The Probe May 2024

KIDS RANGE

Interim no more – Jason Wong officially named Chief Dental Officer for England

When Sara Hurley vacated the role of Chief Dental Officer (CDO) for England in June last year, Jason Wong MBE –deputy CDO at the time – stepped up to fill the void at Interim CDO until a new permanent replacement was named by NHS England and the department of health and social care.

On Monday 22nd April, Jason Wong has been named as Sara Hurley’s permanent replacement, now officially listed as is the Chief Dental Officer for England on the NHS England website.

Jason was awarded his MBE for services to dentistry and oral health in 2020, the same year he became Deputy CDO. He previously chaired local dental

networks throughout the Midlands and the East of England, and had served as secretary of the Lincolnshire Local Dental committee for 16 years.

According to NHS England, Jason’s new role as Chief Dental Officer ‘sees him working in collaboration with local and regional teams to deliver improved outcomes for patients, while also championing the role of dentists and dentistry within the health system.

‘The Office of the Chief Dental Officer England represents the head of the dental profession in England, providing system wide professional and clinical leadership, by setting the strategic vision for England’s oral health.’ ■

Official data shows over 60% of dentists in England thinking leaving the NHS

The British Dental Association has lamented Government’s failure to tackle the growing exodus from the NHS workforce, as new official data shows the numbers are set to mount.

Dentists’ Working Patterns, Motivation and Morale data shows morale is now at an all-time low – with only 16% of dentist practice owners and 18% of dentist associates in England saying morale is high, a record low result for both groups. 6 in 10 of all dentists say their morale is low or very low.

With the access crisis hitting millions across England, 64% of practice owners and 61% associate dentists in England are now thinking of leaving NHS dentistry.

The BDA has described the Government’s recent Recovery Plan as ‘unworthy of the title’ and has lambasted the non-stop spin from Ministers attempting to defend their unambitious and unfunded policies.

Dental Minister Andrea Leadsom MP told Parliament last week that “it isn’t the case dentists are disappearing from the NHS,” citing supposed ‘growth’

of 1,352 dentists, by comparing to 2010 figures. The reality is NHS dentist headcount has fallen to levels not seen since 2017, with today’s data showing a steady fall in the proportion of NHS work dentists do.

Last month the Secretary of State had to correct the official record after informing Parliament that the plan was funded by £200m of ‘new’ money. It is entirely funded by recycling underspends in the service’s existing £3bn budget, which has been cut by a third in real terms since 2010. The Government has tried claiming that 500 practices are now taking on new NHS patients as a result of this package. The

reality is officials have just changed the definition of ‘access’ on NHS.uk.

A recent poll of dentists in England by the BDA showed just 3% think the plan will result in their practice seeing more NHS patients. 43% believe the plan will actually lead to their practice seeing fewer NHS patients. Only 1% of respondents believe the plan is capable of meeting the government’s stated objective to provide NHS dental care to ‘all who need it’.

The BDA has slammed Government for rejecting the Health and Social Care Committee’s key recommendation to break with the discredited NHS contract, which is fuelling this exodus. It stresses that any progress will hinge on real reform and sustainable funding.

BDA Chair Eddie Crouch said: “This Government hasn’t given dentists any reason to be cheerful. The PM promised to ‘restore’ this service, but all we’ve had is spin, and unfunded, unambitious plans. We can’t have NHS dentistry without NHS dentists. Without real reform Ministers won’t make it a place dentists want to work.”

A welcome from the editor

Change is a constant, which is somewhat of an oxymoron. But it’s true. Life is a series of changes, one after the other, and they chip away until the differences in where we’ve come from and where we find ourselves are undisputable when looking back. It could be that this constant state of change is why we have the saying, the more things change, the more they stay the same. Too much philosophy for the start of the magazine. My head’s spinning. However, if you turn to page 10, Barry Cockcroft reflects on just how much things have changed. And, as I type this, I have just had a terrific conversation with Fiona Sandom and Michaela O’Neill about the charge they’ve been leading for more than a decade, which is finally coming to fruition in the form of new powers for dental hygienists and dental therapists. Look out for that soon on The Probe Dental Podcast and across our social media platforms. It’s a discussion not to be missed.

Happy National Smile Month to you all, too! It comes around quicker every year. Find out how you can get involved on page 6.

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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 fall

Dr Rebecca Williams Associate Dentist Cox and Hitchcock

John Maloney Country Manager GC UK

Dr N. Tony Ahmed Shropshire & Staffordshire Local Dental Network

Dr Biju Krishnan Founder CFAST System

Catherine Rutland Clinical Director Denplan

Dr Philip Johnstone Dentolegal Consultant Dental Protection Oral Health Content Specialist Oral Health Foundation

Dr Barry Cockcroft CBE Former Chief Dental Officer for England

Take part in National Smile Month

National Smile Month is one of the longest-running oral health campaigns in the UK. The Oral Health Foundation could not have achieved this enormous success every year without your help. National Smile Month offers dental professionals the opportunity to raise awareness about the importance of good oral health, promoting healthy messages to patients and the local community. This year’s campaign theme is “Love Your Smile” – and here are just a few of the ways you can get involved.

Refresh your dental practice!

Join in with thousands of dental practices who revitalise their dental practice during National Smile Month with vibrant displays and informative posters. A strategically placed pop-up stand in your waiting room can serve as a powerful conversation starter. Make your stand engaging with colourful bunting, a Smiley photo frame, or even one of our comprehensive 2024 campaign

packs, equipped with everything you need for a successful display.

Each week of National Smile Month has a unique focus for your team to delve into and they are perfect for tailoring your displays to.

• Week 1: Caring for Your smile.

Highlight the importance of daily hygiene routines and their benefits for patients’ smiles. Showcase the influential role of the dental team in helping patients achieve good oral health.

• Week 2: Food and Drink. Discuss how diet directly affects oral health. Explain what happens to teeth, tongue, and gums when patients consume certain foods and drinks, distinguishing between the good and the bad.

• Week 3: Confidence and mental Wellbeing. Explore how a healthy smile can boost self-esteem and confidence. Discuss the mental health benefits of a healthy smile and provide tips on how patients can love their smiles more.

• Week 4: Disease and Conditions. Educate about the link between oral health and various physical and mental conditions. Discuss common oral health diseases and preventive measures that patients can take.

• Week 5: oral health Products. Guide patients on the oral health products they need for a healthy smile. Discuss different products, their usage, and their effectiveness in maintaining oral health. All display resources can be purchased from our online shop at www.dentalhealthshop. org. All proceeds contribute to our charity’s mission of promoting oral health.

Reaching out through social media

As dental professionals, we have a unique opportunity to make a significant impact during National Smile Month. Harnessing the power of social media, we can extend our reach beyond our patient base and into the wider online community.

This initiative is not just about promoting oral health, but also about fostering team spirit and unity within our practice. Imagine the entire team coming together, brainstorming creative ideas for posts, and sharing their passion for oral health. It’s a fantastic team-building exercise that also serves a greater purpose. Use the downloadable content available on the National Smile Month website to create engaging and informative posts. This resource is completely free and designed to help us spread positive oral health messages effectively.

But why stop there? Let’s make this campaign even more interactive and fun by incorporating the iconic ‘Smiley’ into your posts. These Smileys, available in the online shop, are perfect for photos and can add a touch of joy and positivity to your messages.

Don’t forget to use #SmileMonth in your posts and let’s make a difference, one smile at a time. Remember, every post we make, every ‘Smiley’ we share, helps to raise awareness of oral health. And who knows? We might even inspire someone who isn’t a patient yet to take that first step towards better oral health.

Practical activities for everyone

There are lots of fun activities that you can take part in the National Smile Month. One of our most popular activities has always been ‘The Great British Brushathon’. On Monday 13th of May 2024, The Great British Brushathon will connect people from all around the world in one giant communal toothbrushing event.

All you need to do is take a selfie whilst brushing your teeth and post it to social media. Alternatively, if you want to get a bit more creative you can film a video of yourself brushing and you can get your staff and patients involved too.

Do not forget to include the hashtags #SmileMonth and #GreatBritishBrushathon and tag three other people to keep the chain going. Let us know if you are planning to take part and we can look out for and share your post.

During National Smile Month, many dental practices also seize the opportunity to extend their impact beyond their practices by visiting local schools. They deliver invaluable lessons on dental health, utilising our free Dental Buddy programme (available online). This programme offers a wealth of resources, including lesson plans and activities tailored for Early Years Education, Key Stage One, and Key Stage Two.

No matter how you choose to participate in this year’s National Smile Month, your efforts are greatly appreciated. On behalf of all of us at the Oral Health Foundation, we extend our heartfelt thanks to you. Here’s to making this year’s campaign the most successful one yet! n

about the author Karen Coates, oral health Content specialist at the oral health Foundation, and RDn

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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.

‘Transparency’ and ‘trust.’ Yeah… Right.

The story so far…

In November 2022, the General Dental Council announced the launch of a ‘research project’ to collect data on the prevalence of suicides by dental registrants while under fitness to practice investigation. The GDC decided to look at data for the period 2019-2021 and said it would publish a report on its research in the first half of 2023. Its response followed interest that arose after a Freedom of Information request by consultant orthodontist, Dr Farooq Ahmed, asking for those figures in the summer of 2022.

But when the first half of 2023 arrived, it brought with it the regulator’s excuses for not publishing a report ‘in the first half of 2023.’ Entitled Progress on reporting the cause of death of registrants who have died while fitness to practise concerns are investigated , an article on the regulator’s website by the executive director of strategy Stefan Czerniawski announced that, although ‘considerable progress’ had been made during its research, there would be a delay because their work, amongst other things, had “identified some additional areas of complexity in gathering and interpreting evidence.”’

Mr Czerniawski said, “We need to consider carefully how best to address those issues, so as to be sure that we are being led by the evidence and drawing on expert advice on interpreting and presenting the data.”

Now, you would be forgiven for thinking that maybe the GDC was overwhelmed with the numbers involved, but a Freedom of Information request in 2023 by Shaun Howe, a former dental therapist, indicated that during the research period, 16 registrant deaths had been recorded. Now on reading Mr Czerniawski’s May 2023 piece, the cynic in me immediately thought, “The GDC wants to formulate the best way of presenting the data with the best possible spin in order to show it in a good light.” To be honest, what I ACTUALLY thought was unprintable in a respectable professional dental journal. However, when a freelance reporter recently asked the GDC media office why the regulator doesn’t just present and publish the raw data – i.e. the precise number of registrants who took their own lives whilst undergoing FtP investigation – the response was: “The blog post previously provided outlines the work we are doing in this area, confirms what data will be released and the timescales for the release. We have nothing further to add to this at this time.” That ‘blog post’ referred to was the one released a year

ago, in May 2023. So much for the GDC’s media department keeping journalists updated. ‘Transparency,’ in a nutshell.

Having resolutely defied growing calls for the GDC to publish its data, help arrived for the beleaguered regulator when a knight in shining armour rode into view, in the shape of Katrina Hepburn, the Area Coroner for Central and South East Kent. Inadvertently, the coroner provided the GDC with a means for deflecting attention onto another matter, albeit related.

In August 2023, Katrina Hepburn sent a report to the General Dental Council following her investigation into the sad death of a dentist who took his own life while under Fitness to Practise investigation. In her report, the coroner wrote: “There was evidence provided by the Family that [the dentist’s] mental health, affected by the GDC investigation in the first instance, then deteriorated after the detail of the complaints/concerns of his work practices entered the public domain via the GDC Website.”

The GDC had published an Interim Orders Committee decision that interim conditions had been placed on the dentist’s ability to practise for a period of 18 months. A seven-page report was subsequently published on the GDC website.

The GDC took the ball and ran with it, publishing an Update on transparency, trust and improving the Fitness to Practise process at the end of March, on its website. The ‘update’ (no one outside the GDC appeared to know about this ‘work’ until this publication) opened with:

“We have provided an update on work underway to address concerns about the level of detail that is put into the public domain regarding serious concerns considered by an Interim Orders Committee (IOC), to report data about the cause of death of registrants with an active fitness to practise (FtP) case and to improve the FtP process to reduce the impact it can have on participants.”

So, there it was. A perfect opportunity was presented to the GDC to deflect criticism from itself on the length of time it takes to carry out investigations and the way it scrutinises every last detail of a registrant’s practise so that it can pile on charges until some registrants are so overwhelmed that they contemplate taking their own lives. The GDC could claim, “It is important that the public can see where the GDC takes substantive action including, in the most serious cases, erasure and suspension. It is also important, particularly given the time it takes to get to a substantive hearing, that the public can see that immediate risks are addressed.”

All I can say is that a dentist in my home city died by suicide in the early 90s while under investigation by the GDC, WELL BEFORE online hearing reports and proceedings were ever thought of. It was the regulator’s investigation process that contributed to that tragic death. He was a popular dentist and an allround good bloke.

A recent case against a dentist encapsulates all the justifiable criticisms that have been made against the GDC – namely the length of time it takes to carry out investigations, which is absurd, and the charges it brings against registrants - which, in this instance, are risible, if not simply cruel.

It’s not just me saying the GDC is taking too long in bringing cases, either. In its 2022-23 report, the Professional Standards Authority stated: “The GDC did not meet Standard 15 because it is taking too long to deal with fitness to practise cases.”

In early April 2024 , a dentist faced a Practice Committee at the GDC. At the time of writing, the outcome isn’t known, but the dentist was charged with (absurdly, in my view), not introducing himself to Patient A in advance of beginning the appointment, dropping papers on more than one occasion, and asking his dental nurse for paperwork that he was already holding (I did that all the time while in my practice). The GDC’s brief charge sheet also said that when discussing the content of a video, the dentist said he had fallen asleep because of his narcolepsy and that he was on medication for narcolepsy. Now, to me, that sounded like the practitioner was making a joke. Surely? But no, the GDC said that his conduct was ‘Misleading,’ ‘Lacking in integrity’ and ‘Dishonest.’ Dishonesty, by the way, is a favourite charge meted out by GDC caseworkers, according to one experienced indemnity organisation representative. That was pretty much the case against the dentist. The charge sheet concluded: “AND by reason of the facts alleged above, your fitness to practise is impaired by reason of misconduct.”

Really?

Interestingly, a dentist with the same name was mentioned under parliamentary privilege by Conservative MP Peter Bottomley IN JU ne 2015 . He told ministers in the Commons: “I have the case of Dr **** *******, a good dentist in my constituency, who was reported to the dental regulators on trumpedup charges and has not been able to practise for over six months.” Dentistry.co.uk reported at the time that it found on the GDC website that in March of that year, ‘The Interim

Orders Committee suspended (the dentist) for a period of 18 months.’ When someone submitted a publicly available Freedom of Information request in June 2015 asking, “Why is the charge sheet for [the dentist] not presently available on the GDC website? Due to the growing controversy with this case (and trust me it is presently the subject of many a social media thread) […] can the GDC appreciate how unhelpful it looks for the details of the case to be invisible?” the GDC’s response was that it, “Neither confirms nor denies whether it holds this information,” citing contravention would contravene the data protection rights of the dentist in question. Surely, that was the same practitioner in 2015 and 2024!?

Not surprisingly, after an unnecessarily lengthy ordeal over incredibly trivial charges, on April 2nd the Fitness to Practise Committee found that although the facts were found proved, it did not amount to misconduct. The case was concluded. But the last word should go to my good friend Shaun Howe. He is an ex-dental hygienist and dental therapist. He served as an FtP panel member from 2003-08 and as an Investigating Committee member from 2014-16.

“When I was on the Investigating Committee, there was a case presented to us. It was an accusation of fraud against a registrant. To me, it seemed like a simple case of miscommunication, and no patient was harmed or suffered loss. I wanted it to go to a full hearing because that way, if completely innocent (which I felt he was), the registrant would be exonerated. The Lay person was a serving police officer who essentially judged that the case was clearly fraud and that the registrant ‘didn’t have a leg to stand on.’ In my opinion, and after I protested that it was our role to decide if it met the threshold for a hearing and not to judge, the Lay member was adamant that the case needed to go to an Interim Orders Committee hearing, in the public interest.

“I again pointed out that no patient was harmed or suffered loss and, therefore, there was no requirement for an IOC referral. I also quoted case law where nonclinical matters, on the whole, do not merit IOC intervention. I lost the argument. It went to the IOC, at great cost.

“No order was imposed.

“Do not get me started on ‘expert witnesses.’” n

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

Plus ça change, plus c’est la même chose

Never has this been so true!

It was a real honour to be invited to speak at the recent BASCD conference in Greenwich alongside so many eminent contributors. The twoday conference was wonderful, although I think my age started to show after the dinner when the (largely) younger diners seemed to have so much more energy than me after 11pm!

The audience was really positive and interested to learn about the history of dentistry. I was reminded of the above quote from the French philosopher Jean Baptiste Alphonse Kerr. You can learn a lot from history – but history is what it is! Having decided to stay in London in the days after the conference, we visited the “Moonwalkers” exhibition at The Light Room near Kings Cross (highly recommended) and I was again reminded how things change in all fields, but in some ways don’t. I remember watching the first moon landing and walk in 1969, sitting in our lounge with my father. Nearly 55 on years on, the United States is planning to return to the moon in 2025, this time with more computer power than 1969, when the power available then would be dwarfed by the technology in the Fitbit many wear on their wrists today.

In the breaks at the conference, I chatted with several younger members of the dental professions and they were largely unaware of some of the major changes in oral health, education and services over the years, and thought the challenges facing the profession now were new. Two of the slides I used in my presentation generated particular interest: one showing the proportion of the population that is edentate since 1968, when I was offered a place at Birmingham to study dentistry, and the second showing caries prevalence in five-year-olds since epidemiological data was first regularly collected in 1973. The proportion of the population that was edentulous in 1968 was around 35% and, before I could graduate, I had to have provided 12 sets of full/full dentures. Now, less than 3% of the population is edentulous and at least one dental school is advertising to find full/full cases for their students. This, of course, means that we are now dealing with an almost completely dentate population, with the inevitable increase in treatment demand that brings. How did the powers that be at the time come to the conclusion that this was a good time to close three dental schools? Unbelievable now but then everybody has 20/20 hindsight!

In England we have some of the best data in the world, and the

second slide to attract attention was that showing the massive change in caries prevalence in five-year-olds since 1973. In 1973, the average dmf in this group was not far off four, and around 70% of five-year-olds were affected – an unbelievable situation now and something that the young found hard to contemplate.

Now, the average dmf is under one, and many children are, thankfully, caries free. This improvement is fantastic but all data contains a degree of granularity and the disease is now largely, but not completely, present in deprived groups, unable or not motivated to access NHS care and unable to afford private options. In addition, this group is less likely to make good lifestyle decisions around diet and oral health care.

This degree of inequality inevitably took me on to one of my passions and possibly the best aspect of the recently published dental recovery plan, which most speakers found somewhat underwhelming.

In my time as a student in Birmingham, we became aware of the massive impact water fluoridation had on caries prevalence across all sections of the population, and it was widely predicted that fluoridation would be implemented across the country where it was feasible to do so, but this has not happened. People seemed to have become rather bored with the topic because a) it had been known about for so long and no significant progress had been made; and b) because caries prevalence has fallen significantly overall without it. It was great to see other slides in another presentation that showed, even in these days of overall improvement, that fluoridation still has a significant effect, and particularly so in less affluent parts of the community.

Peter Kelly, who spoke about the current consultation on the expansion of water fluoridation in the North East, discussed his journey to discover how impactful it can be, and used the phrase that Mike Lennon, the late Chair of the British Fluoridation Society, often quoted: “Water fluoridation gives

poor children rich kids’ teeth.” Peter showed that Hartlepool, which is naturally fluoridated, scores very low on almost every measure of health except for the prevalence of dental caries. The post-meeting comment, which pleased me most personally, was an email from a delegate who congratulated me for being the only speaker who mentioned the benefit for older people (I do, of course, have a vested interest!). As I said earlier, we now have a largely dentate older population, some of whom might struggle to access care in the traditional dental environment, and the reduction in root caries, insidious and difficult to treat if allowed to develop and progress, is significant. Thankfully contract reform was not prominent during the conference but in conversation it was good to talk about the history of dental contracting. Many people in the audience had qualified after 2006, and many thought that the current dissatisfaction and access difficulties were new and linked to the introduction of local commissioning. In fact, the first report into unhappiness with the “dental contract” was the Tattersall report, published in 1964, which 60 years ago suggested that capitation might be a better way to remunerate dentists working in primary care.

Access issues are multifactorial and to blame the current situation on one thing is stupid. It is largely forgotten, or conveniently ignored, that between 2006 and 2014, access to NHS dental services increased by 2 million, and we now have a wider workforce available if only the NHS and Government would do something to encourage that wider workforce to play a greater part in providing NHS care.

Miranda Steeples, President of BSDHT, gave an excellent presentation on the larger part DCPs could play in the delivery of NHS care, but the Government does not seem willing to tackle these barriers. The majority of the population is now dentally healthy and, given that it is good for everybody to work towards the top of their skill set, we should align the clinician with need.

I finished off my presentation with something a bit challenging. People are always talking about their rights in terms of healthcare, but they have responsibilities, too. I did an interview last summer with one of the most respected radio stations in the country following a story running in the press the previous day about a child who was told she had to wait up to six months to have a significant number of deciduous teeth removed under general anaesthetic. I asked the producer, who I knew from his days at the BBC, why no one was asking why this child needed these extractions. What had the child’s diet been? Had they been shown how to brush their teeth with the correct toothpaste?

There are 8,760 hours in a year, but most people spend less than an hour in a clinical environment. It is what happens in the remaining 8,759 hours that determine oral health status.

The title of the conference was “collaboration” and that collaboration does not just involve clinicians. This same issue exists in relation to general health, and we need to recognise that, as well as rights, we all have responsibilities. Somehow, people seem to ignore this. Some cannot do this for a variety of reasons not connected to services and we have to recognise this but, if health – including oral health – is to continue to improve we need to make better decisions, individually and at government level.

The new Chief Dental Officer for England was the first speaker, and I wish him well in his new role. As a leader you have an opportunity to make a difference on a larger scale than you can as a clinician working with individual patients, important as that is. After we published Delivering Better Oral Health in 2007, all the major toothpaste companies around the world changed the concentration of fluoride in toothpaste for the very young from 440 parts per million, which evidence showed is not effective in reducing caries, to 1,000 ppm, which is effective. That is the sort of impact a leader can have, and I wish Jason, the second CDO with a background in general practice, all the best.

The conference was a joy, the enthusiasm amongst the audience was palpable, and the hospitality and company could not have been bettered. n

About the author Dr Barry Cockcroft CBe is the former

Chief Dental officer for

england and current chair of the British Fluoridation society.

BAsCD president Charlotte Jeavons

Relating with colleagues – part two

Dr philip Johnstone, Dentolegal Consultant and Cases Team Lead at Dental Protection, concludes the two-part series looking at areas that could negatively impact professional relationships and increase workplace stress

The first part of this series (scan the QR code to read) looked at the approach to referrals, second opinions and handling criticism from colleagues. In this second part, we will look at how to manage differences of opinion, conflicts and competition.

Differences of opinion

In academic life, or in a scientific and clinical environment such as dentistry, professional colleagues may not always share the same views and opinions. It is important to maintain appropriate ethical standards in managing these differences. There are accepted professional channels for airing and discussing these opinions – for example, through literature and at professional meetings – and one should avoid bringing these debates to any forum where the reputation of the profession and individuals within it might be damaged or called into question. One should always respect the views of others and their right to hold and express sincerely held opinions, even where you might personally disagree with them. Whether or not there is any scientific evidence to support the person’s view is another question entirely. A professional response is to seek to influence the views of colleagues through reasonable and mutually respectful debate, as opposed to any attempt to discredit or ridicule the colleague in question.

Occasionally, you may be in a position to observe or influence the

progression of differences of this nature between other professional colleagues. Timely intervention of a professional colleague to remind the parties of their ethical obligations can assist in defusing the situation.

Conflicts

When relationships of any kind break down, the emotional fall-out and anger that results can be stressful and sometimes destructive. When the parties involved are professional colleagues, there is an additional complication that patients and members of staff can become drawn into the conflict. The intensity of feelings experienced in such disputes can sometimes result in inappropriate comments being made about a professional colleague. These remarks might be of a personal nature (for example, impugning the character or integrity of the other person), or of a professional nature (criticising clinical standards or perhaps academic/ research standards). These comments

may be made to patients, to members of staff or to other professional colleagues. Where conflicts arise, it is advisable that these are addressed promptly and professionally and they must never be allowed to adversely impact on patient care. Adherence to this approach preserves patients’ confidence in the profession, and fosters a collaborative and collegiate working environment, which in turn has a positive effect on the wellbeing of all those involved in the care of the patients.

Competition

Competition is a natural part of professional life and colleagues may be competing for jobs, for representative appointments or positions of responsibility in dental associations, colleges and academies, dental boards and councils, etc. Many of the processes leading to these appointments remain confidential within the profession rather than being in the public domain, but they still reflect upon the profession and the standards within it.

A true ‘Dental Maverick’

Having previously embarked on a month-long volunteering and teaching stint in Cambodia, where she worked in a university and several schools, as well as rural outreach areas, Gill Bird was inspired to create the Facebook page, NZ Dental Volunteers with a group of fellow dental therapists.

“There were four of us in the beginning, and we went to India, where we travelled and volunteered in a school doing dental work,” she recalls.

Following this experience, the NZ Dental Volunteers didn’t want to stop and began looking into other trips. Gill’s son had been volunteering with Igniting Change, a non-profit in Australia involving Richard Branson. He was told Richard Branson’s mother, Eve Branson, was associated with a charity called Dental Mavericks in the UK and, from there, a connection was made.

Gill got in touch with the Dental Mavericks’ Executive Director, Cally Walker, and formed a group to go on a trip in 2017. Inevitably, Gill fell in love with everyone involved as well as the children they were treating.

Gill says, “It was something wonderful to do with my friends. We had an excuse to go travelling and do something good with our careers as well.”

When Gill returned, Cally asked her if she would like to be an advisor for Dental Mavericks, which then grew into a role on the Board of Trustees.

The NZ Dental Volunteers Facebook page was rebranded to NZ Dental Mavericks, and it now facilitates annual trips to provide essential dental care to communities in need.

Despite the challenges posed by the Covid-19 pandemic, Gill remains steadfast in her commitment to the cause. “Many of my friends who expressed interest have been vigorously encouraged to join us on these trips,” Gill says, underscoring her dedication to involving others in this impactful work.

Gill’s role as a professional advisor in NZ has enabled her to help Dental Mavericks incorporate educational training sessions into the trips, allowing volunteers to earn CPD hours for their registration.

Looking ahead, Gill and her team are gearing up for their next endeavour – a trip to Essaouira this month, marking Dental Mavericks’ return to the town post-Covid. As they prepare to embark on this new chapter, Gill’s journey serves as a testament to the transformative power of volunteerism and its enduring ripple effects.

https://tinyurl.com/Dp-relating

It is important at all times to adhere to the guidance as set out by the General Dental Council (GDC) in Principle 6 of Standards for the Dental Team1 and to treat all colleagues with fairness and respect, irrespective of where you encounter them in your professional life.

summary

Maintaining good professional relationships is key to demonstrating an awareness of and compliance with the fundamental tenets of professionalism, it also ensures a culture of openness and transparency, which promotes and protects patient safety. n

Reference

1. Standards for the dental team (gdc-uk.org)

About the author Dr philip Johnstone, Dentolegal Consultant and Cases team lead at Dental protection.

“I have so much gratitude for the New Zealander volunteers willing join me each year on trips to Morocco,” Gill concludes. “They fly across to the other side of the world, give up their annual leave while leaving family behind to help vulnerable communities. A number of them have returned up to four times with me.” n

gill Bird (right) with two of her fellow Dental Mavericks

Suddenly, home didn’t feel like home anymore.

A complaint to the GDC can turn your world upside down. Our dentolegal experts are here to help turn it the right way up again. Join the

for protection and be ready for whatever life throws at you.

2023 Dentist of the Year, a year on

With just weeks to go until the 2024 Dental Awards winners are announced on 23 May, The Probe caught up with last year’s Dentist of the Year victor, Amit Jilka, to discuss what’s changed in the past 12 months, his practice’s family feel, and his ‘why’

what was it like to win the award for Dentist of the Year?

I was very surprised to have won the award as my team had entered me into it. I was extremely grateful to my team for recognising my contributions to them and the practice over the many years we have built Abbey House Dental.

I felt that the title of Dentist of the Year came with some responsibility, and it inspired me to continue leading by example and helping the profession as much as I can –especially my team.

You had big plans in place for Abbey House Dental last year. what have you been up to over the past 12 months?

Since winning the award we have launched a new, state of the art dental practice in the heart of Stoke on Trent. This opened in August 2023 and has flourished ever since. We offer the full range of dentistry from advanced implant surgery to sedation and orthodontics, with an on-site CBCT scanner and multiple intra oral scanners. We also built a bespoke training facility at this new site with

conference rooms and catering areas for delegates. This led to us launching the Abbey House Dental Academy.

We have since run courses for dental nurses, treatment coordinators, implant surgeons, and Invisalign providers. We hope to grow the academy by offering more courses to help our colleagues. We were also approved by the National Examining Board for Dental Nurses (NEBDN) to deliver our in-house dental nursing course. As recruitment is a massive issue in Staffordshire, being able to train anyone to become a dental nurse will help our own practice as well as the local practices in Staffordshire.

How did you get into mentoring and what satisfaction does it bring?

Over the years I have had the privilege of mentoring dentists for sedation and dental implants. I have really enjoyed helping dentists advance their careers, and I work hard at building my associates’ skill sets while they are with us at the practice. It is so nice to see some of my older associates now in a position to mentor others going full circle. As my team has more than 30 clinicians now, mentoring has become my day-to-day role, and I no longer see many of my own patients.

when we met you at the Dental Awards presentation, there was a real family feel to your team. Does this lend itself to your success?

That is really nice to hear. My wife and I built up our practice from a two-surgery site to a multisite dental

practice over the past 12 years, and this has only been possible with our phenomenal team. The ethos of the practice – our why – summarises this well:

For Us – Our Hope

We strive to better ourselves and go on a path of continual improvement to benefit everyone we meet and interact with. We want our families to be proud of our accomplishments and for us to look back and feel we did a great job.

For Our team – Our Strength

We strive to encourage our team to grow and develop their roles and skills to feel valued, empowered and satisfied in knowing they are the best they can be. We want them to love what they do. Passion for what you do is important to us. A positive attitude is contagious and lifts everyone’s spirits, including ours and our patients.

For Our Patients – Our Mission

We strive to provide our patients with the highest level of care and treatment we can offer, so that they feel at ease about dentistry and confident in smiling and eating. We want each patient to feel that they are a part of us and our practice. We want the people of Stone to know that Abbey House Dental is committed to them. Our why is our journey to providing confident and meaningful contributions. It should give us, our team and our patients satisfaction, happiness and confidence. It is our pathway for now and the future. It should encourage us to benefit the world we live in. We are Abbey House Dental and we believe in our why. n

Reducing the stress of it all

Dentistry is widely acknowledged to be a particularly stressful profession compared to others, with dentists most anxious about making mistakes, patient complaints and patient confrontation among a long list of potential concerns. There are various things that can be done to reduce the pressure that individuals are under on a daily basis, and one of these is building strong working relationships with team members. This includes both practice staff and professionals that support the practice with products and services.

the effects of stress

The impact of this stress on dental professionals is substantial. Firstly, it is associated with reduced wellbeing among dentists, increasing the risk of mental health concerns like depression and addiction, as well as burnout. There is also some evidence to suggest that high levels of prolonged stress can negatively affect professional standards and clinical performance, although more research is needed in the field to better determine the link between the two. Finding ways to reduce the stress experienced by dentists and dental teams every day is, therefore, crucial.

collaboration

Research has shown that effective collaboration within the workplace is hugely

beneficial. One study showed that working well as a collective can motivate individuals to achieve more, to enjoy their work and to perform more productively. The same experiment suggested that people working together also developed greater endurance for the task at hand, meaning they were able to persist for longer without experiencing a negative psychological impact.

This teamwork can be optimised in a wide range of circumstances by establishing strong working relationships. This is particularly true for individuals who hold leadership or management roles (including principals, practice managers, lead dental nurses, treatment coordinators etc.) but can be applied to those in many different positions. As such, it’s important to consider the rapport that is built across the business, both within the practice and between practice staff and external sources such as equipment suppliers and software support services.

communication

To establish and maintain these strong working relationships between colleagues, open and honest communication is important. This encourages engagement between team members and is key to both facilitating professional relationships and developing the organisation as a whole. Good communication also plays a vital role in improving productivity and building trust –

both of which are essential within the dental practice. Once again, these are applicable both with regards to internal and external relationships. However it is achieved, studies have linked effective communication with a more supportive working environment and reduced stress levels.

an equipment supplier you can count on

To achieve a stress-free life in dentistry – or as close to it as possible – you need to know that you’re working with an equipment provider that shares your commitment to collaboration and communication. You need confidence that your questions will be answered quickly and by the right people. Your team also needs to know that any equipment malfunctions will be responded to rapidly. It is just as crucial that you trust your provider to keep you in the loop when software upgrades are due or new parts are being ordered. Without these aspects, your practice schedule will likely be disrupted, your patient appointments could be delayed and your business will likely have to contend with additional costs and inefficiencies. Such situations will do little to reduce stress levels in the practice, so preventing them is essential. This is why choosing a supplier you can count on is vital.

Working with a team like RPA Dental for your dental equipment needs will help you avoid all of this. Louise Hilton,

Practice Manager at PBA Dental & Implant Clinic in Liverpool, says of her 20+ year relationship: “We trust RPA Dental. They really understand our business and we know the team well enough to trust in what they say. The whole team is fantastic and they communicate well. We’re like a closeknit family – over the years, we have built a brilliant working relationship and this makes a big difference to our practice. I think they’re brilliant.”

teamwork at its finest

There are many potential sources of stress for the modern dental team. Don’t let equipment maintenance be one of them for your practice. Find an equipment supplier that works effectively with you, communicates clearly and builds an excellent working relationship with your practice for the best results.

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

about the author adam Shaw, Sales Director at rpa Dental Ltd.

The real cost of equipment breakdown

Productivity and efficiency are crucial within the dental practice today to ensure that patients receive safe and effective care, and that the practice experiences the greatest levels of uptime to provide such treatments. There are many different factors that can impact the dental team’s ability to deliver dental services. For example, if essential infection control equipment like your autoclave were to malfunction or breakdown completely, this would significantly impact patients, the professional team and the business in a number of ways.

patient care suffers

The first, and most important, issue caused by an autoclave breakdown is its impact on patient care. When the decontamination process is paused, the team will quickly run out of sterilised reusable instruments, meaning that appointments must also be halted until a resolution is found.

A survey from last year, although focusing on all NHS services, found that 66% of patients believed cancelled care appointments impacted their lives due to on-going pain, worsening symptoms, reduced mental health and other reasons. Though no data exists specifically for dental patients, it is likely that delaying dental care provision would have a similar effect on patients. The lack of access to dentistry and huge demand for services would also make rescheduling appointments difficult, meaning that individuals could wait some time before being seen.

Financial implications

For the practice there are several financial implications of equipment malfunctions.

Firstly, the cost of an emergency engineer callout could set the practice back £50£250. That’s before they have assessed the damage, made repairs, ordered parts or offered a replacement. Depending on the issue, finding a solution could cost several hundreds more, which is money that the practice will have to pay immediately.

At the same time, the business will suffer a significant loss of income. For a single surgery practice, cancelling one day of appointments could mean losing £1,000-£2,000. But what if the engineer can’t get to the practice until the next day? What happens if the issue can’t be resolved there and then? What if it takes another 24 hours after the problem is identified to receive the necessary new parts? For a multi-surgery practice that ends up having to cancel two days of appointments, the financial implications are substantial.

team impact

Individual team members will feel the effects of mass appointment cancellations too. Associates, for example, will be impacted financially with loss of earnings where they are unable to deliver treatment to patients. The whole team will also likely be affected by the increased stress that surgery downtime can cause. Dentistry can be a stressful profession, with over 50% of dentists, 45% of dental hygienists and therapists, and 85% of dental nurses experiencing stress and anxiety in the UK. Disruptions to the daily schedule and the resulting discontent from patients is likely to create a more difficult environment for the team. This could contribute to the long-term stress of the team which in turn has been linked to reduced productivity and job satisfaction.

Beyond the immediate concerns

Although all these elements will negatively impact the dental practice, the real cost of equipment breakdowns goes even further. In today’s world, a single unforeseen event – particularly if managed poorly or not sufficiently prepared for – can leave a lasting impression and derail the business’ reputation.

If the only autoclave in a dental practice stops working and two days of appointments are cancelled, many of the affected patients could go elsewhere and some will not return. They will tell their friends and family about the inconvenience and are unlikely to recommend the practice, negatively affecting its reputation in the local community. If the autoclave were to break a second time six months later, this could spell disaster for the business. Not only will practice growth be restricted, but the value of the business could decrease too.

peace of mind

To avoid all of this, it’s essential to minimise the risk of infection control equipment breakdowns. This begins with the implementation of effective products. HTM 01-05 sets out an array of aspects that must be assessed during the procurement process to ensure the selection of equipment that is fit for purpose and fully complaint. The document also highlights the importance of adequate equipment maintenance and servicing to ensure that the autoclave continues to function effectively and efficiently.

Eschmann offers total peace of mind with their Care & Cover servicing and maintenance programme. This gives

practices access to a network of 50+ Eschmann trained engineers across the nation, who are committed to getting your autoclave and your practice back up and running quickly, with minimal downtime. They fix 91% of issues on their first visit when called out to practices, with original manufacturer parts in their vans as standard and an unparalleled knowledge of Eschmann equipment and technologies. Plus, the Care & Cover package covers autoclaves, washer disinfectors and RO Water Systems and incorporates Annual Validation and Pressure Vessel Certification (PSSR), annual service and software upgrades, unlimited breakdown cover, unlimited Eschmann parts and labour, and Enhanced CPD user training.

The real cost of equipment malfunctions or breakdowns in the dental practice is huge. Protect your patients, your team and your business by looking after your infection control equipment.

For more information on the highly effective and affordable range of infection control products from Eschmann, please visit www.eschmann.co.uk or call 01903 753322 n

about the author Nicky Varney,

Senior Marketing Manager

at eschmann.

How going paperless transformed the West Midlands NHS dental referral process

The power of technology to improve health services underpins the NHS Long Term Plan and recognises that digital systems are key to the evolution of our health care system.

This is something I have seen firsthand in three decades of NHS dentistry, with the shift from analogue to digital enhancing every aspect of dental care. This progression has been pivotal in my dental network in the West Midlands, and has helped shift our focus from merely treating conditions to actively preventing them.

Dentists know that early detection and treatment of dental issues is critical. We see regularly how neglect can lead to severe repercussions for patients, affecting not only their physical wellbeing but also their mental health. As a result, ensuring our patients get swift access to specialist care when needed is a priority.

As the chairperson of the Shropshire and Staffordshire Local Dental Network, I have the privilege of collaborating with a diverse group of professionals, including specialists, patient groups, dental nurses, and health commissioners. Our collective goal has always been to elevate the standard of dental care for our community and we’re constantly seeking innovative approaches to enhance our services.

One such innovation, which has been a real team effort, was the overhaul of our referral system. Referrals have traditionally been paper-based, with letters being sent to clinics

and then passed onto specialists. The process is cumbersome, often resulting in misplaced documents and consequent delays.

We were aware that electronic referrals had been successfully implemented in other NHS sectors and, with increasing waiting lists, we felt the time was right to bring those benefits to our local dental services.

Improving referral quality

The old system was not just time-consuming but also prone to errors. We would send off referrals that would arrive missing vital information, like scans and X-rays, leaving specialists without crucial data during consultations. The way we communicated with clinicians was also more difficult, which could lead to misdirected or incorrect referrals.

Patients were often the ones who felt the brunt of this inefficiency. Imagine the frustration of arriving for a procedure, only to discover that the necessary specialist isn’t available or, worse, being sent back to join the waiting list.

As a local dental network, we believed that technology could streamline the referral process and make it more transparent. Our aim was to integrate the disparate referral systems of each speciality into one unified platform to direct patients more accurately to the correct clinical pathway.

We partnered with NEC Rego to create a one-system referral process to improve communication between primary and secondary care.

The results have been far reaching with referrals now taking minutes rather than days or weeks.

The quality of the process has improved as well. With comprehensive patient medical histories and clinical documents all in one place, it ensures no detail is overlooked.

An important development for all local dentists is the ability to quickly consult with specialists through the Rego portal. If a patient presents with a suspicious lesion in their mouth – a potential sign of oral cancer – an immediate referral is vital. We can simply upload a photo of the lesion along with the patient’s medical history and a specialist can review it remotely. This can save weeks of worry and unnecessary appointments if a consultant is able to determine quickly that the lesion is a benign side effect of the patient’s medication and can be managed by the dentist.

A regional focus

Digitising the referral process has significantly benefited both dental professionals and patients throughout the area. Our patients can now track their referral in real-time via email so they are better informed about their treatment journey. Communication has also improved between primary and secondary care, which is simpler and more straightforward. Patients have greater control over their referral choices as they can now choose from a wider selection of providers, often opting to

travel further for those with shorter waiting times. This helps spread the load for local services, reducing the pressure on those that are at capacity or in city centres. For dental practitioners, the digital platform means less time spent on administrative tasks and more time available for patient care.

Since we introduced the digital referral system seven years ago, over 200 dental practices in the region have adopted it. This in turn gives us valuable insights from the data collected on the specific needs of our local community. By identifying areas with a shortage of oral surgery or orthodontic services, we can respond by commissioning additional services to meet those needs. It is a challenging time for NHS dentistry and, whilst technology cannot fix everything, we’ve seen how digitisation enhances our patient outcomes. Reducing the administrative burden on dentists has been instrumental in our shift towards a more proactive and preventive model of dental care, which significantly benefits both dentists and patients. 

About the author

Dr N. Tony Ahmed is a practicing dentist and chair of the Shropshire and Staffordshire Local Dental Network.

Cleaning up your dirty data

There is a need for an enormous amount of information storage in dentistry. As this piles up over time, it’s important for a dental practice to narrow down the necessities and avoid the build-up of ‘dirty data’. The definition of dirty data changes dependent on where you look, but it commonly boils down to the collection of information that is in some way wrong or unnecessary. In the dental practice this could include patient clinical and financial records, which are kept despite containing incorrect or outdated information.

the damage of dirty data

To understand how data becomes ‘dirty’, we must know what contributes to data quality, and how it can be applied to a dental practice. Data quality has been defined as the degree to which the accuracy, completeness, consistency, and timeliness of the data satisfy the needs of a specific user. A poor standard of information would do little to help an individual meet their intended outcomes and could adversely impact a workflow if it fails to excel in any of these areas.

If a patient’s medical history does not mention a recently diagnosed condition that could alter a clinician’s approach to treatment – diabetes for example –appropriate care may not be provided. This would fall under an incomplete quality of data that has not been updated in a timely manner.

On the opposite end of the spectrum, a dental practice may still be holding onto patient records that are no longer required, in physical or digital form. Clinical information that is more than 11 years old could fall into this category, and contribute to unnecessarily inflated patient files. An excess of information creates an inefficient medical record system, which dental professionals interact with every day.

Ensuring your practice has efficient and well-kept documentation is essential when looking to optimise your workflows. Poorly designed systems can grow the risk of dirty data, which increases the time searching patient records, as well as the chance of clinical errors and even clinician burnout. Individual dental professionals may see a decrease in job satisfaction and the quality of care they can provide as a result of poor record management.

Know your regulations

To avoid the unnecessary collection of outdated information, a practice should have processes in place to review patient records regularly and remove and destroy those that are no longer needed to be kept.

NHS England reduced the retention period of clinical dental care records from 15 years to the aforementioned 11 years in May 2023, where it may then be reviewed and destroyed if no longer needed. This includes FP17 and FP170 forms, and is applied to all dental care settings. For financially related records, this is reduced to just 2 years of retention before review.

Workplace wellbeing

Chronic stress accounts for around half of all cases of selfreported work-related ill health in Great Britain, and it is rife within the dental profession. But it doesn’t just affect dentists. Dental nurses, and dental hygienists and therapists are also shown to experience high levels of mental ill health due to work-related stressors.

Levels of work-related ill-health due to stress have been increasing since 1998/99 in the UK, peaking in recent years. According to the Health and Safety Executive (HSE), this caused the loss of 17 million work days in 2022-23. When pressure becomes chronic, it can trigger symptoms like insomnia, anxiety, depression high blood pressure or digestive problems, among many others.

Workload is named as the biggest contributory factor to workplace stress in the UK, and dental practices are no exception. The most significant interventions recorded by the GDC in lowering stress due to workload were strategic changes, which ranged from simple shift rescheduling, to adaptations towards more informed, communicative leadership and more collaborative working. The organisational allocation of duties is also very important. The more clarity and control team members have over their roles the easier it is for them to manage workload demands. Clinician-based interventions, like Employee Assistance Programmes (EAPs), that offer subsidised counselling and other support, can be helpful for stressed professionals. Resilience relates to the ability to problem-solve and adapt, and individuals can benefit from

For a child’s records, the retention period is more flexible, and instead extends to the specific individual’s 25th birthday (or their 26th if the patient was 17 at the end of treatment).

Reviews must be conducted before the destruction of a record because it may still meet the requirements of quality data, and not yet be considered dirty. For example, NHS England states a clinical care record could provide information on a serious incident that is still needed decades into the future, and therefore require it to be kept on file for up to 20 years.

Clinicians must also consider who the information may be valuable to, as this variable can change the importance of a record. Whilst clinical information from over a decade ago may not prove useful to every general dental practitioner, it may contain valuable insight for someone suffering from a rare condition or undergoing an innovative treatment, and the record may be of use to another medical professional in the future.

inefficiency

The best time to assess your data management workflows is now. Practices are likely to already be working with a digital system, but ensuring it streamlines your workflows with complete ease of use is essential. A cloud-based system is ideal for the modern clinician, who can then keep their patient data accessible and organised across multiple practices, and even on the go.

With a solution like R4+, a Sensei product, from the practice and patient management brand of Carestream Dental, clinicians can easily navigate and record medical tracking, clinical treatments, and patient communication in a convenient patient record storage, all within a few clicks. With the support of Patient Bridge, also a Sensei product, patients can fill out and sign important forms digitally, including medical history, treatment plans, consent and FP17. Each document can be reviewed and amended where appropriate, to keep up with the record management demands placed on today’s practices. Run through the cloud, your practice saves space, whilst also making information accessible for clinicians from anywhere, at any time. Dirty data can set back the everyday running of a dental practice when the information held is incorrect, outdated, and unnecessary. With an effective system in place, everyday workflows can run smoothly, and benefits will be felt in every aspect of clinical care.

For more information on Sensei Cloud visit https://gosensei.co.uk/ n

about the author Nina Gilbert, carestream Senior Global product Line Manager.

developing strategies to cope with adversity in all areas of their lives, including work. However, organisation-focused initiatives are significantly more effective. Organisational resilience can be measured in how well an organisation plans and adjusts in response to external factors, and this translates directly into the wellbeing of team members.

pressure versus stimulation

Not all pressure in a work setting is negative. There is such a thing as ‘good stress’ and it’s actually vital for a healthy life. A positive level of stress can stimulate memory and improve cognition, and in the short term it can enhance immunity. Psychologists refer to ‘good stress’ as ‘eustress’. It’s the sensation of excitement we feel when we are mentally stimulated or challenged by a situation. Superficial symptoms may be similar to stress – our pulse quickens and our hormones surge – but there is no threat sparking feelings of distress or fear.

A lack of stimulation – being in a situation where you feel unable to utilise your skills and exert your energies in positive directions – can be as stressful as being overworked. Even in today’s busy dental practices, under-stimulation is felt by many dental staff who feel their potential and training is under-utilised.

Streamlining as an adaptation to pressure

A great dental practice, like any good business, values the contribution of each team member. This will be reflected in a

system of proactive communication and where needed, consultation over change. Each and every role will have a stake in making the business flow. All team members will have a clear part to play, and will feel engaged, busy, challenged and stimulated. Digitally streamlining processes through dental practice management systems can enable seamless team working, even across multiple sites, by featuring secure access to shared reports, and integrated communication tools.

Fear of complaints from patients has been cited as a prime stressor for dentists. To reduce the risk of complaints, fully informed consent must be obtained from the patient and adequately recorded. Practice management systems can incorporate signed consent into treatment plans to aid in this. Some systems can even create realistic visualisations of treatment to help patients understand their treatment better. The resulting clear informed consent builds trust and improves compliance as well. Workloads can be improved through practice management system functions that automate certain tasks. For example, when the information is integrated, data from appointments, team rotas, payments, treatment decisions and associated trends can be analysed at the touch of a button through comparative reports. As well as enabling busy practices the capacity to generate metrics quickly, the data can enable strategic planning across a practice so that workload is allocated appropriately, and growth areas can be identified more easily.

The dental practice management software (DPMS) from AeronaDental is a system designed to take the stress out of the dayto-day operation of dental practices. Totally cloud-based, the system works securely to enable clear communication, and manage all clinical and commercial aspects of single-site as well as multi-site businesses. The system has intuitive charting tools, and enables clinicians to share and sign treatment plans digitally with patients. Patient engagement is easier with online consultation tools, forms, and survey tools. Business and finance tools are integrated, so practice managers and business owners can analyse performance to plan for improved resilience.

Structural approaches to wellbeing are most effective in dealing with the problem of workplace stress. Managing the health risks of stress are as important as managing any workplace health concern, and a collaborative approach to working is a great way to start improving workplace wellbeing. Investing in ways to streamline workload, improve communication both with patients and team members, and improve strategic planning with business tools could make all the difference. For more information, please visit aerona.com n

about the author Mark Garner, General Manager, aeronaDental.

Creating a calming environment for our patients

Dr teki Sowdani has opened two new clinics in recent years, the first project undertaken July – August 2020, and the second September – October 2023. He describes his experience of working on his most recent project, and offers advice to anyone looking to embark on a similar journey

My motivation to set up a new clinic was to be able to implement all of the ideas I had gathered and developed while working as an associate to give the best experience to my patients.

The main goal was to make the practice feel as little like a dental practice as possible so that we could create a calming environment for our patients, allowing them to feel relaxed and at home. At the same time, I wanted to offer them the latest technology and the best quality of care.

My main worry was having to run the practice and everything that involves, as well as giving patients my undivided attention. The project took me a long time to prepare for, financially. Mentally, it was going through the pandemic that gave me the extra push to chase my dreams – because nothing was guaranteed.

From the very first conversation that I had with Matt Rowlingson from Clark Dental, I was really impressed with the service that I received and how bespoke things could be for the practice that I was building. The communication was always great and that gave me the confidence that, even after the project was finished with regards to aftercare and the maintenance side of things, I would be looked after.

Decision making around equipment

I had an idea of the equipment I wanted as I was lucky enough to have trialled some in the practice that I was working in as an associate. Then it was a case of me finding the best and the very latest versions of that equipment. Clark Dental helped me in my decisions to ensure I was choosing

the right solutions for my own practice – the advice from the team was always bespoke, taking my unique needs into account at all stages.

The Axano treatment centre has taken intuition to the next level for a dental chair. I am still being amazed by the new features that it has. And, from a style perspective, it wows every patient that comes in. It is also practical and comfortable for the patient, which are incredibly important requirements.

I have had previous experience using the x-ray systems that I chose, and the team at Clark Dental offered advice and recommendations with regards to the specific models (Dentsply Sirona Xios Supreme digital x-ray kit and Nomad hand held x-ray machine) to allow me to meet the needs of the practice. Similarly, I was familiar with autoclaves and handpieces from W&H, and Clark Dental helped me to decide on the specific models.

The installation process was smooth and it was good to get to know the engineers during the process. I found it very interesting, they were great at explaining things – and I was able to take great progress pictures along the way which was helpful.

reflecting on the experience I was quite lucky as to not come across major challenges during the project, it went very smoothly. I believe this was a credit to Clark Dental –always being at the end of the phone and being flexible with my working day, especially considering that we were a busy clinic with patients every day. I had found it much more manageable than anticipated to balance these two sides of my work.

I definitely met my main goal with this project. It makes me happy every time I have a patient that comes in and gives feedback. Patients don’t feel like they’ve come to the dentist, and describe how relaxed they feel. I have also received feedback from other dentists who come and visit the practice to do training, who are also wowed by the quality of the equipment that we have. To them, everything looks and feels very premium which is fantastic.

Opening my new clinic has allowed me to create the work life balance which was difficult to achieve without having my own business. It has also given me an insight into the workings of owning and running a practice rather than solely clinical work. And I have been able to meet some really nice and helpful people in the industry. My advice to others would be that, when you are creating a project like this, it’s important to build life-long relationships. This is because it’s not just a case of once you’ve built the practice that’s it, there is a lot of

maintenance and things that might potentially go wrong. So, you need to be comfortable and feel safe that who you’ve chosen to work with are going to be able to deliver the aftercare that you may need.

I would definitely recommend Clark Dental, and when I opened up my second site, there was no question as to who I was going to use to install the equipment and support me there.

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

about the author

Dr teki Sowdani is the owner of and principal dentist at teeth by teki, a private aesthetic clinic in islington which focusses on elevating patient care. Over the past 10 years, teki has built his experience, skills, and social media presence, providing invisalign and composite bonding to his patients.

Lupus – an autoimmune disease with profound consequences

Lupus (systemic lupus erythematosus, or SLE), is a chronic autoimmune condition that causes inflammation, and can damage any part of the body. The cause is currently unknown, although research has indicated that genetics, hormones and certain infections, including viruses, may be factors. Symptoms may vary, but patients often experience joint pain, painful facial rashes, hair loss, oedema, pain when breathing deeply or lying down, headaches, depression, abdominal pain, sensitivity to the sun and a high incidence of oral health problems.

Inflammation in the body caused by SLE can have a devastating impact on a patient’s overall health, in severe cases affecting kidney function, damaging the brain and central nervous system and affecting cardiovascular health. With such a long list of possible symptoms, as well as periods of remission between flare-ups, lupus can be difficult to diagnose. No single test can detect the condition, so a number of blood and kidney function tests are used. There is no cure, but a combination of treatments can be effective in managing many of the symptoms.

SLE commonly affects adult women, more than men by 9 to 1. It is thought that currently up to 50,000 people in the UK have the condition. Lupus affects people of Afro-Caribbean, Asian and Hispanic heritage more than other populations; a study in the US found that African American women had almost twice the prevalence of SLE as white women.

lupus and oral health

Lupus affects every bodily function, so it’s no surprise that the condition can significantly affect patients’ oral health, greatly impacting their oral health-related quality of life (OHRQoL).

Because of additional risks to oral health, careful dental care routines and frequent dental visits are vital to protect sufferers. However, visits to the dentist can be a challenge for many patients with SLE. The condition is associated with high risk of metal delayed-type hypersensitivity, including nickel, gold and mercury, often present in dental materials. Use of fluorescent light, such as surgical lighting, can also cause flare-ups due to an increased risk of photosensitivity.

Oral lesions occur in more than 40% of people with SLE. In some cases, non-treatment of oral ulcers carries an increased risk for development of cancer. Development of oral shingles is also possible. Shingles (herpes zoster, or HZ) is reported as the most prevalent viral infection in patients with SLE.

Saliva dysfunction and oral microbial changes are a common symptom of lupus, leading to a high incidence of caries development in patients. Studies have shown that about 79% of patients with SLE suffer from hyposalivation, and xerostomia is a common side effect of the condition. The decrease in salivary flow rate in SLE may be the result of secondary Sjogren’s syndrome, a condition affecting saliva production, which often accompanies immune system disorders.

Xerostomia carries with it a number of risks to oral health. Saliva supports oral hygiene, providing lubrication to condition teeth and wash away food particles, keeping the oral cavity moist and clean. Salivary amylase helps to initiate the digestive process, and mucin and immunoglobulin in saliva protect the oral mucosa from microbial infection. When saliva production is affected, gingivitis and periodontitis, dental caries, halitosis, fungal infections (candidiasis), and accelerating enamel erosion can occur.

Inflammation, periodontitis & lupus

Studies have also shown that SLE carries a significantly increased risk of periodontitis. The inflammatory condition is generally preventable through exercising good oral hygiene, however, once inflammation extends to the periodontium, the risk of bone loss, infection and tooth-loss increases. Studies clearly demonstrate an association with periodontal disease and the development of several autoimmune inflammatory conditions, including SLE. A causal link is difficult to prove, but there is a clear prevalence of poor oral hygiene and periodontal disease in patients presenting with symptoms of lupus.

Managing a complex condition

Lupus is a complex condition to manage. Maintaining periodontal health with increased attention to daily oral hygiene is a very important element of this. Frequent tooth-brushing is fundamental for maintaining oral health and reducing the

formation of biofilms. However, research has shown that brushing alone may only remove 42% of plaque. Dental professionals are encouraged to educate patients on the added importance of interdental cleansers. FLEXI interdental brushes, used with PREVENT GEL from TANDEX are an ideal system for maintaining periodontal health. The FLEXI interdental brushes come in 11 different sizes, and the flexible brush can be shaped to reach all the gaps that a toothbrush can’t reach. The addition of PREVENT GEL supports patients who have impaired saliva production, containing chlorhexidine and fluoride to strengthen enamel and protect against bacteria.

Patients with autoimmune diseases like SLE have been shown to suffer disproportionately with poor oral health, and have been shown to have a greater risk of periodontitis. Educating patients with lupus on the importance of interdental cleaning helps them manage the additional risks to their oral health.

For more information on Tandex’s range of products, visit https://tandex.dk/ n

about the author Kimberley lloyd-rees on behalf of tandex.

Kimberley graduated from the University of Sheffield in 2010, where she now works as a clinical tutor in Dental hygiene and therapy as well as working in practice.

Building good habits for better dental health

Daily interdental cleaning is recommended by the NHS, as it helps manage the buildup of biofilm, and can reduce the likelihood of developing gingivitis and periodontitis.

However, in a recent UK survey, only 37 percent of those aged 55 and over claimed to floss their teeth daily, and just 18 percent of 18 to 24-year-olds. It seems the interdental cleaning habit isn’t sticking here in the UK.

Dentists know that the best chance of successful oral health in adulthood is given by building up positive dental care habits, including interdental cleaning, in childhood. Even if we were lucky enough to have had this instilled when we were growing up, the challenges around building certain healthy habits is something all of us can relate to. Maintaining a robust dental care routine, including interdental cleaning, can be even harder for some patients with impaired executive function.

executive function and oral health

Executive functions are the high-level cognitive processes that govern one’s approach to adapting behaviour beneficially to circumstances. They affect the ability to problem-solve, make decisions or meet goals. A person with impaired executive function will struggle to connect tasks in the short-term to their longer-term benefits, and so can be at a disadvantage when attempting to form favourable routines.

The causes of executive function disorder (EFD) are not always clear; however, studies show that neurological conditions like Attention Deficit Hyperactivity Disorder (ADHD), and Adverse Childhood Experiences (ACE), as well as mood disorders are factors. It’s no coincidence that patients with these conditions are more likely to suffer from poor dental health. ADHD is a complex condition, but those with the condition may particularly struggle with forming and maintaining habits, no matter how beneficial. Symptoms are characterised by lack of attention, hyperactivity and impulsiveness, and it is very difficult for patients with the condition to foresee outcomes in any given scenario, both positive and negative. According to some researchers, the ADHD brain is in a state of ‘reward deficiency,’ related partly to differences in dopamine function. As a result, people with ADHD can be focused on short-term sensation rather the benefits of delaying gratification.

Many studies have looked at the connection between ADHD and oral health. Adolescents with ADHD are particularly at risk, as they have a significantly higher incidence of dental caries and gingival bleeding than those without the condition. To maintain gingival health, young patients with ADHD need more attention from dental professionals and those responsible for their diet and oral hygiene.

Oral health suffers where there have been ACEs. Particular connection between poor

oral health and childhood neglect and abuse has been noted by researchers. Where there has been neglect of basic care, children can develop a range of disorders, many of which affect executive and cognitive functioning. Survivors of ACEs may present with a spectrum of oral health problems including erratic dental hygiene patterns, tooth loss, dental pain, periodontal diseases and dental anxiety in adulthood.

Executive dysfunction can accompany mood disorders as well as other psychiatric conditions. Individuals with mental illnesses are more likely to suffer from poor dental health; many common depressive symptoms, such as anhedonia or a lack of motivation, feelings of worthlessness, and fatigue, may adversely affect an adult’s ability to maintain regular habits around oral hygiene.

Building good habits

It’s never too late to work on improving executive function, even in patients with EFD. In cases of extreme impairments, medication might be considered, with cognitive behavioural therapy recommended to teach behavioural strategies and emotional regulation techniques.

Psychologists advise a gradual approach to building healthier patterns of behaviour, starting with small and simple changes, building new habits into existing routines, and incorporating rewards, making them immediate and pleasurable.

Anyone who has used a Water Flosser can attest to the simplicity – as well as

the fun-factor – of incorporating it into a daily routine. The Waterpik® Water Flosser, accredited by the Oral Health Foundation, is also effective in removing up to 99% of plaque from dental areas, and is up to 50% more effective in improving gum health than string floss. The Waterpik® Cordless Advanced Water Flosser comes in an attractive range of lightweight, convenient and easy-to-use units. It is also rapidly rechargeable, ultra-quiet, powerful, portable, and easy to use, making it an easy addition to patients’ daily routines. It even be used it in the shower.

Clinicians may struggle to help patients incorporate regular, interdental cleaning into their daily oral care routines. Anything that helps improve dental health by making good habits easier and more appealing is to be embraced.

For more information on Waterpik® Water Flosser products visit www.waterpik. co.uk. Waterpik® products are available from Amazon, Costco UK, Argos, Boots, Superdrug and Tesco online and in stores across the UK and Ireland. n

about the author

Susan hutson joined Waterpik as a Professional educator 4 years ago. She is passionate about the work she carries out, delivering lunch & learn educational sessions to dental professionals.

Patient participation starts with patient education

The General Dental Council (GDC) Standards for the Dental Team clearly sets patients’ interests at the core of ethical practice. The code elucidates much of this principle in terms of integrity; in honest communications, and holistic clinical care. Dental professionals are increasingly encouraged to seek patient participation throughout the whole consultation process, from selecting treatments, to managing appropriate self-care. Clinicians often find that delivering the best treatment requires some education, and building rapport and developing communication is key. This increases trust and enables collaboration, contributing to greater case acceptance. It can be hard not to take it personally when patients refuse to participate, or to adhere to carefully considered recommendations. Although it may be a simple case of a patient having little interest in following advice, a patient’s inability to listen or to trust professionals may be linked to a number of circumstances. These include poor mental health, treatment burnout due to a chronic illness, learning difficulties, neurodivergence or behavioural disorders. For example, oppositional defiant disorder (ODD), is a behavioural disorder that is generally seen in children and can persist into adulthood. The condition is characterised by negative, aggressive or defiant behaviour, as well as a mistrust of those in positions of authority. ODD is linked with attention-deficit hyperactivity disorder (ADHD), as well as depression and

anxiety, and it negatively effects patients’ overall health and life chances.

Due to the nature of the condition, it can be difficult to communicate instructions to patients with ODD, or to build a rapport to help them participate in treatment. It can be easy to become defensive in response to unreasonable defiance. Those seeking to educate ODD patients are advised to stay calm, reinforce positive behaviour, offer choices and adopt a collaborative approach as much as possible over a didactic one.

It may be helpful to remember that many behavioural problems are associated with anxiety as well. Studies have found that about 60% of those with lifetime ODD also met criteria for lifetime anxiety disorders.

Whatever the reason for a patient failing to follow advice, professionals have a duty to communicate effectively so they can implement a holistic and preventative approach to patient care. Training in persuasive techniques can be helpful.

Quick tips

for effective persuasion

1. Exercise empathy: Evidence has shown that empathy training can be very helpful in promoting treatment acceptance. Empathy improves communication skills and builds rapport. Empathetic practice has also been shown to improve the behaviour of patients towards practitioners.

2. Educate: Promoting health literacy is key in helping patients develop selfefficacy around their health care needs, and people with high levels

of self-efficacy have better health and quality of life. Patient education and collaborative, partnership approaches to treatment enable genuine participation in treatment, improving outcomes.

3. Communicate: In order to be most effective, communication should be bi-directional, and educating patients will be more effective if there is a genuine exchange of information – this means listening. Providing clear information is a vital part of communication and of ethical practice. Clear, visual information for use in-practice and online is particularly helpful for allaying anxieties in those with impaired learning skills.

4. Some people just need time: Sometimes it’s best to provide patients with information about their condition, with advice and options, and give them time to absorb it. Time allows patients to contemplate options, gather additional information, confer with family and friends, consider individual preferences, and address their personal worries or concerns.

Knowledge is power

Once options for treatment are discussed with patients, this should be immediately documented. To assist in collaborative decision-making, patients benefit from having direct access to pertinent information and advice. Documentation sent to patients should contain clear, personalised and succinct information related to their diagnosis and treatment options, including clear costs. Ideal documentation should convey complex

information in clear terms, and should be educational by outlining the detailed risks and benefits of the treatment options. Kiroku Docs enables clinicians to create any documentation needed. Patient information letters, treatment plans, consent forms and referral letters, can be created from consultation notes in an instant. Powered by AI, the system automatically converts Kiroku Notes into any number of customisable documents. Clinicians have full control over the level of complexity of the language used, ensuring the information is appropriate for every recipient. Instant conversion enables clinicians to spend more time discussing approaches to treatment with patients.

Dental professionals that take time to communicate empathetically with patients, and help them develop knowledge and understanding, reap the benefits in terms of case acceptance and more positive outcomes. Patients, especially those with conditions affecting collaborative skills like ODD, benefit from clear information that allows them to give their fully informed consent to treatments.

To find out more about Kiroku, or to start your free trial, please visit trykiroku.com 

About the author

Hannah

Burrow, CEO of Kiroku.

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Straumann Group takes on Portugal for the 2024 Charity Bike Ride

Straumann Group is raring to go for another successful fundraiser for Dentaid The Dental Charity this September. This year, an intrepid team of cyclists will be traversing top to toe of Portugal – an impressive 746 kilometres – over the course of five days. It will be a beautiful journey, but a demanding one. The route takes them across 11 mountains and crosses 13 rivers, starting at the northernmost point of Portugal, and ending at the beaches of the Algarve. The team are excited for the challenge, not least to add another important donation to Dentaid, which has been a lifeline for vulnerable people all over the world for nearly three decades.

Dentaid The Dental Charity, has worked to improve the lives of patients living in the most difficult circumstances across the world since 1996. Oral diseases affect 3.5 billion people around the world, and Dentaid’s outreach services go to the communities who need it most.

In the UK, Dentaid’s eight mobile dental units take vital treatment and oral hygiene advice to thousands of people who would otherwise struggle to access dental care. Volunteer dental professionals visit soup

kitchens, hostels and community centres to deliver services to those experiencing homelessness, survivors of abuse, cancer patients, refugees and asylum seekers, and under-served communities. Dentaid’s compassionate, non-judgemental volunteers allow patients to feel fully supported as they talk about their oral health before being offered treatment.

Every week, Dentaid receives calls from charities and organisations across the UK desperately seeking dental care for their clients. The charity has a number of great opportunities for volunteers to help them serve more communities in need; they are eager to hear from you! The commitment level is flexible, allowing professionals to do as little or as much as they want.

Andy Evans, CEO of Dentaid, will be joining the riders once again for 2024 and comments: “I’m looking forward to getting back out with a fantastic group of cyclists who are busting a gut over five days. It’s great to meet even more people to share how their hard-raised funds are benefiting vulnerable communities in the UK.

“Thank you also to Straumann for supporting our adventure for another year. The mobile dental unit that was part funded by Straumann in 2023 has now been on the road for a whole year and has enabled hundreds of people experiencing homelessness, abuse and other health equalities to access essential dental care.”

Homelessness in the uK

Reports indicate that homelessness has risen by 14 percent in the last year, and now affects at least 309,000 people in the UK, with a 26 percent increase in rough sleeping in the last 12 months. The number of people sleeping rough is now 61 percent

higher than it was 10 years ago and 120 percent higher than when data collection began in 2010.

Homelessness affects families across the UK. Between July and September 2023, 109,000 households were living in temporary accommodation, up by 10 percent on the same time last year. Whatever the state of temporary accommodation, families are unable to refuse, and so can find themselves in lessthan-ideal circumstances, sometimes far away from friends, schools and loved ones. Being homeless is a dehumanising situation, and takes a serious toll on the physical, mental and oral health of sufferers. Reports have found that 41 percent of homeless people reported a long-term physical health problem and 45 percent had a diagnosed

Staying ahead of the game

The transformation of technology and treatment techniques in orthodontics has opened the field to a vast number of opportunities to develop knowledge. Time is precious, and demands on practitioners to maintain a competitive advantage necessitate the best quality learning experiences.

Dental professionals can gain useful learning about advances in their field of practice in a number of ways. Alongside more traditional training methods, events discussing innovative new treatments in orthodontics that take you out of your routine can be a brilliant way to encounter new ideas. Practitioners can develop new areas of interest and expertise from learning about cutting-edge research, from fun and engaging speakers in an audience with likeminded professionals.

a great learning experience ClearCorrect® is a premier clear aligner system worth learning about. Relevant topics around ClearCorrect® and clear alignment treatment will be explored by a number of experienced speakers in an inspiring conference this summer.

The event, ‘Elevating ClearCorrect® Excellence 2024’ on June 14 at Millennium Point, Birmingham, is a one-day experience for dental professionals involved in

orthodontics. The event will be useful to all those who want to know more about the potential of clear aligner treatment, and how to achieve the outstanding results made possible through ClearCorrect®, hearing directly from practitioners already well-versed in the system.

The keynote speaker is renowned orthodontist and international clinical consultant on aligner treatment, Dr Andrea Bazzucchi. Andrea, based in Italy, leads an expert team of clinicians, focusing on multidisciplinary treatment. He will kickstart a number of lectures at the conference by some of the most engaging voices in orthodontics. Topics range from a discussion of ethical advocacy, clear aligner treatment for older people, maximising treatment

mental health problem – almost double the incidence of the general population. Homeless populations are at the forefront of current health inequalities in the UK. Most people experiencing homelessness suffer from poor access to dental services, affecting their oral health. Homeless people have an increased risk of tooth decay, periodontal diseases and oral cancer. A recent survey of these communities found that over 78 percent of respondents were concerned about their dental health, and poor oral health had a significant impact on their self-esteem and wellbeing.

a new start

Dentaid The Dental Charity passionately supports the belief that dentistry can play a key part in someone’s journey out of homelessness and help them to move on to a new chapter in their lives. Treatment relieves pain, and helps patients gain much-needed confidence in their smiles.

As Sophie, a Dentaid patient experiencing homelessness in Broadstairs, said: “Today the dentist has built up my tooth at the front and now it looks like a proper tooth. It looks so nice. It’s not just my smile, it’s that he took the time and the care. Before, I couldn’t open my mouth and now I can smile.”

With the right funding, ambitious plans will take Dentaid’s services into dozens of new communities needing support, but the charity needs to raise money to enable this. Due to the great need to expand services this year, Straumann Group and its customers have requested that the majority of the proceeds from the event will benefit patients in the UK.

For more information, visit dentaid.org or, to donate, visit justgiving.com/team/dentistsinlycra2024 n

success, to an introduction to the fastmoving history of clear aligner treatment.

Delegates won’t want to miss a discussion on function before aesthetics by led by Dr Sami Butt. He makes a compelling case for a framework that ethically increases caseacceptance as well as improving trust by prioritising long-term outcomes for patients.

And finally, the event features a lecture by Dr Ruairi Leonard, who has pursued a special interest in minimally invasive, anatomically-driven cosmetic dentistry since graduating from Queens University Belfast in 2019. Ruairi introduces the unique advantages of ClearPilot™ 8.0., the ClearCorrect® planning software. More than any other system, ClearPilot™ puts full control over treatment plans in the hands of the dental professional as well as enabling greater collaboration with patients. In his lecture, Ruairi will explore the advanced features designed to improve predictability, that will help practitioners move towards more minimally invasive dentistry.

advances in orthodontics

Clear aligners are the treatment of choice for many patients looking for a more discreet and comfortable alternative to traditional braces. This conference will cover all the special features that make ClearCorrect® the premier solution for orthodontists.

With innovation professionals have come to expect from brands within the Straumann Group, ClearCorrect® aligners are fabricated in ClearQuartzTM tri-layer material for the industry leading combination of durability and discretion. Their performance trimline has been demonstrated to give the most effective results in terms of tooth movement, providing the highest passive force when compared to other designs.

A powerful digital workflow suite provides a flexible, integrated and seamless experience for you and your patients. ClearPilot™ 8.0.planning software is a powerful and intuitive treatment planning tool for customising and visualising outcomes with patients. With the system, clinicians have a unique level of flexibility and control over everything, from planning to approval. ClearControl™ Clinical Features adds advanced editing tools for improved clinical outcomes according to the specific needs of each case.

Discover the innovative features that make ClearCorrect® the system of choice for clear alignment treatment. Book now for ‘Elevating ClearCorrect® Excellence 2024’ to take part: https://event.clearcorrecteducation.co.uk/ For more details, please visit: https://clearcorrecteducation.co.uk/ n

New opportunities, broader horizons

It’s never been a better time to pick and choose where and how you work as a dental professional; there are opportunities with different types of contracts for different roles, levels of expertise and specialisms all over the country. Pressures on dentistry in recent years have presented challenges for many practices, but have also created opportunities for growth, and dental practices are increasingly looking for positive ways to attract great staff. If you are looking to provide NHS or private services, are foundation-level or an experienced dentist, or a dental hygienist/ therapist, and you want to work with a new dental provider, what are the things to look for when choosing the right fit?

Meaningful work, recognised and supported by organisational culture Professionals want to receive fair payment for a job well done, but research shows that individuals are not wholly profit-driven. A recent study found that in the UK, meaningful work is seen as the strongest factor determining job-satisfaction in all careers.

For some dentists, meaning can come from working to improve the lives of disadvantaged patients and their families joining outreach programmes or charity work that supports the most deprived communities in the UK. Recent government reports show that oral health inequalities remain a significant public health problem in England. Children from disadvantaged backgrounds are disproportionately more likely to be admitted to hospital to have teeth extracted. In a study from 2017, almost one-fifth of such admissions in the UK were for children from the most deprived tenth of the population.

For others, the greatest meaning as a dental professional can come from using their skills and expertise to push the ‘art and science of oral health’. This could be through using the latest in technology and resources to conduct ground-breaking research, or specialising in an area that pushes the envelope of the science of dentistry.

Whatever the passion that drives you, you will benefit from finding a practice culture that facilitates and encourages this motivation so you can enjoy work that means the most to you. A good dental provider will ensure that dentists’ clinical interests can flourish by supporting the personal as well as professional development of clinicians.

a culture of support, learning and development

A recent review of the evidence by the Chartered Institute of Personnel and Development (CIPD) found that organisations with a strong learning culture are simply better to work for. They experience more profitability and productivity, enabling more income potential for dentists and greater investment in workflows for streamlined daily routines and reduced stress among the team. Studies correlate learning culture with job satisfaction, and the effect is cyclical. The more that organisations invest in the development of individuals,

the higher the motivation among peers to communicate well, sharing information and learning with peers.

Supporting the overall wellbeing of professionals practising dentistry is also important, both to safeguard the health and safety of individuals, and to ensure a consistently high-quality service for patients. A good organisation will invest in training, genuinely useful resources and programmes to support the wellbeing of employees as well.

Finding the right fit

When seeking a new position, you will want to ensure the operational and clinical support offered meets your needs, and that you are respected both as a professional and as a person. Does the company have a culture that encourages and supports growth? Does it respect your core motivations, your professionalism, and does it allow you to flourish? Does it have mechanisms in place to provide emotional as well as practical support when needed?

Rodericks Dental Partners is a dental group that has created a supportive culture of continuous development, where teams are empowered to deliver exceptional dental care and are genuinely fulfilled by their work. Rodericks Dental Partners has six core values: ‘respect, flexibility, empowerment, openness, integrity and support’, underpinning the right kind of culture to foster growth and development as well as a positive and safe environment.

Joining Rodericks Dental Partners gives dentists, dental hygienists/therapists and all team members access to a large network of practices offering opportunities for personal and professional development. For example, an experienced dentist could become an educational supervisor or mentor other dentists.

Working with Rodericks Dental Partners gives access to a dedicated clinical team, operational team and compliance team, allowing dentists to focus on their clinical work. Alongside all this support is respect for every practitioner’s autonomy. Dentists working with Rodericks Dental Partners have complete and genuine clinical freedom. Clinical expertise is valued and trusted, so dentists can treat patients in the way they see fit.

Being respected for your skills, as well as being part of a supportive and learningfocused network is beneficial to anyone working within the dental profession. Finding a support system that enables you to flourish in your own way, according to your own motivations, is a recipe for job satisfaction.

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

about the author

Glenn rhodes, Head of Marketing, rodericks Dental Partners.

From VT to associate

Supported development with Clyde Munro

It doesn’t matter how long you have been working in dentistry, what you have achieved so far or what your career aspirations are, Clyde Munro offers supported development opportunities for you. In fact, we are proud to provide a comprehensive pathway for all our dentists, with on-going education and training taking clinicians from VT to associate dentist, and later on to lecturer, teacher, mentor or associate with special interests.

From the very beginning, we help dentists create an effective development plan for them. We have a huge network of highly experienced dentists and mentors to offer advice and guidance, enabling all young dentists to discover the right pathway for them. But this support doesn’t stop there. Education and training are available to all our dentists at every stage of their career. With practices across Scotland, we always have great opportunities for dentists looking for different responsibilities and new challenges.

Post-qualification

Clyde Munro has various VT training practices set up specifically to enable VTs to consolidate, advance and broaden their skills in a safe and effective way. We give them access to cutting-edge technologies, encouraging them to deliver the highest quality patient care from the very beginning. With a network of talented and highly experienced clinicians across the group, we offer expert mentorship for VTs throughout their training.

The standard VT study days are complemented by Clyde Munro’s own Best Foot Forward Programme, further improving each dentist’s transition into an associate role. This provides additional training days throughout the year, covering important topics that we feel VTs need to understand as they lay solid foundations for a long and successful career in dentistry. Sessions explore technology that utilises artificial intelligence (AI) and its impact on patient care, including how it facilitates the reading of radiographs for accurate diagnostics and improves patient communication. The programme also aims to build confidence in endodontics, help individuals maximise opportunities as selfemployed contractors, and enable dentists to better manage their stress for enhanced wellbeing. We appreciate the pressure that dentists can be under, so we feel it is especially important to help our clinicians optimise their own physical and mental health, as well as their patients’.

Dr Paul Capanni said in his VT year: “Working within Clyde Munro, you feel like you’re a part of something bigger. There’s a lot of support in everything from clinical aspects to logistical and financial. It’s nice to be at the forefront of digital dentistry and to be exposed to things you might otherwise not be exposed to. It’s a good group to work for; they are always investing in you in some way.”

early careers

Beyond VT, Clyde Munro provides the Flying Start Programme. This initiative continues the support dentists need to make the very

most of their initial years as an associate. It provides training on a range of clinical, financial and business topics. From further education in endodontics to ethical selling, optimising digital workflows and improving sustainability, the programme explores all the areas that clinicians need to know about. Dr James Campbell commented: “The Flying Start Programme has been integral to my personal and professional development. It means that there is a network of peers and more experienced colleagues to turn to for support whenever I need it. The practical advice, help and training received from experts on aesthetic treatment plans and patient communication has been most helpful for me.”

Later career

Even once dentists are established within their careers, Clyde Munro continues to offer education, CPD and development opportunities. Have a special interest in a certain area? We can help. Looking to start teaching or mentoring others? We have a network for you to support. Learning never stops in dentistry, and neither does the support from Clyde Munro. Whatever your career aspirations, we have the passion, support and facilities to make them happen! Dr Bruce Duguid said: ”I have been a GDP for 28 years and working with Clyde Munro for about 2 years. The biggest reason I enjoy working with them is the huge support network available. It’s a very large family of dentists, rather than an isolated group of practitioners. Dentistry can be a very lonely and isolated profession. As such, it’s nice to have other professionals to reach out to and get support from if needed.”

Join us

No matter what stage you have reached in your career, consider joining Clyde Munro to fulfil your potential.

Find out more about the career opportunities and vacancies available with Clyde Munro today at careers.clydemunrodental.com or contact joinus@clydemunrodental.com for a confidential chat. n

Paul capanni

Bond Apatite

The natural mineral bone material that doesn’t wash away!

Augma’s Bond Apatite is a natural mineral bone regeneration material that does not wash away, unlike most bone materials.

Supplied in an all-in-one syringe that enables immediate dispensing directly into the bone defect, it is incredibly quick and easy to use. Simply depress the plunger to activate the ingredients, dispense it into the defect and apply pressure using a sterile gauze and it’s set. The whole process takes literally seconds.

Bond Apatite sets hard, so it won’t wash away even in the presence of blood and saliva. And, because it sets hard, there is no need for a membrane which saves additional time and unnecessary expense. There is no need to achieve tensionfree closure, this is actually contraindicated, or even complete primary closure for gaps less than 3mm. Small dehiscences can be left exposed without any risk of infection or breakdown. Larger dehiscences can be protected by suturing an Augma Shield protective layer over it. Formed from a patented mixture of biphasic Calcium Sulphate and Hydroxyapatite in a 2:1 ratio, Bond Apatite sets like a cement in the oral cavity, even in the presence of blood and saliva. After a few weeks it transforms into a radiolucent matrix, before calcifying and becoming radiopaque new bone. It produces 90% new bone after 3 months and over 95% new bone after 8 months. Benefits recently challenged by the distributors of a synthetic bone material, but proven histologically correct.

Full Day bond apatite Hands-on Workshop

Trycare are running a Full Day Bone Cement Hands-on Workshop on Saturday 8th June at the Guide Post Hotel in Bradford, West Yorkshire. It will be presented by Dr Lucio Faria who has been a National and International Speaker for Nobel Biocare since 2011, is a Surgical Master in Regenerative Implant Dentistry and has undertaken extensive Postgraduate Studies in Prosthodontics, bone and soft tissue grafting, and Zygomatic implant surgery and rehabilitation.

Dr Faria will review four of the most common surgical protocols using Bond Apatite bone grafting cement, which sets immediately and is accompanied by minimally invasive surgical procedures that do not require a membrane.

Delegates will receive practical knowledge on how to perform socket grafting without flap reflection, lateral ridge augmentation and augmentation in the aesthetic zone. The course includes a variety

of resources, such as animated videos, recorded live surgery demonstrations and clinical videos. Evidence based data histology shows how following the surgical protocols leads to clinical success and complete bone regeneration for the patient.

The course fee is £195.00 plus vat (including all course materials and lunch).

3rd international

Symposium –Sintra, Portugal

Augma are hosting their 3rd International Symposium at the Ritz-Carlton Penha Longa Resort in Sintra, Portugal, on 26th to 29th September 2024. Penha Longa is located in the district of Lisbon and offers phenomenal 5-star hospitality including spa, indoor and outdoor activities and nine restaurants, three

of which hold coveted Michelin stars. The 3rd Augma International Symposium features a line-up of bone cement speakers from nine countries including Drs Amos Yahav, James B Fine, Jose Camelo Ferreira, Mirela Shveys, Ramiro Zaera Le Gal, Jonathan Abenaim, Damian Dudek, Michael Katzap, Ewa Swiech, Raja Naddaf, Stephane Berg, Lucio Faria, Alexander D Salvoni, Robert Mogyoros and Omri Rudberg.

The 3rd Augma International Symposium is aimed at providing an upgraded toolkit for bone augmentation across all augmentation procedures, with the ability to connect with fellow Clinicians, share ideas and spread them within the Augma community. There will be over 10 hands-on workshops to choose from on the 26th September, whilst during the course of the main twoday symposium there will be 16 lectures, culminating in a Gala Event on 28th September.

The AIS Access Package includes access to all the symposium lectures, welcome reception and Gala Event and all meeting lunches and coffee breaks. It is available for the Early Bird rate of 750€, with an additional 50€ discount for Trycare Customers. The AIS Bundle+ Package includes all the features of the AIS Access Package plus 3 night-stay at the Ritz-Carlton Penha Longa Resort and one complimentary hands-on workshop. Limited to the first 100 registrants the Early Bird is 1750€ with an additional 100€ Discount for Trycare Customers. n

Lucio Faria

Minimally invasive smile design protocol for patient presenting with anterior crossbite

In my experience, a significant number of adults present looking for an aesthetic improvement in the appearance of their smile, but are unwilling to invest time in comprehensive orthodontic treatment or are unwilling to undergo more invasive procedures such as veneers and/or crowns to achieve their desired results. For these patients we need to offer suitable treatment alternatives, which although may not be ideal, are minimally invasive and offer a significant improvement in aesthetics. It is important not to underestimate the psycho-social impact of an aesthetically pleasing smile, after all.

Patient AD presented for a consultation concerned about the appearance of his teeth and was looking for a quick restorative solution. He was experiencing crowding of approximately 5mm in the upper arch and 4mm in the lower arch. The patient had attended previous orthodontic consultations over the years, as this was deemed the ideal way to treat his concerns, however he had dismissed this option due to the time commitment of between 18-24 months for treatment. As a semi-professional mixed martial arts competitor this had an impact on the possible treatment options as the patient had a small window of opportunity each year in which he was not competing.

effective solutions

We had a detailed discussion regarding the options available to him, which included comprehensive orthodontics, as well as aligners, lingual or labial fixed braces for cosmetic tooth alignment only. Aligners were not used because the patient was concerned about compliance and treatment time, and a lingual appliance was not financially viable. We decided to proceed with an upper and lower fixed labial orthodontic appliance to align just the anterior teeth, following which there would be a course of teeth whitening and composite bonding as required. This progressive approach to smile design allows for a minimally invasive process to be adopted while meeting the patient’s aesthetic demands. It can be summarised as a an “ABC” approach to smile design:

- A) Align the anterior teeth. This can be done in a number of ways according to the patient’s preference.

- B) Bleaching or teeth whitening.

- C) Correction, usually using composite or ceramic to rectify any wear or irregularities in size, shape or colour of the newly aligned teeth. It must be stressed at this stage that the initial alignment should not be confused with orthodontic treatment. Yes, we are carrying out orthodontic tooth movements, but this does not equate to orthodontic treatment in the true sense. We are not trying to correct any malocclusions or improve jaw relationships in any way. The patient has been offered the orthodontic option and has declined this approach. Instead, the idea of the initial alignment is to make any subsequent restorative treatment simpler and minimally invasive.

The term Short Term Orthodontics, STO, has become widely used to describe this initial alignment phase but I believe that this term is quite misleading and can be confused by both dentists and patients into thinking it is an abbreviated form of orthodontic treatment – it is not. As such, the term Cosmetic Tooth Alignment or Pre-restorative Alignment is more accurate in describing the aims of this stage of the procedure.

Putting it into practice

The patient opted for a fixed labial appliance and the Cfast self-ligating brace was used to complete this stage of treatment. The brace was fitted using an indirect approach with the brackets held in a laboratory constructed stent and cemented a quadrant, six brackets, at a time. Interproximal reduction (IPR) was carried out in the upper arch between the 12, 11 of approximately 0.15mm. In the lower arch IPR was carried out using a 0.1mm IPR strip between all the incisors.

A very light 0.014” nickel titanium (NiTi) wire was placed to initiate tooth movement. (Fig 1)

The patient was reviewed 5 weeks later, (Fig 2) and even after this short period there was a significant aesthetic improvement, and one of the patient’s main presenting complaints, the anterior crossbite, had already been corrected.

Further IPR was carried out in the lower arch only and the patient was referred to the dental hygienist as some gingival inflammation was noted, especially around the 22, 23 region. The patient was then reviewed 4 weeks later, and where it was

observed that the teeth were almost fully aligned and the gingival condition had greatly improved. (Fig 3) Alignment continued in this fashion until it was mutually agreed that there was enough of an improvement in tooth position to proceed to the next phase of treatment and subsequently the braces were removed. (Fig 4)

Following alignment

The patient then proceeded to have his teeth whitened using a take home whitening system of 15% carbamide peroxide. Composite bonding was carried out on several teeth to correct the effects of differential incisal edge wear as well as to mask some discolouration. (Fig 5)

To ensure the stability of the final appearance, the patient was given both fixed and removable retainers which were stressed at the outset as an indefinite requirement. The patient did not want metal bonded lingual retainers, so we opted for a fibre reinforced composite resin retainer using an indirect approach. Fibre reinforced composite resin retainers are an alternative to metal lingual bonded retainers. (Fig 6, 7)

Overall, the ABC approach to smile design allowed us to achieve a significant improvement in the patient’s dental appearance without the need for protracted orthodontic treatment or potentially quite destructive restorative approaches. (Fig 8) summary

In my opinion, it is no longer acceptable in the provision of cosmetic dentistry to simply pick up the drill and cut healthy tooth tissue without consideration of tooth alignment in the treatment planning phase.

As the dental profession generally moves towards more minimally invasive techniques to provide cosmetic improvements, there is a need to offer solutions to patients that will greatly reduce or completely remove the need for any enamel preparation. These solutions should, of course, include idealistic treatment options that will correct any underlying malocclusion. However, for a significant number of patients, this is not acceptable as the time taken to achieve these more idealistic treatment plans is unrealistic. As the late, renowned and visionary orthodontist Dr Vince Kokich is quoted as saying, “Children should be treated idealistically and adults should be treated realistically.” With the development of simple and well supported, GDP focused, cosmetic tooth alignment procedures, it is possible to practice truly minimally invasive cosmetic dentistry. It is incumbent on dentists that these techniques be routinely incorporated into the treatment planning phase of all elective cosmetic and restorative procedures.

Dr Biju Krishnan is currently taking referrals for cosmetic and orthodontic cases at the One To One Dental Clinic in London. Visit 121dental.co.uk/for-dentists/referrals to find out more. n

about the author

dr Biju Krishnan qualified from dundee university in 1993, and has gone on to become an awardwinning dentist focused on providing high-quality and minimally invasive cosmetic and orthodontic treatment. He is founder of the cFast (cosmetically Focused adult straight teeth) cosmetic tooth alignment system, and has lectured around the world on the topic of cosmetic tooth alignment. dr Krishnan is delighted to have recently joined the One to One dental clinic in Harley street, London, where he is actively taking on referrals for cosmetic and orthodontic cases.

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An easier and more sustainable option for all patients

Interdental cleaning is a crucial aspect of every oral hygiene routine. Removing the build-up of bacteria in between the teeth helps patients to keep their mouths healthy, prevent disease, and reduce any bad odours. Consistent motivation and encouragement is

interdental spaces and thoroughly remove bacteria, plaque, and debris. For the best results, assist patients in finding the right size brush for each interdental space, providing a sizing chart to help them keep track of the best brushes to use in each area of the mouth.

key for helping patients to clean interdentally every day, providing them with the knowledge and skills they need to carry out effective cleaning 1 . Conventional tooth brushing is simply unable to reach the interdental spaces, and is less effective for patients who have orthodontic appliances, for example, so it’s important to provide each patient with the unique recommendations they need to improve their oral hygiene.

Making it easy

Some patients may be put off by the recommendation that they floss, associating the practise with fiddly and time-consuming cleaning, which can be very difficult for many people. As such, it’s important to discuss the various options for interdental cleaning with patients, and find the best solutions for them. While traditional string floss is able to fit in between the teeth and clear away some of the bacteria, it cannot reach every surface of the interdental space 2 It might remain a good option for the anterior teeth for some patients, as string floss can only clean the surfaces which have a uniform shape. However, this makes much of the bacteria unreachable when cleaning in between the posterior teeth. Interdental brushes from Curaprox are a fantastic option for many patients, allowing them to easily move the brush in and out of the

Implants, braces, and oral appliances

Curaprox interdental brushes are also a great choice for patients who are undergoing or have undergone dental treatments. For example, those with fixed orthodontic appliances are likely to find it difficult to clean in between their braces and their teeth, with plaque and debris building up over time. Interdental brushes can allow them to eliminate this, easily cleaning the areas which are traditionally difficult to reach 3 . It’s vital to maintain excellent oral hygiene during orthodontic treatment, to help achieve the best possible results, and to reduce the risk of disease in the teeth and gingiva.

Similarly, interdental brushes can be very helpful to clean around dental implants and oral appliances such as bridges. Removing bacteria is essential for reducing the risk of peri-implantitis and periodontitis, respectively, in these cases.

Be kinder to the environment

CPS interdental brushes from Curaprox are the ideal solution for patients looking to improve their oral hygiene. The brushes feature super-fine, extralong, ultra-resilient filaments, which offer effective and gentle cleaning with a single brush action. Available in a wide range of sizes, the CPS range has the right interdental brushes for everyone – including those with natural teeth, implants, narrow spaces, larger

spaces, crowns, and bridges – making interdental cleaning simple.

What’s more, the CPS range of interdental brushes uses the Curaprox Click System, which makes daily oral hygiene routines kinder to the planet. Interdental brush heads are available in environmentally friendly refill packs, which work with all Curaprox interdental brush holders. Patients need simply click the old brush head away, and click the new brush head on. This means that the handle can be used again and again – a convenient solution for less waste.

And, as brush head refills are compatible across all Curaprox handles, patients have the freedom to choose the best solution for them. This includes the choice between a long or a short handle, enabling them to access those hard-to-reach spots in the mouth.

Effective interdental cleaning for all

Maintaining a clean mouth is essential for staying healthy and preventing dental problems in the long term. As such, it’s important to explain the significance of interdental cleaning to each patient, and ensure they feel comfortable carrying it out daily, as part of their routine. Curaprox interdental brushes are the ideal solution, offering all patients an easier and more sustainable option for interdental cleaning.

For more information, please visit curaprox.co.uk and curaden.co.uk n references

1. https://curaden.com/#studies 2. https://gently.curaden.com/ interdental-brushing-everything-youneed-to-know/

3. https://curaprox.ch/en/info/ interdental/interdental-brush

Planning for predictable results

Dr rebecca Williams presents a case of mild crowding and rotated incisors, with a clear aligner solution that requires no attachments

Afemale patient presented with concerns about the appearance of her teeth, particularly the rotated upper incisors, and was seeking a solution that would restore her confidence to smile.

The patient was new to the practice, and a comprehensive assessment of her dentition was conducted. Mild crowding was present in the upper and lower arches, and the upper incisors were rotated mesiopalatally – the UL1 was rotated by 22º and the UR1 by 23º, respectively.

The molars, canines and incisors on the right and left side demonstrated mild Class II relationships, and the dentition was minimally restored. The patient was experiencing a restricted envelope of function, which was exacerbating tooth wear. Following X-rays, an orthopantomogram and bitewings, no bone loss was detected, making her an ideal candidate for orthodontic treatment.

a unique opportunity

A range of treatment options were presented to the patient. The use of a fixed brace and clear aligners were proposed, with the use of 3D visual aids to improve the patient’s understanding of the treatment process.

Clear aligners were preferred for their aesthetic benefit, especially as this case would not require attachments. This was possible with SureSmile aligners, which allowed for customised trimlines. Where other systems scallop around the teeth, I was able to opt for a solution that had a straightened trimline of 1mm, eliminating the need for attachments while ensuring safe, controlled and predictable movement.

An analysis for treatment was devised with the help of the Spacewize+ digital space calculator and SureSmile software, though the initial proposal was not thought to be ideal by both myself and my mentor from IAS Academy, Claudia Waddell. It required excessive proclination of the teeth and round-tripping, and my mentor advised that we amend the use of interproximal reduction (IPR) and predictive proximal reduction (PPR). In the revised proposal, these were to not be performed on

overlapping contacts, and only enacted once the patient’s teeth were untangled.

As determined by our treatment planning software, IPR was to be carried out between the UL1 and UL2, and UL2 and UL3, each 0.3mm. Through the LR3 to the LL3, 0.3mm of IPR was once again prescribed in each interdental space. Between the LR3 and LR4, and LL3 and LL4, 0.2mm was planned for.

Both arches were to be aligned simultaneously. 16 aligners were planned for the upper arch, and another 18 for the lower. The patient was also advised that the use of refiners may be necessary.

I did not plan for the use of composite bonding once treatment had ended, but the patient was made aware that this option was available to her should it be judged necessary.

Carrying out care

The fitting appointment was far quicker than normal, as no attachments had to be placed. This created plenty of time to provide instructions for effective oral hygiene measures and proper use and maintenance of her aligners. By wearing the aligners for at least 22 hours a day, and changing the devices every two weeks, there was a greater chance of our predicted progression being achieved.

Frequent appointments were made to ensure that the case tracked as it should, and any potential issues could be spotted before they developed. I shared the outcome of each appointment with my IAS Academy mentor, and she advised on the miniscule details that would make the greatest differences throughout treatment.

This was especially helpful when carrying out IPR and PPR as treatment progressed. The mesiopalatal rotations of the teeth had contributed to an uneven wear pattern. The bases were wider than the necks of the teeth and without the use of IPR and PPR, black triangles in the interproximal spaces may have developed over time. Sometimes this is unavoidable, but effective planning and monitoring throughout treatment can minimise the effect.

A soft flex disc was used to carry out the PPR at the first appointment and throughout the rest of the patient’s care,

with callipers used for precision. In some cases, a reduced amount of IPR was performed where PPR was judged to have a greater effect. For example, an intervention of 0.2mm may be split between 0.1mm of IPR, and 0.1mm of PPR that detriangulates the teeth, resulting in a seamless smile.

Overall, treatment tracked as expected throughout this case. My IAS Academy mentor even went as far as superimposing images of the patient’s dentition during treatment onto the corresponding stage of the 3D planning software. They matched up well, and allowed for the judgement of any necessary IPR, whilst helping me decide upon any advice that I needed to give to a patient. For example, I realised that I needed to reiterate the importance of orthodontic aids, such as chewies, throughout treatment.

The patient undertook a course of Boutique Whitening for two weeks to achieve a brighter tooth shade, and create a uniform, brilliant smile.

No considerable departures were made from my overall treatment plan, and the final result was attained with only minor contouring needed. I once again owe this to a comprehensive treatment plan that was considered with great care with the help of my IAS Academy Mentor.

On reflection

This was my first clear aligner case that did not require attachments, and I was delighted with the functional and aesthetic result. The patient was equally happy, and noted that the process was easier than she had anticipated. She was thrilled

with the newly crafted smile, noting that the change is very visible in photos, and friends she hadn’t seen in some time now complimented her teeth.

I gave her two removable retainers to wear nightly, which were preferred by the patient over fixed solutions. The potential for relapse was discussed, and the patient recognised their role in this outcome. I have since seen the patient at three-, six- and nine-month intervals posttreatment, and the results have held with time. This case has allowed me to further consider the importance of an effective treatment plan, and refine my recognition of the need for IPR and PPR in a variety of situations. With support from my IAS Academy mentor, I feel better equipped to treat similar cases in the future, and provide patients with a smile that they adore. For more information on upcoming IAS Academy training courses, please visit www.iasortho.com or call 01932 336470 (Press 1) n

about the author

Dr rebecca Williams is an associate Dentist with the Cox and Hitchcock Dental Group in Cardiff.

Dr Williams’ work can be found on Instagram at @rebecca_dentist_art.

Giving ‘mouth to mouth’ a whole new meaning!

You’ve heard of the heart transplant. You’ve heard of the face transplant.

But now there could be an oral bacteria transplant?

As an endodontist who is constantly treating the after effects of dental decay, I was very interested to read about a new way to prevent oral disease. Researchers in Australia are looking into the idea that certain bacteria could be intentionally introduced into the mouth in order to improve a patient’s oral health. Termed an ‘oral microbiome transplant’, the research has involved extracting plaque bacteria from someone with a naturally healthy oral microbiome and transferring it that of a dentally unhealthy patient.

Early testing has been very positive, with preliminary trials showing that the transplant can successfully reduce decay. Importantly, there have also been no adverse side effects in other areas of the body, including the gut. If proven safe, effective and cost-efficient, this research could prove pivotal in our fight against dental decay worldwide.

As part of the study, which is being performed by the University of Adelaide in collaboration with Penn State University, professionals are developing a way to screen patients and identify healthy oral microbiomes. This will help select potential suitable donors and also provide insight into what exactly

constitutes a healthy oral microbiome free from decay. Their work so far has suggested that around 250 species of bacteria are needed to prevent tooth decay, of which they are building a ‘biobank’ for future research. Currently, one in three adults in the UK are estimated to experience dental decay. If successful, this research could lead to a specially designed toothpaste or gel that we as dental practitioners can use to help high-risk patients minimise their risk of caries, transforming the heath of thousands of people. Such a solution would also perfectly complement and support the delivery of preventative, patient-centric and minimally invasive dentistry.

Of course, it will likely take some time to refine the formula and create a viable product for the dental profession to add to its arsenal. However, it does demonstrate just how creative and innovative dentistry is becoming in order to tackle the rising challenges of dental health in the modern world. Dental decay is one of the biggest problems we face. Could an oral microbiome transplant be the answer? n about the author endoCare, led by Dr michael Sultan, is one of the UK’s most trusted Specialist endodontist practices.

Before and after treatment of the upper arch, anterior view

Fitting of the first aligner with a 1mm trimline, open anterior view

Healthy aesthetics

Patients seeking cosmetic dental treatment may do so simply to improve their appearance, and dental professionals will recommend treatments within an ethical framework. Clinicians prioritise function, and the informed consent and participation of patients in any given treatment. Awareness of possible risk factors is a vital factor in helping patients to understand why a preferred treatment may not be recommended for them. Cosmetic dentistry is the art of improving the appearance of teeth, and/or gums, while maintaining and protecting oral health. Practitioners employ a number of approaches, depending on the nature of the problem, but these can include peroxide-based whitening, cosmetic bonding, adult orthodontics, veneers, gingival contouring and implants. Research has shown that poor dental aesthetics can have a severe impact on people’s mental health as well as job prospects. Abnormalities in tooth colour, or problems like pitting, chipping or malalignment can have a significant effect on oral health-related quality of life (OHRQoL), especially if the anterior teeth are affected. For these reasons, more and more patients are seeking improvements to the aesthetics of their teeth.

Starting simple

Offering one of the least invasive cosmetic solutions, tooth whitening has become a popular cosmetic treatment in the UK and can be used to treat both extrinsic and intrinsic defects. Extrinsic dental discolouration results from the

accumulation of chromogens – a family of compounds that change colour in response to stimuli – on the outer layer of enamel or the salivary pellicle that covers teeth. Intrinsic discolouration happens when chromogenic material stains the internal structure of either the dentine or enamel. In the developing tooth, exposure to high levels of fluoride, tetracycline or some other drugs, inherited developmental disorders and trauma may result in preeruptive discolouration. Once teeth have erupted, most intrinsic discolouration can be attributed to factors like pulp necrosis and the effects of medications or illness.

There are many in-office and over-thecounter products on the market that can treat both intrinsic and extrinsic staining with varying degrees of success, however, due to potential damage that some solutions can pose, home treatment is not recommended. For mild staining, good oral care with regular brushing and interdental cleaning is recommended, and moderate stains may be treated with a good scale and polish.

The efficacy of light accelerated whitening (LAW) has been debated for decades, but recent studies show that blue light can accelerate whitening, within the limits of an in-vitro model. The findings show that LAW accelerates the bleaching process, and that it attacks more stain compounds than peroxide alone does.

Teeth whitening products may not be a suitable treatment for many patients, and any underlying conditions like periodontal disease should be treated before treatment is considered. Hydrogen peroxide is a key ingredient in bleaching products, which in high concentrations can cause enamel

softening, surface roughness, and can lead to demineralisation. If patients have any restorations, they may be advised not to seek bleaching treatments due to the greater chance of restored teeth becoming sensitive.

alternative treatment options

A number of treatments with varying degrees of invasiveness may be appropriate for patients seeking improved aesthetics, from aligners to treat mild malocclusion, to implants to treat edentulism.

Porcelain veneers can be offered in the treatment of many conditions affecting dental aesthetics. Minimal-prep veneers are a conservative and effective treatment for diastemas, misaligned teeth, worn dentition, chipped and pitted teeth, as well as excessively discoloured teeth.

Treatment with veneers can be effective, but clinicians must manage the expectations of patients as it’s not always a quick fix. Patients with a bruxism habit, edge-to-edge relation, insufficient enamel, or with poor oral hygiene may not be suitable, or will require intervention before cosmetic treatment.

Dental crowns are an increasingly predictable treatment for the restoration of a smile, and technology around materials has evolved in recent years to better replicate the true colour, translucency and shape of natural teeth. For example, treatments like 5-mol% yttria partially stabilised zirconia (5Y-PSZ) are more robust than porcelain. Crowns are a more invasive and expensive treatment than veneers, but may be more appropriate treatment for complex cases.

Visualising treatment

Three-dimensional simulations allow clinicians to explain more easily how each dental procedure influences further treatments. Helping patients to visualise procedures is useful in demonstrating the effects of different treatment approaches, enabling a collaborative strategy.

Chairsyde – a state-of-the-art patient consultation platform – enables clinicians to demonstrate different treatment procedures clearly using a comprehensive portfolio of patient-friendly animations. Illustrating the risks and benefits of different treatment options, it enables patients to participate fully in decision-making, improving caseacceptance. In addition, post-consultation summaries can immediately be sent to patients with animations explaining agreed treatments for reference.

Patients can experience a great deal of stress due to conditions affecting the visual appearance of their teeth. Clinicians strive to offer patients solutions that promote the best conditions for oral health as well as improving aesthetics. An approach that helps patients understand and collaborate in recommended treatment is an excellent way of building trust, and helps them achieve a beautiful smile that lasts.

For more information, or to book a Chairsyde demo, please visit chairsyde.com or call 020 3951 8360 n

about the author

Loven Ganeswaran, CeO and founder, Chairsyde.

The dental implant kaleidoscope

The traditional kaleidoscope is not often used as a metaphor for the dental implantology field. However, it fits well –implantology is a diverse and complex world with many different layers. Finding the right combination of accurate diagnostics, careful treatment planning and excellent surgical and restorative execution is essential for the beautiful, functional and long-lasting outcomes that patients deserve. Being able to deliver this depends on a number of factors, one of the most important being clinical education and training.

Impact on success rate

A substantial body of research has demonstrated a range of factors that affect implant success rates. These include patient age, length and diameter of the implant used, bone quality and region of the jaw in which the implant is being placed. It has also been determined that the level and type of education delivered to clinicians has an impact on the treatment delivered and survival rate they achieve for dental implants. Practitioners with more clinical training and experience have been shown to achieve shorter operating times. In addition, research has found an association between the number of implants a dentist has placed and the success of treatment outcomes.

As such, the quality of education that dentists seek as they begin to provide implants, and as they advance their skills, is critical in their ability to optimise results.

aesthetics and function

Societal pressures and trends have led to an increase in aesthetic demand among patients seeking any type of dental treatment, including implants. As such, patient satisfaction is often now determined by a combination of functionality, longevity and aesthetics. This means ensuring high survival rates alone is not enough for a happy implant patient.

To optimise aesthetic outcomes, clinicians have to consider a host of elements from implant location to the position of adjacent teeth, the gingival biotype, the smile line and the unique anatomy at the surgical site. To achieve all of this and more, the clinician’s education once again comes to the forefront. It is the dentist’s duty to have undertaken sufficient clinical training so as to be able to manage cases effectively and facilitate the best possible outcome for the patient.

a broad education

Consequently, it is important that the dental implant training sought incorporates a wide range of relevant topics, from basic oral surgical skills to soft tissue management techniques, bone grafting solutions, sinus

lifting procedures, socket preservation and more. Even for clinicians who choose not to perform certain aspects in-house, it remains crucial to have knowledge of all evidence-based and emerging treatment options available in the market. Only then is it possible to discuss all relevant solutions with patients and ensure fully informed consent during the planning process.

It is also crucial that dentists obtain a combination of theoretical and hands-on training to enable their skill development. The latter is especially important when learning new techniques or trying new materials, giving the clinician practical knowledge that will allow them to safely perform the treatment in practice.

Completing the puzzle

Finding high-quality education across the range of topics required can be challenging for dentists and their teams, but there are highly trusted sources available here in the UK.

The Association of Dental Implantology (ADI) is dedicated to supporting professional education across the dental implant field.

The highly-anticipated ADI Team Congress is an excellent example of the training and knowledge sharing that is made available to members and non-members alike. Not only does the programme feature worldclass speakers who are keen to share their expertise in a broad range of related subjects,

but it also caters to the needs of the entire dental implant team. The 2025 event is set to encapsulate everything that modern dental implantology is today, with both learning and networking opportunities for implant dentists to take advantage of. Entitled “The Implant Aesthetic Kaleidoscope”, the Congress will be held on 1-3 May at the Brighton Centre – it is a not-to-be-missed event for anyone with an interest in dental implants or who is looking to take their skills to new heights. Whether you are just starting out on your dental implant journey, or you have several years of experience, it is always important to keep your knowledge and skills up-to-date. This is an incredibly multi-faceted field with countless opportunities to improve patient quality of life, but with this power, comes a responsibility to do so in the safest way possible. Ensure your professional training and education is continuous and of adequate quality to enjoy a long and prosperous career in dental implantology. For more information, visit adi.org.ukBecome a member today n

about the author

Dr Zaki Kanaan, aDI President, has a special interest in Dental Implant treatment, and achieved a masters Degree from the GKt Dental Institute.

Innovation and problem-solving

The concept of using rotary tools to cut hard materials, such as granite, is at least 6,000 years old. As early as 25,000BCE our ancestors were using handheld lithic borers to cut shells without breaking them. These tools were generally made of flint, and were pressed against the object to be perforated and then twisted back and forth at low speed and relatively high torque. Powerful modern handpieces have elevated the principle of variable speed and high torque to enable precise cuts into much harder materials like zirconia.

Restorative material science is developing quickly, driving innovation in the development of tools. Durable materials like zirconia increasingly have the potential to emulate the aesthetic and function of real teeth. With these robust materials has come a need for advances in the technology around rotary cutting, as destructive disassembly remains the safest and least traumatic option for removing a failed crown.

the use of zirconia in restorative dentistry

Zirconia, ZrO2 zirconium dioxide, has become a popular material in restorative dentistry for its biocompatibility, high fracture toughness and radiopacity. Dental zirconia is more often a modified yttria (Y2O3) tetragonal zirconia polycrystal (Y-TZP), because it has greater mechanical properties and better tear resistance than other ceramics. Different formulas are

currently in development to continue to improve on aesthetics as well as durability.

Despite the advantages of zirconia, restoration failure due to crown fracture remains a possibility. In a recent survey, the difficulty associated with its removal or replacement was reported by practitioners to be one of the main disadvantages of using zirconia as a prosthetic material.

Material science is a crucial aspect of drilling science, and different materials are described in terms of hardness using the Mohs Hardness Scale. Zirconia is 8.8; around the same hardness as tungsten carbide, which is a commonly used material in burs. Diamond is 10 on the Mohs Scale, and super coarse diamond burs have been found to be more effective at cutting zirconia than others, although the greater force needed to cut zirconia still results in frequent bur wear.

Friction and heat

Balancing the relationship between torque and speed, while managing the effects of friction, is an enormous challenge when cutting very hard materials. Thermal damage to patients is a greater risk when working intraorally, due to the very high temperatures generated in the process.

The bur in a modern handpiece can rotate at speeds of 200,000–400,000 rpm, and the associated friction can heat the target material to 240°C before cooling. In tests, an intrapulpal temperature increase of 5.5oC for 10 seconds was shown to

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cause irreversible damage to pulp tissues.

To mitigate against thermal damage to patients, high-speed handpieces have incorporated a function to spray cooled water, usually so that water flows through the tool and is sprayed onto the surface through holes in the head during cutting.

The heat generated within the handpiece itself is higher when cutting hard material, this can cause the water to heat up, which can potentially hurt the patient and/ or handpiece operator, so techniques to reduce overheating and improve cooling have had to be innovative. The faster the coolant flow rate, the more effectively it will maintain a lower temperature. The normal spray rate is 15ml/min. Increasing this to 25ml/min not only reduces the risk of thermal damage, it has also been shown to improve cutting performance and keep burs cleaner.

Vibration and ergonomics

Vibration is another risk to be mitigated when cutting into high resistance materials. The use of dental handpieces exposes practitioners to hand-arm vibration (HAVS), which, despite being well under regulated levels, over time can contribute to permanent finger-symptoms. Damage from HAVS can include the inability to do fine work and cold can trigger painful finger blanching attacks. Handpieces with higher torque operate effectively at a lower speed, and have a lower vibration rate than lowtorque handpieces.

the cutting edge

W&H has been a global leader in the development and manufacture of medical technology products since 1890. Their new Synea Power Edition has been specifically designed to manage the hardest new materials used in dentistry today including zirconia. Cutting efficiency is maximised by the optimum ratio of torque and speed, making it the optimal solution for advanced ceramic material like zirconia. Its superior cooling capabilities allow a flow rate of over 50ml/min – more than triple the normal spray rate – ensuring greater safety and improved durability.

Innovation in one area of technology often requires other technologies to advance rapidly to keep up. As long as material sciences continue to develop to deliver greater restoration robustness, innovation in handpieces designed to support new clinical needs will undoubtedly also grow. To find out more visit www.wh.com, call 01727 874990 or email office.uk@wh.com n

about the author

Kate Scheer, marketing executive, W&H (UK) Ltd

A whiter shade of pale

Achieving natural, aesthetically pleasing results for anterior restorations is a key goal for every dental professional – and their patients. One crucial aspect of this process is effectively determining and matching the right colour and shade of the restorative material to the patient’s existing dentition.

Because aesthetic dentistry imposes several demands on the artistic abilities of the dentist and the technician, knowledge of the underlying scientific principles of colour is essential. A dentist’s ability to perceive and evaluate colours accurately is crucial for achieving optimal aesthetics and patient satisfaction. Indeed, tooth colour is one of the most important factors determining patient satisfaction with their dental appearance. Self-satisfaction with tooth colour decreases with increasing severity of discolouration. Owing to the extensive range of natural tooth colours, achieving an intimate shade match between the restoration and natural teeth can be challenging.

Colour matching

The human brain can identify nearly one million shades, and precise devices that can recognise approximately 10 million different shades have been developed. Human dentition shades differ significantly, and electronic devices can identify approximately 100,000 dental shades while the human eye can identify only 1% of these.

Three variables are used to characterise the perception of light reflected from the tooth surface: hue, value and chroma. Hue describes the dominant shade of the tooth, value is the lightness or darkness of the tooth shade measured independently of the hue, and chroma is the quality that distinguishes the degree of vividness of the hue.

Effective shade-taking techniques require proper lighting conditions, shade tabs and digital shade-matching devices/shade guides. Dental professionals should be aware of the disadvantages of shades guides. These include the fact that the colours often differ for each manufacturing company and that they do not cover the volume of colours that exist in natural dentition.

Spectrophotometers, sometimes referred to as the gold standard for shade assessment (technology is always moving the goalposts), and digital photography can also improve the accuracy and consistency of shade selection.

Guiding light

The importance of the lighting conditions cannot be overstated. Dental colours exhibit metamerism, meaning they change under different light sources. Dentists should evaluate shade matches under various lighting conditions to ensure colour accuracy. There are several factors that can influence shade matching. Primarily, the tooth’s structure and optical properties are key. When selecting restorative materials,

Minimally invasive implants

Zygomatic implants are now increasingly in demand to treat a severely atrophic maxilla. This is no surprise, given the stunning results that can be achieved for partially or fully edentulous patients needing to restore their function and aesthetics.

A limited number of restorative options are open to patients once an advanced level of bone resorption has taken place. Low maxillary bone density associated with physiological bone remodelling and resorption can prevent implant placement without either alveolar ridge and/or sinus augmentation. Although they are a good solution for many patients, and the field is developing in fascinating ways to reduce the impact as well as associated risks for patients, bone grafts are still not without some pitfalls.

Recent advances in zygomatic implantology have made this procedure an increasingly appealing addition to the skillset of oral surgeons, as it enables them to restore dental function where there is not adequate bone for standard implants. Zygomatic implants typically require just one surgical procedure, and allow for immediate loading, which considerably shortens rehabilitation time and removes many of the risks compared to alternative treatments.

Despite the complexity of the procedure, and the skill level required, zygomatic implants are now considered a relatively minimally invasive solution. In recent years, the small number of post-zygomatic implant complications identified in studies is a testament to the skill of existing implant surgeons utilising the treatment.

Complications are rare today, but can be serious. A potentially devastating outcome is orbital trauma, mitigated by selecting

dental professionals must consider the dentine, the enamel thickness, translucency and opalescence.

Age-related changes in tooth colour and gender-specific preferences may impact shade selection. One study found that, in general, older people (aged 55 and above) were more likely than younger people to be satisfied with their dental appearance, suggesting that the appearance of their teeth is not as important to older individuals than to younger. However, dental appearance is becoming equally important in all categories due to the strong impact of social media which portray men and women of all ages as needing to look younger and more beautiful.

Composite considerations

Direct composite restorations have become a pivotal part of dental practice. They involve a delicate procedure that requires skilful use of appropriate materials to aesthetically mimic natural tooth structure. Utilising multiple layers of composite or ceramic materials can create depth.

Translucent restorative materials can allow underlying tooth structure to show through, and they can also reflect surrounding tooth structure. Both of these phenomena can result in colour changes in restorations. Therefore, determining the level of translucency or opacity required for a particular case can create lifelike restorations.

BRILLIANT EverGlow from COLTENE is a submicron hybrid composite. The average particle size of the glass filler has been reduced to below 1 micron to achieve maximum ease of polishability and gloss retention. The award-winning composite ensures natural-looking restorations that blend seamlessly with the surrounding teeth. The wide range of shades available allows dental clinicians to achieve accurate colour matching, resulting in highly satisfied patients and it is suitable for both anterior and posterior restorations. It delivers excellent handling characteristics, making it easy for dental professionals to sculpt and shape the material precisely. Its superior high gloss increases its wear resistance, durability and smooth feel.

Achieving natural-looking anterior restorations requires a meticulous approach to colour analysis and shade selection. A dental professional’s proficiency in these areas directly impacts the success of their treatments and patient satisfaction. Selection of the correct shade is the foundation for superior aesthetics which dentists can be proud of and their patients will love. n

about the author nicolas Coomber, COLtene national account & marketing manager.

the appropriate size and direction of the implant into the zygoma. Accurate 3D preoperative planning and appropriate surgical skills, precision and accuracy are also vital. The complexity of the zygomatic bone and overall maxillofacial structure means that any intervention poses risks to blood vessels and nerves, again requiring a high level of expertise to negotiate. Biological complications, such as maxillary sinusitis and buccal mucosal recession, can be mitigated through the use of innovative new surgical techniques.

Cutting-edge expertise in zygomatic implant procedures to treat a severely resorbed maxilla is a real advantage in the quickly-expanding field of implantology. This includes a familiarity with the newest and most appropriate technology to maximise outcomes for patients.

Piezoelectric surgery – the benefits of precision, powered by ultrasound

Piezoelectric surgery has been developed principally for use in bone surgery. The ultrasound-driven technology is based on the high frequency vibration of a metallic tip which can cut bone without damaging soft tissue. Selective cutting and minimal operative invasion reduces bleeding as well as the risk of perforating the Schneider membrane.

Although the principles behind piezoelectric surgery have been around for over 70 years, there has been a recent boom in the development of technology and techniques because of its myriad advantages. Particularly in the field of maxillofacial and implant surgery, piezosurgical devices

have been lauded for precise, safe and effective osteotomies. They have been shown to be particularly effective in various techniques like sinus lift, ridge splitting and bone harvesting, which may be used if the alveolar ridge is inadequate.

Micrometric cutting offers superior precision with no bone loss, and requires significantly less force than conventional drilling, meaning superior control. Further control over the surgical site is made possible because of the ‘cavitation effect’, where bubbles are created from the physiological salt solution, leading to implosion and generating a shock wave that enables precise micro-coagulation and less bleeding.

The lack of necrosis in the cut area accelerates bone regeneration, so patients heal faster and are less likely to experience complications. Studies have also identified an antiseptic effect, as cells are stimulated by oxygen released with the piezoelectric vibrations, and the lack of air-water spray generated with rotary instruments removes the risk of emphysema.

Piezoelectric surgery and zygomatic implants, the minimally invasive combination Innovations in piezoelectric surgery combined with new developments in implant surgery make zygomatic implants an even safer option for patients. The Minimally Invasive Piezo Technique was designed to minimise the risks of zygomatic implants using piezoelectric technology. It was developed by leading oral surgeon, Professor Andrea Tedesco in Italy, and first presented in the UK at the Zygomatic 2019 Conference in London.

Professor Tedesco, and eminent Specialist Oral Surgeon, Professor Cemal Ucer, will be sharing the wealth of their knowledge in an upcoming course at the ZAGA centre Manchester/ ICE Postgraduate Dental Institute, Manchester. The course will provide intensive hands-on surgical experience in the use of zygomatic, nazalus, trans-sinus and pterygoid implants for the treatment of severely atrophic maxilla. Delegates will receive training in the conventional, as well as the Zygomatic Minimally Invasive Technique (Z.M.I.T) with piezoelectric instrumentation, and will have access to the most state-of-the-art facilities to explore the latest techniques with the highest possible level of guidance. Those who wish to introduce zygomatic implants into their practice will benefit from incorporating the most current techniques to minimise the risk of collateral damage occurring to vital anatomical structures, including the surrounding blood vessels and nerves. Having optimal skill in this most cutting-edge area of dentistry will mean clinicians can offer more patients with limited options a real reason to smile.

Please contact Professor Ucer at ucer@icedental.institute or Mel Hay at mel@mdic.co.

Call: 01612 371842

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

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

Roaccutane - a.k.a Roc-lip

As dental professionals, I am sure we are all familiar with treating and advising patients suffering from a dry mouth. But what if their problem is dry lips? Obviously the two are often connected because it makes sense that a lack of saliva leads to a dry mouth as a whole. But it is a lesser-known fact that, aside from xerostomia, there are many conditions and medications that also make patients susceptible to dry lips, including anything from eczema, and nutritional deficiencies to Crohn’s disease. But perhaps one of the most common aetiological factors is an acne treatment called Accutane (a.k.a. isotretinoin), which is also sometimes used to treat certain types of cancer.

Accutane is the brand name for the Vitamin A derivative isotretinoin (although Accutane was discontinued in 2009, isotretinoin treatments are still collectively called Accutane). The treatment is described as ‘the closest thing there is to a cure for acne’ and, whilst it cannot ensure a blemish-free skin, it usually significantly improves the condition.

Historically, it has only been prescribed to patients over the age of 12 with acute nodulocystic acne (i.e. large, deep, angry cysts), but now it is also recommended for those with acne scars or whose skin is unresponsive to alternative treatments. However, it can only be prescribed by a consultant dermatologist as it is a specialist acne medication.

Accutane works by reducing the size and activity of sebaceous glands, decreasing oil production throughout the body, which, although it helps acne, means all of the mucous membranes in the body become dry, resulting in dry, chapped lips, among other things. This is clinically known as cheilitis and usually persists until the treatment is stopped. The good news is that the dryness is an indicator that the medication is working! But the bad news is that, although it’s clinically proven for treating acne and its associated scarring, there are many possible risks and side effects, which should have been discussed fully with the patient, and their parent/carer if applicable, prior to prescribing. They include:

• Depression – although in many cases the opposite is true, with improved skin alleviating depressive symptoms. Nonetheless, we should be aware of patients with low mood

• Liver problems – which is why caution is advised with regards to alcohol consumption

• And perhaps of most significance to us: Dry lips, which can be very debilitating However, as you can imagine when most patients begin their first round of treatment, they would literally try anything to clear the acne and improve their skin. So, possible side effects are not a deterrent.

tips to help dry lips

How can we help our patients? Well, it is essential that the lips are hydrated and

provided with a protective barrier to help lock moisture in. Flavoured and scented balms should be avoided as they encourage lip licking and, although ordinary lip balm may alleviate the symptoms, a stickier texture is better at preventing cracking, especially if used vigilantly several times a day. Occlusive agents are recommended, as they can help seal in moisture and protect lips from further irritation. Ingredients to look out for include:

• Petrolatum, found in petroleum jelly (a.k.a. Vaseline)

• Glycerine

• Shea butter

• Ceramides that strengthen the skin barrier

• Oils

• Vitamin E-a powerful antioxidant

• Hyaluronic acid, which supports lip hydration

There are also specific products containing hydrocortisone manufactured especially for use by Accutane users, which help reduce any inflammation. Fortunately, as mentioned above, once treatment is stopped the unpleasant side effects will go away and, although patients should be aware of this, there is no harm in reassuring them.

Lip balms and ointments are undoubtably helpful, but there are other things our patients can do to prevent their lips from becoming even more dry and chapped:

• SPF: Sun protection is crucial for all patients but particularly those on Accutane as it makes users much more sensitive to UV rays. A lip balm with a minimum of SPF 15 is required in the

UK, increasing to at least factor 30 –preferably 50 – when abroad.

• Lip masks: If your patient’s lips need an additional helping of moisture, they could try a lip mask. These work just like facial sheet masks, with some designed to be used overnight, whilst others are applied for a shorter duration.

• Avoid spicy and salty foods.

• Drink plenty of water: It makes sense that chapped lips are dry lips, so its important to stay hydrated and drink plenty of water.

• Avoid licking, biting or picking the lips: When the lips are licked constantly, the saliva dries and makes them even more chapped. However tempting biting, picking, or peeling may be, habits like this act as an irritant and exacerbate the problem.

• Use a humidifier: This helps, especially at night, and particularly in mouth breathers. Chapped and dry lips can be very debilitating but, once the cause is established, a good lip care routine should alleviate symptoms and bring about a noticeable improvement in the condition of the lips. n about the author ali Lowe is the founder of Fit Lip UK – a campaign aimed at encouraging people to wear SPF lip balm in order to protect their lips, prevent lip cancer and keep their mouth healthy.

Appreciating the value of an hour

“Few other things are as important to people’s lives as how they spend their time. The use of their time significantly determines how happy people are from moment to moment, and it is a significant predictor of their overall satisfaction with life.”

- (Krekel and MacKerron, LSE)

There comes a time for us all when reality kicks in and we realise that we’re not actually superhuman – sad times I know. I cram all sorts into each day, week, month, and year – from personal development, developing my practices, training and mentoring young dentists, to fitness training, family life, time with friends, travel (although mostly workrelated), and lots more.

How busy we appear has somehow become society’s measure of success, and I find myself joining in the competitive busy-ness almost unconsciously. I need to slow down a little, appreciate things more and do things better, which inevitably means I have to be selective about how I spend my time. Time is the true currency of our lives.

Maybe it’s an age thing or (perhaps to be kinder) the ever-growing demands on us as we age but we must examine the shape of our days and see what serves us best. We can do this by weighing up the merits of everything we do. Looking at how best to allocate our minutes and hours means being as

DENTISTRY TODAY

objective as possible, standing back and considering the various parts of our lives that we have accumulated over the years.

Here’s an interesting activity I came across recently. List all the main components of your current day-today existence. Roughly mark up the number of hours you spend on each over a typical month – this will paint a picture of how balanced (or not) your life is. Then make a list of questions that resonate with you. These will be different from person to person.

Here are some ideas of those questions:

1. Do you enjoy it?

2. Do you benefit from it?

3. Does it adversely affect others in your life?

4. Is it meaningful or satisfying?

Going home

Musician Mark Knopfler, together with his ‘Guitar Heroes’, has released a charity fundraising version of his composition, Going Home – a.k.a. theme from Local Hero . If you’re under 50, then let me explain: Mark Knopfler was the leader, guitarist, singer and songwriter of the band Dire Straits. Local Hero was a 1983 film set in Scotland, about a US oil company that wanted to buy a beautiful bay, a small village, and numerous small farms in order to build a huge refinery. Going Home was the theme that played out over the film’s closing credits and is also played at St James’ Park before every Newcastle United home game.

5. Can you afford it?

6. Does it offer you something positive?

7. Is it healthy?

8. Does it make you happy or contented?

9. Does it align with your values?

10. Does it offer some balance?

11. Do you like it?

12. More than that, do you LOVE it?

Create a simple score system and subject each part of your life to the list of questions and see what kind of information it gives you. Ultimately, the questions all boil down to just one: does it serve you?

Your list might contain some bad habits – doom scrolling, working late into each day, watching rubbish TV, spending time in the pub. Wherever your weaknesses lie, don’t be quick to dismiss them if they tick some of the ‘time well spent’ boxes. If they aren’t very useful to you and you’re spending a lot of time on them, maybe just reduce the focus on them to free up some time for other more beneficial things. We all need a bit of escapist Netflix from time to time!

The time issue for me has been building up for a few years. It was important to

This new version has been produced by long-time Knopfler collaborator Guy Fletcher, who has stitched together more than 60 great musicians’ contributions. The funds raised will benefit the Teenage Cancer Trust.

I was prompted to write this as I have been to more than my share of funerals recently and had the “what music will you have played at yours” discussion. Going Home seems popular amongst my friends, family, and contemporaries, unlike one of my friends who had the congregation sing along to Bohemian Rhapsody at his cremation.

That’s the final tune sorted out. But what will you want people to say about you? Or will you be beyond caring? My friend, ocean-rower turned politician Roz Savage, reminded me recently about Stephen Covey’s funeral obituary “exercise” in which one takes some time to imagine what people will say either in a funeral oration or in a written obituary as you make the journey into the great blue yonder. This takes time and your own company. Firstly, take a piece of paper and write the best

obituary you can imagine, where you have dared to dream big, have accomplished much, lived life on your terms, and enjoyed a glorious, successful, fulfilled and happy life. You are respected for your accomplishments, your principles, your skills, and character traits. As per Covey’s beautifully alliterate phrase, you have lived, loved, learned and left a legacy.

Next, take another sheet of paper and describe what will be written or said if you carry on without making any changes in your current course. As Roz wrote in Rowing the Atlantic , “after half a page of apathetic note taking, my enthusiasm ebbed away and I gave up. My life was pleasant but leaving no legacy except a house clearance sale and a few friends with fond memories. Clearly something was going to have to change.”

In Covey’s words, “Begin with the end in mind.” One needs the idea of an ultimate destination before you can plan your path; and you need a plan before you can take the first step – or in Roz’s case, commit to your first stroke. Of course, there will be changes

stop and reassess things. That has led to me taking one day off each week from teaching and my endodontic practice. I’ll still be ‘at work’ but it’ll be time spent on getting organised, getting through admin, doing real thinking, and planning. Yes, admittedly, it might involve working from a coffee shop or somewhere restful and scenic now and then, but the change of environment will certainly serve me, as well as the coffee and cake (see point 12, avoiding point 7!). 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.

along the route. One of the great joys of my life has been dealing with the challenges that changes have thrown at me.

If you’re feeling in a rut, you’re stuck, or have had enough of the direction you are heading, perhaps it’s time to get your paper out and write your own obituaries. The exercise works best with a pen and paper for some tactile reason. Don’t forget that the only difference between a rut and a grave is the dimensions. Your life, your choice.

references

• https://markknopfler.lnk.to/download

• https://en.wikipedia.org/wiki/Roz_ Savage

• https://www.rozsavage.com/

• https://en.wikipedia.org/wiki/ Stephen_Covey

• https://en.wikipedia.org/wiki/The_7_ Habits_of_Highly_Effective_People

Meet the Council: Risha Patel

Dr Risha Patel describes her career in endodontics, and her role within the British Endodontic Society (BES)

Areal highlight of my career has been the ability to complete a full circle, from being a student in endodontics through to teaching the undergraduates and postgraduates in the same departments I trained.

The field of endodontics has always appealed to me for a number of reasons. It is technically challenging, requiring precision and patience in equal measure, and it offers variety in management and use of skillsets each day. The advances in materials and techniques we have seen over the last few years have really helped to elevate the care we can provide, and it is incredibly rewarding to be able to relieve patients of true pain.

I am the Honorary Communications Officer for the BES, largely dealing with the PR and Marketing for the Society. Having started in September 2022, I have focussed on enhancing our existing digital platforms, as well as introducing and growing the Society’s social media platforms, as a new project. It’s been an insightful journey, allowing me to learn about everything from press releases and editorials, to hard copy vs digital, to social media content creation and algorithms.

My favourite aspect of the BES is the community – comprising of dental professionals from all walks of life, with a common interest in and passion for endodontics. Being a part of the BES has allowed me to connect with and learn from so many – all of whom have different qualifications, experience levels, working environments, and interests, these include: clinicians, academics, educators, students, product manufacturers, and sales representatives. We all get together at annual BES meetings, and the impact that this networking has had on my career to-date is invaluable. This current chapter of my life is all about the balancing act of

motherhood and career. So, most of my time is spent with my son, watching him grow up far too quickly and wondering how I can magic more time into the week for

my patients. My ‘me time’ is spent dancing and at Pilates! For more information about the BES, or to join, please visit www.britishendodonticsociety.org.uk 

Naturally GTO®. From syringe to defect. GTO®

Peri-implant defect treated with OsteoBiol® GTO®

Author: Dr Patrick Palacci, Marseille, France

• Outstanding stability due to ideal viscosity

• Ready-to-use in sterile syringe

• Easily adaptable to the recipient site

• Innovative dual-phase biotechnology

• TSV Gel inside for optimal stickiness

• Directly injectable into bone defect

• Faster and safer surgical handling

• Cortico-cancellous collagenated matrix

Hot tips for preventing burnout

One of the main reasons I am contacted by principals is worry about their practice manager. “They need support, and it can’t always be me.”

It doesn’t take long for me to understand why! Of course, there are many contributing factors, but the starting point is to look at what the PM is doing on a daily basis, and how they are managing their time, or whether they are just trying to get through the day.

Developing a structure and implementing some zoning is a helpful way to make sure that you aren’t going home frazzled every day, feeling like you haven’t achieved very much.

I’m a huge fan of creating a daily planner. We love a tick list, don’t we?

Set yourself daily, weekly, monthly, quarterly, and annual tasks, and try to follow some of these hot tips for regaining some control!

1. prioritise self-Care

• Just as you prioritise patients’ oral health, prioritise your own well-being. Regular exercise, adequate sleep, and proper nutrition are essential.

• Consider mindfulness practices like meditation or deep breathing to manage stress.

2. set realistic Goals:

• Break down larger tasks into smaller, manageable steps.

• Avoid overcommitting. Learn to say no when necessary.

3. Delegate Wisely:

• You’re not a one-person show. Delegate tasks to your team members.

• Trust your team’s abilities and empower them to take ownership.

4. Time Blocking:

• Allocate specific time blocks for different tasks. For example:

- Morning: Emails, HR, compliance

- Afternoon: Financials, KPI’s, marketing

• Stick to these blocks as much as possible.

5. Use Technology efficiently:

• Invest in practice management software to streamline scheduling, billing, and patient communication.

• Automate repetitive tasks wherever possible.

6. regular Breaks:

• Step away from your desk. Take short breaks throughout the day.

• Use lunchtime to recharge, not to catch up on work.

7. Learn to say “Good enough”:

• Perfectionism can lead to burnout. Strive for excellence but recognise when something is good enough.

• Remember that patients and the team appreciate your effort, even if things aren’t flawless.

8. seek support:

• Connect with other dental practice managers through organisations such as ADAM, introduce professional support for areas such as HR, compliance, marketing.

• Share experiences, learn from others, and seek advice.

• Ensure you have protected time to speak to principals, and regular meetings.

9. Monitor Your energy Levels:

• Pay attention to when you’re most productive. Schedule important tasks during those times.

• Avoid energy-draining activities.

Childcare and Catch Ups

With dentistry now being more than 50% female overall (and some DCP roles over 90%), childcare is an important subject. Those nice people at HM Revenue and Customs (HMRC) have sent BADN details of Tax Free Childcare schemes for all working families (including those where one or more parent is self employed) – details are available on our website or via our newsletter (details at the end of this article). Essentially, Tax Free Childcare is a government funded top-up scheme for working parents that can save them up to £2k a year on childcare for

children aged up to 11 years (or up to £4k a year and 16 years of age if the child is disabled). It can be used to pay for any approved childcare that suits the family’s needs – childminders, nurseries, nannies, before and after school clubs, holidays or activity clubs. Latest statistics show that almost 650,000 working families are using it to help pay for childcare.

In England, eligible working parents of two-year-olds have been able to access 15 hours’ free childcare per week since the beginning of April. This will expand to 15 hours from nine months old up to starting school by September 2024 and to 30 hours by

September 2025. Tax Free Childcare can be used with the free hours if parents meet the eligibility criteria. Tax Free Childcare may not be used while claiming Tax Credits or Universal Credit (which is replacing Tax Credits by April 2025) but tax credits do offer alternative childcare support. If you already claim tax credits, you will receive a letter from HMRC by 19 June 2024.

More information and details of where to register for Tax Free Childcare are available on our website www.badn.org.uk and via our e-newsletter on the subject.

Join BADn this month in Birmingham and Braehead!

BADN will have a stand at both the Dentistry Show in Birmingham and the Scottish Dentistry Show in Braehead this month.

Join us at stand K01 (right next door to the Dental Nurse Lounge) in Hall 5 of the NEC on 18 and 19 May at the Dentistry Show, where President Joan Hatchard will also be chairing the Dental Nurse Forum. The Forum Programme is available at birmingham.dentistryshow.co.uk/conferenceprogramme and you can register at birmingham.dentistryshow.co.uk/

We will also be at stand A07 at the Scottish Dental Show in Braehead on 31 May-1 June – details are available at https://sdshow.co.uk/. Our special

• Keep hydrated and have healthy snacks to hand.

10. reflect and Adjust:

• Regularly assess your workload, stress levels, and satisfaction.

• Adjust your strategies as needed to maintain balance.

If you would like to join ADAM, visit adam-aspire.co.uk or contact Lisa directly through Practice Managemenr Matters at practicemanagementmatters.co.uk n

About the author Lisa Bainham is president at ADAM and practice management coach at practice Management Matters.

show offer – £5 off the membership fee if you join at a show – will be available at both shows, plus we will have a prize draw for dental nurses joining or renewing their membership at either event. See you there!

BAD n Coffee Catch Up –DeCon p ete

An apology – due to gremlins in our system, the registrations for our Coffee Catch Up with “DeCon Pete” talking about managing hazardous waste have crashed! If you signed up (and record numbers of people did), please go back to our website and register again, or contact jacek@badn.org.uk to ensure that you receive the Zoom link and joining instructions the day before the event. If you haven’t yet registered but would like to attend, please visit www.badn.org.uk/Events/CoffeeCatch-Up-April-2024 to register. If you haven’t yet signed up for our e-newsletters, which keep you up to date with events, news, special offers and Coffee Catch Ups, please do so at www.badn.org.uk/newsletter. n

About the author pam swain is Chief executive of BADn

Transforming dentistry: BDCDS & DTS 2024

into the heart of dental innovation and leadership at the British Dental Conference & Dentistry Show and Dental Technology Showcase. Don’t miss this chance to shape your future in dentistry – register now!

In an era defined by rapid innovation and the quest for excellence, the British Dental Conference & Dentistry Show (BDCDS) sits as a key event for dental professionals.

Scheduled for 17 and 18 May at the NEC in Birmingham, this conference and exhibition aims to offer new perspectives and insights into the evolving landscape of the dental profession in the UK.

At the heart of this is the headline session by Steven Bartlett, a figure synonymous with groundbreaking entrepreneurial success and inspirational leadership.

As the youngest dragon in BBC’s ‘Dragon’s Den’, Bartlett brings to the BDCDS a wealth of experience in leveraging digital platforms for business growth, particularly within the health and wellness sector.

Bartlett will be in conversation with Dr Nilesh Parmar on the future of dentistry, team culture, the psychological aspects of running a practice and much more. His experience with overcoming challenges and diversifying interests will undoubtedly offer critical insights for dentists at all career stages.

Beyond the headline

While Bartlett’s session is a highlight, the BDCDS offers a wide variety of opportunities for learning and connection.

For instance, the exhibition will showcase

the latest dental equipment, technologies, and products, providing hands-on experience that is crucial for understanding the potential impact of new tools on patient outcomes and practice efficiency.

With stands for the likes of 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 to name just a select few out of 400+ exhibitors, the exhibition is set to dazzle attendees with innovations that promise to enhance the quality of dental care.

Then there are the networking opportunities, with the BDCDS providing a unique platform for dental professionals to renew old friendships and forge new alliances, offering personal encounters that foster trust, rapport and collaborative relationships. This aspect of the event highlights the intrinsic value of face-to-face interactions in building a vibrant professional community.

What’s more, in collaboration with key organisations such as the British Dental Association (BDA), the BDCDS enriches its programme with a range of clinical and practical insights. This partnership ensures that the content is not only relevant but also reflective of the current challenges and opportunities within dentistry, making it a

A comprehensive programme for every dental professional

The BDCDS and DTS 2024 pride themselves on offering something for everyone in the dental profession. Whether you’re a foundation dentist just starting out on your journey, a dental technician keen on the latest laboratory leadership insights, or a specialist looking to deepen your expertise, this conference has been tailored with you in mind.

Among the highlights of the event are presentations from some of the most well-respected figures in dentistry. Each speaker brings a wealth of knowledge and experience in their respective fields, ensuring attendees leave with actionable insights and deeper understanding.

Here’s a sneak peek at some of the distinguished speakers and their presentations…

• Simon Chard, Cosmetic and Implant Dentist, Co-Owner of Rothley Lodge Dental and PÄRLA: ‘Dental Growth Protocol: an evidence-backed guide to unlocking a more fulfilling, resilient and productive career in dentistry.’

• Eddie Crouch, Chair, BDA: ‘Panel discussion: in an election year, what’s the future for dentistry?’ and ‘The future of NHS dentistry.’

• Helen Kaney, Dental Adviser, MDDUS: ‘Complaints – how to deal with them and how not to stress about them.’

• Justin Leigh, Managing Director, Focus4growth Ltd: ‘Lab Management and leadership: how to inspire your lab team through coaching.’

• Benjamin Marriott, Dental Hygienist, General Practice: ‘Transgender inclusion in dentistry: small changes make a big difference.’

• Victoria Sampson, Dentist with Special Interest in Periodontology: ‘The mouth body connection and the oral microbiome: what can be done to improve patient outcomes?’

• Paul Tipton, Specialist in Prosthodontics, Tipton Training Ltd: ‘Treatment options for the bruxist and wear patient.’

• Reena Wadia, Specialist Periodontist, RW Perio: ‘Pink aesthetics: management of gummy smiles and gum recession.’

• Sir Nairn Wilson, President Emeritus College of General Dentistry: ‘The future of dental technology.’

must-attend event for professionals seeking to stay at the forefront of dental practice.

The dual

dynamics of BDCDS and DTS

While the BDCDS 2024 sets the stage for an unparalleled exploration of dental excellence, the concurrent Dental Technology Showcase (DTS) brings an additional layer of depth to this year’s event. Here, the focus shifts to the critical aspect of leadership within dental laboratories, a domain where the fusion of technical skill and visionary leadership determines both present success and future growth.

With DTS positioned as the UK’s only event dedicated to dental laboratories and technicians, it offers a unique opportunity for networking, learning, and discovery. Part of that includes exhibitors offering a range of educational sessions right at their stands, providing a hands-on experience with the newest products and the opportunity to gain invaluable insights directly from the experts.

With all that in mind, DTS offers an unrivalled opportunity to invest in professional growth by connecting with innovative suppliers, gaining

insights from speakers with accomplished industry backgrounds, and walking away with a competitive edge.

The gateway to future dentistry

With their comprehensive programmes and array of esteemed speakers, the BDCDS and DTS stand as beacons for learning, growth, and connection within the dental community.

Whether you’re seeking to expand your clinical knowledge, explore the latest in dental technology, or simply connect with peers and mentors, these events promise an enriching and transformative experience for every attendee.

Don’t miss this opportunity to be part of an event that shapes the future of dentistry. Secure your place now and join us in Birmingham for what promises to be an unforgettable experience, filled with learning, innovation, and community engagement.

To ensure you don’t miss out on this momentous occasion, visit the BDCDS and DTS websites today to register free of charge – birmingham.dentistryshow.co.uk and the-dts.co.uk. 

Connecting for social and professional enrichment

Taking time to connect with colleagues, peers and new friends in a stimulating environment is a precious thing in today’s fastmoving world. Sharing clinical research, problem-solving techniques and practical knowledge can open doors, both professionally and personally. Networking can provide informal and formal learning experiences, and professionals can develop lasting relationships with peers, mentors and mentees.

Highlights from the all-new BACD Aesthetic theatre at BDIA Dental showcase 2024 This spring, BDIA Dental Showcase presented another phenomenal opportunity for the best and brightest working in dentistry today to socialise, present new ideas, test products and learn from each other. The showcase didn’t disappoint, unveiling hot new products, exploring new research and offering enhanced CPD, all in the aid of raising standards of oral care.

This year, BDIA Dental Showcase was proud to present a schedule of informative lectures at the brand-new BACD Aesthetic Theatre, sponsored by the British Academy of Cosmetic Dentistry (BACD). The BACD has been a community of members, including dentists, technicians, other team members and students with a shared commitment to clinical excellence in ethical cosmetic dentistry for 20 years.

Highlights in the BACD Aesthetic Theatre included talks about immediate

Dr Chris McConnell

implant placement and loading by Dr Christopher Leech, anterior adhesive aesthetics by Dr Shiraz Khan, and the ortho-restorative workflow by Dr Jenni Rawes, among many others.

Trade Director for the BACD, Doug Watt, kicked off proceedings with an excellent introduction to best practice in digital smile design. Doug is a prize-winning restorative dentist with a special interest in digital dentistry, and he presented a comprehensive workflow for the best clinical outcomes, including ways to improve patients’ understanding of treatment options. Doug presented methods to ensure patients’ smile designs were aesthetically pleasing, discussing optimal ratios and axial inclination. He presented useful strategies to ensure patients are fully informed through visualisation techniques as well being able to physically experience options with the latest in 3D printing technology.

Dental surgeon and former BACD President, Chris McConnell, continued the digital dentistry theme in an engaging talk about digitally guided veneers. Chris outlined the features of some exciting new materials available in the field, and, like Doug, stressed the advantages of digital dentistry in managing patient expectations, as well as securing patient participation and informed consent in the process of designing an improved smile.

Neil Gerrard is an award-winning dentist with a special interest in complex rehabilitation. He is a boardmember, examiner and Fellow of the BACD, and spoke about predictable crown-lengthening for the GDP in daily practice. Neil demonstrated techniques in detail using clear and pertinent examples; including correction of biological width invasion, aesthetic treatment of microdontia, and creating level gingival margins. Throughout the lecture, Neil stressed the health benefits of crown-lengthening treatment as well as the profound improvement in aesthetics.

Rocio Lazo has been a Specialist Paediatric Dentist for over 20 years, and presented detailed information (with the help of a 1980s soundtrack and some stuffed animals), on the use of new bioactive materials in minimally invasive dentistry. Rocio investigated the use of exciting new biomimetic formulations that are effective in treating molar incisor hypomineralisation, and facilitate the regeneration of affected dentine to treat dental caries.

Hear from world-renowned experts at

The IFEA World Endodontic Congress (WEC) is set to host some of the most experienced endodontists this September –presenting sessions based on a wide range of subjects. This is a fantastic opportunity for dental professionals who are interested in endodontics to come along and expand their knowledge and enhance their skills amongst others with a passion for the field.

Whether you’re interested in trauma, regeneration, imaging, vital pulp therapy, surgical endodontics, restorative dentistry, or systemic health, the Congress educational programme offers something for you. Speakers from all around the world will gather in Glasgow to share their expertise on these essential topics, sharing their cases and offering advice to those who would like to expand their skillset.

Dr. Yoshi Terauchi will be presenting his session “Why MTA obturation over gutta-percha obturation in nonsurgical

retreatment?” at the event. This is an important topic on which he will share his expert insight. Commenting on the advantages of attending the Congress, he says: “The benefit of attending the international conference at IFEA Glasgow is to make friends with people from all over the world. You will hear many international lecturers talking about many different topics, so it’s beneficial to attend the event.” Making connections is key in the dental profession for facilitating growth and expanding knowledge. Networking at events such as the IFEA WEC enables professionals to meet with colleagues who share their passion for endodontics, as well as presenting mentorship and referral opportunities. The event also offers the unique opportunity to hear new perspectives, with clinicians from around the world coming together to share their professional perspectives.

Professor Ove Peters will be presenting two sessions at the event entitled “What

Responses to the talks were highly positive. As Angela Mohammed from Deddington Dental said: “[Rocio was a] fantastic lecturer. I’ve been practising for 10 years, and I still learned so much!”

Another attendee said, praising the talk by Chris McConnell: “Great talk…a good overall overview. Interesting to watch.”

Helen Paisley from Community Dental Services CIC praised the quality of the talks she attended as part of the BDIA programme, and was pleased by the stands and the venue. She said of the event: “The venue is excellent. I have attended the event over both days and found the stands to be excellent, with brilliant networking!”

The BACD Aesthetic Theatre at BDIA Dental Showcase this year was a prime example of the benefits of affiliation with organisations that promote excellence. Not only did the programme offer valuable CPD delivered by experts, it enabled people to meet and discuss their interests, queries and concerns with like-minded people. n

save the date BDIA Dental showcase 2025 14th-15th March exCeL London dentalshowcase.com

is optimal endodontic care and how can we achieve it?” and “Addressing the life cycle of teeth: A restorative driven path to endodontic excellence”. In anticipation of his upcoming appearances, he comments: “I very much look forward to travelling to Glasgow for the IFEA meeting, and I hope to meet you there! I have been assigned to give two presentations – both in the realm of endodontics and restorative dentistry. A worldwide forum like IFEA is perfectly suited for these two presentations and I hope you will enjoy listening to my thoughts, as much as I enjoyed putting them together.” The Congress enables experts to share their views on some of the most cutting-edge topics in endodontics – a great way for those interested in the field to learn more about what’s possible.

Joining us from the University of Siena, Professor Simone Grandini will be presenting his session “Endodontics & Beyond: Decoding Multimorbidity in Rootto-Crown Treatment Planning”. This is a key topic and an area of interest for many dental professionals. He shares this excitement: “I am really looking forward to attending WEC 24, it will be a unique

opportunity to learn and share some good times with the best in endodontics.”

Professor Matthias Zehnder will be presenting his session “Continuous chelation in endodontic irrigation” discussing the development of root canal irrigation and best practice. This is a great opportunity for delegates to learn more about the latest techniques. He discusses what he is looking forward to the most: “Why should you attend a Congress like this? It’s always fun to meet people from around the world. Also, I believe that the programme this year is very good. The British Endodontic Society helped to put this together – many diverse and interesting topics within endodontology are going to be covered.”

A diverse educational programme is essential for a well-rounded experience. This is exactly what the BES has aimed to provide at the upcoming IFEA WEC, supplemented with an exciting social calendar, to help ensure that attendees are able to make the most of their time in Glasgow.

Register today for IFEA WEC 2024 at ifea2024glasgow.com/registration

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

Ove Peters

Yoshi terauchi

simone Grandini

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

The team at the heart of excellent dental care

The delivery of high-quality dentistry today is only possible with input from the entire dental team. Effective collaboration and skill mix utilisation are crucial for the successful delivery of patient care in any situation. This means that all team members must advance their knowledge and skills, using evidence-based products and techniques to support the provision of dental treatment and care.

For those looking to upgrade their materials, systems and oral health solutions, BDIA Dental Showcase afforded the perfect opportunity to see everything in the UK market right now. New products were featured, as were many trusted favourites from decades gone by, allowing the dental team to discover, compare and try various innovations in one place. Professional associations, societies and education providers were also in attendance – including ADAM, BADN, BADT, BSDHT, and more –allowing individuals to find out more about membership and connect with professionals that have the same interests and passions.

Though BDIA Dental Showcase is best known for its extensive dental exhibition, the 2024 event presented a dynamic educational programme of equal calibre. This meant there was plenty to see and do for all members of the dental team, with hours of CPD available for all to enjoy.

The Oral Health Theatre, for example, discussed a broad spectrum of relevant topics from improving patient communication to enhancing periodontal management and considering the global landscape of oral health right now. Among the popular

sessions was Dr Mahesh Kumar’s lecture providing an update on mouth cancer. He offered a range of tips on how to conduct a thorough examination, considering the impact that HPV has had and continues to have on mouth cancer rates.

Dr Celia Burns from Nothing But The Tooth, commented: “This was a really helpful talk that was appropriately pitched for GDPs. It was useful to hear the details of the 2-week wait referral guidelines. Time flew by as the talk had plenty of clinical examples, which were also helpful to illustrate what we are looking for.”

For dental nurses, Laura Hardy discussed career pathways into dental implantology on behalf of the BADN, sharing useful advice on how to take those important next steps. Fiona Sandom, dental therapist and Past President of the BADT, presented on “The Business of Dental Therapy” was also well-received, with dental therapists and dentists learning more about how to effectively integrate the dental therapy role within a busy practice.

Louisa Eyeoyibo, treatment coorindator, said about the session: “I liked this presentation; there was some excellent information provided in bite-sized chunks that were appropriate for the environment. The use of surgery pictures was helpful and the session will really help with NHS care.”

A later session on mental health and wellbeing proved insightful for all members of the team, as did a presentation by Dr Kunal Shah, principal of LeoDental, on the impact of artificial intelligence in dentistry. Team members seeking further information and updates in clinical areas such as

periodontology, intraoral scanning, patientcentric care and facial aesthetics, had the opportunity to join the Clinical Theatre where more leading speakers covered a wealth of topics. The Dental Update Theatre was equally as popular, with discussions around medico legal issues in periodontology, mouth cancer prevention and sleep dentistry taking centre stage.

The CDO Theatre was another port of call for any team members with an interest in hearing from the Interim Chief Dental Officer England, Dr Jason Wong, and his team. A session dedicated to skill mix in the dental practice proved popular, with all team members represented by speakers. Debbie Reed – Lead for Professional Development Programmes, CHSS University of Kent –presented research into reasons dental nurses may be thinking about leaving the profession, citing pay as a leading factor –although other important considerations were extended sick pay, GDC registration covered and CPD provided. Miranda Steeples –President of the BSDHT – highlighted the opportunities afforded by direct access, while

Simone Ruzario – Honorary Treasurer of the BSDHT – shared her personal experience as she began to fully use her scope of practice. Bill Sharpling – Associate Dean (CPD), Faculty of Dental, Oral & Craniofacial Sciences, King’s College London & Honorary Professor – went on to share a clinical dental technician’s perspective and Amy Howard –orthodontic therapist – explored the benefits of the orthodontic therapist.

A common theme throughout the session was that practice owners, managers and front-of-house staff need to understand team members’ full scope of practice in order to make the most of their skills. By covering such hot topics, the programme provided plenty of food for thought and certainly stirred conversation. Dental professionals were able to engage with speakers, share their thoughts with colleagues, seek expert guidance from product experts and carry on the discussion beyond lectures.

No matter what role you fulfil within the dental team, be sure not to miss BDIA Dental Showcase 2025. Save the dates: 14th-15th March! n

Reflecting on the ADI Implantology Zone at BDIA Dental Showcase

BDIA Dental Showcase 2024 saw the first ADI Implantology Zone and Theatre, hosted by the Association of Dental Implantology (ADI). Delegates flocked to visit lectures presented by expert speakers in the Theatre and see what was on offer from dental implant product and technology providers.

Hard and soft tissue management

Day one in the ADI Implantology Theatre was kicked off by with an introduction from Amit Patel, Immediate Past President of the ADI, who invited attendees to enjoy what the ADI Implantology Zone had to offer. Dr Selvaraj Balaji’s session, titled “Management of Hard and Soft Tissues in Complex Defects”, explored the importance of understanding the unique biology of each individual patient, and each individual tooth.

Selvaraj began by sharing the challenges he faced in the early stages of his implant career, and his struggle with managing hard and soft tissues. A bone graft will not survive unless the soft tissue is stable – with a minimum of 2mm of soft tissue required. The choice of bone graft material is important, with autogenous bone the gold standard, and allograft and xenograft options for slow resorption. He highlighted the importance of choosing the right membrane for each defect, and the benefits of a non-resorbable membrane like PTFE. Selvaraj recommends planning treatment

according to the individual tooth, meeting the needs of the bone type. He explained that, by following this, he has been able to offer his patients a five-year guarantee with every bone graft.

Intramucosal implants

Dr Amit Kotecha’s session “Intramucosal implants: consent and case planning” discussed using thin dental implants which allow space for soft tissue, like the Prama implant from Sweden & Martina. Amit highlighted that patients are paying for their improved smile, and restored dignity, so it’s important to choose a predictable treatment approach. Further to this, he discussed the importance of taking complete, accurate, and contemporaneous notes, ensuring that you offer patients all of the available options, even if it means referring them to another professional. He discussed disclosing the risks of doing nothing for a patient with tooth loss – sharing that he shows his

patients images of bone loss, to ensure they get a true visual understanding of the consequences. Amit highlighted that timing is everything when providing dental implants as, if treatment is provided prior to structure loss, the patient journey is far easier. In terms of alternative treatment options, it’s important to explain to patients that dentures compress the soft tissue, eventually leading to bone loss due to reduced blood flow. Amit also commented that, while implants are often advertised as having a life of 10-12 years, results can be better than this. He showed a case example of an all-on-6 which lasted 26 years with no problems. The patient described the result as a miracle.

Dr Kevin Allanam from Prodental was among the audience for the lecture, about which they commented: “Amit described his cases well. I will use all of the important information I have learnt in this lecture, and I would highly recommend attending BDIA Dental Showcase.”

Digital implant workflows

Dr Douglas Watt discussed the benefits of a digital workflow in his session “Digital implant retained dentures”. Doug explored the relationship between traditional and digital workflows in a world where, often, everything is intraoral scanner based. He highlighted that, in cases where a traditional impression is taken, the workflow can still be digitised, by scanning the impression itself. A digital workflow means that dental professionals don’t need to re-do

anything should a denture need remaking for any reason. Doug described his digital workflow and decision making, including his preference for milling over 3D printing, and the use of a surgical guide for every procedure to ensure predictability.

Minimally invasive approaches

In his session “Minimally invasive implant dentistry” Henri Diederich discussed the importance of changing the implants for the anatomy rather than changing the anatomy for the implants. Focusing particularly on patients who have limited bone, Henri highlighted the use of zygomatic implants, and thin paranasal implants. When patients have a very narrow crest, using thin implants can help to avoid bone grafting/ridge splitting, and cause less damage. Henri went on to explain the Bone Truss Bridge (BTB) concept. The technique uses more implants for improved outcomes. Henri talked through several cases which included younger patients between 40 and 60 who were looking for long-term solutions.

In attendance at Henri’s session, Dr Anusha Rudresh from Alliance Dental commented: “My participation in the lecture gave me various different approaches to treatment planning that can help me when explaining to patients.”

Many thanks to all who attended the ADI Implantology Zone at BDIA Dental Showcase 2024. We look forward to seeing you all next year on 14-15 March 2025, ExCeL London. n

Investing in the value of IFEA WEC for clinicians

The IFEA World Endodontic Congress (WEC) will be hosted by the British Endodontic Society (BES) in 2024. The highly anticipated event will take place at the Scottish Events Campus in Glasgow, entitled “Phases & Interfaces”.

A comprehensive programme will include a range of workshops and seminars from world-leading speakers, with various social events and an extensive trade exhibition.

The BES is delighted to announce Dentsply Sirona as the Platinum Sponsor for WEC 2024. Not only does this partnership reflect shared values for furthering education in the endodontic field, but it also ensures highly relevant learning and networking opportunities for professionals.

Sharing some insights into the growth of endodontic equipment across the globe, Jean-Marie Guillemin – Marketing Director for Dentsply Sirona Endodontics –highlights two key areas:

“Over the past 20+ years, there has been tremendous progress in the development of endodontic motors and file technology. The clinical performance of these tools has the ability to elevate the treatment experience for clinicians and their patients. That’s why it’s important for manufacturers to think clinically when developing new motors and to ensure precision engineering that enables precise motor movements and makes a difference to the quality and outcome of the procedure. For this reason, our recently launched X-Smart Pro+ is the first endodontic motor we have ever developed, sourced and manufactured in-house at Dentsply Sirona.

“The other area of development relates to the second step of the endodontic procedure, irrigation and activation, where there still is a lot of potential for innovation. This step is critical for a successful clinical outcome, so we are looking for effective ways to improve disinfection without risking damage to the canals, for example, with our SmartLite Pro unit, now with a specific Endo Activator head.”

Aside from the intricacies of the procedure itself, practitioners face other challenges that impact their clinical workflows and results. Sarah Waldmann – Director of Global Clinical Education for Dentsply Sirona Endodontics – discusses three key difficulties that need to be overcome:

“How clinical challenges are managed depends on the dentist’s experience level. Those early in their careers may lack exposure to hands-on training, especially for professionals whose education was affected by the pandemic. This will need to be rectified in order to build clinical confidence with different procedures and become familiar with the specific products and materials available in the practice.

“Another challenge clinicians face is the time and effort required to stay up-to-date with the rapidly evolving ecosystem of technologies available to support endodontic treatment.

Artificial Intelligence (AI) and cloud-based solutions like DS Core are changing the game, offering new ways to deliver safe and compliant care through integrated networks of technology and people.

“The third area that clinicians can find difficult is building a streamlined yet adequately varied armamentarium of tools and materials to facilitate safe and predictable endodontic procedures.”

Regardless of the challenges, approximately 10% of the population require endodontic treatment, so it is crucial that clinicians have the skills and confidence to deliver care. That’s why education remains key. Jean-Marie comments:

“It is important that undergraduate endodontic education is supported and continually improved worldwide, as this will ensure that clinicians enter the field with competence and confidence. In addition to developing effective products, we feel responsible for ensuring that clinicians know how to use these tools correctly – innovation and education go hand-in-hand, which is why training is in our DNA at Dentsply Sirona.”

This dedication to education is what aligns Dentsply Sirona with IFEA WEC so effectively. In fact, the organisation has

supported Congresses for several years and is pleased to continue this tradition by working with the BES for 2024. Sarah says:

“The BES shares our ethos for education and training in endodontics. We have had very productive meetings where we are clearly working in the same direction. For 2024, the theme of ‘Phases & Interfaces’ resonates with us especially, because it corresponds with our own customer journey. Further still, being involved with this and similar events is important to help our organisation tailor our own educational offerings, ensuring we cover the topics that clinicians around the world need support in.

“Our sponsorship of IFEA WEC 2024 is an opportunity to show the world our continued commitment to high-quality endodontics. It aligns perfectly with our mission to elevate clinical standards, utilising the latest science and experience in the field to effectively develop our solutions.”

Jean-Marie adds: “The Congress will also be an opportunity to put everything into practice, as we’ll be hosting some handson workshops as well as supporting speakers who will discuss various topics from development of early career clinicians to reciprocation advice and overcoming challenges with paediatric patients. We will also be hosting a social event for students and teachers to engage in an informal setting outside the sessions for some valuable peer-to-peer interaction. Of course, anyone wanting to know more about our legendary products –from ProTaper to WaveOne or Reciproc endodontic files, and our new DS Core integration platform – can visit our booth for more details.”

Dentsply Sirona’s involvement with IFEA WEC 2024 will strengthen the educational activities delivered throughout the programme. It will honour and reflect the passion shown by clinicians who provide endodontic treatment and give them the development opportunities they need to really thrive. Sarah concludes:

“IFEA is valuable for all clinicians with an interest in endodontics, regardless of their specialisation or career stage. That’s why we’re investing in what it offers and what it stands for.”

Register today for IFEA WEC 2024 at ifea2024glasgow.com/registration

For more information about the BES, or to join, please visit britishendodonticsociety.org.uk or call 07762 945847 n

Dental exhibitions and the customer experience

Marketing is an aspect within business that has developed from simple ads in the local news paper, to entertaining radio jingles to short product-focused clips on our televisions.

But in today’s marketing landscape, marketeers have found that whilst these traditional marketing channels can be valuable when it comes to brand awareness and conveying product differentiation, they are limited in impacting something even more valuable – the customer experience.

This is where experiential marketing comes in. Experiential marketing is a solution for marketeers who find that traditional promotional channels aren’t as effective as they once were. It seems now TV ads are no longer the marketing tool of choice and every brand is trying to keep up with social media trends.

Experiential marketing is a reminder that it isn’t solely the product that motivates

people to come back to a brand, but rather the way they experience it.

From pop-up stores to highly anticipated events like New York Fashion Week, marketing events create something exciting and engaging for customers to associate your brand with. Unlike social media marketing and TV ads,

event marketing gives brands the peace of mind that their investment is reaching their target audience. Customers, potential and existing, have the opportunity to speak with sales teams and get to the core of their needs putting brands in a great position to strengthen their brand awareness, address any customer

complaints and form meaningful relationships that extend beyond a sale.

For any company that operates within the dental industry, dental exhibitions are one of the most valuable marketing tools that help their customers experience what they have to offer. Whether that’s testing out newly launched products or discovering special promotional offers on company stands.

Dental chairs are a long-term investment for any doctor which is why these exhibitions are the best opportunity to learn more about their potential purchase.

This year, A-dec will be exhibiting at the 2024 Dentistry Show with a stand showcasing its industry-leading dental equipment, including the A-dec 300 CORE – an entry level package that delivers the usual A-dec quality. Visit stand B40 at BDCDS 2024 in Birmingham, 17-18 May, to discover A-dec’s smart ergonomics, legendary reliability and unparalleled quality A-dec for yourself.

birmingham.dentistryshow.co.uk/ exhibitors/a-dec-dental-uk-ltd n

The importance of saliva

Tepe is delighted to bring you this article, with the aim of supporting the ongoing Enhanced CPD needs of dental healthcare professionals in improving and maintaining the oral health of their patients.

Learning objectives

• To better understand the role of saliva in a healthy mouth

• To appreciate the causes and oral health impact of a lack of saliva

• To be aware of new solutions available to help patients relieve the symptoms of dry mouth

Learning Outcome: C

Patients may not consciously think about it often, but saliva plays a crucial role in the mouth. Indeed, it is probably only ever discussed when saliva is found to be lacking and the resulting dry mouth – xerostomia – begins to cause problems. For the dental team, it is important to recap on the potential causes of reduced salivary flow, symptoms, oral health impacts and management techniques.

Salivary functions

Saliva fulfils important functions within a healthy mouth. These include:i,ii

• Buffering – saliva contains bicarbonate, phosphate and protein to help maintain a neutral pH range in the mouth between 6-7.5.

• Remineralisation – the calcium hydroxyapatite in saliva helps to prevent demineralisation of the enamel.

• Digestion – enzymes like amylase, lysozyme and lipase in the saliva begin the process of digestion in the mouth.

• Oral health protection – salivary mucins help to form a barrier against pathogens. It contains various proteins with antimicrobial properties – such as lysozyme and lactoferrin –to protect the mouth from bacterial, fungal and viral colonisation.

• Lubrication – the chewing and swallowing of food is made easier in the presence of saliva.

Feeling parched?

Lack of saliva in the mouth, both in terms of quantity and quality, can be caused by several triggers.

Various systemic conditions have been associated with saliva hypofunction, particularly autoimmune diseases, diabetes mellitus, end-stage renal disease and chronic graft-versus-host disease.iii The mechanisms leading to reduced salivary flow differ between conditions, but include infiltration of immunocompetent cells, granuloma formation and dehydration. Other disorders that are commonly related to dry mouth symptoms include Sjögren’s syndrome,iv eating disordersv and asthma.vi Furthermore, there is a high risk of dry mouth among patients with advanced cancervii and radiation-induced xerostomia is a common side effect of treatment. This can be a particularly difficult group of patients to support,

because their tolerance of adjunctive dry mouth solutions may be low.viii

Also related to systemic health, there are several medications that can cause xerostomia in patients. So called ‘xerogenic’ pharmaceuticals include psycholeptics, psychoanaleptics, oral antidiabetics, respiratory agents, quinine, non-steroidal anti-inflammatory drugs and opioids, among several others.ix In fact, more than 500 medications from 42 different drug groups have been linked to dry mouth side effects.x

A person’s mental state can have a significant impact on salivary function too. Researchxi has shown that stress, depression and anxiety are significant factors. Higher levels of salivary cortisol were identified when a participant was stressed, meaning that composition of the saliva could be changed when the psychological state was challenged. Stress can also lead to salivary gland hypofunction, reducing salivary flow rates. Finally, there are lifestyle factors that can increase the chance of a person experiencing xerostomia. For example, smoking has been shown to significantly reduce salivary flow rate.xii There is also some evidence to suggest that a diet higher in carbohydrates, proteins and oils is associated with a lower chance of xerostomia.xiii

Impact on oral health

A lack of saliva has been associated with various oral health impacts. For example, reduced salivary flow has been linked with a higher risk of dental caries. Among its many roles, saliva removes the acid products from the mouth as plaque is metabolised after sugar consumption, which lowers the risk of bacterial colonisation and decay. Helping to re-establish a neutral pH and promoting remineralisation also help to avoid the development of caries.xiv

Though still widely debated, a link between salivary flow rate and chronic periodontitis has been suggested. Research xv has shown that the progression of periodontitis coincides with reduced stimulated and unstimulated salivary flow rates, so further study is certainly needed in the field.

Prevalence and diagnosis

The prevalence of xerostomia among the UK population is unclear, with estimates ranging from 1-68% with regards to persistent dry mouth. xvi Women and elderly people seem to be most at risk.

Symptoms of dry mouth can include, but are not limited to:xvii

• Difficulty chewing, swallowing or talking

• Mouth is painful, red, swollen and/ or bleeding

• Sore white patches in the mouth

• Taste impairment

• Chapped lips or lips sticking to the teeth

While it is quite normal for everyone to experience minor dry mouth for short periods of time – perhaps when nervous or after sport – patients should be encouraged to seek help when their symptoms persist.

The enormous disparity in the figures is likely due to the subjectivity of symptoms and severity experienced by individuals. Many people may simply not realise that they have a problem, or they might believe the dry mouth to be the least of their issues while facing larger systemic health challenges. As such, studies have shown that self-reported dry mouth is not an accurate measure of oral dryness experienced by patients.xviii

To diagnose dry mouth, professionals often test salivary flow. Average daily saliva production is estimated at 0.51.5 litres. The unstimulated saliva rate in a healthy mouth should be around 0.3-0.4ml/min at rest and 0.1ml/min during sleep.i Stimulated saliva rate should be approximately 1.5-2.0ml/ min. Hyposalivation is often diagnosed

with an unstimulated salivary flow rate of ≤0.1ml/min and stimulated rate of ≤0.5-0.7ml/min. vii

Treatment and management of symptoms

Of course, the ideal solution when a patient presents with persistent dry mouth is to treat the cause of the issue. Medications may be reviewed and adjusted, diets improved, smoking cessation achieved, and hydration elevated. However, is it not always possible to avoid xerostomia altogether. Instead, dental professionals should consider what they can do to help patients reduce the impact of their symptoms. For instance, patients can be encouraged to ensure sufficient water intake, suck on ice cubes or sugar-free ice lollies and use sugar-free chewing gum.xvii Consideration should also be given to the oral health products being used. These can not only alleviate dry mouth symptoms, but also enhance dental hygiene to minimise the risk of the aforementioned oral health adversities. By recommending the right adjunctive solutions for patients to use at home, the entire dental team can play an important role in their health journey.

Designed specifically to support patients experiencing dry mouth, consider the brand-new hydrate range of solutions from oral healthcare expert, TePe. The innovative portfolio consists of the Hydrating™ Mouthwash and Hydrating™ Mouth Gel, both available in a fresh apple/peppermint or unflavoured variety. These products have been formulated to stimulate saliva flow and alleviate the discomfort of dry mouth, respectively, moistening and soothing the mucosa in a fast and convenient way. There is also the Pure™ Toothpaste, designed to be extremely gentle on the gingiva, with a mild and SLS-free formula.

The support patients need Saliva plays an essential role in everyday life – and in oral health. With so many potential causes of dry mouth and subjective selfreported symptoms, it can be difficult for dental professionals to diagnose dry mouth. However, by communicating clearly with patients, building their trust and being aware of their systemic conditions, it is possible to provide the support, and relief, that they need. For more information on the innovative new products available from TePe, please visit www.tepedirect.com

References

i. Iorgulescu G. Saliva between normal and pathological. Important factors in determining systemic and oral health. J Med Life. 2009 Jul-Sep;2(3):303-7. PMID: 20112475; PMCID: PMC5052503.

ii. Vila T, Rizk AM, Sultan AS, Jabra-Rizk MA. The power of saliva: Antimicrobial and beyond. PLoS Pathog. 2019 Nov 14;15(11):e1008058. doi: 10.1371/journal.ppat.1008058. PMID: 31725797; PMCID: PMC6855406.

iii. Mortazavi H, Baharvand M, Movahhedian A, Mohammadi M, Khodadoustan A. Xerostomia due to systemic disease: a review of 20 conditions and mechanisms. Ann Med Health Sci Res. 2014 Jul;4(4):503-10. doi: 10.4103/2141-9248.139284. PMID: 25221694; PMCID: PMC4160670.

iv. NHS. Overview Sjögrens’ syndrome. https://www.nhs.uk/conditions/ sjogrens-syndrome/ [Accessed February 2024]

v. Hasan S, Ahmed S, Panigrahi R, Chaudhary P, Vyas V, Saeed S. Oral cavity and eating disorders: An insight to holistic health. J Family Med Prim Care. 2020 Aug 25;9(8):3890-3897. doi: 10.4103/jfmpc.jfmpc_608_20. PMID: 33110784; PMCID: PMC7586628.

vi. Alcázar Navarrete B, Gómez-Moreno G, Aguilar-Salvatierra A, Guardia J, Romero Palacios PJ. Xerostomia relates to the degree of asthma control. J Oral Pathol Med. 2015 Apr;44(4):2737. doi: 10.1111/jop.12228. Epub 2014 Aug 26. PMID: 25154765.

vii. Walsh M, Fagan N, Davies A. Xerostomia in patients with advanced cancer: a scoping review of clinical features and complications. BMC Palliat Care. 2023 Nov 11;22(1):178. doi: 10.1186/s12904-023-01276-4. PMID: 37950188; PMCID: PMC10638744.

viii. Ma SJ, Rivers CI, Serra LM, Singh AK. Long-term outcomes of interventions for radiation-induced xerostomia: A review. World J Clin Oncol. 2019 Jan 10;10(1):1-13. doi: 10.5306/wjco. v10.i1.1. PMID: 30627521; PMCID: PMC6318483.

ix. Villa A, Connell CL, Abati S. Diagnosis and management of xerostomia and hyposalivation. Ther Clin Risk Manag. 2014 Dec 22;11:45-51. doi: 10.2147/ TCRM.S76282. PMID: 25653532; PMCID: PMC4278738.

x. Adolfsson A, Lenér F, Marklund B, Mossberg K, Çevik-Aras H. Prevalence of dry mouth in adult patients in primary health care. Acta Odontol Scand. 2022 Nov;80(8):605-610. doi: 10.1080/00016357.2022.2069282. Epub 2022 May 26. PMID: 35617454.

xi. Gholami N, Hosseini Sabzvari B, Razzaghi A, Salah S. Effect of stress, anxiety and depression on unstimulated salivary flow rate and xerostomia. J Dent Res Dent Clin Dent Prospects. 2017 Fall;11(4):247-252. doi: 10.15171/joddd.2017.043. Epub 2017 Dec 13. PMID: 29354252; PMCID: PMC5768958.

xii. Rad M, Kakoie S, Niliye Brojeni F, Pourdamghan N. Effect of Long-term Smoking on Whole-mouth Salivary Flow Rate and Oral Health. J Dent Res Dent Clin Dent Prospects. 2010 Fall;4(4):1104. doi: 10.5681/joddd.2010.028. Epub 2010 Dec 21. PMID: 23346336; PMCID: PMC3429961.

xiii. Stankeviciene I, Aleksejuniene J, Puriene A, Stangvaltaite-Mouhat

CPD Questions

1. What are key functions of saliva?

a) Buffering and lubrication

b) Oral health protection

c) Digestion

d) All of the above

2. Which of these systemic health conditions are listed in the article as potential causes of dry mouth/reduced salivary flow?

a) Sjögren’s syndrome, cancer, autoimmune diseases and diabetes

b) Heart disease

c) High blood pressure

d) None of the above

3. What lifestyle factors can contribute to reduced salivary flow in patients according to the article?

a) Not enough exercise

b) Smoking and diet

c) Alcohol consumption

d) Too much exercise

4. What is one of the reasons why nationwide prevalence of dry mouth unknown?

a) Only men are affected

b) Testing is not available

c) Symptoms are self-reported and subjective

d) All of the above

5. What easy-to-implement solutions could dental professionals recommend to patients with dry mouth symptoms?

a) Sucking ice lollies

b) Using sugar-free chewing gum

c) Using the new Hydrate™ Mouthwash and Mouth Gel

d) All of the above

L. Association between Diet and Xerostomia: Is Xerostomia a Barrier to a Healthy Eating Pattern? Nutrients. 2021 Nov 25;13(12):4235. doi: 10.3390/ nu13124235. PMID: 34959787; PMCID: PMC8703915.

xiv. Guo L, Shi W. Salivary biomarkers for caries risk assessment. J Calif Dent Assoc. 2013 Feb;41(2):1079, 112-8. PMID: 23505756; PMCID: PMC3825179.

xv. Vallabhan CG, Sivarajan S, Shivkumar AD, Narayanan V, Vijayakumar S, Indhuja RS. Assessment of Salivary Flow Rate in Patients with Chronic Periodontitis. J Pharm Bioallied Sci. 2020 Aug;12(Suppl 1):S308-S312. doi: 10.4103/jpbs.JPBS_92_20. Epub 2020 Aug 28. PMID: 33149477; PMCID: PMC7595476.

xvi. Mehrabi F, Shanahan D, Davis G. Xerostomia. Part 1: aetiology and oral manifestations. Dental Update 2024 49:10, 707-709.

xvii. NHS Inform. Dry Mouth. https:// www.nhsinform.scot/illnessesand-conditions/mouth/dry-mouth/ [Accessed February 2024]

xviii. Shimosato, M., Asai, K., Yokomichi, N. et al. Diagnostic accuracy of patient-

reported dry mouth as a predictor for oral dryness in terminally ill cancer patients. Support Care Cancer 29, 2743–2748 (2021). https://doi. org/10.1007/s00520-020-05798-y n

About the author

Miranda has worked in Dentistry for over 20years, as a Dental Therapist in NHS practices treating the general population. Miranda volunteered at the 2012 London Olympics treating athletes. In 2016 Miranda travelled to Tanzania to treat local villages and train local clinical officers in emergency dental care. Miranda has taught at the University of Central Lancashire teaching undergraduate Dental Therapy and Postgraduate Dentistry. Working for Colosseum Dental Group Miranda help facilitate the use to Dental Therapists in their clinics and was part of the Medical Board for Colosseum Dental Group UK. Now currently working at TePe as the Clinical Education Manager, driving education and healthy smiles for life.

How to Enhance Profitability Ethically in Implant Dentistry

Aims:

To enhance the knowledge and skills of dental professionals in the economic and efficient management of dental implant practices through the integration of advanced technologies and strategic inventory management. This CPD article aims to foster a deeper understanding of cost-effective practices and the adoption of high-quality dental implants without compromising patient care and outcomes.

Objectives

• Understand the Impact of Technology on Implant Dentistry: Dentists will learn about the latest advancements in technology, such as 3D imaging and CAD/CAM systems, and how these tools can be used to improve the precision, efficiency, and outcomes of dental implant procedures.

• Optimise Inventory Management: Readers will gain insights into effective inventory management strategies, including the consignment stock model, to reduce overhead costs, minimise wastage, and ensure a wide range of implant options are available for patient care without unnecessary financial burden.

• Evaluate Cost-Effective Implant Systems: This module will provide an overview of the benefits of high-quality, affordable implant systems. Dentists will learn how to assess and choose implant systems that offer reliability and excellence in patient care, without imposing significant costs on the practice or the patient.

• Apply Ethical and Profitable Practice Management: Dentists will understand how to balance quality, time, and cost in their practice, focusing on ethical profitability that does not compromise patient care. Strategies for enhancing operational efficiency while maintaining high standards of treatment will be explored.

• Foster Sustainable Business Models: The course will discuss ways to implement these strategies in practice to create a sustainable, profitable business model that benefits patients and enhances the clinic’s reputation for excellence and integrity in the competitive field of implant dentistry.

By achieving these objectives, dentists will be better equipped to make informed decisions that enhance the profitability of their practices while upholding the highest standards of patient care and ethical responsibility.

Learning Outcome: B, C

In the rapidly evolving field of implant dentistry, dentists are continuously seeking ways to increase their profitability without compromising on ethics or quality of care.

With the more patients feeling strapped for cash there are less patients opting for treatment. The question is how can we reduce costs for patients without compromising on quality.

By adopting strategic approaches, dentists can find ways to enhance their efficiency and profitability ethically.

A pivotal part of this strategy involves selecting high-quality yet cost-effective materials and systems, such as those provided by Meisinger Implants, a trusted manufacturer known for its precision and reliability; distributed in the UK by J&S Davis.

Understanding the Quality, Time, Cost Triangle

At the core of sustaining a profitable practice in implant dentistry is mastering the delicate balance of the quality, time, cost triangle. This conceptual framework is pivotal, with each vertex representing an essential component that influences the financial health of your practice:

• Quality: Refers to the calibre of care, including the materials and techniques employed during treatments.

• Time: Concerns the efficiency and promptness of service delivery.

• Cost: Encompasses the expenses related to providing services, such as the cost of materials and operational expenditures.

Navigating this triangle effectively is crucial for ethically boosting profitability. Among these elements, quality stands out as non-negotiable for ethical practitioners. Compromising on the standard of care or the materials used not only erodes trust with patients but is fundamentally unethical. Quality in dental care directly impacts patient outcomes, and reducing it to cut costs can lead to adverse effects, undermining the very essence of healthcare provision.

Quality forms the foundation upon which a practice builds its reputation. High-quality care leads to better patient satisfaction, and ultimately, a more successful practice. In implant dentistry, where procedures are complex and the stakes are high, the margin for error is minimal. Using substandard

materials or cutting corners in procedural standards can result in implant failures, complications, and significant distress for patients and significantly harm profitability in the long run.

Therefore, while managing time and cost is essential for a practice's profitability, it must never come at the expense of quality.

By investing in quality—through the use of reputable materials like those from trusted manufacturers, ongoing professional development, and adherence to best practices—dentists can ensure patient satisfaction and loyalty, which are invaluable for long-term profitability.

While time efficiency and cost management are important, quality remains the cornerstone that should never be compromised. Ethical dentists

prioritise high standards of care, recognising that this commitment is integral to both patient welfare and the enduring success of their practice. So then we need to look at other areas to save money;

Strategies for Improving Profitability

1. Streamline Operational Efficiency: Efficiency in operations is the linchpin for balancing the time and cost aspects of the quality, time, cost triangle in implant dentistry. Streamlining various facets of practice management, such as appointments, scheduling, patient management, and treatment planning, not only reduces operational bottlenecks but also significantly enhances the practice's ability to serve more patients effectively without diminishing the quality of care provided.

Optimising Treatment Planning: The utilisation of digital dentistry tools, such as intraoral scanners and computer-aided design/computer-aided manufacturing (CAD/CAM) systems, revolutionises treatment planning.

A notable success story is that of a midsized dental practice that implemented a digital treatment planning system. By integrating digital scans of the patient's mouth with virtual implant placement software, the practice was able to reduce the planning stage for implant procedures by 30%, leading to a 20% increase in the number of implant surgeries performed monthly. Moreover, the accuracy of the

digital planning process significantly reduced the instances of post-operative complications, enhancing patient satisfaction and further contributing to the practice's reputation and profitability.

Embracing Digital Dentistry Tools:

Beyond treatment planning, digital dentistry tools streamline the execution of dental implant procedures. Technologies such as guided surgery software provide dentists with real-time navigational assistance during surgeries, making the procedures faster and more predictable. This not only saves significant time but also improves the success rate of implant placements, ultimately leading to better patient outcomes and increased clinic throughput.

2. Optimise Inventory Management:

Effective inventory management is crucial for dental practices, especially those specialising in implant dentistry, where the cost of materials can significantly impact overall profitability. An excellent strategy to manage these costs is through the implementation of a consignment stock model for dental implants and supplies.

Example of Effective Inventory Management

Consider the case of "Smile Dental Clinic," a growing practice that places 20-30 implants a month. The clinic was facing challenges with its inventory management, particularly with the high costs associated with stocking various types of dental implants and the related restorative components. To address this issue, Smile Dental Clinic entered into a consignment agreement with their implant provider.

Under this consignment stock agreement, the implant supplier provided Smile Dental Clinic with a comprehensive range of dental implants and components,

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which were stored on-site at the clinic. However, Smile Dental Clinic was not required to purchase this stock upfront. Instead, they only paid for the implants and components as they were used.

Benefits Realised:

• Reduced Overhead Costs: By not having to purchase the stock upfront, Smile Dental Clinic significantly reduced its inventory carrying costs. This arrangement freed up capital that could be invested elsewhere in the practice, such as in marketing efforts or advanced training for staff.

• Minimised Wastage: The consignment model allowed Smile Dental Clinic to keep a broader range of implants on hand without the risk of overstocking items that might not be used before their expiration. This flexibility meant the clinic could offer customised solutions to patients without the worry of wastage due to unsold inventory.

3. Leverage High-Quality, CostEffective Implant Systems:

One of the most direct ways to address the cost component without compromising quality is by choosing high-quality but more affordable implant systems. Their commitment to quality ensures that practices do not have to sacrifice the standard of care for cost savings.

Meisinger Implants prioritises highquality production while significantly reducing overhead costs. By directing focus away from the industry-standard practices of subsidising international implant societies and incurring high promotional and sales team expenses, Meisinger ensures that its core investment is in the development, and manufacturing of high-quality dental implants. This approach allows the company to maintain excellence and innovation without the added cost burden which is then typically passed on to dental practices and their patients. This efficiency not only reduces unnecessary expenditures but also enables Meisinger to offer its implants at a more accessible price point, all

CPD Questions

1. What is the pivotal part of a strategy to enhance efficiency and profitability ethically?

a. Selecting high quality yet cost effective materials, systems and trusted manufactures.

b. Ensure effective cost management

c. Making sure the patient is happy

d. Careful inventory management

2. What are the three key factors to balance in sustaining a profitable practice?

a. Patients, Clinicians and Cost

b. Quality, Treatment and Clinician

c. Practice closures, patient numbers and overheads

d. Quality, Time and Cost

3. By implementing a digital planning system how much time could be reduced in your implant planning stage?

a. 40%

b. 30%

c. 20%

d. 70%

4. Name the two benefits realised by ‘Smile Dental Clinic’ by implementing the consignment stock model?

a. Reduced overheads costs and minimised wastage

b. Good relationships and happy customers

c. Reduced stress and better organisation

d. Good use of storage space and happy clinicians

5. Where does Meisinger ensure its core investments lie?

a. In their high quality products and services

b. In Germany

c. Development & manufacturing of quality dental implants

d. Within their people and processes

without compromising the products' quality or reliability.

The result is a direct benefit to dental practices seeking cost-effective yet highquality implant solutions for their patients, making superior dental care more widely available.

Central to Meisinger's philosophy is the commitment to providing "implants without compromise." Operational efficiencies are carefully crafted to cut costs in areas that do not impact the quality of the product.

Meisinger Implants not only sets a new standard in dental implant affordability but also furthers its mission to expand access to quality dental care globally, ensuring excellent patient outcomes without the premium price tag.

4. Implement Technology Wisely: The judicious use of technology, such as 3D imaging and computer-aided design/ computer-aided manufacturing (CAD/ CAM) systems, can improve both the quality and efficiency of dental implant procedures. These technologies allow for more precise planning and execution, reducing the time required for procedures

and the likelihood of complications, which in turn can lower costs associated with rework and adjustments.

Conclusion

Profitability does not have to come at the expense of ethics or quality. By intelligently navigating the quality, time, cost triangle and implementing strategic improvements across these dimensions, practices can enhance their profitability ethically. Central to this approach is the adoption of high-quality, cost-effective solutions like Meisinger Implants, which enable dentists to provide exceptional care without undue financial burden. In doing so, practices can achieve a sustainable model that benefits both their business and their patients, fostering a reputation for excellence and integrity in the competitive field of implant dentistry. n

About the author

Andrea Worth National Implant Specialist J&S Davis Ltd

Sterilising Ultrasonic Handpieces and Adhering to the Rule of 3

Aims and objectives

To provide an update on how ultrasonic dental handpieces should be managed, in relation to infection control and patient safety.:

Objectives:

• Understand the importable of sterilising ultrasonic handpieces.

• Understand why an ultrasonic handpiece should be managed in the same way as a dental turbine or contra-angle handpiece.

• Understand why there is a ‘rule of 3’ in relation to the number of ultrasonic handpieces each surgery should have.

• To be aware of how to seek clarification about sterilising ultrasonic handpieces.

• Understand how to process ultrasonic handpieces.

Learning Outcome: C, D

Ultrasonic handpieces have become invaluable tools for dental professionals, offering precision and efficiency in prophylaxis, periodontal, endodontic, and restorative procedures. However, as clinicians integrate these devices into their daily practices, maintaining a stringent protocol for sterilisation is paramount to ensuring patient safety and prevent the risk of crosscontamination.

Accessible information surrounding sterilisation guidelines is readily available online with regulatory body’s issuing professional guidance to adhere to.

The Centers for Disease Control and Prevention (CDC), states: “handpieces and other intraoral devices that can be removed from the air and waterlines of dental units should be cleaned and heat-sterilized between patients. Follow the manufacturer’s instructions for cleaning, lubricating, and sterilising these devices. These devices include high-speed, low-speed, electric, endodontic, and surgical handpieces, as well as all handpiece motors and attachments, such as reusable prophylaxis angles, nose cones, and contra-angles.”

Acteon is increasingly concerned about the confusion surrounding sterilisation of ultrasonic handpieces within the industry. Clinicians regularly ask for clarification as to how often ultrasonic handpieces should be sterilised. This is becoming a common issue within dental practices, that needs addressing now. We thoroughly sterilise dental turbines and contra-angle handpieces after every use, so why are ultrasonic handpieces being treated differently? Imagine eating in a restaurant where the used cutlery was merely wiped down in between sittings. You would never return, and the business would almost certainly be closed. There have been several incidents noted throughout the years of clinicians having not followed standard

sterilisation practices. In one research study, according to The Telegraph, figures from a Care Quality Commission report revealed that one in nine dentists inspected by watchdogs were found to be in breach of cleanliness and infection control guidelines. Some 189 out of 1,667 practices inspected were found to have not been following Department of Health guidelines for clean surgeries and dental equipment. Evidence reported cited unclean autoclaves in its findings.

Another widely read news article revealed a practice being investigated by PHE and the GDC following an initial concern, when it was brought to light that the ultrasonic handpieces were not being sterilised between every patient. Hundreds of terrified patients were recalled and to be tested for bloodborne diseases such as HIV and Hepatitis B and C.

The HTM01-05 provides the below guidelines for the correct processing of equipment that consist of more than one part and handpieces:

‘Where recommended by the manufacturer, instruments and equipment that consist of more than one component should be dismantled to allow each part to be adequately cleaned’.

‘Dental handpieces 4.7 Practices can seek the advice on the decontamination of handpieces from the handpiece manufacturer. Dental handpieces are constructed with a number of features that are difficult to clean and steriliise. The use of a validated washerdisinfector may be successful provided that the handpiece and washer-disinfector are compatible’.

The dental industry is reliant upon patient trust and patient safety, so we must ask ourselves why is there

still so much confusion about the correct sterilisation protocol? Acteon is looking to educate clinicians on the importance of sterilising ultrasonic handpieces and, most importantly, adhering to the rule of three.

Importance of Sterilising Ultrasonic Handpieces

Ultrasonic handpieces play a pivotal role in dental prophylaxis, periodontal therapy, endodontic and restorative procedures. Their intricate design, comprising several internal components and lumens like that of any other dental handpiece, necessitates meticulous sterilisation to eliminate potential pathogens between patient encounters. Failure to adhere to rigorous sterilisation protocols can compromise patient safety and lead to healthcare-associated infections (HAIs). Not only that, but the level of enquiries relating to ‘how often should we be

sterilising Ultrasonic Handpieces’ on public forums, can be damaging to the clinician or practice reputation.

The Rule of 3

In the pursuit of maintaining a high standard of infection control, Acteon is urging dental practitioners to swear by the "Rule of 3”, where an absolute minimum of three ultrasonic handpieces are available in every surgery.

1. Continuous Workflow

Having three ultrasonic handpieces within the practice ensures a seamless workflow. While one handpiece is in use, the second can be undergoing sterilisation, and the third is readily available for the next patient. This approach minimises downtime between appointments, optimising the efficiency of dental procedures.

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2. Be Prepared for Emergency Procedures

Unforeseen circumstances, such as technical malfunctions or unexpected patient needs, can arise during dental procedures. Having a spare ultrasonic handpiece readily available ensures that clinicians can swiftly address any challenges without compromising patient care or safety.

3. Comprehensive Infection Control

The Rule of 3 facilitates the implementation of a robust infection control strategy. Clinicians can adhere to the recommended sterilisation times without rushing the process, reducing the risk of incomplete sterilisation and cross-contamination.

Acteon’s Best Practices for Sterilisation: To ensure the effective sterilisation of ultrasonic handpieces, clinicians should always follow our manufacturer guidelines.

1. Pre-Cleaning

Dismantle the ultrasonic handpiece before processing. Some of our

CPD Questions

1. How can you seek clarification about how to correctly process ultrasonic handpieces?

a) The Centers for Disease Control and Prevention (CDC)

b) The Manufacturer

c) Sales representative

d) Health technical memorandum 01-05 (HTM01-05)

2. When should ultrasonic handpieces be sterilised?

a) If they have visible debris on them

b) At the end of the session: for example, at lunch time and at the end of the day.

c) After every patient

d) Once a day, if a protective sleeve is used.

3. How many ultrasonic handpieces is recommended per surgery, to ensure a seamless workflow?

a) 1

b) 2

c) 3

d) 4

4. Who recommends that manufacturer instructions for decontamination handpieces are followed?

a) CDC

b) Manufacturer

c) HTM01-5

d) All the above

handpieces have a removable nose cone or LED ring and diffuser. See images above.

Thoroughly clean handpieces before sterilisation to remove any debris or contaminants. Acteon ultrasonic handpieces can be thermally disinfected at 90˚C for 1 minute.

2. Sterilisation

Utilise autoclaves for sterilisation, as they provide high-temperature steam, which is effective in eliminating microorganisms. We recommend a vacuum autoclave as our handpieces have several lumens and difficult to clean areas.

Conclusion

In conclusion, always follow manufacturer guidelines to ensure the safety, longevity, and proper functioning of ultrasonic handpieces. The incorporation of ultrasonic handpieces in dental practices has revolutionised patientcare, but their usage demands a meticulous commitment to infection control. Following the ‘Rule of 3’ and implementing best practices for sterilisation are imperative steps toward safeguarding patients, maintaining aseptic conditions, and upholding the professional standards of dental care and as importantly, your reputation for ensuring patient and employee safety. n

The Dental Awards 2024 –Shortlist Revealed! THE DENTAL AWARDS 2024

The 2024 Dental Awards are almost upon us and, as the original and most prestigious Awards event in British Dentistry gears up for its 26th edition, it gives us at The Probe great pleasure in announcing the shortlisted entries for each of the categories.

Dates For Your Diary

The winners and finalists will be announced in a live-streamed presentation on Thursday 23 rd May

at 12pm (Midday). The broadcast, hosted by BBC weather presenter and meteorologist Sarah Keith-Lucas, will be available to tune into on the-probe.co.uk, as well as The Probe’s Youtube Channel.

Don’t worry if you’re unable to watch live, as the presentation will be immediately available on-demand.

The winners will then be invited to join judges and sponsors at a top London venue on Friday 5th July to celebrate their victories in style, and to be presented with their trophies and certificates in person.

BEST OUTREACH OR CHARITY INITIATIVE

• Avan Mohammed, Queen’s Gate Orthodontics

• Community Dental Services CIC - Severe Multiple Disadvantage Project

• Gold For Kids Charity

• KeepStokeSmiling

• Liz Matthews, Langmans Dental Health Centre

• Smile Together Dental CIC

• Well Connected

WEBSITE AND DIGITAL CAMPAIGN OF THE YEAR

• Cheadle Hulme, Manchester

• DRMR Clinic, London

• Inspired Dental Care, Exeter

• Meliora Dental, Leeds

• {my}dentist, Kearsley

FRONT OF HOUSE/RECEPTIONIST OF THE YEAR AWARD

• Kelly Bird, All Saints Dental Clinic, Kings Heath

• Mary Holroyd, Shiraz Endo, Solihull

• Shauna Church, Inspired Dental Care, Exeter

• Trudy Horne, Dorset Dental Clinic, Poole

TEAM OF THE YEAR

• Cheadle Hulme Dental and Cosmetics, Manchester

• Community Dental Services CIC, Prisons Team

• Cyncoed Dental Practice, Cardiff

• Dorset Dental Clinic, Poole

• Glenhaven Dental, Cardiff

• Kings College Hospital Community Oral Health Promotion Team, London

• Lodge Causeway Dental Centre, Bristol

• Ridge Dental, Bristol

• Ropergate Dental Care, Pontefract

• Shiraz Endodontic Practice, Solihull

• Smile Stories, Bournemouth

• Stradbrook Dental, Tonbridge

• Weybridge Dental Care, Weybridge

PRACTICE MANAGER OF THE YEAR

• Alex McWhirter, North Cardiff Dental, Cardiff

• Amanda Reast, The Dental Architect, Leeds

• Amy Eadie, Ropergate Dental Care, Pontefract

• Brittany Pittham, Inspired Dental Care, Exeter

• Denise Griffiths, Glenhaven Dental, Cardiff

• Fiona McHugh, Dorset Dental Clinic, Poole

• Lorraine Diaper, Bar Hill Dental, Cambridgeshire

• Simona Pacuraru, All Saints Dental Clinic, Kings Heath

Special Thanks

A massive thank you to everyone who entered this year’s awards. The high volume of entries from dentists, therapists, hygienists, practices, nurses and dental teams lends itself to the immense talent and skill within the profession, as well as the high esteem in which the Dental Awards is held.

A special thanks goes to our expert judging panel, comprising: Ben Atkins, Tim Newton, Lisa Bainham, Miranda Steeples, Debbie Hemington, Pam Swain, Davinder Raju, Amit

DENTAL NURSE OF THE YEAR

• Amy Collin, Ropergate Dental Care, Pontefract

• Aqsah Ali, All Saints Dental Clinic, Kings Heath

• Brittany Pittham, Inspired Dental Care, Exeter

• Karima Ewida, Need A Nurse, Kidderminster

• Naomi Gbasai, Shiraz Endo, Solihull

• Natalie Marucci, Clear Dentistry, Southampton

• Rebecca Silver

• Shannon Wilkes, Euston Place Dental Practice, Leamington Spa

• Wiktoria Wisniewska, Ridge Dental, Bristol

DENTAL HYGIENIST OF THE YEAR

• Amanda Harbrow-Harris, Sharrow Dental Group, Chelmsford

• Carly Perry, Six Gables Dental Care, Cardiff

• Danuta Kurcharczyk, Six Gables Dental Care, London

• Emma Fletcher, Dental Studio, Waterlooville

• Gemma O’Callaghan, The Periodontal Therapy Clinic @ 10 Dental, Southport

• Poppy Irvine, Adel Dental Practice, Leeds

• Rafina O’Brien, Colosseum Dental, Yeovil

• Sakina Syed, Bupa Dental Care, London Bank

• Zara Shirvani, Zara The Hygienist

DENTAL THERAPIST OF THE YEAR

• Chrystal Sharp, Wimpole Street Dental Clinic/ODL, London

• Emily Hatfield, Ridge Dental, Bristol

• Francesca Rhodes, Mola Dental, Sheffield

• Jagjit Malhi, Clear Smiles, Wolverhampton

• Kayley McCauley, Dorset Dental Clinic, Poole

• Natalie Peary, Smile Together Dental CIC, Bodmin

• Victoria Akinfenwa, New Cross Dental Practice, London

YOUNG DENTIST OF THE YEAR

• Awaz Sharief, Bupa Dental Care, Bolton Silverwell

• Azhar Chauhan, 1 Kings Dental, London

• Chloe Harrington-Taylor, Hereford Dental Implant Clinic, Hereford

• Dharmesh Mistry, YOR Dental, Salford Quays

• Giovanni Martino, Somerford House Dental Clinic, Bristol

• Karam Singh Lalli, Staffa Lodge Smile Clinic, Ipswich

• Rajen Nagar, Yorkshire Dental Suite, Leeds

• Roshan Vasaiwalla, Denvolve | Dental, London

• Russell Hashemi, Inspired Dental Care, Exeter

• Salman Siddiqi, Queensway Dental, Stockton on Tees

Patel, Paroo Mistry, Ewa Rozwadowska, Glenys Bridges, and Amanda Oakey. The Dental Awards is sponsored by B.A. International, Colosseum Dental, Dental Elite, and Waterpik, and is presented in association with the Oral Health Foundation, ADAM, BADN, BADT, and BSDHT. We thank you all.

Shortlist Reveal

And now, on to today’s main event, as we reveal the entrants shortlisted for contention in The Dental Awards 2024. 

• Sanjana Sudarshan, Wimpole Street Dental Clinic and Kings Road Dental Practice, London

• Shamaila Mahmood, All Saints Dental Clinic, Kings Heath

• Uzair Janjua, Clear Smiles, Wolverhampton

• Wiktor Pietraszewski, Fulham Road Dental, London

• Zain Remy, Auckland Cosmetic Dental Clinic, Bishop Auckland

DENTIST OF THE YEAR

• Ahmed Farooq, All Saints Dental Clinic, Kings Heath

• Aly Virani, North Cardiff Dental, Cardiff

• Anam Sadozai, Solihull

• Andre Faro Leite, Inspired Dental Care, Exeter

• Andy Davies, Abercorn Dental Care, Banbridge

• Avan Mohammed, Queen’s Gate Orthodontics, London

• Gayathiri Ramani Balasubramaniam, Sandal Dental Care, Wakefield

• Karen Gangotra, Smilessence, East Molesey

• Kunal Rai, Meliora Dental, Leeds

• Martina Hodgson, The Dental Architect, Leeds

• Nida Kamal, Shiraz Endo, Solihull

• Philip McCauley, Dorset Dental Clinic, Poole

• Rachel Derby, Chapel Dental, Flackwell Heath

• Shi Karim, Cheadle Hulme Dental and Cosmetics, Manchester

• Wajiha Basir, Trinity House Dental Care, Wilmslow

PRACTICE OF THE YEAR

• Cheadle Hulme Dental and Cosmetics, Manchester

• Codsall Dental Practice, Codsall

• Cyncoed Dental Practice, Cardiff

• Dorset Dental Clinic, Poole

• DRMR, London

• Glenhaven Dental, Cardiff

• Lodge Causeway Dental Centre, Bristol

• North Cardiff Dental, Cardiff

• Ropergate Dental Care, Pontefract

• Shiraz Endodontic Practice, Solihull

• Smile Stories, Bournemouth

• Smile Together Dental CIC, Bodmin

• SMILESSENCE, East Molesey

• The Dental Parlour, Coventry

• Vitaliteeth Dental Spa, Edinburgh

• York House Dental Practice. West Byfleet

Envision your future practice

With the new Carestream Dental CS 8200 3D Family

State-of-the-art CBCT imaging is now within reach and without compromise. Explore our family of solutions including the new CS 8200 3D Access and the CS 8200 3D Neo Edition.

Discover more confident diagnosis, broader treatment options and better patient engagement with advanced imaging technology that boosts in-office procedures and provides the chance to expand your business.

Learn more at Carestreamdental.com

Excellent image quality for all double duty

Reliable imaging enables you to decrease the time to diagnosis and accurate treatment. Clark Dental understands the importance of this, which is why they offer a wide range of intraoral and extraoral imaging systems to meet your needs.

The Dentsply Sirona XIOS XG Supreme AE is an excellent option. With multiple functions and features like varying cable lengths, sensor sizes, and connectivity options, the sensor can adapt to your requirements.

XIOS XG Supreme delivers fantastic image quality, as well as the ability to immediately see images on the computer. The sensor is designed to optimise chairside diagnosis for all patients, whether you provide general or restorative dentistry, endodontics or hygiene procedures.

To find out more about the XIOS XG Supreme from Clark Dental, please contact the team today.

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

Reliable adhesion is a prerequisite of any dental restoration. If the wrong adhesive is chosen, then the treatment may fail or result in a poor aesthetic outcome.

SUPERKRAFT from COLTENE offers the reliability dental professionals and their patients demand.

SUPERKRAFT consists of SoloCem universal dental cement and ONE COAT 7 UNIVERSAL bond which, when used in combination, create dependable and solid adhesive strength for indirect restorations.

Dental clinicians can use the materials separately, or as a duo for maximum versatility. The SoloCem cement provides colour stability and optimal integration, and ONE COAT 7 UNIVERSAL offers strong bonding on different surfaces.

Contact the COLTENE team today for more information about SUPERKRAFT, and how it can transform your restorative workflow.

For more information, info.uk@coltene.com and 0800 254 5115 COLTENE loyalty scheme: https://rewards.coltene.com n

Explore the many benefits of the premier clear aligner, ClearCorrect®, at an inspiring educational conference this summer.

The event, ‘Elevating ClearCorrect® Excellence 2024’ on June 14 at Millennium Point, Birmingham, is a oneday experience for dental professionals who want to know more about the latest innovations in clear aligner treatment. It will also cover how to achieve the outstanding results made possible through ClearCorrect® with sessions presented by practitioners already wellversed in the system.

any other system – puts full control over treatment plans in the hands of the dental professional as well as enabling greater collaboration with patients.

tools for a successful recovery

Following implant surgery, it’s important to offer patients all of the support they need for a successful recovery. The Implant Care Kit from Curaprox is a fantastic solution.

For more information, please visit: www.curaprox.co.uk and www.curaden.co.uk n Learn with the best

Learn about the unique advantages of ClearPilot™ 8.0., the ClearCorrect® planning software, which – more than

ClearCorrect®, the innovative clear aligner treatment trusted by clinicians all over the world for predictable results. Find out more about ClearCorrect®, and how it can benefit you and your patients. Book now for ‘Elevating ClearCorrect® Excellence 2024’ to take part: https://event.clearcorrecteducation.co.uk/n

Meet the expert Endocare team

At EndoCare, we offer an array of advanced endodontic services by referral, helping colleagues across the UK to save their patients’ teeth. Our team is passionate about ensuring clinical excellence, utilising their extensive experience to deliver, highly effective, safe and ethical endodontic solutions.

They include:

Dr Federico Foschi

Dr Corneliu Gherasim

Dr Satinder Matharu

Dr Adi Morgan

Dr Michael Sultan

As with any dental appointment, taking complete notes during an emergency appointment is crucial. Kiroku, the digital note taking platform, provides you with the dynamic templates you need to take complete, accurate, and contemporaneous notes during any emergency dental appointment.

To find out more about our team, their qualifications and experience, visit the website today!

For further information please call EndoCare on 020 7224 0999 Or visit www.endocare.co.uk n

The emergency template from Kiroku allows the user to record the most common dental emergencies from start to finish – this includes the patient complaint, through to the examination, special tests, diagnosis, and treatment.

The template provides the user with helpful prompts relevant to each case to easily take notes in just a few clicks,

eliminating the worry of missing out any important information. Plus, Kiroku makes it easy to tailor your notes, so they will always be unique to you and your patients.

To find out more about Kiroku, or to start your free trial, please visit trykiroku.comn

The Kit contains everything from a surgical toothbrush and Perio plus Support toothpaste, to Perio plus chlorhexidine oral rinse and Implant interdental brushes. By offering patients this helpful Kit, you can ensure that your patients have everything they’ll need to properly take care of their oral hygiene after their surgery. By offering the best possible postsurgery care, you’ll help to ensure that your patients’ overall experience is positive and that their recovery is as comfortable as possible.

To find out more about the Implant Care Kit, please get in touch with the Curaprox team today.

Maxine Northall-Rollins is the stock controller at Scott Arms Dental Practice in Birmingham. She has nothing but praise for the Eschmann decontamination equipment and service she has received for many years. Don’t just take our word for it, here’s what she had to say:

“We have had some of our Little Sister autoclaves for well over 10 years now and have been really happy with them. The machines are easy to use and very reliable. We did look at other products and even tried a different brand just to see what else was out there – but wish we hadn’t bothered and in the future, we will not be going anywhere but Eschmann.

“We protect our autoclaves with the Eschmann Care & Cover servicing and

Leaning to approach more complex cases with the aid of clear aligner treatments means you can help a wider range of patients, whilst giving them confidence throughout their care. With the Clear Aligners (Level 2) course from the IAS Academy, clinicians can expand upon their experiences and deliver an entirely new range of care.

The course, running in both June and November of 2024, is led by specialist Josh Rowley, and covers digital planning, complex elements of malocclusions, considerations for extraction cases, and so much more.

maintenance package, which has also been really good. All our autoclaves are added to the service contract – we wouldn’t even think of not having them covered. It’s good to have the back-up, knowing that someone will come in every 12 months to check over the equipment. They find and fix any issues before they become much bigger problems.

For more information please visit the website or call 01903 753322n

It is the perfect opportunity to understand how to accurately perform stage tooth movements with clear aligners and interproximal reduction in complex cases, so clinicians can achieve more predictable treatment outcomes.

To learn more about this brilliant chance to further your clear aligner treatments and welcome a new wave of patients to your practice, contact the team today.

For more information on upcoming IAS Academy training courses, please visit www.iasortho.com or call 01932 336470 (Press 1) n

www.the-probe.co.uk

Our memory foam cushions support patients necks, backs, knees, making them more comfortable, reducing tension and anxiety, and in doing so, making them easier to treat.

With the headrest, patients heads are cushioned and tilted to a better position for access.

The long chair pad cushions the whole body. The child booster lifts children to a better height for access. Long procedures are made more bearable.

Our British manufactured, memory foam dental chair cushions conform to British fire retardancy standards and are covered in wipeable medical grade, anti-microbial fabric.

For more information visit: www.dpsdental.co.uk n

Do you require guidance on how to reduce those continually rising costs? Opt for us and enjoy the advantages of our extensive experience, premium components, competitive pricing, and the support of the most seasoned technical and customer service team in the industry.

Are you tired of seeing your costs continually rise? Our team is here to help you navigate through those challenges. With years of experience under our belt, we’ve honed our craft to provide costeffective solutions without compromising on quality.

When you choose us, you’re not just opting for a repair service – you’re

Enter a new dimension with the Planmeca Viso G3 say no to foam

Newly launched to the UK market, the Planmeca Viso G3 CBCT unit brings new features to the market including video-based FOV placement and a new generation sensor with an even better signal-to-noise ratio. There is also an optional back of the head support for more comfortable positioning and a Graphical User Interface which matches the style of the Plameca Romexis software for ease of use.

Combine this with Planmeca CALM - an algorithm which analyses and compensates for slight patient movements during 3D X-ray scanning resulting in sharper final images – and you’ll eliminate the need for re-takes.

It is a truly multifunctional CBCT device covering all extraoral imaging needs from 2D to 3D imaging, and it’s available to order now. n

AdI – supporting those new to implantology

Dr Viraj Patel was among the coveted speakers at the inaugural ADI Next Gen Masterclass, which was designed for clinicians who are relatively new to dental implantology. Viraj’s session, entitled “Socket Grafting for Successful Long Term Implant Outcomes”, explored the literature available in the field. He says:

“The ADI is one of the few organisations in the UK that is unbiased in that it has no affiliations to any particular brand or manufacturer. It also gives every clinician an opportunity to learn, which is amazing. The ADI has a family feel, made up of likeminded clinicians without egos – it’s just a great environment to be in. ADI events are a big networking benefit and there are always great speakers; the biennial ADI

Team Congress, for example, is the one event that is 100% in my calendar every time!”

To access the industry-leading education presented by the ADI, in addition to the network of highly experienced clinicians and several other benefits available, join the association today!

For more information about the AdI, visit www.adi.org.uk Join today n

“I was really impressed with the service that I received”

Dr Teki Sowdani describes his experience of working with Clark Dental on his new clinic:

“From the very first conversation that I had with Matt Rowlingson, I was really impressed with the service that I received and how bespoke things could be for the practice that I was building. The communication was always great and that gave me the confidence that, even after the project was finished with regards to aftercare and the maintenance side of things, I would be looked after.

“Clark Dental helped me in my decisions to ensure I was choosing the right solutions for my own practice – the advice from the team was always bespoke, taking my unique needs into account at all stages.

Products

investing in peace of mind. Don’t let handpiece issues slow you down. Choose MC Repairs Ltd as your trusted repair partner and experience the difference firsthand. Get in touch with us today to learn more about our services and how we can help you streamline your operations and reduce costs.

Follow us on Linkedin - https://www. linkedin.com/company/mc-repairs-ltd/ Follow us on the website below.n

Regular maintenance of the aspirator/ suction system can not only ensure patient safety but also peak performance and increased life span of the equipment.

Bossklein DAILYasp has been designed specifically for daily use to remove contamination and micro-organisms that can cause biofilm build up from inside aspirator systems and to help prevent the transmission of disease. The non-foaming and non-abrasive formulation ensure maximum microbial effect with no risk to sensitive equipment.

With a rapid contact time from only 15 minutes, a wide effective spectrum, and a 2% dilution ratio - DAILYasp has the performance of a market leader with a much lower price tag.

Bossklein DAILYasp is available now.

For more information call 0800 132 373 or visit www.bossklein.com n

High-resolution images in seconds

From Carestream Dental, the CS 7200 Neo Edition is an ultra-compact imaging plate system which is designed to meet your practice’s everyday needs. Using a fast and simple workflow, the CS 7200 Neo Edition produces high-resolution images and can be used chairside for a seamless workflow.

Producing high-quality images in just 8 seconds, the CS 7200 Neo Edition is ideal for busy practices who require sharp, detailed images to make a confident diagnosis.

For more information, please contact the team at carestream dental.

For more information on carestream dental and our new

“I was lucky as to not come across major challenges during the project, it went very smoothly. I believe this was a credit to Clark Dental – always being at the end of the phone and being flexible with my working day, especially considering that we were a busy clinic with patients every day.

“I would definitely recommend Clark Dental, and when I opened up my second site, there was no question as to who I was going to use to install the equipment and support me there.”

Tel: 01268 733 146, Email: info@clarkdental.co.uk n

extended warranties visit www. carestreamdental.co.uk

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

save time and see more patients

Intraoral scanning gives the dental professional accurate data and streamlines processes, while patients benefit from greater comfort than traditional impressions alongside enhanced education and trust.

The award-winning Virtuo VivoTM Intraoral Scanner from the Straumann Group is a small and lightweight solution which is ergonomically designed for a penlike grip. It uses an open system, allowing the clinician to easily export and share scan data with partner laboratories. With the Virtuo VivoTM hard and soft tissue are scanned from multiple orientations simultaneously, capturing

difficult-to-see areas with minimal effort. It also boasts a removable, autoclavable sleeve in coated metal to ensure proper hygiene standards.

With two out of three patients saying they would consider switching to a dentist who uses more advanced technology, discover how the Virtuo VivoTM Intraoral Scanner could transform your practice by visiting the website today!

For more details, please visit https://www.straumann.com/digital/us/ en/home/equipment/io-scanners.html n

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 f omin 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. These combine with saliva to form fluorapatite which strengthens teeth, aids effective remineralisation of enamel and provides effective treatment for hypersensitivity. Patients report that teeth feel smoother and cleaner, there is a absence of background oral sensitivity and that gums are healthier and less prone to bleeding. BioMin F enables patients to enhance their smile and improve their oral health. It is the only toothpaste approved by the Oral Health Foundation for sensitivity relief and remineralisation.

Telephone: 01274 885544n

trycare - triple Headed toothbrush Welcome to the best smile of your life!

With the introduction of the Triple Headed Toothbrush, Trycare have launched a paradigm shift in electric toothbrush heads that makes the Philips Sonicare even more effective, in fact three times more effective!

Designed by a Dentist, the Triple Headed Toothbrush Head features individual labial, lingual and occlusal orientated brush heads which combine to provide the most thorough toothbrush experience your mouth has ever enjoyed, delivering three times more prophylaxis for a two minute cycle.

Featuring patented angled brush heads that clean along the gingival margin and extra soft bristles that do not harm enamel

or gingiva, the labial and lingual heads are positioned at a 45° angle so they automatically brush perfectly every time. The three sides of the brush naturally adapting to the teeth so that it works on teeth of all shapes, sizes and positions.

For more information about Triple Headed Toothbrushes contact your local Trycare representative, call 01274 885544 or visit www.trycare.co.uk/triple-bristlen

Tecnoss®’s OsteoBiol® GTO® is the stateof-the-art Second Generation Guided Bone Regeneration Material distributed by Trycare. All Tecnoss® OsteoBiol® products are Second Generation because they contain a Dual-Phase resorbable bone matrix incorporating both mineral component and collagen. Unlike ceramized first generation materials which undergo very little resorption and are therefore never completely replaced by newly formed bone, Dual-Phase biomaterials do resorb progressively and are replaced by adequate new vital bone.

Handling like a sticky putty, OsteoBiol® GTO® is Tecnoss®’s state-of-the-art readyto-use pre-hydrated biomaterial that can be

When your dental practice grows, you need a management system that can develop with you. Use the acclaimed Sensei Cloud, the dental practice management Software-as-aService platform from Sensei, the practice and patient management brand from Carestream Dental, to engage patients and expand your business potential.

easily dispensed into defect sites direct from the syringe. It enables clinicians to skip the hydration phase with saline or blood, saving time and decreasing the risk of accidental exposure to pathogens. OsteoBiol® GTO® contains Tecnoss®’s innovative OsteoBiol® TSV Gel which ensures optimal stickiness of the material, allowing easy adaptability to the recipient site and extreme stability.

For more information, call Trycare Ltd on 01274 885544 or visit the website.n

are running your first practice, or tenth. Plus, as you open new sites, scheduling can be made seamless across multiple locations and specialties. Liaising with patients is easily organised and incredibly effective through the platform, creating professional relationships that last.

The cloud-based platform lays out live metrics on performance and finances in realtime dashboards, allowing dental professionals to simply analyse the potential opportunities for growth. Only the relevant information is shown, making business management accessible whether you

A new path to clinical freedom restore balance

Learning new skills can open new possibilities and help advance your clinical career. And with more than 130,000 implants being placed in the UK every year already, dental implantology has an exciting future.

The Straumann Group brand Anthogyr®, in conjunction with training academy Implant Conneqt, has carefully put together a Post-Graduate Diploma in Implant Dentistry (awarded by EduQual). Targeted at clinicians who are new to dental implants or who need more experience to build their confidence, it comprises 13 modules and includes eight clinical days and one residential module. The course is delivered in a flexible

format that enables dental professionals to learn around their current work and personal commitments. All the theoretical modules are completed online, complemented by one-to-one support from clinical supervisors during clinical days.

Every delegate is guaranteed to place and restore up to 10 dental implants, significantly more than most similar courses.

To find out more about this wonderful opportunity – you can enrol at any time –visit the website to browse the brochure today! n

Eschmann care & cover – service and support you can trust

When you have invested in high-quality dental equipment, investing in reliable service and support is a must to ensure a fully compliant and efficient practice, particularly in the event of a breakdown.

Eschmann Care & Cover provides expert service and support for your Eschmann dental decontamination equipment, helping to ensure full compliance with HTM01-05 and SDCEP guidance.

With no hidden charges, Eschmann Care & Cover includes Manufacturer’s Annual Validation and Pressure Vessel Certification (PSSR), unlimited breakdown cover (including call-outs, parts and labour), as well as annual Enhanced CPD User Training for staff.

Managing plaque levels is key for reducing the risk of periodontal issues. As such, mouth rinses which contain antimicrobials act as a helpful supplement for those who are at a higher risk of developing periodontal issues, as well as patients with limited dexterity.

Perio plus Balance mouth rinse from Curaprox is the ideal oral hygiene supplement for patients who are at a higher risk of dental disease. The rinse contains 0.05% chlorhexidine, CITROX®, polylysine, and xylitol. Each active ingredient works to control bacteria and protect against caries. This is the perfect solution for patients who need longterm protection against gingivitis and

By utilising the internet, Sensei Cloud can be accessed from anywhere, at any time. All of your data is still kept secure and GDPR compliant, combining convenience with reliability.

To learn more about how Sensei Cloud can transform your practice management structures, contact the team today.

Follow us on Facebook and Instagram @ carestreamdental.uk n

periodontitis – as the rinse can be used day and night for up to six months.

To find out more about the Perio plus range, please contact the Curaprox team today.

For more information, please visit: www.curaprox.co.uk n

With a team of over 50 engineers working on Eschmann decontamination equipment, we fix over 91% of breakdowns on our first visit. Technical telephone support is available with many issues fixed without an engineer needing to attend. Exclusive access to Eschmann spare parts is included in our Care & Cover service packages, so your practice is up and running with minimal downtime.

While the speed of Kiroku, the AI based note taking platform, is unbelievable – it can help dental professionals complete their notes 60% faster – the level of detail it captures impresses too.

As London-based dental therapist Cat Edney says: “With Kiroku I get complete, contemporaneous notes which are all done by the end of an appointment. For me it’s not about being quicker, it’s about being thorough.”

Find out how Eschmann Care & Cover can assist in your practice, visit the website today. Visit the website or call: 01903 753322 n

The system removes the need for typing through the use of clickable buttons that auto-populate the section being worked on and pre-fill related sections. Unlike other software, as Kiroku is AI-based, it learns from every user. This means it

can make suggestions that the user can accept, edit or decline.

For more information about how Kiroku can help you and the rest of the dental team in your practice, get in touch with the team today.

To find out more about Kiroku, or to start your free trial, please visit trykiroku.comn

Future-proofed imaging solutions Align with the experts!

Guarantee excellence for your patients for the next decade with a CS 9600 CBCT Scanner from Carestream Dental, with a 10-year warranty for long-lasting success.

Clinicians can protect their investments through our promise of replacing any faulty parts with our own solutions, made in our exceptional production facilities in France. This 10-year warranty ensures your practice can deliver astounding 2D and 3D imaging capabilities that inform the highest quality treatment plans.

With the capabilities of five systems in one, the CS 9600 CBCT unit can also create 2D panoramic and cephalometric images, with 3D facial and model scanning also possible for comprehensive applications in the practice.

All images are sharp, with high resolution results up to 75 microns to serve endodontic needs, while also providing the ability to capture the entirety of the mouth in one scan.

To learn more about the leading warranty on this versatile CBCT solution, contact the team today.

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

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

Maximise your skillset with minimally invasive care

Invest in the next steps of your clinical career with the Align, Bleach & Bond (ABB) course from IAS Academy.

Two transformative courses in one, students start with the Removable Appliances Course, which provides clinicians with a full day of expert insight into Inman and clear aligner treatment workflows. Once confident with the entire treatment process, from planning and placement through to retention, clinicians will move onto day 2.

This second day is made up of the Ortho Restorative course, and provides clinicians with the ability to carry out simple edge bonding and polishing, aesthetic tooth

shaping, and tooth wear treatments with confidence.

Together, they make up the ABB course, which is rooted in IAS Academy’s principles of effective, functional and minimally invasive treatments and outcomes, that are sure to look outstanding as part of a patient’s smile.

To learn more about the ABB course and how it can transform your skillset, contact the IAS Academy team today.

Please visit the website or call 01932 336470 (Press 1) n

Clear aligners are hugely popular and the material they are made of plays a key role in their efficacy.

ClearCorrect® aligners from the Straumann Group are made from a proprietary ClearQuartz™ tri-layer material combining two layers of resilient polymers with an elastomeric inner layer to produce a gentle but consistent application of force. This, alongside software that features enhanced precision editing tools and arching editing solutions, means highly controlled treatment planning and tooth movement.

ClearCorrect® aligners feature a flat trimline above the gingival margin, resulting in a comfortable and retentive oral device.

In addition, the Doctor portal affords streamlined case organisation and management, with the opportunity to identify and filter cases and colour-coded patient notes.

To discover how ClearCorrect® aligners could transform the smiles of your patients, visit the website today.

For more details, please visit the website belown

straumann.com/clearcorrect/gb/en/landing/clearcorrect-aligners.html

Waste made easy

Don’t be confused about your waste management responsibilities. Initial Medical is on hand to help you make sense of your practice’s commitments, with a variety of useful solutions for every day.

Initial Medical provides simple-tounderstand Follow the Colour Code waste segregation posters.

These can be placed around your practice for clear, instantly digestible information. By using solutions such as these, your waste management processes can be more efficient and can better protect the environment, by ensuring that waste items are accurately sorted.

Initial Medical also provides a wide range of colour coded waste containers and bags, such as our new selection of sustainable

clinical waste bags made of 30% recycled plastic, and our improved Griff Pac rigid containers. These ultralightweight fold flat clinical waste containers are made from corrugated polypropylene and are resistant to liquid contamination. They are suitable for the disposal of a wide range of waste including soft waste, aspirator tips, cannulas, and suction tubing.

To learn more about the products that are designed to help simplify waste management in your practice, contact the Initial Medical team today.

To find out more, get in touch at 0808 304 7411 or visit the website today.n

Managing diabetic burnout with collaborative care Patient education for early detection

PREVENT GEL from TANDEX, used with their range of FLEXI interdental brushes, is a great product to recommend to patients with additional oral care needs due to diabetes. Increased risk of periodontal disease makes interdental cleaning an important part of daily oral care.

Not only does TANDEX have the right tools to maximise oral health for people with diabetes, they have helpful FLEXI Educator tools to assist patients in understanding the need for interdental care.

PREVENT GEL from TANDEX includes many of the minerals and enzymes diabetic patients need due to impaired saliva production. FLEXI interdental brushes are easy to use and effective, making a great choice for sustainable, ethical care with all

Make the most of this tax year with specialist advice from money4dentists, the independent financial advisers who have spent decades solely helping and guiding dental professionals.

The team will provide comprehensive insight into advanced tax planning, with the help of sister firm accountants4dentists. We will tailor our advice based on your unique financial situation, which can be extremely different within the dental profession when compared to other industries.

By taking effective actions early in the tax year, you could implement advanced tax planning actions that maximise your ability to use efficient investment vehicles, to meet your needs.

In a free consultation, you can begin

the comfort, affordability and convenience patients need.

Find out more about how PREVENT GEL from TANDEX, used with their range of FLEXI interdental brushes can benefit patients.

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

to understand the exceptional support the money4dentists team can provide, and even enquire about the broad range of other services available, including support for medical and life insurances, pension planning, income protection and mortgages.

To learn more about the steps you need to take this tax year, and how money4dentists can support you, contact the team today.

More information, call 0845 345 5060 or 0754DENTIST.

Email info@money4dentists.com or visit www.money4dentists.com n

With more than 744,000 cases each year worldwide and less than a 50% five-year survival rate, it’s crucial that clinicians raise awareness of oral cancer.

Discussing risk factors with patients and carrying out regular checks is essential for preventing oral cancer, and detecting it in its early stages. By becoming familiar with the early symptoms, and educating patients, dentists are more likely to pick up on the signs more quickly.

Plus, if a dentist does detect a lesion, the use of a pre-diagnostic test such as the BeVigilant™ OraFusion™ system from Vigilant Biosciences® can identify the presence of biomarkers associated with

oral cancer, producing a result in 15 minutes or less.

The result of this test can then be used to inform further examinations and referral to a specialist. Please contact the team for more information.

For more information, please visit https:// totaltmj.co.uk/products/bevigilant-orafusion/ Call: 01202 313702 or Email: Info@totaltmj.co.ukn

totaltmj.co.uk/products/bevigilant-orafusion/

Dr Pujan Soni recently enlisted Dental Elite to renegotiate on his behalf while selling his practice. He ended up achieving 60% more than the original deal price and here shares his experience:

“Dental Elite were so professional, knew their numbers and had dealt with similar sales situations like mine before. They filled me with confidence. They also had the invaluable experience and contacts needed for a smooth process.

“It was an amazing experience. Phil Kolodynski immediately understood my requirements and was always at the end of the phone, day or night, weekend or even on holiday! I was very happy with

the deal he achieved. If you’re thinking of selling, don’t think twice – use Dental Elite!”

To find out how Dental Elite could help you realise and achieve your practice’s full worth the time comes to sell, contact them today.

For more information contact the Dental Elite team on 01788 545900 https://dentalelite.co.uk/n

The rising challenge of root caries

John Maloney, GC UK Country Manager looks at the growing challenge of treating and preventing root caries in an increasingly elderly population

Growing old is an inescapable fact of life, but the good news is that today’s older population is healthier and living longer than ever before.

The population of England and Wales has continued to age, with Census 2021 results confirming over 11 million people - 18.6% of the total population - were aged 65 years or older, including over half a million (527,900) people who were at least 90 years of age .

While living longer is something to be celebrated, it also has implications not just for the economy and society in general, but for health care providers and dental practices in particular.

By 2050, it’s expected that 22% of the European population will be 70 years or older, while today more than 80% of people over 65 retain at least some of their natural teeth. This means there is already greater demand for restorative dentistry, as well as more care for unrestored teeth in a growing elderly population.

the issue with ageing

Caring for older people’s oral health can be problematic for many reasons, including reduced mobility, a decline in cognitive abilities, or problems with the mouth or jaw leading to difficulties in eating, drinking and oral hygiene. All of these factors can have a negative impact on wider general health.

Older people are more likely to have chronic or long-term health conditions that put them at increased risk of dental disease, which can make treatment planning more complicated. As people age they tend to experience greater exposure of the root surfaces of the teeth, due to the accumulated effects of periodontal disease . Once exposed, these root surfaces are at greater risk of demineralisation, especially for patients who have reduced saliva flow and diminished buffering capabilities for counteracting acid attacks.

Be prepared

As more people keep their teeth for longer, the range of dentistry required will be technically more complex than in the past, with an even greater reliance on restorative and preventative materials.

The treatment of root caries lesions in elderly patients is challenging and there is a great need for cost-effective prevention. GC’s Back to your roots! initiative can help practices tackle root caries by identifying at an early stage the presence and risk factors of root caries, preventing their development, and restoring root caries lesions in a minimally invasive way.

Identify the risks

Caries risk assessment is the first step in caries management. GC Tri Plaque

ID Gel can help to identify cariogenic plaque and highlight where bacteria are most active, by disclosing the acidic pH. This disclosure technique also helps to educate patients about the plaque that remains on teeth, motivating them to improve their brushing technique.

Chronic dry mouth (xerostomia) and reduced salivary function are common problems for older people, both of which increase the risk of caries as the effect of saliva’s natural anti-caries properties is reduced.

GC Saliva-Check BUFFER is a chairside test to evaluate the ability of the patient’s saliva to protect their teeth, while also helping to identify underlying factors that disrupt the oral balance and cause demineralisation.

Protect and prevent

Where saliva levels are low, the application of GC MI Paste Plus, containing bio-available calcium phosphate and fluoride, to tooth surfaces creates a favourable environment for tissue remineralisation, while helping to facilitate tooth repair and relieve sensitivity.

GC’s MI Varnish enhanced fluoride varnish treatment combines bioavailable calcium and phosphate to form a strong protective coating against carious lesions, boosting enamel acid resistance while inhibiting demineralisation.

To help alleviate the problem of xerostomia and dry mouth often experienced by denture wearers, GC Dry Mouth Gel is a pH neutral, sugar-

free gel to give long-lasting comfort to soothe the symptoms of oral dryness.

restore

Glass ionomers, glass hybrids or composites can all be used to restore root caries lesions. For active lesions EQUIA Forte HT long-term glass hybrid restorative adheres well to root surfaces and is easy to contour. With its ion exchange capacity, it prevents demineralisation and stimulates remineralisation.

Where controlled speed and ease of use are priorities, Fuji II LC lightcured, resin-modified glass ionomer is indicated, particularly for patients who lack the necessary cognitive or physical skills to fully cooperate. Where aesthetics matter, G-ænial Universal Injectable composite is an ideal option when the lesion is noncarious or arrested, and there is the opportunity to isolate well with rubber dam. GUI polishes easily to a high gloss, which reduces plaque retention, and is strong and wearresistant, which is important in areas subject to abrasion.

Challenges heading this way

Good oral health is an essential component of active ageing and the majority of older people now retain some natural teeth. However, root caries are increasingly becoming one of the most significant clinical challenges faced by those treating older people and the dental profession will need to be equipped to meet this challenge.

Every practice increasingly has patients whose oral health is dependent upon halting the progression of carious lesions, preventing the development of new root carious lesions, and the preservation of the vitality of infected dental tissues.

The Back to your roots! campaign from GC raises awareness about the treatment and prevention of root caries in an ageing society and offers a range of minimally invasive treatment solutions that place emphasis on prevention and manageable treatment.

To find out more about GC’s campaign on root caries, visit www.gc.dental/europe/en-GB/ gccampaign/rootcaries

To find out more about GC’s comprehensive range of restorative products, contact GC UK on 01908 218999, email info.uk@gc.dental or visit gceurope.com n

about the author

John Maloney, GC uK Country Manager.

Empowering women in dentistry

In April, I had the pleasure of being joined at Twickenham Stadium by women from across the dental profession, including a dental nurse, practice manager, dental therapist, and a few women with experience in several of those roles, as well as dentists at different stages in their careers. We gathered to discuss a topic very close to my heart: empowering women in dentistry, while enjoying watching the Red Roses rugby team defeat Ireland in the Women’s Six Nations. At Denplan, we often hear from our members how important creating inclusive and welcoming spaces are. I could talk at length about being a woman in dentistry, but my view is limited to my own experience as a dentist and, while I share some experiences with my dental colleagues, they have their own stories. We’re committed to creating space for these conversations and sharing the learnings from the experiences of women in dentistry; the shared and the unique.

Our afternoon at Twickenham was an open, honest, and wide-ranging discussion about the profession we all love working within, which made it clear that, while we’ve made progress as an industry, there’s still lots of work to do.

Over three-quarters of the dental profession is now female according to the GDC register and, yet, in my experience, and those of the women at Twickenham, it often feels like men dominate the professional landscape. Most conference speakers are men, men attend professional events in

far greater numbers than women, and men are often the ones in senior roles. Why is this? This was the starting point of our conversation. Internalised barriers was a theme that emerged for most of us, in different ways. Some of us said that experiencing imposter syndrome and our own internalised bias limit us professionally. We reflected on the wider cultural and societal expectations for women – that old notion that girls should be ‘seen but not heard’ and how that has shaped our view of ourselves and our potential. We talked about how, culturally, women are taught to be quiet and humble and not shout about their achievements. This has led us to become nervous to speak up on subjects that we’re experts in, or to celebrate our progress for fear that we’ll be perceived as a ‘know it all’ or a ‘show off’, or even ‘aggressive’ if we put our point across assertively – by other women in our profession as well as by men. We discussed how we can unlearn this engrained behaviour by being more aware of it and challenging ourselves, as well as seeking training to support our development. There are also clearly external barriers to success for women in dentistry. We discussed the internal biases that can be held when recruiting for jobs, the oldfashioned concern that a woman will be less committed to her role because of parental duties. This was an interesting area of discussion because several women present are practice owners who have had the

same thought cross their mind when recruiting. It became a wider societal conversation about how workplaces support women and men who want families with things like flexible hours and affordable childcare, and how businesses can be supported to balance their needs. We also agreed it’s wrong to assume that a woman wants a family, and wrong to assume that a man wouldn’t be impacted by parental responsibilities.

Pay disparity is an issue we read about time and time again in the world outside of dentistry, but I hear stories about it happening in dentistry too, with men paid more than women for no discernible reason, or given senior positions over equally qualified and experienced women. We also spoke about the inappropriate comments that many of us have experienced from men in dentistry. These comments are perhaps sometimes meant in good humour, but they can have a significant impact on us.

It can be difficult to speak out when we do experience negative situations. We worry about being viewed as too emotional, we worry about our concerns not being taken seriously, and we worry about the impact that speaking out may have on our professional opportunities.

Many of the women felt that having a support network for women in dentistry would really help their professional development and could also be particularly valuable when speaking out about issues. Having a peer to talk to about the issue, and someone to help you take a step

back from the situation to allow you to communicate clearly would make a difference. We also agreed that networking and connecting with other women across registrant groups is vital to help us empower each other and improve our wellbeing. From my own experience, the more senior positions I hold, the lonelier I find it, but connecting with other women helps me feel less alone.

Women in dentistry also need men in dentistry to advocate for us. Men are often the ones in the positions of power that can create change. Advocate for your female colleagues even when they’re not in the room, call out inappropriate comments and behaviours, take the time to approach women’s experiences with curiosity, and be supportive. Women in dentistry really appreciate our male allies. n

about the author

Catherine Rutland, Clinical director at denplan and Simplyhealth.

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Building an Intentional Culture

Ihave just read, People: Dare to build an Intentional Culture , which is part of the EOS Master Series. I really recommend it.

If you were to ask your team to describe your businesses culture in five words, would their lists be consistent? It’s an exercise worth trying, and if your business is typical, then the results will likely be very varied. In businesses, where corporate “values” are merely words on the website, the “culture” tends to be experienced differently, depending on the role and level of the person. Because if your people can’t name the values that drive the culture, how can they collectively live them?

Businesses that invest time and energy into establishing clarity around this subject create an ‘intentional culture’. An intentional culture continuously aligns and regulates an organisation’s values, beliefs, and behaviours in support of the business strategy. Businesses that are purposeful about their culture routinely outperform their competition that lack focus in this area.

Often, people think of culture as something that is intangible and impossible to define. The leaders of an organisation may see the culture through a completely different lens than the employees. Yogi Berra once said, “If you don’t know where you’re going, you might end up someplace else.” This piece of wisdom is a good starting point

in a conversation about business culture because it spotlights what makes it so valuable: Culture tells your team where you’re going.

A cohesive businesses culture provides a clear vision and direction, making it easier for everyone to work together toward a common goal and to weather hardship and change when it happens. It also tends to make work a more fun place to be.

Furthermore, an intentional culture is incredibly important for companies because, once established, it will also help attract and retain amazing talent and create an environment for increased employee engagement and high morale.

As Peter Drucker once said, ‘Culture eats strategy for breakfast.’

It is an interesting exercise to explore your organisational truths. How do your colleagues treat one another, formally or informally? Through ad-hoc communication or structured meetings?

The book explains the four company cultures that cover off most businesses. We were a ‘happy accident’. This worked very well in the early years of the business but as we grew we knew our culture had to evolve to support a bigger enterprise. So, take a few minutes to consider where your business sits. c ommand and c ontrol: This is a culture that favours and rewards blindly following orders from the top. Command and control is the type of culture you might

find in a Charles Dickens novel, where workers are treated as cogs in a machine rather than as valuable team members. It’s undoubtedly an intentional choice, but far from a healthy one.

The Happy a ccident: This is the opposite of command and control. It’s what can happen when a business is built with no organising principle beyond hiring people the founders like. On a small scale, this can end up working great and bring a personal touch to work. However, if you plan to grow your businesses over time, then you need something more structured and intentional.

c haotic: If you fail to have any type of intentional cultural vision by the time you move past the point of hiring only family and friends, you’re going to end up with dysfunction. Factions will form and office politics will become more important than productivity.

i ntentional: This is a culture that is built from the bottom up around core values that act as a strong foundation for everything else. That includes hiring, firing and everything in between. With this organic approach, you can create a workplace built around love and a shared vision rather than one based on scarcity or fear.

We are taking the steps we need to get from ‘Happy Accident’ to ‘Intentional’.

We started with a vision. A vision of what our business will look like in one, three, and 10 years’ time. Our vision

includes financial goals, what our team will look like, and the tools we need to deliver on the vision.

We have created a set of five core values that act as the pillars of our vision. We made the core values authentic, practical beliefs that drive our businesses. They are not a motivational poster. They are much more considered than that and probably unique to your business. We only share our core values with our team. They are not used in our marketing or promotional material. But our clients should ‘feel them’ when working with us. It is a fundamental requirement of our hiring process that candidates reflect our core values. We do not share them in advance. You cannot prep for this if you are a candidate. People either exhibit them or they don’t.

I know from talking to my EOS implementor, Dave Feidner, that building a healthy culture won’t always be a frictionless process. But we are reminded that the goal is to create a culture that delivers growth, less friction, higher energy and happier clients. We want our culture to help the business become a better version of itself. n

about the author abi Greenhough, Managing Director of Lily Head Dental Practice sales.

The impact of AI on Google PPC ads

Revolutionising dental marketing strategies

In today’s dynamic digital landscape, online advertising is in a state of perpetual evolution. A significant transformation is the integration of artificial intelligence (AI) into pay-per-click (PPC) advertising platforms like Google Ads.

Dentists utilise pay-per-click (PPC) ads as a powerful tool to generate leads due to its targeted and cost-effective nature. PPC ads allow dentists to reach potential patients precisely when they are actively searching for dental services online. By bidding on relevant keywords and targeting specific demographics, dentists can ensure their ads are displayed to individuals most likely to require dental care, thus maximising the chances of conversion. In addition, PPC ads operate on a pay-per-click basis, meaning dentists only pay when users engage with their ads by clicking on them. This cost-effective model allows dentists to allocate their advertising budget efficiently, ensuring optimal return on investment (ROI) while generating a consistent stream of leads for their practice. Therefore, the importance of dentists learning to comprehend how AI is reshaping the realm of Google PPC ads is pivotal for maintaining a competitive advantage in the market. Let’s delve into the ways AI is revolutionising dental marketing strategies and maximising their advertising efforts.

ai in Google PPc ads: a closer look At the core of Google PPC ads lies AI algorithms, fundamentally altering the presentation, targeting, and optimisation of advertisements. Harnessing the capabilities of AI empowers dentists to efficiently and effectively reach their intended audience. AI algorithms meticulously sift through extensive datasets to pinpoint potential customers most likely to engage with dental services. This targeted approach ensures ads are displayed to the right audience, thereby increasing the likelihood of conversions. It’s essential to understand that the goal isn’t merely to showcase your ad at the top of the page to everyone; rather, it’s about displaying your ad to those most likely to convert based on their online profile.

Dynamic Ad Creation, another facet tied to AI tools, tailors ad content automatically to align with the preferences and search intent of individual users. This personalised approach heightens ad relevance, driving higher click-through rates. Essentially, by providing Google with sufficient information, dynamic campaigns generate tailored ads based on users’ search queries. This flexibility is particularly advantageous for those starting out, aiming to boost new patient numbers across the board. Furthering the theme of ad creation, AI plays a key role in crafting effective

Google Performance Max ads by leveraging advanced algorithms and machine learning capabilities. Unlike dynamic ads, Performance Max ads encompass a broader array of content such as photos, logos, videos, and longer descriptions, coupled with calls to action.

With Performance Max ads, AI enhances audience targeting by analysing vast datasets to identify potential customers based on demographics, interests, and online behaviour. This ensures ads are displayed to the most relevant audience, thereby increasing conversion likelihood. Additionally, AI facilitates dynamic ad creation by tailoring ad content to match individual users’ preferences and search intent. This personalised approach not only boosts ad relevance but also leads to higher click-through rates and better overall performance. Moreover, AI continuously monitors ad performance in real-time, adjusting bidding strategies to maximise ROI. This dynamic bidding

process ensures optimal allocation of resources, preventing wastage of ad spend on keywords unlikely to yield business. Enhanced conversion tracking empowers dentists to monitor all leads originating from Google Ad spend. AI-powered conversion tracking tools offer valuable insights into the customer journey, facilitating precise measurement of PPC ad impact on conversions. Google can actively track leads over time, attributing conversions even if users interact with ads weeks before completing a desired action.

In summary, the integration of AI into Google PPC ads marks a paradigm shift in how dentists market their services online. From enhanced audience targeting to dynamic ad creation and advanced analytics, AI-powered tools equip dentists with the means to reach their audience more effectively than ever before. By leveraging AI-driven insights and automation, dentists can navigate the competitive landscape with precision and agility, achieving their marketing objectives with efficacy. n

about the author Michael Leach, Digital Marketing strategist, connect My Marketing connectmymarketing.com

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Selling to a body corporate?

If you are considering selling to a corporate there are a few things to consider before you take the plunge.

Whilst there are a number of household names, there are a significant amount of newer, lesser-known corporates or dentists who own, say, 10–20 practices.

The lure of selling to a corporate and not having to ‘openly’ market the practice may appeal to some larger dental practices. However, to ensure that you are maximising the value, it is important to approach as many as possible, as often the price and terms can vary significantly. This can still be done in a ‘off-market approach’ by a good dental agent.

What prices are being paid?

Corporates are generally not concerned with how the income is generated (i.e. through the NHS, by dental plan or as private fee per item) but are more focused on the profitability they are generating. We typically see multiples between 7 and 8 being paid for most practices, but this can be influenced by the area the practice is in and the level of interest that it will be generate. However, it should be noted that the calculation of the multiple is as important (if not more) than the multiple itself.

Calculating an EBITDA is not as simple as looking at the accounts of your practice and adding back a few items. An experienced

valuer will be able to consider other things that are outliers against market norms, look at hygiene recharge, principal pay (which if reduced could enhance the value of the practice) and advise you on how to maximise the value.

It is not the responsibility of a body corporate to tell you about all of the items that should be adjusted, and it would often not understand the practice well enough to make them in any case. Therefore, I urge any prospective seller not to go it alone. Corporates are familiar with the process, and you need the same level of experience on your side. We have also had examples in which we have been instructed after someone has had an offer from corporates, only for us to increase the offers significantly because of errors in the corporates’ calculations – something that we can check against our own calculations.

Tie-ins

Good or bad, the body corporate is likely to want the principal to remain as an associate post-sale. This can often be advantageous for principals who are ‘cashing in’ on their value but are not quite ready to stop dentistry or retire. Therefore, the fact that the practice is being sold to a body corporate (running an associate-led model), means they are still required as a dentist and have job security without the worry of selling the dental practice when they do

Happy New Tax Year!

When April rolls around, we are all called to celebrate one of the inevitabilities of life: the new tax year. Running from 6th April to 5th April the following year, it is not traditionally a time for fireworks. There are steps you should be putting in place now to make next year’s tax payments more palatable, and potentially save some of your income. Doing so in a well-intentioned manner is essential, and getting the aid of specialist financial advisors can ensure that your actions maximise the benefits available to you in a lawful and responsible way.

best foot forward

When it comes to minimising tax contributions, your first thought might be about tax planning. This is the analysis of a financial situation that allows you to put certain actions into motion to legally pay the lowest taxes possible, and be tax efficient. This is not tax evasion, wherein you act against the law, or even tax avoidance, where you aggressively or abusively subvert the letter of the law to your own advantage. Taking charge of your finances early in the year allows you to account for every pound of income you earn. But first, you must understand how much of your income is taxable and judge which tax thresholds you meet.

understanding your tax bands

Individuals are not charged on the first £12,570 of their yearly income, but should

decide to retire. For those principals who do not wish to carry on, a tie-in will be a burden and they are likely to want it to be the minimum possible. There are ways in which the principal tie-in can be reduced by removing the dependency on the principal by shifting patients/income to other associates prior to sale. However, this comes with a warning: you don’t want to see turnover reducing if those associates cannot maintain the same levels of income. This would fundamentally bring down the value of the practice. The timescales that you as a principal would be tied into should be considered when planning the retirement/ sale. Don’t leave it too late!

Deferred payments

If the principal has agreed to stay for, let’s say, four years, what protection will the body corporate require? Most will ask for a retention or a deferred payment of the sale price on the principal staying. Thus, if the practice was valued at £1,000,000, a body corporate may ask for 30% to be deferred – and this would mean £700,000 of the sale price would be paid upfront with £300,000 deferred. At the end of each year, £75,000 (£300,000/4) would be paid based on the principal staying at the practice and, at the end of the four years, they will have achieved the full £1,000,000 sale price.

It is also likely that the retention being paid will also be based on the turnover being maintained (or even increased). Should there be a shortfall, it is important to understand how this would be reduced, i.e. £1:£1.

speed of sale

One main advantage with the body corporates is that they are often quite good at getting deals done in a timely manner. They do not need to spend weeks raising finance or worrying about small matters that may concern a private buyer. In our experience, the process can often be completed in as little as four months. The type of practice and location will impact on the likely buyers and, as mentioned previously, the smaller, lesser known corporates are very active in the market. Smaller corporates will not often ask for the tie-ins or retentions that the household names do, and are therefore certainly worth considering alongside the bigger players. A good agent will have contact with all types of corporates and, therefore, can ensure that you get the best deal for you. n

about the author

Martyn bradshaw is a Director of PfM Dental and heads up the dental practice sales agency.

they earn over

£100,000, this allowance will decrease. For every £2 you earn over that limit, your personal allowance drops by £1. If you receive more than £125,140 in a given year, the allowance is effectively dissolved.

In England, the tax bands changed for the 2023/24 period – whilst the 20% basic rate remained between £12,571 and £50,270, the higher 40% rate saw the bracket shrink to between £50,271 and £125,140. The ceiling was down from £150,000, which had been the maximum boundary since its implementation in 2010.

Beware this bracket’s seemingly innocuous 40% tax rate. Whilst it is high, you may think it is manageable. However, it could become a 60% tax trap when you consider the reduction of your personal allowance kicking in at £100,000, taking this previously protected income immediately from a 0% rate to a 40% rate. With this in mind, for every £1,000 you earn above £100,000, up until £125,140, you would owe £600 in tax. Past that limit, individuals will pay a flat rate of 45% on any income earned.

claiming expenses

Tax planning can manifest in many different ways. The most appropriate course of action will depend on your income and unique financial situation, and you should consult a specialist financial advisor or accountant who completely understands your aims before making any decisions. Claiming tax relief on work expenses may be suitable for many dental professionals.

This requires you to spend money on something related to your role in dentistry, meeting a strict ‘wholly, exclusively and necessary’ test.

Generally, ‘wholly’ and ‘exclusively’ mean your investment cannot serve both a business and a non-business purpose. The ‘necessary’ means that someone couldn’t provide your care without that investment, for example, implant dentistry couldn’t be performed without paying for and undertaking a relevant course that equips you with the fundamental clinical skillset.

If you are self-employed, allowable expenses could include anything from a training course to new equipment, or even advertising and travel costs. When you claim on an allowable expense as a selfemployed professional, this is deducted from your taxable turnover. This may be extremely beneficial if you are on the boundary of a tax bracket, and wish to redirect your taxable income.

Say you earned £105,000 over the tax year. If you spent and were able to claim £10,000 in expenses, your taxable income would drop to £95,000. You would regain the entirety of your personal allowance, and miss out on the aforementioned 60% tax trap. Overall, you would save £5,000 from your tax bill, which you may consider better spent on your own care provisions.

The right advice

As you look online, you may find a variety of sites offering tax planning advice that often seem confusing – they reel you in with talk

of pension schemes, before it all becomes extremely complex. You must only make decisions when you are well informed and have a complete understanding of your financial situation and taxation responsibilities.

Consulting financial advisors is essential in this process. When you speak to the money4dentists team, who works closely with the sister firm accountants4dentists, you receive specially tailored advice from experienced professionals who know dental finances like no-one else. The team has dedicated their support to dentists for decades, and provide a free consultation to begin your journey towards efficient and safe tax planning.

Whilst the process is often complex, engaging in tax planning early into the financial year is essential to making the most of your savings. With help from professionals you trust, you could be better distributing your hard-earned income in no time at all.

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.

What’s happening with NHS orthodontic contracts?

UK dentistry has long been a somewhat turbulent landscape and the recent changes to NHS orthodontic contracts once again disrupted the way the profession is structured. Historically, NHS orthodontic contracts have always been time-limited, but those who held them have been confident that their contracts would be renewed. As such, the practices have held their value, often fetching up to six times their EBITDA (Earnings Before Interest Taxes, Depreciation and Amortization). This has presented a viable long-term business model for dental professionals in the field and made contracts fairly attractive for potential buyers.

In 2017, an announcement was made by NHS England that rocked the boat. A number of contracts were due to expire in early 2019 and it was broadcast that a nationwide procurement process to award new contracts would be performed at this time. This meant that all existing contracts had the potential to be re-tendered and the confidence in existing contracts being renewed reduced significantly. The result was that goodwill values plummeted and practices with NHS orthodontic contracts were left unsure of whether they would retain contracts beyond their existing agreements. Those in the Midlands faced increased uncertainly given that many aborted the tendering process altogether and were then stuck in limbo for the months that followed.

Since then, however, the impact on some of the affected practices has been

positive. New contracts were awarded for those in London and the South East, guaranteed for seven years, with the option to extend for a further three years. This has made NHS orthodontic contracts in these areas more secure than they were historically, representing greater value for businesses in the long-run.

Things have not been so good in the Midlands, where contracts of 5-6 years have been rolling out, with 3-year extensions available. Unfortunately, the shorter contract length is not enough to create decent goodwill values. As such, banks are less confident lending to buyers in these areas, reducing the ability to sell. In Essex and Hertfordshire, from June, they will have access to the longer NHS orthodontic contracts, and while it would seem that the remainder of the Midlands will follow suit eventually, many practices here remain on a hiatus.

For the most part, the new contracts are structured in a similar way to the previous model. They are still PDS (Personal Dental Services) contracts, so there is certainly the possibility of selling the goodwill with no problems.

The only down-side is a slight reduction in UOA (Units of Orthodontic Activity) values in some areas of the country, although the enhanced security of the new NHS orthodontic contracts still makes them very profitable. Many practices have recently agreed contracts based on a UOA rate of £65, with various review Body on Doctors’ and Dentists’ Remuneration

(DDRB) uplifts attempting to increase this. For any practices operating north of £70 per UOA mark, be prepared to accept a lower rate in exchange for the confidence that the new 10-year NHS orthodontic contract could afford your business.

This extended security also has great potential to make practices more attractive to potential buyers, which is ideal for anyone thinking about selling or wanting this flexibility for the future. With the longer agreements, we saw EBITDA values start where they left off, but since then they have begun to rise to as much as six and half to seven times their EBITDA, depending on location. This is not far behind standard NHS contracts, which is reflective of the demand for orthodontic services in the UK.

We have also seen no issues with borrowing in light of this new NHS orthodontic structure to date. Lenders have often looked upon the dental sector favourably and this has largely been the case for orthodontic contracts despite the dip in goodwill values back in 2019. Although any PDS contract doesn’t deliver guaranteed income, the new structure does encourage stability of revenue for the business. Plus, the current NHS orthodontic contracts are a scarcer resource than they were in the past and with continued demand for them among patients and professionals, their value is being realised by lenders.

Of course, if you need any advice or support, the experienced team from Dental

Building business with enhanced treatment acceptance

It has been estimated by various sources that around half of patients don’t proceed with dental treatment that they enquire about. Why? For a number of reasons, most often including the extent of their existing dental condition and severity of complaints, the perceived cost-benefit and proposed treatment time. Not only does low treatment acceptance mean patients are not receiving care they would benefit from, but it also reduces revenue for the practice. To turn this around, the dental team should consider ways to increase their conversion of patient enquiries into completed treatments.

Monitor your conversation rate

The first step is to determine your practice’s existing conversion rate. This can be achieved by assessing reports from your practice management software to measure the proportion of treatment plans that remain open and have not commenced. This data can also be used to identify trends and provide further insight into potential areas of improvement. For example, you may find that treatment acceptance is lowest in the field of orthodontics, where patients see

certain clinicians, or when they are new to the practice. Equally, the data will indicate situations where treatment acceptance is highest – such as for teeth whitening, or among patients who have been referred to the practice by a friend or family member.

The information obtained can be used to improve the patient journey or tailor marketing activities in order to increase the likelihood of treatment acceptance moving forward.

finance options

The opportunity to spread the cost of treatment can often seem much more manageable for patients who are uncomfortable or unable to pay for everything upfront. There are also various payment plan providers that allow patients to pay a monthly membership in order to benefit from reduces rates for certain procedures. Any of these or other options that make paying for treatment easier will likely benefit your business.

Patient education and communication

Perhaps one of the most important aspects when it comes to increasing treatment acceptance, is enhancing patient

Elite would be more than happy to help. Our team intricately understands all the nuances of the modern dental profession, meaning we are well-positioned to guide you towards a more profitable and valuable practice. It appears that the changes to NHS orthodontic contracts are bringing several benefits to the profession. They are certainly not something to be immediately dismissed and are all set to continue offering practice owners a lucrative and sustainable business opportunity.

For more information on Dental Elite visit www.dentalelite.co.uk, email info@dentalelite.co.uk or call 01788 545 900 n

about the author Luke Moore is one of the founders and Directors of Dental elite and has overseen well in excess of 750 practice sales and valuations. With over 19 years working in the dental industry, Luke has extensive knowledge in both dental practice transfers and recruitment and understands the complexities of nHs and Private practices.

education. If patients really understand their current oral health status and the reasons for treatment, they are far more likely to follow professional recommendations.

To achieve this, patient communication must be highly effective. This means being clear and concise, using relatable language and allowing patients to ask questions. There is also evidence to suggest that visual aids can improve patient understanding of dental conditions and treatments.

As such, technology can be a very useful tool when communicating with patients, offering a new way to share information. Chairsyde is a state-ofthe-art consultation platform that offers an array of animations designed specifically to explain a range of dental problems and their related treatments, including all associated benefits, risks and limitations. It is an excellent way of enhancing patient education and encouraging engagement with their oral health for shared decision-making and optimal treatment acceptance rates.

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.

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