The Probe July 2024

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Gingival recession Prescription medicationsOrthodontic appliances 42% of adults1 66% of adults2 4M in the U.S.3

*"Caries risk and social determinants of health," JADA, December 2022

*"Caries risk and social determinants of health," JADA, December 2022

1 “Periodontal Disease in Adults (Age 30 or Older).” National Institute of Dental and Craniofacial Research, U.S. Department of

Assess their caries risk, and consider prescribing high fluoride to increase caries control5 Be confident prescribing Colgate® Duraphat®, the brand your patients

www.nidcr.nih.gov/ research/data-statistics/periodontal-disease/adults

2 Georgetown University. “Prescription Drugs” Health Policy Institute, 2019, hpi.georgetown.edu/rxdrugs/

1 “Periodontal Disease in Adults (Age 30 or Older).” National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services, www.nidcr.nih.gov/ research/data-statistics/periodontal-disease/adults

3 “Does Dental Insurance Cover Braces?” Humana.com, www.humana.com/dental-insurance/dental-resources/dental-braces

2 Georgetown University. “Prescription Drugs” Health Policy Institute, 2019, hpi.georgetown.edu/rxdrugs/ 3 “Does Dental Insurance Cover Braces?” Humana.com, www.humana.com/dental-insurance/dental-resources/dental-braces

Legislative changes welcomed for skill mix and improved access

The General Dental Council (GDC) is the latest organisation to welcome a legislative change, effective 26 June 2024, that aims to improve direct access for patients to dental hygienists and dental therapists, while promoting better use of skill mix in the dental team.

The new legislation, as previously reported, will enable dental hygienists and therapists across the UK to legally supply and administer specific prescription-only medicines under an exemptions mechanism, without the need for a dentist’s prescription, a patient-specific direction, or a patient group direction.

While specified medicines can legally be supplied and administered under exemptions, the GDC has stated that it ‘expects dental hygienists and dental therapists to undertake the appropriate training to ensure they are competent to use this new mechanism,’ before adding in its statement that, ‘there is no obligation for dental hygienists and therapists to administer and supply these medicines under exemptions, and many of them may wish to continue to rely on existing mechanisms in their work instead.’

The regulator added: ‘We expect all dental hygienists and dental therapists to be able to demonstrate successful completion of a training course. This is

crucial to ensure they have the required knowledge and skills to be able to work safely under this new mechanism.

‘We strongly encourage hygienists and therapists to select a course that follows the training curriculum developed by the British Association of Dental Therapists (BADT) and the British Society of Dental Hygiene & Therapy (BSDHT).’

In addition, NHS England and Health Education and Improvement Wales (HEIW) are developing training courses with details expected shortly.

Ross Scales, GDC Head of Upstream Regulation, said: “We welcome this legislative change, because it will bring improvements for dental patients across a number of settings. We thank colleagues at the professional associations and at NHS England for developing a curriculum outlining the knowledge and skills needed for dental hygienists and dental therapists

to work to this mechanism. This curriculum also provides a basis for undergraduate training providers to build relevant training into their courses, so future generations of dental professionals can benefit too.”

Debbie Hemington, BADT President, said:

“This is a change that will bring lasting benefits to not only the dental team, but the patients who they provide care to. It will make better use of the skills UK-based dental therapists hold, and will improve the efficiency of dental practices day-to-day.”

Miranda Steeples, BSDHT President, commented: “We are pleased to be working with BADT to make sure we encourage dental hygienists and therapists to take up the right training course, so that those who want to make use of this mechanism can do so confidently and competently.”

For further information on this legal change, please read the GDC’s statement and the official government consultation document. ■

Learn more by watching or listening to our interview with Fiona Sandom and Michaela O’Neill, who were instrumental in developing the legislation.

You can find the interview here: https://t.ly/MpdRC - as well as by scanning the QR Code, subscribing to The Probe Dental Podcast on your preferred podcast platform, or via our YouTube channel: https://www.youtube.com/@theprobemag

New initiative reduces waiting times for paediatric dental care

A network of Community Dental Services CIC (CDS) Support Practices has been established in the East Midlands to relieve the pressure on waiting times for paediatric patients in the aftermath of the Covid-19 pandemic. They are being operated by leading community dental provider CDS and general dental practices in the East Midlands. The aim of the Support Practices is to deliver a high-quality service for children requiring level one care.

Covid-19 caused significant interruptions to dental care and many children have not seen a dentist leading to increased dental need among this group. Teams in the practices have been supported to treat patients that may otherwise only have been able to access care through the community dental service. Paediatric patients referred to CDS are triaged and assessed for suitability

for care in a Support Practice, enabling them to be seen and treated more quickly. It has increased capacity for the teams in CDS to treat more complex paediatric and special care patients, also reducing the time they are waiting for appointments.

Prior to starting to treat CDS referral patients, the dentists from the Support Practices receive online training with the Midlands Paediatric Team and a hands-on study day. Dentists take part in regular peer review sessions and are invited to attend the paediatric MCN meetings.

Milan Chande, Principal Dentist at The Dental Wellness Centre in Leicester, said, “Being a CDS support practice has been really rewarding and has upskilled the team. We usually see patients who require multiple restorations, silver Diamine Fluoride, Hall crowns or extractions.

It is fantastic to know we have done something to improve the oral health of the child and have given them a positive dental experience.”

Nicola Milner, Chief Operating Officer for CDS in the East Midlands, said, “During the Covid-19 pandemic, we were used as an Urgent Care Site for Covid positive patients. This led to a significant backlog of patients waiting for an assessment appointment. Transferring level 1 patients to the Support Practices allows us to focus on treating the more complex paediatric patients who really need our specialist care and reduces the waiting time for appointments. We are incredibly grateful to all our partner Support Practices in Leicestershire, Derbyshire, and Nottinghamshire and we have really appreciated working with them to treat these paediatric patients.”

A welcome from the editor

Depending on when you’re reading this, you most likely know the winner of the general election. With a press date for this issue set a couple of days beforehand, and no access to Mystic Meg’s crystal ball, we haven’t been able to accurately predict the outcome. However, I hope that the next Prime Minister – be it Sir Keir Starmer or a returning Rishi Sunak – is reading, as we have plenty of analysis of what you, the nation’s dental professionals, would like to see from the government. Barry Cockcroft and Karen Coates explore how NHS dental access can be improved, and oral health policy recalibrated, respectively, on page 10. Meanwhile, the DDU’s Bryan Harvey asks what the new government should prioritise on page 11. Then, over on page 39, Denplan’s Catherine Rutland navigates the election countdown.

There is, of course, more to this issue for those of you who are sick and tired of the political debate. We also continue to celebrate those who were named finalists, commended, and winners at this year’s Dental Awards. Find a selection of winners on page 40 or scan the QR code to see the full list of finalist and winners, and to watch the presentation: https://the-probe.co.uk/awards/the-dental-awards-2024/

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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 RCS(Eng), D’Orth RCS(Eng); Mark Wright BDS(Lon), DGDP RCS(UK), Dip Imp Dent.RCS (Eng) Adv. Cert, FICD; Dr Yasminder Virdee BDS. Readers who

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James Harker Co-founder Dentally

Nick Davies Co-founder Dentally

Cliff Traill Product Manager Agilio Software

Caroline Oldfield Property solicitor PFM Legal

Dr George Wright Deputy Dental Director Dental Protection

Davinder Raju Founder Greener Dentistry Global

Catherine Rutland Clinical Director Denplan

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Compulsory tethering to the NHS:

Another insane idea created to ‘save’ the service

Afew weeks ago, a proposed government plan was announced that would mean new dental graduates could be forced to work in the NHS to help tackle the access crisis. The Guardian reported that the proposed plan would mean new dentists ‘would have to undertake NHS work for “several years” after leaving university or face paying back some of the £200,000 cost of training them.’

Believe me. I know about tethering. In 1978, I was arrested. To be more accurate – I’d hate to embellish my feeble ‘bad boy’ image more than is absolutely necessary – I was wrongly arrested.

In those days I was a journalist, working for a large provincial evening newspaper. By that time, I had switched from being a reporter to a press photographer and, one blazing hot June day, whilst I was covering a church fete, I was called into the vicar’s office to take a call from the newsroom of the paper’s regional office. In those days, of course, there were no mobile phones – a point to note for later in the story. The chief reporter asked me to, and I quote, “Get your **** down to the A** now! There’s been a crash!”

Now, half of me was relieved to get away from what I regarded to truly be a ‘fete worse than death’ but on the other hand, I REALLY didn’t want to be at the scene of an accident until all the injured had been taken to hospital. In my view, there is nothing worse than photographers and camera crews filming the aftermath of human tragedies and getting in the way of the emergency services. So, I drove as slowly as I could to the scene of the accident. In those days I was exceptionally squeamish and it would be another five years before I would be forced to dissect a cadaver.

Unfortunately, I arrived before the emergency services had even begun to start the retrieval operation. I won’t go into detail, but I have never been able to forget the scene I was confronted with. A large lorry on a major arterial road, adjacent to the town where I was based, had taken out the side of a coachload of tourists, killing a number of the coach passengers.

I approached the scene with a Nikon F around my neck and a camera bag over my shoulder, but I had no intention whatsoever of taking a photograph. In the distance I saw a young trainee photographer from the local rival weekly newspaper, taking pictures from the roadside of one of the deceased who was still in the coach. I was about to tell him to stop, when I heard a uniformed officer from inside the coach, clearly upset, shout: “Arrest them!”

Within what seemed like a couple of seconds, both of us were frogmarched

to the back of a blacked-out police van by burly police officers who weren’t going to be dissuaded by my pathetic protestations of GENUINE innocence. So, there I was, sat in the back of the 70s version of a Black Maria, breaking out in hives, with my only companion being the callow youth I had by now developed an intense loathing for. The worst thing was, despite knowing I was completely innocent, nobody from the newspaper knew I was there. In all, we baked in that van for at least 90 minutes before we were released.

Mercifully, a reporter from my paper had arrived at the scene a few seconds before my arrest and had witnessed the travesty of justice. He then had to drive back to the office – after he carried out his reporting duties, I might add – no rush – to make a call to our editor in the distant head office. The editor then apparently phoned the Chief Constable of the police force in question, who sanctioned our release. However, I was advised by the officer who let us out of the van that, “You two haven’t heard the last of this.”

And I hadn’t. Shortly after that incident, I moved to another daily newspaper within the police authority’s area. One day, two detectives from another force turned up on my doorstep. The officer who had requested my arrest had been subject to a complaint from the editor of my old newspaper. I was having none of it. I backed up the Chief Superintendent fully. It was outrageous that the kid from the rival newspaper was taking photographs. I was just collateral damage. It was shortly after that episode that I took a long, hard look at my life and thought that I should do something a little more grown up with my life. Unfortunately, I chose dentistry. And my point? I was in a situation I couldn’t do anything about. I was literally locked in through no fault of my own, but if the Tories plan takes off, or is adopted by a Labour Government, new dentists could find themselves in an interminable Hell that is a thousand times worse than an hour-and-a-half inside a sweaty police van.

The full horror of this plan dawned on me when I looked back on my first years in dentistry, before I became a practice owner. I can’t imagine what it would have been like to find myself tethered for ‘several years’ to practices that I managed to quickly extricate myself from in the late eighties and early nineties, let alone being forcibly tied to the UDA system.

For example, there was one scallywag I worked with as a part-time associate in the late 80s. I arrived on my first day at the branch practice to find that there was no light-cure machine

because that usually resided at the head practice, some 10 miles away. You could only book a composite after consulting with the head practice receptionist to ensure nobody else was doing a composite on your proposed treatment day. But the worst thing was arriving to find that the practice –and I’m not making this up – had NO matrix bands. The owner apparently didn’t use them. My bitewings on his patients showed clearly that was the case. The owner said he wasn’t going to spend unnecessary money on a new set of matrix bands, so I put my notice in, avoiding Class II restorations for the rest of my stay, referring them back to him if they were unavoidable. In those days, we had to put three months’ notice into the Family Practitioner Committee. That was the longest three months of my life. In those days, we didn’t have the Care Quality Commission, but we DID have Dental Practice Advisors AND the RDO (Regional Dental Officer). So, what went wrong there then? The idea of being tethered to a practice like that for unspecified years, was beyond the pale. In my defence, I did bring my concerns to the FPC regarding those and the practitioner’s other, more serious, misdemeanours.

At another practice I worked at in the early 90s, the partners, a married couple – and both members of the Local Dental Committee – reportedly disposed of their sharps at a local tip. Can you imagine being tethered to those people for two years? You can make the point that any practice that takes on a new graduate under the proposed new scheme would have to be approved – but these practitioners WERE approved for the vocational training scheme that was then in place.

And if you think these are just laughable, historical tales from a bygone age, I heard post-CQC

(from an impeccable source) that the owner of a practice run by – again an LDC member – one day delivered calcium hydroxide paste directly into a root-canal that had been previously used on the last patient. The tip had only been wiped. When the nurse protested, the dentist’s spouse, also a prominent member of the dental community, gave the nurse a lecture, telling her something like: “What you have to understand, is that the calcium hydroxide kills any bacteria that might still be lurking around.” Risible, if it weren’t such a serious breach of crossinfection control guidelines. Could you imagine working for creatures like THAT for several years?

By the time you read this, the results of the General Election will be known and HOPEFULLY, the Tory Government will be no more – but can we be sure that the new Government will truly save NHS dentistry? After all, it was Tony Blair’s Labour Government that started the demise of the NHS dental service in 2006 with the introduction of the UDA-based contract. I wouldn’t put anything past either major party with regard to their attitude to health service dentistry. UK governments in general appear to pay scant regard to the importance of oral health. I’m glad I’m not a new graduate. I’m sure even metaphorical handcuffs would bring me out in a rash. n

About the author ollie Jupes is the pseudonym of a former nHs dentist. He monitors dentistry on twitter X as @DentistGoneBadd

Improving GDC investigations

One year ago, Dental Protection launched its campaign to improve the GDC investigation process following some worrying survey results showing the impact that investigations have on dental professionals’ mental health.

Eight in 10 respondents to the survey said their experience of an investigation had a detrimental impact on their mental health. More than one in 10 quit dentistry due to the investigation, and a further two in five considered leaving. Over a quarter (28%) said they experienced suicidal thoughts during the process. Many left comments about how their experience would have been less traumatic if the investigation had been handled differently.

Our campaign set out several calls for action to the GDC: to bring about a more compassionate tone in communications, improve signposting to mental wellbeing resources, ensure correspondence is accessible across all devices, discourage complaints that clearly do not require regulatory action, and to publish data on registrants who have died by suicide during an investigation without further delay. The to-do list we set for the GDC was extensive and exposed many shortfalls in the regulator’s processes and communications.

We also set out a raft of recommendations aimed at tackling the chronic delays to fitness to

practise investigations. In our survey, 82% of respondents said the duration of their GDC investigation affected their mental health the most, with some cases lasting many years.

Of course, reform to the GDC’s outdated legislation could play a key role in reducing delays, as amongst other things this could give the regulator greater discretion to not take forward investigations where allegations clearly do not require action. The regulator could then focus on the most serious allegations and process them faster. The next Government must progress with GDC reform with urgency, but we have always felt that the GDC can and must make changes of its own volition in the meantime.

Now, one year on from the launch of our campaign, I have been reflecting on the progress made to reduce the impact of GDC investigations on mental health. There have been several positive developments.

First, in response to our feedback, the GDC reviewed and then revised the contents of the letters sent to registrants during an investigation to ensure a more empathetic tone and include signposting to health and wellbeing support. This alone is a positive step and we believe the new letters are much improved. In our survey, 74% of dental professionals said the tone of communications from the GDC affected their mental health most, with one respondent describing it as unnecessarily ‘cold and harsh’. Second, the GDC has launched a

fitness to practise pilot, expediting the conclusion and closure of simple cases. The pilot, which has recently been extended, deals solely with single-patient clinical complaints where there is no history of fitness to practise concerns. We welcome this move, and hope it brings faster resolution for these cases. We also hope the pilot demonstrates the potential for the GDC to do more to bring about speedier, more informed and robust decision making across all cases.

A bigger concern for the dental professionals we represent at Dental Protection is the lack of proportionality and timeliness in handling cases that are not closed at the initial assessment stage.

Third, the GDC is undertaking a review into the level of detail that is put into the public domain when the Interim Orders Committee is considering fitness to practise concerns, and the allegations have not been determined one way or another.

This follows the unfortunate case of a dentist who took their own life while under investigation, prompting the Coroner to direct the GDC to take actions to prevent future tragedies.

Albeit in response to the Coroner’s request, the GDC is taking steps, and in a March 2024 update on this also confirmed that it is working to build a framework to report the causes of death of dental professionals where there is an active fitness to practise case, guided by an evidence review and engaging with experts including the National Suicide

Prevention Strategy Advisory Group. A report covering the period 2019-2022, is due to be published in 2024. This report is long overdue, and it is important that the GDC keeps to this commitment. When it is eventually published, I anticipate it will make for difficult reading, but it will provide some much-needed transparency and will expose the full extent of this issue. This is the first real step in tackling the issue. These are just a selection of examples of where we have seen some recent progress. We know some of the problems, particularly around delays, cannot be solved overnight, and we know there is much more that could be done. But the GDC did engage with us constructively when we presented them with the findings and recommendations from our campaign, and my colleagues and I at Dental Protection –who support members through GDC investigations and witness the effects on mental health first-hand - feel the GDC finally seems to be in ‘listening mode’. So, is there a light at the end of the tunnel for the GDC’s fitness to practise processes? Perhaps – a glimmer at least. Our quest for improvements continues unabated. n

About the author Dr George wright,

Deputy Dental Director at

Dental protection.

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Improving access to NHS dentistry following the election

Short term fixes look obvious but long-term reform carries many risks

All the political parties have mentioned improving access to NHS dentistry in their manifestos but what that really means only time will tell. Several parties have fallen into the same trap when referring to improving access to both dental care and general medical services in referring to improving access to “GPs” and “NHS dentists”. What they should have said was everybody should be able to see a dentist when they need to and the same with GPs.

I am registered with a great medical practice in London and have had great care on the NHS but have not seen my GP (other than a friendly chat in the waiting room) for several years. My reviews, vaccinations, visits and questions have been dealt with by the many members of the team that are all registered healthcare professionals but not doctors. Similarly, with dentistry, the largely orally fit majority could be supervised, monitored and largely treated by other members of the dental team, especially if some of the unnecessary barriers to them working in practice were removed and a few incentives explored: why are dental therapists working in hospitals or the salaried services eligible to be part of the NHS pension scheme while those working in practice are not?

Prior to the election being called, Andrea Leadsom, the then minister with portfolio responsibility for dentistry, held some roundtable meetings and, for the first time, the whole dental team was represented –surely a model for the future.

These issues could be sorted quickly after the election if there is a will. The BDA is fixated about contract reform but access, having been reducing since 1992, improved by 2.6 million between 2006 and 2014. What happened in 2015 to change the direction of travel? When there was real political will, extra money was found. The dental spend in 2002 was around £1.7 billion and by 2009 the budget was over £3 billion. Money does not seem to be the major issue now as the budget is underspent by around £500 million but there has been no obvious attempt to use that money over the last nine years. The new leaders at the top of the NHS need to work with commissioners at ICB level and ensure that money is used for the purpose it was intended; not difficult if the will is there.

The long term looks more problematic. I referred to Rory Stewart’s book in my last article and, as he says, “policy is one thing but implementation is the tricky bit”.

I was asked to move to the DH in 2002 because we had been piloting a system based on capitation for four years and had made it work for everybody. There were, however, several problems that needed to be resolved. Ministers had already laid the groundwork for introducing local commissioning as a way to halt the ongoing drop in access but I was told that there were several “red lines” that could not be crossed, and they still exist today. We were given strict instructions from Downing Street (number 11, not number 10) that patient charge revenue must not fall. In our practice, access had improved and we were able to work more preventively. We were moving away from six-monthly recalls when it was not clinically necessary but patient charge revenue had fallen by around 30%.

I was told about the proposed legislation on my first day at the Department and was informed straight away that capitation was not a short-term possibility because of the patient charge issue.

The BDA were on the working group overseeing the contract reform programme, although they did say from the outset that they would “agree nothing”. They insisted from the outset that no dentist working in the NHS at the date of transition to the new arrangements should suffer financially. This led to variations in UDA values, the currency that the BDA played a part in developing, but contract values should be equivalent to earnings before transition with a 5% reduction in activity. Managing this transition again will be a major headache and, although the BDA have been clear that they believe weighted capitation is the way forward, something I would agree with, they have no idea how to manage a transition to any new system and protect contract values at the same time. The good news is that any significant change to legislation would likely take three to four years at least, so the best thing is to use the flexibilities already in the system and make sure the dental budget is spent on NHS dental services. During my time as CDO, achieving a ring-fenced budget was one of the biggest challenges, and to see it being breached and raided was hugely disappointing but not a surprise! n

About the author

Dr Barry Cockcroft

CBe is the former Chief Dental officer for england and current chair of the British Fluoridation society.

Recalibrating oral health policy after the General Election

As dental professionals, we are not only on the frontline, providing often complex and challenging treatment and dealing with all the potential stress this entails, but all too often we also deal with the systemic failures of an NHS dental contract that is fundamentally flawed.

At the time of writing, we don’t know the outcome of the General Election. Regardless of the result, the period immediately following the election presents a timely opportunity for us to unite as a profession, engage with policymakers, and tackle the issues head-on.

We need to demand the changes that we, as a profession, and our patients deserve.

Having worked in dentistry for over three decades, I’ve experienced both highs and lows, although these past few years have been the most challenging of my career. It’s time for a real change in how policymakers view and prioritise oral health.

The many years of progressive underfunding of NHS dental services is no secret. We’ve been forced to stretch our resources thin, often making it impossible to provide the service that our patients deserve. It feels like juggling chainsaws while riding a unicycle. The 2006 NHS dental contract is a relic that needs urgent reform. It prioritises quantity over quality, which is counterproductive. We should be focusing on preventing issues, not just fixing them when they become unmanageable.

The dental workforce is another area that’s been sorely neglected. Recruitment and retention have become herculean tasks. The result? Overworked, underappreciated professionals, and let’s not even start on the NHS regulations and anomalies that come with it. Many young dentists are opting for private practice or leaving the profession entirely, citing burnout and lack of support. It’s heartbreaking to see such talent and potential being wasted when our dental health care system could be the envy of the world.

Prevention is where we can make the most significant impact, yet it’s the area most overlooked by governments of the past. Water fluoridation, a simple and effective measure to reduce tooth decay, remains a patchwork effort across the UK.

Some areas benefit, while others, particularly deprived communities, suffer the consequences of inaction. It’s baffling that something so straightforward has been so difficult to implement uniformly.

Education, too, has been sorely lacking. Public awareness campaigns are sporadic at best, and we’re not seeing the longterm educational programmes that could instil good oral health practices from a young age. As dental professionals, we see firsthand the results of this neglect. It’s like trying to mop up a flood without turning off the tap.

We have launched a manifesto, ‘Prevention, Care, Education: A People’s Manifesto for Improved Oral Health in the UK’ to address some of the challenges regarding the political will for changes to how oral health works in the UK. This document, released ahead of the 2024

General Election, outlines our key priorities for transforming oral health across the nation. It’s a call to action for the next government to see oral health as a crucial component of overall wellbeing.

The manifesto emphasises three pillars for better oral health: preventive measures, access to high-quality care, and investment in educational programmes. These are not just lofty goals; they are actionable steps that can significantly improve public health.

To make these changes a reality, the Oral Health Foundation has proposed 10 policy priorities. Reforming the NHS dental contract to prioritise preventive care over reactive treatment is crucial. This change would shift the focus towards early intervention and overall health maintenance rather than merely addressing issues after they arise.

Another key proposal is looking at the real impact of sugar and combatting it. Closing the many loopholes in the Soft Drinks Industry Levy (often called the sugary drinks tax) and curbing junk food advertising aimed at children can significantly reduce the incidence of tooth decay and improve general health.

Furthermore, integrating oral health within the general health system would ensure comprehensive patient care, reduce healthcare costs, and improve outcomes by fostering collaboration between dental professionals, GPs, pharmacies, and social care. We need to put the mouth back in the body.

These policy changes, among others, aim to create a healthcare environment where oral health is seamlessly integrated with overall health, ensuring no aspect of a patient’s wellbeing is overlooked.

Oral health has been sidelined for far too long. By prioritising oral health, we can ensure a healthier population, reduce healthcare costs, and promote a more productive workforce.

I sense I’m not alone in these thoughts, especially to readers of The Probe. These messages must be hammered home to policymakers and relevant members of all political parties.

You can download and share ‘Prevention, Care, Education: A People’s Manifesto for Improved Oral Health in the UK’ from the Oral Health Foundation’s website at www.dentalhealth.org/manifesto2024. Over the coming years, we’ll be using the points raised in this manifesto to guide our discussions with policymakers, and I encourage you to do the same.

As dental professionals, we have the knowledge and experience needed to guide and educate policymakers. In the aftermath of the General Election let’s come together to shape a future where oral health is a priority. Let’s help them get things right this time. n

About the author

Karen Coates, oral Health Content specialist at the oral Health Foundation, and RDn

Celebrating 10 years of Dentally

To celebrate the 10th anniversary of the launch of dental software company Dentally, The Probe caught up with co-founders Nick Davies and James harker to discuss how software in dentistry has changed over the last decade and where it might be heading in the future

how did Dentally come into being?

JH: Nick and I both studied biomedical engineering at Imperial College London, which is where we first met. Like many aspiring young students we were perpetually broke, so in order to try and earn a bit more money we started an IT support business before moving on to web design.

At that time, I started thinking about how hard it would be to build a dental practice management system in the cloud. My family are all dentists and, despite not following a clinical route myself, I did find myself inevitably drawn towards the dental industry.

ND: We started working on James’ idea in 2012, went beta with our first customer in 2013, and officially launched Dentally in 2014. Unsurprisingly, in those early days, we had a lot to learn, but it’s been a very exciting journey.

PMS systems are now commonplace, and they already contribute a lot to the running of a practice. But for us and all the teams we work with, what is really exciting is that we’re just scratching the surface in terms of how far technology can move dentistry forward.

What is Dentally’s key focus? is it to enhance the patient experience or is it more to do with the operational aspects of running of a practice?

ND: I think patient experience will be one of the key drivers in the future. Dentistry is always going to be a surgical discipline, but it’s so important to engage with your patient base. Dentistry is becoming competitive, and practices now need to do more to entice and engage to get patients through the door.

JH: Patient experience is a massive part of the dental practice success and, although we see and read a lot about this, the fact is that the majority of UK dental appointments are booked in person at reception or by phone. Some practices have the facility to book online, but it’s not as widely available as you might expect, which is surprising when you consider how well integrated online booking is in other sectors. I think there’s a huge opportunity for the industry to embrace technology, and massively improve the patient experience.

how much change have you witnessed in the dental digital landscape in the last 10 years?

ND: One big change is the journey the UK dental industry is going through in terms of consolidating into the corporate space. Corporates typically approach software and technology on a larger scale and engage

more on the marketing side to attract new patients. One of our aims is to make sure we provide the right technology to make it easy for everyone, from dentists running their own independent practices, all the way through to the largest corporate clients.

Another big change is the rise of digital dentistry, not just in terms of practice management software and the patient experience, but in the way that dentistry itself is provided. The end-to-end digital workflow has definitely been one of the biggest transformations dentistry has seen in the last 10 years and I think we’ve just reached the tip of the iceberg in terms of how that works and how it can benefit practices and patients.

JH: There’s a huge opportunity in terms of automation for dental practices. Software that completely streamlines the patient journey, from pre-appointment, to arrival at the practice and post-appointment follow-up, is available now and will only get better and more integrated in the future. This not only benefits patients, but it also frees up staff time, enabling them to concentrate more on patient care instead of administrative tasks.

Ai is a real buzzword at the moment. Do you think Ai will be a big game changer in dentistry?

JH: I think AI will be evolutionary rather than revolutionary. Where I think it will provide assistance to practices is by completing repetitive tasks – allowing a computer to do them more efficiently and effectively than a human can. This basically frees up staff in the practice to focus on the patient and provide a much more personalised care path for patients.

ND: Dentistry will always be about human interaction. But ultimately technology can be a fantastic support that optimises the time available and makes sure that the precious time available in practice is used well and effectively.

You have been operating Dentally now for 10 years. What does the trajectory look like for the next 10 years?

JH: I can see AI being like a co-pilot in the dental practice, whether that’s for someone on reception, the practice manager or dental care professionals. An AI tool that

helps them all to do their job quicker, more efficiently and with greater accuracy. Going forward I think we will see a big change in the way we think about software around dentistry, with more tools within PMS systems that are capable of doing more tasks. It also will not be viable to run a dental practice without some sort of online presence or ways of putting patients in control of their own care pathways. I believe software will become much more ingrained in how dental practices operate on a patient level and on a day-to-day-level.

ND: One of the key things we talk about is how technology is going to drive dentistry forward. But the only way we can really do that is by knowing what the profession needs and wants. That’s why, at Dentally, we want to make sure we are always here to talk and listen to our customers and the wider industry as a whole.

For more on Dentally, visit dentally.com or follow them on social media:

X: @DentallyApp linkedin: Dentally

Watch or listen to the full converation now via The Probe Dental Podcast. Find us on Youtube or your preferred podcast platform, or by scanning the QR code to visit https://tinyurl.com/DentallyDecade

Dr Paresh Patel, Principal Dental Surgeon “

You need dependable equipment and service in a busy practice - Eschmann provides this.

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Equipment, service & support you can rely on.

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Experience Eschmann excellence at www.eschmann.co.uk, or call us on 01903 875787.

In partnership with

Building a powerful practice identity

When you think about any major brand out there, from popular drinks to sports clothing, there are a number of connotations that immediately follow. The image of a beautiful person in the gym; the feeling of relaxation on a Friday night while out with friends; the joy of going on holiday with your loved ones. These are all the result of carefully constructed branding, which the relevant organisations have built diligently over time.

It’s important that you do something similar for your dental practice. You want prospective and existing patients to associate your practice with positive thoughts and feelings, and for these to accurately reflect the type of business you have built. To achieve this, it’s necessary to consciously develop your brand according to what you want to be known for and what your vision is for the practice. The consequences of getting this right are extensive.

What a practice identity means for you

Your practice identity encompasses everything that makes the business what it is. Though important, it goes beyond the logo, colour scheme and strapline you use – all characteristics, values and attributes like personality and culture within the business will play a role. Your identity is as much about what your practice stands for as how it looks and feels for patients interacting with your services.

A strong practice identity will afford numerous advantages. Your brand is a great way to establish credibility within the dental health field, earning the trust of both new and existing patients. Research has directly linked a positive brand experience with increased patient loyalty, demonstrating the long-term impact that an effective practice identity can have on the business.

In the broader landscape, building a strong brand is also an effective way of increasing competitiveness, which is important for any dental practice looking to stand out to patients, especially those that offer predominantly private dental services. In addition, improved brand loyalty can have positive implications for the perceived quality of services available. This is important for dental practices, as patients who appreciate the value of the care they receive are far more likely to accept recommendations and comply with oral hygiene advice.

Finally, a strong practice identity is crucial for recruiting and retaining a good professional team. Individuals want to know they are working for an organisation that shares their values. In the dental practice, attracting the right staff also influences the quality of care delivered and therefore contributes to patient satisfaction, further enhancing reputation. This has never been so important as it is right now, given the current challenges surrounding recruitment.

Staying on message

To achieve all this, there are many different elements to consider. Your practice identity

and branding will need to be reflected consistently in different ways and across multiple platforms. Everything from your website to your marketing activities, your practice design and the technology you employ will have an impact.

Think about your most important messages, your mission statement and your core values as a dental provider. If you are promoting the importance of dental care from a young age, make sure your marketing appeals to a younger, family-orientated audience. The physical premises will also need to capture the imaginations of young patients, to inspire children and show parents that you can support them. Think bright colours, play areas and interesting surgeries that young patients are more likely to feel comfortable in and to engage with.

If your practice focuses on complex cosmetic and restorative dentistry, you may prefer to create a persona of luxury, elegance and sophistication. This will be achieved by wording your marketing emails appropriately, advertising on relevant websites or collaborating with local leisure or spa facilities. The practice design will need to reflect this too, with state-of-the-art technologies that optimise treatment outcomes, patient comfort and professional efficiency. Consider advanced features like voice control dental chairs and touch-screen equipment operation to create such an environment.

For expert advice and guidance on achieving your ideal dental practice and bringing your vision to life, work with the experts at RPA Dental. They have years of experience specifically within dentistry and are renowned for going the extra mile in order to ensure you have the right practice design and dental equipment for you. They will remain by your side for years to come, offering bespoke advice and support to help you create and maintain a practice identity that sets your business up for real success.

Building a brand and a future

Your practice identity will be instrumental in building the kind of business you aspire to lead. Establishing your brand and replicating it consistently across all areas will be a powerful asset in your practice development.

For more detail about the solutions and services available from RPA Dental, visit www.dental-equipment.co.uk, call 08000 933 975 or email info@rpadental.net n

about the author

adam Shaw, Sales Director at rpa Dental Ltd.

Is a washer disinfector really worth it?

There are many challenges facing dental professionals today. From time restrictions to increasing patient expectations, changing regulations and constantly rising overheads, practice teams must optimise safety and efficiency in everything that they do. For this reason, technology has been widely implemented to streamline all manner of workflows, from clinical processes to infection control.

As such, the washer disinfector has become an ever more important piece of equipment for dental practices. Much like clinicians have introduced digital dentistry to upgrade treatment outcomes, many have also made use of washer disinfectors to enhance their instrument decontamination.

Manual cleaning vs automated

The first step of instrument decontamination – prior to sterilisation in an autoclave that renders appropriate items safe for reuse – is to remove all physical debris. Traditionally, this was achieved with manual cleaning. Following the dirty-to-clean workflow, staff would clean instruments of blood and other visible soiling in dedicated sinks.

However, there are issues with this method of cleaning. Firstly, there is a risk of sharps injury as professionals are handling instruments. Secondly, the manual cleaning process is unpredictable as the quality achieved has many variables, and therefore cannot be validated. If any visible debris is found on the instruments at any point after this step, the decontamination process must be restarted, costing the practice time and money.

The washer disinfector is a more effective alternative. It provides an automated and validated method of cleaning and also thermal disinfection that increases the reproducibility of this important pre-sterilisation step. The nature of the equipment also means that it is easier to demonstrate compliance with the relevant regulations. Unbiased and robust data will be recorded to show that adequate conditions were met during each cycle to ensure the effective cleaning and disinfection of the instruments.

In addition, needle-stick injuries are reduced because staff need only place the instruments into the machine and then leave the technology to do the rest. Handsfree instrument trays are also available to further minimise the risk of needle stick injury among staff.

time savings

Not a new innovation

The washer disinfector is not a new development in dentistry. Not only has it been around for many years but a large proportion of dental practices across the UK are already making the most of the efficiency and peace of mind that the equipment affords.

In Scotland, SDCEP guidelines mandate a thermal washer disinfector be implemented within every dental practice. In England, the equipment is recommended as part of the Department of Health’s HTM 01-05 best practice guidelines. The businesses that have not yet introduced the equipment should do so soon to avoid being left behind given the ever-more meticulous infection control standards being maintained in dentistry today.

Making it work for you

If you are taking the next step towards best practice, it’s important to know your options with regards to washer disinfectors. For a start, they often don’t require as much space as people think. Different models are available, including benchtop and under-bench designs. They are built to be compact so that they fit within even a small decontamination room or area. If the initial financial outlay is the greatest barrier your business faces, then different purchasing options could be beneficial. For example, some of the leading equipment is available on a lease basis, meaning no upfront sum is necessary for simpler budgeting. Plus, this gives you the option to either complete payment and own the technology at the end of the agreement or swap it in for a newer model. Finally, there are highly effective ways of protecting your equipment and your investment that will truly maximise your investment. The expert in decontamination, Eschmann, offers the unique Care & Cover package, which includes all the necessary testing, validation, servicing and maintenance required to keep your washer disinfector functioning optimally for years. Both the Hydrim C61 benchtop and Miele PG8581 under bench models from Eschmann are also available either for purchase or lease, ensuring the best option for you and your business, whatever your needs.

Don’t get left behind

As briefly mentioned above, time can be optimised with a washer disinfector. Not only does the equipment minimise the risk of having to repeat the instrument sterilisation process, but it also improves workflow efficiency for the team. Staff can perform other tasks while the washer disinfector cleans and disinfects the instruments, increasing productivity while giving the team more time to focus on patients. The time saved every day quickly adds up, covering the initial investment cost quicker than you might think.

If you don’t yet utilise a washer disinfector, consider changing this before your practice gets left behind. The safety of staff and patients alike is a priority, so achieving this in the most efficient, validated and cost-effective way is essential. A washer disinfector enables automated instrument reprocessing from start to finish, making it a crucial piece of equipment for every dental practice. For more information on the highly effective and affordable range of infection control products from Eschmann, visit eschmann.co.uk or call 01903 753322 n

about the author

Nicky Varney, Senior Marketing Manager at

eschmann.

The importance of ergonomics in everyday practice

Ergonomics is the application of design “to optimise human well-being and overall system performance”.

Dentists are at a particularly high risk of suffering from musculoskeletal disorders (MSD), and ergonomics is the discipline of problem-solving factors that heighten cognitive and physical stress. Good design improves productivity and prevents occupational diseases related to the practice of dentistry. Ultimately, ergonomic design results in greater comfort for both the professional and the patient.

Clinicians are over 50% more likely than the general population to experience debilitating neck pain, and nearly 40% more likely to suffer from lower back pain. In a recent survey, female dental professionals reported a higher MSD prevalence than their male counterparts, regarding all body regions surveyed. Occupational health hazards among dental professionals have a significant negative overall impact on daily life. Proper ergonomic design is necessary to prevent injuries which can develop over time and can lead to long term disability.

Dental professionals can be more prone to forward-head postures when they examine patients. In this posture, the vertebrae no longer support the spine in an optimal fashion, leading to a pain pattern, often referred to as ‘tension neck syndrome’. This syndrome can also cause headaches and chronic neck, shoulder and inter-scapular pain, sometimes radiating into the arms.

Repetitive motion hand disorders are a risk factor for dental professionals due to the ‘pinch’ action commonly employed by clinicians when using dental tools; chiefly

when employed in forceful action or extended use of heavy or vibrating instruments. This is exacerbated when the wrist is deviated from neutral posture into an abnormal or awkward position. Other common contributing factors include working for long periods without resting or alternating hands. Mechanical damage to hands can be sustained by grasping sharp-edged instrument handles.

Some common hand and wrist conditions experienced by dental professionals are debilitating muscle cramping, carpal tunnel syndrome (CTS), tendonitis/tenosynovitis, trigger finger, DeQuervain’s disease, hand-arm vibration syndrome (HAVS) and Guyon canal syndrome.

To obtain the optimal view of a patient’s teeth, or to manoeuvre complex and heavy equipment, some clinicians may employ awkward poses that place a great deal of stress on the body. Lifting, lowering or handling objects with a bent or twisted back puts a great deal of pressure on spinal disks. An ergonomic workspace, awareness training – and where needed, physiotherapy – is of great importance to ensure professionals are able to adjust their postures for more sustainable working.

Psychosocial factors

There is a strong relationship between psychological stress and musculoskeletal disorders. Not only can chronic pain lead to mental ill-health, studies have found that those with poor mental health also have an increased risk of MSD.

As well as advice to practice regular selfcare, some researchers have espoused the use of micro-breaks to assist with some

Breaking the mould

Diagnosing a cracked tooth can be a difficult task as symptoms can differ according to the location and extension of the incomplete fracture. Early detection is critical because restorative treatment can prevent fracture propagation, microleakage, pulpal or periodontal tissue involvement, and catastrophic cusp failure.

As you know, cracked dental enamel occurs when the outer layer of the tooth is compromised, while incomplete tooth fractures involve damage to both the enamel and underlying layers of the tooth. These conditions can arise due to several causes, including trauma from accidents or injuries, biting down on hard substances like ice or nuts, bruxism and tooth decay. One of the primary symptoms of cracked dental enamel and incomplete tooth fractures is tooth sensitivity, especially to hot or cold temperatures. Patients may also experience pain or discomfort when biting or chewing, as the damaged tooth structure can put additional pressure on the nerve endings. The prevalence of cracked teeth is around 80% in patients over 40 years of age and these fractures are more common in restored teeth. Micro enamel cracks and incomplete tooth fractures are conditions that often go unnoticed in 2D dental imaging techniques. Indeed, traditional methods of dental crack detection are not sensitive or specific. They include clinical examination, visual inspection, exploratory excavation, and percussion

symptoms of stress on the mind and body. Just a few minutes of physical activities such as stretching and exercise can improve mental wellbeing and reduce fatigue. A quick check-in with friends is associated with increased energy-levels, and can result in a reduced sense of conflict between work and private life. Watching a short movie clip can increase recovery and improve performance.

improving performance with great design

Taking breaks is very important, but considering the design of instruments, and the layout of your workspace is core to improving the ergonomic experience of work. When a serious health and safety incident takes place at work, a responsible person has a statutory obligation to report this to the Health and Safety Executive (HSE). The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR) include occupational diseases associated with repetitive strain, due to the severe impact these injuries can have on individuals’ lives. In extreme cases, ignoring human factor design guidelines could result in fines or legal action.

Practitioners should consider use of lighter-weight automatic instruments instead of manual hand instruments. Handpieces should be as light and well balanced as

possible. Clinicians are recommended to use low vibration instruments, with incorporated lights to improve visibility. Proper consultationroom lighting, ergonomically designed seating, and an organised and accessible workspace are also recommended.

Advanced low weight design for comfort and efficiency makes W&H the choice for dental practices to meet ergonomic demands. For example, the Synea Vision and Synea Fusion combine exceptional power and quality alongside design for optimal safety and comfort. Both handpieces share an easy system for changing burs, an excellent grip and very low vibration thanks to ceramic ball bearings and innovative gearing technology. They benefit from an exceptional field of illumination with LED+, optimum cooling for improved working, hygienic head system to prevent cross infection, smooth, monobloc design and are angled and designed with small heads for excellent access. Both offer uncompromising comfort alongside reliability and outstanding quality.

The aim of ergonomics in the dental profession is to create an environment that enables safe, efficient and healthy working. Considering ergonomics at work is not only covered by statutory guidelines, but creates the basis for a more sustainable career, and a healthier life.

To find out more visit wh.com, call 01727 874990 or email office.uk@wh.comn

about the author Kate Scheer, Marketing executive, W&H (UK) Ltd

testing. The dye test used blue or gentian violet stains to highlight fracture lines.

early detection

3D scans, however, can give a more precise examination of the damage caused to the tooth’s structure, allowing for early detection of cracks and fractures and therefore an enhanced prognosis. In fact, cone-beam computed tomography (CBCT) has been shown to be more efficacious than traditional clinical dental imaging techniques in detecting longitudinal tooth cracks.

One of the main advantages of 3D oral scanning technology is its ability to capture highly detailed and accurate images of the teeth and surrounding structures. Unlike traditional imaging techniques like X-rays, CBCT scanning creates a three-dimensional model of the entire oral cavity. This allows an examination of the teeth from all angles and can detect even the smallest cracks or fractures that may be present.

CBCT scanning technology allows for precise measurements to be taken. This is particularly useful in diagnosing micro cracks and incomplete fractures, as it can help determine the extent and severity of the condition. Dental professionals can then accurately measure the depth and width of the crack or fracture, providing them with valuable information to develop the appropriate treatment plan.

CBCT scanning then facilitates the creation of custom-made dental restorations for

patients with a crack or fracture diagnosis.

The scan data can be sent to a dental laboratory, where technicians can use computer-aided design and manufacturing technology to fabricate precise and natural-looking dental crowns or fillings (if necessary). This ensures a better fit and durability compared to traditional communication methods, improving the long-term prognosis for patients with these dental conditions.

ai assistance

Artificial intelligence (AI)-powered systems have significantly improved the diagnostic capabilities of 3D oral scanning. By analysing the captured data, AI algorithms can detect abnormalities, identify potential cavities, and even assist in early-stage oral cancer detection. This can help dental professionals make more accurate and timely diagnoses, enabling earlier intervention and better treatment outcomes. This data-driven approach allows for more personalised treatment planning too, as dental clinicians can consider individual patient characteristics and history when making informed decisions.

The CS 9600 CBCT system from Carestream Dental features AI-powered positioning which records each patient’s parameters, making follow-up imaging repeatable with a single touch. Featuring never before achieved 2D and 3D imaging quality, the unit is scalable and designed

to grow with a practice. It offers a multifunction system blending 2D panoramic and cephalometric imaging, CBCT imaging, 3D facial scanning and 3D model scanning. With its Scan Ceph module, the system is even smarter and more versatile than ever. Boasting a 10-year warranty for greater peace of mind, it is perfect for dental professionals looking for a new level of precision.

CBCT scanning technology is a valuable tool for dental professionals in the diagnosis and treatment of micro enamel cracks and incomplete tooth fractures. Its ability to provide highly detailed and accurate images, precise measurements, and aid in treatment planning makes it an invaluable asset in modern dentistry. By incorporating CBCT scanning into their practice, dental professionals can enhance their ability to detect and treat these dental conditions, resulting in improved patient outcomes and overall oral health.

For more information on Carestream Dental visit www.carestreamdental.co.uk n

about the author

Nimisha Nariapara is the trade Marketing Manager at carestream Dental covering the UK, Middle east, Nordics, South africa, russia and ciS regions

Me and my ex

Practice-owner Davinder Raju on how he coped after the departure of his beloved dental chair – and why manufacturers should collaborate on standardising parts

My relationship with my dental chair is deep. For starters, we have so much history. I worked with that chair most of my working life, and saying goodbye has been upsetting. It’s true; I do have a replacement. And the new chair is the same make and the same colour – I know my type – but breaking up difficult! Let me start by explaining how I fell in love with my first chair. When I first set eyes on it at a dental show, I was wowed by its ergonomic design and soft upholstery, and it moved with such ease and grace that it simply oozed sophistication. I thought the chair might be out of my league. It was, after all, a Sirona chair, i.e. high end. But my saving grace was that it was

On 22 June, Dr Davinder Raju was inducted as a Fellow of the International College of Dentists at the European section annual conference in Cyprus. Dr Raju’s fellowship recognises his work in raising awareness of sustainable dentistry and developing the Greener Dentistry Global (GDG) toolkit and accreditation programme, launched in 2023. The programme is inspired by the Dove Holistic Dental Centre, the UK’s first sustainable practice, established by Dr Raju in 2017.

a showroom model. The design was already mature, which meant that I could afford to bring this beautiful model back to my surgery.

I knew I wanted to keep her in my life and, for 17 years, we were an inseparable team, complementing each other’s work every day to bring smiles to our patients. Yes, it was a highmaintenance relationship, but regular care and attention and scheduled services paid dividends. Of course, we had our difficulties, but whenever there was a problem, I got help, parts were replaced, and our partnership continued. The point was, I was committed.

(Did you know, by the way, that the average working life of a dental chair is 10-12 years?)

But then came the day earlier this year when the chair began to malfunction. At the ripe design age of nearly three decades, my once sleek beauty had exhausted its lifespan. My engineer, playing the role of the grim reaper, declared it beyond repair and advised me it was futile to attempt a rescue. He couldn’t guarantee the availability of the necessary parts. The cost of repair, he said, would not be justified. It was a bitter pill to swallow, but the end had come for my faithful chair. If I sound accepting, then I’m misleading you. I was devastated. What did I do? I chose to move on and replace my chair. My ex is entitled to feel I am moving on too fast. But hey, I’m a dentist! I visited the showroom of Clark Dental and bought another Sirona (now Dentsply Sirona) chair or, more accurately, a treatment centre.

It wasn’t just loyalty that impacted my choice. I did my research, and Dentsply Sirona has a great record for sustainability. My susceptibilities have not changed. It is another showroom model, bringing it within my price range.

Having said a sad goodbye, I am now getting used to a new relationship with my replacement chair. We are taking things slowly, as you would expect.

What of my ex? Could there be a second chapter for my ‘one and only’ chair? My dental nurse proposed that I donate it to a developing economy. I loved this idea. However, it would have been more of a burden than a blessing. The most eco-friendly destiny for the chair is for it to be dismantled, with any functional parts rescued by the engineers and the remainder sent for recycling.

You may ask if I have any lessons or thoughts I can share. I do:

• Longevity : Dental equipment lasts longer with regular, tender, loving care, benefiting the practice’s bottom line and the environment.

• Sustainability: Select a chair that’s green, and I don’t mean the upholstery: choose a manufacturer with a strong sustainability record to support ecofriendly partners in the dental industry.

• Responsible disposal: When it’s time to part ways, do it responsibly. Reuse, recycle, but try not to discard.

• Emotional connection : [Dentsply] Sirona provided a product that has stood the test of time. I fell for a Sirona not just once, but twice.

• Modular design in dentistry: It’s a shame dental equipment isn’t like Lego, with interchangeable parts. It would make life a whole lot easier, cheaper, and greener. But it would require everyone in the industry to collaborate… now there’s an idea! 

About the author Davinder Raju is the owner of the Dove Holistic Dental Centre and the founder of Greener Dentistry Global, the sustainability programme for dental practices. For more information: https://greenerdentistry.global

Texting triumph

Time, resources, money –monitoring patient recalls can be a taxing process for every practice. As paper records shift to digital and communication ventures online, reliably engaging with your patients is essential to keep your practice flourishing and your patients smiling. In 2023, the average UK resident spent 2 hours and 52 minutes per day on their phone. Despite seeing a reduction since the pandemic years, the figures for daily screentime depict a country that is constantly looking down. The phone is therefore the optimum gateway for practices to better communicate with their patients through. It is hardly surprising that half of dentists have already incorporated teledentistry into their practices, sending texts to patients with a recall interval but no booked appointment.

Breaking barriers

The directness of SMS makes it a vital tool. An SMS gives the receiver clear information which can be instantly copied and saved or referred back to. SMS also limits misunderstandings so that the trust between patient and practice is strong. SMS can be of great help to patients who have to overcome a communication barrier: blind, deaf, anxious and international patients can all benefit from a text service. Most phones, even less advanced ones, make reading, speaking and translating texts easy. This makes them a preferred communication method for many individuals. Other communication options, such as phone calls and paper letters can be misheard, misremembered or lost, leading to misunderstandings and a risk of complaint.

Keeping patients in the loop

Effective communication has been found to help manage patient anxiety, with dental attendance often increasing with the quality of patient communication. Enhanced communication, such as SMS, can ease patient anxiety by sending early reminders for appointments and enabling patients to quickly reschedule if they do not feel ready, all without the confrontation of a phone call or a face-to-face meet.

Keeping patients notified on exclusive deals, discounted treatment plans and bundled services can increase the likelihood of patients booking their next appointment with your practice, whilst the speedy sharing of any updates around their appointments, or from within the practice itself, can reassure patients that they are in competent, supportive hands.

Speed and staffing

One of the biggest strengths of incorporating SMS, along with its cost-effectiveness, is its speed – electronic communication saves time. It is easy to prepare and send

automated messages that are guaranteed to quickly reach patients, and it can be easy for patients to respond. Younger patients in particular prefer SMS, as 26% of adults aged 18-24 actively avoid phone calls and 47% prefer a text prior to receiving a call. It feels like administrative staff spend a lot of time ringing up patients – a job that can be accomplished faster with automated texts. Giving patients the autonomy to book appointments through texts and extending digital tools to allow patients to pay online will further streamline your practice by reducing your administrative staff’s workload and minimising the risk of human error. Automated systems will ultimately better equip the practice to meet patient preferences and expectations by freeing up staff bandwidth.

No no-shows

No-shows are costly and detrimental to business. Using SMS can prevent this damage by getting patients to book new appointments with ease, minimising the risk of oral health problems or dental emergencies that can emerge from no-shows. Patients can cancel and reschedule appointments quicker via SMS than through a phone call too, allowing your practice to fill in short-notice cancellations that otherwise may have been no-shows. Filling in these empty appointments can increase satisfaction among the patients who can be treated faster.

cloudy with a chance of success

SMS as a recall tool for practices is a proven success, with a 98% open rate and a 45% response rate. This is significantly higher than using email which has a 20% open and a 6% response rate, showing that SMS has a far greater reach that does not depend on Wi-Fi.

Texting patients is becoming the new normal. For a superb recall system, consider AeronaDental. Practices worldwide are already using the innovative cloud-based system to streamline their patient journey and grow their business. With AeronaDental, your practice can organise automated appointment reminders and confirmations, as well as promotional messages to engage your patients, who can easily reply using a variety of texting options. The software’s Patient Portal will also improve attendance rates and increase revenue through encouraging enhanced engagement.

Reduce workloads and keep communication clear and quick with AeronaDental.

With the world constantly looking at their phones to read books, write blogs, binge boxsets and buy their bread, booking a dental appointment can be done in a heartbeat. Use SMS and let your practice thrive.

For more information, please visit aerona. com or call 028 7000 2040

Follow us on LinkedIn: @Aerona Dental Software and Instagram @aeronasoftware for the latest updates n

about the author

Mark Garner, General Manager, areona Dental

“Kiroku is insanely good value”

Dr camilla Morrison discusses her experience using Kiroku, the digital note taking platform, and the importance of meticulous note taking for the dentistry she provides

It’s really important that my notes are meticulous, and they capture the clinical and the emotional aspects of what we do. Legally, we are required to have well written notes that capture every appointment. Good quality notes mean that I can do my treatment planning from home on my sofa with a cup of tea, rather than at the clinic.

It relieves that pressure and allows me to think about the case in my own headspace. That means I don’t miss anything, I can look at different options, and I can discuss interdisciplinary cases with colleagues. So, from a clinical treatment planning side of things, it’s less stressful, and patients receive better treatment planning and therefore better outcomes.

For the type of dentistry I provide, we’re not just capturing the clinical information. We’re also capturing the emotion and slight nuances of what the patient is looking for and what has driven them to seek treatment. Again, when we communicate and plan treatment, we’re really tailoring it rather than using a ‘cookie-cutter’ approach. This means that, from start to finish, our note-taking, treatment planning, and solutions must be very personal.

Kiroku as a solution

One of the things that’s most time consuming and draining about being a dentist is writing notes and making sure that notes capture everything we’ve said. That’s because we need accurate notes for our own treatment planning and from a legal standpoint. We all know the old saying “if we didn’t write it down it didn’t happen”. This increases stress and anxiety and can take up headspace which is far better spent thinking about our patients, or spending time with our families. I felt that my records were taking too much physical and mental time and I wanted to make a change.

Then I came across Kiroku and, at first, I was a little dubious about how much it would be able to improve things. Now my notes are written before I’ve even finished the appointment. That’s because, as I’m doing the assessment, my dental nurse clicks and populates my notes for me. From here, I’ll check the notes and make tiny tweaks to personalise them, based on the particulars of the conversations. Ultimately, when my dental nurse and I are working as a team using Kiroku, most of the time it takes me less than 5 minutes to write my notes – generally I’d say 60 seconds for the majority of my patients. This means I’m not working through my lunch or afterhours writing notes – everything is written there and then, just as it’s supposed to be!

the benefits of treatment plan letters

I also use Kiroku Docs to write treatment plan letters which describe the details for my patients, so they can take the information away once we’ve gone through it together. It allows them the freedom to review their plan in their own time, talk

about it with family and friends, and have something to refer back to. I find that, it can take a little bit longer to make sure that these letters are written well. Previously, it could take me anywhere between 1-5 hours to write a treatment plan letter depending on case complexity. I was happy to do this, to ensure that patients fully understand what they’re signing up to, and increase treatment acceptance, but it did end up eating into my personal time. Whilst treatment plan letters are an important part of my process, it taking that long was not a good use of my time. So, since Kiroku brought out Docs, I have been able to use my assessment notes to start populating a letter. The bones of the letter are already written, then I go in and make it personal, adding in the emotion and particulars. For me, it’s perfect! Instead of it taking hours to write a letter, it’s taking 5-10 minutes. So, for me, it has radically changed how long it takes to complete that workflow.

it is insanely good value

A colleague recommended Kiroku to me and it was one of the best things I have ever been introduced to as a dentist! It has had a massive impact on my day-to-day life. As I continue to learn and update my templates, Kiroku goes on the journey with me – taking the mental burden off me. I would recommend Kiroku for everyone. It is insanely good value considering how much time it gives you back – it’s magical. To find out more about Kiroku, or to start your free trial, please visit trykiroku.com n

about the author

Dr camilla Morrison is well established in the dental profession, with a keen interest in aesthetic dentistry. Millie provides a wide variety of treatment types, with a particular affinity for clear aligner orthodontics. She is an international lecturer and runs a mentorship level 7 certificate in clear aligner therapy.

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Creating, deploying and adopting AI safely in dentistry

Artificial Intelligence (AI) is increasingly being used across various industries, including dentistry. In order to implement it safely and without unintentional consequences, it is necessary for dentists to understand the technology they have in practice, developing an awareness of the potential risks and how to mitigate against them.

Narrow and Generative artificial intelligence

Machine Learning (ML) and AI have long been used for data analysis, diagnosis, prediction and recommendation across industries, including healthcare. This wellestablished branch of AI starts with a clear scope or target application, develops models with well-defined datasets, and results in models which excel at the specific tasks for which they are designed. This is “Narrow AI” – niche, expert systems with clear and measurable deliverables to assess performance and steer continuous model development and improvement.

Since the public release of ChatGPT, “Generative AI” using Large Language Models (LLMs) have been rapidly and enthusiastically deployed across nearly every area of our lives. An LLM can be conceptualised as a compressed digital representation of meaning and context between words, predicting which word would best follow a current dialogue. LLMs are non-deterministic – results will differ when provided the same input and it is not possible to deduce how an LLM gets to the results it generates. Benchmarks and defined datasets are used to measure the capabilities of LLMs and rank competing models as they race to evolve. Their generic nature, wide applicability and variability of output makes it challenging

to evaluate and quantify the performance of generative LLMs for specific applications.

ai in dentistry

In dentistry, AI-assisted technologies are already demonstrating early potential to support clinicians, streamline professional workflows and improve patient care and communication.

Narrow AI is being used to analyse radiographs supporting diagnosis and treatment presentation. Web chatbots provide automated and personalised initial contact, signposting and qualifying new patient inquiries. LLMs can be used to generate letters and written reports. Different AI models, technologies and implementations are required for the wide range of tasks, applications and automations within the operation of the dental practice.

In the clinical setting, it is crucial to make sure that AI technologies are created, deployed and adopted safely without compromising clinical standards or introducing risk and unintended consequences.

ai risk awareness

Risk, a measure of impact and likelihood of an undesirable outcome, exists in every technology, process, system and action. Sources of risk introduced by AI particularly relevant to dentistry include accuracy, reliability, repeatability, accountability, privacy and medico-legal considerations. The acceptable tolerance of risk factors will vary based on the specific use case.

For example, a chatbot designed to automatically qualify, categorise and signpost patient enquiries using an LLM – finetuned with information you provide –

should process little personally sensitive data and present a low clinical impact if incorrect or inaccurate information is presented. In contrast, if asked to advise patients on treatment decisions or medical factors, it must prove that it will reliably present correct and accurate information, or always advise the patient to speak to a dentist.

AI technologies used to support clinicians with assessment or treatment planning need to demonstrate high and quantifiable levels of accuracy, reliability and repeatability to ensure clinical safety of the patient. This requires a highly focussed, narrow AI specialising in the discipline and task. The experience of the clinician will affect the ability to interpret and confidence to challenge presented information – an AI system may not have the capability to consider the nuances of a particularly complex or unique case.

One of the hopes for Generative AI is the potential to free dentists from the administrative burdens of clinical record keeping, reports and letters. LLMs impressively create, summarise and reword text, mimicking comprehension and expertise. LLMs are not clinical or precise. They are prone to hallucination, confidently and coherently introducing incorrect or inaccurate information, introducing risk for patients and clinicians. The dentist is fully responsible and accountable, and a thorough and immediate critical review for accuracy and correctness is essential. The written record must be a true and accurate representation of what really happens in an appointment, not a report of what should have happened in an ideal world. If used in a medico-legal claim, you as a clinician will need to prove beyond all doubt that the record is indeed fully valid and reliable to provide any protection.

Making the vision real

Delivering the visions presented by AI evangelists is possible, and we must do so in a sensible and level-headed way, taking a conscientious approach to risk management in order to ensure the safety and interests of patients. AI systems will need to be backed up by solid, reliable data to prove accuracy and integrity.

For dentists looking for an effortless, highly accurate, complete and contemporaneous way to ensure this data exists, Dental Audio Notes (DAN) offers a solution. It provides robust evidence of the communication between patient and practitioner during the appointment via clinical audio recording and transcription for both the patients’ and dentists’ protection. Even more, DAN manages the consent, security, accessibility, privacy and storage of the data for the full lifetime of the record, so dentists can be confident that when they need it, they have the most reliable data and one less thing to worry about.

For more information about Dental Audio Notes (DAN), or to arrange a free demo, please visit dentalaudionotes.com n

about the author aleksandra rozwadowska (ala) is a dentist and the co-founder of Dental audio Notes alongside her husband, adam. Dental audio Notes was created in response to the challenges of trying to master every aspect of clinical dentistry.

How can digital technology revolutionise endodontic workflows?

Traditionally, pulp sensibility tests have helped to form the basis of clinical endodontic diagnoses.

During an examination, the clinician performs a number of tests to elicit a response from the patient, informing whether they may have clinical signs of pulpitis/pulp necrosis. Whilst these tests have been used for many years, and do have a place in modern endodontics, they are often subjective, which can make the results difficult to measure. As such, clinicians should consider the impacts that digital technology could have on endodontic diagnostics, and how and when to implement these testing methods.

traditional pulp testing: benefits and challenges

Pulp testing is traditionally used to assess the neural response of the dental pulp. These tests include temperature, electric, and percussion tests, each of which reveal different information about the pulp, and have their own strengths and weaknesses. For the best results, clinicians should first test a control tooth, which they believe to be healthy, to ascertain a normal response, in order to recognise an abnormal response for each patient.

According to the British Endodontic Society’s (BES) Guide to Good Endodontic Practice, cold testing should be used as a first line evaluation. Cold testing is now most often performed using a refrigerant spray, with ethyl chloride, dichlorodifluoromethane, and ice used

historically. The cold temperature causes the dentinal tubule fluid to contract, resulting in negative pressure. The results of a cold test indicate both pulp vitality as well as the condition of the pulp. Patients should alert the clinician if they feel a sensation during this test, recording both the intensity and duration of the response. In this type of test, a positive response indicates vitality, whilst a negative response may indicate pulp necrosis in some cases.

Electric pulp testing is carried out using an electric pulp tester (EPT) which flows a high frequency electrical current from the probe tip through the tooth. This current stimulates viable fibers in the tooth, triggering a tingling sensation. Whilst a positive response indicates vital pulp tissue, it does not signal pulpal health. A negative result, however, does reveal pulp necrosis.

Percussion tests can be used to accurately identify the effected tooth, where the disease has progressed apically to affect the periodontal ligament. Clinicians should tap gently on the incisal or occlusal surface of the tooth using the blunt end of an instrument. This requires gentle force, and the patient should inform the clinician of any sensitivity. A positive response does not necessarily indicate endodontic disease, with trauma and periodontal disease also resulting in sensitivity.

Digital imaging to form a diagnosis

Digital imaging is now well established in endodontic diagnosis, offering lower exposure doses compared to conventional

radiographs. Current radiographic imaging software enhances images to aid clinicians in diagnosis, treatment planning, and visualisation of root canals during treatment. Cone beam computed tomography (CBCT) may also be used to support endodontic workflows where appropriate, but only after conventional radiographs have been taken. CBCT images are able to produce an accurate 3D reconstruction of the anatomy, enabling clinicians to more easily understand the structure of the root canals. Radiographic images are essential for successful endodontic treatment, enabling practitioners to plan their path through the root canals, and identify the effected pulp.

Guided endodontics

Guided endodontics is a technique which is still evolving. Its use is applicable over multiple treatment types but is useful, in particular, when accessing and locating root canals, microsurgical endodontics, and in endodontic retreatments.

Static guided endodontics requires a CBCT image and dental impression to create a surgical guide to cover the teeth in the area. Drill holes can be designed to allow direct access to specific root canals. It is thought that static guided endodontics results in shorter treatment times for patients, and improves accuracy and safety when compared to conventional treatment. However, time is required to create the guides, and they are only effective for straight canals.

Dynamic guided endodontics uses CBCT images with the help of a camera connected to a dynamic navigation system. This technique is more ergonomic, and allows adjustments and repositioning to be made in real time. As such, it is accurate as it does not include design errors, and can be used on multi rooted teeth. Clinicians require additional training to be competent in using this technique for the best results.

Looking to the future

The implementation of digital technology in the endodontic field so far is promising, enabling clinicians to more efficiently and more accurately diagnose and treat endodontic infections. Looking to the future, we can anticipate the introduction of more digital tools which will further improve endodontic workflows and diagnostic procedures, as well as improve the longevity of treatment results.

https://mimetrik.co.uk n

about the author

alyn Morgan is the endodontic teaching

Lead at the Leeds Dental institute, immediate past president of the British endodontic Society, and the co-founder and ceO of a spin-out company from the University of Leeds, Mimetrik Solutions.

Beware of cheap imitations

The internet is a boon for many patients for both convenience, and price and quality comparison. Many legitimate and effective dental hygiene products can be purchased and delivered with ease. However, buying a cheap imitation product from an online outlet can be a disappointing experience at best, and at worst, dangerous.

Fraudulent advertising via social media platforms has become an increasing problem for consumers. A recent investigation by the TSB retail banking chain found that 34% of listings on social media were scams, and calculated that buyers were losing over £160,000 per day on fake purchases.

In addition, online marketplaces, are not currently required by law to regulate the quality or to check the safety of products sold on their sites. Many electrical goods sold through these outlets are manufactured overseas, where they will not have been safety tested to UK standards and are often produced as quickly and cheaply as possible.

According to government statistics, approximately 24% of accidental dwelling fires in England between 1 April 2010 and 31 March 2023 were caused by faulty appliances and leads. The London Fire Brigade estimates that on average these are the cause of one fire a day in the capital. It is further estimated that one in 10 people in the UK have had first-hand experience of electrical fire or shock due to an electrical product they’ve bought online.

has awarded Waterpik® with the highly prestigious accolade of accreditation, based on independently verified research. The Waterpik® Water Flosser has been evaluated in 75 scientific studies to date, and its safety and efficacy is backed by a strong body of research. The Waterpik® Water Flosser is clinically proven to be:

• Up to 50% more effective than traditional dental floss

CE or UKCA marks to verify electrical safety are an indication of legitimacy. Products sold in Great Britain may display:

• CE marking, or

• UKCA marking, or

• UKCA marking and CE marking, or

• UKNI marking and CE marking Products sold in Northern Ireland may display:

• CE marking, or

• UKNI marking and CE marking. However, these markings can be copied, and even reviews can’t be trusted. Some sites cross-reference user reviews with their buyer database and label those people as ‘verified purchasers’. It is important for patients to exercise caution to avoid inadvertently buying a substandard or counterfeit electrical appliance and that the retailer is legitimately selling a trusted brand.

Avoiding risks & disappointment

Founded in 1962, Waterpik® is the leading manufacturer of a safe, affordable and high-quality Water Flosser. The company has a rich history of innovation and design, engineering a range of products to deliver the wellness benefits of water. From the professional grade Whitening Flosser, to the comprehensive and convenient Cordless Water Flosser, Waterpik® has been a trusted name in dentistry for decades. Waterpik® has exceeded the standards of most home care products to provide evidence to ensure consumers are protected. The Oral Health Foundation

• Proven to remove up to 99.9% of plaque from treated areas with a 3-second application

• Up to 3 times as effective for removing plaque around braces vs. string floss using the Orthodontic Tip

• Up to twice as effective for improving gum health around implants vs. string floss using the Plaque Seeker™ Tip. When recommending any product to a patient, clinicians should advise them to

exercise extreme caution when buying online. While the internet has enabled patients to make convenient purchases, buying an imitation product from an online marketplace risks their safety as well as disappointment.

For more information on Waterpik® Water Flosser products visit 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. 

Prevention: the key to oral health and human happiness

Curaden, a leading provider of oral health education and solutions, is delighted to have officially unveiled its latest project – The Gentle Guide to Oral Health and Human Happiness. It is a book designed to promote prevention and inspire professionals to continue driving the revolution towards better oral and systemic health that is happening around the globe.

The book itself is a clever amalgamation of stories, ideas and achievements, shared by more than 40 dental professionals and other health and coaching experts. It is a beautiful demonstration of the passion and ambition that individuals and teams worldwide have shown in the quest to improve public health and build a better future for the generations to come.

At a professional event to officially launch the first edition, Bruno Affentranger –Partner at Curaden – was keen to highlight Curaden’s commitment to education and prevention above all else. He said:

“For many decades, we at Curaden have believed in prevention. Oral care is the door to systemic health. We produce toothbrushes, but we invest significantly in helping to positively change habits across society. To quote the WHO: oral disease is a major health burden right now, and prevention is the key for finding a solution. That’s what this book is all about.”

The Gentle Guide to Oral Health and Human Happiness encourages dental professionals to become oral health coaches for their patients. It offers practical guidance on what to communicate to patients, how to engage them and how to motivate them to enhance their oral and systemic health.

The publication presents a combination of facts and statistics from around the world, as well as strategies for engaging with patients and insights into relevant research and industry reports. These are accompanied by real-life accounts and interviews with dental clinicians, healthcare specialists, coaches and other individuals who explore what prevention means to them and reflect on projects or approaches they have personally utilised to connect with more patients about oral health.

Bruno eloquently concluded:“We can build a healthier and happier society by revolutionising oral self-care – that’s our goal at Curaden.”

You can download your free copy of The Gentle Guide to Oral Health and Human Happiness at curaden.com/gentle-guide. n

Exploring the link between oral diseases and Alzheimer’s Disease

Alzheimer’s Disease (AD) is thought to contribute to between 60-70% of dementia cases. It is characterised by memory loss, behavioural changes, and a lack of ability to perform daily tasks. Patients with latestage dementia will eventually need fulltime care and face lower life expectancy. The pathological hallmarks of AD include Amyloid-Beta protein (Aβ) in the brain, and intracellular Tau protein aggregation (forming neurofibrillary tangles), leading to neuroinflammation and eventually neuronal death. Currently, over 55 million people have dementia worldwide, with nearly 10 million new cases every year. Globally, cases are expected to reach 78 million by 2030, and 139 million by 2050. Both periodontal disease and endodontic disease have a high global prevalence, of more than 50%. Similar oral bacteria have been implicated in both periodontal and endodontic diseases, such as the keystone pathogen, Porphyromonas gingivalis. As a major cause of tooth loss, these oral diseases compromise mastication, aesthetics, self-confidence and quality of life. Over the past several decades, significant associations between oral health status and systemic diseases have been established, including cardiovascular disease, diabetes and AD (Figure 1).

My PhD supervisor at University of Central Lancashire (UCLan), Dr Sim Singhrao, was the one of the first researchers to link periodontitis and AD, after detecting a known virulence factor of P. gingivalis in post-mortem brains of AD patients more

than a decade ago. Since then, mounting evidence have pointed consistently to the infectious and inflammatory aetiology of AD.

the importance of research

Currently, the Alzheimer’s Society and the World Health Organization (WHO) do not include oral disease as a modifiable risk factor. Whilst AD causation due to infection is difficult to prove, recent discoveries have reignited interest into the links to oral health. Epidemiological studies have reported lower odds of developing AD when procedures which removed oral infection were carried out such as endodontic treatment and limited extractions of grossly carious teeth. Patients who had frequent periodontal emergencies and those with more than four teeth extracted increased their odds of AD. Clinical studies have shown a correlation between periodontal disease with serum levels of Aβ It is important to acknowledge the potential bi-directional relationship in discussions with patients to encourage preventive measures.

research techniques and key findings

My research comprised of a number of laboratory studies using a variety of methods. These included: scanning electron microscopy (SEM), immunohistochemistry, transmission electron microscopy (TEM), antimicrobial assays, and cell culture studies.

The detection of Aꞵ protein in endodontic-periodontal infected teeth

This study on extracted teeth found that microbes associated with endodontic

and periodontal disease produced insoluble A β . Like prions, insoluble A β can have the potential for cross-seeding to the brain and aggregating to form plaques, potentially increasing the risk of development of AD later in life. In the UK, endodontic instruments are single use to minimise the risk of cross-seeding prions, which theoretically confers protection from the cross contamination of the A β protein as well.

The Tau peptide and gingipains study

The gingipains enzyme from P. gingivalis can release the Tau protein from nerve cells. Once released, Tau changes its form to filaments and re-attaches to nerve cells, causing severe damage, becoming incorporated into the lesion known as neurofibrillary tangles. This kills nerve cells, leaking more Tau peptides into the brain and the process is repeated leading to further cognitive impairment as AD progresses.

The P. gingivalis - human neuroblastoma cell culture study

This cell culture study showed that P. gingivalis and its virulence factors, in the presence of inflammatory mediators, can increase the production of Aβ proteins. This suggests that P. gingivalis virulence factors can act as antigens of the immune system. The Aβ proteins may be harmless when they exist in low quantities, but when they are at consistently high levels, along with inflammation, the risk of developing AD is likely to be higher.

Impact on the profession

At the recent British Endodontic Society’s (BES) Spring Scientific Meeting, I was honoured to win the Poster Prize. This was a unique opportunity to share my research findings with a diverse range of dental professionals including specialists, private practitioners, NHS dentists, and consultants in attendance. I would encourage more colleagues who are conducting endodontic research to engage with the BES as a platform to showcase their scientific findings, as it is a great way to raise awareness about your research. The BES also provides many opportunities for young researchers via the

Undergraduate Research Prize and Aspiring Endodontic Researcher Prize, as well as the BES Research Grant.

I hope that my research will facilitate further conversations around oral diseases and systemic health, particularly Alzheimer’s Disease, and increase awareness of this link amongst the profession. Longitudinal clinical studies will be able to produce stronger correlations but will likely require tracking larger patient cohorts over a long period of time, thus requiring sufficient funding. With stronger evidence, organisations like the Alzheimer’s Society and the WHO may consider acknowledging oral diseases as a modifiable risk factor. This is crucial for increased public awareness and contributes to AD prevention.

looking to the future Going forward, awareness of the bi-directional relationship between oral health and general health amongst patients is crucial. Clinicians must have conversations with patients about the benefits of good oral hygiene practices as well as the importance of retaining as many natural teeth as possible as they age. Many infected teeth need not be extracted with early endodontic intervention. Attending regular dental appointments is crucial for both dental and overall health – and the whole dental team must remind patients of this. In the context of AD and many other systemic diseases, interdisciplinary research collaboration between the specialties of endodontology, periodontology, together with our medical colleagues could pave the way for improved patient outcomes.

For more information about the BES, or to join, please visit the website www.britishendodonticsociety.org.uk or call 07762945847 n

about the author Dr Shalini Kanagasingam, Senior Clinical lecturer, University of Central lancashire and Consultant in endodontics, King’s College hospital trust.

Figure 1

Personal support for improved oral health

Adental professional’s ability to accommodate the needs of their patients is essential for providing effective care. When a patient requires additional support, clinicians should do all they can to offer tailored dental care plans. As has become increasingly clear in recent years, mental health and oral health are intrinsically linked. Amongst the most common mental illnesses that might impact a person’s oral health are anxiety, panic attacks, depression, eating disorders, and obsessive-compulsive disorder (OCD). It is important to approach patients who are experiencing mental illness with sensitivity, helping them to feel safe and confident in your abilities. It’s crucial that clinicians understand the link between mental illness and dental health, the long-term effects, and how best to support their patients.

Mental health and dental health

There exists a bi-directional relationship between mental health and dental health. Dental anxiety and phobia can cause issues when seeking dental care, and mental health issues can lead to dental problems. These might include erosion, caries, and periodontitis which, when left untreated, can lead to tooth loss. As such, patients with mental illness are 2.7 times more likely than others to lose all of their teeth. Because of this, it’s important to understand the specific issues affecting different patients, and the best ways to assist them.

There are a number of factors which contribute to oral health issues in patients with mental illness. Some may avoid dental care to the point of neglect, unable to keep up with consistent oral hygiene routines, making caries and gingivitis far more likely. Anxiety is another key factor, with dental-specific anxiety leading patients to stop attending regular dental appointments, having a severe impact on oral health. Clinicians should also consider the effects that eating disorders could have on oral health. Bulimia, in particular, often leads to dental erosion, and low levels of calcium affects the health of the teeth. Some mental health conditions, such as bipolar, may make over-vigorous brushing more common, increasing tooth wear. Further to this, some medications can have an effect on oral health, often causing dry mouth. Some people may also engage in selfsoothing behaviours when experiencing poor mental health, such as drinking alcohol, smoking, or eating more processed foods. All of these have negative impacts on oral and general health. As such, its important to discuss lifestyle factors with patients, to help them manage and to make helpful recommendations for their health. Additionally, patients who have anxiety may be more likely to experience bruxism or suffer TMJ pain. Should a clinician notice the symptoms of this, it may be helpful to recommend patients wear a splint to prevent excessive damage.

the long term effects

In the long-term, if patients do not receive the preventive care and advice they need, and continue to neglect their oral hygiene, they may be more likely than others to experience oral diseases such as caries, gingivitis, and tooth wear. This can further worsen the effects of mental health conditions, with added stress and anxiety about their dental problems restarting the cycle.

tailored support

Sometimes, mental health issues can make it more difficult for patients to access dental care. To assist patients who may feel vulnerable in a dental setting, be sure to encourage openness about their mental health, and any medications they take, to help build a picture of their overall health. Communicating clearly about this will enable you to identify any high-risk areas and where to target care. Encourage patients to bring someone with them to their appointments, should they need support, who can help them to discuss their needs and concerns.

Should a patient require treatment be sure to explain procedures thoroughly, and make sure that they do not feel rushed. When patients have a good understanding of what to expect from treatment, they are likely to feel less anxious.iv Enable patients to speak freely about their concerns, particularly if they have not previously attended regular dental appointments, as this will help to build trust.

Prevention for lasting oral health

Preventive care is key when treating patients with mental ill health, particularly as they may be at higher risk for caries and gingivitis. As such, it’s important to recommend products which boost oral hygiene, and are easy to use, like FLEXI interdental brushes and PREVENT GEL from TANDEX. When using both of these together, patients are able to remove plaque from in between the teeth with ease, whilst also applying 0.12% chlorhexidine for an antibacterial effect, and 900ppm fluoride to help strengthen enamel.

In order to effectively help patients with mental ill health, it is important for clinicians to provide tailored preventive advice, particularly for patients who are at a heightened risk of tooth wear, caries, and gingivitis.

For more information on Tandex’s range of products, visit https://tandex.dk/ Our products are also available from CTS Dental Supplies www.cts-dental.com/ n

about the author Jacob Watwood on behalf of tandex.

Diagnosing obstructive sleep apnoea

In the UK, it’s estimated that more than 1.5 million people have sleep disordered breathing, including obstructive sleep apnoea (OSA). It is characterised by the intermittent cessation of breathing whilst asleep. Many patients are unaware that they have this debilitating condition, unable to recall waking during the night, however, exhibiting daytime symptoms such as, but not exclusive to, waking unrefreshed. Snoring is a common symptom of OSA and it is important that OSA is diagnosed and treated, as it can lead to serious medical co-morbidities and reduced lifespan if left untreated. In addition, untreated, OSA could lead to development of high blood pressure, increased risk of stroke, type 2 diabetes, heart disease, and depression, as well as neurocognitive disorders such as dementia. Additionally, it can make staying awake and concentrating during the day very difficult due to increased tiredness and reduced cognition.

Can dentists diagnose oSa?

Whilst dentists are not qualified to formally diagnose sleep apnoea, dental professionals are often the first to notice signs and symptoms. As part of routine dental appointments, practitioners should examine the patient’s maxillo-facial and oral anatomy, giving them the opportunity to recognise the risk factors for OSA such as a narrow airway, large and/or scalloped tongue, a retrognathic jaw and possibly underlying sleep bruxism.

Any signs of a restricted airway, be it from a large tongue or enlarged tonsils, should be a cause for concern, and should prompt you to screen the patient for any potential sleep and/ or breathing disorders, including snoring and OSA. In view of this, dentists should be in a position to advise patients of their risk of OSA and manage them accordingly.

This is a great chance to ask simple screening questions, which might help to identify patients with disrupted sleep. Alternatively, practices could include a few questions which relate to breathing and sleep quality in the medical questionnaire completed by patients prior to visiting the practice. This can enable you to gather relevant information to indicate whether they may need a targeted sleep disorder assessment.

During an assessment, clinicians should check for any signs of obstructive sleep apnoea. These may include:

• Indentations in the tongue which might indicate an enlarged tongue

• Large tonsils which may block the airway

• Obesity and a large neck which might make restrict the airway

Making note of these signs can help practitioners form a diagnosis, and form a basis for referral to a specialist.

Working within scope of practice

It is important that dental professionals work within their scope of practice. If a dental professional suspects that a patient may have OSA, and they are not qualified to offer any help, it is vital that they refer patients to a qualified healthcare professional, or a sleep clinic for further investigation. Whilst it is not within a dentist’s remit to diagnose medical conditions, it is important to refer patients for a sleep test, or carry one out if the clinicians has had the appropriate training. Once completed, sleep tests must always be reported to a sleep physician or physiologists for a formal diagnosis and preferably a prescribed treatment from the sleep specialist.

Following diagnosis, an appropriately trained clinician can treat patients using a Mandibular Advancement Device (MAD). Depending on the diagnosis, recommended courses of treatment may differ. For some, especially those who experience significant daytime sleepiness, Continuous Positive Airway Pressure (CPAP) is considered the ‘Gold Standard’ of care. If the patient, however, is resistant to CPAP followi

offering treatment for each individual

O2Vent is the ideal solution for patients who require an alternative OSA treatment type.

It is customised to fit each patient’s unique anatomy, ensuring maximum comfort. Its innovative design enables air to travel through the device, to reach the back of the throat. Additionally, it advances the mandible for an improved position to enable the airway to remain open during sleep. O2Vent is the convenient, comfortable, and portable solution for patients who require OSA treatment.

It is vital that clinicians work within their scope of practice when caring for patients with obstructive sleep apnoea. This means looking out for the signs and symptoms of OSA, asking patients targeted questions, and referring patients for further investigations when appropriate. Once a diagnosis has been established, trained clinicians should support patients and offer advice regarding the most suitable course of treatment for them. This will allow patients to receive the treatment they need, and help to prevent the development of more serious health conditions in the long term.

To find out more please visit: openairway.uk, email infouk@openairway.com, and follow us on LinkedIn: linkedin.com/company/o2ventuk n

about the author

Justin Smith, Commercial Director, open airway Dental Solutions UK ltd

Hassle-free, predictable placement with Adin Guided Surgery!

Using guided surgery for implant placement has become increasingly popular among Implantologists because it offers many benefits for the Clinician and their patients.

For the patient there is dramatically reduced surgical time, which helps to improve patient comfort and reduce their apprehension. Plus, because it utilises flapless surgery it significantly improves the healing process and healing time in the majority of cases. It also minimizes the risk of surgical complications.

For the Implantologist it significantly improves implant placement accuracy, reduces the risk of complications and minimizes chair time leading to greater efficiency and cost savings.

Why choose adinguideTM?

The adinguide™ guided surgery system has been specifically designed

for optimum osteointegration and minimised risks of post-operative complications.

Self-centering drills & Tools

The keyless, self-centering drills and tools are designed to enable Implantologists to perform faster, easier and more intuitive implant surgeries. Organized in a way that enhances safety and ease of use, Adin sleeves are embedded within the 3D printed surgical guide and precisely centre and guide the drills and insertion tools. Self-centering drills, controlled by a main diameter cylinder at the top of each drill centres the drill in the guide’s sleeve. In order to ensure correct positioning of the drill, the surgical guide and drilling procedure are designed so that the self-centering cylinder engages the sleeve before the drill touches the bone.

to deliver effortless procedures plus accurate and predictable implant placement. Consequently, it delivers everything you need in a guided surgery system. It offers many unique advantages compared to other guided surgery systems.

Keyless Procedure

Unlike other systems which require the use of keys to hold the stent in place, adinguide™ is a keyless system which helps to save surgery time whilst still ensuring accurate and predictable implant placement.

activeFlowTM Irrigation Technology

The adinguide™ ActiveFlow™ Irrigation Technology is a unique design that forces coolant through the guide to ensure that the irrigation reaches the bone. Within each cylinder unique channels allow the coolant to stream through the sleeve while drilling. As the drill starts to spin, ActiveFlow™ starts to operate and delivers the coolant from the handpiece directly to the surgical site and thereby helps to prevent the bone heating, which helps to maintain healthy bone

Built-in Stoppers enhance Safety

Built-in stoppers ensure precise and accurate drilling to the desired depth. The fixed value of the offset between the top of the implant and sleeve allows Clinicians to choose to use shorter drills when they want or need to. This provides another safely measure and facilitates another layer of verification before reaching the final drilling depth.

Simplicity

The adinguide™ kits are intuitive, simple and effortless to use. There is no need for keys or any other assisting tools. They help ensure a hassle-free, logical and straightforward procedure that saves the Clinician time and worry.

Minimal Number of Tools

The adinguide™ kit is organized into six areas. Each area representing a specific function during implant placement and insertion. For further information visit the Trycare website, www.trycare.co.uk/adin, or request one of their Surgical Essentials and Adin Catalogues. To request a catalogue please contact your local representative or call 01274 885544. n

Keyless guided surgery aids faster, easier, more intuitive placement

activeFlow™ Irrigation helps maintain healthy bone

Evolving perceptions of masculinity and men’s health

As healthcare professionals, we are concerned for the health and wellbeing of everyone –regardless of gender, sex, age, culture, background or beliefs. However, it can be helpful to focus on a certain group at a time in order to really understand the health challenges that many people are facing. With Men’s Health Week celebrated in June, I thought this a timely opportunity to consider why there is still so much work needed in the field.

In addition, men have a higher risk of cancer compared to women at most shared anatomical sites – including kidney, gastric cardia, biliary tract, skin, liver, oropharynx, bladder and larynx. With regards to male-specific concerns, the number of prostate cancer diagnoses in Europe has increased by 41% between 1993/95 and 2015/17, though this slowed to 4% between 2005/07 and 2015/17. In the UK, more than 52,000 new cases of prostate cancer were diagnosed annually

the risks of being male

Men are at a higher risk of various systemic health conditions. These include cardiovascular disease and stroke mortality, which are up to five times higher and twice as high in men than women respectively. Kidney stones are also more common among men. Differences have been found between the sexes regarding the immune system as well, with men experiencing more severe symptoms of conditions like the coronavirus. Regarding dental health, men disproportionately experience periodontal disease and dental trauma. In most cases, hormones are suspected to be behind differences in the sexes.

between 2016 and 2018. The good news is that the survival rate of prostate cancer for 10 or more years is nearly 80%, so it remains a fairly manageable disease if caught early. The disease is a key focus of the Men’s Heath Week 2024 campaign.

Barriers to healthcare

In this day and age, you would hope that no barriers exist based on sex that would prevent someone from getting essential care. However, there are still areas that we as a society need to work on.

A systematic review from 2016 reported several factors influencing the uptake of health screening for men. Facilitators

included the partner’s role, a desire to be healthy in order to look after family and a non-invasive screening procedure. Key factors that prevented men from attending health screenings included fear of receiving a disease diagnosis, a perceived low risk of long-term problems, fear of a painful screening procedure, time restraints and a lack of knowledge about health or screening.

Within the social domain, knowledge, attitudes and values, fear and masculinity attributes featured widely. This highlights the continued existence of a stigma around men’s health and a perception that to seek help is a weakness of some kind. The study found that heterosexual self-presentation and the avoidance of femininity were leading barriers to health screening for men.

Sadly, these findings support previous research that men would rather hide signs of pain of suffering in order to meet societal expectations of them. A more recent poll also found that one in three dads wouldn’t know how to talk to their sons about health, 17% of which would find it awkward and uncomfortable. This is something that must change if we are to give men the healthcare and support that they need – and deserve –without fear of judgement.

Modern masculinity

And it seems this change is already afoot. The attitudes of younger generations today are driving new ideals and challenging traditional values of what a ‘man’ should be. A 2021 systematic review reported an evolution of public perception towards all manner of topics, including sexuality, emotional intimacy and the establishment of any gender roles. The new generation

is challenging traditional values in favour of increased inclusivity and a whole new approach to masculinity.

It is hoped that this change in public perception will encourage men to be more open about their health and related concerns. In turn, this would increase the number of men who attend health screenings and enhance early detection –and therefore improved management – of all health conditions.

Back to the dental practice

Of course, all of this is interesting stuff, but what we need to focus on as dental professionals is how we can better care for our patients. Keeping in the mind the impact that traditional values may have on our male patients, we should be trying to beat the stigmas with conversation and education.

Where we can, it’s our duty to get the conversation started. By sharing important health information and signposting individuals to trusted resources that they can browse in their own time, we can encourage more men to educate themselves on a range of health topics. We can also show that these are not taboo topics to discuss. If we can talk about them in an unbiased, judgement-free way, we set a good example for others to follow. 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.

Bad breath and the impact on self-confidence

Our teeth and oral health can play a significant role in our self-confidence. The impact may be due to the appearance of the dentition, because of the colour or alignment of the teeth, or gaps caused by diastemata or tooth loss. However, halitosis, or bad breath, can also be a major contributor to decreased self-confidence.

The effect of halitosis on selfconfidence and self-esteem is interesting, mainly because of the fact that it is often not self-perceived. Where aesthetic features that differ from the societal norm may be easily spotted in the mirror, bad breath may not be picked up by an individual at all.

Halitosis is a common condition, with an estimated prevalence of 10-30%. However, only approximately 5% of individuals will say they suffer from halitosis. This contrast indicates an inability to recognise one’s own oral malodour. However, studies show that people are far more likely to notice their own halitosis after identifying it in someone else around them.

affecting mental health

Patients with low educational and income levels are thought to experience

a greater psychological impact from halitosis. Similarly, women may be impacted more than men.

The realisation that one has bad breath can be detrimental to a person’s mental health. A patient with untreated halitosis may experience distress and possible social isolation. In some cases, an eventual overconcern about halitosis leads to negative psychological wellbeing, even lasting long after treatment if they think their halitosis is not well managed or completely cured. It is important to recognise how this can have a wider impact on a patient’s life. They may be impeded from reaching academic and professional goals, and experience an overall decreased quality of life.

Communicating with care

With an understanding of how halitosis can severely affect an individual, it’s essential to recognise how clinicians can most effectively communicate a treatment plan.

Feelings of shame and embarrassment about the dentition can exacerbate dental anxiety and fears. To successfully overcome these fears, and leave a longlasting and positive impact that can help a patient restore their overall confidence and mental wellbeing, clinicians should take a positive, patient-centred approach.

Positive communication between patient and dentist has been linked with greater patient satisfaction and reduced dental fear. In the case of halitosis and a lack of self-confidence, the clinician may act as a source of emotional support to alleviate any associated fears.

Be aware that for some individuals, the fact that their halitosis may not have an immediate resolution can be of concern. Recognising the greater impact on their quality of life, and assuring them of an overall management strategy may be beneficial for the patient, and allow them to buy into a longer-term treatment plan where necessary.

the role of the clinician

There are a variety of reasons a patient may develop halitosis, from oral health problems, to medical conditions such as tonsilitis and acid reflux, smoking, and even eating or drinking strong-smelling or spicy foods and drinks. Whilst addressing each individual cause will be helpful in improving patient confidence, effective general oral hygiene advice remains essential.

Encouraging patients to brush twice a day and implement daily interdental cleaning is very important. However, sometimes, even when periodontal health is perfect, tongue

coating can be a key source of halitosis. Ensuring patients clean the tongue dorsum with an appropriate brush, tongue scraper or tongue cleaner is therefore key.

Suggesting patients implement other specially designed oral hygiene products as part of their routine will also be incredibly useful. Consider the Fresh Breath Oral Rinse solutions from The Breath Co., which are specifically designed to combat bad breath for up to 12 hours. Available in Mild Mint or Icy Mint flavours, The Breath Co. Oral Rinses bring long-lasting freshness by actively combating odour-causing bacteria. The unique formula is powered by active oxygen, and is able clean the whole mouth and neutralise bacteria in the hardest-to-reach places. For more information about The Breath Co., please visit www.thebreathco.com/ n

about the author

anne Symons is a Dental hygienist currently working in a specialist periodontal/ implant practice and also a busy NhS surgery. She is also a Professional educator for Waterpik.

Sustainability and scalability with the Tyscor suction systems

Radial blower reduces energy consumption by up to 75%.*

Monitoring and remote maintenance by VistaSoft Monitor reduces CO 2 emissions .

Grows with the practice: From two to twelve users, without replacing the machine.

They

Choose your words carefully

The importance of effective communication within dentistry cannot be overstated. With the chance to gain new patients, improve appointment attendance and increase treatment acceptance rates, understanding how to best develop the patient-clinician relationship is essential.

One brilliant method of communication in modern dental care is storytelling. By listening to patient stories, and telling those of the practice team, you may be rewarded with improved clinical and business outcomes. It’s perhaps the simplest way to communicate, and recognising how to optimise the stories you tell can positively affect patient habits and choices in relation to their oral health care.

The clinical story

Patient choice is key. Many individuals are eager to engage with the decision-making processes surrounding their care. This will be helped by presenting each of the available treatment options to a patient, and the potential outcomes. People provided with decision aids feel more knowledgeable and better informed about their treatment, and have a more active role in decision making, which can help them choose the treatments they will truly be happy with.

Narrative medicine, a proposed model for facilitated shared decision making, recognises storytelling as an important way to communicate a patient’s needs, as well as a clinician’s understanding of the problem and proposed resolution. When practised with narrative competence, it’s thought to facilitate a patient-clinician relationship, and can be a useful tool for information collection.

From the patient to the clinician, the stories told are generally used to communicate the origin and impact of an oral health problem. By listening to these stories with respect and understanding, dentists can respond empathetically, which is absolutely fundamental in the clinical relationship. It’s also conducive to reducing patient anxiety and improving perceptions of safety and understanding.

For many patients, telling a story may be the only way to put what they’re feeling into words. They give a time or place, noting when they first felt pain or discomfort, describing the most notable sensations, and in turn the clinician formulates a diagnosis and solutions to manage the problem.

By making patients feel understood, the experience increases trust and confidence in the clinician, and improved treatment adherence can be observed.

Reaching out to patients

Storytelling as a form of communication should not be limited to the clinical experience. Practices have the chance to tell their own stories when marketing to existing and potential patients, in order to see professional growth.

Dental professionals will have to consider ways they can present their key messages to an identified audience. These may include unique aspects of the practice that set them apart from local competition, or specific problems that they wish to treat. However, their approach must elicit a strong reaction and subsequent desire to seek treatment to be fruitful.

Studies find that storytelling is one of the most effective ways to initiate emotion in a customer, or patient, and facilitate the sharing of experiences to improve trust, and build a rapport with an individual. Stories also have an exceptional impact on our ability to retain information. When conveyed through a story, retention rates can increase from 5%-10% to 65%-75%.

If patients feel strongly about your practice, and can recall information about it clearly, they are then able to share it further with those around them. The awareness of your practice, its unique features and aims, and available treatments can then spread through word of mouth.

How to become a storyteller

You could establish pages on your website that are about your potential patients and the issues they face, such as dental anxiety or finding a clinician that holds similar lifestyle values, and place your practice as a ‘character’ that can support them.

The hooks in the narratives are your unique qualities that set you apart from other practices or clinicians – the support from your team, your eco-friendly approaches to dentistry – and the payoff is the brilliant care they will receive.

Authenticity is key, and communicating the team’s dental experience, hobbies, and interests can help you develop a memorable brand, as well as build trust with your audience.

Telling stories is one of the key aspects of the Business and Mindset Mastery course from the IAS Academy, led by Dr Prav Solanki, which provides clinicians with powerful marketing growth hacks for ethically gaining and retaining more patients. Prav, an owner of several successful dental and implant clinics, will share insights he has developed from more than 16 years in dental marketing, including how to develop a life balance, and how to articulate a brand-voice. By understanding how you can use narratives to develop connections with existing and new patients, you may observe greater interest in your practice, and the chance to write a new story of your own.

For more information on upcoming IAS Academy training courses, please visit www.iasortho.com or call 01932 336470

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About the author

Dr Tif Qureshi, founder and a clinical director of IAS Academy.

Recognising the signs

Alollipop is being developed with the aim to detect the early signs of mouth cancer. This comes as many patients find the prospect of a biopsy very daunting, causing anxiety not only about the result, but the procedure itself. Currently, the lollipop is required to be immersed in the sample for up to 12 hours, making it inappropriate for use in the practice. However, it is true that quick pre-diagnostic tests are a great tool for detecting mouth cancer in its early stages, without frightening patients with the prospect of a biopsy.

Mouth cancer diagnosis

Diagnosing mouth cancer begins with noticing the symptoms. For instance, if a clinician spots an unusual lesion or discolouration in the mouth during a routine examination, it is likely to require further assessment. Most commonly, a symptom of mouth cancer might appear to be a mouth ulcer which does not heal in three weeks. It can affect the inside of the cheeks, roof of the mouth, lips, gingiva, and tongue. However, symptoms can also include a lump in the mouth, bleeding, and red or white patches. Sometimes, symptoms are similar to minor issues, so patients may not realise that they could have the early signs of mouth cancer. As such, it’s important that clinicians look out for the signs in every appointment.

Usually, at this point, if mouth cancer is suspected, the patient is referred to a specialist doctor for further assessments. In order to make a diagnosis, a doctor will remove a small piece of tissue from the affected area, which is then tested to check for cancer cells.

Detecting it early

In order to offer patients the best possible outcomes, it’s important to detect mouth cancer in its early stages. Currently, over 70% of mouth cancer cases are diagnosed at stage III or IV, with five-year survival rates approximately 50%. This highlights the importance of early detection as, when it is detected at stages I and II, five-year survival rates improve to around 90%. This drastic improvement is lifechanging for patients, determining the severity of their cancer, the extent of the treatment they need, and their chances of recovery. As such, clinicians’ ability to recognise the signs and symptoms of mouth cancer is crucial, as is knowing how and when to act.

This vigilance is particularly key at a time when many patients are experiencing delays when accessing dental care, potentially allowing problems to go unnoticed for longer than normal. If a patient is not familiar with the early symptoms of oral cancer, they are unlikely to seek urgent care for a lingering mouth ulcer until it’s reached its later stages.

Pre-diagnostic tests

Whilst it is important to be familiar with the early symptoms of mouth cancer, clinicians may not come across them regularly during check-ups. Because of this, they may feel uncertain about their

decision making when referring patients for a biopsy. As such, some may feel it more appropriate to adopt a ‘wait and see’ approach, inadvertently extending the time to diagnosis. In order to avoid unnecessary delays, pre-diagnostic tests can be incredibly helpful for ensuing patients receive the care they need as quickly as possible.

Initial examinations include a visual exam in which a clinician looks for lesions in the mouth and throat, and any discolouration. An examination will also include palpation, using the fingers to feel for any unusual lumps or bumps around the neck, face, and jaw. Some practitioners also use a pre-diagnostic tool called toluidine blue dye to coat any lesions which are likely to be cancerous, or an oral cancer screening light along with a fluorescent mouthwash to identify abnormal tissue.

To avoid a ‘wait and see’ approach, and to ensure that patients receive a diagnosis as soon as possible, the use of a pre-diagnostic tool is useful. When a clinician identifies an unusual lesion, the BeVigilant™ OraFusion™ System detects biomarkers in a single saliva sample, and when combined with common risk factors, establishes a patient’s risk of mouth cancer. The results of the test are accurate, and can be used by practitioners to decide whether to take no action, schedule a follow up exam, or refer to a specialist for biopsy. The BeVigilant OraFusion System produces a result in 15 minutes or less, and is ideal for chairside use, ensuring patients gain a diagnosis and start treatment as soon as possible. Even though dentists are unable to diagnose mouth cancer in the practice, the use of thorough exams and pre-diagnostic tests enable clinicians and their patients to be informed about their level of risk, and refer them for biopsy with confidence. For more details about the BeVigilant OraFusion System, visit the Total TMJ website totaltmj.co.uk/products/bevigilantorafusion/, or email info@totaltmj.co.uk n

About the author

Phil Silver, Founder of Total TMJ, which distributes innovative technologies from leading healthcare manufacturers to dentists and clinicians around the UK.

Confidence in referrals for complex cases

Sometimes a patient may come to you with treatment needs that exceed your current skillset. Every clinician, at some point in their career, has encountered it. Today, this may be common when patients are looking to receive a dental implant, or require maintenance care for one that has previously been placed. Not all dentists will be adequately equipped to provide an effective solution when a patient requires such care. In particular, the ability to place dental implants requires advanced, dedicated training in order to reliably provide high-quality and safe treatments. You may not have focused your time on acquiring the necessary skills to treat such cases, but you must know the options available to you for making the correct referral.

Directing a patient to another clinician is required of all professionals when the case in front of them may be pushing their clinical capabilities a step too far, and can ensure each individual recieves the care they need.

The importance of referral

Dental implant treatment may be necessary for a variety of reasons, from tooth loss through injury or disease, to attempts to improve the stability and function of a restoration for patients that already use dentures. The case may demand experience of advanced techniques, but dental professionals must only carry out treatments if they are appropriately trained, competent and confident, working solely within their mental and physical capabilities. For example, a patient

may be lacking adequate bone structure for a straightforward implant placement, so may require more complex implant solutions. If you have not yet undergone training for augmentation workflows, taking on such a case would be wholly irresponsible.

Similarly, patients may have specific nonclinical needs related to their care that make dental provision difficult, and therefore require a referral. The General Dental Council’s Standards for the Dental Team notes that patients’ disabilities must be considered, and where reasonable adjustments to your care cannot be made, a referral must be considered.

In either case, the patient’s best interests must be put before anything else – including your developing clinical experience, your relationship with other clinicians, and other such motivations for either taking on treatment, or referring them to another practitioner.

Identifying complex cases

Providing treatment without the adequate skills may increase the risk of developing issues such as infection, damage to surrounding structures, or even implant failure.

Referring the case will not only better support you from a medicolegal stand point, where the current atmosphere amongst dental professionals is one of particular concern and worry, but also improve the patient’s happiness with the treatment outcome. With fewer complications, they may be able to experience an improved quality of life sooner, and for longer.

Studies have found that early dental implant failure is twice as common as late

implant failure. The former is commonly associated with impaired bone healing, or inadequate osseointegration due to heatinduced necrosis and incorrect positioning at the time of surgery, amongst other factors. However, late implant failure is considered to be heavily impacted by patient-related factors, such as oral hygiene management and infection prevention. By referring the original treatment, you would maximise the quality of care that is provided, and reduce the chance of early failure. You may then care for the patient in the months following, where your skills may be better applied to managing the recovery of the treatment site. If any complications are met, you would be able to speak to the referral clinician for support and insight on the unique case.

Finding clinicians you can trust

Identifying dental professionals that can confidently take on complex dental implant cases can, at first, be a challenging process. Consider the GDC Standards for the Dental Team; they state that although you can delegate the responsibility for a task, you may still be held accountable for the treatment. Therefore, in such cases you must ensure the dental professional you are referring the patient to is appropriately trained, indemnified, and competent, in order to carry out the procedure.

For difficult cases concerning dental implantology, consider Dr Fazeela KhanOsborne and Dr Nikolas Vourakis at The One to One Dental Clinic of Harley Street, London.

Both clinicians are highly experienced and celebrated in their fields, with the ability to take on a variety of complex dental implant referrals. Dr Khan-Osborne is the founder of One to One Dental Implant Education, where she teaches clinicians how to treat advanced implant cases with the help of Dr Vourakis, emphasising their skill and expertise within the discipline.

Referring difficult implant cases to clinicians you can trust is essential when you cannot provide effective treatment with complete confidence. Consistently choosing dental professionals that are known to provide high quality care can also help your patients further trust your recommendations for treatment long into the future.

To learn more about referrals to The One to One Dental Clinic, visit 121dental.co.uk/for-dentists/referrals/ or contact 0207 486 0000 n

about the authors

Dr Fazeela KhanOsborne, Principal Implant and restorative Surgeon.

Dr nikolas Vourakis, Senior Implant and restorative Surgeon in private clinics in London and edinburgh.

Filling the gaps in black triangle treatment

When considering the many aspects to dental aesthetics that can contribute to an ideal smile, it’s essential to not underestimate the impact of of open gingival embrasures, commonly known as black triangles.

The absence of interdental papilla creates spaces within the dentition, posing both functional and aesthetic complications. These small gaps facilitate the retention of food debris – obviously detrimental to the health of the periodontium – and smiles with multiple large black triangles are seen to be less attractive than a conventionally healthy smile.

There is a consensus that demand for cosmetic dentistry is rapidly growing, and social media (including the likes of Instagram, Facebook, and Snapchat) is one driving factor behind the surge. As such, patients may be presenting at your practice looking for treatments for black triangles more often moving forward.

Understanding how to effectively aid these individuals with minimally invasive solutions is key, and could help you expand your everyday treatment offerings too.

a developing problem

Black triangles are by no means uncommon. They are particularly common within the elderly population, but some estimates put incidence rates at 67% for individuals over the age of 20. For younger patients, this is only 18%.

A multitude of factors could contribute to the development of black triangles. These

include aging, periodontal disease, the loss of height of the alveolar bone relative to the interproximal contact, root angulations, triangular-shaped crowns, and so much more. Fixed orthodontic treatments can increase the development of open gingival embrasures by approximately 58%.

With an older population that is expected to grow in the coming years and the established rise in aesthetic dentistry demand, including orthodontic treatment, it can be postulated that the prevalence of black triangles will also develop with time.

Advising patients on how to avoid the development of black triangles can be simple: engage in a sustained oral hygiene routine. This will help to prevent the development of periodontal diseases that cause gingival recession and bone loss, and brushing gently will avoid abrasion to the gingiva. However, with some factors such as aging, crown shape, and root angulations being largely out of an individual’s control, even the most diligent of patients may have concerns.

minimally invasive solution

Providing a highly functional and, importantly, aesthetic solution to patients in these cases is key.

Veneers, orthodontics, and surgical interventions such as papilla re-contouring, preservation and reconstruction have each been discussed as potential solutions in the literature. However, none of these fulfil the demand of predictability with a minimally invasive approach, a combination that is understandably attractive to many clinicians.

This is where the Bioclear® Method presents as an effective treatment option. With the utilisation of injection moulding the Bioclear® Method involves using flowable composite and heated conventional composite within anatomical clear mylar matrices, and has the advantage of creating a homogenous monolithic restoration that is stronger than composite layering, whilst retaining aesthetics.

With matrices of differing sizes and individualised shapes, clinicians can eliminate black triangles whilst establishing the appropriate height of a contact zone, as well as an emergence profile that will perfectly support the soft tissue. These are essential to achieve an aesthetic result whilst respecting the gingiva.

The Bioclear® Method is notable for being entirely additive. Heated flowable and paste resin composite materials fill a Bioclear® matrix in a manner that allows for an ideal transition to the tooth structure, thanks to the solutions’ viscosity. It can then be moulded into a thin layer, requiring a simple etch-and-rinse protocol for effective adhesion, and preserving the entirety of the healthy tooth structure.

Where other approaches are unappealing due to their complex nature and demand for extensive clinical expertise, such as for the use of conventional celluloid matrices, the Bioclear Method is simpler to implement whilst promising brilliant results.

materials make the difference Alongside the clinician’s technique, the chosen flowable and conventional composite solutions will make all the difference in providing an aesthetic and functional result through the Bioclear® Method. For black triangle restorations in the anterior dentition, consider solutions like the Filtek Supreme Flowable Restorative and Filtek Supreme XTE Universal Restorative composite materials from Solventum, formerly 3M Health Care. The award-winning* Filtek Supreme Flowable Restorative offers exceptional adaption and versatility, and is made with TRUE nanotechnology from Solventum for excellent polish retention and wear resistance. Used in conjunction with the Filtek Supreme XTE Universal Restorative, which is available in 36 shades for optimised aesthetics, black triangles can be a concern of the past. Black triangles are as much of an aesthetic concern as they are a functional problem, and a risk for the health of oral tissues. By implementing non-invasive and predictable approaches to restorative care, such as the Bioclear® Method, clinicians can approach this common problem with confidence, and provide restorations that patients love. n ©Solventum 2024. Solventum, the S logo and Filtek are trademarks of Solventum and its affiliates. 3M and the 3M logo are trademarks of 3M.

Adult orthodontics with fixed braces

Safety and success in the hands of professionals

Dental professionals maintain an ethical code of practice around communicating honestly, and seeking fully informed consent throughout treatment, which should be clearly and carefully planned. This is important, as managing patient expectations can be challenging.

When adult patients do express dissatisfaction with orthodontic treatment, it is chiefly due to treatment either not meeting a desired aesthetic outcome, or frustration with slow progress. Patients can also express discontent when they feel communication is lacking. It is therefore very important – as the British Orthodontic Society (BOS) states – that objectivesetting is realistic, and agreed between the patient and practitioner; and that all aims of treatment are clearly documented.

Complex cases – for example, those that include severe crowding – require especially thorough assessment and treatment planning. Complicating factors associated with crowding, such as difficulties accessing periodontal areas to maintain adequate hygiene, may prolong the total treatment time and negatively affect the final outcome.

Patient compliance plays a very important role in the success of treatment. Any underlying conditions affecting periodontal health must be addressed before considering orthodontic treatment. The necessity for the very precise and gradual treatment in patients with crowding and compromised periodontal health can lead to

a lengthier process than may be expected. Candour and clarity are, therefore, vital in managing expectations.

the statistics

In a 2023 survey conducted by the BOC, over 76% of orthodontists reported an increase in adult patients seeking orthodontic treatment over the last three years. 83% of these were aged between 26 and 55. 65% of orthodontists cited increased virtual team-working as a factor, and 38% claimed their adult patients are influenced by celebrities. Almost 45% of people in the UK have a degree of dental crowding which is the most common reason for adults to seek orthodontic treatment.

Fixed braces are offered as a treatment by 97% of orthodontists, and are the most popular system used to treat adults. Fixed braces are sometimes more effective than other options such as aligners in producing adequate occlusal contacts, controlling teeth torque, and retention. During post-retention time, patients treated with clear aligners relapsed more than those treated with fixed braces.

Lingual braces are offered by about 10% of British orthodontists, and have the advantage of being less visible than traditional fixed braces. However, this treatment is less comfortable, and requires more chair time, is more technically challenging, and is more costly than traditional fixed braces.

Clear aligners are an increasingly popular alternative to fixed braces, and have an 80-90% success rate for mild to moderate tooth movements. They can be an effective

Marylebone Clinic: 74–78 Seymour Place, London, W1H 2EH info@happykidsdental.co.uk

Chelsea Clinic: 18 Cadogan Gardens, London, SW3 2RP chelsea@happykidsdental.co.uk

Happy

alternative to traditional braces, but the expense in production, dependency on patient cooperation, and the inability to treat certain malocclusions limit their effectiveness and suitability in some cases.

When surveyed, an alarming 88% of dental professionals expressed a concern that their patients might seek direct-to-consumer (DTC) orthodontic treatment. It goes without saying that without the supervision of a trained professional, complications are a far greater risk for patients seeking home treatment. Commonly reported adverse events include occlusal problems, pain, sensitivity, and periodontal disease, and some are irreversible.

relapse and associated problems

Orthodontically treated teeth are at high risk of relapse within the first 2 years following treatment. Movement back towards the original malocclusion may occur as a result of periodontal, gingival, occlusal and – in children and adolescents – normal growth-related factors. Because it is not possible to predict who may be affected by relapse, clinicians advise long-term retention for all. This can be a significant commitment for patients, and so retention and the potential for relapse must form a key part of the informed consent process prior to commencing the procedure.

maximising comfort

Orthodontic treatment can be uncomfortable, and in some cases, patients requiring treatment using fixed braces may suffer from discomfort for longer than those undergoing other treatments.

Pain has a negative effect on patients’ compliance as well as oral hygiene, and is a major reason for discontinuance of orthodontic treatment. Pressure after adjustments can be painful whatever the choice of treatment, but fixed appliances can additionally cause soreness due to the appliance making contact with delicate soft tissues in the mouth.

Analgesics can assist with the aches and pains of orthodontic treatment, and orthodontic wax is a fantastic remedy for pain from chafing. Orthodontic Relief Wax from Kemdent® is a pleasant, minty-tasting, soft, gum protector for patients with fixed braces that can be used in a pinch to cover brackets and protruding wires with a smooth surface. Kemdent® Relief Wax is also conveniently packaged in 100% recyclable and planet-friendly, sustainable materials. Before undertaking any treatment, it is important that patients truly understand what each stage of treatment entails, how long it may last, what complications might occur and what behaviour is necessary to optimise success. Making sure patients are well-informed and comfortable can go far in ensuring the happiest of outcomes for both patient and practitioner. For more information about the leading solutions available from Kemdent, please visit www.kemdent.co.uk or call 01793 770 256 n about the author alistair mayoh, marketing Director, Kemdent.

The challenges of vestibuloplasty

Vestibuloplasty is a surgical procedure performed in dental implantology to enhance the depth and width of the oral vestibule. It is a crucial step in the rehabilitation of patients requiring dental implants in areas with inadequate gingival tissue. The procedure involves the manipulation and reconstruction of the vestibular depth to create an optimal environment for successful dental implant placement. However, like any surgical procedure, vestibuloplasty poses several challenges and requires specific techniques to ensure favourable outcomes.

One of the main challenges is determining the appropriate depth and width required for the oral vestibule. The ideal depth of the vestibule is determined by various factors such as the type of dental prosthesis planned, the patient’s buccal cavity, and the expected aesthetic outcome. Achieving the correct depth is crucial to ensure the optimal placement of dental implants and the successful integration of the prosthetic.

The width of the keratinised gingiva and the attached gingiva is still a matter of discussion but researchers have currently agreed upon 2mm of keratinised gingiva and 1mm of attached gingiva as the gold standard.

Another challenge is identifying the correct surgical technique. Various methods are available, including the split-thickness flap and full-thickness flap techniques. The choice of procedure depends on the individual patient’s needs, the desired outcome, and the success rate of each technique dependent on the individual case.The dental clinician must have a thorough understanding of these techniques and the ability to select the most appropriate one for each patient.

Post-op complications

Managing post-operative complications is another hurdle. Common complications can include graft failure, infection, and wound dehiscence. The success of vestibuloplasty depends on proper wound healing and the integration of the graft. Vigilant post-operative monitoring and adequate patient compliance are essential to minimise the occurrence of complications and ensure optimal outcomes.

To overcome these challenges, certain techniques can be implemented in vestibuloplasty procedures. First and foremost, a meticulous pre-operative evaluation is crucial. This should include a thorough assessment of the patient’s medical history, anatomical considerations, and the desired outcome. Proper radiographic examinations such as Cone Beam Computed Tomography (CBCT) can aid in assessing the adequacy of bone availability and planning the surgical approach.

During the surgical procedure, proper tissue handling and preservation techniques are vital. Maintaining the blood supply to the surgical site is essential for graft survival. Atraumatic tissue handling, ensuring adequate irrigation, and minimising trauma to the soft tissues can ensure optimal outcomes. Additionally, the use of tissue biocompatible biomaterials, such as collagen-based membranes or acellular dermal matrices, can aid in promoting wound healing and graft integration.

regenerative techniques

Another technique that can be employed is the use of tissue engineering and regenerative techniques. Utilising growth

factors and bioactive materials can enhance the healing process and maximise tissue regeneration. Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are examples of these regenerative techniques that have shown promising results in improving tissue healing and graft integration.

The main difference between PRP and PRF lies in their method of preparation, composition and fibrin architecture. PRF offers a more sustained release of bio-active products such as cytokines and growth factors due to the fibrin matrix. Additionally, PRF retains leukocytes, which have osteoimmune modulating properties that have been shown to significantly enhance hard and soft tissue healing and regeneration.

To address post-operative care and minimise complications, patient education and compliance are essential. Patients should be educated about the importance of maintaining good oral hygiene, adhering to dietary restrictions, and following postoperative instructions. Regular post-operative follow-ups and close monitoring by the dental team can help identify and address any complications in a timely manner.

accredited training

Vestibuloplasty is just one of the vital elements covered in the Postgraduate Certificate in Implant Dentistry run by Ucer Education. Led by eminent specialist oral surgeon Professor Cemal Ucer, Ucer Education is an accredited provider of postgraduate courses and offers dental professionals the chance to develop clinical competence in a range of implant techniques, with courses ranging from Full Mouth Oral Implant Rehabilitation to an MSc in Dental Implantology. Whether you’re a GDP or looking to take your practice to the next level of implant dentistry, there is a range of postgraduate implant courses and hands-on clinical training to suit your needs. Courses take place at the ICE Postgraduate Dental Institute and Hospital in Salford Quays, Manchester, which boasts state-ofthe-art teaching and clinical facilities.

Vestibuloplasty in dental implantology presents several challenges that require specific techniques for successful outcomes. Achieving the appropriate depth and width of the oral vestibule, selecting the correct surgical technique, and managing post-operative complications are some of the challenges faced.

However, with meticulous preoperative evaluation, proper tissue handling techniques, and the utilisation of regenerative techniques, these challenges can be effectively managed. Additionally, patient education and compliance play a vital role in achieving favourable outcomes. By addressing these challenges and implementing appropriate techniques, dental clinicians can enhance the success of vestibuloplasty procedures and improve the overall patient experience. For more information, please contact Professor Ucer at ucer@icedental.institute or Mel Hay at mel@mdic.co Call: 01612 371842

Visit: https://icedentalimplants.co.uk/

about the author

Prof. Cemal Ucer, BDS, mSc, PhD, FDtFed., ItI Fellow, Specialist Oral Surgeon

Stress can take its toll

Restorative treatment in bruxism patients

According to The Bruxism Association, around 8-10% of the UK population experience bruxism. The condition, which can result in tooth wear and breakage as well as jaw disorders such as temporomandibular disorder (TMD), is characterised by grinding the teeth and clenching the jaw. Because bruxism can damage the teeth, it’s important that dental professionals can recognise the signs of tooth wear caused by parafunction, and design customised treatment plans to effectively address the concern. As such, factors such as unique grinding/clenching patterns and rhythms should be considered, as well as management techniques and effective restorative materials where appropriate.

Bruxism: what are the causes?

In order to gain a full understanding of the unique challenges bruxism presents, it’s important to grasp the potential causes of the condition. Firstly, it might be classified as awake or sleep bruxism. Awake bruxism is generally characterised by clenching the jaw involuntarily, while sleep bruxism involves automatically and rhythmically grinding and clenching while asleep. Further to this, bruxism may have a number of underlying causes. These include associations with medications like antidepressants or recreational drugs, Parkinson’s disease, depression, and anxiety. Additionally, sleep bruxism may be triggered by other sleep disorders, such as obstructive sleep apnoea, which cause disrupted sleep patterns.

Stress and anxiety are thought to be key causes of bruxism, with research suggesting that around 70% of sleep bruxism cases are related to these triggers.

A survey conducted by the Mental Health Foundation in March 2023 found that 73% of participants felt anxious in the previous two weeks, with 20% revealing that they felt anxious most or all of the time. As such, it’s important that clinicians take into account their patients’ overall wellbeing, and the ways that stress and anxiety might be impacting their oral health. In doing so, this may allow dental professionals to more effectively manage their condition, and provide appropriate care.

What to consider when restoring worn teeth

the restoration options available to the patient. If there is sufficient tooth structure, then direct or indirect adhesive restorations may be appropriate. However, if tooth wear is more severe, removable overdentures may be more suitable, depending on the patient’s unique situation.

appropriate materials for restorative treatment

Should a patient be a suitable candidate for an indirect adhesive restoration, it’s then important to consider which material might be most suitable. It must offer shock absorbing effects, especially if the patient continues to sometimes clench their teeth following treatment, as this will help to extend the longevity of the restoration, and reduce the risk of early failure. Composite materials with this feature are a great choice for providing conservative treatment which is minimally invasive and preserve remaining natural healthy enamel.

As mentioned, bruxism causes attrition, which often leads to damage of the teeth – with tooth wear and pain common side effects. However, due to the nature of the condition, restoring damage caused by bruxism presents a number of challenges. The nature of the bruxing activity should first be identified and might include lateral grinding, anterior grinding, or simple clenching. By identifying the type of bruxism, and whether its effects are localised or widespread, clinicians will be able to more easily plan the reconstruction needed. This is because, when the unique situation is understood, restorations which are sympathetic to the behaviours can be created, as opposed to those which create conflict.

Additionally, the extent of the tooth wear should be considered, in order to inform

One such example is BRILLIANT Crios from Coltene. Recommended for use when treating bruxism patients, due to its shock absorbing properties, BRILLIANT Crios is a reinforced composite block, which combines all of the advantages of an innovative submicron hybrid composite material with a CAD/CAM fabrication process. This enables clinicians to deliver reliable, aesthetic, and fast restorations with shock absorbing effects. Plus, because it’s available in two sizes, three translucencies, and 15 shades, BRILLIANT Crios offers a broad range of options for day-to-day use. In order to provide bruxism patients with the care they need, its vital that dental professionals first gain a good understanding of the condition, its many forms, and the factors which may be causing it. Stress-related bruxism is very common, and stress affects patients of all ages. It’s therefore important to consider patients’ overall health, look out for the early signs of tooth wear, and offer preventive advice or restorative treatment where appropriate. For restorative treatment to be most effective, assessing patients’ bruxing patterns can be very helpful to design a long-lasting, resilient restoration which will improve their smile aesthetics, oral health, and, ultimately, quality of life. For more information, info.uk@coltene. com and 0800 254 5115 n

about the author nicolas Coomber, Coltene national account & marketing manager

ClearCorrect in Sync with Digital Workflows

ClearCorrect has wowed providers with a suite of upgrades and new features in its mobile case planning app.

ClearCorrect Sync is a mobile and tabletbased platform that allows users to submit and manage cases on the go.

The latest suite of upgrades added digital photography templates, which means users can now upload crystal-clear clinical photography straight from mobile without using a DSLR.

Following upload and case submission, Sync users can view and track the progress of multiple cases, receiving real-time notifications and shipment alerts as cases progress.

Sync also provides in-app access to ClearCorrect’s Doctor Portal and ClearPilot management and planning systems.

Thumbs up from new providers ClearCorrect relations and education clinical manager Rob Wood said the upgrades are another step towards a fully mobile digital workflow for the company’s clear aligner providers: “When we demonstrated the app to the most recent cohort on our Level-1 Accreditation training, delegates were blown away,” he added.

“Delegates who were new to clear aligner treatment or just getting started were able to submit pro-level photography and submit cases with no guidance from our team—it really is that simple!

“Our established providers are already seeing significant clinical and workflow gains from the new features, including fewer case resubmissions and reduced treatment timelines.”

Digital Ecosphere

Marketing manager Caroline Cross said the latest version of Sync is the realisation of ClearCorrect’s mission to empower efficient digital workflows.

“Whether leading the way with digital planning and case submission platforms or comprehensive online training, cuttingedge technology has always been at the heart of our mission to empower clinicians to do their best work.

“When our providers said digital photography and uploading can feel like stepping out of an otherwise seamless digital flow, we listened.

“Mobile connectivity just feels more natural to everyone. It allows busy clinicians to manage cases on the go with no training needed, and capture perfect images using more familiar technology.”

ClearCorrect Key Opinion Leader, Sarah Weston was among the first providers to road-test the app. “The new photo templates have been a game-changer. I have the confidence to get high-quality imagery to support case submission.”

“Having one dashboard with notifications for all cases has significantly streamlined my caseload planning and management.”

Digital and Real-World Development

Sync upgrades are the latest in a long line of ongoing digital development from ClearCorrect aimed at supporting users to meet the growing demand for the clear aligner.

ClearCorrect’s innovative ClearPilot software recently received a boost with new bite jump simulations, enhanced editing features, and a customisable UX that puts the most used features at providers’ fingertips.

The team has also added case collaboration and business development features to its Doctor Portal case management system.

Caroline added: “What’s really great about these systems is that they are both accessible from the mobile Sync app. Together, they represent a trio of powerful clinical and business tools—all through one simple interface.”

ClearCorrect continues to develop its OrthoCampus online learning resource, which provides training for clinicians at all skill levels.

Outside the digital sphere, the aligner has also been given additional features to make it even more effective for treating complex cases. New features like posterior bite ramps, engager templates, and extended bevelled edges all improve precision in handling challenging tooth movements.

Caroline concluded, “We know dental practices can be busy places. With Sync and other digital innovations, ClearCorrect has proved that more streamlined and less

time-consuming processes can improve quality and patient care.

“With Sync, ClearCorrect continues to advance in supporting dental practices in achieving truly seamless digital workflows, meeting teams’ and patients’ evolving expectations, and ultimately doing their best work.”

Get started with ClearCorrect

If you’re considering starting with clear aligners or have completed a small number of cases and want to progress to the next level, ClearCorrect Level-1 accreditation is the ideal starting point.

With 90 days of online and in-person lectures, hands-on learning, mentoring and peer review, accreditation gives clinicians the skills and confidence to start.

Training also includes three free ClearCorrect cases.

To learn more about ClearCorrect digital workflows, accreditation, and becoming a provider, visit clearcorrect-uk.com 

Let’s mix up the learning!

How each of us receives and processes information is a relatively new concept. For centuries the accepted standard was the all-knowing teacher imparting wisdom to a largely ambivalent classroom of blank faces. This style of teaching is still often used as the basis for learning but with the welcome consideration and far higher levels of engagement and interaction. I enjoy seeking out these different dimensions for my own dental teaching.

As our working patterns have flexed in all directions, so we learn. Online, in person, self-paced, one-to-one, in a group, traditional workbooks, single sessions, longer courses: it is open season both for the trainer and trainee. My endo training is largely in person, classroom based and spans one- and three-day short courses (through evo endo) – as well as mentoring and supporting newly qualified dentists at the London Deanery.

How we give and receive information is fascinating, with many studies emerging about the different types of learners we all are. Categorisation became popular with learning models such as VARK (published in 1987 by education theorist Neil Fleming). He divided us up into having a visual, auditory, read/writing or kinesthetic learning bias. It was a refreshing revelation after such a deeply embedded history of ‘teacher front and listen’ delivery.

There are many models in the vein of VARK – if you want a steer on which one you are, consider how you might tackle the problem of changing the oil in your car. Do you reach for the glove compartment to read up or do you opt for YouTube to watch how it’s done?

Might you ask a friend or go on an online discussion forum? If you’re going

on holiday, do you buy the Lost Planet guide or do you scroll through images and recommendations on your phone?

Visual learners:

Have a tendency towards charts, graphics and diagrams. They like a highlighter pen and often use symbols instead of words

Auditory learners:

Listen to audio notes, discuss content and concepts, enjoy reading notes aloud, seek peer/group discussions and explanations

read/write learners: Write notes, and then they write more notes! Reorganise existing notes. Convert visual aids such as flowcharts and diagrams into statements

Kinaesthetic learners: Enjoy case studies, like real-life examples, might undertake their own practical experiments, use visual aids Don’t you think we all like certain aspects of each of these styles? I’m not convinced that one strand would be a

success on its own. I much prefer the concept that good teaching combines a banquet of modalities and results in a range of digestible content (forgive the food analogy but, like a buffet, there’s something there for everyone). That way you will resonate with all of your students at different frequencies (depending on how they like to learn) but the end result is more interesting, dynamic and attention-grabbing in its varietal style. Unless you are offering one-to-one personal development sessions, a mixed format is the way forward!

A training course with some direct delivery – speaking and explaining, supported with high quality slides and some video will have a good chance of hitting the mark. If you add in some hands-on, ‘have a go’ practical sessions, this will cement the theory. Some further one-to-one conversations, questions and guidance takes the understanding to a much higher level. Providing good course materials for note-taking and later reference is another box ticked. The combination of all four will undoubtedly do more than a straight lecture-style delivery.

Too many stars?

Iblame Spinal Tap. As good a start to a piece as any, it may even help to get me a 6-star review. This is Spinal Tap is the mockumentary featuring the titular heavy rock band who had their amplifiers recalibrated so they could be turned up to 11, making them, in terms of their heavy logic, the loudest band in the world. This is about 5-star reviews, their potential problems, and how to deal with them.

We all love praise, and we all want to be thanked. It helps make us human. But there is a difference between the warm feeling of pride from a job well done coupled with the genuine thanks of a patient, and the manipulative process of ‘5-star persuasion’. Call me a cynic – and you would be right – but I am suspicious of yet another ‘sure-fire’ marketing ploy, and wary of embracing superlatives. My main reason is that the peddlers of the ‘new big thing’ have usually moved on to something else before the wheels start to fall off. There is nothing wrong with genuine feedback and reviews, but I question the point of everything having to be superlative. I see it as the drift of professional, relationship care towards a transactional and retail model. If there is no space for the less than perfect in your life, how on Earth can you ever learn? How will you grow, set yourself standards and improve on them year after year?

I design training to cover all four learning styles and aim to include lots of short bursts of each of the VARK pillars, especially with the hands-on sessions. We have invested in lots of equipment because putting the theory to the test is one of the best ways I’ve seen delegates gain skills… and make mistakes, too – which is just as important. I enjoy being honest with delegates about the errors I made as a young dentist when we’re combining practicals and theory – and the lessons we can take from these.

However you teach, or learn, one thing is certain: if the person taking the course knows their stuff, is passionate about passing on knowledge, and likes to combine the theory with the practical – and the student is a keen, eager sponge – aspirational and curious, you are more than halfway there. I find that a student body that asks good questions, as a result of their environment, is a barometer of engagement and also creates an energetic place of learning for themselves – and 100% for me, too. 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.

Clients now panic if they get a less-than-perfect online review. My response is, “Don’t panic, respond fairly and firmly, don’t get involved in a handbag swinging row, try to see things from the other person’s point of view, and ask yourself two questions: ‘Did we overpromise and under deliver?’ and ‘Why is there a gap between perception and reality?’”

I remember looking at the Finest Dental websites in early 2020 and wondering about the truth of all their 5-star reviews. This was just before the news of their decision to cease trading hit – news that was then overwhelmed, but not forgotten, by the pandemic.

All of us are the recipients of feedback requests. It’s become a fact of life. However, I seem to run into the sort of trouble that has dogged me since I learned to talk. I am perceived as a troublemaker, either because I see better ways of doing things or I am openly honest. Or usually both.

After a recent online purchase, I was asked for my post-transaction opinion. As always, I tried to avoid hyperbole and gave some of the long list of questions scores of four out of five. 80%, in my mind, is pretty passable but I was then asked why I had only scored the service/product four from a possible five. Had I somehow damaged the algorithm by dragging the average down to circa 90%?

Digging deeper, I have discovered that it is quite straightforward to buy affordable online reviews (5-star of course), thus devaluing the entire process and making me question the whole palaver. The firms that supply them all assure me that they have 5-star reviews from their clients, so it must be good for business. Their business, but not necessarily yours. n

Utilising dental therapists for the benefit of patients and dentists alike

Fiona Sloss

, Dental Therapist at Clyde Munro Dental Group,

discusses what the role means to her and how dental therapy skills can be better utilised within the practice

Istarted working as a Dental Nurse when I was 19 years old, but I wanted to be more hands-on and involved with patient care. I took the online access to higher education diploma and was later accepted by the University of Sheffield to study hygiene and therapy when I was about 21. It was a fantastic course and I couldn’t recommend it enough – there was a practical approach with a lot of emphasis on therapy and we were trained alongside dentists.

I studied during Covid, which brought its own challenges. We could only see a limited number of patients each week, which delayed graduation. I was therefore pleased to find a job in a great practice, which later joined the Clyde Munro group. It meant moving to a small Scottish town, which might not have been the easiest relocation, but my practice colleagues helped me find an Airbnb until I could purchase my own place which was amazing. My family is Scottish so I have spent much time here, and I can’t speak highly enough of the country and the people.

What do you enjoy most about the dental therapist role?

Definitely the patient interaction! I enjoy getting to prevent problems, while also being able to help people out of problems that have already occurred. Seeing patients leave the practice happier than when they arrived is the best.

I also really enjoy the restorative work and in future would like to focus more on the cosmetic side. Between Direct Access and potential incoming changes to the dental hygienist/therapist’s prescribing rights, there are many things we can do – and even more we will be able to do – in these areas.

How important is the role of dental therapist in practice?

For patients, the dental therapist can help shorten wait times for treatment. My scope of practice is smaller than a dentist’s, but that means I focus specifically on the procedures I do offer. I also usually have more time in appointments to dedicate to prevention and patient education, which is essential for their current and future oral health. Especially when it comes to children, I find I am able to send more time with them than a dentist feasibly could.

From the practice’s perspective, my role as a dental therapist allows the dentists to focus on more advanced treatments. One of the dentists I work with likes to concentrate on implants, for example, so I take on more of the restorative work that his patients need to allow him time for this. That’s where I think the dental therapist can be best utilised in practice – working alongside dentists with a special interest in a specific area. However, the ability to share the workload is useful for many practices, especially given that most are fit to bursting with patients right now!

Why do you think dental therapists may be under-utilised across dentistry as a whole?

In many cases, I think dentists aren’t fully aware of what a dental therapist can do. The sooner that dentists understand the dental therapist’s scope, the better. That’s why I believe my university training alongside dentists was so beneficial. Those dentists could see the value of dental therapy for them and their patients from the beginning of their careers.

What can every practice team implement to enhance the benefits of a dental therapist?

Communication is essential. I know that I can speak to a dentist whenever I have a query or want to confirm a course of treatment. This ensures continuity of care for the patient and also shows the dentist which areas I am most confident in. This is important for building their trust in my skills – which is the second most important aspect of utilising the skill mix in the practice.

What is it like working with Clyde Munro?

On a day-to-day basis, the practice hasn’t changed since joining Clyde Munro. It’s good to know that high standards are maintained in order to meet expectations across the group, but our clinic was already in a good place. Clyde Munro has helped me introduce the GBT kit into my work, funding and supporting the change of process this required, which I really appreciated. I have been using this now for over a year and patient feedback is incredible!

What are your thoughts on the Clyde Munro’s Dental Therapist Support Programme?

I’m a big believer in this programme. If it had been available when I started at the practice, I would have raced to get involved. It’s providing a level of support that is just not available elsewhere. To have the support of the dentists in your practice echoed by the group on a wider level means a lot. It also provides a great opportunity to meet other dental therapists and hygienists – we’re often the only dental therapist/hygienist in the practice so being able to connect with more professionals in our position is amazing. In addition, Clyde Munro’s Dental Therapist Programme covers useful clinical topics which enhance the skills of newly qualified professionals or offer a valuable refresher for those who have not had a chance to utilise their therapy skills for some time. It’s all about building competence and confidence.

Any final thoughts?

The more we get used to working as a team, and the sooner all professionals become comfortable working together in this way, the better dentistry will be further down the line. For dentists beginning to

work with a dental therapist, there is going to be a learning curve, but if you don’t start you won’t ever see the benefits. Find out more about Clyde Munro’s innovative Therapist Support Programme at careers.clydemunrodental.com/therapistsupport-programme/ 

Bite Club

The first rules of creating an outstanding patient journey

Training your team to provide each of your patients with an amazing patient journey is vital. Many people do not automatically have the understanding required to ensure that a patient has a positive experience at each point. Below, I have set out some top tips for delivering that journey:

Second Rule: Online discovery

How are our patients finding us?

• Website optimisation: Ensure your practice website is user friendly, informative, and mobile responsive. Provide essential information about your services, team, and location.

• Search Engine Optimisation (SEO): Optimise your website for search engines to increase visibility. High-quality content, relevant keywords, and proper metadata are crucial.

• Online Reviews: Encourage satisfied patients to leave positive reviews on platforms like Google, Facebook, or a specific platform.

Third Rule: Research and consideration

• Content Marketing: Create informative content related to dental health, treatments, and patient testimonials.

• Online Scheduling: Implement an online appointment booking system for convenience.

• Virtual Consultations: Offer remote consultations for initial discussions and assessments.

• Dive deeper into research and consideration after discovering your website.

• Decide on a strategy.

Fourth Rule: Initial contact

Discuss how potential patients make contact with your practice.

• Quick Response: Ensure prompt responses to enquiries via email, phone calls or chatbots.

• Warm and Welcoming Reception: Create a friendly environment in your practice.

Fifth Rule: First visit

Explore the significant milestone of the first in-person visit.

• Efficient Check-In: Streamline the process with advance forms and online paperwork.

• Comprehensive Examination: Engage patients in discussions about their oral health and treatment options.

Sixth Rule: Treatment planning and education

Highlight the importance of educating patients about treatment options.

• Clear Communication: Explain treatment plans thoroughly and present options to gain informed consent.

• Visual Aids: Use images or diagrams to enhance understanding.

Seventh Rule: Build Lasting Relationships

• Emphasise the need for ongoing engagement and patient satisfaction.

• Encourage repeat visits and referrals. For those diligent readers, you may have noticed that I missed the first rule and, that is because, without effective communication, all of the above will not reach full potential.

First Rule: Communication

• Understanding how to communicate effectively, with verbal and nonverbal skills.

• Be self-aware and ensure that you are communicating in a way that suits the individual patient.

• Seek to understand by using questions

Scottish Dental Show 2024

BADN Honorary President Joan Hatchard and I, together with Jacek our IT & Comms Admin, manned the BADN stand at the Scottish Dental Show at the Braehead Arena in Glasgow on 31 May-1 June – the first time at this show for all of us. Shows are my pet peeve at the moment, with an increasing preponderance of exhibitors who have nothing to do with dentistry. The other is Shows with nothing of interest to dental nurses – amongst either the exhibitors or the speaker programme. Dental nurses are the largest registrant group but at least one organiser is completely ignoring them (on the grounds, I suppose, that they don’t “sign the cheques”, a short-sighted approach, as dental nurses are gatekeepers and influencers). Happily, the organisers of this show are very cognisant of the importance of dental nurses, and had kept the non-dental exhibitors to a minimum. They had also very kindly upgraded BADN from a popup on the edge of the show floor to a full stand next to the GDC – so many thanks! We were also next door

to Bridge2Aid (my Presidential charity when I was Pres of Blackpool Soroptimists), with whom we are planning to collaborate in the future. An article on their work in Tanzania and Malawi will appear in the Summer edition of the British Dental Nurses’ Journal. The speaker programme was very wide ranging, covered all the GDC-recommended subjects and much more, including BADN badged presentations by Ilona McKay and Kayleigh Robinson on both days. Other subjects on the programme ranged from an update from the Scottish CDO on dental reform in Scotland, to suicide prevention, via dental hypnosis, forensic odontology, sleep apnoea and immigration law!

Many thanks to the organisers for all their hard work, and for their hospitality! 

to gain the knowledge you need from the patient.

Here is an example of how to reflect, reassure and find a resolution

Mrs. Johnson (Patient): “I’ve been considering dental implants, but have a few concerns. I’m in my late 60s, and I wonder if I’m too old for this procedure. Second, I’ve heard that it can be painful. And finally, I’m concerned about the cost. Can you help me understand better?”

Sarah (Reception): “Hello, Mrs. Johnson. Thank you for reaching out. I can certainly help you. Let’s address each of your concerns one by one:

Age Concerns:

“Mrs Johnson, age is not necessarily a “barrier to getting dental implants. What matters more is your overall health and bone density. We’ll assess your specific case thoroughly.

“Many patients in their 60s and beyond successfully receive dental implants.

Healthy bone structure and good oral hygiene play a crucial role.

“We’ll perform a comprehensive evaluation to determine if you’re a suitable candidate.

Pain Perception:

“I understand your worry about pain.

Dental implant surgery is a minor surgical procedure, and some discomfort is normal.

“However, we use local anesthesia during the procedure to ensure you’re comfortable.

“Most patients report minimal pain afterward, which can be managed with over-the-counter pain relievers.

“Remember, the long-term benefits of dental implants often outweigh any temporary discomfort.

Cost Considerations:

“Dental implants are an investment in your oral health and quality of life.

“While the initial cost may seem higher than other options, implants offer longterm benefits.

“They are durable, look and feel natural, and can last a lifetime with proper care.

“We can discuss payment plans, insurance coverage, and financing options to make it more manageable.

Overall Benefits:

“Dental implants improve chewing function, speech, and aesthetics.

“They prevent bone loss and maintain facial structure.

“Our team will guide you through the entire process, from consultation to postimplant care.”

Mrs. Johnson: “Thank you, Your explanation helps put my mind at ease. I appreciate your thoroughness.”

Sarah: “You’re welcome, Mrs. Johnson. If you have any more questions or would like to proceed with an assessment, I can schedule an appointment. We’re here to support you!”

Of course, not every conversation results in a patient booking an appointment, and there are lots of diversions along the way, that we need to be prepared to manage. Don’t let it be a fluke, train your team to be winners! 

About the author

Lisa Bainham is President at ADAM and practice management coach at Practice Management Matters.

About the author

Pam Swain is Chief Executive of BADN

NEW BORA 2 Iconic reliability

Over its 30-year history, the BORA turbine has continued to reaffirm the quality of its engineering. Its reliability and service life are self-evident. Because of the trust you have placed in it, we wanted to ensure that this legacy continues. The new design of the BORA 2 turbine provides even better performance, whilst retaining the legendary reliability which has characterised previous versions since 1991.

Simplifying the recovery of a prosthetic abutment

A single material for a dual purpose

Often in dentistry, we are forced to make clinical compromises with our patients. In the following case, we have the fracture of an abutment from an old prosthetic and are faced with the decision of either a complete overhaul – for example, a new bridge in the case of a lost abutment – or limit ourselves to simply addressing the emergency. Functional and aesthetic needs require us to act quickly, so simplifying procedures, minimising the number and duration of each step, is an objective that must always be sought in daily practice. At the same time, the materials used to handle restorative-prosthetic cases of this type must guarantee the highest performance possible in the hands of the general dentist and not only in those of the specialist. Ultimately, we must meet the expectations of patients in terms of speed of execution, final aesthetics and longevity of the work while ensuring that the clinician has easy-to-use materials that provide reliable results.

In the case described below, the patient came to my attention after losing the prosthetic crown of tooth 1.1 combined with tooth 2.1 due to a fracture of the respective abutment (Fig. 1).

Given the urgency of the situation, and the resulting aesthetic impact, it was decided to endodontically retreat tooth 1.1 and to reconstruct it with a fibre post. This way, a prosthetic preparation could be created and the patient could be discharged with a temporary crown until a later date, when we could establish a definitive treatment plan for teeth 11-21, which were previously prosthetically joined. Given the juxtagingival position of the margin, before performing each operative act, the treatment site is isolated by drilling the rubber dam at tooth 1.1 only. This will allow clam 212 to apicalise soft tissue as much as possible (Fig. 2).

After removing the coronal seal applied by the endodontist, the excess root canal

filling material is removed (Fig. 3). Once the canal has been cleaned, the little residual enamel is etched with phosphoric acid (selective etching) for 15 seconds (Fig. 4).

The tooth is rinsed and dried properly. A universal adhesive system is then applied and rubbed onto the application site with a microbrush for 20 seconds (Fig. 5).

After curing the adhesive (Fig. 6), we select a fibre post that best fits the anatomy of the canal. Next, we cement the post and reconstruct the abutment with the same dual-cure composite. The material is first extruded through a dedicated dispenser to the mouth of the canal (Fig. 7).

Taking advantage of the self-levelling characteristic of the flowable composite, the post is inserted into the tooth canal while taking care not to incorporate bubbles. It is then held in position for a few seconds in order to compensate for the hydrostatic pressure that develops.

After waiting approximately one to two minutes, the shrinkage stress is reduced and the self-curing feature is activated. The composite resin is then light cured for 20-40 seconds (Fig. 8).

A matrix is inserted so that the abutment can be formed and reconstructed easily and quickly (Fig. 9). While the restorative material is extruded from the dispenser, a millimetre periodontal probe is utilised. The flowable composite is applied in 4mm increments so that the final shape of the abutment may be anticipated while reducing the duration of the next preparation step. Additionally, this ensures complete lightcuring of each increment without waiting for further conversion of the dual material.

The matrix is then finally slightly overfilled, which completes the restoration phase. The newly formed restoration is then allowed to completely self-cure for approximately five minutes before removing the matrix and rubber dam. At this point, the dentinlike consistency makes the prosthetic preparation of tooth 1.1 quick and easy (Fig. 10), and the tooth is ready to receive a temporary crown.

conclusions

Modern dentistry enables us to respond quickly and efficiently to patient requests. Aesthetic denstistry, in particular, require us to immediately rectify situations such as the one shown, without sacrificing the main requirement for long-lasting work: quality.

Having the ability to rebuild a prosthetic abutment in only a few minutes allows the clinician to spend more time performing other procedures (i.e. finishing the preparation) at the time of treatment as opposed to waiting until a second appointment. The consistency of the core composite used in this case is very similar to dentin due to the presence of zirconium dioxide. This makes the preparation phase of the abutment extremely easy. The fluidity and smoothness allows for easy cementation of root canal posts without forming bubbles or microgaps. This is particularly relevant at the tooth-restoration interface, which is often the critical portion of the restoration itself and could lead to early failure.

The dual polymerisation allows a complete conversion of the material in a few minutes, which is especially beneficial in areas that are difficult to reach by the curing light, such as within the post space. Also, the high radiopacity is ideal to perform radiographic checks and detect any errors before proceeding with the finalisation of the prosthetic case. These characteristics, together with the mechanical properties of the material, encourage its use and make it a reliable choice when handling singleappointment cases like this one. n

the

about

author alessandro colella, dds, Bari italy

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Navigating the Election Countdown

Catherine Rutland assesses the election for dentistry

In May, Rishi Sunak fired the starting gun on the election campaign by calling a snap election on the fourth of July. The announcement of a summer election took many by surprise, raising questions on what the next few months hold, and what we should be paying attention to, to ensure dentistry is prioritised in policy as we step into the next parliamentary term.

Across the political spectrum, we’ve heard ‘grand plans’ to ‘save dentistry’. Preet Gill, the Shadow Minister responsible for dentistry, emphasised that the “future of NHS dentistry will be on the ballot paper” at the next election. It’s clear dentistry is firmly on the agenda, but remains misunderstood. While new legislation is now on hold, the manifesto published in June reaffirmed Labour’s commitments to offer incentives to attract new dentists to underserved areas, introduce supervised toothbrushing for young children and reform the dental contract. The Conservative manifesto largely echoed these pledges and reiterated commitments made in the party’s Dental Recovery Plan, including ‘golden hellos’ for incoming dentists and expanding toothbrushing schemes for children. The Liberal Democrat manifesto committed much of the same – a focus on NHS care and supervised toothbrushing schemes. The increased political attention to the issues being felt across the dental sector is welcome. However, I remain concerned that a deeper understanding is needed on the sector’s complexities to ensure that reforms deliver on improving access to services, supporting the workforce and promoting preventative dental care.

As I write this, Parliament is currently dissolved, meaning former MPs are now once again prospective parliamentary candidates (PPCs), and though they can still engage with constituents and businesses, their focus will largely be on campaigning. No new legislation can be passed during the preelection period, though the ongoing consultations on overseas registration and NHS tie-in proposals will continue, albeit with limited publicity. The extent to which a new Government will adopt the consultation responses and recommendations remains uncertain. Given the scale of the crisis in access to dental care, it’s unlikely that dentistry will fall off the political agenda, especially in areas where access to dentistry is particularly poor. On the doorstep, PPCs will have heard that access to dental care is a leading issue for their constituents. Through the manifestos, we have a clearer view of the ambitions each major party have to tackle this crisis, and how these might measure up to what is needed in

order to have a tangible impact on the oral health of the nation. During this time, and after the election, dentists are in a unique position to engage with their local parliamentarians, sharing their experiences of the challenges facing dentistry so that MPs can comprehensively address the issues their electorate are facing.

At Denplan, we are proud to be the representative voice for our 6,700 member dentists, leading the conversation around the vital role of mixed and private practice in ensuring accessible dental care. Over the last six months, we have engaged with MPs from all parties to advocate for policies that will have a tangible impact on the daily lives of our members and patients, and the wider dental industry. Although some of these meetings have been postponed until after the election, we look forward to collaborating with the incoming cohort of parliamentarians, equipping them with the resources needed to drive policies that secure a sustainable dental landscape in the UK. 

About the author

Catherine Rutland, Clinical Director at Denplan and Simplyhealth.

Perfectly coordinated products with easy and efficient application for safe and aesthetic results – that is the SHOFU X-Factor, for the added plus in your daily practice.

For further information, please contact the SHOFU office 01732 783580 or sales@shofu.co.uk

‘And the winners are’ - Part Two

The

Probe proudly presents The 2024 Dental Awards

The 2024 Dental Awards marks the 26th edition of this prestigious event that, for more than quarter of a century, has sought to recognise the outstanding individuals and teams whose dedication and drive continues to raise standards throughout the UK dentistry profession. Winning or becoming a finalist in the Dental Awards is a tremendous accolade that provides a significant boost to the profile of a practice. Not only is the event an opportunity to share in the happiness and success

Front of house /

receptionist

winner: trudy horne, dorset dental Clinic, Poole

of those who win an award, but it offers the chance to see what fellow dental professionals are doing across the United Kingdom.

The Dental Awards presentation, which streamed on the-probe.co.uk, as well as on The Probe’s Youtube channel, is available to watch on-demand now. Scan the QR code (below) to see the winners of The Dental Awards 2024 react to their victories, as well as to discover who was named a finalist in each of the 12 hotly contested categories.

Trudy truly embodies what it means to be the face of the practice. Her calm, authoritative yet kind manner enables her to support nervous patients, negotiate with difficult customers, and develop a positive team environment. This has led to Trudy being well-liked by patients and highly respected by colleagues.

highly Commended: shauna Church, Inspired dental Care, exeter

Finalists: Mary holroyd, shiraz endo, solihull

Kelly Bird, all saints dental Clinic, Kings heath

Practice Manager

winner: amanda reast, the dental architect, leeds

Amanda regularly goes above and beyond for her practice. With more than 30 years’ experience of the profession, she spends her time across multiple sites and consequently no one day is alike.

highly Commended: alex Mcwhirter, north Cardiff dental, Cardiff

Finalists: Fiona Mchugh, dorset dental Clinic, Poole

simona Pacuraru, all saints dental Clinic, Kings heath

Brittany Pittham, Inspired dental Care, exeter

national smile Month

winner: Community dental services CIC - Oral health Improvement team

With a team of 13 covering five counties, Colworth House’ ‘Brush for Better Health’ National Smile Month campaign was inspired. Promoting National Smile Month at 21 different events. By linking in with Library Rhyme Time session, Baby groups and various pop-up events, the team managed to train over 5,200 people directly and impact a further 13,500 people indirectly.

The Dental Awards 2024 is brought to you by B.A. International, Colosseum Dental, Dental Elite, and Waterpik, in association with The Association of Dental Administrators and Practice Managers, British Association of Dental Nurses, British Association of Dental Therapists, British Society of Dental Hygiene and Therapy, and The Oral Health Foundation.

For more, visit https://the-probe.co.uk/awards/thedental-awards-2024/

to see the full list of our winners, highly commended, and finalists, and to watch the 2024 dental awards Presentation, scan the Qr code or visit:

https://the-probe.co.uk/awards/the-dental-awards-2024/

trudy horne

amanda reast

team of the Year

winner: Glenhaven dental, Cardiff

The team at this family run, multi-generational practice are an inspiration. The judges said that their entry was beautifully presented and that the team focus was clearly apparent, as was a holistic approach to care for patients as well as the wider community.

highly Commended: smile stories, Bournemouth

Finalists: dorset dental Clinic, Poole

Cheadle hulme dental and Cosmetics, Manchester

stradbrook dental, tonbridge

Practice

winner: smile together dental CIC, Bodmin

The judges were extremely impressed by the unique way in which Smile Together CIC works, its ethos and its team dynamic. Being one of the South West’s largest NHS referral and emergency dental care providers, it partners with NHS Cornwall and the Isles of Scilly Integrated Care Board to provide emergency dental treatment for people who don’t have their own dentist. This numbered over 32,000 appointments last year alone. The practice is run as an employee-owned community interest company that reinvests profits into improving patient facilities. Reinvesting over £7 million since 2016, Smile Together was also the first UK dental practice to achieve B corporation certification in 2022.

highly Commended: dorset dental Clinic, Poole

Finalists: Glenhaven dental, Cardiff

north Cardiff dental, Cardiff

drMr Clinic, london

website / digital Campaign

winner: Cheadle hulme dental and Cosmetics, Manchester

The judges described the look and feel of the Cheadle Hulme website as extremely animated. Not only does it contain all the essential information that a dental website needs to present, it also guides potential patients around the practice premises so they can be familiar with the environment when they visit helping to allay any concerns.

highlyCommended: {my}dentist, Kearsley

Finalists: Inspired dental Care, exeter

Meliora dental, leeds

drMr Clinic, london

Best Outreach or Charity Initiative

winner: Keepstokesmiling

The judges described the KeepStokeSmiling outreach campaign as a breath of fresh air. Originally conceived in 2018, they not only target an audience in need, but reach an entire community in all its diversities, whether vulnerable or otherwise. Continually promoting the importance of good oral health, a real benefit has been achieved in both changing habits and increased awareness.

highlyCommended: avan Mohammed, Queen’s Gate Orthodontics – teddy dentists

Finalists: liz Matthews, langmans dental health Centre smile together dental CIC

Community dental services CIC

Glenhaven d ental

s mile together d enta

Ensuring safety and trust in dental practices

The DentaPure Cartridge Solution

The hidden dangers in dental unit waterlines

In the dental profession, unseen threats can significantly impact patient safety, staff wellbeing and the overall reputation of a practice. One such hidden danger lurks in dental unit waterlines (DUWLs), where the narrow width, extensive length and consistently moist environment create a perfect breeding ground for microorganisms. These microorganisms form microbial organisms, which adhere to the walls of waterlines and pose a serious risk if not properly managed. Despite their invisibility, the consequences of microbial contamination are very real and demand immediate attention.

Microbial

contamination risks

Water flowing through contaminated DUWLs can carry microbial fragments out through dental instruments like air/water syringes and high-speed handpieces, potentially

streamlined and effective solution to this problem. By simplifying the waterline treatment process to an annual routine, DentaPure eliminates the need for routine shocking protocols and continuous monitoring. Designed to be used with either Independent Water Bottles or Municipal Water Lines, the cartridge is free from harsh chemicals and silver, and won’t interfere with dental materials and bonding 1. It employs elemental iodine (I2) to control bacterial growth as water passes through, ensuring safety for up to 365 days. Remarkably, the DentaPure Cartridge is EPA registered to provide ≤10 CFU/mL, significantly below the safe drinking water standard of 500 CFU/mL. This recent change from the previous statement of ≤200 CFU/mL is a significant enhancement in ensuring water safety far beyond the regulatory requirements.

exposing patients and staff to harmful bacteria. This exposure not only threatens health, but can also tarnish a practice’s reputation. The Environmental Protection Agency (EPA) sets the standard for safe drinking water at ≤500 colony-forming units per milliliter (CFU/mL). However, adhering to this standard by merely using source water with <500 CFU/mL does not suffice if microbial contamination within the waterlines is not controlled.

The challenge of traditional methods

Chemical germicides are necessary to remove or inactivate microbial growth, but traditional methods such as shocking protocols and daily tablets can be both costly and timeconsuming. These methods require diligent attention and can lead to issues like the build-up of tablet residues, which may block narrow passageways and necessitate frequent service technician visits. Thus, dental practices are faced with a pressing question: how can they effectively treat DUWLs to minimise microbial growth without incurring excessive costs and labor?

The DentaPure Cartridge solution

The DentaPure Cartridge offers a

How DentaPure works: iodine facts

The DentaPure Cartridge contains iodinated resin beads. During a typical treatment, the resin beads release 2-6 ppm of elemental iodine (I2) into the water passing through the cartridge. The elemental iodine interacts with the bacteria in the water, controlling it effectively. Contrary to common misconceptions, iodine is not an allergen 2, it is a normal trace element present in the human body, essential to produce thyroid hormone and involved in normal metabolism. It is not the iodine that is the source of allergies, but rather a protein present in the specific food that is the source of the allergy 3 Hence, the use of iodine in DentaPure is both safe and effective.

Installation and maintenance: ensuring safety and reliability

The DentaPure Cartridge simplifies the complex task of dental unit waterline maintenance, making it easier to ensure safe and reliable water quality. Before installing the DentaPure Cartridge, it is recommended to perform a shocking protocol to thoroughly clean the waterlines. This step should never be done through a functional or depleted

cartridge; this is why it is performed only once. After installation and to ensure the performance of the DentaPure Cartridge, it is essential to follow a simple monitoring and maintenance routine, starting each day with a two-minute flush of every line to ensure that the iodine is evenly distributed and active. For practices using water bottles, it is recommended to empty the water nightly, dry the bottles upside down or return them to the manifold and follow the bottle manufacturer’s cleaning protocol. Then, each morning, refill the bottles with potable water for starting a new day of patient care. For accurate tracking of water quantity run, dental offices can use the practical Water Usage Chart. By adhering to these best practices of installation and maintenance, dental practices can confidently protect their patients and staff from potential waterborne contaminants.

Iodine testing approaching the end of cartridge life

As the cartridge nears the end of its life, utilising SenSafe Iodine Test Strips can help verify its performance. To maintain effectiveness, it is recommended to check the iodine level at 11 months or when approaching 240 liters of water usage. Ensuring the iodine output has not fallen below 0.5 ppm is crucial,

DentaPure™ Municipal Cartridge DPI365M

particularly for busy practices. If the iodine parts per million (ppm) reads below 0.5, replacing the cartridge is necessary. If the ppm reads 0.5 or greater, continuing normal use for another week and then re-checking levels is advised. These regular checks are key to maintaining optimal water quality and ensuring patient safety.

Conclusion

The DentaPure Cartridge addresses a critical need in dental practice management by providing a safe, effective and simple method to control microbial contamination in DUWLs. Its ability to maintain water quality well below regulatory standards with just an annual installation makes it an invaluable tool for any dental practice committed to ensuring the highest standards of patient care and safety. By reducing the potential for human error and the burden of continuous maintenance, DentaPure revolutionises waterline treatment. Dental professionals can have confidence that their waterlines remain safe, protecting both their patients and their practice’s reputation with minimal effort.

For more information about DentaPure Cartridge and the guidelines for installation, visit the dedicated page: hufriedygroup.eu/dental-unit-waterlines 

References

1. Puttaiah R. Effects of Low Grade Iodine in Dental Unit Waterlines On Shear Bond Strength of a Dentin Bonding Agent, Baylor College of Dentistry

2. Schabelman E., Witting M. The relationship of radiocontrast, iodine, and seafood allergies:a medical myth exposed, J Emerg Med. 2010 Nov; 39(5):701-7. doi: 10.1016/j. jemermed. 2009.10.014. Epub 2010 Jan 4.

3. Huang S. Seafood and Iodine: An analysis of a medical myth. Allergy and Asthma Proc 2005;26:468-9.

All company and product names are trademarks of Hu-Friedy Mfg. Co. LLC, its affiliates or related companies, unless otherwise noted.

The Power of Visual Communication

Aims

The aim of this article is to highlight the importance of taking intra-oral images to enhance patient engagement, improve their understanding of dental conditions, and facilitate more effective two-way communication.

Objectives:

• Demonstrate how intra-oral images can bridge the communication gap between dentists and patients by providing clear visual representations of dental conditions, treatment progress, and expected outcomes.

• Show how intra-oral camera’s are effective educational tools that help patients better understand their oral health status.

• Explain how visual evidence from intra-oral images can increase patient engagement in their treatment plans and build trust in their dental care providers.

• Highlight the role of intra-oral images in aiding dentists to make more accurate diagnoses, plan effective treatments, and monitor the progression of dental conditions with greater precision.

Learning Outcome: A, D

Enhancing Patient-Professional Communication

Effective communication between dental professionals and patients is fundamental to achieving optimal oral health outcomes. The intra-oral camera (IOC) stands out as a revolutionary tool in this regard, transforming traditional verbal methods of oral hygiene advice (OHA), to powerful visual interpretation that allows your patients greater

understanding resulting in more effective, two-way communication. This article explores how the C50 Intra-oral camera by Acteon®, enhances patient engagement and compliance, ultimately leading to better oral health and patient relationships.

The Importance of Effective Oral Hygiene Advice Studies have shown that effective

delivery of OHA, combined with professional mechanical plaque removal (PMPR), significantly reduces gingival inflammation however, patient compliance remains a challenge. One key issue is the discrepancy between what dental professionals advise and what patients remember. Typically, OHA is provided verbally or occasionally via written leaflets, which can be impersonal and less effective in motivating

behaviour change. Personalising these interactions is crucial, as further emphasised by recent UK guidelines on managing periodontal diseases. The C50 intraoral camera by Acteon addresses these challenges by providing a personalised and engaging way to deliver OHA and information about dental conditions such as caries. Its high-definition, crystal clear images enable patients to see the exact

condition of their oral health, making it easier for them to understand and follow professional advice. A study by Reissmann et al. (2019) found that patients who were shown intraoral images felt more informed and involved in their treatment decisions. This transparency reduces anxiety and fosters a sense of control and confidence in the dental care process.

A pilot study to evaluate the impact of digital imaging on the delivery of oral hygiene instruction at Bristol Dental University *Journal of Dentistry 118 (2022) 104053 with the aim to determine whether personalised Oral Hygiene Advice (OHA) using an intraoral-camera (IOC) combined with standard OHA as provided in general dental practice reduces plaque levels after 4 weeks more than the provision of standard OHA, concluded that: the use of IOC further personalises the prevailing standard of oral hygiene advice and generates greater patient

CPD Questions

1. According to a study in the ‘Journal of Clinical and Diagnostic Research’ What is the use of intra-oral cameras associated with?

a) Better periodontal health

b) Higher case acceptance rates

c) Better Patient notes

2. What remains a challenge in significantly reducing gingival inflammation after OHA and PMPR is carried out?

a) Patient compliance

b) Lack of oral health leaflets

c) Nothing, these two methods alone should result in successful outcomes.

3. What was the conclusion of the pilot study carried out at Bristol Dental University?

a) No change was evident

b) Moderate plaque reduction and improved gingival health.

c) Significant plaque reduction and improved gingival health.

4. According to a study by Reissmann et al. (2019), how do patients who have been shown their intra-oral images feel?

a) More informed and involved in their treatment decisions

b) More confident about the suggested treatment

c) More motivated

engagement with pictorial reports to facilitate a more in-depth patient explanation of their gingival health, resulting in significant plaque reduction and improved gingival health compared to the standard OHA alone.

Increasing Patient Engagement and Compliance

According to a study in the ‘Journal of Clinical and Diagnostic Research’, the use of intra-oral cameras was associated with higher case acceptance rates.

The ability of the C50 to capture and display high-quality images in real time, significantly boosts patient engagement and compliance of the treatment plan because they can see the evidence for themselves, making the dental professional’s recommendation more compelling and trustworthy. Visual aids are powerful in helping patients grasp the importance of oral hygiene and the implications of neglecting it. When patients can see the before-and-after images of their treatment, they are more likely to appreciate the cost and the benefits of adhering to OHA for long term oral health.

Seamless Integration

The C50 integrates seamlessly into existing practice management

software systems so images can be stored direct in the patients record. The user-friendly design allows dental professionals to quickly switch between the different modes: Cario, Perio and daylight and capture pictures effortlessly. Ease of use means the full patient chart can also be captured in images and saved in minimal time, facilitating superior patient notes and precise followup details, for better continuity of care. Tailored Patient reports can be created and given to the Patient to take home, further deepening their understanding of the treatment plan or OHA, or sent to a referral dental professional, allowing them to visualise the referring notes ahead of seeing the Patient.

Conclusion

An Intra-oral camera is more than just a diagnostic tool, it is a bridge between dental professionals and their patients, enhancing communication and understanding by providing clear, detailed visual evidence of oral health conditions, patients are empowered to take charge, leading to better compliance and improved oral health that can last a lifetime. As dental practices continue to adopt innovative technologies like the C50, the future of patient-centred dental care looks promising. n

Building confidence to practise with clinical freedom

The move from foundation dentist (FD) to associate can be daunting for professionals, so finding a supportive environment in which to take this step is crucial.

Dr Pooja Gupta is currently benefiting from the FD+1 programme available through Rodericks Dental Partners. This unique programme is designed to deliver valuable support for clinicians as they transition from FD into an associate role. Individuals gain access to on-going educational events for further skill consolidation and development, as well as being part of an extensive network of colleagues for reassurance and motivation.

Specifically, the year-long scheme offers hands-on teaching that covers a range of topics from restorative dentistry to endodontics, clinical photography, composite bonding and oral surgery. Sessions are run by highly experienced clinicians and focus on the practical application of skills in real-life practice. All FD+1s are also assigned a dedicated Clinical Support Lead who will hold regular meetings and drop-in sessions to discuss their progress in detail and offer bespoke guidance. The entire programme is geared towards building dentists’ competence and confidence, so they can always safely and effectively put their patients’ best interests first.

Reflecting on the greatest appeals of the programme for her, Pooja comments:

“I chose to join Rodericks Dental Partners on the FD+1 programme because I felt comfort in knowing that I could get advice and up-skill through the study days provided. The programme provides the support of having a clinical mentor to turn to, as well as the ability to utilise further CPD opportunities and gain further skills.”

Reflecting on what she has found most valuable, Pooja says:

“I have really enjoyed the opportunity to access practical study days to improve my skills and knowledge in a useful way. This has helped ease the transition from FD to associate. The knowledge that I have someone to message when I am unsure or would like a second opinion has been very reassuring. This is invaluable for all new dentists. The ability to contact other clinicians and discuss treatment plans nurtures a community feel and ensures continuous mentorship opportunities.

“Overall, the FD+1 programme has allowed me to grow my confidence and skills within a safe environment and has provided me with opportunities which I would not otherwise have been able to access.”

Aside from the FD+1 programme, Rodericks Dental Partners strives to create a positive, supportive and motivational environment for all clinicians and dental team members to work. The focus is always on providing excellent patient care, and this requires that dentists have all the necessary skills, equipment and clinical freedom to tailor treatment according to every patient they see. Career progression and professional education are key, so Rodericks Dental Partners ensures these are readily available to all. The group also prioritises communication by regularly engaging with individuals across the organisation and keeping everyone up-to-date with relevant company and industry news. This includes a clinical newsletter that is sent out weekly to all professionals, which helps to foster a supportive and inclusive environment for the whole team.

As a young dentist, Pooja finds these communications particularly helpful in her everyday practice, adding:

“The clinical newsletter is very helpful as it provides opportunities to access further CPD, as well as chances to meet other clinicians.”

Beyond the FD+1, Pooja and her colleagues will have various opportunities available to them to continue their education and broaden their skills with Rodericks Dental Partners. All clinicians retain access to a wide network of professionals throughout the organisation, who provide invaluable clinical, administrative and personal support. For anyone considering their next career move, whether you are just starting out or have 30 years of experience, Rodericks Dental Partners has a place for you. Pooja concludes: “Rodericks Dental Partners is definitely a supportive environment to grow as a clinician, to up-skill and learn. I’d definitely recommend working here.”

To find out more about what it’s like to work with Rodericks Dental Partners and to discuss current vacancies, you can visit rodericksdentalpartners.co.uk/careers n

Sinus augmentation: learning from the masters

Development in sinus augmentation techniques in recent years has been remarkable, and practitioners have to work hard to stay ahead of the curve. Various techniques enable clinicians to build a sound foundation for implant treatment among edentulous patients with impressive success rates. Maxillary sinus augmentation procedures have become increasingly popular before placement of dental implants in posterior maxillae that have suffered severe bone loss due to sinus pneumatization, alveolar bone atrophy, or trauma.

The Association of Dental Implantology (ADI) recently presented a Masterclass on the topic, featuring a number of internationally renowned speakers. Expert speakers gave engaging and informative talks about the latest methods for achieving predictable results.

anatomical considerations to mitigate risk

The event kicked off with a discussion on important anatomical considerations in sinus augmentation. Scientific Director at the Academy of Craniofacial Anatomy (ACA), Dr Gabriele Rosano, outlined the importance of thorough CBCT scanning to mitigate against potentially damaging delicate adjacent structures. Dr Rosano discussed the complexities of managing maxillary sinus wall fenestration, pathological membranes not identifiable by CBCT scan, and the importance of identifying septa height. Finally, Dr Rosano introduced some of the possible complications that must be considered by surgeons due to the extensiveness of the maxillary vascular network.

Predictable reconstruction

Dr Guillermo Escobar Ruiz continued the Masterclass with an excellent introduction to the autogenous bone graft workflow. In his lecture, “Sinus Lift and 3D Bone Reconstruction”, Dr Ruiz talked about rebuilding areas affected by 3D bone atrophy using autologous bone – usually from the mandibular ramus. He specified the proper surgical techniques that result in less autologous bone loss, achieving “fully predictable results”.

State of the art sub-crestal sinus augmentation

World-renowned periodontologist, Professor Ziv Mazor, provided historical context of various sinus augmentation techniques, with a particular focus on the benefits of subcrestal sinus floor elevation. Professor Mazor cited the perforation rate ranges in the literature of the lateral approach to the sinus membrane, to give context for the newer techniques discussed in his lecture.

Since 2014, a revolutionary new concept for osteotomy called osseodensification (OD) has been at the forefront of changes in surgical site preparation in implantology. This process requires trabecular bone, and so instrumentation needed to be rethought to prevent fractures that require long remodelling time and delayed secondary implant stability.

Professor Mazor detailed how OD sinus protocols can result in predictable, reproducible results in any ridge, for any implant in any jaw. He showed how he avoids sinus membrane perforation, as well as retention cysts, and referred to some other anomalous cases where these new protocols reduce risks. Professor Mazor ended his enlightening lecture with a call to look out for a new multicentre study coming soon, and highlighted the importance of maintaining a close awareness of clinical research as a practitioner.

Prevention and management of complications

Eminent surgeon, Dr Pascal Valentini, is the President of European Association for Osseointegration (2012-2014), and among many other honours, is a is a Program Director for European Post Graduate Oral Implantology at the University of Corsica (Corte, France) and for the University of Liege in Belgium. Dr Valentini identified the three main techniques for treating an atrophic maxilla with advice on how to avoid complications.

the palatal approach

Dr Radoslaw Jadach is an internationally renowned expert on microsurgery techniques and extensive soft tissue reconstructive surgery for the purpose of alveolar implantology. Dr Jadach concluded the Masterclass with a lecture on the rationale behind palatal approaches to sinus grafts, as well as indications and classifications of use to practitioners.

excellent education for remaining at the forefront of the field

The ADI is the UK’s independent network for implant dentistry, which connects members to the best minds working in the field today. Through education, mentoring and access to the latest research, members receive support at every stage in their career. Among many other benefits, dentists, dental technicians, dental care professionals and students gain free access to a national programme of ADI study clubs, and over 600 hours of CPD resources.

Rapid advances in technology and protocols associated with procedures like sinus augmentation, require constant updates to the knowledge and expertise of practitioners. There is no better way to remain current in this complex field than to secure membership of a world-class organisation. Doing so not only provides you with access to a network of likeminded and knowledgeable peers, but enables you to remain at the forefront of your practice.

For more information, please visit www.adi.org.uk 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.

Nothing is off limits in The Probe Dental Podcast, so be sure to tune in wherever you get your podcasts! The Probe Dental Podcast features discussions that explore all areas of the British dental sector.

For more information, sponsorship opportunities or to book a podcast please contact

Optimise more than aesthetic outcomes with guided implantology

Dr Chris Leech explores the development and importance of guided implant workflows for achieving exceptional treatment outcomes ahead of his workshop at the highly-anticipated BACD 20th Annual Conference

Dental implantology has developed substantially in recent years. Implants are no longer just placed where there is sufficient bone and prosthetics designed around this. Dr Christopher Leech – Principal of Clear Dentistry in Southampton, Fellow of and Examiner for the Royal College of Surgeons Edinburgh – considers the emerging gold standard approach for implant treatment:

“For a good outcome, never mind an excellent aesthetic result, it is paramount for an implant to be placed in a prostheticallydriven position. This means that the restoring dentist determines the most appropriate implant location, with surgical guides and stents created to ensure that the implant is placed exactly as planned. The result is optimised function, aesthetics and longevity of the restoration.

“Technology and techniques available today make the guided implant workflow a reality for every dentist,” Chris says. “CT/ CBCT scanners and 3D printers are more widely accessible and make it possible. Where inadequate bone volume is identified at the preferred implant site, regenerative techniques like guided bone regeneration (GBR) can also be implemented to facilitate amazing restorative outcomes.”

For those who are new to the guided implant workflow, Chris is confident that it can cost substantially less than you might think: “To implement this modern approach to dental implants, you will need the relevant guided kits and compatible equipment.

The upfront investment required is hugely variable. If you buy a new CT scanner or 3D printer, for example, that will incur significant costs. Guided implant burr and drill kits cost around £1,500. However, if you’re just starting out in the field, then referring your patients for image acquisition and outsourcing guide manufacture to your lab – fees for both will be covered by your patient – will mean your personal investment is £0. Similarly, many manufacturers will provide the kits for free when you purchase the implants, costing you absolutely nothing upfront to try guided surgery.”

Chris goes on to explain some of the many advantages of guided implant surgery:

“Guided implant surgery minimises the risk of surgical complications like iatrogenic trauma to the patient, which reduces stress for the clinician. It makes surgery faster as you have everything planned. In addition, restoration is simpler because you know exactly what kind of access you’ll have for the prosthetic screw, and will be appropriately prepared. The emergence profile created is also optimised, preventing gingival recession and enhancing aesthetic outcomes. What’s more, the prosthesis is more cleansable for the patient, further improving longevity.

“There are monstrous implications for medicolegal protection when using guided surgery as well. If you hit a nerve having not used a guided approach, there is little defence against a complaint. Guided surgery is

becoming increasingly accessible ¬– avoiding it puts you at an unnecessary increased risk.”

Chris will dive into all this and more during his workshop at the upcoming BACD Annual Conference in London this November. Entitled “Guided Implant Placement and Cosmetic Outcomes:

The Perfect Pairing”, the session will give delegates an opportunity to learn the guided workflow and then place an implant in a model themselves to really understand the process. Highlighting what he hopes colleagues will gain from attending, Chris says: “My session will be an introduction to guided implant surgery for beginners, so there are no silly questions. I hope clinicians gain a complete understanding of how they can utilise the workflow to make their lives easier and less stressful, while also improving clinical outcomes. I hope to show how easy it is to access this world, and that you don’t need huge amounts of additional training or money to get started.

“As with any area of dentistry, I would recommend finding a mentor in order to apply these new skills in practice – being at the BACD Annual Conference helps with this too. You will be surrounded by experienced and talented clinicians who

Continuing to raise standards

Everything we do in dentistry is for the benefit of patients. The goal is always to enhance the care delivered, improving clinical outcomes as well as the treatment experience. There are many different elements involved with achieving this. Dental professionals must consider each area in order to continue raising standards across the board and ensure that all patients receive the very best care.

Clinical competence and confidence

One of the most important factors affecting the quality of patient care is the skill of the clinician. Professionals must be adequately trained and confident in delivering whatever procedures they offer to their patients. A practitioner’s clinical education has a direct impact on the success of treatment outcomes and the quality of the patient experience. For example, an Australian study found that students who had performed more extractions demonstrated a statistically significant improvement in academic outcomes. In dental implantology, those with more training have been shown to achieve higher implant survival rates and shorter operating times. With an increase in training also comes greater confidence, which is important for any healthcare practitioner to ensure effective clinical decision-making for their patients. In turn, belief in efficacy of one’s skills further facilitates better treatment results.

Research

For dentists not directly involved with academia, it is important to bridge the gap between practice and research. There is a substantial body of evidence within all dental disciplines, giving clinicians the opportunity to utilise scientifically-backed techniques and materials every day for more predictable outcomes.

To make the most of this research, it’s necessary for clinicians to remain abreast of the latest findings in areas appropriate to their practice. Once aware of new research, it’s then important for clinicians to be able to assess the quality, reliability and clinical relevance of its findings. Everything from the type of paper to its sample size and limitations should be considered. Clinicians can further ensure the highest standards of research inform their practice by drawing independent conclusions rather than relying blindly on the authors’ interpretations.

technology

Perhaps one of the fastest growing areas that has the potential to influence both the quality of dental care delivered and the patient experience, is technology. Solutions today, especially those driven by artificial intelligence, afford several advantages in improving patient communication, understanding and engagement with their oral health for enhanced long-term outcomes. Technologies also exist

that help individuals visualise recommended treatment, increasing treatment acceptance and ensuring that more people get the care they need. From the dentist’s perspective, cutting-edge solutions facilitate diagnostics, guide treatment planning and streamline the entire professional workflow. There are also benefits to be had by the wider dental team, with technologies optimising everything from appointment scheduling to business analytics.

A well-thought-out combination of technology can provide a more predictable and enjoyable treatment journey for patients, as well as greater efficiency and productivity for dental professionals.

thousands of products, people and learning opportunities

For dentists and teams looking to build upon each of these areas, it’s vital to find platforms that offer the necessary information, advice and guidance. It’s often beneficial to join a professional association or society, as they will provide training, share important research updates and provide a network of like-minded colleagues from which to seek product recommendations. For professionals to further broaden their reach and ensure they are exposed to a dynamic combination of training, research and technology, BDIA Dental Showcase is a must for the diary.

As the largest and longest running dental exhibition in the UK, BDIA Dental Showcase 2025 will return with hundreds of premier

you can ask for advice and seek mentorship from. Colleagues are always welcome to shadow me at my clinic and I’m sure many of my BACD peers would feel the same.”

Aside from an extensive network of like-minded professionals who care passionately about clinical excellence and patient care, the BACD Annual Conference affords many further benefits for all who attend. Chris considered why he feels this is such a fantastic event every year:

“The BACD Annual Conference is synonymous with quality and value. The programme delivers the highest quality of education for your CPD, with outstanding speakers from around the world. When you see how much you get when compared to other independent events, you will also discover the enormous value that this Conference offers. This is provided within a highly supportive network of peers – dentistry can feel insular, especially if you are challenging the status quo or looking to bring about positive chance. Being around like-minded people is mentally beneficial and hugely stimulating as you strive to be the very best clinician you can be.”

Don’t miss the BACD Annual Conference this November and help us celebrate 20 years of success. The Gala Dinner is set to be a stunning affair and the perfect complement to the comprehensive educational programme. Book today! BACD 20th Annual Conference 7-9 november 2024

It’s Our Birthday And We’ll Smile If We Want To! Pre-sale tickets available at bacd.com n

brands across the trade floor. This will be a hub of information and expert insights that dental professionals can utilise to guide critical decisions for their practice development. Exciting product launches and exclusive promotions and discounts, mean that visitors can save money and maximise their investments in themselves and their businesses.

What’s more, all members of the dental team will benefit from face-to-face networking, with the chance to strengthen working relationships across the profession. Seven conference streams, plus the one-of-a-kind hands-on workshops will provide comprehensive education for an enriched learning experience. The programme is also constantly being refreshed and optimised, with the launch of the brand-new ADI Implant Zone and BACD Aesthetics Theatre in 2024, and even more to come in 2025.

Pushing boundaries

No matter how long you have been in dentistry, where your special interests lay or what your future professional goals may be, delivering high-quality patient care will be a priority. Developing clinical skills and confidence, being aware of the latest research and utilising cutting-edge technologies will help you achieve the best results.

BDIA Dental showcase 2025 14th-15th March

exCeL London dentalshowcase.com n

The Perfect Couple

Meet FLEXI & PREVENT Gel

The couple that helps you to achieve even better oral hygiene

FLEXI

• The special FLEXIBLE HANDLE makes it possible to angle the handle to achieve better and easier access to all interdental spaces.

• The non-slip handle ensures good grip even when fingers are wet.

• All brushes have plastic coated wire. This ensures no metal is in direct contact with teeth and gums, thus making them much more comfortable to use and preventing dental injuries.

• 11 sizes ensure that all needs are covered.

TANDEX PREVENT Gel

• Strengthens the enamel and has an anti-bacterial effect.

• 0.12% chlorhexidine and 900 ppm fluoride.

• The consistency combined with the needle shaped tube end make it easy to apply directly on the FLEXI brush and use wherever needed.

• Pleasant taste of peppermint.

• No alcohol or abrasives.

Getting dentistry buzzing: A look back at BDCDS and DTS 2024

Attendees were buzzing with excitement as the British Dental Conference & Dentistry Show (BDCDS) and the Dental Technology Showcase (DTS) 2024 set a new benchmark for excellence and innovation

Reflecting on the monumental buzz and success of the British Dental Conference & Dentistry Show (BDCDS) and the Dental Technology Showcase (DTS) 2024, it is clear that this event was a landmark in the evolution of dental professionalism and innovation.

Held over the 17th and 18th of May at the NEC in Birmingham, the event was buzzing with energy and excitement. Stands were alight with activity, lectures were packed to capacity, and the atmosphere was electric with innovation. It was a vibrant mix of knowledge, expertise, and technological advancement, tailored to enrich every aspect of dentistry.

The event felt incredibly positive, with new organisations entering the market and bringing fresh ideas. The exhibition stands were extraordinarily innovative, featuring music, TV screens, and their own forums, creating an immersive experience that even enticed industry giants like Sony to participate.

This year also saw a broader age range of delegates than ever before, with younger generations exuding excitement and enthusiasm, making the event feel reminiscent of pre-COVID times. The BDCDS and DTS 2024 truly set a new standard for dental events, marking a brave new chapter in the profession’s ongoing evolution.

‘Attending the Dentistry Show was an invaluable opportunity to stay at the forefront of dental innovation, network with industry leaders, and gain insights that can transform the practice and patient care. It’s where passion for dentistry meets cutting-edge advancements.’

Polly Bhambra, Treetops Dental Surgery, Wolverhampton

A brighter future with Bartlett

At the heart of the conference was a live interview featuring Steven Bartlett, the trailblazing entrepreneur known for his profound insights on digital marketing and business growth in the health and wellness sector. Bartlett pulled in people who might not otherwise have attended a conference, creating an incredible sense of community throughout the event.

This talk was deftly navigated by Nilesh Parmar, a figure equally respected in the

dental community for his expertise and visionary approach.

In an unprecedented move, the dialogue between Bartlett and Parmar was opened to the audience well before the event. Parmar, engaging with his peers and the broader dental community, extended an invitation for questions and discussions, fostering a collaborative environment that proved ripe for the exchange of innovative ideas.

‘Interviewing Steven was not only an honour but also a unique chance to bring fresh perspectives to the dental community,’ Parmar remarked, underlining the session’s significance in shaping the future discourse of dental practice and business acumen.

Their discussion, enriched by audience contributions, spanned a variety of pertinent topics, including the future of dentistry, team culture, the psychological aspects of running a practice and much more. Steven’s experience with overcoming challenges and diversifying interests undoubtedly offered critical insights for dentists at all career stages.

This session not only shed light on the path for dental professionals aiming to leverage technology for growth but also highlighted the collective wisdom of the community in addressing the challenges and opportunities presented by the digital age.

A timely discussion

Little had anyone known that less than a week later, a General Election would be called. However, with CloserStill and the British Dental Association’s (BDA) fingers on the pulse as always, Preet Gill, Shadow Health Minister responsible for dentistry, had been added to the lineup for the BDA theatre session, ‘In an election year, what’s the future for dentistry?’

Held on the Friday in the BDA Theatre, the session saw Ms Gill give a speech outlining Labour’s plan to rescue NHS dentistry. She remarked that the future of NHS dentistry will be a topic of significant consideration in the upcoming General Election. Without doubt, her

presence underscored the significance of this event in an election year, elevating the dialogue about the future trajectory of the dental profession.

Ms Gill was directly followed by the BDA panel, chaired by BDA CEO, Martin Woodrow. It was led by BDA Chair, Dr Eddie Crouch, along with other key dental leaders: Dr Shawn Charlwood, Chair of the General Dental Practice Committee (GDPC); Dr Sarah Canavan, Chair of the GDPC Associates Group; Dr Natalie Bradley, Chair of the Young Dentist Committee; and Dr Nadia Ahmed, Chair (2022-2024) of the Central Committee for Hospital Dental Services.

The session provided crucial insights into the current landscape of dentistry and the BDA’s efforts to shape its future.

As the UK now approaches a General Election, the dialogue was particularly pertinent, addressing how the BDA influences dental policy and practice.

Attendees gained valuable knowledge about the challenges and opportunities facing the dental profession, exploring key issues such as the importance of dentistry as an election issue, Labour’s plans for the sector, and emerging trends impacting the field.

With such expert panellists sharing their insights and engaging with the audience,

the event proved to be an indispensable opportunity for understanding the future trajectory of dentistry in the context of the forthcoming election.

A first-class conference programme

Beyond this illuminating exchange, the BDCDS and DTS 2024 stood as a testament to CloserStill’s commitment to providing a comprehensive programme that catered to every professional within the dental sphere.

From students taking their first steps in dentistry to experienced specialists looking to deepen their expertise, the event offered an array of learning opportunities.

Renowned speakers, such as Ben Atkins, Chris Barrow, Prof. Iain Chapple, and Sir Nairn Wilson, shared insights on a wide range of topics. These included dental sleep medicine, AI and the future of dentistry, systemic health, and advancements in dental technology.

Elsewhere, Victoria Sampson’s exploration of the mouth-body connection and the oral microbiome offered groundbreaking perspectives on enhancing patient outcomes through holistic care approaches.

Then there was Paul Tipton’s presentation on treatment options for the bruxist and wear patient, which provided invaluable insights into managing general but sometimes challenging dental conditions, further enriching the conference’s educational offerings.

Additionally, in partnership with key organisations like the BDA, the BDCDS and DTS enriched its programme with both clinical and practical insights, addressing the immediate needs and future aspirations of the dental community.

Pressure-free industry opportunities

The exhibition floor was another highlight, showcasing the latest in dental equipment, technologies, and products.

Over 400 exhibitors provided attendees with a hands-on look at innovations set to elevate the quality of dental care and practice efficiency.

In fact, one of the standout features of the BDCDS and DTS is the incorporation of no-pressure exhibitions, designed to foster an environment of exploration and discovery, free from the high-stakes pressure typically associated with sales environments. Attendees benefit immensely from this relaxed atmosphere, which encourages genuine engagement with the latest innovations and products on the market.

Dental professionals from across the UK and beyond had an unparalleled opportunity to interact directly with representatives from leading companies and startups alike, gaining insights into the cutting-edge technologies and services poised to transform dental practice.

Among the distinguished exhibitors, names such as A-dec, Agilio, Bridge2Aid, DD, Dental Defence Union, EMS, Kent Oral Care, Listerine, Mouth Cancer Foundation, NHS Dental Services, Straumann Group and UCL Eastman Dental Institute stand out.

Each exhibitor brought a unique contribution to the dental field, showcasing everything from advanced dental equipment and patient care products to innovative software solutions and educational resources.

thriving together

Networking opportunities were also plentiful, reinforcing the intrinsic value of face-to-face interactions in forging and strengthening professional connections.

Indeed, the invaluable opportunity for networking at events like the BDCDS and DTS transcends mere professional exchange; it offers a profound sense of camaraderie and community.

In a profession where the pressures and solitude of dental practice can sometimes lead to feelings of isolation, these two events provided a vibrant arena for both social and professional connections. They presented a unique chance for dental professionals to meet peers facing similar challenges, share experiences, and forge new relationships that can enrich both their personal lives and professional endeavours.

This dynamic setting encouraged the exchange of ideas, strategies for overcoming common obstacles, and discussions on advances in dental care, fostering a sense of belonging and mutual support.

Be part of the future of dentistry

As we look back on the BDCDS and DTS 2024, it is evident that these events were more than just conferences and exhibitions. They represented a milestone in the journey of dental excellence, marked by learning, innovation, and community engagement.

And yet, the journey doesn’t end here.

The upcoming Dentistry Show London, set for the 4th and 5th of October 2024 at ExCeL London, beckons with the promise of unveiling the latest concepts in dentistry from both national and international suppliers and speakers, as well as delivering over 100 hours of content aimed at inspiring, informing,

and invigorating the dental community.

In an era of rapidly advancing dental practices, Dentistry Show London stands at the forefront as the next major UK event. The exhibitors represent all aspects of dentistry, including renowned names like Agilio Software, Dental Implant Education Ltd, the GDC, Kent Brushes, Listerine, and MDDUS, plus NHS Dental Services, among many others eager to connect with delegates.

This free-to-attend event celebrates the dynamism and creativity of modern dentistry. With a stellar lineup of speakers and an enticing exhibition, it is an unmissable opportunity to equip practices with cutting-edge dental education, business insights, materials, supplies, and equipment, paving the way for the future of dentistry.

Attendees will have the chance to earn enhanced CPD hours, discover

breakthrough innovations, and build meaningful connections with likeminded professionals. So, whether you are a practice owner or a team member seeking the latest clinical techniques and equipment, or a supplier eager to showcase your innovative products, Dentistry Show London offers something for everyone.

Get ready to spark your excitement for Dentistry Show London 2024! Immerse yourself in the forefront of dental innovation by registering your interest today at london.dentistryshow.co.uk/registerinterest-2024. Stay ahead of the curve with exclusive updates and be among the first to secure your spot when delegate registration goes live. Don’t miss this opportunity to be at the vanguard of dental excellence - act now and make sure you are part of the future of dentistry! 

Using guided surgery for implant placement has become increasingly popular among Implantologists because it offers many benefits for the Clinician and patient.

For patients there is dramatically reduced surgical time, which helps improve patient comfort and reduce their apprehension. Plus, because it utilises flapless surgery it significantly improves the healing process and healing time in the majority of cases. It also minimizes the risk of surgical complications.

For the Implantologist it significantly improves implant placement accuracy, reduces the risk of complications and minimizes chair time leading to greater efficiency and cost savings. The adinguide™ guided surgery system delivers effortless procedures plus accurate

Conventional 1450ppm and above fluoride toothpastes only deliver fluoride for a maximum of 90 minutes, whatever their fluoride content and provided the patient does not rinse. Despite its lower 530ppm fluoride content, Biomin F remains active for up to 12 hours, continuously releasing fluoride to strengthen teeth and protect against decay, even if the patient’s toothbrushing is erratic and inefficient.

Available from Trycare, BioMin F contains tiny bioglass particles made up of fluoro calcium phosphosilicate bioactive glass which bonds to teeth and enters the dentinal tubules, where they gradually dissolve for up to 12 hours, slowly releasing calcium, fluoride and phosphate ions.

and predictable implant placement. Consequently, it delivers everything you need in a guided surgery system.

Unlike other systems which require the use of keys to hold the stent in place, adinguide™ is a keyless system which helps to save surgery time whilst also ensuring accurate and predictable implant placement. It features ActiveFlow™ Irrigation Technology which delivers coolant from the handpiece directly to the surgical site.

To request a catalogue please contact your local representative or call 01274 885544.n

These combine with saliva to form fluorapatite which strengthens teeth, aids effective remineralisation of enamel and provides effective treatment for hypersensitivity.

Patients also report that teeth feel smoother and cleaner, there is a noticeable absence of background oral sensitivity and that gums are healthier and less prone to bleeding.

Contact your local representative or call 01274 885544. n

Alcohol free solutions are safer and kinder to materials. Modern advancements in active raw materials provide top level performance with almost universal compatibility.

The fast acting (60 sec) Bossklein V-WIPE ZERO formulation contains no alcohol and takes advantage of safer and greener chemical components to create a simpler and more effective product. Ideal to use on the majority of wipeable surfaces, including dental chairs. Wipes have a pleasant apple aroma.

The Bossklein Classic wipe substrate is an everyday, all-purpose wipe providing the ultimate value for money. Each wipe measures 200x200mm and each

pack contains 200 ready to use wipes. Available in both economic refill packs and reusable dispenser tubs. All Classic tubs are made from 35% recycled plastic. For more information call 0800 132 373 or visit www.bossklein.com n

Trycare Ltd, the UK’s fastest growing dental dealer, are UK Distributors of Tokuyama Dental’s unique range of spherical composites including Estelite Sigma Quick.

Featuring Tokuyama’s patented RAP monomer and aesthetic spherical filler technology, Estelite Sigma Quick delivers an extended working time in ambient light yet cures in only 10 seconds! There is also less residual monomer and minimal after cure colour change for long term aesthetic satisfaction.

In addition, Estelite Sigma Quick offers miracle shade matching! Because of its unique spherical filler particles it

Discover the ADI Team Congress 2025 entitled “The Implant Aesthetic Kaleidoscope” taking place 1st – 3rd May 2025 at The Brighton Centre.

To match its exciting and colourful title, the Congress aims to highlight the multitude of skills, techniques, and expertise required by a dental implant team, and the way these complementary elements create some truly beautiful results.

Dr Zaki Kanaan, President of the Association of Dental Implantology (ADI), extends a warm welcome to attendees:

“The biennial ADI Team Congress is one of the leading dental implant meetings, not just

here in the United Kingdom but also one of the foremost implant meetings in Europe.

“The ADI Congress is more than a platform for learning; it’s a community coming together to share, connect, and inspire one another. Beyond the educational sessions, join us in Brighton for a Congress that promises growth, inspiration, and fun.

“We are excited to welcome you all and look forward to creating memorable moments together.”

Please visit the website to find out more about the ADI Team Congress 2025. n

Think bigger with the CS 8200 3D Neo Edition from Carestream Dental, a CBCT scanner that boasts nine selectable fields of view, for unbeatable versatility.

Clinicians can utilise the extended field of view to scan the full arch – including third molars – in one scan, or limit exposure to just 4 cm x 4 cm and reduce the dose received by a patient, where it is appropriate.

In fact, the radiation exposure delivered to your patients is minimised with low-dose imaging, which delivers high-quality 3D images at the same or lower dose as a standard panoramic exam. For a 5 cm x 5 cm scan, that can be up to 86% lower, creating safer examinations.

The CS 8200 3D Neo Edition blends

Digital dentistry has changed the face of the profession, transforming the way that many clinicians work. As technology continues to evolve, there are more options available to integrate digital solutions in the practice.

Clark Dental offers an industry-leading portfolio, featuring the CEREC Primescan intraoral scanner, Primemill milling machine, and the Primeprint 3D printer. With this equipment available in the practice, clinicians have the ability to adapt to their patients’ needs, giving them the choice to complete aspects of a digital workflow in-house, and outsource to a dental lab when needed.

Primescan is a fantastic way to start implementing digital dentistry – giving you the ability to produce quality impressions quickly, and confidently – with Primemill and Primeprint enabling you to provide superior chairside manufacturing.

For more information, please get in touch with the team at Clark Dental.

For more information call Clark Dental on 01268 733 146, email info@clarkdental. co.uk or visit the website. n

BRILLIANT EverGlow® composite from COLTENE uses the latest materials science to effortlessly deliver highly aesthetic and durable restorations.

Thanks to submicron glass fillers, BRILLIANT EverGlow® has exceptional polishability, and a long-lasting lustre. The pre-polymerised fillers are perfectly harmonised with the uncured composite to further enhance and support gloss retention.

EverGlow® has a sophisticated shade system and three translucency levels. It can be used for single-shade as well as multishade layered restorations. Low water sorption supports excellent long-term colour stability. Due to its high compressive strength and resistance to masticatory forces, BRILLIANT

offers inherent shade mimicking so that, in most cases, just one shade will blend perfectly with the natural teeth leaving invisible margins and undetectable restorations. These spherical fillers also facilitate outstanding polishability and a lustre that lasts and lasts, allied to high wear resistance and very low abrasion of the opposing teeth. For more information, call Trycare Ltd on 01274 885544 or visit the website.n

CBCT imaging, 3D model scanning and 2D panoramic technology into one unique system.

Additional features such as CS MAR (Metal Artifact Reduction) technology and a low dose scout image mode makes image taking and interpretation even more reliable.

To learn more about the CS 8200 3D Neo Edition, contact the team today.

For more information on Carestream Dental visit the website.

For the latest news and updates, follow us on Facebook and Instagram @ carestreamdental.uk n

EverGlow® is a long-lasting solution, ideal for posterior teeth.

Find out more about the enduring brilliance of EverGlow® from COLTENE today! Email info.uk@coltene.com or call 0800 254 5115 COLTENE loyalty scheme: https://rewards.coltene.com n

Back pain? We have something for itthe Bambach® saddle seat

Back pain is a widespread health problem in our modern world. Did you know that more than 80% of the population suffers from back pain? Some people only occasionally, but more than a third chronically.

This is where the Bambach® Saddle Seat comes into play. With its back-friendly properties, it’s inspiring users in doctors’ and dentists’ surgeries for more than 25 years. Sitting on a “normal” chair forces the spine into an unhealthy posture, which increases the pressure on the intervertebral discs enormously. This causes health issues and pain usually in back, neck, arm, hand or shoulder.

The Bambach® Saddle Seat is different. It supports the pelvis, allowing the spine to assume its natural and healthy “S”-posture.

As a result, the Bambach® Saddle Seat actively prevents an unhealthy (incorrect) sitting posture. It significantly reduces the pressure on the intervertebral discs and spine.

Better posture not only has a positive effect on health, it has been proven to increase productivity and quality of work.

The new BamBasic® has the original Bambach® seat surfaFce but comes at a more affordable price. for more information call 020 8532 5100 or email: ask@fortunabambach.com n

straumann Group puts it comprehensive portfolio on display

Known for supporting clinical excellence across dentistry, Straumann Group demonstrated an array of its industryleading brands at the recent British Dental Conference & Dentistry Show Birmingham.

Implant dentists had an opportunity to discover the different implant systems available, including those from Straumann®, Neodent® and Anthogyr®. With varying features, these solutions afford a spectrum of benefits for different patients and situations.

Clinicians interested in providing predictable aligner treatment were interested to discuss the ClearCorrect® system, which offers an unparalleled level

of customisability and control of tooth movements.

Other brands on display included Medentika® and Dental Wings, showing the breadth of Straumann Group’s comprehensive product portfolio.

Want to find out more? Visit the website today.

For more details, please visit: www.straumann.com n

Hypersensitivity in Minutes with Predicta® Bioactive desensitizer

Predicta® Bioactive Desensitizer by Parkell swiftly alleviates dentin hypersensitivity using natural tooth elements, calcium and phosphate. Upon application, it forms hydroxyapatite plugs in the dentinal tubules and adds a mineralization layer that broadens the seal, protecting painsensing A-delta nerve fibers. Ideal to treat sensitivity from exposed roots after periosurgery, bleaching, scaling, root planing, and gingival recession.

Patients report immediate relief from sensitivity lasting up to six months.

Get your heavily discounted Predicta® Bioactive Desensitizer kit here:

https://europe.parkell.com/predictabioactive-desensitizer-uk-proben

Clark Dental supplies the Heliodent Plus from Dentsply Sirona. This intraoral imaging system generator, supports and elevates your intraoral care and allows for optimum functionality.

This system is exclusively available from Clark Dental. The Clark Dental team will support your equipment journey, offering expert knowledge through the whole process and aftercare. Collaborating with the Clark Dental team will assure the best possible equipment for your practice, as well as maximising the success of your future patient treatment outcomes.

Contact the team at Clark Dental to find out more.

the Gentle Guide: out now could not have asked for a better experience!

The Gentle Guide to Oral Health and Human Happiness, the new book about prevention from Curaden, is out now. Curaden understands that prevention is a necessity, particularly as we are now living in a world in which health and wellbeing are valued highly. Oral health has a significant impact on individuals’ systemic health. To support both, dental professionals must respond with prevention for the long-term health and happiness of their patients.

Over 40 dental professionals contributed to The Gentle Guide, sharing their experiences of preventative dentistry, and the effects that it has on their patients. The book offers coaching and motivational tips to help professionals encourage preventative

Nervous or anxious patients may find endodontic treatment daunting. If you have a patient who requires extra support consider working with EndoCare to deliver the best care.

Our highly experienced team offer a range of solutions to help nervous patients complete the endodontic treatment they need.

Here’s a recent 5-star review from one of our patients:

“I’ll start by saying I never write reviews and I am PETRIFIED of the dentist. Every time I’ve attended EndoCare, Michael Sultan has been incredible. He has such a warm and professional manner which always puts me at ease. Mr Sultan is an exceptional endodontist

behaviours in their patients, and information to raise patients’ awareness of their oral health and microbiome, helping them to better understand their own situation.

The Gentle Guide to Oral Health and Human Happiness is available to download here: https://prof. curaden.com/gentle-guide

For more information, please visit: www.curaprox.co.uk and www.curaden.co.ukn

At Dental Elite, it’s our mission to connect talented dental professionals with their dream career opportunities. And Dental Elite’s services are just as appreciated by prospective team members. As Georgie Mellis wrote recently: “I could not have asked for a better experience! Toni!!! She really has gone above and beyond for me. I applied for a position and she returned my call within the hour. Very informative and has been an absolute star. She has answered any questions I have had very promptly and really couldn’t have been more supportive. I have an interview today (less than 24 hours after me applying) and she has sorted everything. She’s even asked for a follow up which is a lovely gesture. 10* if I could!”

who works with integrity. Thank you.”

See how EndoCare could help support your nervous or anxious patients by contacting the team today.

For further information please call EndoCare on 020 7224 0999 or visit www.endocare.co.uk n

Dr Chris Pritchard purchased a Miele PG58581 washer disinfector from Eschmann last year, followed by two Little Sister SES 3000 autoclaves and a Reverse Osmosis (RO) System from Eschmann more recently. He shares his experience:

“I chose Eschmann, as amongst my peers, it was repeatedly recommended as being the best company for quality and reliability when it comes to decontamination equipment. Rather than purchasing multiple pieces of equipment from various companies, we felt that keeping everything under the umbrella of Eschmann made sense.

“We have a designated engineer, Andy, who provides us with a first-class service

Eliza Dancho adds: “I had a great experience working with Toni from Dental Elite. She was incredibly professional, attentive, and dedicated throughout the process. Her communication and responsiveness were outstanding. Thank you, Toni, for your exceptional support!”

Find out more about Dental Elite’s fantastic recruitment services by contacting the team today!

For more information contact the Dental Elite team on 01788 545900n

every time, complete with a smile! So far, we have just needed routine maintenance, so long may it continue.” Eschmann provided ECPD training for Chris and the team when installing the new equipment, in addition to the on-going maintenance mentioned. Want to see how Eschmann could support your business towards enhanced infection control processes? Contact the team today. For more information on the infection control products from Eschmann visit the website or call 01903 753322.n

bambach.co.uk

parkell.com

With exceptional organisation comes pure simplicity in your everyday workflows. With R4+, a Sensei product, your practice can manage the daily schedule, finances and patient communication in one easy-to-use and secure place. Sensei is the practice and patient management brand from Carestream Dental.

The efficient R4+ offers intuitive clinical and periodontal charting systems for adaptable styles, whilst making sure patients get into the dental chair on time with a clear appointment calendar.

Patient records have never been easier to find, complete and store, with in-depth information on clinical treatments, communication and medical tracking available within a few clicks.

R4+ has been revolutionised with the capabilities of Sensei Cloud, which provides clinicians with greater control and insight into their practice’s most important data, from anywhere in the world. All the while, patient and practice information is kept secure, for guaranteed peace of mind.

To learn more about R4+ and how it can transform your everyday clinical workflows, contact the team today.

For more information on Sensei Cloud visit the website. For the latest news and updates, follow us on Facebook and Instagram @ carestreamdental.uk n

Interdental cleaning for every patient

Want to help your patients clean interdentally? Recommend CPS interdental brushes from Curaprox.

Available in a selection of sizes, you’ll be able to find the right size brush for each space which features super-fine, extralong, ultra-resilient filaments. Curaprox interdental brushes enable patients to easily achieve a gentle and effective clean every-day, as an effective adjunctive oral hygiene solution.

The Association of Dental Implantology (ADI) is dedicated to supporting the continued education and growth of its members. Because of this, it offers a number of membership benefits which support learning. These include free access to ADI Study Clubs, Dentistry CPD, and dental journals, in addition to £150 credit for the Osteocom Dental Education Platform.

Education is crucial, particularly for those who provide dental implants, as keeping up with the latest technology and techniques, as well as refreshing your understanding, will ensure you’re able to offer your patients the highest possible standards of care.

For more information, and to become a member, please visit the website and get in touch with the ADI team. For more information, please visit the website. Become a member today n

To find out more, please contact the team at Curaprox.

Better yet, Curaprox CPS interdental brush heads are replaceable, so patients can keep using the same handle and save on plastic waste. Interdental brush refills fit into all Curaprox holders, allowing patients to choose between long or short, and straight or bent based on their preference.

For more information about Curaprox products, please visit www.curaden.co.ukn

The 2024 Goodwill Report from Dental Elite demonstrates strong lending, and market resilience despite a number of serious challenges in the form of external factors such as inflation, interest rates and trends around recruitment. Owner-operator sale averages are holding steady overall, but scrutiny of the data shows that private and mixed practices surged in terms of multiples, while NHS practices dipped.

Group buyer dynamics shifted last year, with micro-consolidators picking up some of the slack left by Tier One buyers as their activity slowed. Multiples in affluent areas reached 9.00x EBITDA, but high multiples were not limited to affluent areas. Great results were achieved based on variables like the EBITDA margin or income diversity, regardless of location.

If you’re looking to buy or sell a practice in the next 12 months, don’t hesitate. The time is right! Dental Elite have the right specialist expertise to help you realise your dreams today.

To find out more, contact the team! For more information contact the Dental Elite team on 01788 545900 https://dentalelite.co.uk/n

Eschmann – ensuring an excellent service Patient anxiety – clear communication to allay fears

Eschmann, the expert in decontamination, strives to deliver exceptional service and support that dental practices can trust to keep their equipment running smoothly. But you don’t just have to take our word for it. Here’s what Sharon Davies, practice manager of Rhos Cottage Dental Practice in Pembrokeshire, had to say:

“I’ve been with Rhos Cottage for nearly two years but the practice has worked with Eschmann for many years before then.

“We really appreciate how quickly an engineer is allocated to resolve an issue –they always deal with it straight away and minimise delays within the practice. Recently, we rang the team of engineers at 9.30am with a concern and by 1.30pm, Andy Jones had arrived on site to repair the equipment. I

creating

The FLEXI range of interdental brushes from TANDEX enables deeper, more effective cleaning in all those hard-to-reach areas. Available in 11 different sizes, FLEXI interdental brushes provide an efficient, comfortable solution to suit every patient’s needs.

With longer handles and a special ergonomic grip, FLEXIMax completes the family, making it easier for patients with less hand strength to reach interdental spaces at the back of their mouths.

Just a few drops of PREVENT GEL from TANDEX applied to the FLEXI brush surface offers the extra protection of fluoride and chlorhexidine to strengthen enamel and keep

have nothing but praise for his friendly and professional approach; he consistently delivers excellent service.

Engineers from other suppliers are never as friendly or obliging as an Eschmann engineer.

“The autoclaves from Eschmann have also proven efficient and we have relied on them to ensure we are contamination free.

“I would certainly recommend Eschmann and give them a 10 out of 10 rating.”

For more information on the infection control products, please visit the website or call 01903 753322n

Anxious patients may feel nervous during consultations and making it difficult for them to remember details, especially if there is a lot of information to take in.

Kiroku Docs helps dental professionals convert contemporaneous notes into clear documents for your patients, to provide information, allay fears and ensure consent is fully informed.

At the touch of a button, clinicians can convert notes into all the relevant documentation needed to make referrals, send bespoke letters, and obtain consent with an integrated e-signature form.

With Kiroku Docs the language and tone of your communication can be controlled using customisable templates. AI does the

rest, so you can reassure your nervous patients with ease.

Find out more about the many ways Kiroku Docs can assist you and your patients today.

To find out more about Kiroku, or to start your free trial, please visit trykiroku.comn

the mouth cleaner for longer. Find out more about the great products from TANDEX today!

For more information on Tandex’s range of products, visit https://tandex.dk

Our products are also available from CTS Dental Supplies: www.cts-dental.comn

Having a healthy engagement in your personal life as well as your work life, improves your physical and mental health – and it also improves your experience of work. AeronaDental is dental practice management software designed to take the stress out of all aspects of the day-to-day operation of dental practices, giving team members more time to focus on life outside of work. The system is cloud-based and has powerful, easy-to-use online tools, including an integrated video consultation platform. The system is intuitive and can be accessed from any device, allowing team members to work more flexibly. Business, finance, consultation, notation,

communication and survey features are all integrated to support easier business planning. It’s fully scalable, working well for single, group and multi-site practices. With the right strategies, you can achieve a healthier work-life balance – both for yourself and any team members you manage. Find out how AeronaDental can support your business today.

For more information, please visit aerona.comn

www.the-probe.co.uk

orthodontics made affordable

Whilst aligner companies like Smile Direct Club are going bust, and Invisalign are increasing their lab fees, IAS Lab are committing to low fees for IAS Clear Aligner cases. We have devised an increase in operational efficiencies with no compromise in quality, which means fantastic orthodontic outcomes can be achieved at an even better price.

Clinicians can approach “small movement” aligner cases with fees beginning at just £75 per arch for IAS Members, or £100 for nonmembers.

The IAS Lab can work with images from any scanner that your practice uses, as well as physical impressions, with an efficient, five-day turnaround on all appliances.

We have been providing a wide range of orthodontic appliance solutions since 2007,

Best practice guidelines for waste segregation require following the Department of Health’s colour code for different waste streams. This helps to ensure that waste items are correctly separated and disposed of in the most appropriate and least energy-intensive way possible.

To make the process easier for staff throughout the practice, consider putting up posters that remind individuals which waste items go where and why. This will not only enhance the effectiveness and efficiency of your waste management, but it will also help to protect your team, your patients, and the wider environment from harm.

Initial Medical offers a range of colour-coded waste posters, that are free to download from the website. These are designed to make

the role

of the nose use

Nasal breathing can be difficult for some patients, particularly if they suffer from congestion or allergies. When this happens, patients are more likely to mouth breathe during sleep. For patients with obstructive sleep apnoea (OSA), this can make CPAP treatment difficult.

If your patients are unable to tolerate CPAP treatment, it’s important to be able to offer them a solution which opens their airways. O2Vent® is customised to fit each patient’s unique anatomy. Its innovative design enables air to travel through the device to the back of the throat, avoiding obstructions in the nose and mouth. While the unique ExVent valve creates a positive pressure in the airway,

including IAS aligners and retainers, fixed brace set ups and Inman Aligners, as well as whitening trays (official Philips Zoom! partner) and custom sports guards.

Alongside high-quality orthodontic solutions, the IAS Academy also offers comprehensive mentoring to IAS-affiliated dentists on the ClearSmile aligner range, with complete support from case selection to completion.

To learn more about the IAS Lab’s fantastic orthodontic solutions that perform far above their price, contact the team today.

For more information visit:

www.iaslab.co.uk or call 01932 336470 n

Kiroku makes the practice more efficient

Jennifer Owen is Practice Principal at Park View Family Dental in Gateshead – a large NHS practice. She is also Local Dental Committee (LDC) chair for the northern region and liaison for the BDA ensuring practices achieve high standards of care. Jennifer discusses her experience of using Kiroku for practices:

“The problem with other notes templates is that all of your notes will look almost exactly the same each time, plus it’s easy to leave options in a template by mistake.

“I bought Kiroku for my team because it makes the practice more efficient. If I can make it as streamlined as possible, then they are free to see more patients. Before Kiroku I had a foundation dentist who, when they were newly qualified, had a 20-minute appointment

and spent 45-minutes writing the notes. The balance was completely wrong. Now she would never look back, she’s set for life now.

“Guidance is always changing. We like that Kiroku stays up-to-date automatically, as you don’t always know what you don’t know.

“We regularly have emergency appointments, and we need to know what they’re in for, and why they’re returning to the practice. Kiroku is much better than handwritten notes, I’m used to the format so I know where to look to get key information.” To find out more please visit trykiroku.comn

Tailoring your treatment recommendations down to the smallest details helps patients recognise the high-level of care you provide with every visit. Arm & Hammer™ toothpastes provide effective solutions for your patients, covering a wide range of needs.

Within the exceptional 100% Natural Baking Soda Toothpaste range, dentists can choose to recommend Whitening Protection, which is clinically proven to whiten teeth in just 3 days, or Gum Protection, a solution that is clinically proven to improve gum health. Each toothpaste is crafted with baking soda, which is alkaline in nature, and helps to return the oral pH to neutral. This way, plaque bacteria and acids from everyday food and drink have less of a chance to cause

waste management simple to understand and follow, providing an easy way to support staff in their responsibilities every day.

To find out more, visit the website today.

To find out more, get in touch at: 0808 304 7411 or visit the website today n

ensuring that it remains open through the night.

To find out more about O2Vent®, please visit the website and get in touch.

To find out more, please visit: https:// openairway.uk,email us at: infouk@openairway.com, follow us on LinkedIn at: www.linkedin.com/company/ o2ventuk or call us on 0800 8611828 n

In the UK, 57% of adults’ daily intake is derived from ultra-processed foods (UPFs), and the figure is even higher in adolescents (66%). Researchers at the University of Bristol showed that eating 10% more UPFs is associated with a 23% higher risk of head and neck cancer, and a 24% higher risk of oesophageal cancer. Many patients may not realise that they’re at a heightened risk of oral cancer. As such it’s important to carefully monitor for the early signs in every patient. The BeVigilant™ OraFusion™ System from Vigilant Biosciences® is a quick and easy pre-diagnostic test which is designed to be used at point of care, using saliva.

The BeVigilant™ Orafusion™ System can be used to identify the presence of biomarkers associated with oral cancer, producing a result in 15 minutes or less. Please contact the team to find out more. For more information, please visit: www.vigilantbiosciences.com or email info@vigilantbiosciences.com n

the forefront of implant education

Ucer Education has been at the forefront of postgraduate education in dental implantology in the UK for over a quarter century.

Ucer Education’s Postgraduate Certificate (PGCert) in Implant Dentistry (EduQual Level 7) gives aspiring clinicians a fantastic grounding in all aspects of the field. It is delivered by a team of expert teachers and instructors, led by Specialist Oral Surgeon, Professor Cemal Ucer.

The course is thoroughly modern, covering the latest, evidence-based techniques and technologies including different implant systems and their provision, full digital workflow including

CBCT scans, 3D treatment planning and printing, and much more.

To find out more, visit the website or contact the team today.

Please contact Professor Ucer at ucer@ icedental.institute or Mel Hay at mel@mdic.co Tel: 01612 371842

www.ucer-clinic.dental n

permanent damage.

The special formula is also brilliant for recovery, by encouraging remineralisation and strengthening enamel, and contains 1450 ppm of fluoride.

To learn more about the toothpastes that pair perfectly with your patients’ needs, contact the team today.

For more information about the carefully formulated Arm & Hammer™ toothpaste range, please visit https://www. armandhammer.co.uk/ or email: ukenquiries@ churchdwight.com n

Part of what makes money4dentists such an excellent choice for dentists is our commitment to ensuring that we understand your financial needs to the ninth degree.

Our team has decades of experience working with dental professionals, and as such we’ve gained an unrivalled knowledge of the industry. This way, we’ve helped thousands of dental professionals to achieve their current and future financial goals by tailoring our advice exactly to their needs.

So, if you have a specific goalpost in mind or want to assess your taxes, explore pension policies, or ensure that you have the everything in order as you head towards retirement, you know who to call.

Benefit from exceptional independent advice by contacting the team today.

For more information please call 0845 345 5060 or 0754DENTIST. Email info@money4dentists.com or visit www.money4dentists.com n

Transforming dentistry with recruitment, retention and mentorship

Recruitment, retention and mentorship are the cornerstones of building a thriving dental practice, essential for achieving excellence in patient care and team satisfaction, writes c liff Traill in the first in a series of opinion pieces

In the world of dentistry, the pursuit of excellence hinges not only on the clinical skills of dentists but also on the strategic management of their teams. Recruitment, retention and mentorship are essential for building a successful dental practice. Consequently, as practices grow and evolve, ensuring that team members’ personal development plans are consistently reviewed and updated becomes crucial. This approach not only nurtures a culture of continuous learning and development but also yields substantial benefits, including enhanced patient care, higher retention rates of team members, and a more harmonious working environment.

a compelling value proposition

Recruitment in the UK dental profession presents unique challenges. The demand for highly skilled professionals often exceeds supply, making it imperative for practices to differentiate themselves as attractive employers.

Competitive salaries and benefits packages are fundamental, but they are not sufficient alone. Modern dental professionals seek workplaces that offer growth opportunities, professional development, and a supportive environment. Practices must, therefore, create a compelling value proposition that aligns with these expectations.

A strategic recruitment process should begin with a clear understanding of the practice’s needs and culture. Defining the roles and responsibilities accurately and reflecting the practice’s values in job postings can attract candidates who are not only qualified but also a good cultural fit. During the interview process, it is important to assess not just clinical and technical competence but also interpersonal skills, adaptability, and the potential for growth.

Retention is an equally critical aspect that was often overlooked until it became a pressing issue. High turnover rates can disrupt patient care, increase recruitment costs, and lower team morale.

Retention strategies should focus on creating an environment where team members feel valued, supported, and motivated. Competitive compensation is essential, but so are opportunities for career progression,

recognition of achievements, and a positive workplace culture.

One effective retention strategy is the implementation of comprehensive personal development plans. These plans should be tailored to each team member’s aspirations and career goals.

Regular reviews and updates will ensure that these plans remain relevant and challenging. Fostering a culture of continuous learning not only helps team members to grow professionally but also keeps them engaged and committed to the practice.

Mentorship plays a pivotal role in both recruitment and retention. A structured mentorship programme can provide new recruits with the guidance and support they need to integrate smoothly into the practice. For existing team members, mentorship offers opportunities for professional growth and development. Experienced practitioners can pass on their knowledge and skills, fostering a culture of collaboration and continuous improvement.

supporting growth

For growing practices, my top tip is to ensure that personal development

plans are consistently reviewed and updated across the team. This process is integral to fostering a culture of learning and development, which, in turn, can lead to greater patient care, higher retention rates, and a happier working environment.

Reviewing and updating development plans should be a collaborative process. Engage with team members to understand their career aspirations, provide regular feedback, and set realistic yet challenging goals. Encourage continuous learning by providing access to training programmes, workshops and seminars. Recognise and celebrate achievements and provide constructive feedback to help team members overcome challenges.

Investing in the development of your team members is not just about enhancing their skills and knowledge. It is about showing that you value them as individuals and are committed to their professional growth. This investment pays off in numerous ways, such as higher job satisfaction, increased loyalty, and a more competent and motivated team.

On track for success

Ultimately, the success of a dental practice depends in no small part on its ability to attract, retain, and develop talented professionals. By prioritising recruitment, retention and mentorship, practices can build a strong, cohesive team capable of delivering exceptional patient care. Personal development plans are a key component of this strategy, providing a structured approach to continuous learning and growth.

With tools like Agilio’s iLearn Mentor software, practices can effectively manage these plans, ensuring that their team members are always on track and equipped to provide the highest quality care. As the dental profession continues to evolve, practices that invest in their teams will be best positioned to thrive and succeed. for more details on iLearn Mentor, enhancing team development and paving the way for career progression and personal growth, visit tinyurl.com/agilioilearn n

about the author cliff Traill is agilio software’s Product Manager and has been working in dentistry for the last 15 years

Success and failure both start with your character

Dental practice sales are often portrayed as being a mathematical and regulatory exercise. Market valuations, bank valuations, lending facilities, CQC registration, the attitude of landlords, buyers and sellers to risk are just some of the factors that affect a deal. But there is a factor that is often overlooked. That is the importance of having the right mindset to get the right deal done. While we represent vendors in the transactions we manage, I have always believed that every deal must be successful for both parties.

However, buying and selling is often a competitive exercise. Vendors are up against other practices of a similar profile, which are available for purchase. Purchasers are competing with other purchasers and must work to make their offer the most compelling. There is only ever one winner.

In our business, we must earn the trust of vendors who wish to sell their practice. We know the market, we have the experience, we have the connections, we can reach all the interested buyers but what our prospective clients are also looking for from us is character.

Mindset and skill are important, but I find they run a distant second to the importance of a person or group of people’s character. In my experience, success and failure both start with our character. And it is the same for

the vendors and purchasers in the transactions we manage.

Your character is the first thing another person considers about you when you initially meet – in person or virtually. People ask themselves, “What type of person is this and can I trust them?”

This is a fundamental, important, and unavoidable, part of human nature. I’m often struck by the number of articles I read where the sole focus is on sales methodologies and playbooks when talking about how to engage with people. They seem to ignore the piece about bringing your character to the discussions. It’s first things first. You can have the perfect opening to a phone call, and you can have the perfect success-oriented mindset, and still fail to connect and engage with other people if they sense something amiss in your character. Character precedes everything.

When we talk about the fact that people deal with those they ‘know, like and trust,’ what we are really talking about is character. This kind of thing is important to my business and to my clients. We talk about it in our meetings and I read about it to help me understand how people connect. It was something I thought a lot about in my previous career as an occupational therapist.

What determines our character? This is probably a thesis in itself but let’s start with a few easy-tounderstand concepts:

Having

integrity

This doesn’t mean honesty. Honesty is non-negotiable. Integrity means that your words and your actions are in alignment. Are you really there to work together with the other parties to get the best outcomes? This does not mean compromising your position.

What is your intent?

Are you just trying to pitch your position, or is it your intent to help the other parties find solutions that meet their requirements too? Ralph Waldo Emerson, the American philosopher said, “What you do speaks so loudly, I cannot hear what you say.”

empathetic

listener

It’s not enough to understand the other people’s point of view. You must be able to listen to what you’re saying to them in the same way they hear it. This is what makes empathy come to life. That’s how you bridge the empathy gap between you and the other parties.

Responsive

Being responsive means prioritising the needs of the other parties. Being responsive is the key to making that happen and aligning your actions with their objectives. People want to quickly gather the information they need to make a good decision with the least investment of their time and resources possible. It is

an immediate red flag when buyers or sellers start ghosting us and each other.

Open mindset

Open-mindedness involves being receptive to a wide variety of ideas, arguments, and information. Being open-minded is generally considered a positive quality. It is necessary in order to think critically and rationally. It also encompasses the belief that other people should be free to express their beliefs and arguments, even if you do not necessarily agree with those views.

To summarise

We see the proof every day, in what we read and hear in the news, that your true character will eventually be revealed. Your character doesn’t have to be hard wired into your persona. You can adopt the values that make you more human and ‘other-centric’. It takes self-awareness and humility to admit that you need to invest in developing your character if you want the best chance of getting the outcomes that are important to you through discussion and negotiation with other people. n

about the author abi Greenhough, Managing Director of Lily Head Dental Practice sales.

The smile behind customer service

In the competitive world of healthcare, the importance of customer service is a key element. And within the dental sector, where trust and comfort are paramount, exceptional customer service is not just a nicety but a cornerstone to success. The interaction between patients and your dental team goes beyond clinical expertise and needs to encompass empathy and communication, plus a commitment to ensure each visit is a positive experience for your patients, where trust, rapport, and credibility are built instantly. Here’s why customer service is crucial for dental practices: building trust and rapport Trust is paramount. Dental patients entrust their oral health, which can often be fraught with vulnerability and anxiety, to the hands of dental professionals. Exceptional customer service fosters trust by creating a welcoming environment where patients feel valued, respected, and understood. This starts with a warm greeting from your reception team and extends to the compassionate chairside manner of your dentists or hygienists –every interaction shapes the patient’s

perception of your practice. When patients feel acknowledged, with their needs heard and supported, they are inclined to take on treatment plans, recommend the practice to others, and schedule return appointments.

enhancing the patient experience

A visit to the dentist can stir various emotions, ranging from apprehension to relief. However, exceptional customer service has the power to transform these emotions by turning what might seem daunting initially into a positive experience. From the moment a patient schedules an appointment to the follow-up after treatment, every interaction with your team is an opportunity to exceed their expectations. Clear communication, personalised care, and attention to detail can make all the difference in easing anxiety and making your patients feel at ease and comfortable throughout their journey.

fostering loyalty and retention

In today’s competitive landscape, patient loyalty is a prized asset. A dental practice that prioritises customer service will be able to cultivate loyal patients who return for their own dental needs and recommend your

practice within their social circles. Word-ofmouth referrals from satisfied patients are invaluable and can significantly contribute to the growth of your practice. In addition, patients are more likely to explore additional services, such as cosmetic dentistry or preventative care, which are all important for the success of your practice.

addressing complaints and improving reputation

Even the most well-run dental practices may encounter occasional challenges or hurdles. How these are addressed can have a profound impact on your practice’s reputation. Promptly addressing any concerns, offering sincere apologies, and taking corrective action demonstrates a commitment to patient satisfaction and a willingness for continued improvement. By prioritising customer service, your dental practice can mitigate negative feedback, salvage relationships, and safeguard your reputation in the community.

Driving practice growth and success

Exceptional customer service is not just about fulfilling immediate needs it is also about

laying the foundation for long-term success.

A positive patient experience can set your dental practice apart within a crowded market, engaging new patients and retaining existing ones. Furthermore, satisfied patients are more likely to leave positive reviews, which can bolster your online presence and attract a broader audience.

Customer service is not merely a supplementary aspect of your dental practice but an integral part of its success. Your dental practice can set itself apart and flourish in a competitive industry by establishing trust, enhancing the patient experience, fostering loyalty, and proactively addressing concerns. After all, behind every bright smile is a dental team dedicated to delivering unparalleled customer service, one patient at a time. n

about the author susan Ward, customer service expert, connect My Marketing.

MINIMALLY INVASIVE

SOLUTIONS

SHORT IMPLANTS

(FROM 4,5 MM)

RETHINK TREATMENTS FOR BONE ATROPHIES

FOR 3

REASONS:

1. Less trauma: no complex reconstructions.

2. More success without postoperative complications.

3. Greater patient acceptance: no delays in rehabilitation and no cost increases

Selling a leasehold practice

Key things to know about Authorised Guaranteed Agreements

Where the owner of a dental practice occupies the property under a lease, and there is a significant number of years left to run on the term, the seller and the buyer of the dental practice may decide to assign the seller’s interest in the lease to the buyer.

The owner of the dental practice will be required to obtain consent of the landlord to assign its interest in the lease to the buyer. The landlord’s consent is given by writing in a document called a Licence to Assign. Where the lease is a ‘new lease’ for the purposes of the Landlord and Tenant (Covenants) Act 1995 (entered into after 1 January 1996) the landlord may request an authorised guaranteed agreement (AGA) as a condition of giving its consent to the assignment of the lease. It is usual that the AGA is incorporated into the Licence to Assign, alternatively it will be a separate document.

An AGA is an agreement that places an obligation on the outgoing seller/ tenant (assignor) to guarantee the performance by the new tenant (assignee) of the tenant lease

covenants contained in the lease. This would include (but is not limited to) payment of rent and other outgoings, and compliance with the repair and decoration covenants.

If the assignee fails to perform the tenant covenants in the lease, the AGA allows the landlord to pursue the assignor under the terms of the AGA for remedy of the breach. In addition, the AGA may require that the assignor takes a new lease for the residue of the

original term of the lease (on the same terms as the existing lease), or payment of a certain number of months’ rent instead, should the tenant’s breach mean that the lease is terminated.

The assignor’s liability under the AGA will continue until the lease term comes to an end or when the assignee assigns the lease to another party, whichever is sooner.

It is commonly found that sellers of dental practices are not aware

of the reality or implications of their obligations under an AGA. However, it is possible that a request can be made to the landlord to dispense with an AGA or at least limit it to a shorter period, where the assignee is of sufficient financial standing and has the covenant strength to take over the lease obligations. Alternatively, the landlord may be encouraged to take a rent deposit from the incoming tenant rather than pursue the AGA.

AGAs are common in leases of commercial property. However, it is vitally important that both the seller and buyer of a dental practice understand their legal obligations before entering into an AGA or a new lease. n

about the author caroline Oldfield is a property solicitor within PfM Legal, part of the PfM Dental Group dealing with the valuations and sales of dental practices, Legal, accountancy and financial advice.

Dentists need critical illness insurance

When considering the long-term future of your livelihood as a dental professional, it is all too important to consider the potential for an unfortunate turn of events that may put a halt to your ability to work – even if only for a small amount of time.

Your health is one factor that may influence your capacity to provide effective dental care, but it is ultimately impossible to predict. It can be difficult to think about, but in the future you may be subject to an illness that influences your care – the opportunity to prepare for such an outcome is one each dental professional should take up.

This may come in the form of critical illness insurance – a type of medical insurance that offers some aid in the event of a diagnosis for a number of serious illnesses, diseases and medical conditions. Each policy will differ greatly, and you should have a full understanding of what you are being offered before you decide upon taking a policy out, and whether it’s right for you.

understanding your policy

The coverage offered by each critical illness insurance policy may vary greatly between providers, from the medical conditions it covers, to the payouts awarded, and the parameters that must be met to receive such compensation. Your chosen agreement will list specific ‘critical’ illnesses, which may include conditions such as some cancers,

strokes, or the development of deafness or dementia, amongst others.

It’s important to understand which illnesses are covered by your policy.

Insurance providers may state the extent to which a condition must have had an impact on you, or a specific presentation of the illness, to pay out. For example, if you develop mild cognitive impairment – which may be a sign of the disease that causes dementia – that could heavily impact your care, but you may not qualify for reimbursement, even if dementia is one of your specified critical conditions, as it is ultimately not the illness.

The unfortunate development of a critical illness is often unpredictable, but by looking at certain trends in our population’s health, the need for critical illness insurance becomes more apparent. Cancer Research UK stated that, since the early 1990s up until 2018, the incidence rates of all cancers combined increased across every age group in the UK. The largest of these was of 25-49 year olds, with a prevalence of diagnoses increasing by 22%. Around 90% of cancers affect

people over 50, but the increase across the board lays a prescedent for the need for critical illness insurance.

Cancers are, as mentioned, not the only medical condition covered by critical illness insurance, but the growth in incidence rates represents a wider trend across the healthcare landscape.

If you are at an increased risk of developing a serious condition, for example because of a familial history of disease, obtaining this cover may be an even greater necessity.

The need for support

As a dental professional, your health will be intrinsically linked with your ability to work safely and confidently. Dental care roles require controlled dexterity, are often psychologicaly demanding, and can be extremely stress inducing. A crtitical illness diagnosis may keep you away from the practice for days, months, or even indefinitely.

With this in mind, consider obtaining cover that can help you to provide for any specific forseeable debts. These may include mortgage payments, or arrangements for nursing care or for further medical assistance.

Consider also the expenses you would need to provide for any dependents who could be relying on your source of income at the time of a diagnosis.

You should know that many insurance policies may only pay out after a set time frame following a diagnosis. For example, you may not receive any payment until 28 days after living with the confirmation of your illness. Aside from choosing the most

suitable policy for you, this also means you may want to set aside some savings to cover this period’s expenses.

finding your

solution

There are a variety of factors to consider when choosing the right critical insurance policy for your needs. What medical conditions should be covered? How much will you need paid out? Could a joint policy with a partner be ideal? As a result, the market can, at first, seem overwhelming. Specialist independent financial adivsers, like the money4dentists team, can help you to find the right insurance policy without any unnecessary stress. They understand your unqiue needs as a dental professional, working exclusively with dentists and their partners for decades. money4dentists’ experienced advisers will help to assess the policies available to you, and direct you to your optimal solution.

Critical illness insurance is more necessary than ever, and by actively seeking an appropriate policy now, you may be well prepared for the years to come.

For more information, please call 0845 345 5060 or 0754DENTIST., email info@money4dentists.com or visit www.money4dentists.com n

about the author

Richard T Lishman, Managing Director of

the 4dentists Group of companies.

The 2023–24 dental acquisitions market in a nutshell

Every six months, Dental Elite releases updates to show how the dental practice market has been performing, with benchmarking data from the previous year, regional trends and notable changes articulated and explained. In our most recent Goodwill Report, we have been able to demonstrate that the nuance involved is more important than averages to unpick disparities and more accurately project continuing trends.

The data shows that the market over the past financial year has been resilient, despite a number of serious challenges. There have been some notable adjustments in the types of buyers across different kinds of practices in different regions. Owner-operator sales are achieving higher rates in more favourable locations, with averages that mask some significant variations between outcomes for private versus mixed and NHS practice sales. Group buyer dynamics have also shifted, and group acquisitions are also achieving higher rates in sought-after regions, with interesting high-value exceptions across the country.

Multiples, ebiTDa and goodwill

For accurate valuations in dental acquisitions and mergers, we use a number of factors – tangible and intangible – to ensure calculations reflect the true value of dental practices. Dental Practices are valued by applying a market multiplier to the net profit of the dental practice. Generally, when we refer to multiples, we are alluding to a calculation based on the projected value of the dental practice’s earnings before interest, taxes, depreciation and amortisation (EBITDA), or Fair, Maintainable Trade (FMT). Multiples are a useful tool for comparing data pools across regions and articulating trends where businesses follow different models.

Multiples account for goodwill – an accounting concept used to demonstrate the value of the intangible assets of a going concern. This might include the practice’s reputation and patient base, as well as the projected worth of ongoing trade. Goodwill is affected where there are unknowable variables in play – such as variable recruitment challenges in different regions.

a closer look at recent trends in the independent market

In the financial year 2023-2024, multiples remained generally consistent, with multiples in sales to first time buyers very slightly lower than the previous year period. Within these averages were slightly higher multiples for mixed and private practices, and a very slight dip for NHS practices.

The detail behind average prices paid tells an interesting story. The independent market saw a small reduction (1.55%) in prices overall; but this doesn’t give an accurate picture of changing practice characteristics. Mixed practices saw a 10.63% increase, and private practices saw a 7.49% surge. At the same time, average prices paid for NHS practices dropped by 17.71%, with smaller deals or fire sales, skewing the data.

There was a slight fall (3.77%) in independent sales overall, but all signs point to a burgeoning confidence in borrowing. There has been a significant reduction in inflation since our interim Goodwill Report Oct 2023, which has fostered a more positive outlook – reassuring buyers amidst the uncertainties. The base rate at the time of writing remains at 5.25% but the prospect of a gradual reduction to around 4% by Christmas, and to around 3.25% by 2027 offers hope.

Group acquisitions – shifts in buyer dynamics alongside external factors

Buyer dynamics are ever-changing in the group acquisition market. The largest Tier 1 group buyers (owning 50 plus practices) have slowed, while micro-consolidators have gained traction. This is partly due to softer multiples overall, but also because Tier 3 (10-20 practices) or Tier 4 (3-9 practices) often offer better deal terms with larger upfront payments, or no deferred consideration at all.

This trend has allowed the group sales market to sustain higher multiples. Tier 3 and 4 groups may pay higher multiples on average, but may encounter difficulties executing larger transactions. On the lower end of the multiple range (6.43x), 47% are private, 37% mixed and 16% are NHS. Averages hit 7.27x, and the highest figure in the multiple range reached 9.00x EBITDA. On the higher end of the multiple range, the market reflects a movement towards private from NHS practices. Last year, 61.9% of the market was private, 28.57% was mixed and 9.52% NHS.

Although multiples outside London and other affluent areas may be slightly lower on average, the multiple can increase depending on variables like the EBITDA margin or income diversity, regardless of the location.

exciting prospects, keeping the market buoyant

The dental acquisition market, despite the recent pressures of Covid-19, inflation and interest rates, remains resilient and is a green-light market for investors, buyers and banks. Last year’s interest rate rise did impact the market, but the dental sector didn’t fall off the edge. Funding is

Ethical principles in practice

For clinicians, the ethical principles laid down by the GDC are more than just a box-ticking exercise. Principles around integrity and authentic engagement to maximise patient participation and education are a matter of honour, but also result in better treatment outcomes. Abiding by ethical principles in approaches to treatment makes business as well as clinical sense. Strong ethics enhance reputation, and protect practices from litigation.

An ethical approach to team culture is also vital. Having clear policies around staff training, issues like bullying and harassment, whistleblowing, performance management, health and safety and flexible working is another important way for businesses to look after team members, as well as to maintain a good reputation.

Ethics is not merely a philosophy; it is the discipline that governs moral action. In terms of dentistry, ethical practice is the mechanism for ensuring patients are fully and adequately informed. It enables all patients to participate in decisions about their treatment according to their capabilities. The principle of putting the patient first requires treating them in line with their wishes, as long as their expectations are feasible. Practitioners must maintain an awareness to ensure care is provided without discrimination or prejudice.

unintended consequences

Action or inaction that results in a poor ethical outcome may well have no bearing on the honesty and integrity of an individual. For example, a non-tech savvy team member’s naivety about cybersecurity could result in a breach which would contravene the ethical principle of protecting patient data. A clinician’s lack of understanding about the capabilities of a person with learning disabilities could result in inadequate efforts to include them in decision-making around their treatment. Though no disrespect will have been meant, the result would be the same, and the treatment of the individual could be affected.

Another example of an unintentionally poor ethical outcome might be due to not ensuring a patient’s consent is truly informed. For instance, a clinician might have earnestly tried to educate the patient about a recommended orthodontic treatment, and may have obtained written consent. However, the patient might not have properly understood the time, habits and commitment required from them to make the treatment work. If the clinician has not sufficiently recorded the information they have shared alongside the patient’s consent, it might not be valid.

still readily available and buyers are still looking to acquire. The most encouraging news for prospective buyers is that banks are currently very open to supporting first-time-buyers, as well as dentists with existing businesses. Commitment is strong from lenders, with exciting new players emerging. Rates are holding steady from 2.35% above the base rate, and partial amortisation loans are upwards of 1.7%.

At Dental Elite, we use our 14 years of specialist experience to work closely with clients and ensure each practice is evaluated on its own merits. With our help, vendors are successfully achieving the best deals possible based on their practice’s own unique attributes, regardless of location.

Working closely with a specialist agent that understands the market is vital to ensure your valuation is as accurate as possible. It also ensures you make the best of opportunities within the current market, and achieve the deal – as well as the buyer – that best suits your practice.

For more information on Dental Elite visit www.dentalelite.co.uk, email info@dentalelite.co.uk or call 01788 545 900 n

consent – a core ethical principle

One of the core principles of ethical practice is that clinicians will do all they can to obtain genuinely informed, valid patient consent before starting any treatment. Consent should be based on a patient’s clear understanding of the risks as well as benefits of treatment at every stage, and should be checked and documented on an ongoing basis.

Chairsyde is a state-of-the-art consultation platform that operates as an unparalleled educational tool as well as a solution for providing all the documentation needed to obtain valid consent. A large bank of patient-friendly animations, videos, images and customisable content allows clinicians to explain a patient’s condition, prognosis and options for treatment –including associated benefits and risks. Consultations are recorded for safety, and can be instantly sent via email for patients to review in their own time.

A dental practice may have strong ethical principles at heart, and all team members may have absolute integrity, but if they fail to underpin those principles with the appropriate systems and procedures, their hard work may well be undermined.

For more information, or to book a demo, please visit www.chairsyde. com or call 020 3951 8360 n

business bites addressing everything business

Loven Ganeswaran, ceO and founder chairsyde.

Helping dentists around the world empower their patients to make better decisions about their health. about the author Luke Moore is one of the founders and Directors of Dental elite.

We’re a specialist dental practice sales agency, so whether you are looking to sell your dental practice on the open market, selling to your associate or intrigued with Corporate interest, we’ve helped thousands of dentists like you.

You cannot be in better hands with our expert valuers, a single point of contact throughout the sale and in-house legal team, allowing us to

We work with dentists all over the UK

Our scale and reach means we’re here to help wherever you’re based

Practice sales over the past 12 months 50+

Current dental accountancy clients 1200+

Practice finance raised in the last year £15m+

Expert Valuations

Accurate valuations for associate & principal led models with advice on enhancing the practice value.

advise you from start to finish. Supportive Throughout

We liaise with solicitors, buyers, and CQC to ensure everything is in place to minimise stress and give a smooth sale.

1000s of buyers

Get access to 1000s of pre vetted purchasers, being individuals, small groups and all of the major corporates.

In House Legal

We have specialist dental solicitors with expertise in commercial law, property law, and CQC processes.

Offer Negotiation

We will ensure your practice attracts the best possible price by negotiating the sale on your behalf.

Fee Free Sale

95% of our NHS practices sell to priority buyers meaning the purchaser covers the agency fee.

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• Carry out supra and subgingival instrumentation

• Use a combination of our products if surgical intervention is required

• Continue to monitor and support the patients’ oral health throughout their life