reset adds up.
“Where innovation demands shocking and radical reform, all Kaizen asks is that you take small, comfortable steps toward improvement.”
– Robert D Maurer
An acquaintance is extremely messy, and she gets overwhelmed by the idea of tidying up. Once she had learned about the concept of the reset she was ecstatic. She no longer felt under pressure to clean her whole house, agree to every social occasion, or achieve something significant every day at work. Little by little, she manages to make a difference to her mental and physical state without the overwhelm. That’s Kaizen in practice.
Overwhelm
The reset provides the perfect opportunity for some mindfulness. Tidying, sorting and arranging all provides some scope for switching off and emptying our minds for a few minutes. So, not only are you improving your surroundings and systems, you are also restoring some order internally as well. You can use a reset as an opportunity to focus a wandering mind. When you’re facing an unusually busy time, you could take time out to make a list of things to be done or reorganise your workspace. This is also a type of mindfulness, arranging your thoughts and taking time now to create better quality, productive time later. By the way, autocorrect prefers ‘rest’ to ‘reset’ – I believe one eventually leads to the other. What could you reset right now to make your life more ordered and restful? I am starting by writing the key dates of my worklife on a wall planner – speaking engagements, training courses and
Defined by my Collins Dictionary as a ‘vb. tr.’ (verb transitive) meaning: “to overpower the thoughts, emotions, or senses of.”
We have all been there, that sensation of having little or no control of what we are thinking or feeling, where outside thoughts and influences produce an experience akin to our losing control. The sensation of just holding on to the command of a situation by your fingernails is no fun at all.
I’m writing this piece in the buildup to Christmas, a time that is often manic and pressurised. “Personal” pressures – and surely, as we’re all people, all pressures
are personal to us – of family, friends and social commitments can so easily mount up. These often feel as if they are beyond our compass, and “someone” expects you to be ever ready and at your best.
This is all before the “just one last patient” who arrives with a crowned central incisor fractured at gum level and assures you,
“I’ve got the crown, you just need to stick it back in”. Oh, just rewards for the “just” situations.
In the cold light of January, the possible nightmares and disasters that you feared have almost certainly turned out to be like so much Scotch Mist in the sunny dawn and you wonder why you felt as you did. But before you charge full pelt into a shiny New Year take a little time, after the resolutions have faded, to explore that feeling of overwhelm, how to avoid and, if needed, to control it.
1. Prioritise. Decide what’s
important and do that first. Break large tasks into smaller steps for easier management.
2. Look at the way you spend your time. Does your diary control you or you it? If it’s the latter, get help.
3. Just say no. Set boundaries, delegate. Knowing your limitations is a sign of strength, not weakness.
4. Take breaks, both within your day and your life in general. Deep breathing, short walks or stretches are not just for the “woo-woo” crowd, they do work. Always, no exceptions, have your next holiday booked ahead, know what time off you are going to take, and take it. The misery of being self-employed is that you are able to work seven days a week, 52 weeks a year if you’re not careful. Nobody will stand over your grave and say, “Wonderful person, never took a day off.”
other commitments. This means I can keep an eye on the shape of my year, which might influence what I agree to as the year progresses. You can, if you wanted to, reset some of life’s bigger ticket items such as life goals but I prefer to integrate the reset into each and every day so that, in line with Kaizen, it’s a series of achievable, small steps. n
About the author Dr Dhiraj Arora has two dental practices in Twickenham and Gerards Cross. He is also a Dental foundation Training educational supervisor for Health education england, Honorary Lecturer in endodontics at QMUL Masters programme, and runs his own courses via evo endo in Central London for general dentists. His background spans nHs and private settings, from Harley street to community HealthCare.
5. Focus. When you’re on, you’re on. Turn off your phones, intercoms, all unnecessary interruptions, and focus 100% on that moment. Your patients expect you to be fully on and you will work better when the blinkers are in place.
6. Delegate everything that you possibly can. You should only do what only you can do – delegate the rest. Your accountant, solicitor or brain surgeon doesn’t spend their weekends dealing with software updates, plumbing problems or suction pumps. Neither should you.
7. Get help. If overwhelm is becoming a way of life then reach out to someone, anyone, for assistance – talk to someone you can trust and you may well be surprised to hear that many others have “been there, experienced that” and come out the other side better for it. n
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Are your associates unconsciously competent?
As we enter the 3rd financial quarter, it’s a great time to engage with your associates and look at any issues, improvements or challenges they may be facing.
As self-employed members of the team, and with HMRC selfemployment indicators looming, we often don’t appraise our clinician’s performance in a way we do with our employed staff.
Visiting many practices has shown me that it is a common, if not, “always one in every practice” scenario, where there is an associate that isn’t on board with your patient journey, discounts fees, refers on cases they don’t fancy, and sometimes barely generates enough revenue to cover the costs of their surgery.
We too often put up with attitudes or poor work ethics due to being worried about recruitment or employment legalities or we may want to avoid an awkward conversation. In my experience, it’s best to embrace that conversation.
I have produced a performer assessment that asks the clinician to reflect on their strengths and
areas for improvement, as well as to understand what the practice expects of them. Asking your associate to use the assessment as a self-appraising tool and then arranging a meeting to go through it is a great, non-awkward conversation starter. It will also give you an insight into where they lay in the realms of conscious incompetence or, hopefully, unconscious competency.
Here are some easy steps:
• Provide associate with a performer assessment document – what do you want to look at? (Or if you would like to contact me, I am happy to share mine with you)
• Ask performer to fill out the assessment
• Arrange a meeting to discuss the assessment results
• Set goals and expectations
• Identify training and development needs
• Give constructive feedback
• Identify how you can support them and what resources they may need
• Establish how the wider team may assist more
• Review
• Review
• Review
Do not waste this opportunity or be put off by a bit of perceived awkwardness and allow heads to be buried, otherwise we might think you are consciously incompetent. Conscious incompetence is a stage of the Four Stages of Competence, a model that outlines the stages a person goes through as they acquire new skills or knowledge.
The four stages are:
1. Unconscious Incompetence: At this stage, a person is unaware of their lack of skill or knowledge in a particular area. They don’t know what they don’t know.
2. Conscious Incompetence: In this stage, the individual becomes aware of their lack of skill or knowledge. They recognise the gap between what they know and what they need to know. The recognise their limitations and/or the complexity of a subject.
3. Conscious Competence: As the person continues to learn and practice, they gain competence. However, performing the skill requires conscious effort and attention. They are aware of the steps and details involved in the process.
Leap into 2024 with BADN
New Year, new start, new President and Executive Committee, new app, new members… there’s a lot going on at BADN in 2024!
First of all, we have a new Honorary President – Joan Hatchard; a new Chairman – Michelle Brand; a new President-elect – Preetee Hylton; and a new Treasurer – Ruth Garitty. All took up their posts at BADN’s AGM in late November and are looking forward to their two years in office. More info on all the Executive Committee can be found at https://www.badn.org. uk/NewPublic/NewPublic/ExecutiveCommittee.aspx.
And, of course, there is our new app which makes accessing the BADN website or reading the British Dental Nurses’ Journal much easier when on the move.
Or you can:
• Renew your membership.
• Access Members’ Area and BADN Rewards.
• Explore Dynamic News Feed which you can tailor directly to your needs and wants.
• Checkout upcoming events, how to get there, and add them to your schedule.
• Dive into the Resource Library with guides, documents, templates and more.
• Grow your network through our Members directory and in-app messaging.
• Share your knowledge and get involved in different discussions in the Forum.
• Never miss an important update with our Push Notifications
The BADN app is now available for
download on both the Apple Store and Google Play. Current BADN members can then log in using the same username and password as for their BADN member account on the website. Non-members can also use the app with limited access.
• Apple Store: https://apps.apple.com/ app/badn/id6453682869
• Google Play: https://play.google.com/ store/apps/details?id=com.clowder.badn
The providers of our Rewards scheme, Parliament Hill, have recently run a competition for members who have downloaded the app – five members have won a £10 life:style voucher and one lucky member has won a £50 voucher!
In these financially difficult times, we thought we should spread the joy of BADN membership a little –so, now, non-registrant practice managers and receptionists can join BADN as Associate Members, and profit from most of the benefits of membership (www.badn.org.uk/ join). Our new(ish) Refer A Colleague scheme means that if current member dental nurses refer their practice manager and receptionist colleagues, both parties receive a £5 credit in their BADN member accounts, which can go towards purchases from our online shop, or their BADN renewal. For more information on the Refer A Colleague scheme, please visit https://www.badn.org.uk/Member/ Refer-a-Colleague.aspx.
BADN is also supporting the Saving Grace campaign (launched by another publication), whose slogan is “All I Want for Christmas is Fairer Legislation”. The campaign is aimed at the GDC, who – once again this year – have been striking off dental nurses (and other members of the dental team) for minor discrepancies in their CPD declarations… Sometimes missing as little as one hour of the 10 required every two subsequent years, or because they have had a real-life event that has prevented them from declaring by the deadline – or sometimes because the GDC won’t accept CPD certificates from the NHS because they don’t meet the GDC’s stringent requirements for CPD certificates. (Even though they are accepted by all other regulators!) Some other associations have apparently declined to support the campaign, presumably for fear of upsetting the GDC – but BADN firmly believes that it is the role of a professional association to do just that when the GDC is in the wrong! You can read more about the campaign, and sign the petition urging the GDC to take a more realistic and sympathetic approach to such minor discrepancies, at https:// www.badn.org.uk/News/All-I-Wantfor-Christmas-is-Fairer-Legislation. aspx, where there is also a link to my article supporting the campaign.
4. Unconscious Competence: In the final stage, the skill has been mastered to the point where it becomes almost automatic and can be performed without conscious thought. The term “conscious incompetence” specifically refers to the second stage, where someone is aware of their lack of proficiency in a particular area. This stage is crucial for personal and professional development because it signals the beginning of a journey toward improvement. Recognising one’s weaknesses or gaps in knowledge is the first step towards actively seeking to address and improve them. It reflects a level of self-awareness and a willingness to learn and grow. n
About the author Lisa Bainham is president at ADAM and practice management coach at practice Management Matters.
We are also planning to update our systems in the BADN office and – hopefully – introduce Direct Debit payments at some point in 2024. This will make it a lot easier for members to renew their membership. We have been having some problems with the software that collects payments, and plan to change to another company this year, which will also then allow DD payments. What isn’t new in 2024 is that BADN will once again be exhibiting at all the major dental exhibitions – the North of England Show in Manchester on 9 March (https://dentistry.co.uk/ shows/north-of-england-dentistryshow), Dental Showcase at ExCel on 22-23 March (https://dentalshowcase. com), the Dentistry Show at the NEC on 17-18 May (https://birmingham. dentistryshow.co.uk) (where we will host the Dental Nurse Forum and the Dental Nurse Lounge), the Scottish Dentistry Show at Braehead on 31 May – 1 June (https://sdshow.co.uk) and the London Dentistry Show at ExCel on 4-5 October (https://london. dentistryshow.co.uk).
We look forward to seeing you at them! Happy New Year! n
About the author pam swain is Chief executive of BADn
Meet the Council: William McLean
William McLean
When I reflect on my varied career, I’d say I’ve had a winding journey. I left dental school and completed a house job in oral surgery. Following this, I pursued a PhD in Craniofacial Developmental Biology the work for which was carried out at Harvard Medical School in the United States. Following this I took up a position as a Lecturer in Developmental Biology. During this time, I taught undergraduate medical and dental students, which reignited my passion for dentistry.
council member, then took on the role of treasurer. I am now President Elect of the BES and will be President in the year of the WEC which is exciting. Our past presidents and current president are fantastic, and I have big shoes to fill when my time comes.
I then moved to a position working as a GDP, where I witnessed the struggles of the population which sparked my passion for endodontics. Having worked in a dental practice, I missed the opportunities I once had for research and teaching and began to seek these out once more. I have met some fantastic people in my academic career and, as part of IFEA, I have recently been awarded Chair of WEC 2024 in Glasgow.
The comradery that’s been offered throughout my journey has made my career special. I am constantly surrounded by friends, and it just so happens that they are my colleagues as well.
William has much experience working within the BES, he shares his journey as a council member and member of the BES.
Within the BES, I started as a
I would say that the main benefit of being a part of the Society is meeting like-minded people and sharing conversation with other members. This is incredibly valuable in our profession.
William discusses his hobbies
Outside of work, much of my time is taken up by my two very busy children, who canoe competitively. Other than this, I very much enjoy cycling and open water swimming. For more information about the BES, or to join, please visit www. britishendodonticsociety.org.uk
Meeting demand
Dentists across the UK continue to report a growing interest in dental implantology from patients. The allure of a fixed solution to missing teeth is great and an increasing number of people are willing and able to invest in their oral health in this way.
In order for dental professionals to cater for these changing patient needs, it is important that they seek the appropriate training and education in the field. With no predetermined pathway into implantology, it is up to the clinician to choose a programme they can trust to deliver high-quality, evidencebased teachings, supported by first-class instructors, mentors and products.
With an extensive scientific grounding, industry-leading products and decades of experience in the field, Straumann® is delighted to present an array of training opportunities in collaboration with various prestigious academies and professional organisations. These include the International Team for Implantology, VSSAcademy, BAIRD, Delta Dental Academy, the University
of Bristol, Advanced Implant Training and The Campbell Academy.
The courses vary in complexity and focus, with the comprehensive portfolio including options that introduce clinicians to the discipline and others that offer education on highly advanced techniques for the more experienced. Topics include single and multiple implant placement, different placement and loading protocols, soft and hard tissue management, sinus lifts, zygomatic implants and more. Many also provide both theoretical and practical content, so delegates obtain all the necessary information and hands-on experience for comprehensive professional development.
Further still, all programmes are designed to ensure clinicians gain the competency and confidence they need to apply their skills to practice safely and effectively. There are even options for dental nurses and treatment coordinators to utilise too, bringing the whole team up to speed with implant workflows for maximum practice efficiency and an exceptional patient experience every time.
Dr Harmeet Sehmi has attended various training courses with The Campbell Academy, which were all supported by Straumann®. He says:
“I decided in 2017 (6 years post qualifying) that I wanted to incorporate implant placement into my general practice. After speaking with several colleagues, The Campbell Academy’s implant course seemed the right fit. By the end of the course, I was hoping to feel
confident in placing implants in simple cases within my own practice.
“The course exceeded my expectations. I certainly felt confident in placing implants by the end, and the support throughout and after was very reassuring. I enjoyed all the lectures and speakers. However, placing my first implant was my highlight -– there was a huge adrenaline rush after. The main challenge was to get into the right frame of mind and calm the nerves before placing my first ever implant.
“The course teaches with Straumann® implants, but they have a wide knowledge of many other systems. For me, I have only used Straumann® implants due to the quality and reliability.
“Since the Year 1 Implant Course, I have carried out the Year 2 Implant Course and numerous masterclasses. The overall ethos, mindset and support that you receive from The Campbell Academy is fantastic.”
In addition to helping you meet the increasing patient demand for implant therapies, broadening your abilities is also a great way of diversifying your everyday routines and boosting your job satisfaction. Attending courses will expose you to new techniques and technologies as well, which ensures that you can inform patients about all of their available options, further enhancing consent.
Information on all the courses available from Straumann® and partners is accessible on the website. Here, you can also join a mailing list to receive priority places on upcoming programmes, securing your career development for the future. Find out more about all educational courses supported by Straumann® at www.straumanncourses.com n
The right skills in complex situations
Innovation continues to transform the dental landscape: processes are becoming more streamlined, treatment quicker and less intensive for patients; and opportunities for skills progression more abundant than ever before. Despite such momentous advancements, there are many risks that could still present during treatment, namely the biological complications that can interfere and potentially compromise the final outcome. With patient expectation and demand so potent in this digital age, alongside the growing needs of an ageing population, clinicians and their teams must be prepared to tackle ever-more complex cases. As such, it is essential to remain abreast of skill acquisition and development, which provides a myriad of benefits to your patients, your career and your standards as a professional.
the biological problem in implant dentistry
A lot of status is placed on a person’s visual appearance, and trends in the dental market are often driven by said status: as a result, the dental market has become rife with options to improve the aesthetics of one’s smile. Interest in treatments like dental implants has seen impressive growth; simultaneously, so have opportunities for clinicians to refresh their skillsets and improve the care they deliver. This is not only imperative for delivering safe and ethical dentistry, but it also allows professionals to expand their clinical capabilities and, by extension, their confidence when tackling more complex cases.
An expansive skillset enables clinicians to provide more options for patients, which in turn also makes it easier to ascertain the most appropriate course of action – especially when complications present during treatment. In dental implantology, bone resorption is a common issue, occurring largely in the first 3 months following a tooth extraction, according to studies. As you know, bone resorption, especially in patients with more complex needs, drastically compromises the rehabilitation pathway. Depending on other biological considerations, such as patient age and overall health, there may be several potential options that clinicians will need to deliberate. For instance, certain surgical techniques may be indicated, such as bone grafting or sinus lifting; if suitable, newer techniques like zygomatic implant surgery can be implemented, as this modality shows positive success rates in those with severe maxillary atrophy.
Having a wider range of skills allows you to avoid referring patients elsewhere if the case falls outside of your remit. You can build a more comprehensive patient base, utilising your knowledge to tackle the more complex cases and provide successful, long-lasting outcomes to a wider range of patients.
taking your skills to a new level
The literature supports the view that a strong sense of confidence is integral to personal development, one’s ongoing study and improved competence. When it comes to skill and knowledge acquisition, the more you invest in your training over
time, the wider the playing field in which you can determine the best course of action for each patient. Patients value trust and demonstrating your excellence is a potent way to earn and sustain that trust. Being able to plan treatment well, communicate effectively and engage the patient encourages a more proactive relationship, helping to manage patient expectations and improve patient compliance throughout, and long after, surgery.
Skill acquisition is more than simply adding new techniques and modalities to your dental repertoire: it is about providing a higher level of care, bolstered by clinical confidence, competence and the ability to offer more in your practice. As such, it is vital to choose a training pathway that provides you with only the best resources, including guidance from professionals who will help you gain comprehensive knowledge that is immediately applicable in practice. If you are an experienced implant dentist, you need to invest in a training programme that is tailored to enriching and building on your existing skills. If you are seeking a comprehensive, carefully curated course, consider the Advanced Certificate course in Bone and Tissue Regeneration and Sinus Grafting, a blended University Certificate course delivered in 5 parts over 5 months including 2 days of hands-on workshop and 2 intensive days of a cadaveric surgical training programme. Headed by a faculty of expert ENT consultants, under the eminent Specialist Oral Surgeon Professor Cemal Ucer’s lead, you can take your abilities further with this unique learning opportunity. The syllabus
covers a variety of pertinent topics, from block bone grafting, zygomatic and pterygoid implant options, 3D diagnostic imagining and much more.
Keep going, keep growing
Dentistry is constantly adapting to changing demands and expectations. With an ageing population and the social media phenomenon shaping what is required from the dental team, skill development is an absolute necessity. Making prime decisions as to where and with whom you train means you can flourish in a way that best suits you and your current skill level. You can take what you’ve learnt and go much further: to the benefit of your patients and your own clinical abilities.
To find out more, contact Ucer Education today. Contact Professor Ucer at ucer@icedental.institute or Mel Hay at mel@mdic.co; call 01612 371842 or visit www.ucer-clinic.dental. n
about the author Professor cemal ucer (BdS, MSc, Phd, oral Surgeon, iti Fellow.)
dr Harmeet Sehmi
Make 2024 a year of growth, excellence, and professional transformation
Astart of a new year signifies a fresh chapter, allowing us to reflect on the past year and set a course for growth and development in the months ahead. For dentists, it presents an ideal occasion to refine existing skills, broaden your knowledge, and strive for new heights in both your professional and personal life.
Whether you’re aiming to refine your tooth preparation skills, master the intricacies of occlusion, offer better quality dentistry to your patients, explore opportunities in your practice or achieve a more harmonious worklife balance, Tipton Training stands ready to help you on your journey. As Europe’s largest private postgraduate dental training provider with over 33 years’ experience training dentists, Tipton Training is dedicated to enriching your capabilities, advancing the standard of your patient care, and shaping a path towards a brighter and more prosperous future for yourself within the field of dentistry. Make 2024 the year to invest in yourself and achieve your goals. Level up your dentistry with Tipton Training!
Deliver better quality dentistry & enhance patient care: Choosing Tipton Training means more than advancing your knowledge; it’s a commitment to enhancing the quality of dentistry you provide to your patients. Tipton Training’s comprehensive year-long training programmes are designed to instil a heightened sense of confidence and proficiency, empowering you to deliver exceptional patient care. Beyond refining your clinical skills through practical handson training, its courses will also help refine your patient communication skills, teaching you how to engage, inform, and educate your patients comprehensively.
Stay up to date with the latest advancements in dentistry: Tipton Training’s programmes are continually evolving to ensure they deliver courses based on the latest scientific research and clinical studies. This approach empowers dentists to keep up to date with the latest advancements in dentistry and make informed decisions when it comes to patient care. It also integrates digital scanners into all its courses, ensuring that dentists are equipped with the essential tools to
fully leverage the potential of digital technologies and advancements in AI. Leading the way in teaching Digital Smile Design, Tipton Training showcases the transformative power of AI in diagnosis and treatment planning.
Expand treatment options:
Tipton Training empowers you to broaden your skill set, enabling you to offer superior and more advanced treatment options that directly impact the level of care you extend to your patients. Whether your goal is to perfect the art of smile design and enhance your proficiency in cosmetic treatments, or to become proficient in offering lifelong solutions to your patients through implantbased tooth replacements, Tipton Training’s array of Post Graduate courses are tailored to align with your professional aspirations.
Maximise earning potential for greater flexibility:
Applying your newly acquired skills into practice enables you to expand your range of treatments, creating new avenues for growth and financial success. On average, Tipton Training’s delegates report a remarkable increase in private income of £21,500 during
and immediately after completing their course – a figure backed by robust statistics. This boost in income can provide you the flexibility to trim your workdays, offering more quality time with your family and the opportunity to indulge in well-deserved holidays.
attain a distinguished Level 7 post graduate qualification: Upon successfully completing a Tipton Training course, you are set to achieve an EduQual accredited Level 7 Postgraduate qualification, be it a Certificate or a Diploma. This nationally recognised credential not only signifies your expertise, but also emphasises your unwavering commitment to your professional development. What’s more, it grants you the privilege of adding the distinguished post-nominals “PG Cert” or “PG Dip” after your name.
gain a prestigious rCSEng accreditation:
One of the key attributes that sets Tipton Training apart is its accreditation from the prestigious Royal College of Surgeons of England. This distinction places it at the pinnacle of dental training excellence, offering students unparalleled quality in their educational journey. By choosing Tipton Training, you set yourself apart in the pursuit of dental excellence, placing yourself in the best position to excel.
Join a network of elite dental professionals:
Joining Tipton Training also means becoming part of an elite network of Tipton alumni. This community offers ongoing career mentorship, helping you navigate your professional journey with the support of those who have
walked the path before you. Being part of Tipton Training’s community ensures life-long connections with their esteemed mentors, including Professor Tipton himself.
Tipton Training postgraduate Certificates & Diplomas
For over 33 years, Tipton Training has been at the forefront of post graduate dental education, transforming the careers of more than 5,000 dentists. With locations across five venues in the UK, Tipton Training offers a range of Level 7 Postgraduate Certificates and Diplomas designed to help dentists like you benefit from a structured career path and a supportive mentorship network.
Tipton Training is thrilled to share their comprehensive course schedules for 2024. This marks the opportune moment to lay the foundation for a successful year ahead by enriching your professional skills with its Level 7 courses.
The Level 7 PG Certificate portfolio includes:
• PG Certificate in Restorative Dentistry
• PG Certificate in Operative Dentistry
• PG Certificate in Aesthetic Dentistry
• PG Certificate in Dental Implantology
• PG Certificate in Advanced Dental Implantology
Tipton Training also offers PG Diplomas, which are essentially comparable to completing the education associated with two or more certificates.
If you are enthusiastic about advancing to the next phase of your dental career, reach out to Tipton Training today.
0161 348 7849
www.tiptontraining.co.uk
enquiries@tiptontraining.co.uk n
ECPD for your whole practice
CPD 4 DCPs is a fully veri able ECPD programme that enables each member of the dental team to complete one year’s ECPD requirement in a highly cost-effective manner. Covering all the highly recommended subjects, each volume is specially designed to cover the ECPD needs of up to 10 DCPs.
Providing 10 hours of veri able ECPD, one Volume covers the annual veri able ECPD needs of most practices.
Subjects covered:
• Don’t let sensitivity be a pain
• Identifying missing teeth
• Air pollution: keeping patients and staff safe
• Educating patients about the HPV vaccine
• Harnessing digital imaging solutions for an accurate diagnosis
• When to say no
• Stress and burnout
• Maintaining soft tissue health around dental implants
• Protecting vulnerable patients – an introduction to safeguarding
• Dealing with a patient suffering from a cardiac emergency in the dental practice
Just one Volume per practice per year, up to 10 people
10 hours veri able CPD including all recommended subjects
Ongoing modular learning programme
The whole team learning from the same information at the same pace
Saves time and money
Can be used by GDPs
Enhanced CPD Compliant
Communication, engagement and business development
Building a strong practice that will stand the test of time means delivering an exceptional patient experience, which often stems from effective communication. It also requires a team that is willing and able to maintain the highest of standards, as well as a leadership model that supports team members in this mission.
Justin Leigh, Managing Director of Focus4Growth, understands the importance of these factors and here reflects on what he feels are the main barriers to good patient communication:
“Good communication is not simply about explaining a proposed treatment. Many clinicians fall into this trap – but it’s not enough to really educate the patient and connect with them. Instead, it is essential that clinicians take the time to understand their patients, to have a two-way conversation. Dentists need to pause and listen to patients. They need to show empathy and make patients feel comfortable enough to express their needs and ask questions.
“Patients today are more informed than ever and often do research before visiting the practice. The macro environment right now, with substantial issues like the high cost of the living, means that people are more discerning about their treatment (and investment) choices. They need to know what’s involved, but also the value of what they are receiving.
“It’s not easy to achieve, because you’re attempting to change heavily ingrained habits, but mastering these communication skills will positively impact everyone involved. Patients will be more engaged in their oral health and empowered to partake in the decision-making process. They are also more likely to be satisfied with their treatment, reducing the risk of complaints for the dentist. Plus, treatment acceptance can be increased, leading to higher productivity and revenue for the practice.”
Justin will explore this topic further
during his Saturday session in the Business Theatre at the BDIA Dental Showcase 2024 – held on 22nd and 23rd March at the ExCeL London. He highlights some of the takeaways of the presentation:
“If communication and patient engagement are missing, a disconnect forms and patients don’t commit to treatment. You want the patient to ask questions and participate in the conversation, so the discussion ends with actionable points like booking the next appointment.
“I’ll present a structured, consultative, ethical sales approach that dentists can utilise in these situations. You’ll learn practical hints and tips on how to listen effectively, what to ask patients and how to build rapport. Sharing content from my book ‘Inspire, Consult, Sell’, I’ll enable you to help your patients confidently commit to treatment. I’ll also share common challenges and solutions I come across in the practices I work with.”
In Justin’s session on Friday 22nd March at BDIA Dental Showcase, he will focus more broadly on how to build a world-class practice. So, what makes a world-class practice? Justin continues:
“You can judge the quality of your practice based on three key areas. The first is feedback from patients to ensure that you provide the patient experience you’re striving for.
The second is an assessment of the team in terms of engagement, motivation and performance – you need a proactive team that is highly engaged, energised and committed to deliver an exceptional standard of care. And finally, you need to review the quality of your leadership team to ensure that they are directing investment into team development and business management.
“In my experience, some of the biggest gaps tend to relate to this last point. Dental practices must focus on the clinical aspects but they also need to run as efficient businesses. It’s important to go back
to fundamentals, review the numbers regularly, set targets and measure their effectiveness.
“Leadership is another area commonly overlooked. A strong leader will make time for coaching conversations with team members, share business progress with them, seek their input on challenges or changes, and facilitate their skill advancement. We have also found that one of the most influential facets of team engagement is clarity of expectations. This is essential for retention of good team members, which, at a time when recruitment is so difficult, is a must.
“A lack of time is often used as an excuse for not doing these things
adequately, but it’s crucial that time is consciously allocated to such elements in order for the business to thrive. For some practices, bringing in a business manager is the most effective answer.”
For anyone wanting to know more, don’t miss Justin’s second session in the Business Theatre, where he will present a framework for delegates to take away and implement in practice straightaway. There will also be Q&A opportunities in both sessions so you can get bespoke advice or information from Justin.
Concluding with a few thoughts about BDIA Dental Showcase in general, Justin adds:
“In two days at this event, I can establish and strengthen relationships that would otherwise take me all year. I love the variety of educational activities, with world-class speakers and content – I always come away with a list of actionable items. It’s a great way to discover the latest technology in dentistry, and see how the market is innovating, evolving and moving. There’s a real warmth from attendees, making it an excellent place to expand your network. I have found this a really valuable event in the past so I prioritise this show in the diary every year!” n
BDIA Dental showcase 2024 22nd-23rd March
exCeL London
dental-showcase-2024.reg.buzz/ register-free-pr
Justin Leigh
Revolutionising oral health: a sneak peek into the future of the BDCDS
As we eagerly anticipate the BDCDS in May, Alex Harden, Portfolio Director at CloserStill Media, unveils some truly exhilarating details about the upcoming event...
Alex, as the anticipation builds for the 2024 BDCDs, could you give us a glimpse into why this year’s event is being hailed as a must-attend for professionals in the dental industry?
Alex: Absolutely! The Show, on 17th and 18th May, is shaping up to be an unprecedented coming together of innovation, learning, and networking. It’s not just an event; it’s the future of dentistry unfolding. Imagine the latest in digital dentistry, AI diagnostics, and treatment advancements, all under one roof. This year, we’re pushing boundaries – not only will attendees get to witness the evolution of dental practice, but they’ll also be part of a movement setting new standards in patient care.
With each BDCDs surpassing the previous, what new and exciting features can attendees expect that set the 2024 show apart?
Alex: We’re infusing the show with interactive experiences that are both informative and entertaining. Think hands-on workshops with the latest technology, and live demonstrations of breakthrough procedures.
the speaker lineup is always a highlight of the show. Could you reveal a few of the exclusive speaker announcements that attendees can look forward to this year?
Alex: This year’s lineup is shaping up to be the best yet! We’ve secured keynotes from some of the most visionary thinkers in dental science and business strategy. Without giving too much away, their insights will be invaluable, and some come from areas of expertise that will surprise, delight, and educate.
To give you just a small taster, the line-up includes Professor Paul Tipton, Simon Chard, Finlay Sutton, Dev Patel, Lisa Bainham, and Maria Lessani.
In previous years, the BDCDs has been a platform for groundbreaking industry announcements. Are there any teasers you can share with us about what might be unveiled in 2024?
Alex: The boundaries between technology and biology are blurring. We’ll be showcasing advancements that not only improve treatments but also focus on prevention and overall wellness. Expect announcements that are going to redefine dental health paradigms.
We’re on the brink of several ‘firsts’ that will be announced exclusively at the show. It’s not just about tools and techniques, but a revolution in patient experience and treatment outcomes.
Prepare to be awed!
networking and professional growth are pillars of the BDCDs. Can you talk about how the 2024 event will foster these for new and returning attendees?
Alex: Like its predecessors, the show is poised to be a significant event for dental professionals, focusing on both networking and professional growth.
A key feature of the BDCDS is its comprehensive conference programme. These sessions, led by experts in various dental fields, offer the latest insights and skills development opportunities.
We’re delighted to confirm that the British Dental Association (BDA) is joining forces with us once more, marking a continued collaboration that promises to stir the imagination. Who will appear on the BDA Theatre stage is still a secret, but keep your eyes peeled for the big reveal in a few weeks’ time!
Each year, the show evolves to meet the needs of its attendees in ever new ways and 2024 is no different. As a small sneak peek, I can tell you that we are working more closely with exhibitors than ever before, so that stands will showcase innovation and creativity, also like never before. Exhibitors such as ClearX, Practice Plan, Acteon, TePe and EMS, to name just a few, are among those set to have the wow factor.
The exhibition also allows for the exchange of ideas and the building of professional relationships, while social gatherings like coffee breaks and lunch provide a less formal setting for delegates to connect and network.
the keynote speaker often sets the tone for the entire event. Could you give us a hint about who will be taking to the stage and what vital topics they will be addressing?
Alex: This year, we’re talking keynote speakers, plural! The keynote sessions are set to be nothing short of inspirational. We have secured some of the most influential minds in dentistry – individuals who are at the forefront of their specialities. They’ll cover a spectrum from technological innovation to holistic patient care. And let’s just say that we might have some iconic appearances that will surprise you. Stay tuned!
Lastly, how can dental professionals and industry insiders best prepare to make the most out of the BDCDs 2024, and where can they go to stay updated with the latest news and developments as the event approaches?
Alex: Co-located with Dental Technology Showcase, this is a comprehensive event, bringing together the whole dental team, with 9,000 dental professionals gathering under one roof. So, to make the most of the BDCDS fully, we suggest setting clear objectives – are you there to discover, learn, network, or all the above?
We also recommend visitors download our app, which is replacing the traditional brochure in line with our sustainability ethos, ensuring the
experience is as seamless as it is environmentally conscious.
To stay abreast with the evolving configurations of the show, ensure you’re plugged into our digital channels. Follow the show’s social media, subscribe to newsletters, and mark your calendars for alerts that will peel back the curtain, bit by bit, on what is poised to be a transformative event.
As the countdown to the BDCDS 2024 begins, engage with peers, envision the advancements, and prepare to be part of a narrative that will shape the future of dental excellence.
Join in, stay connected, and let the building excitement be the compass that guides you to the heart of dental innovation. To keep up to date with the latest news and developments regarding the event, you can visit the website at birmingham.dentistryshow.co.uk. n
Learning from world-class speakers at the ADI Members’ National Forum
The ADI Members’ National Forum 2023 brought together colleagues from across the country to hear from world-class implant experts, and network with likeminded professionals. Members convened at the Royal College of Physicians, for a day of education, networking, and socialising.
The event saw a wide variety of clinical and non-clinical topics covered, with expert speakers presenting case studies which explored various cutting-edge techniques, and offering their peers advice based on their experiences.
“I am very grateful to everyone who joined us for our Members’ National Forum. We had a number of our ADI NextGen dentists presenting sessions throughout the day, and we hope that they inspired the new generation of implant dentists by sharing their own experiences. We were delighted to be joined by a wide variety of expert speakers who are working at the forefront of the field, offering us the opportunity to learn from our colleagues in this setting is incredibly valuable. Events such as this really help us to experience the community aspect of the ADI, bringing colleagues together to share their passion for implantology. I also love being able to catch up with friends and colleagues outside of lectures,
strengthening relationships and meeting new people.”
- Amit Patel – immediate past president
The Members’ National Forum was also the setting for the ADI’s Annual General Meeting, during which Amit Patel handed over the Presidency to Zaki Kanaan.
“I would like to thank Amit, the rest of the team who are working behind the scenes, and the board members for all that they’ve done for the ADI. Amit worked incredibly hard throughout his presidency, from 2021-2023, overcoming challenges presented by COVID, for example, and I would like to thank him for all of his effort. I’ll give you my blood, sweat, and tears and every decision I make will be for the benefit of the ADI and its members. I hope that we will go from strength to strength.”
- Zaki Kanaan – president
The value of community for our members
Attendees shared their experience of the event, what they enjoy most about being a member of the ADI, and their hopes for the future of the field.
“I would recommend ADI membership to all practising dentists. The variety of topics presented by the speakers were as interesting to the novice as to an experienced practitioner. Going forward, I would like to see a closer relationship between implantology and the field of periodontics to be able to place implants in a more predictable manner in the compromised patient.”
- Dr Michel Heidweiller
“The ADI Members’ National Forum has been very well organised, well timed, and has supported a wide range of worldclass speakers, with plenty of chances to visit different sessions and the trade exhibition. This has been a fantastic opportunity to network, and meet with the many implant dentists and generalists who make up the ADI membership. I very much enjoy being a member of the association, and it is a fantastic way to get involved with the community and contact experts in the field.”
- Dr Sumair Khan
“This year’s event has featured a fantastic range of expert speakers. The ADI has a great board, and I have particularly enjoyed my membership for the past couple of years. The association provides a lot for its members, more so than other organisations in my opinion.”
- Dr Harj Bansal
“The ADI Members’ National Forum has been really good. The speakers are world-class, and the format has meant that all sessions and panels have run smoothly. I first joined the ADI due to their excellent reputation, and I wanted to become part of the wider community of implant dentists in the UK.”
- Dr Andrew Farr
The ADI is very grateful for the support we have received from the dental trade which has allowed us to host this fantastic event. We hope that our members enjoyed the event, and found the opportunity to attend educational sessions, as well as network with colleagues in the field, valuable. If you’re a dentist who provides dental implants, offers related restoration services, or who is looking to start doing so in the future, membership to the ADI offers access to a wealth of knowledge, and a community of likeminded individuals.
For more information, please visit www.adi.org.uk
A “mind-blowing” event
The British Endodontic Society (BES) was delighted to welcome delegates to Belfast in November 2023 for another fantastic Regional Meeting. With a record number of delegates, a packed two-day programme, exceptional speakers and a night to remember, this event had it all!
Things kicked off on Friday morning with the uniquely formatted Table Clinics, which offered delegates the opportunity to rotate around four short sessions looking at bonding, bioceramics and obturation, crown lengthening and the impact of digital technology for patients and clinicians.
Speakers Dr Asmaa Al-Taie, Dr Nimit Patel, Dr Satnam Singh Virdee and Dr Risha Patel offered a wealth of information and useful nuggets of advice for all to take home.
Dr Jose Anthraper was particularly impressed with the Table Clinics and the entire event, commenting:
“The table clinics were presented in a fantastic format. They were short and informative and covered a lot of topics. Throughout the entire event there has been a very high standard of speakers, discussing current topics and offering useful insights even for practitioners who are experienced in the field. I certainly gained everything I hoped to from attending this event – it’s been mind-blowing.”
President of the BES, Dr Alyn Morgan, welcomed delegates to the main programme after lunch, with a few words of appreciation for Chief Operations Officer, Annabel Thomas, on her amazing 26 years of service with the Society! He also paid tribute to two BES Past Presidents who sadly passed recently, Dr Tony Druttman and Dr Mark Hunter.
endodontic microsurgery and shared the four steps of good bleeding control.
Next up, Dr Daniel Č erný looked at the philosophy, technology, clinical protocols, problems and operator-related factors involved with endodontic treatment.
Backed by science and research, Daniel offered an array of take-home messages to help delegates enhance each area of their own practice.
Friday came to a close with the BES Prizegiving, during which three individuals were recognised for their hard work and clinical excellence. Congratulations to:
The programme commenced with a passionate session from Dr Paula Villa, who considered the basics of endodontic microsurgery. She discussed the impact of gingival phenotype on surgical outcomes, as well as the pros and cons of different incision protocols – and which should be avoided. Paula also explored the indications for grafting alongside
• Tanaka Kadiyo – Foundation Dentist prize winner
• Sam Johnson – General Dental Practitioner prize winner
• Iad Gharib – Inspirational Lecturer prize winner
The day concluded in the iconic Titanic Museum, where attendees could browse the stunning museum before sitting down
Day two continued with much of the same enthusiasm, with Dr Byron Tsivos discussing the revolution that CBCT has brought to endodontics. Talking about static and dynamic guides, Byron emphasised the importance of imaging accuracy, comparing lab scanners to CBCTs and intraoral scanners. Extending this to 3D printers, the point was clear – not all technologies are equal and it is essential to invest in the best equipment for safety and success.
Dr Paula Villa returned for the second part of her session, continuing the conversation into guided microsurgery. Covering its indications and workflows, Paula concluded that a guided approach does help to reduce some of the risks associated with endodontic microsurgery, especially when operating near important anatomical structures.
The programme came to an end with Dr Ernest Lucas Taulé demonstrating the potential of autotransportation procedures as an excellent alternative to implants, particularly in paediatric patients. Buying a patient 8-10 years without implant surgery is a success for endodontics, according to Ernest, and one that all endodontists should be proud of.
Throughout the entire event, delegates had access to a focused trade exhibition and various opportunities to network with friends and colleagues from across the field.
Dr Richard Kahan shared his experience of the meeting:
“I thought the event covered some excellent topics by good lecturers – it’s been very well done. The advanced content was very interesting to me; it sparked some
thoughts on how I could do certain aspects of my own work.”
Dr Ernestas Dapkus also had nothing but positive things to say:
“There have been some really interesting topics over the two days and great speakers. It’s been useful to look around the exhibition and I had a very good time at the Conference Dinner on Friday night. I have been a BES member for a couple of years now and find it really beneficial. They provide helpful information and I like the member newsletter, which keep me updated on future events. I would certainly recommend the BES Regional Meeting!”
Though some of the topics explore advanced endodontic subjects, the Regional Meeting provided useful insight to GDPs with an interest in the field or working alongside endodontists in practice too. Dr Antonia Paolella said:
“It’s been fascinating. I’ve really enjoyed seeing these sessions and the amazing technology that is available, it’s eye-opening. I also think it’s good to know what is possible by colleagues in the field.”
If you are an endodontist, a specialist in the field or a GDP with an interest in endodontics, the BES offers an array of educational and networking events that can develop your skills and further your career. In 2024, you can look forward to the IFEA World Endodontic Congress, which the BES is hosting in Glasgow. Become a member to find out more today!
For more information about the BES, or to join, please visit www.britishendodonticsociety.org.uk or call 01494 581542
to the Conference Dinner in front of the famous Titanic clock and staircase.
Who wouldn’t want to be award winning?
Faye Mear from Corona Marketing considers the benefits of your practice winning an award
It may seem an obvious question but why would your dental practice want to win awards? What are the tangible benefits of being able to tell new and existing patients that you and your practice are ‘award-winning’? Well, I think that there are 5 key benefits:
1. An award win, or even shortlisting, acts as a third-party endorsement for your practice. A win can give a seal of approval to your activities and is a sign of quality for potential patients. It’s a great way of differentiating your practice from competitors and will send out positive signals to patients. Existing patients love the fact that their dentist is recognised as it vindicates their choice of being with you. New patients will want to go to a practice that wins awards.
2. Massive awareness in terms of PR and marketing. Local media love to see a business in their area do well at national awards. Even being shortlisted can improve awareness of your brand and promote your practice to new patients. Awards celebrate hard work and success and are great PR opportunities. It’s fantastic to be recognised, so it’s important to make sure that people know what your business has achieved.
3. The opportunity to benchmark your practice. By entering an award, you are often forced to look at your business from a different perspective and compare yourself to your competitors. It is the chance to look at your practice as an outsider would and really see where you are at. This valuable exercise can allow you to appraise what you are doing, encourage you to think about ways you could be doing things better and consider the changes you may need in order to get to where you would like to be. This could benefit you in more ways than achieving the award itself.
4. Awards recognise the hard work and achievements of your team, so winning one can help boost staff morale and improve motivation. It will give team members focus on what’s great about the practice they work for and pride in being a part of it. Maximise and recognise the team effort by holding a staff celebration of your victories.
5. Who wouldn’t want to join an awardwinning practice? It can be a difficult time to recruit at present and an award
alongside a well-motivated team is likely to be a much more attractive proposition to potential new team members. Convinced? I hope so! If so, what do you need to do now?
Choose your awards
Which ceremony? There are a number of dental awards and they all have their own particular spin and feel. You need to decide which will suit your practice best.
You may also consider non-dental awards – these will speak to a different audience so my advice would be to enter both. Non-dental awards are often supported by a local paper or local group, such as a Chamber of Commerce, and that means that good local media coverage is likely. It also means you will be considered as not ‘just a dentist’ but as a valuable local business embedded in your community.
Which category/categories should I enter?
What is really needed here is some self-awareness. Do you really believe that your team are the best? Is your practice up there with all the great ones in the local area? If so, these are the categories that you should enter, but don’t be afraid to look at your practice and say, “No, we won’t be in the running for that this year, but if we make changes, we can enter it next time.” In this way, awards are fantastic for business development too.
I include the plural for the reason that putting all your eggs in one basket could be a little risky, if you choose to enter only one award. It makes sense from a time management perspective to enter multiple categories as there will be commonalities across the categories – both in terms of evidence and content too.
What does a good award entry look like?
This will obviously depend upon the category that you enter and your practice’s particular achievements, but there are common themes to all awardwinning entries.
• Answer the question – make sure that you provide all the material that the award category asks for
• Pictures – they may not be worth a thousand words but they do convey more about a practice or team member than simply text can. They also help break up overly wordy entries.
• Video – A good selection of video content can help your entry stand out from the crowd – patient testimonials, patient journey, promotions from social media and so on
• Evidence – this is where so many well-written entries come unstuck. You can never have too much of this.
Don’t forget, there’s still time to enter The Dental Awards 2024. You have until 23th February to get your entries in at: the-probe.co.uk/awards
For example, if you were entering a dental award ceremony for Best Patient Care, and said, “We really look after our patients,” you need to prove it. How do you? Illustrate your patient journey, show how the team go the extra mile
• Strong leadership – not simply telling people what to do but truly leading them by example
• Community – a dental practice is not just a business in isolation. It is part of a wider community. What part do you play in that community? CSR (Corporate Social Responsibility) is a must
You may consider the services of an award writing agency. The crafting of award entries takes time and skill and, as more and more practices enter, this could greatly improve your chances of success.
We’ve been shortlisted –what should I do now?
Congratulations! Tell people! Make sure that you let patients know when they visit the practice. Feature it in your practice newsletter if you have one and let all your followers on Facebook, Instagram and TikTok know. Online, do not be afraid to tell people several times – it is by its very nature somewhat transitory, so tell people more than once. Email your patient database and tell them how delighted and honoured you are. Contact the local press –newspaper, magazines, radio and television – make it easy for them and have a press release drafted with the important Who, What, Where, When, How and Why questions answered.
We won! What should I do now?
Repeat above! I kid you not, the beauty of awards is that by their definition they have a shortlist and a winners’ list. This means that if you win, you get two bites of the cherry. Not only can you tell everyone that you were shortlisted, now you can tell them all again that you won. Make sure you maximise PR exposure and update your marketing materials with the award logo, including business cards, website, literature, email and treatment information.
At their basest level, people like winners, that is why any kind of award stamping you as ‘The Best’ is of value to your practice. n
About the author Faye Mear is an awards expert at Corona Marketing, a specialist dental marketing agency. For more information please call 0845 370 2211, email faye.mear@coronadental.co.uk or visit coronadental.co.uk/dental-awards/
don’t get in a fix
If you’re curious about fixed appliances, you can easily gain the skills you need to provide these treatments with the IAS Academy.
The Fixed Braces course is designed for beginners, and will cover both the theory and hands-on training needed by professionals for them to start providing fixed brace options. From learning how to perform interproximal reduction to selecting the best archwires for the appliance, this course is a comprehensive look at the treatment journey and covers every aspect of fixed braces to ensure confidence.
There are plenty of dates available, so why not get in touch today?
For more information on upcoming IAS Academy training courses, please visit www.iasortho.com or call 01932 336470 (Press 1) n
Quality, support and reliability
Dr Harmeet Sehmi reflects on his experience of the training courses he’s attended with The Campbell Academy, which were supported by Straumann®:
“I decided in 2017 (6 years post qualifying) that I wanted to incorporate implant placement into my general practice. After speaking with several colleagues, The Campbell Academy’s implant course seemed the right fit. By the end of the course, I was hoping to feel confident in placing implants in simple cases within my own practice.
“The course exceeded my expectations. I certainly felt confident in placing implants by the end, and the support throughout and after was very reassuring. I enjoyed all the lectures and speakers. However,
placing my first implant was my highlight -– there was a huge adrenaline rush after. The main challenge was to get into the right frame of mind and calm the nerves before placing my first ever implant.
“The course teaches with Straumann® implants, but they have a wide knowledge of many other systems. For me, I have only used Straumann® implants due to the quality and reliability.”
Discover all educational courses supported by Straumann® at: www.straumanncourses.comn
Hands-on against infection
Excellent hygiene standards can help to keep your patients and clinicians safe by preventing the spread of infection in your dental practice. Tackle germs with confidence by utilising UltraProtect™ hand sanitiser solutions from Initial Medical.
An alcohol-free hand sanitiser, UltraProtect™ is an effective and longlasting answer to infection control. It kills 99.99% of germs including swine flu, staphylococcus aureus and norovirus, and after 1 minute of exposure it kills 99.99% of Coronavirus*.
Hand surface protection is provided for up to 8 hours, whilst the solution is dermatologically approved to not dry out or crack skin. That is effective power, with a kind touch.
Flexible friends
To avoid serious dental conditions such as cavities and gum disease, effective plaque removal is essential. The FLEXI range of interdental brushes from TANDEX can help patients remove more plaque than brushing alone. Each product’s handle is flexible, and the brush can be bent into the perfect shape to clean in between the teeth.
Available in 11 different sizes, the line presents a solution for each individual patient, for a comfortable and effective clean. Additionally, FLEXIMax features an ergonomic handle for an even easier clean.
FLEXI brushes can be used to easily apply PREVENT GEL too, a product which contains 0.12% chlorhexidine
Maximise your care with the No Touch UltraProtect™ Hand Sanitiser Dispenser. With touch-free automatic capabilities, it is the most hygienic solution in the Signature Range. Simple to check and refill, the dispenser can be wall mounted or placed on a portable stand to help make a difference anywhere in your practice.
*Independently tested against feline coronavirus, a surrogate virus for coronavirus.
Tel: 0808 304 7411 n
and 900ppm fluoride known for their antibacterial and enamel strengthening properties.
To find out how the FLEXI range and PREVENT GEL can help your patients visit the website today.
Facebook page:
https://www.facebook.com/TandexUK n
In today’s world, cleanliness is paramount, especially for medical professionals and dentists relying on crystal-clear loupes for precision.
The alcohol-free antibacterial formula by Centrostyle ensures loupe frames and lenses remain impeccably clean and sanitised. Available in various sizes to accommodate every need—compact 35ml and 60ml for on-the-go professionals, and a generous 150ml for optical maintenance. Spray Clean caters to all types of lenses, even those with special coatings. For optimal results, pair it with our Macroclean kingsize microfibre cloth.
Elevate your loupe hygiene with
Centrostyle’s Spray Clean and ensure your vision remains crystal clear.
For more information call 0808 1000 888, email sales@evident.co.uk n
As he steps down as President of the ADI, Dr Amit Patel reflects on his term and the people he has worked with:
“At the ADI, everything we do for and offer our members is designed to facilitate the delivery of implant treatment that is in the best interests of patients. We also want to help streamline and improve the professional workflow, with benefits that make everyday life in practice that little bit easier.”
“It has been a privilege to help steer the ADI over the past couple of years. I would like to thank the fantastic Board, various Committees and head office team who have supported me along the way – without their help the task would have
been impossible. There are many people who work tirelessly behind the scenes to keep the association operating smoothly and they all deserve our recognition and gratitude. Thank you again to you all.”
For more information on the ADI, upcoming events, or to join, please visit www.adi.org.uk n
Meet friends and discover innovation on the straight and narrow
“The BDIA Dental Showcase is the perfect place to meet old friends and make new ones. You can’t beat face-toface customer contact and Showcase is the best annual event in the UK for COLTENE to increase brand awareness and present the latest product innovations and treatment concepts to the dental community.”
Nic Coomber, National Account Manager and Marketing Strategist for COLTENE, shares why the organisation will be once again attending BDIA Dental Showcase. The UK’s longest standing dental exhibition, this will be the event of 2024. Hundreds of dental companies, manufacturers, training providers and more will be among the trade floor,
where you can discover the latest innovations in dentistry. It will also be a fantastic opportunity to connect with product experts, meet new suppliers and replenish stocks with show-only offers and promotions.
Registration is now open – secure your place today!
For patients needing implant treatment but presenting with reduced interdental spaces and bone availability, Helix GM Narrow from Neodent®, a Straumann Group brand, offers a stable, long-term implant foundation.
The Ø 2.9mm Helix GM Narrow provides an immediate, small diameter solution, which is suitable regardless of whether guided or non-guided techniques are used.
Produced from the most commercially pure and mechanically strong titanium grade 4, the implant uses an optimised, stable and strong screw-retained morse taper connection. Designed to offer clinicians
greater levels of treatment flexibility, it can be used for both single and multiunit restorations.
To discover how Neodent® could bolster your dental implant treatment work visit the website today.
For more information on Neodent® visit https://www.neodent-uk.co/portal n
Martin Woodrow, Chief Executive of the British Dental Association (BDA), will be exploring some of the challenges of NHS dentistry in his session at the BDIA Dental Showcase in March 2024.
“The challenges faced within NHS dentistry make it a less attractive place to work for many professionals. A shift to private dentistry offers more freedom in how they approach the provision of care. It enables more time to deliver dentistry, with fewer constraints and less bureaucracy.
“There are risks of course; NHS dentistry offers greater security of income and additional benefits such as an NHS pension and parental leave. Given the limited resources we have to provide publicly-funded oral healthcare, many
Dr Jacob Taekke is a dentist who works with dental implants, prosthetics, and cosmetics. He discusses his experience using Kiroku – the digital note taking platform:
“Kiroku is a programme that I’m really passionate about. It helps you to write good notes quickly and effectively while freeing up your time and giving you less stress.
“Meticulous record keeping is important for any kind of dentistry. For complex dental procedures like dental implant treatments, record-keeping can be an enormous and very taxing task. Records are by nature, completed following clinical appointments and sometimes at the end of the day. One can very easily
would make the argument that those resources ought to be focused towards people who need care the most.
“I’ve enjoyed attending BDIA Showcase to mix with representatives of the industry and with colleagues from across the profession. Come to my session if you want to hear the latest thinking on these and more topics from the voice of dentists.”
Apposite
Looking for a versatile, durable composite? Brilliant Crios from COLTENE is a reinforced composite bloc for the fabrication of permanent, indirect restorations using a CAD/CAM grinding process.
For endodontists, specialist endodontists and general dentists with an interest in endodontics, don’t miss the next World Endodontic Congress (WEC) from the International Federation of Endodontic Associations (IFEA)!
Hosted by the British Endodontic Society (BES), the 2024 Congress will be held on 11-14 September at the Scottish Event Campus in Glasgow.
Titled “Phases & Interfaces”, the event will present a comprehensive programme with extensive line-up of speakers who are operating at the cutting-edge of the field. There will also be various social events and networking opportunities, as well as a
A magnet for talent
Attracting the right people to join your practice’s team is always a challenge, even more so during the current recruitment crunch.
According to the Chartered Institute of Personnel and Development (CIPD), most candidates expect to search and apply for jobs online, meaning employers need to pay attention to their business website and their online brand. For dental professionals, this means being aware of their social media presence and how the practice is viewed and reviewed.
The CIPD also recommends the use of recruitment agencies that have a good understanding of the specific sector and its requirements.
make clerical mistakes or omissions in patient records and this can have unfortunate consequences.
“Since I started using Kiroku, I have saved many hours of work and I have been able to focus more on the clinical side of dentistry and spend more time with my family.”
“I absolutely recommend Kiroku to any dentist and I am glad to say that many of my colleagues are now also using Kiroku.” For more information, please get in touch with the Kiroku team, or visit our website. n
Available in two translucencies (and two sizes) with a total of 13 shades, it offers a broad spectrum of solutions for aesthetic single-tooth restorations – including inlays, crowns and veneers – and is ideal for use in both the anterior and posterior regions. Brilliant Crios’ outstanding mechanical properties are the result of controlled, stress-free, thermal curing. Its multimodal composition of dental glass and amorphous silica in combination with a reinforcing resin matrix, make it an optimal
Planning on scanning?
Embracing intraoral scanning can enhance the patient experience – no more messy impression trays – and make workflows quicker and easier.
The Virtuo VivoTM Intraoral Scanner from Straumann® is a light and small handpiece (only 130g), ergonomically designed to provide a pen-like grip and exceptional patient comfort. Teeth and soft tissue can be scanned from multiple orientations, capturing difficult-to-see areas with minimal effort. Resulting scans are in colour and high resolution. The scanner boasts a removable, autoclavable sleeve in coated metal to ensure proper hygiene for the patient and practice.
Virtuo VivoTM uses an open system, meaning that data can be exported and
2024!
broad-spectrum trade show with a variety of organisations showcasing their endodontic products, technologies and solutions.
Early bird registration rates are available until 31st May 2024, offering significant discounts for IFEA members, non-members and postgraduate students.
Secure your place today at: ifea2024glasgow.com/registrationn
Dental Elite is a well-established dental recruitment agency specialising in sourcing and hiring for jobs in the dental sector. To find out how Dental Elite can assist with your recruitment needs – or if you’re looking for a new professional challenge – contact them today. For more information contact the Dental Elite team on 01788 545900 https://dentalelite.co.uk/ n
material for permanent single-tooth restorations. Its shock-absorbing effect reduces the stress transmission and so is also well suited for implant restorations. To discover how Brilliant Crios can work for you and your patients visit the website today!n
shared in a secure way with any dental lab partner.
To discover how the Virtuo VivoTM Intraoral Scanner can work for you and your patients, visit the website today! For more details, please visit the website below.n
Wanting to boost your patient communication and engagement? Patient Bridge, a Sensei product, is a cloud-based platform that allows dental practitioners to centralise their patient communications. Sensei is the practice and patient management solution brand of Carestream Dental.
Blending seamlessly with either existing R4+ software or with Sensei Cloud, the platform enables dental professionals to streamline practice visits, optimise patient satisfaction and generate more revenue. Patient Bridge features a virtual
Validated sanitation
Eschmann washer disinfectors offer reproducible, validated cleaning and disinfection and are proven to be an effective way to help remove proteins and contaminants from instruments prior to sterilisation.
Using a washer disinfector not only saves time, but also helps to minimise the risk of needle stick-injury. The risk of cross infection from manual cleaning is also reduced.
Eschmann has two different-sized, WRAS-approved washer disinfectors available. The Miele PG8581 is an under bench model which can accommodate up to 360 instruments per cycle, while the Hydrim C61 is a benchtop machine that can take up to 120 instruments. Both
waiting room, contactless check-in, digital form completion and managed marketing campaigns.
Patient surveys can be automated too, and the information is presented through dashboards allowing dental professionals to track and discuss feedback with the team.
The system utilises a mix of SMS messaging and HTML email, including links and images, together with direct mail letters to optimise patient connection.
The platform supports GDPR management of opt-outs so that communications remain compliant at all times.
To discover how Patient Bridge could work for your practice, visit the website today! n
models can automatically record all cycles via a wireless data manager, simplifying the professional workflow.
To see which one is right for you and your practice, visit the website today!
For more information on the highly effective and affordable range of infection control products from Eschmann, please visit www.eschmann.co.uk or call: 01903 875787n
Eschmann provides a comprehensive portfolio of equipment, consumables and services to help you maintain exceptional decontamination processes.
These include the range of Little Sister autoclaves, offering ‘B’ and ‘N’ type cycles with varying capacities and sizes to suit different practice needs. Added features such as real-time recording and automatic data logging ensure efficient and highly accurate cycle monitoring and documentation.
Hitting the right notes
Kiroku, the AI digital note taking platform, can help dental professionals complete their notes 60% faster.
Designed to take the stress out of writing endless clinical notes, the system removes the need for typing through the use of clickable buttons that auto-populates the section being worked on and pre-fills related sections.
All Eschmann equipment can also be supported by the all-encompassing Care & Cover programme, which provides invaluable maintenance and servicing by factory-trained, UK-based engineers. Tel: 01903 875787 n
Another solution in the portfolio is the Miele under bench washer disinfector, which offers heavy duty cleaning, disinfection and drying in under an hour to support best practice cleaning of instruments. The combination of touch controls, autoclose doors and a built-in water softener streamlines workflows and prolongs product life.
complete control over treatment planning
ClearCorrect® now gives clinicians even more control over their treatment plans with ClearPilot™ 7.0. With enhanced features like Bite Jump Simulation, and the Arch Editing Tool, along with a variety of user interface improvements, treatment planning and simulation has never been simpler. ClearCorrect® also now offers expanded editing capabilities for ClearControl™ Clinical Features, making it easier than ever to utilise 3D editing controls to design optimal anterior and posterior bite ramps, pontics, bars, engagers and cutouts. And, with more precise editing tools on offer, clinicians have more control over the teeth they keep in position, with the ability to ‘lock’ teeth and simulate IPR.
If you’d like to find out more about treatment planning features from ClearCorrect®, please get in touch with the team.
For more information on ClearCorrect®, visit: www.clearcorrect-uk.com n
Keeping scotland smiling
Clyde Munro is the largest Scottish dental group, offering exceptional dental care to patients across the country. We are offering some exciting opportunities for dentists looking to progress in their careers and make a change in their lives. We’re looking for new dentists to join the group and help us reach even more communities while further raising the standards of dentistry in Scotland. Our commitment to state-of-the-art technologies, cutting-edge materials and on-going professional education mean we offer the means, the training and the support our practitioners need every day. No matter what stage of your career you have reached so far, we can help you go further and realise your professional
A
ambitions. Plus, you could achieve all this with a stunning Scottish backdrop! Contact our team or visit the website today to find out more.
Find out more about the career opportunities and vacancies available with Clyde Munro today at careers. clydemunrodental.comn
powerhouse of natural ingredients
For businesses seeking a more natural answer to infection control, look to the Citrox Protect range distributed by Oraldent.
Plant-based and eco-friendly, Citrox Protect products have been independently proven to be effective against a range of pathogens, including SARS-COVID. Ingredients include an organic acid (lactic acid), which works to disrupt the biofilm and prevent bacteria from growing, as well as a patented complex of naturally-derived bioflavonoids.
The formula is non-carcinogenic, nontoxic, non-allergenic, non-corrosive and demagogically tested, so completely safe for human use and for the environment. The range includes: antibacterial hand
gel, surface cleaner and disinfectant, hard surface sealant and textile surface sealant.
For more information, call the team or visit the website today.
For more details, visit oraldental.co.uk or call 01480 862080 n
Unlike other software, Kiroku is AI-based so learns from every user. This means it can make suggestions that the user can accept, edit or decline.
Another benefit is that Kiroku works alongside a practice’s existing dental software because it is accessible from any browser (optimised for Google Chrome).
The user simply completes the notes in Kiroku, clicks the ‘Copy notes’ button and pastes into their own software. Easy! For more information about how Kiroku can help you in your practice, get in touch with the team today.
To find out more about Kiroku, or to start your free trial, please visit trykiroku.com n
Graham Welch has joined Aerona as the new Training & Onboarding Success Specialist. With more than 20 years of experience in several training and customer service roles, Graham will be a highly valuable addition to the team.
He says: “I will be calling on my training, technical support and customer service experience to support and mentor Aerona customers, helping them to achieve the best from the features within this fully cloud-based solution, including the flexibility and security that it can bring to a practice.
“I have known Simon Garthwaite, Bill Starky and Mike Stonell for many years,
and respect their experience and working ethics greatly. We all share the same values of customer care and support that is at the centre of the business.
“It will be fantastic to work with these guys again, and I look forward to working with my new Aerona family.”
For more information, visit aerona.com n
Enhancing patient understanding of gingival disease
Research has shown animations to significantly improve patient understanding of health and medical information. As such, Chairsyde is a useful tool when it comes to explaining gingival disease and related treatment options.
Chairsyde is a state-of-the-art consultation platform designed for dentists. It offers a comprehensive library of animations covering a wide range of oral health issues and treatment solutions, including those associated with gum disease. Videos clearly demonstrate what gum disease is, how it progresses and what treatments are available to arrest its development. All benefits, risks and limitations of each treatment option are covered in detail, empowering the patient
to take control of their oral health. The platform is easy to use, automatically featuring associated topics and treatments on each page for quick and simple navigation.
Discover Chairsyde today. Tel: 020 3951 8360 n
Expand your skills in tooth loss management
With 74% of the UK population having had a tooth extracted, staying on top of the latest tooth loss management techniques is a must.
An Advanced Certificate in Management of Tooth Loss: Immediate Implants vs Socket Preservation is a new course offered by ICE Postgraduate Dental Institute and Hospital/University of Salford. It is designed for both beginners and experienced implant dentists looking to expand their knowledge and clinical skills in tooth loss management. This includes minimally traumatic extraction techniques and socket preservation.
The course, led by eminent specialist oral surgeon Professor Cemal Ucer, covers disuse atrophy, osseointegration
and soft tissue management as well as immediate implant placement and loading using analogue or fully digital workflows. Delegates will also receive hands-on practical experience in socket augmentation and alveolar ridge preservation.
To enquire about this exciting new opportunity visit the website today! Contact Professor Ucer at ucer@ icedental.institute or Mel Hay at mel@ mdic.co Tel: 01612 371842 n
Illuminating Innovation Meets unrivalled comfort!
Fasmedo is revolutionising the world of professional lighting with the FL-210 Cordless Headlight, a true game-changer for those in need of reliable illumination. This headlight boasts a Cordless Head Mount Design, offering unrestricted mobility and convenience, without the hassle of cords.
One of its standout features is the Continuous Knob Control, allowing you to adjust lamp intensity seamlessly, ranging from 4800 to a dazzling 72000 Lux, ensuring optimal brightness for any task. With a colour temperature of 5000K and a uniform light spot, the FL-210 provides true-to-life lighting for precision work. Despite its power, the FL-210 remains incredibly lightweight at just 200g,
reducing fatigue during extended use. Plus, the rechargeable battery offers 3-10 hours of uninterrupted operation, ensuring you never run out of light when you need it most.
The Fasmedo FL-210 Cordless Headlight is your dependable companion for every professional lighting need. Experience innovation, convenience, and unbeatable performance - experience Fasmedo today! n
Add Perio Plus+ to daily routines
More patients are appreciating the importance of keeping their gums healthy, not just their teeth.
With periodontitis now affecting a large number of UK adults, if they ask you how to improve their daily routine, recommend the Perio Plus+ mouthwash range from Curaden.
With your guidance, they can use Perio Plus+ to protect themselves against a wide range of harmful bacteria. Perio Plus+ mouthwashes contains CITROX®, which has a pleasant taste and minimal side-effects. Naturally derived from bitter oranges, CITROX® is a natural ingredient that will not only eradicate biofilm but will slow down its regrowth.
In Perio Plus+ mouthwashes, CITROX®
is combine with chlorhexidine (CHX), which is well-known as an anti-plaque agent. That’s TWO effective ingredients in ONE alcohol-free formula. Introduce you patients to Perio Plus+ mouthwashes today.
For more details, please visit: www.perioplus.com/uk n
Education was key at the AdI Members’ National Forum 2023
The ADI Members’ National Forum saw colleagues come together at the Royal College of Physicians for a day of education, networking, and socialising. Delegates enjoyed sessions presented by expert speakers which explored case studies and techniques at the cuttingedge of the field.
“The ADI Members’ National Forum has been very well organised, well timed, and has supported a wide range of world-class speakers, with plenty of chances to visit different sessions and the trade exhibition. This has been a fantastic opportunity to network, and meet with the many implant dentists and generalists who make up
the ADI membership. I very much enjoy being a member of the association, and it is a fantastic way to get involved with the community and contact experts in the field.” - Dr Sumair Khan For more information about the ADI, or to join, visit the website www.adi.org.uk n
A non-invasive option for early detection
Tests to assist in the diagnosis of oral cancer can be invasive, and sometimes inappropriate for detecting cancer in its early stages. Saliva tests can be an effective, non-invasive pre-diagnostic tool.
The BeVigilant™ OraFusion™ System from Vigilant Biosciences® is a noninvasive fluoroscopic and visual saliva biomarker-based semi-quantitative risk assessment tool which is intended to be used during examination, without the use of a tissue biopsy. In 15 minutes or less, the BeVigilant™ OraFusion™ System easily identifies the presence of biomarkers associated with oral cancer and produces a report of either low, moderate, or elevated risk levels to assist dentists in their decision making.
Good oral health starts with thorough interdental care capturing
Do your patients struggle with interdental cleaning? Do they find floss uncomfortable or fiddly?
Recommend to them Curaprox interdental brushes, with super-fine, extralong and ultra-resilient filaments for a superior clean. Solutions are able to bend around the teeth, gently clearing away any food debris or bacteria.
Curaprox solutions are also available with a unique click system – patients need only click off their old brush head, and click on the new one. This way, replacing the Curaprox interdental brush is easy and convenient, with less plastic waste.
The range includes options suitable for natural teeth, dental implants, crowns and bridges, in addition to larger or smaller spaces.
To find out more, visit the website or get in touch with the team today.
For more information, please visit: www.curaprox.co.uk n
To discover more about this pre-diagnostic testing system, please visit the website or get in touch today.
For more information, please visit: www.vigilantbiosciences.com or email: info@vigilantbiosciences.com n
panoramic images with ease
For dental professionals looking for a smaller ‘plug and pan’ scanner for routine imaging needs, the CS 8100 3D Evo Edition, from Carestream Dental, boasts a sleek, compact design that fits into the tightest of spaces.
Using the latest Tomosharp technology, it delivers outstanding image clarity in seconds. Easy to install and learn to use, it covers all your everyday needs from standard panoramic images to segmented bitewing, TMJ, maxillary sinus and cephalometric images. Visit the website today to learn more!
For more information on Carestream Dental and our new extended warranties visit www.carestreamdental.co.uk.
For the latest news and updates, follow us on Facebook and Instagram @ carestreamdental.uk n
Thinking about selling your practice and undecided as to whether an independent or corporate buyer is right for you? Some of the pros and cons were outlined in a recent Dental Elite webinar.
The informative session also covered how current interest rate activity has affected the market and just how important it is to keep an eye on materials, lab and staff costs in the lead up to a sale, on an associate led EBITDA basis, every £1 of profit saved, could be worth circa £7 in value (Multiple Dependant)
The webinar discussed the impact of recent market disruptions too, given the consolidation of eight buying groups becoming four and the need to get expert advice to ensure the best possible deal
is negotiated in terms of purchase price and the terms related to the sale
You can revisit the webinar by heading to https://webinars.dental-update.co.uk/#/ pastwebinars
To find out how Dental Elite can assist with your business decisions, contact the team today.
For more information contact Dental Elite. Visit www.dentalelite.co.uk, email: info@dentalelite.co.uk or call: 01788 545 900 n
It can be difficult to know when to treat an endodontic case and when to refer it, especially if this is a discipline you are less confident in.
If you ever need a second opinion, or wish to simply bounce ideas off leading clinicians in the field, we’re here for you at EndoCare.
Our team consists of registered specialists and expert endodontists who draw on several decades of experience to support your diagnosis and treatment plan. They can answer any questions and help you make a confident decision as to whether referral is appropriate or not. Think of us like an extension of your team. We can share some advice and even provide advanced treatment where
it is beyond what you are comfortable delivering. Contact us today to find out more.
For further information please call EndoCare on 020 7224 0999 Or visit www.endocare.co.uk n
With over 28,000 individual products in stock, Trycare not only supply all their Surgical and General Practice specialist products from Adin, Centrix, EVE, Tecnoss OsteoBiol, Tokuyama and many more market leading manufacturers, but everything else you need too! This includes everything available from Acteon to Zhermack, including composites like Kulzer’s Charisma.
You can get it all from Trycare!
For further information contact your local Trycare representative, call 01274 885544 or visit www.trycare.co.uk. n
With over 28,000 individual products in stock, Trycare not only supply all their Surgical and General Practice specialist products from Adin, Centrix, EVE, Tecnoss OsteoBiol, Tokuyama and many more market leading manufacturers, but everything else you need too! This includes everything available from Acteon to Zhermack, including precision impression materials like 3M Impregum. You can get it all from Trycare!
For further information contact your local Trycare representative, call 01274 885544 or visit www.trycare.co.uk. n
safer & greener instrument care
New greener and less hazardous chemical components make a much safer solution for both the user and the environment. IDactiv contains plant based and biodegradable ingredients alongside naturally occurring amino acids. The modern formula is free from alcohol, chloride and PHMB. A mild fresh aroma is a pleasant change from other solutions with harsh odours.
Economical and powerful. Unlike many other competitors, Bossklein IDactiv is effective against all enveloped viruses and TB. EN 21530 testing ensures compatibility with a wide range of different materials while preserving instrument quality.
Bossklein IDactiv is designed for the
disinfection and cleaning of manual instruments as well as rotating instruments such as burs, diamonds and polishers. Safe to use inside both instrument and ultrasonic baths.
Available now in 1L, 2.5L or 5L bottles. For more information call 0800 132 373 or visit www.bossklein.com n
With over 28,000 individual products in stock, Trycare not only supply all their Surgical and General Practice specialist products from Adin, Centrix, EVE, Tecnoss OsteoBiol, Tokuyama and many more market leading manufacturers, but everything else you need too! This includes everything available from Acteon to Zhermack, including glass ionomers like GC’s Fuji IX. You can get it all from Trycare!
For further information contact your local Trycare representative, call 01274 885544 or visit www.trycare.co.uk.n
With over 28,000 individual products in stock, Trycare not only supply all their Surgical and General Practice specialist products from Adin, Centrix, EVE, Tecnoss OsteoBiol, Tokuyama and many more market leading manufacturers, but everything else you need too! This includes everything available from Acteon to Zhermack, including local anaesthetic like Dentsply’s Xylocaine. You can get it all from Trycare!
For further information contact your local Trycare representative, call 01274 885544 or visit www.trycare.co.uk.n
The Planmeca Compact I Classic Limited Edition dental unit is currently available at a very special price, and comes with some very desirable features as standard.
An ideal choice for any surgery, this compact chair comes with everything you want - an LED light, Electric motor, Fibre optics, a Knee Break leg rest and the choice between balanced or hanging tube instruments. It even has upgrades available so that you can tailor the unit to the way you work.
All this at a great price and with a 5-year warranty! This limited-edition package is currently available to try out in our mobile showroom. Contact Planmeca to book your appointment.
Bio-Emulation symposium
The Bio-Emulation Symposium, held on November 4th and 5th in the vibrant city of Sofia, Bulgaria, brought together leading dentists, dental technicians, and industry professionals to explore cutting-edge trends in the field of dentistry. Hosted by the Bio-Emulation team and proudly sponsored by GC Europe, this event set the stage for ground-breaking discussions and collaborations.
The symposium was a resounding success with over 500 attendees from 32 countries. The eleven lecturers all showed a high level in dentistry and dental technology, which they also showcased in the hands-on workshops and demos.
Email: infouk@planmeca.com
Tel: 0800 5200 330 n
With over 28,000 individual products in stock, Trycare not only supply all their Surgical and General Practice specialist products from Adin, Centrix, EVE, Tecnoss OsteoBiol, Tokuyama and many more market leading manufacturers, but everything else you need too! This includes everything available from Acteon to Zhermack, including local anaesthetic like Septodont’s Lignospan. You can get it all from Trycare!
For further information contact your local Trycare representative, call 01274 885544 or visit www.trycare.co.uk.n
In total, 10 lectures and 8 workshops were given. This included presentations, workshops, and a students’ panel with demonstrations, covering a wide range of topics for dentists as well as technicians, fostering interdisciplinary collaboration that promises to drive treatment optimalisation. To learn more about the Bio-Emulation team and stay updated on future events, please visit https:// www.facebook.com/ BioEmulation n
Guests join us from all areas of the industry to provide their own unique perspectives on a wide range of topics, from manufacturers and figureheads of various dental organisations, to those in the trenches working in practice, and more.
For
Nothing is o limits in The Probe Dental Podcast, so be sure to tune in wherever you get your podcasts!
Wall Street for dentists
The stock market is often complex, and may seem like a far removed entity from the world of dentistry. However, it’s beneficial for dental professionals to understand the investment opportunities it offers, which could potentially maximise and protect their income.
When choosing to interact with the stock market, individuals put their own capital at risk. The highs of a profit are as equally significant as the potential lows of a loss, and it’s important for people to understand the landscape of the stock market before they invest. This can be an extensive ordeal, which is why some investors could choose to seek out a stockbroker.
a third party
Individuals do not need the help of a stockbroker to trade, but working with one could open up more time to focus on other individual or business projects, whilst reaping the rewards. A stockbroker is an individual who will buy or sell your shares, finalising trades on your behalf.
The level of control a dental professional hands over is entirely dependent on the deal struck with their stockbroker. For example, the investor could research the shares that interest them, and instruct the stockbroker to buy or sell at an agreed time and given price. This way, decisions can be based entirely on their own understanding of the market.
Share trading is often complex, and it’s no surprise that some professionals may not wish to balance a career in dentistry, a private life and a comprehensive approach to investing. Their stockbroker may take on a more advisory role, providing insight into potential trades that they have researched and recommended. This removes some of the leg work from the process – but not as much as a discretionary approach.
Here, the stockbroker will buy and sell shares completely on your behalf. The purchase and sale of shares may be completed when the stockbroker thinks they can get the best deal, without the investor having to interfere heavily in the process.
Less time spent researching the market and making decisions based upon it is more convenient, but choosing a quality stockbroker that you trust is essential: a 2015 report found that half of its analysed discretionary portfolios underperformed in the market over three years, whilst 20% saw positive returns.
choosing wisely
The right stockbroker for each investor may be entirely different. You may wish to trade online, for example, which will widen the range of brokers you can work with, and will allow you the freedom to make trades from wherever you are in the world. Exploring online brokers that make communication clear and simple would be key.
The expense of working with a stockbroker should also be considered. Many will charge on a commission basis, taking a percentage of the transaction value. A minimum fee may have to be met, or paid regardless as a flat fee. Understanding how much this is, as well as the amount of money you are willing to invest over time, could help you judge whom you wish to trade with, as well as the type of stocks you want to invest in.
Most importantly, investors should engage with stockbrokers registered with the Financial Conduct Authority (FCA). This body regulates nearly 50,000 businesses, aiming to keep financial markets honest, fair and effective. When a stockbroker is registered with the FCA, they are obliged to act in the best interests of their client – this is essential when protecting and managing investments.
if the time is right
Stocks fluctuate all the time, and there is no guarantee of a rise or fall at any given moment. Looking broadly, by the beginning of 2023 indexes such as the FTSE 100 had recovered following the dramatic hits it took during the coronavirus pandemic, reaching lows in March 2020.
However, fears over another recession may make investors think twice. Share values fall with a recession, and if it were to creep over the horizon, there may be better times to make the leap into the market
Strategy for a successful sale
Given the media headlines around the UK’s interest rate changes, Phil Kolodynski, director of practice sales at Dental Elite, kicked off a recent webinar by putting dental professionals’ minds at ease about how it was affecting the market.
“We’re in a very cash rich industry,” he said. “Lots of dentists have significant savings and, due to Covid with many practices seeing a boom in increased private income, associates have saved huge deposits to buy their first practice. Not every buyer needs finance and the bank of mum, dad and family isn’t affected by base rate increases.”
However, he believed it was naïve to say there was no impact at all. For example, comparing August 2022 and August 2023 annual repayments on the basis of a 15-year term and borrowing £1m (£92,555 vs £115,696) shows a difference of £23,141. “That’s straight out of the pocket of the buyer. Effectively that business is £23k less profitable in the buyer’s eyes,” he explained. As a result, the main impact has been fewer buyers. “Where a mid-sized £1m NHS practice in London 18 months ago would have probably attracted 18 buyers, now it’s only 10 buyers,” he said. “What we’ve noticed is that the buyers thinking about if they should buy a practice or stay an associate, have gone into hibernation. There’s still a big pool of serious buyers in the market. We’ve just lost the tyre-kickers.”
benchmarking report
Nick Moore, senior valuer for the south west and London, explored three key areas to examine when it comes to valuing a practice that are covered in Dental Elite’s
recent benchmarking report: material and lab expenditure, UDA rates and staff costs.
Its data shows a clear difference in the levels of material and lab expenses when comparing private and NHS practices. The cost goes up as the NHS contingent is reduced. Nick emphasised that private practices have greater control over treatment fees as material costs can be factored in to the price the patient pays.
“You don’t have that luxury in an NHS practice,” he said.
He urged practice owners to use the benchmarking percentages in the report to test their own businesses and cost controls: “What it may highlight is that you might need to put your treatment prices up.”
Phil agreed. “Often when we look at these spends, it’s not necessarily about a practice spending too much on the materials, it’s about not charging enough for the work,” he said. To put this into context, Phil explained that in a £1m turnover practice, if it can save 1% of EBITDA (£10k) on materials and reducing lab fees then that could mean an additional £70k to £80k to the value of the business.
When it comes to UDA rates, the data shows that the average is up from £10.50 to £11.89 for mixed practices and £13.15 for NHS focused practices. This is down to the lack of dentists and current challenges in recruitment. “What we’re seeing is the NHS paying more to retain the dentists they have,” Nick said. “If you don’t pay the rates, they’ll look to leave or not do NHS work full stop.”
Staff costs are the biggest expense in a practice and need to be examined regularly. Staff costs as a proportion of gross revenue is greater in NHS practices. This is not because they pay more but
than now. The decision can’t be made by anyone but the investor, or whoever they trust their investment funds with, but the prospect of potential success and losses should be evaluated with equal fervour, even when working with a stockbroker.
Dental professionals should consider a free consultation with money4dentists, the specialist independent financial advisers that have worked exclusively with dentists for more than 16 years. They understand the unique financial situations of dental professionals, and can help organise and decide upon investments that suits your risk preferences and financial capabilities. The expert team makes share dealing simple to understand and can help those beginning and during their investment journey.
Share dealing isn’t for everyone, but the benefits for a sensible investor may be exceptional. Understanding your unique ability to trade in the market, and finding the right stockbroker to help you on your way, could help you decide upon investments that reward you in the years to come.
For more information, please call 0845 345 5060 or 0754DENTIST, email info@money4dentists.com or visi money4dentists.com n
about the author Richard T Lishman, Managing Director of the 4dentists Group of companies.
because more of their income is delivered by chair time which necessitates more staff. Mixed practices benefit from weighting their hourly rate for private treatments and private practices generate more income from fewer chairs. And fewer chairs equal fewer staff. In terms of valuations, this is crucial: “Too many heads erode your profit margins,” Nick advised.
state of the nation
Nick ran through the various acquisitions and mergers that have recently disrupted the market. “Basically, eight strong buying groups have become four,” he said with Real Good Dental’s purchase of Enamel Dental Care; Riverdale buying 19 Hanji Dental Care practices; Dentex and Portman merging; and Dental Partners and Rodericks Dental joining forces.
On the upside, he highlighted that MyDentist is now looking to expand and that Todays Dental is ever expanding and growing into the Midlands. Envisage Dental too is very active.
Phil pointed out that although the report highlights the big groups, there is a tier of buyers below them. “These are people with two or three practices and looking to grow, these buyers can offer competitive prices whilst being more flexible than groups on deal terms,” he said.
Nick and Phil explored the pros and cons of selling to an independent or multi-site buyer. While a corporate will almost always make a higher offer, the deal structure may not be so advantageous. An independent will pay 100% on completion whereas with a corporate there will be a tie-in – between three and four years – and the seller will have to stay with the practice.
Nick warned that some corporates may approach dental practices directly but urged dentists to ‘get valued and don’t do it alone’. Dental Elite offers free valuations so those looking to sell have nothing to lose.
A recent case in point: a corporate made a direct offer valuing a practice at £1.3m on a multiple of 5.8x and just two weeks later Dental Elite secured a deal valuing the practice at £1.85m, on a multiple of 8.25x. Now, that’s a win!
You can download the full benchmarking report at delite.click/so0 and revisit the webinar at https://webinars.dental-update. co.uk/#/pastwebinars
For more information contact Dental Elite. Visit www.dentalelite.co.uk, email info@dentalelite.co.uk or call 01788 545 900 n
Phil Kolodynski
Dental Practice Sales: How do you sell a Limited Company?
If you have incorporated your dental practice and now trade as a limited company, there will be knock-on implications when you sell your business. We often see dentists going into the unknown in this situation and some guidance and pre-planning will be useful. The sale process is a little different from a traditional asset sale, where an individual simply sells to another party. Making sure you know exactly how a limited company sale works can ensure that problematic areas are resolved, and planning can save you £1,000s in tax.
NHS Contracts
Where the NHS contract is held within the limited company, the way in which the contract is transferred is quite different to the ‘partnership transfer route’ that is used for an asset sale. As the limited company is a separate legal entity and holds the NHS contract, when selling the shares of the limited company, the NHS holder (the limited company) does not change. As such, as far as the ICB (Integrated Care Board) is concerned, the NHS contract has not changed hands.
However, if the vendor has created a limited company, but holds the NHS contract outside the limited company, this would then be transferred via a partnership route. The buyer may prefer to purchase the assets from the limited company, leaving you with the empty shell of a limited company. We can advise on the most suitable sale route for your business.
CQC
As with the NHS contract, CQC registration should be in the limited company name. This does not change and, therefore, the buyer may not need to go through a new CQC application. As mentioned, the registration will not change, although if the vendor is the ‘registered manager’ (RM) then they may be required to submit a new RM application.
Offers (Cash/Debt Free)
When you have your practice valued and receive offers, they will most likely be on a ‘cash/debt free’ basis. In simple terms, if someone offered £1,000,000 for the business, they are assuming that there is no debt (or assets) within the company. If for example, there was £100,000 of Corporation tax bill outstanding,
which was going to remain post-sale, then the buyer would pay £900,000 for the business (£1,000,000 - £100,000) as they would be responsible for paying the debt. In an opposing situation, should you have £100,000 of retained cash within the business, the buyer would pay £1,100,000 (£1,000,000 + £100,000). It is important to note that the tax liability for a business sale largely falls under the more favourable Capital Gains Tax (CGT) regime and not the income tax regime. Therefore, it is possible to use the sale of your dental practice/ limited company as a way to extract the cash on a very favourable tax rate. So, instead of drawing dividends at 39.35%, you could withdraw cash at the 10% ‘entrepreneurs’ relief’ rate. If in doubt, you should consult your accountant to advise you on this.
Summary
The above examples simplify the position and there will be many smaller calculations to consider. For example, where staff are paid one month in arrears, or how to deal with a lab bill that comes in one month after the sale. As only the ‘cash/ debt free price’ is known in advance,
completion accounts are prepared several months after the completion to ascertain the final value (e.g. £1,000,000 – liabilities + assets). You may end up selling the assets of your company and then dissolving the company to access the cash personally. In these circumstances, apart from the potential double taxation, there are severe HMRC anti-avoidance rules that you will need to consider carefully, so be sure to take advice before heads of terms are agreed.
In summary, the sale of a sale of a limited company may allow you to achieve significant tax savings, However, the process is not straightforward. Some planning prior to the sale with professional advice should ensure that you maximise the benefits of selling your dental practice and avoid the pitfalls.
About the author Martyn Bradshaw is a Director of PFM Dental and heads up the dental practice sales agency.
Fixed fees locked for 2 years when you transfer to us
In addition to a full range of accounting and tax advisory services, we can provide expert support with NHS Pensions, incorporating practices and business planning.
Our services include:
• Practice purchase/sale advice
• Tax planning
• Accounts and tax returns
• Payroll bureau
• Cloud accounting – regular reports with tax forecasts
• Personal service with all day-to-day advice included
If you would like to discuss your own situation and how we can provide assistance, please get in touch for a no obligation quotation.
On the up and up
Love it or loathe it Amazon is one of the biggest business successes in recent times.
Few can probably recall the time when it was only a digital store undercutting your local book shop and nothing more. But over the past two decades, under the guidance of Jeff Bezos, it has pursued a path of vertical integration, venturing into warehousing, logistics, electronics, household items and even clothing.
Vertical integration is a business strategy where a company expands its operations by acquiring or merging with other businesses operating at different stages of the production or distribution process. This approach enables a company to streamline its operations, gain control over its supply chain, and ultimately enhance its overall efficiency.
Many companies grow and prosper through acquisition. Recently in the dental industry, global digital dental laboratory group Corus Dental acquired Byrnes Dental Laboratory, expanding its reach into the UK market. Corus now operates 74 laboratories across nine countries.
a different approach
Vertical integration is a little different and takes a different approach. There are two main ways of achieving vertical integration: backward and forward. A company that opts for backward integration moves the ownership control of its products to a point earlier in the supply chain or the production process. For example, a
Knowledge
Ofurniture manufacturer buying a wood distributor. Forward integration is when a company expands by gaining control of the distribution process and sale of its finished products, such as a clothing manufacturer opening its own stores.
One of the key benefits of vertical integration is cost reductions. By integrating into the supply chain – for example a dental practice integrating with a dental lab – a company can eliminate the markup costs associated with purchasing inputs from external suppliers.
There are numerous precedents of this in the dental sector. For example, in 2022 Dentex Health bought its very first standalone dental laboratory, Ceramiart Dental Laboratories and the Gensmile dental group boasts 35 practices and four dental laboratories.
Vertical integration also provides greater control over quality and consistency. When a company has control over the various stages of production, it can ensure that the output meets its desired standards. This control also enables companies to maintain consistency across their product line and quickly respond to customer feedback or market demands. Imagine what this could mean to the workflow in a dental practice.
competitive advantage
Another advantage is increased market power and competitive advantage. By controlling multiple stages of the value chain, a company can have a stronger market presence. In the current
competitive world of dentistry, that can only be a good thing. Integrating a dental practice with a lab can help to optimise its operations, reduce costs and deliver value to patients at a more competitive price.
This approach to growth can also foster innovation and strategic flexibility. Companies that control different stages of the value chain have the advantage of exploring new technologies, processes, or business models that can enhance their operations. For example, a tech company that integrates into component manufacturing can develop proprietary components, which can lead to unique product offerings and differentiation. What could this mean for a dental practice integrating with a lab?
Vertical integration can enhance the overall customer experience. By integrating various stages of the value chain, companies can coordinate activities and improve communication and collaboration internally. This coordination can lead to seamless operations, faster response times, and improved customer service. For example, a dental practice that vertically integrates by owning a lab could provide a seamless end-to-end experience for patients, resulting in increased satisfaction and loyalty.
When performed well, vertical integration of businesses can lead to quicker turnaround times and simpler logistics because an entire process is managed in-house. However, it should be remembered that businesses can’t vertically integrate overnight. In fact, it is a long-term process that requires
alone is not enough
ne of the main priorities of modern dentistry is patient education. Patients must know why their oral health is so important for their general wellbeing. Information is also always being offered by the dental team on how to maintain dental hygiene at home. However, the information alone is not enough. Knowledge is useless if it is not properly understood.
The challenges of understanding So, why might patients not fully understand the information provided by their dental team?
Language – it can be easy for dental professionals to use dental jargon when explaining current oral health status or describing treatment options. Many of the words will mean very little to some patients so their understanding of the information being provided will be limited. Instead, we should be using layman’s terms during conversations. The use of visual aids can also improve patient understanding –especially where the patient speaks English as a second language. Furthermore, animations significantly improve patient understanding of health and medical information, when used in addition to verbal instructions.
Fear – dental anxiety or phobia is estimated to affect half the UK population. Research has shown that stress and anxiety can significantly impact cognitive abilities
and impair decision-making. If a patient is uncomfortable in the dental environment, worried about a procedure or scared about the cost, they will not be paying attention to professional explanations or recommendations. This is a difficult one to overcome, but establishing a rapport and building trust between patient and practitioner is essential. As is communicating potential treatments clearly and concisely.
Perceived need – often a difficulty when it comes to treatment acceptance, patients often don’t fully understand why they need to improve their oral hygiene or undergo a certain procedure. The dental team, therefore, needs to show the patient their current oral health condition in a way that they can more easily appreciate. Talking through their radiographic images or clinical photographs can really help, as can presenting videos or animations of the disease process to explain which stage they are at and what could happen in the future without intervention.
Turning knowledge into power
Part of the problem with a lack of understanding among patients is that they don’t know how to turn the information they receive into actions. Say they have been informed that they have gingival disease. They must also appreciate what this means for the health of their gums and teeth over time, and what specifically they need to
widespread buy-in. The team at Dental Elite has more than a decade of experience in the buying and selling of dental laboratories and dental practices and are able to advise on the potential for possible mergers and acquisitions. Vertical integration offers several significant advantages to businesses. It can reduce costs, ensure quality and consistency, increase market presence and power, foster innovation, and enhance the overall customer experience. When implemented wisely, vertical integration can be a valuable strategic approach for companies looking to achieve long-term success and competitive advantage. Dental practice and dental laboratory owners should take note.
Visit dentalelite.co.uk for more info, email info@dentalelite.co.uk or call 01788 545 900 n
about the author Luke Moore is one of the founders and Directors of Dental elite and has overseen well in excess of 750 practice sales and valuations. With over 19 years working in the dental industry, Luke has extensive knowledge in both dental practice transfers and recruitment and understands the complexities of nHs and Private practices.
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do differently at home to arrest disease progression, before this knowledge is of any use to them.
That’s why Chairsyde was developed. As a state-of-the-art consultation platform designed specifically for dentists, it helps to bridge the gap between knowledge and understanding, empowering patients to take control of their oral health and remain active in the decision-making process for more engaged – and successful – dental hygiene. Its library of animations enables clinicians to demonstrate a patient’s existing health concerns in a way that they understand, whether that is the development of gingival disease or on-going tooth wear. There are also videos to describe treatment procedures, including their benefits and risks, ensuring that patients fully understand what is being recommended and why. Plus, animations demonstrate correct techniques for brushing, interdental cleaning and more, so patients know exactly what they have to do at home.
It is crucial to inform patients of their oral health status and to share all relevant details of proposed treatments with them. However, knowledge alone is not enough. With the right approach and innovative technology, you can bolster your patients’ understanding of their oral health for improved outcomes.
For more information, or to book a demo, please visit www.chairsyde.com or call 020 3951 8360 n
Loven Ganeswaran, ceO and founder chairsyde.
Helping dentists around the world empower their patients to make better decisions about their health.
