The Probe November 2026 by Purple Media Solutions Ltd

Colgate® Duraphat®, the only fluoride varnish that carries the weight of clinical evidence* See overleaf for more details and prescribing information...

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Colgate® Duraphat®, the only fluoride varnish that carries the weight of clinical evidence* Colgate® Duraphat® is the only fluoride varnish licensed for caries control in the UK† • Fast and easy application • Temporary visual tint to aid application • Raspberry flavour 22,600 ppm Fluoride

Protect your patients, your team and your dental practitioners’ prescribing responsibilities with Colgate® Duraphat® Fluoride Varnish1-5 Adverse events should be reported. Reporting forms and information can be found at www.yellowcard.mhra.gov.uk. Adverse events should also be reported to Colgate-Palmolive (U.K.) by calling 00-800-321-321-32.

*For caries control. †Colgate® Duraphat® fluoride varnish for patients 3 years of age and over. References: 1. Delivering better oral health - an evidence-based toolkit for prevention, Office for Health Improvement and Disparities’ 2021. 2. Marinho VCC, Worthington HV, Walsh T, Clarkson JE. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews 2013. 3. The use of fluoride varnish by dental nurses to control caries. NHS. Primary Care Commissioning, 2009. 4. https://www.england.nhs.uk/long-read/supply-and-administration-of-medicines-by-dental-hygienists-and-dental-therapists/ 5. https:// www.england.nhs.uk/commissioning/wp- content/uploads/sites/12/2016/09/avoidance-doubt-v4-1.pdf. Name of the medicinal product: Colgate® Duraphat® 50mg/ml Dental Suspension. Active ingredients: 1ml of suspension contains 50mg Sodium Fluoride equivalent to 22.6mg of Fluoride (22,600 ppm F-) Indications: For the prevention of caries in children and adults as part of a comprehensive control programme., desensitisation of hypersensitive teeth. Dosage and administration: Recommended dosage for single application: for milk teeth: up to 0.25ml (=5.65mg Fluoride), for mixed dentition: up to 0.40ml (=9.04 Fluoride), for permanent dentition: up to 0.75ml (=16.95 Fluoride). For caries prophylaxis the application is usually repeated every 6 months but more frequent applications (every 3 months) may be made. For hypersensitivity, 2 or 3 applications should be made within a few days. Contraindications: Hypersensitivity to colophony and/ or any other constituents. Ulcerative gingivitis. Stomatitis. Bronchial asthma. Special warnings and special precautions for use: If the whole dentition is being treated the application should not be carried out on an empty stomach. On the day of application other high fluoride preparations such a fluoride gel should be avoided. Fluoride supplements should be suspended for several days after applying Duraphat®. Interactions with other medicines: The presence of alcohol in the Duraphat® formula should be considered. Undesirable effects: Oedematous swelling has been observed in subjects with tendency to allergic reactions. The dental suspension layer can easily be removed from the mouth by brushing and rinsing. In rare cases, asthma attacks may occur in patients who have bronchial asthma. Legal classification: POM. Product licence number: PL 00049/0042. Product licence holder: ColgatePalmolive (U.K.) Limited, Goldsworth Place, 1 Forge End, Woking, Surrey, GU21 6DB. Price: £22.70 excl VAT (10ml tube) Date of revision of text: June 2024.

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Six million toothbrushes and toothpastes delivered as Joe Wicks MBE joins campaign to boost children’s oral health Children across the country have been better supported to look after their teeth as six million toothbrushes and toothpastes have been delivered directly to nurseries and schools, government and Colgate-Palmolive announced today (13th October 2026), celebrating one year of the national supervised toothbrushing programme. As the programme enters its second year, Fitness coach, author and founder of The Body Coach Joe Wicks MBE has joined the initiative to help parents, teachers, and children build better brushing habits. His role will be focused on sharing practical tips for busy families to help make brushing for two minutes, twice a day second nature. The five-year collaboration aims to boost oral health among children across the country, supported by Colgate-Palmolive’s commitment to donate over 23 million toothbrushes and toothpastes. It is also providing educational materials through its Colgate Bright Smiles, Bright Futures initiative, and a public-facing children’s oral health campaign supporting the NHS, developed with its experience of global oral health education. The government introduced the supervised toothbrushing programme to tackle a longstanding children’s oral health crisis. The most common reason children aged 5 to 9 are admitted to hospital is to have treatment for decayed teeth. 1 in 5 children aged 5 have experienced tooth decay in England, with higher rates of up to 1 in 3 in more deprived areas. The programme is tackling these levels of poor health by ensuring children get the support they need to learn positive habits and prevent tooth decay, in turn helping to avoid

related illness, poor oral health later in life and safeguarding their healthier futures. Health Minister James Frith said: "One year into our national supervised toothbrushing programme, we are already seeing incredible progress in tackling the children’s oral health crisis. Delivering six million toothbrushes and toothpastes so far shows the power of focusing on prevention to give every child the best start in life. We're working hard to improve the oral health of the nation and our partnership with Colgate-Palmolive and the support of Joe Wicks MBE are so vital to achieving that goal.” Fitness coach, author and founder of The Body Coach, Joe Wicks MBE, who is joining the initiative, said: “As a parent I know how busy family routines can be, but brushing for two minutes, twice a day is one small habit that can make a real difference to children’s health and confidence."Children’s oral health is part of their wider wellbeing

and building good habits early can help set children up for healthier futures. "I’m proud to support Colgate-Palmolive and the government for the second year of the supervised brushing scheme to help parents, teachers and kids feel confident building healthy habits that last a lifetime.” Ricardo Cardenas, Senior Marketing Director at Colgate-Palmolive, said: “Colgate-Palmolive is a caring, innovative growth company that is reimagining a healthier future for all. As part of our purpose, we believe every child deserves the chance to have a healthier smile. We are thrilled with the milestones achieved in the first year of our partnership with the UK Government, and are proud of our impact through Colgate Bright Smiles, Bright Futures (BSBF). “Globally, BSBF has reached over 2 billion children and their families since 1991 with free oral health education and dental screenings. Since expanding to the UK in

The Peak of Scaling Performance

2014, the program has reached over 18 million children across the nation with oral health education and donations of essential health and hygiene products. “The supervised brushing scheme is making a real impact in preventing tooth decay and ensuring brighter futures for new generations. We want all children, regardless of needs or circumstances, to be fully equipped with the education and tools they need to keep improving their oral health every day.” To ensure habits continue outside the classroom, the partnership provides children with brushing kits to take home, alongside educational materials for families and support over school holidays.The scheme works alongside wider public health measures announced by the government, including £21.5 million in government funding for supervised toothbrushing so far, water fluoridation and the biggest overhaul of school food standards in a generation. Targets to reduce sugar and salt, and guidelines to improve labelling in baby food and drink, were also published in 2025 with industry given until February 2027 to make these changes. Three million more courses of NHS dental treatment have been delivered compared to the year leading up to the general election and 7.2 million children (60%) accessed dental care – which is higher than before the pandemic. The government is also bolstering the workforce through the biggest sustained expansion of dental school places in twenty years and getting overseas qualified dentists living in the country into work.Parents and families looking for advice on children's oral health and daily brushing routines can visit colgate.co.uk or follow #BrushWithUs. ■

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CONTENTS

A welcome from the editor

The Probe. Informing the profession since 1959.

It’s November – and you know what that means! Mouth Cancer Action Month is upon us.

This year’s campaign message, “Change is Your Sign: Remove the doubt, get checked out”, is a timely reminder for patients and the profession alike that spotting changes early can make all the difference. And it has never been more important: according to the Oral Health Foundation, cases of oral cancer in the UK have risen by 38% in the last 10 years. With that in mind, we have two must-read pieces in this issue. Over on page 9, the DDU’s Una Man sets out practical advice to increase the chance of an early diagnosis. It covers everything from recording your examination and following up patients who miss reviews to knowing exactly when to make a referral. It’s essential reading for every member of the dental team. Then, on page 60, Dr Rachael England, Head of Policy and Advocacy at the Oral Health Foundation, argues that mouth cancer prevention needs more than awareness. Drawing on the charity’s new report, Tobacco, Alcohol, HPV: Closing the Risk Factor Gap, she explores why chances to reduce risk are being missed, and what dental teams, commissioners and government can do about it. You can read the full report at dentalhealth.org/mouth-cancer-risk-report

E: james.cooke@purplems.com T: 01732 371 581 Follow us: @theprobemag

Whether it’s a patient in the chair or a policy on the table, we all have a part to play this month. Enjoy the magazine! APPEARING IN THIS ISSUE Some of the industry experts you’ll find throughout the following pages

CONTENTS... 3

News

Viewpoints – Brush with balderdash

54 Ollie Jupes Former NHS dentist Dentist Gone Badd

Dean Hallows Managing Director Dental Directory.

Dr Wahab Shakir Principal Dentist Museum Dental Suites

Dr Selvaraj Balaji Principal dentist The Gallery Dental Group

Paula Conwell Litigation Solicitor Dental Protection

Dr Zubair Sacranie President-Elect. ADI

Dr Yousuf Ibrahim Founder ToothRevive

Dr Rachael England Head of Policy and Advocacy Oral Health Foundation

Published by Purple Media Solutions The Old School House, St Stephen’s Street Tonbridge, Kent TN9 2AD Tel: 01732 371 570

The Probe is published by Purple Media Solutions. Registered in England. Registered number 5949065 Managing Editor: James Cooke Commercial Director: Gary Henson Divisional Administrator: Francesca Smith

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Practice – Combining aesthetics and performance

Oral Health – Decoding non-compliance

Case Study – Staged custom fibre post technique

Case Study – Treating vertical and horizontal bone loss

Professions – Alleged failure to obtain informed consent

10 Production Designer 1 : Lorna Reekie Production Designer 2: Rob Tremain Digital Content Manager: Stephen Wadey Circulation Manager: Andy Kirk Managing Director: Ed Hunt Regular Contributors: Sara Hurley, Lisa Bainham, Alun Rees, Dhiraj Arora, Ollie Jupes and Pam Swain E-mail news, stories or opinion to james.cooke@purplems.com Circulation/Subscriptions: The Probe Subscriptions, Perception SaS, PO Box 304, Uckfield, East Sussex, TN22 9EZ, Tel: 01825 701520, https://purplems.my-subs.co.uk ©Purple Media Solutions Ltd, 2014. All rights reserved. ISSN 0032-9185. The publisher’s written consent must be obtained before any part of this publication may be reproduced in any form whatsoever, including photocopies, and information retrieval systems. While every effort has been made to ensure that the information in this publication is correct and accurate, the publisher cannot accept

Treatment – Advancing endodontic outcomes with pulpotomy CPD from GC

CPD from A-dec

CPD from VOCO

Oral Health Foundation – Mouth Cancer Action Month

Events – Dentistry Show London

The Dental Awards 2026 – Dental Hygienist of the Year: Rhianna Clarke

Products

Business & Finance – Brace yourself!

36 liability for any consequential loss or damage, however caused, arising as a result of using information printed in this magazine. The views expressed in The Probe are not necessarily the views of the magazine, nor of Purple Media Solutions 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 outside the terms of control may subscribe at the following rates: UK personal £75; UK institutional £95; Europe £225; rest of the world £225.

Scan to explore The Probe’s back catalogue online or visit the-probe.co.uk/issues Printed by Buxton Press

Other titles in the dental portfolio include:

For all enquiries, contact James Cooke, editor, at james.cooke@purplems.com or call 01732 371 581

The Probe | November 26

30/10/2026 14:09:57

Lighting the way for tomorrow's clinicians.

THE FUTURE OF DENTISTRY IS ALREADY IN THE CLASSROOM Illuminate is Acteon's national education initiative giving dental, hygiene and therapy students hands-on experience with intraoral imaging, while building confidence in patient communication and digital dentistry. Through structured learning and a national clinical case study competition, students can put those skills into practice and prepare for modern clinical care.

Hands-on experience with the Acteon C50 intraoral camera

Judged by leading figures from across dentistry

Structured education + national clinical case study competition

MEET THE JUDGING PANEL

Dr Raabiha Maan

Dr Amit Patel

Donna Schembri

Dr Bhupinder Dawett BDS MDPH PhD

Dental schools can register until TH

NOVEMBER 2026

KNOW AN EDUCATOR OR DENTAL SCHOOL WHO SHOULD BE INVOLVED? SCAN TO SHARE ILLUMINATE.

Dr Randeep Singh Gill, BDS

Amy Hayes

Dr Shameek Popat

Louisa Clarke

Intraoral imaging is increasingly central to how clinicians diagnose and communicate with patients. Bobby Mills-Pew Lecturer & Clinical Supervisor Greater Manchester Hygiene and Therapy Programme

acteon.foleon.com/uk/illuminate/

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viewpoints

Brush with balderdash

few weeks ago, my wife and I went to see a matinee performance of Jeremy Bowen’s Truth Under Fire, where the BBC’s International Editor discussed his four decades of reporting from global conflict zones. I am an unashamed fan of Jeremy Bowen and, to me, he’s always oozed impeccable integrity and epitomises the high standards of what I still believe is the BBC’s inherent, objective, accurate and truthful news service. Jezza also once wore a magnificently luxuriant moustache early in the 90s, which I tried to emulate. I gave up when I realised I just hadn’t got the hormones and after some deep reflection also concluded that I looked slightly sinister – perhaps not a basis from which to build a sound practice base. At the beginning of his talk, Mr Bowen asked the audience if they ever struggled in discerning what is the truth against what is artificial intelligence slop. It was a question that struck home since around that time I had been quietly seething about the avalanche of AI misinformation that had been slithering into my social media feeds regarding what appears to be the miracle saviour of the world’s teeth – hydroxyapatite. The adverts were absurd. Many of them showed video of ‘patients’ squirting gels from syringes on to their teeth and gums. Miraculously, gingivae reattached, bone grew around periodontally compromised teeth, virtually demolished mandibular molars were restored to their true anatomical form and, in a number of these adverts, wide upper central diastemas were closed beautifully, with preternatural speed. Looking at these sorts of products as a former professional, the claims made for them are clearly risible, but what is really disturbing is the fact that the manufacturers often claim they are endorsed by dental professional bodies. Advertised as “A Complete At-Home System for Caries-Related Defects & Tooth Structure Repair” – one product claimed to be “Approved and Officially Recognised by the British Dental Association (BDA)”. I checked. As you doubtless suspected, it doesn’t have anything of the sort. I also checked out the ‘practitioner’ under whose Facebook profile the advert was posted, one Dr Thomas Harrington. Under his name, on his profile, he claims to be a ‘Dentist and dental surgery [sic]’. He also claims to be a ‘Consultant periodontist with 20+ years of clinical experience’. I checked on the GDC’s dental register. There is no such registrant and, since he gives his address as ‘28 Example Street [a clue?], Marylebone, W1G 9XX’, I thought I ought to check that out as well. Of course, it doesn’t exist either. Another ‘Consultant periodontist with 20+ years of clinical experience’ who believes ‘no implant beats a natural tooth’ (amen to that) also isn’t a registered dentist, despite giving his address as 43 Marylebone High Street,

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London W1U 4QD. That particular property actually houses a high-end Italian stationery and paper goods brand, NOT a consultant periodontist with 20+ years of clinical experience. His postcode is wrong as well. You let him down, AI. This ‘specialist’ promotes an ‘advanced formula’ periodontal repair gel ‘Endorsed by the British Society of Periodontology and Implant Dentistry’. I checked: it isn’t. Not only is it not endorsed by the BSP, but there is also no clinical evidence supporting its claims of gum regeneration or reversing bone loss. Many apologies – I’m aware I falsely built your hopes up there. The WORST thing is that this supposed dentist is depicted as a good-looking young man – except the people who created the advert appear to have actually stolen a photograph of a REAL dentist who works in Suffolk. Another fake practitioner on Facebook (this one who claims to work in the USA), pictured sitting with a stethoscope around her neck in front of a framed degree on the wall with a completely different name on it, endorses a ‘CavityRepair Gel’. This product claims to bring professional, clinic-grade technology directly into your home. Based on 10% nano-hydroxyapatite and ‘backed by extensive global clinical literature’, it is said to be FDA recognised. Yet, it isn’t backed by the FDA. This product is said to work by ‘magnetic-like ionic forces’, which help it penetrate deep into microcracks and cavity holes to ‘precisely eradicate decay-causing bacteria and trigger rapid mineral recrystallisation’. It claims to deliver visible repair of teeth ‘in as fast as one hour’. This is the product that can rebuild your demolished carious molar,

fix your mesial incisal fracture and close your sizeable upper central diastema. Now there’s a lot of talk currently about whether AI will kill mankind off in the next 10 years or so. I WAS a sceptic until I saw these AI-generated dental ads. Certainly, I will be a goner in a couple of years after the effect this balderdash is having on my blood pressure. As you know, once you’ve watched one of these ads a couple of times because you couldn’t believe it the first time, the algorithm hand-feeds you more of the same, ad infinitum, until you start endlessly looking to see whether UK dentists are routinely recommending hydroxyapatite products for protection against caries. Mercifully, fluoride remains the gold standard. What is really worrying is when Facebook users – unless they are also fake – say things like, ‘I honestly noticed my teeth felt less sensitive and much smoother. Even the rough, damaged spots seem better than before.’ The 180-day hassle-free return and refund policy seems to sway a lot of people to give it a go. Although I haven’t read any negative comments, you do see quite a few laughing emojis ( ) scattered amongst the replies to comments. The thing about AI at the moment – and I REFUSE to call it Super Intelligence (SI) like Trump demands – is that it is directed by humans. The mouthwash/dental gel/dental powder manufacturers direct AI to come up with these unbelievable videos, but could AI be made to do good instead of evil? I understand AI can analyse bitewings and periapical x-rays as well as the bigger stuff – flagging problems for the dentist’s attention. What I wouldn’t be able to cope with if I were still practising is if AI also rated the x-rays as clinically acceptable or not acceptable.

Making orthodontic measurements and predicting tooth movements seems a useful idea, as do the improvements in CAD/CAM in the manufacture of crowns etc. AI-controlled dental robotics is the scarier thing to my mind. Can you imagine a robot trying to get an edentulous patient in the retruded contact position and ending up throttling them in the process? Or checking for crepitus at the TMJs and snapping the condyles off because the robot couldn’t feel a creak during palpation? Having said that, I would have loved a robotic nurse on occasions. Certainly, I would have preferred one over the nurse who always used to tut every time I said anything to the patient, or the nurse who sighed each time I needed to retake an impression. But what I would REALLY have valued would have been an AI aide who fed small talk suggestions into my ear. I always struggled with small talk. I had, basically, two topics to open conversations – ‘Are you going on holiday?’ or ‘What are you doing for Christmas?’ If stuck, I reached for another couple of well-worn, hackneyed, yet useful openers. But enough of that. I see the weather is turning and the traffic’s been bad through town. n

About the author Ollie Jupes is the pseudonym of a former NHS dentist. He monitors dentistry on Twitter X as @DentistGoneBadd

The Probe | November 26

30/10/2026 14:12:12

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VIEWPOINTS

How to increase the chance of an early diagnosis of oral cancer The DDU’s Una Man explains why dental professionals need to remain vigilant for the signs of oral cancer

ccording to the Oral Health Foundation, in the last ten years, cases of oral cancer have risen by 38% in the UK, and deaths from mouth cancer in the UK have increased by 5% compared to last year. Mouth Cancer Action Month provides a good opportunity for all dental professionals to refresh their knowledge, including how to identify and respond appropriately to suspicious lesions. Early diagnosis and treatment significantly improve the five-year survival rate. Allegations of missed or delayed diagnosis feature prominently in complaints and claims relating to oral cancer seen by the DDU. These allegations can include a lack of screening the patient for oral cancer during their check-up, a failure to diagnose a suspicious lesion, or a delay in referring the patient to a specialist. To reduce the likelihood of a delayed diagnosis, the following DDU advice is a useful starting point:

Tell patients about risk factors

It’s sensible to ask patients whether they smoke and have an idea of their drinking habits, so you can provide relevant oral health advice. However, it’s important to

make patients feel at ease, so explain the relevance of your questions and don’t press them if they are reluctant to answer.

Be wary of preconceptions

Don’t dismiss the possibility of oral cancer in patients who do not drink or smoke heavily. Oral cancer has been increasingly observed in young adults, some without a history of risk factors.

Regularly test your ability to recognise suspicious lesions

The BDA and Cancer Research UK have produced an oral cancer toolkit, which includes images and descriptions of different lesions, from oral cancer to other mouth disorders, as well as an examination video.

Document your examination

Your clinical records should show details of your examination, findings (both negative and positive), diagnosis, recognition and referral, as well as any advice given to patients, including returning for a review appointment. Make a clear note of the duration, size, site, shape, colour and texture of any suspicious lesion and, if possible, take clinical photographs.

Ensure you have a system to follow up patients

Practices should have a procedure in place to monitor patients who need to return for review, so they are not lost in the system. Reception staff should alert the treating dentist if one of these patients declines to make a review appointment, or cancels.

Know when to make a referral

The oral cancer recognition toolkit includes a referral decision guide, and you should also keep up to date with NICE guidance. For example, NICE recommends that dental professionals consider a suspected cancer pathway referral (for an appointment within two weeks) for patients with either a lump on the lip or in the oral cavity consistent with oral cancer, or a red or red and white patch in the oral cavity consistent with erythroplakia or erythroleukoplakia.

Follow local referral procedures

Ensure your referral documentation is clear, concise and includes all relevant information, such as the patient’s personal details (age, sex, occupation and contact details), your concerns and clinical images if available. Check referrals for potentially serious conditions have been processed and received.

Talk to the patient

The GDC expects dental professionals to communicate effectively with patients at a level they can understand. Take time to explain your findings clearly and what you propose to do next, such as making a referral. Be calm and ready to answer any questions and consider providing further information to take away.

If in doubt, seek advice from your dental defence organisation

Contact the DDU or your own dental defence organisation if you are notified of a claim or if you have dento-legal concerns. The DDU website has further advice on helping to avoid a misdiagnosis of oral cancer. 

Selling a practice is about more than finding a buyer. Dr Dan Shaffer wanted successors who would keep Pure Dentistry independent, so he could step back and keep treating patients. After seven years, he found them. Whether you’re thinking of selling now or in several years’ time, knowing your practice’s value is the best first step.

From a dentist’s point of view, Lily Head really took the worry out of my hands. Dr Dan Shaffer See how we helped Dr Dan Shaffer plan his next chapter, scan the QR code to read the Case Study.

0333 772 0654 | dentalbrokers@lilyhead.co.uk | lilyhead.co.uk November 26 | The Probe

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practice

Contemporary elegance How Shikha Mittal combined aesthetics and performance to create an oasis of calm in Bedfordshire

t’s fitting that dentist Shikha Mittal’s latest business venture was once a boutique clothes shop. W ith her well-trained eye for aesthetics and balance, she has created the perfect blend of style and comfort in the setting for her aptly named second dental clinic, Aura Dental. The squat practice opened within 12 months of her purchasing the empty shell and now welcomes a growing number of patients, all treated in an environment designed with their comfort in mind. Harmony and function lie at the heart of S h i k h a ’s a p p ro a c h t o d e n t i s t r y. S h e g r a d u a t e d f ro m C a rd i ff U n i v e r s i t y a n d c o m p l e t e d a d v a n c e d postgraduate training in cosmetic dentistry and i m p l a n t d e n t i s t r y. A s a n a c c re d i t e d I n v i s a l i g n p ro v i d e r, s h e h a s e x t e n s i v e e x p e r i e n c e t re a t i n g patients of all ages and is passionate about delivering confident, natural-looking smiles. This new clinic reflects her philosophy of d e l i v e r i n g t h e h i g h e s t s t a n d a rd s o f c o m f o r t , function and aesthetics. Having established Royston Dental Suite in the Hertfordshire market town, Shikha was keen to expand her brand of care to a fresh pool of patients a little further afield – just 30 minutes north – to create ‘something special’. S h e e x p l a i n s : ‘ R o y s t o n D e n t a l S u i t e re m a i n s a n i m p o r t a n t p a r t o f m y p ro f e s s i o n a l j o u r n e y, a n d I ’ m p ro u d o f a l l w e ’ v e a c h i e v e d t h e re . B u t A u r a D e n t a l m a r k s t h e n e x t c h a p t e r. I t has enabled us to create a purpose-built e n v i ro n m e n t t h a t re f l e c t s o u r v i s i o n f o r m o d e r n , p a t i e n t - c e n t re d d e n t i s t r y w h i l e c o n t i n u i n g t o g ro w a l o n g s i d e R o y s t o n . ’ Aura Dental is on Sandy High Street in B e d f o rd s h i re , a g ro w i n g c o m m u n i t y w i t h a c l e a r n e e d f o r h i g h - q u a l i t y, p a t i e n t - f o c u s e d d e n t a l c a re . S h i k h a w a s k e e n t o m e e t t h a t n e e d . ‘The location presented the perfect opportunity to create a practice that serves local families w h i l e a l s o o ff e r i n g a d v a n c e d c o s m e t i c a n d re s t o r a t i v e t re a t m e n t s . We w a n t e d t o b u i l d a business that would become part of the community and establish long-term relationships with our patients.’ The vision for this next chapter was to transform a t i re d b u i l d i n g i n t o a s p a c e f o r e x c e p t i o n a l f a m i l y d e n t i s t r y. To b r i n g t h a t v i s i o n t o l i f e , s h e e n g a g e d A n g l i a n D e n t a l ’s s p e c i a l i s t t e a m s , w h o c o l l a b o r a t e d o n t h e p ro j e c t a n d o v e r s a w e v e r y t h i n g f ro m designs and technical drawings to flooring, cabinetry and equipment. Wo r k s i n c l u d e d a f u l l s t r i p - o u t o f t h e e x i s t i n g space, along with the addition of stud walls, ceilings, doors, electrical and plumbing works, flooring and LED panel lighting. The scope w a s t o c re a t e t w o s u r g e r i e s a n d p re p a re f o r a t h i rd , a s w e l l a s a C B C T ro o m , d e c o n t a m i n a t i o n ro o m , s t a ff ro o m a n d re s t ro o m s . T h e y a l s o installed high-quality equipment and cabinetry t h ro u g h o u t t h e p r a c t i c e . Shikha says: ‘The priority was to create a space that perfectly balances aesthetics w i t h f u n c t i o n a l i t y. We w a n t e d i t t o f e e l c a l m , spacious and welcoming while ensuring every t re a t m e n t ro o m w a s e r g o n o m i c a l l y d e s i g n e d for efficiency and comfort, with the latest t e c h n o l o g y. We m a d e e v e r y d e c i s i o n w i t h b o t h the patient and the clinical team in mind.’ That philosophy is particularly evident in t h e p r a c t i c e ’s i n t e r i o r d e s i g n . S h i k h a c h o s e a soft, neutral colour palette with warm, natural tones to create a relaxing atmosphere,

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c o m p l e m e n t e d b y A u r a ’s s i g n a t u r e n a v y b l u e , gold and cream. ‘Many people feel anxious about visiting the d e n t i s t , s o w e w a n t e d t h e e n v i ro n m e n t t o f e e l m o re l i k e a b o u t i q u e w e l l n e s s s p a c e t h a n a traditional dental practice. The colours also m a x i m i s e n a t u r a l l i g h t a n d c re a t e a t i m e l e s s ,

elegant aesthetic,’ she explains. ‘Everything at Aura Dental has been designed with the patient experience at its heart. At the same time, the practice has been designed to maximise c l i n i c a l e ff i c i e n c y, a l l o w i n g o u r t e a m t o p ro v i d e t h e h i g h e s t s t a n d a rd o f c a re i n a m o d e r n , w e l c o m i n g e n v i ro n m e n t . ’ > > >

The Probe | November 26

30/10/2026 14:14:42

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practice The equipment was selected with the same combination of aesthetics, performance and patient comfort in mind. As part of the fit-out, S h i k h a c h o s e B e l m o n t t re a t m e n t centres – a Belmont Eurus S1 and a Eurus S8 in Cloud and Champagne upholstery, with Belmont 097 X-rays in each surgery. ‘They combine exceptional patient comfort with outstanding ergonomics for the clinical team. The sleek, contemporary design fits perfectly w i t h t h e p r a c t i c e ’s o v e r a l l l o o k , while also providing the reliability and functionality we needed. It was the ideal combination of aesthetics a n d p e r f o r m a n c e . O u r a p p ro a c h to dentistry is centred on quality, precision and patient comfort. The Belmont chairs reflect those values perfectly by combining thoughtful design with innovative technology and exceptional ergonomics. It lets us deliver the highest standard of c a re w h i l e e n s u r i n g p a t i e n t s f e e l as comfortable and reassured as possible throughout treatment.’ For Shikha, the collaboration with Anglian Dental was an important p a r t o f a c h i e v i n g t h e e n d re s u l t . ‘Their expertise helped us choose equipment that complemented both t h e p r a c t i c e ’s d e s i g n a n d t h e w a y w e w o r k c l i n i c a l l y. T h e y u n d e r s t o o d t h e v i s i o n a n d p ro v i d e d v a l u a b l e g u i d a n c e t h ro u g h o u t t h e p ro c e s s , helping us select solutions that o ff e r l o n g - t e r m q u a l i t y, re l i a b i l i t y and comfort.’

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From purchasing the property to welcoming guests at an open day, the entire project took about a year. It was a significant undertaking, covering everything from planning and design to refurbishment, equipment installation and final finishing touches.

‘It was a long process, but the team took the time to get every detail right, and we’re incredibly proud of the finished practice,’ she says. ‘As with any major refurbishment, t h e re w e re c h a l l e n g e s a l o n g t h e w a y, f ro m c o o rd i n a t i n g m u l t i p l e contractors to managing delivery schedules for specialist equipment. H o w e v e r, w i t h c a re f u l p l a n n i n g and excellent collaboration among everyone involved, those challenges w e re o v e rc o m e , a n d t h e re s u l t matches my vision.’ Wa t c h i n g i t c o m e t o l i f e w a s , S h i k h a s a y s , i n c re d i b l y re w a rd i n g . Seeing the finished surgeries, the reception area and the overall atmosphere exceed expectations w a s a re a l h i g h l i g h t . ‘The most rewarding part, h o w e v e r, h a s b e e n h e a r i n g p a t i e n t s t e l l u s h o w re l a x e d a n d c o m f o r t a b l e t h e y f e e l f ro m t h e m o m e n t t h e y w a l k t h ro u g h t h e d o o r. T h a t f e e d b a c k confirms we’ve achieved exactly w h a t w e s e t o u t t o c re a t e . ’

Aura Dental currently operates two surgeries, but ambitious expansion plans are underway. ‘While Aura has the same number of surgeries as Royston, we’ve completely reimagined the layout to maximise space, streamline workflow and elevate the patient experience,’ Shikha explains. ‘We’ve designed the practice with the future in mind and are already looking to expand by adding a third surgery as d e m a n d c o n t i n u e s t o g r o w, w i t h further space upstairs for three more surgeries.’ T h e c a s e f o r e x p a n s i o n i s a l re a d y c l e a r, a n d t h e p r a c t i c e ’s c a re f u l l y considered design provides a strong foundation for the next s t a g e o f S h i k h a ’s v i s i o n : d e e p e n i n g that all-important commitment to q u a l i t y, p r e c i s i o n , c o m f o r t a n d patient-centred care within an e v e r- g ro w i n g c o m m u n i t y. For more information, visit https://belmontdental.co.uk n

The Probe | November 26

30/10/2026 14:14:59

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practice

What a second appointment really costs

hen practices assess the cost of restorative treatment, the calculation usually focuses on the restoration itself. What is often missed is the cost of the interval around it. A traditional indirect workflow moves from preparation and impression or scanning to laboratory manufacture, followed by a return appointment two or three weeks later. Across a year of restorative work, those additional visits create clinical, administrative and diary demands that rarely appear on the treatment plan or laboratory invoice. The second appointment has never been free.

Missed appointments

A return visit involves much more than the patient simply arranging another appointment with reception. It must be booked, confirmed, sometimes reorganised, and ultimately attended. Research into missed dental appointments has consistently highlighted the effect of non-attendance on the efficient use of clinical resources. Practical difficulties attending at the allocated time and simply forgetting the appointment are among the reasons patients fail to return. A missed fit appointment does more than delay the restoration. In a practice already operating close to capacity, rebooking the patient can displace other treatment further down the diary. Chasing, rescheduling, and reconfirming also falls to a team that may have little spare capacity – and none of that time is recoverable.

Not every second appointment will be missed, of course. But every one creates another opportunity for disruption.

Counting the complete chair time

A fit appointment may appear relatively short in the diary, but its true clinical cost includes seating the patient, reviewing the case, administering anaesthesia where necessary, removing the temporary restoration, cleaning the preparation, re-establishing isolation, checking the restoration, and completing the final placement. There is also the time required to manufacture and adjust the temporary at the first visit. Consolidating treatment does not merely move these activities around the diary; it can remove duplicated stages entirely. Digital workflows already demonstrate how individual stages can become faster. A clinical study of lithium disilicate single crowns found that digital impression-taking required significantly less time than conventional impressions, while achieving comparable marginal and internal fit. The digital route was not a compromise on accuracy. It removed unnecessary steps and handovers.

The cost carried by the patient

Time spent receiving dental treatment is also time taken away from work, school, childcare, and other responsibilities. Every additional appointment brings another journey and, potentially, another period of lost income or inconvenience. These factors may not prevent every patient from returning, but they influence

how attractive and manageable a treatment proposal feels. A definitive restoration delivered in one visit can be a far stronger proposition – particularly for patients travelling some distance or taking time away from work. Convenience is not simply a customerservice benefit. It can influence treatment acceptance, completion, and the way patients value the overall experience.

Removing the interval

For many restorative cases, the choice has traditionally felt binary: place a direct resinbased restoration chairside or prescribe an indirect restoration produced by a laboratory or milling workflow. Both approaches remain important, but there is considerable space between them. A direct restoration may not always be preferred for a larger or more demanding case, while an outsourced indirect restoration normally creates the interval and second appointment described above. SprintRay MIDAS introduces a third pathway: a digitally designed, indirectly produced restoration printed in-practice and delivered in one visit. Inlays and onlays support biomimetic thinking where a large direct restoration may not be ideal and a crown may sacrifice healthy tissue unnecessarily. Digital Press Stereolithography uses a single-use resin capsule to process ceramicfilled definitive formulations, printing crowns, veneers, inlays, and onlays in approximately 7 to 10 minutes, depending on indication. SprintRay Studio’s AI-supported proposal is reviewed and adjusted by the clinician before

printing. Scan to placement typically takes 45 to 60 minutes, depending on case. This is not about replacing every direct restoration or every relationship with a dental laboratory. It is about giving clinicians control over which cases they keep chairside – and removing the interval when doing so benefits the practice and patient.

Counting the whole appointment

The commercial case for chairside production should not be calculated by comparing material costs alone. Practices must consider the temporary restoration, duplicated chair time, administration, diary risk and patient inconvenience created by a second visit. When those elements are included, the economics look very different. Practices that consolidate appropriate treatment into a single visit can release clinical capacity, reduce administrative pressure, and offer patients a more convenient experience. They also gain greater control over when the restoration is designed, manufactured, and delivered. The restoration has a visible price. The interval surrounding it does not – but it may be the most expensive part of the entire workflow. For more information about SprintRay MIDAS and the complete SprintRay digital workflow, visit sprintray.com/en-uk.n

About the author Ross Phillips, SprintRay Area Manager UK & Nordics.

SprintRay introduces Midas Restore™ A new definitive restorative material engineered for Midas Digital Press

printRay is delighted to announce the launch of Midas Restore™, a new glass ceramic and zirconia-filled definitive restorative resin. Available from November 2026, Midas Restore is engineered specifically for the Midas Digital Press to produce same-visit crowns, inlays, onlays, and veneers through a streamlined workflow. Other restorative materials are engineered primarily for maximum strength. Midas Restore was designed around definitive restoration behaviour once adhesively bonded to tooth structure, offering: • Strength where it counts • Resistance to occlusal wear • Lasting polish and natural aesthetics

“If we could 3D print enamel, this is it.”

This captures the design philosophy behind Midas Restore: creating a restorative material that balances polish retention, wear resistance, strength, surface hardness, stiffness, and optical performance while working in concert with the natural tooth. “Traditional dental 3D printing forces a compromise: the material has to be fluid enough to print, which limits how highly filled it can be,” said Amir Mansouri, CEO and Founder of SprintRay. “Midas Restore was designed in our material science lab to address that limitation. By pairing a highly filled glass ceramic and zirconia formulation with Midas Digital Press, we can give clinicians access to a new class of definitive restorative materials and bring them into an efficient same-visit workflow.”

Designed around the bonded tooth

Glass ceramics and zirconia are brittle, so for decades their primary defence against crack propagation has been sheer strength – this means excessive tooth reduction and stiffness. Midas Restore’s resin matrix is designed to arrest cracks rather than simply resist them, with its flexural modulus

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closer to dentine than glass ceramic. Once adhesively bonded to tooth structure, the restoration becomes part of a system in which force is distributed between the material and tooth, rather than concentrating stress at the interface. SprintRay laboratory testing demonstrated that Midas Restore retained 98% of its initial gloss after 5,000 simulated toothbrush abrasion cycles, and delivered five times the wear resistance of SprintRay Ceramic Crown over 200,000 cycles – wear performance comparable to a milled hybrid ceramic. In biaxial flexural testing, Midas Restore reached a maximum strength of 215 MPa, the highest of any SprintRay definitive restorative material.1 The surface hardness was measured to be greater than 80 HV, statistically equivalent to a leading nanofilled direct composite and roughly double that of previous-generation printed restorative resins. Its translucency parameter of 13.5 places it in the same range as milled lithium disilicate HT. “We engineered Midas Restore around how a restoration actually behaves once it is bonded to a tooth, not around a single strength number,” said Hossein Bassir, Chief Product Officer at SprintRay. “Filler content, polish retention, wear resistance, modulus and optics are not separate features. They are one system, and the tooth is part of it.”

Made to be pressed

Achieving this combination of properties requires a filler loading that conventional dental 3D printing cannot process. Due to high viscosity, highly filled formulations do not flow into the print zone freely. SprintRay’s Digital Press Stereolithography technology actively pushes highly viscous material into the print zone from sealed capsules. That is what allows Midas to work with filler loads over 75% by weight – and it is why Midas Restore is engineered exclusively for the Midas Digital Press.

Built for same-visit dentistry

For a streamlined digital workflow, clinicians can press multiple units from a single Midas Restore capsule, postcure in four minutes, and polish restorations to final with two wheels in under two minutes. “With Midas Restore, I can achieve a beautiful, lasting surface gloss in just two or three quick polishing steps with a standard polishing system,” said Andrew C. Johnson, DDS, MDS, CDT, FACP, Diplomate of the American Board of Prosthodontics and prosthodontist at OmniSmile Digital Dental Solutions, who participated in the early clinical evaluation of Midas Restore. “That combination of durability, aesthetics and straightforward finishing is what I expect as a clinician from a definitive restorative material. This is an exciting time for digital dentistry.” Midas Restore builds on the Midas Digital Press platform. Since its launch in 2024, clinicians across 33 countries have produced more than 100,000 restorations with Midas. Join them today and revolutionise your restorative workflow. For more information on the New Midas Restore and 3D printing solutions available from SprintRay, please visit https://sprintray.com/en-uk/ n

The Probe | November 26

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practice

Why value beats the lowest price

onsumables and sundries are understandably one of the biggest ongoing costs in any dental practice, primarily due to the fact that they are required for almost every patient that is welcomed for treatment. As such, they are one of the first places principals might look when they need to cut back on spending and tighten future budgets. Everything from gloves, masks and cups, to bibs, needles and infection control products are ordered in large volumes every week, continuously, so even the smallest difference in unit prices can seem like savings worth your while. Therefore, a principal’s instinct may be to shop around and take the cheapest option on each line, as opposed to shopping for everything altogether. It’s an understandable instinct, but it doesn’t always add up. Chasing the lowest price on each individual item can actually mean that practices end up paying more than seeking the cheapest option of each item.

Why the cheapest line isn’t the cheapest order

As with most industries, a practice doesn’t buy one product at a time, but rather, it buys a basket: an abundance of various items, collated into one order, that need to arrive together and on time. For example, a supplier might be the cheapest around

on gloves and still be pricier, or even out of stock, on everything else. By ordering from them for the impressive saving, the practice could still end up making up for it elsewhere and waiting on two or three separate deliveries for what could have been one; not to mention additional delivery charges and potential small order fees. That is how and where the savings discreetly diminish. Furthermore, every additional order will absorb some of the team’s time and every item a supplier cannot get to you means either an inconvenient substitution last minute or a long waiting game that leaves patients and the practice’s reputation suffering. Realistically, a few pennies off a box of gloves doesn’t actually offer so many benefits if the rest of the basket has to come from three other places.

Value is more than the number

Price is obviously comparable across various sellers, measured by the figure itself only. Value is harder to see but actually matters more, because it considers a whole collection of desirable elements for a practice: reliability, availability, discounts, and support – each alongside cost. A supplier that is ever so slightly more expensive per item, but offers an abundance of other significant benefits is often the better deal for the practice – especially in the long run.

This counts for most of the products a practice gets through in the greatest volume. When a core consumable runs low, nobody stops treatment to wait for a delivery; the team reaches for whatever is to hand and allows for safe, effective care. Confidence in your supplier and knowing that the things you depend on will actually be there, order after order, is worth a fair price, because running short carries its own costs that never appear on a price comparison.

Comparing proportionately

The fairer way to assess a supplier is to look at the whole range of things a practice actually orders, rather than simply whichever single item is cheapest that month. A supplier might get a great price on one star product, but if it costs a fair bit more across everything else, comparing a proper spread of everyday lines gives a much more accurate and truer picture of value. It is also representative of how a practice genuinely buys too as a full basket every week, as opposed to a few one-off bargains.

The full range

Dental Directory supplies the full range of dental consumables and sundries alongside its specialist, equipment, engineering services, and more – so a practice can source vital everyday items and the wider support it needs from a single partner.

A comprehensive and stock-maintained range with dependable delivery means the whole basket arrives reliably. This ensures that your practice runs as it should and your patients are consistently satisfied.

Finding value for your practice

The real saving should never mean seeking the cheapest items from various stores, but rather, figuring out which option is the best value instead. Value involves more than merely price, potentially offering practices a more comprehensive approach to patient care through who they choose to work with for the purchase of items like consumables and sundries. A supplier that can offer you the whole basket, dependably, at a fair and comparable price, whilst supporting you when something goes wrong and offering further benefits, is certainly the best bet for your practice. For more information on the products and services available from Dental Directory, visit ddgroup.com or call 0800 585 586 n

About the author Dean Hallows, Managing Director of Dental Directory.

We’ve got you

ost dental practices buy the same way: purchasing an entire basket of items rather than one at a time. This spans across consumables, sundries, equipment, and more, ordered together and needed together so the surgery can consistently deliver excellent patient care. However, when budgets tighten, the instinct might be to search for each item individually from the respective cheapest sources, rather than all as one basket, from one place – one supplier for gloves, another for sundries, and a third for the next stock item.

The whole basket, from Dental Directory

A range that covers everything

Our range is one of the most comprehensive available to UK practices. From the everyday consumables a practice gets through in volume to specialist items, equipment, orthodontic solutions, and engineering lines, we supply it all through a single account. That means a practice doesn’t have to split its ordering across several suppliers to get good value; it can bring the whole basket to Dental Directory and know it’s competitive on products across the board, rather than one star product. Running right through this range is Dental Directory’s very own Unodent line. Spanning consumables, sundries, orthodontic appliances and more, Unodent gives practices trusted, quality products at a price that makes the whole basket more affordable, without compromising clinical integrity. For practices on an even tighter budget, it is one of the simplest ways to bring the cost of the entire basket down while heightening standards.

Valuable service

At Dental Directory, we know that when budgets are under pressure, every order matters. As the UK’s largest dental supplier, we work with over 12,000 practices every day, supporting them as a supplier they can trust to deliver the whole basket, at a price that stands up to comparison.

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Here at Dental Directory, we’ve never believed that value is just about price. A low price on one line actually means very little if the product is out of stock when you need it, meaning it is only available to you later than the rest of the order. Dental Directory holds a significantly larger amount of stock than competitors, with the complimentary logistics to have it in your practice as quickly as possible. Customers can expect same-day dispatch on orders placed before 6pm and free delivery on qualifying orders. This all comes with the service to match; one Google review describes the service they received as “amazing”, going on to say that “Dental Directory has been incredibly helpful and patient with the initial sign up and ongoing enquiries.” So, Dental

Directory is more than just a supplier, we’ve got your back through everything! For practices that order regularly and in volume, dedicated account management is there for you, helping you get the basket right every time.

Why the whole basket matters

Sourcing everything from Dental Directory does more than secure a competitive price, it changes the meaning of value entirely. It cuts the admin of running several accounts, strengthens a practice’s buying position, aligns the ordering process and consistency, and gives one clear point of contact when a query or an item shortage needs attending to.

Your complete practice partner

Dental Directory is the single supplier relationship that covers everything a practice needs to run. Our engineering team is one of the largest networks in the UK, keeping practices functioning compliantly, and our scale means we can hold the range and move it quickly when it’s needed. Whatever your practice needs, from a single sundry to a full surgery, we’ve got you. For more information on the products and services available from Dental Directory, please visit ddgroup.com or call 0800 585 586 n

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PRACTICE

How much revenue is already in your enquiry pipeline? Louise Buscombe explores how better visibility over patient enquiries can help dental practices identify missed opportunities, improve conversion and make more informed decisions about growth

or many dental practices, conversations about growth quickly turn to attracting more new patients. Marketing, campaigns and new enquiries all have an important role to play, but there is another question worth asking first: how much potential revenue is already sitting within the enquiries your practice receives? That question is increasingly relevant as private dentistry continues to represent a significant part of the UK dental market. General Dental Council data published in March 2026 shows that one in five dentists surveyed now provide private care only, while a further 14% spend more than three quarters of their time delivering private care. For practices looking to grow private treatment, understanding how effectively patient interest becomes appointments and treatment is therefore just as important as generating that interest in the first place.

What happens after an enquiry?

A patient may contact the practice with an enquiry, speak to somebody at reception and then go quiet. Another may be genuinely interested in a particular treatment but need more time to think, while someone else may simply miss a call back or never receive the follow-up they expected. Even with the best will in the world, individual enquiries like these can easily be overlooked during a busy week. Over months, they can create a substantial gap between the value of the interest coming into the practice and the treatment that is ultimately booked. Having clear visibility over what happens after somebody first makes contact can therefore make a real difference. Can you see where the enquiry came from, what treatment the patient was interested in and what happened next? Do you know whether they booked an appointment, needed further contact or stopped responding? If an enquiry becomes inactive, is there a clear process for returning to it? For many practices, enquiries arrive through several routes and follow-up activity may sit across inboxes, spreadsheets, handwritten notes and individual team members’ task lists. That can make it difficult to see the whole picture or identify where opportunities are being lost.

Follow-up with purpose

Patients rarely make every treatment decision immediately. They may be comparing options, considering costs, discussing treatment with family or simply trying to fit dentistry around a busy life. A clear and consistent follow-up process can help practices remain part of that decision-making process without relying on somebody remembering to return to an enquiry later. The quality of that follow-up is also important, because patients need relevant information at the right point in their journey rather than repeated contact with no clear purpose. For reception and treatment co-ordination teams, this can be difficult to manage alongside patients already in the practice, telephone calls, diaries and administration. Bringing enquiry activity into one place gives the team a clearer view of who needs attention, what contact has already taken place and what should happen next. DenGro, part of Agilio Software, is a dental CRM designed to help practices capture and manage leads, automate elements of follow-up and track how enquiries progress towards appointments and treatment. Bringing that activity together can help

Discover where potential revenue may already be sitting within your enquiry pipeline, and see how DenGro can help your practice manage, track and convert patient interest more effectively at agiliosoftware.com/lp/hidden-revenue. You can also take the Practice Growth Assessment at agiliosoftware.com/yourpractice-growth-assessment to identify other areas where your practice could unlock further growth.

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teams stay on top of patient interest while helping managers understand conversion performance and where opportunities may be dropping away.

Look beyond lead numbers

It is easy to judge marketing activity by the number of enquiries it generates, but that tells only part of the story. A campaign may produce a high volume of interest but relatively few treatment starts, while another source may generate fewer enquiries but a much greater proportion of appointments and completed treatment. Understanding those differences can help practices direct their time and budget towards the enquiry sources and treatment areas generating the strongest return, while highlighting where additional team training or resource could have the greatest impact. It is also worth looking again at enquiries that did not convert first time. A patient may still be interested but simply not have been ready to proceed because of timing, cost or other personal circumstances, so a thoughtful follow-up can sometimes restart that conversation.

Find the opportunity already there

Before increasing marketing spend or setting a new lead-generation target, it is worth understanding how effectively the enquiries already coming into the practice are being managed. Agilio’s online Hidden Revenue Calculator offers one way to explore where potential revenue could be sitting within existing patient and enquiry activity, while the Practice Growth Assessment can help practices look more broadly at areas that may be limiting growth.

For practice owners and managers, the value lies in having a clearer starting point for decision-making. Sustainable growth depends on more than attracting attention, because practices also need to understand what happens once somebody shows an interest. Greater visibility can help turn that interest into something measurable: where enquiries originate, where they are being lost, which opportunities deserve attention and which activities are contributing most effectively to growth. There may already be considerably more potential within the pipeline than you realise. Understanding where it sits, and what happens to it next, is a useful place to begin.

Reference 1.

General Dental Council. Dentists’ working patterns data for 2026. Published 17 March 2026. Available at: https://www.gdc-uk.org/news-blogs/news/ detail/2026/03/17/gdc-publishes-dentists’-workingpatterns-data-for-2026. Accessed 7 October 2026.

About the author Louise Buscombe is Growth Customer Success Team Manager at Agilio Software, leading Customer Success for DenGro and iGrow. She works closely with dental practices to help them turn more patient enquiries into treatment starts, improve follow-up and make the most of the opportunities already in their pipeline.

The Probe | November 26

30/10/2026 14:22:26

XX_Probe-Nov_ADS.indd 6

28/10/2026 14:36:57

www.the-probe.co.uk

practice

The pitfalls of sterilisation and how to avoid them

n the dental practice, infection control rarely fails as a result of bad intentions. Often, rather, they come as a result of pressures, familiarity, and the erosion of vigilance over time. In busy clinical environments, it’s easy to see how a practice that was once fully compliant slips into risky behaviours, without noticing. These actions arise as a result of time pressures that alter routines, familiarity reducing perceived risks, temporary shortcuts becoming permanent habits, and when responsibility is diffused across a team. Because of this, it’s important that clinicians and the dental team reflect on their infection control protocols regularly, to ensure standards are not quietly slipping.

Potential infection control issues

What starts as cutting corners in infection control to save time – without immediate negative outcomes – can become entrenched behaviours in dental teams, ultimately increasing the risk of contamination. This might mean that ultrasonic cleaners or washer disinfectors are used incorrectly, for example. It’s imperative that gross debris is removed from instruments prior to placing them in the cleaner, and that the units are not overfilled, in line with the manufacturer’s instructions. Correct documentation is another aspect that might fall through the gaps. Retaining documentation of the daily use of each autoclave, in addition to their maintenance, is essential to remain compliant with regulations.

Ensuring a strict dirty to clean workflow is another essential aspect of infection control. It’s important that the team remains vigilant here, with clearly defined areas for dirty and clean objects and processes. Becoming lax about the possibility of splashes created from the dirty sink could mean reprocessed instruments are no longer sterile. Whilst there are far more examples of errors which may occur during infection control tasks, one final key one is simply not following the manufacturer’s instructions for their cleaning systems. Without checking first, individuals cannot know how many items can be loaded in a steriliser, and how to load it properly to ensure it works. To ensure safety, efficacy, and compliance, it’s essential.

Sterilisation pitfalls

When it comes to instrument sterilisation, specifically, there are a number of key areas where problems arise which result in insufficient decontamination and, over time, can be detrimental to the longevity of the autoclave itself. As mentioned, sometimes standards can fall without individuals realising. That’s why it’s important to identify potential pitfalls in order to meet guidelines consistently. Common mistakes may include overloading autoclave chambers, selecting the wrong cycle for the load, poor placement of instruments, and skipping pre-cleaning steps. Each of these can mean that the instruments have not been reprocessed correctly, and are therefore not sterile. Keeping up with maintenance tasks will also ensure that the autoclave is running as it should. This means

daily gasket cleaning, weekly water reservoir refills, and annual servicing. If these are neglected, it may mean instruments are not sterile, and the lifetime of the autoclave is reduced. Similarly, accurate monitoring tools help to ensure that autoclaves are running as they should, and will enable dental teams to catch failures early. Further to this, using distilled water will help to avoid mineral deposits that might damage components if untreated mains water were to be used.

Maintaining reliable processes

Ensuring a practice has the right number of autoclaves for the number of surgeries is key. For example, for practices with 1-2 surgeries, at least 1 is needed, for those with 3-5, 2 are recommended, for 6-8, use 3, and for 9-12 surgeries, 4 or more autoclaves are recommended. Additionally, practices should consider their contingency planning for if one of their autoclaves is out of order, for whatever reason. As such, whilst only 1 is needed for practices with 1-2 surgeries in theory, having at least 2 is preferable for business continuity during servicing, validation, or unexpected breakdowns.

Any service interruption should be kept to an absolute minimum, so it’s important when investing in a new autoclave to consider the longevity of the equipment, rather than focussing on the initial purchase price – including costs such as delivery, validation, and user training. With Eschmann, there are no hidden costs. Eschmann offers unrivalled service and support through its Care & Cover plans, in addition to dedicated support from a nationwide team of engineers. Eschmann is a leading voice in infection control solutions, boasting over 190 years of continuous innovation. Protect your practice with Eschmann and be certain that your equipment is compliant, running with optimal efficiency and minimal downtime. The most effective way to ensure long term and consistent infection control protocols is to build systems that work. This includes ensuring the maintenance of autoclaves in the practice are taken care of exactly when its needed. For more information on the highly effective and affordable range of decontamination solutions available from Eschmann, please visit www.eschmann.co.uk or call 01903 753322 n

About the author Nicky Varney, Head of Marketing, Eschmann.

Infection rejection with good PPE practise

f anybody was asked to describe a dentist’s uniform, they are likely to mention scrubs, gloves, surgery caps and even visors or eye protection. This is because a core pillar of infection control is the compliant use of Personal Protective Equipment (PPE). Creating a physical barrier between the dental practitioner and the patient, PPE reduces the risk of cross-contamination and the spread of infectious diseases. Despite being so noticeable and prevalent, PPE compliance can vary. For example, a study on the Tamil Nadu region in India found that only 60.4 per cent of dentists strictly adhered to the use of PPE in routine dental practice, whilst 100 per cent had an awareness of its role. In the UK, failure to use PPE appropriately breaches the infection control standards as set out by the CQC, putting the dental team, patients and the practice at risk. To avoid this, one area to pay close attention to is when PPE fails and when it needs replacing. Besides dental scrubs, PPE is largely focused on protecting the hands and face. This means wearing gloves for all clinical procedures, and masks, visors or face shields to provide a barrier during aerosolgenerating procedures, during treatment and when decontaminating instruments.

Gloves

As hands directly interact with instruments, surfaces and patients more than any other part of the body, wearing gloves is

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essential to prevent the spread of infectious pathogens. Patients should not be treated until all members of staff in the treatment room are wearing a new pair. However, every appointment carries the risk of needing to replace the gloves, with the principal indications being: • Any tears or rips • Wetness • If visibly soiled • If the appointment lasts an extended period of time e.g. over one hour (this is because hand sweat and latex hydration can cause micro-perforations) Whilst many of these indications can be unavoidable, there are some control measures to reduce the risk of physical damage, as noted in HTM 01-05. This includes keeping finger nails neatly clipped, removing any rings with edges, following the manufacturer’s storage recommendations and ensuring the hands are thoroughly dried before wearing the gloves to reduce friction (which weakens the material).

Facial protection

Like gloves, facial masks must be changed between every single patient or immediately if it becomes wet, damaged or visibly soiled. If a patient requires an extended procedure, masks should be changed at regular intervals of typically 20-60 minutes. Aerosol heavy environments caused by treatments like ultrasonic scaling or highspeed drilling accelerate the need to replace masks within an appointment as

Filling in the gaps

their filtration efficiency decreases. Dental professionals should take care to avoid touching or dangling the mask during or between appointments and they should never be reused.

Pressure of supply shortages

An anxiety worsened by the pandemic was the risk of running out of PPE. On no account should single-use PPE like gloves and facial masks be reused between appointments, even if the dental professional can see no rips or visible signs of contamination. The risk of another pandemic or a disrupted supply chain is low but never zero. In this scenario, dental practices must remain compliant with HTM 01-05 and proceed with caution. This involves triaging emergency cases and using the limited PPE supply to treat those in the greatest need. Out of date PPE must not be used, even as a last resort, and counterfeit or unregulated alternatives should not be supplied either. The dental practice must suspend appointments if the correct PPE is unavailable, and should not open until the supply chain is secure.

Infection control protocols are just as important as PPE maintenance. When removing a used pair of gloves, hands must be thoroughly washed and dried if visibly contaminated. Once complete, the rest of the PPE can be disposed of: plastic disposable apron, then facial mask, then any face and eye protection. After all this, the hands must be washed again. Dental professionals can feel confident in their hand hygiene when using DentiWash, a trusted hand cleanser from Dentisan. Ideal for frequent use, such as in between appointments and PPE changeover, the solution is solvent free and protects against dryness and irritation due to the skin conditioner and emollient included in its unique formula. HTM 01-05 compliant, you can rely on the Dentisan portfolio to protect you, your patients and your practice from harmful pathogens. Because it so frequently used, it can be easy to take PPE for granted and overlook its correct application. However, dental professionals must remain vigilant in maintaining their equipment and staying on the right side of infection control regulations to reduce the risk of disease transmission. For more information about Dentisan, please visit https://dentisan.co.uk n

About the author Jenny Nixon, Business Development Director at Dentisan.

The Probe | November 26

30/10/2026 14:24:04

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practice

Starting from scratch Selling smiles

etting up a squat practice can be an appealing opportunity, offering clinicians the freedom to build a business around their own values, special interests, choice of services and ideas about how they want the practice to operate. However, starting without an established patient base or inherited goodwill, combined with significant startup costs, means income and expenditure do not align to begin with. This creates enormous pressure to establish cash flow, and makes it important for every surgery and treatment to earn its keep.

Keeping treatment moving

Conventional treatment often involves impression-taking or scanning, followed by laboratory manufacture, a provisional restoration and a second appointment to fit the definitive restoration. Clinicians know that provisional restorations can sometimes fail, requiring an additional visit for re-cementation or remake while the laboratory completes the final prosthesis. Choosing a laboratory also involves more than comparing fees. Practical considerations such as location, collection and delivery arrangements, turnaround times and ease of communication all matter, as does the working relationship between clinician and technician. A good laboratory needs to understand the clinician’s prescription in terms of fit, form, shade and characterisation. Where a laboratory is further away or work has to be posted rather than collected locally, turnaround times may be longer and communication less immediate. Impressions or models can also be lost or damaged in transit. These factors can create delays outside the practice’s control, disrupting schedules, postponing treatment completion and ultimately delaying payment.

Keeping treatment in-house

Advances in digital technology have made it possible to complete more stages of restorative treatment within the practice. Intra-oral scanning captures a detailed digital impression, removing the need for conventional impression materials and providing the data needed to design a restoration digitally. Computer-aided design and computer-aided manufacture (CAD/ CAM) then allows that restoration to be designed on screen and produced on site using a milling or 3D-printing system. This keeps far more of the restorative process under the clinician’s control. Rather than sending an impression or scan to a laboratory and waiting for manufacture and return, the practice can move directly from preparation and scanning to design and production, significantly reducing reliance on laboratory turnaround times and shortening the overall treatment process.

Making every appointment count

Completing a restoration in a single visit rather than across two appointments reduces the number of clinical sessions that need to be scheduled and removes the time and cost associated with provisional restorations. Depending on the case, fabrication may involve waxing up the tooth, taking a physical impression, preparing the tooth, loading the impression with bis-acryl provisional material, trimming and polishing

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the restoration, cementing it and adjusting the occlusion. The impression matrix may then need to be disinfected and stored in case the patient returns with a fractured or lost provisional. For a new practice, where chair time and cash flow are especially important, reducing the number of appointments helps treatment reach completion faster and allows payment to be received sooner.

The patient perspective

Patients generally do not enjoy repeated dental visits. Many are balancing work, childcare, travel and other commitments. Where treatment can be completed in a single visit, fewer appointments mean less disruption and a definitive restoration can be provided sooner. Digital impressions may also be more comfortable for patients than conventional impression materials. Efficient, comfortable dental treatment is immensely impressive to patients, and recommendations from satisfied patients can help a new practice grow quickly. A strong local reputation and word-ofmouth can also reduce reliance on costly advertising, helping a squat practice build its patient base without adding significantly to its early overheads.

Investing for growth

Equipment this sophisticated comes at a price and that cannot be overlooked. For a new practice, the question is whether the investment suits its treatment mix and projected demand. However, investing in technology that expands what can be delivered in-house can also increase capability as the patient base grows.

Chairside solutions

For squat practices considering chairside CAD/CAM, the Clark Dental team can advise on the equipment needed to support efficient restorative treatment from the outset. One option is CEREC Primemill, a high-performance milling unit designed for the rapid chairside production of a wide range of restorations including inlays, onlays and crowns. In Super-Fast Milling mode, it can mill a zirconia crown in around five minutes, making it particularly well suited to single-visit dentistry. Clark Dental can help practices specify, install and integrate the system while also providing ongoing technical support as the practice develops, giving clinicians peace of mind and confidence in their investment. Building a squat practice requires careful decisions about where to invest from day one. Where restorative dentistry forms an important part of the business, chairside CAD/CAM offers a way to keep more treatment in-house, make valuable clinical time work harder and support the practice through those crucial early stages. 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 Stuart Clark, Chief Executive Officer at Clark Dental.

ttitudes towards dentistry have changed drastically in recent decades. While oral health remains a basic necessity for everyone, treatment options that address cosmetic concerns have become increasingly popular. These have become a luxury that people seek in the quest to better themselves, to enhance their selfconfidence, and improve their quality of life. For clinicians providing these elective procedures and looking to build a business from them, a whole new set of skills is required in addition to clinical acumen. These include excellent communication and sales skills, which provide the tools needed to boost treatment acceptance in an effective and ethical way.

A thriving market

An independent report published in 2025 forecast continued cosmetic dental demand in the coming years, with up to 20% growth in the field by 2030. The same paper suggested that a third of under 35s in the UK had undergone cosmetic dental procedures in the previous 12 months, spending an average of £3,500. Several factors are driving this trend and will keep doing so for some time. For many people, the reason to seek treatment is to boost self-esteem. This has been the same for some time, with an increase in confidence being the primary motivator for 43% of patients surveyed back in 2018. Social media is a major external source of inspiration for many individuals. One systematic review found that 72% of patients were motivated by digital influencers, with this content having a significant impact on their treatment decisions. Platforms like Instagram, TikTok, and YouTube proved most popular, especially when promoting procedures like teeth whitening, veneers, and orthodontics. This demonstrates a substantial opportunity for dental professionals to expand their services in order to meet patient demand and grow earning potential. To build a successful and sustainable business in the field, it is important to consider how to discuss treatment with patients, manage expectations, and market services.

Ethical yet effective

It goes without saying that any ‘selling’ in dentistry must be ethical and the procedures recommended must remain in the best interests of the patient. That said, aesthetic dental solutions – especially minimally invasive options – have been shown to enhance oral health-related quality of life, offering justification for this type of care in many situations. Effective communication is the cornerstone of ethical dental care. Not only is it crucial

for informed consent, but it will also lay the foundations for a positive patientpractitioner relationship. The key is to listen carefully to what patients are looking for, to discuss treatment in clear and easy-tounderstand language, to encourage a twoway conversation in which patients can ask questions or provide feedback, and to follow up with patients after a consultation. This patient-centred approach puts them in the driving seat, gives them autonomy over their decisions, and nurtures their engagement in the treatment process and beyond.

A shared responsibility

While rapport between patient and practitioner is crucial, this is not the only exchange that will influence the patient experience. Other members of the team need to be involved to increase treatment acceptance and ensure a seamless journey throughout. It is particularly important that the treatment coordinator (TCO) or practice manager are kept up to date as they will play a vital role in supporting the patient to make the right decisions for them. For the TCO, who will likely remain a main point of contact for the patient during their treatment, excellent patient communication skills will add significant value to both the patient and the practice.

Remove the guesswork

While the fundamentals of good communication and sales will be obvious, their successful implementation can be more complex. To create and deliver a comprehensive communication strategy, the dental team will benefit from dedicated professional training and support. Not only does this expose you to new ideas and evidence-based methodologies, but it also provides an opportunity to practise your new skills and seek expert guidance on how to optimise impact in your own practice. The popular Sales & Communication Mastery for Dentists & TCOs course from IAS Academy offers all this and more. Delivered by marketing scientist Prav Solanki, the one-day programme provides an advanced set of tools designed to help professionals boost sales, marketing and communication. With the easily actionable, yet proven techniques explored on the course, dentists and TCOs will be wellprepared to define and execute a unified, practice-wide approach to sales and communication. The result? Highly satisfied patients, increased loyalty, boosted profits, and strong business security. So, if you’re looking to diversify your services and capitalise on the growing demand for high-quality cosmetic dental services, there’s never been a better time to get started. Effective communication is crucial to maintaining patient rapport, encouraging treatment acceptance, and building your business. Don’t leave it to chance – get a strategic plan in place today. For more information or to book the course, visit courses.iasortho.com/courses or call 01932 336470 (Press 1) n

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

The Probe | November 26

30/10/2026 14:25:29

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www.the-probe.co.uk

oral health

Starting conversations

very November, you may notice an influx of gradually growing moustaches adorning the upper lip of young men and marking the beginning of Movember. In 2025, there were over 250,000 official sign-ups to Movember – a month of fundraising that campaigns to improve awareness of men’s health and encourage the conversations that previously have been stigmatised. These silent concerns extend to the oral cavity, where men are about one-third less likely than women to seek preventive care services and visit the dentist less frequently. This is concerning when accounting for the associations that oral diseases may have with wider conditions. Movember is therefore an excellent opportunity to have open discussions with male patients and investigate the available research into systemic health problems.

Prostate cancer

As the most frequently occurring cancer among males and the second foremost cause of cancer-related death in the Western world, prostate cancer is a worry, and often a focus for Movember . As well as its mortality rate, the impact a diagnosis can have on quality of life, both physically and mentally, is enormous. The gradual increase in the number of ageing men is a further worry due to the increased prevalence of prostate cancer – it mostly affects men over 50 years old. But there is hope: Jeremy Clarkson made headlines earlier this year following his diagnosis and prompted thousands of men to complete online risk checkers, massively boosting awareness.

Along with age, a familial history of prostate cancer and having a Black African or African Caribbean ethnic background are also notable risk factors. The symptoms do not materialise until the cancer spreads from the outer part of the prostate and eventually presses on the urethra. Initial signs can be a weak or staggered urine flow. Further symptoms include erectile dysfunction, blood in the urine, lower back pain, and losing weight without trying to. For dental practitioners, an area to note is the association between periodontitis and prostate cancer. Whilst a direct link has yet to be discovered, ongoing research is worth taking note of.

Periodontitis problems

Prostate cancer is associated with chronic inflammation, and chronic inflammation is associated with periodontitis. P. gingivalis, the harmful bacterium linked to severe gingival disease, has the ability to spread through the bloodstream, with the potential to affect the prostate tissues and create a chronic inflammatory microenvironment. If this happens, it could promote the transformation of prostate disease to cancer. In one study, prostate tissue samples were selected from 30 patients with reported inflammation, benign hyperplasia, and cancer – DNA from periodontal pathogens was detected in every tissue. Of further note is that, running parallel, individuals with P. gingivalis in their oral cavity have a 59 per cent increased risk of pancreatic cancer, emphasising the ability for oral microbes to migrate and contribute to organ inflammation. Whilst a different part of the body, the relationship between the oral cavity and cancer is concerning.

Surface pressure

Compounding the issues of managing men’s health is the societal pressure to not complain – something that Movember hopes to change each year. In a survey, 48 per cent of men agreed that they felt obligated to ‘tough it out’ when faced with a health concern. One-third also said that talking about their health and any anxieties might make others see them as weak, reducing confidence and creating a feeling of isolation. This mindset partly explains why male patients are less proactive in their oral care and attend fewer dental appointments than female patients. Moreover, patients diagnosed with cancer, prostate or otherwise, are at a greater risk of oral disease during treatment, increasing the need for superior oral care habits. However, as cancer is more prevalent in older demographics, this is also the age group that may have grown up with the more traditional, stoic attitude to health, making it a challenge to instil a proactive approach to self-care.

Proactive equals preventive

However, this mindset can be changed through a stronger educational awareness of how the oral cavity is connected to wider systemic problems. Dental practitioners should also encourage male patients to visit the dentist more and optimise their daily oral care routine by integrating interdental cleaning to reduce the risk of oral diseases. A brilliant solution that simplifies interdental cleaning is the CPS brush from Curaprox. Offered in five sizes, each brush has a patented surgical wire that slides into narrow interdental spaces and uses an

umbrella effect to remove harmful particles in a single motion. Gentle on the gingivae yet tough on plaque, each brush prevents biofilm build-up and lowers the risk of periodontitis for a healthier smile. Men tend to have lower health awareness, less consistent oral hygiene and are more likely to avoid healthcare. Events like Movember are a brilliant opportunity to remind male patients of why proactive approaches to health are so important, especially for the oral cavity. By fostering positive conversations and raising awareness of the link between oral diseases and systemic conditions, dental practitioners can improve health outcomes for male patients. To arrange a Practice Educational Meeting with your Curaden Development Manager please email us on sales@curaden.co.uk For more information, please visit curaprox.co.uk and curaden.co.uk n

About the author Andrew Turner, Head of Marketing UK & Ireland at Curaden.

Decoding non-compliance

ne of the most important aspects of the dental professional’s role today is educating patients on the importance of oral health. This means sharing information on their current dental status, helping them reduce the risk factors for future health issues, and recommending products, techniques, and treatment to elevate oral hygiene and maintain long-term dental wellbeing. However, it is not unusual for a patient to seem receptive to advice during an appointment, only to return at a later date having not implemented anything at all. This non-compliance must be addressed in a sensitive yet effective manner if they are to genuinely improve their oral health.

Factors affecting compliance

There is a vast array of possible factors contributing to patient compliance. Health education, oral health awareness, and satisfaction with previous treatment have all been shown to influence patient response to professional advice. These may be reasons for missed appointments too, as patients might not fully appreciate the value of regular dental care and, therefore, consciously or unconsciously de-prioritise their visit. The literature has also found that some patients are not fully aware of their responsibility to maintain or improve their dental wellbeing,

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further reducing the chance that they will take time to make changes. There are practical considerations to take into account. Even if a patient understands the recommendations they receive, a lack of time in their everyday life might prevent them from adding a step into their oral hygiene routine. Similarly, a lack of dexterity could make it difficult or impossible for them to perform effective dental hygiene, especially when it comes to interdental cleaning.

Improving communication and recall

A lot of the above can be rectified with improved patient education, which centres on effective communication. It is crucial that this is a two-way street – practitioners must provide information but also listen carefully to their patients and make an effort to understand their perspective or concerns in order to build a good rapport. Other than that, it’s about being open and honest, remaining friendly and non-judgemental, and giving patients the opportunity to express themselves. Digital solutions can also help, having already revolutionised many other areas of dentistry. Utilisation of suitable technologies or software programmes often provides more flexibility and efficiency in how key information is exchanged and accessed by patients in the time between appointments. Animations are particularly effective in improving patient

recall of important recommendations from the professional team, as they overcome potential health literacy barriers and encourage patient engagement. This could be used to explain an individual’s current oral health status or risk profile, as well as to detail proposed treatment procedures for more informed and confident consent.

Maintaining simplicity

Another way to help patients recall and implement recommendations is to keep them simple and specific. Guiding patients to make important changes one step at a time can make the process less daunting and remove some of the perceived barriers before they become an issue. It’s also vital to tailor advice according to the individual. For example, if they have confided that time restrictions make it difficult to maintain a high-quality oral hygiene routine, don’t make suggestions that will require even more minutes every day. For those with manual dexterity challenges, avoid products that they will struggle to manoeuvre. To further support patients in their decisionmaking, be specific in the solutions they should use, how, and when. Give them examples and recommend by brand so they know exactly what you mean and there is no ambiguity about what you feel would benefit them most. When it comes to enhancing interdental cleaning, for instance, the Cordless

Advanced water flosser from Waterpik™ is proven to remove up to 99.9% of plaque bacteria from treated areas in as little as 3 seconds, and is up to 2x as effective as string floss for improving gingival health. The 360º rotating tip makes it easy to use by those lacking dexterity and 4 unique flossing tips cater for those with restorations, fixed braces, and more. What’s more, Waterpik™ is the only water flosser brand approved by the Oral Health Foundation, providing complete peace of mind for you and your patients.

From insight to action

Patient compliance is a complex and challenging aspect of modern dentistry. It requires excellent communication between practitioner and patient, which will help to remove barriers to enhanced oral health. Simplifying the message, being specific in recommendations, and tailoring guidance to suit each individual will further elevate oral hygiene standards for the best results. For more information on WaterpikTM water flosser products visit waterpik.co.uk n

About the author Rachel Bennett, dental hygienist at Bupa Dental Care Leeds and Churchview Dental Care.

The Probe | November 26

30/10/2026 14:27:07

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28/10/2026 15:13:49

www.the-probe.co.uk

oral health

Rinsing right

ooth brushing and interdental cleaning form the foundations of any effective oral hygiene routine, but a significant number of patients still treat mouthwash as an afterthought – if they use it at all. Recommending the right rinse to patients, and encouraging it to be used the right way, can passively strengthen the results of everything else a patient already does at the sink, and it costs nothing more than a moment of conversation at the chairside.

What mouthwash actually adds

Mechanical cleaning with a toothbrush and interdental tools removes plaque from accessible surfaces, but despite the ergonomics and innovations, they cannot reach every single corner of the mouth. Mouthwash acts as a supplement rather than a substitute, reaching residual plaque that brushing and flossing leave behind. Reviews consistently find that mouth rinses used alongside brushing provide an additional reduction in plaque and gingival inflammation compared with solely brushing alone. The effect is not dramatic on its own, but when compounded with a strong existing routine, it builds over weeks and months, particularly around the gingiva and in areas patients tend to brush less thoroughly.

Not all formulations work the same

Despite what many patients might believe, there are certainly tiers to different

combinations in the creation of mouth washes, and some come out much farther on top than others. Essentially, the active ingredient in a mouthwash determines what it can achieve, so a generic recommendation rarely supports each and every respective patient. Fluoride rinses strengthen enamel and help prevent decay, while antimicrobial agents such as chlorhexidine target the bacteria responsible for plaque and gum disease. Combining the two offers a remarkable advantage: research comparing fluoride, chlorhexidine, and fluoride-chlorhexidine rinses found that the combined formula produced a significantly greater reduction in salivary bacteria than either ingredient used alone. For patients managing bad breath, zinccontaining formulations offer an additional layer of support without diluting the antibacterial or remineralising effect, addressing a concern that brushing alone rarely resolves.

Timing and technique

Patients also often assume any time is a good time to rinse, but timing very much affects how well a mouthwash works. Rinsing immediately after brushing can wash away the concentrated fluoride left behind by toothpaste, reducing its benefit before it works on the enamel. Advising patients to rinse at a separate and specific point in the day – after lunch or before bed for example – allows both the toothpaste and the mouthwash to work in conjunction without interference.

FLEXI interdental brushes and PREVENT Gel, giving clinicians a complete prevention toolkit to recommend as part of one consistent routine.

A habit worth recommending

Furthermore, consistency matters more than frequency as a rinse used daily as part of an established routine will outperform one used sporadically, regardless of how strong the formulation might be. A short, simple instruction at review appointments is usually all it takes to correct the habit, and patients tend to respond well to a clear, practical rule rather than a lengthy explanation of different chemistry formulations.

Supporting patients properly

WASH & PREVENT mouthwash from the TANDEX range gives practices a straightforward way to recommend the right rinse for the right patient. PREVENT WASH combines fluoride and chlorhexidine for a double-active antibacterial effect, while PREVENT plus zinc has been developed for extra protection against bad breath. Both are alcohol-free with a peppermint flavour, making them comfortable for daily use – for all! The range also sits alongside the

Mouthwash will never replace brushing or interdental cleaning, but dismissing it entirely inhibits a significant sector of the oral hygiene routine for so many. For practices looking for a simple way to strengthen patient routines, a considered mouthwash recommendation that has wellresearched formulation is one of the easiest changes to make. TANDEX is giving dental professionals the opportunity to win a FREE FLEXI Educator Kit by answering just a few questions! Enter the quiz by scanning the code or following this link https://form1.tandex.de/ / For more information on Tandex’s range of products, visit https://tandex.dk/ / Our products are also available from DHB Oral Healthcare https://dhb.co.uk/ n

About the author Jacob Watwood on behalf of Tandex Rodericks Dental Partners Associate dentist at Fieldside Dental Practice

Diet, chewing habits, and jaw load

iet is one of the most fundamental aspects of daily life, yet its influence on jaw function is far from the first consideration for patients. The foods we choose and how frequent we eat them, combined with the way we chew, each place taxing demands on the masticatory system. For most people these demands have no consequence, but for those at risk of – or predisposed to – temporomandibular disorders (TMD), the compounded load of these habits can significantly contribute to the onset and persistence of TMD symptoms. While the links between occlusion and stress are often well-understood and explored in relation to TMD, the everyday impact of eating is discussed far less often. Dental professionals are in a unique position to be able to support these patients, and therefore appropriate knowledge is necessary. Namely, they have the opportunity to recognise dietary patterns that might be contributing to strain on the jaw, and to then guide patients towards habits that reduce the load placed on the temporomandibular joint (TMJ) and its surrounding musculature.

The mechanics of chewing

Chewing is a repetitive, high-frequency motion, with significant force generated during mastication. Hard, tough, or particularly chewy foods require greater, more prolonged effort, and extended action can fatigue the muscles over time. Foods such as crusty bread, tough meat, crunchy vegetables, and chewy sweets all require

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a greater engagement of the masticatory muscles than softer foods, and patients are often unaware of just how much effort certain textures require. Chewing gum is one common example that is often considered harmless. However, frequent and sustained gum-chewing means that the jaw hardly gets a break from continuous low-level loading. For patients experiencing jaw fatigue already, this routine activity can worsen symptoms throughout the day. Unlike eating, where chewing is dependent upon the duration of a meal, gum can be – and often is – chewed for hours at a time, taking muscular demand well to a level way beyond what the system would otherwise experience.

Eating behaviours

Beyond what food is being eaten, the way patients eat can also introduce additional strain. For example, biting nails or chewing on pens work the jaw without the reward of food – parafunctional behaviours that place demand on the system without even benefitting the body with nutrition. These habits are of course, usually unconscious, and difficult for patients to identify on their own, making professional guidance extremely useful. Another pattern that often goes unnoticed is chewing predominantly on one side. Unilateral chewing can create asymmetric loading across the joint and surrounding muscles, which over time may contribute to imbalance and localised fatigue. Patients may adapt into this this habit in response to dental pain or discomfort elsewhere, meaning

the underlying cause and the subsequent strain can become intertwined. This makes identifying and addressing the original source of discomfort integral, meaning clinicians can break the vicious the cycle, rather than treating one problem alone.

Diet, inflammation, and recovery

The composition of the diet itself can also influence how the body manages discomfort. Diets high in processed foods and low in nutrients have been found to affect the body’s capacity to manage inflammation and support tissue recovery. While diet alone does not cause TMD, nutritional factors can form part of the wider picture when symptoms don’t subside quickly. Caffeine is another consideration. High intake can heighten muscular tension and, for some patients, contribute to clenching behaviours that add to the load already placed on the jaw through eating. As with many lifestyle factors associated with TMD, the effect is rarely dramatic in isolation but can become significant when sustained over months or years. Meal timing and pace can also play a part. Eating quickly or taking large mouthfuls both increase the demand placed on the jaw. Patients who eat under time pressure may chew more forcefully. Additionally, those that snack continuously throughout the day may not give the masticatory muscles enough opportunity to rest. Encouraging a slower, more considered approach to eating can reduce this cumulative strain without actually requiring any significant change to the diet itself.

Supporting patients

Dental professionals are well placed to identify these different habits that may be contributing to TMD symptoms. Simple conversations about food textures, gum chewing, and more can help patients make impactful adjustments. Alongside this guidance, certain tools can support rehabilitation where jaw function has already been affected. The OraStretch® Press Rehab System from Total TMJ offers a practical solution for patients experiencing reduced jaw mobility associated with TMD. Designed for the gradual improvement in jaw opening and function, the system provides controlled stretching in a simple and accessible way. Better yet, certain adaptations are available for a broad range of patient needs, including edentulous patients, smaller mouths, and those with further limited oral opening.

Eating with awareness

Eating is unavoidable, and for the majority of patients it has no lasting strain effects on the jaw. However, for those predisposed to TMD, the accumulative effect of chewing habits, food choices, and other parafunctional behaviours can contribute to growing discomfort long-term. For more details about Total TMJ products, email info@totaltmj.co.uk n

About the author George Barry, Sales & Marketing Manager at Total TMJ.

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oral health

The patient who doesn’t complain Recognising and managing dental pain in older adults

here is a pattern of under-reporting discomfort when it comes to older patients that perhaps the wider dental industry does not do enough to acknowledge at present. Experienced GDPs may recognise this scenario: an older patient at a routine appointment reports no significant concerns; the examination says otherwise. The patient acknowledges discomfort, perhaps, but nothing that would have indicated the level of oral health difficulty they appear to be presenting with. This pattern is a reflection of several factors, which when combined mean dental pain in older adults is frequently under-recognised, under-reported, and undermanaged. Understanding those factors is the first step toward addressing them in daily dental practice.

Older patients under-report pain

For several reasons, older patients tend to be reluctant, or unable, to report dental discomfort when compared to other demographics. These include sensory changes, cognitive shifts, expectation shifts, and even simply a habit of not wanting to make a fuss. Pain perception changes with age. The somatosensory system undergoes alterations throughout later life, and the result is that older patients may experience acute dental pathology with less acute pain than a younger patient with an equivalent overall status would. A dental issue that would cause significant and unmistakable pain in someone in their 20s may only produce a vague discomfort for someone in their 70s. These sensations are easy to normalise and adapt to, not to mention easy to decline to mention at a routine appointment. As people age, they are also more likely to develop comorbidities that have implications for their oral health, and the effects of polypharmacy used to address these underlying health problems can also influence how oral conditions present and are experienced. Cognitive changes add a further layer: patients with early or moderate dementia may struggle to localise, describe, or consistently report dental pain, and experiences of dental pain among older people living with dementia, particularly those in care homes, have been identified as a significantly under-researched area. As well as physiology, there is also a cultural aspect to it: many older patients grew up during a time when dental treatment was predominantly reactive, often uncomfortable, and something to be endured rather than sought out. The expectation that some degree of oral discomfort is normal, not worth reporting unless severe, is deeply ingrained in a demographic that has spent decades managing symptoms at home.

Polypharmaceutical problems

Under-reporting symptoms amplifies diagnostic challenges in older patients, which leads directly to polypharmacy – defined broadly as the use of five or more medications at a time – and is increasingly common in older adults. Its consequences orally are frequently overlooked.

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One major side effect of prescribed medications in the elderly is a change in salivary flow, which plays a pivotal role in the homeostasis of the mouth. Facilitating speech, swallowing, buffering acid, remineralising teeth, and preventing overgrowth of microorganisms, are all extremely important daily functions of saliva. With affected salivary function, many complications arise, resulting in a decreased quality of life. The clinical repercussions are clear. Xerostomia-related caries develops faster and in less typical locations. Mucosal tissues become more fragile and more susceptible to trauma. Existing restorations are more likely to fail. Then the patient, already predisposed to under-reporting, may attribute the subsequent discomfort to age rather than a treatable condition. A recent study found that polypharmacy was significantly associated with poor oral health, with patients taking multiple medications showing 65% greater odds of poor oral health scores than those who were not.

Pain management

When dental pain is identified in an older patient, management requires additional consideration. As more older people retain their teeth into later life, those with restorations require increased maintenance, and dental teams are therefore well placed to assist with ongoing prevention and pain relief. Systemic analgesics, the default recommendation for acute dental pain in most cases, carry increased risks in older adults. NSAIDs are, similarly, associated with risks. Topical analgesics offer a good alternative precisely because they act locally with minimal systemic absorption, and without the drug interaction risks that make systemic options more complicated with the older population. Orajel® Dental Gel, with 10% benzocaine, and Orajel® Extra Strength with 20% benzocaine, provide fast-acting localised relief at the site of dental pain in just two minutes. When it comes to older patients, particularly those managing multiple medications, or for whom systemic analgesics carry an increased risk, recommending a topical option is both clinically sound and likely reassuring for the patient. For denture wearers, there is also Orajel® Mouth Gel, which provides effective relief from denture pain. Oral health-related quality of life is consistently reported to be poor in older people across multiple systematic reviews. Yet there remains little consistency across the UK in terms of appropriate care for the vulnerable elderly population. GDPs are well placed to change this through proactive assessment and tailored pain management recommendations. For essential information, and to see the full range of Orajel® products, please visit https://www.orajelhcp.co.uk/ n

About the author Sumera Bashir, Church and Dwight UK Medical Affairs & Scientific Engagement Lead.

Protecting enamel when saliva runs dry

ew pharmaceutical developments have entered public consciousness as rapidly as glucagon-like peptide-1 receptor agonists (GLP-1 RAs). Semaglutide, better known in the UK by the trade names Ozempic and Wegovy, is now a familiar presence across news feeds, social media and advertising platforms. Originally developed for the treatment of type 2 diabetes, GLP-1 RAs are now widely used in the management of obesity. As their use has expanded, concerns have emerged regarding gastrointestinal adverse events and associated oral symptoms, including xerostomia. These may have important consequences for oral health and quality of life, yet remarkably the long-term dental impact of this drug class remains poorly characterised. Current evidence is largely drawn from clinical trials, case reports and anecdotal accounts, meaning the true prevalence may be underestimated. This places dentists in the unique position of being among the first to recognise early signs and offer preventive advice.

Ozempic mouth

The informal term “Ozempic mouth” describes a range of reported oral symptoms associated with GLP-1 RA treatment, including xerostomia, altered taste and halitosis. Gastrointestinal adverse effects such as reflux, eructation and vomiting may also contribute to unpleasant breath and dental erosion. A drier oral environment may disturb the oral microbiome, favouring bacteria associated with caries, halitosis and periodontal inflammation such as Porphyromonas gingivalis and Streptococcus mutans.

Mechanistic mystery

Precisely why some patients experience xerostomia during GLP-1 RA treatment is not yet understood. Proposed explanations include direct effects of GLP-1 receptor signalling within the salivary glands, although this remains hypothetical. Indirect factors such as nausea, vomiting, reduced appetite and lower fluid intake may play a role. It remains unclear whether symptoms reflect a subjective sensation of oral dryness, objectively reduced salivary flow, or a combination of both. Symptoms may be underreported because patients are unaware of the possible associations or attribute oral dryness to other factors such as perimenopause, nicotine-replacement therapy or concurrent xerogenic medication.

The secret of saliva

Saliva plays a central role in maintaining oral homeostasis. It lubricates the oral tissues, supports swallowing and speech, clears food debris, buffers plaque acids and supplies minerals needed for enamel health. When salivary flow is reduced, this protective system becomes less effective, leaving the teeth more vulnerable to acid challenge. The adverse-effect profile of GLP-1 RAs may create several overlapping risks. Reflux and vomiting expose enamel directly to gastric acid, while xerostomia reduces the buffering capacity that would ordinarily limit damage. Some patients lean towards grazing to manage nausea, and this repeated carbohydrate intake can provide cariogenic bacteria with a regular supply of fermentable substrate, increasing the frequency of plaque-acid attacks.

However, the overall effect is unlikely to be uniform. Improved glycaemic control may reduce salivary glucose and support oral immune function, while reduced food and carbohydrate intake could lower cariogenic exposure. Individual risk therefore depends on the complex balance between salivary changes, vomiting or reflux, dietary behaviour and baseline susceptibility to caries and erosion. Beyond enamel damage, xerostomia may contribute to reduced quality of life. This can become a double-edged sword: unpleasant adverse effects may reduce patients’ motivation to continue GLP-1 RA treatment, potentially undermining improvements in obesity or type 2 diabetes management. This may create a clinically important feedback loop. Loss of the benefits associated with improved glycaemic control and reduced dietary intake could re-expose patients to the very metabolic and behavioural factors that can increase caries risk.

Understanding and managing risk

When taking a medical history, dental professionals should ask patients using GLP-1 RAs about relevant oral and gastrointestinal symptoms, as they may not report these without prompting. Management should be guided by individual risk with closer monitoring for caries and erosive wear, particularly on the palatal surfaces of the maxillary teeth. Preventive advice currently includes rinsing with water or sodium bicarbonate solution after vomiting and delaying brushing for 30-60 minutes to avoid abrading acid-softened enamel.iv Xerostomia management may include adequate hydration, xylitol-containing salivary stimulants and saliva substitutes, alongside advice to reduce excessive snacking on fermentable carbohydrates. For patients whose natural salivary protection is reduced, the balance between demineralisation and remineralisation can shift towards mineral loss. A toothpaste capable of providing a sustained supply of mineral ions may therefore offer valuable additional support. BioMin® F Sensitivity contains fluorocalcium phosphosilicate, a fluoride containing bioactive glass designed to bond to the tooth surface and gradually release calcium, phosphate and fluoride ions for up to 12 hours. Calcium and phosphate are central to the natural remineralisation process, while fluoride supports the formation of more acidresistant fluorapatite. By maintaining the availability of these ions over an extended period, BioMin® F Sensitivity provides additional mineral protection where natural salivary protection may be compromised. GLP-1 RAs may offer substantial systemic benefits in the management of obesity and type 2 diabetes, but their possible oral effects should not be overlooked. Early recognition of xerostomia and preventive care may help preserve enamel over the long term for patients. The evidence may be immature, but enamel protection should not wait for certainty. n

About the author Alec Hilton, CEO of BioMin Technologies.

The Probe | November 26

30/10/2026 14:30:29

EyeSpecial C-V Dental photography made easy!

The compact, ultralight EyeSpecial C-V makes professional dental photography easy. Thanks to the camera’s intuitive operation and quick disinfection just with a wipe, photographic documentation can be dependably integrated into your daily practice and delegated to your assistants without any problems. The interplay of SHOFU Gumy-V and the "Isolate Shade" mode ensures reliable colour communication with the laboratory: The camera masks any interfering gingiva colours and, at the touch of a button, takes a true-colour image, a photo without the gingiva and a black and white image for value assessment. This allows clinicians and technicians to see the same colour information. Contact us for more information: 01732 783580 or sales@shofu.co.uk

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25.09.26 09:57 28/10/2026 15:43:24

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oral health

Habitual interdental cleaning The rise of the AI doctor

t’s no secret that the UK’s population is ageing. In 2022, 12.7 million Brits were aged 65 or over, accounting for 19 per cent of the population. Projections for 2072 see this rise to 27 per cent, an increase caused by advancements in healthcare and the lowest reported levels of birth in half a century. The impact of an ageing population is well documented in dentistry: the longer people live, the higher the prevalence of edentulism. This increases the demand for dental implants, dentures and other restorative treatments. But what if the teeth could be more easily protected so that oral diseases are prevented? And how can older patients be motivated to maintain such a proactive approach?

Old habits

A lifetime of preventive action can increase quality of living for older demographics, but research into the effect of preventive oral habits introduced among older individuals is largely unexplored. Oral health is a major factor for healthy ageing, with good oral hygiene being associated with improved general health and reduced morbidity and mortality. This is due to two reasons: first, that patients who look after their teeth are also likely to take care of the rest of the body and practice healthy lifestyle choices and, second, because of the strong links found between oral diseases and chronic diseases, both of which influence the other. Good oral health improves tooth retention by reducing the risk of caries and periodontitis. An essential component of this is interdental cleaning; the mechanical removal of trapped food debris and plaque from between adjacent tooth spaces is associated with a lower prevalence of oral disease. One longterm study found that older individuals who flossed at least once a week on average lost one tooth over a 5-year period, whilst individuals who did not floss on average (and lived in greater isolation) had lost four teeth. The impact of this is multi-faceted: edentulism affects masticatory function, self-esteem and overall quality of life. Of particular concern is the dietary change and declining nutritional intake for those with severe edentulism – the adverse consequences of not being able to eat certain foods can increase the risk of wider health problems. So, interdental cleaning must be encouraged for more at-risk patients.

New habits

Motivating older patients to floss on a daily basis can be a struggle. A survey found that many patients recommended 8-11 as the age range for interdental self-care to begin, as this creates a habit that will last a lifetime. But not everybody will start at that age and introducing the habit late may not guarantee the same level of compliancy. However, the view that the elderly cannot learn new habits as effectively as younger generations (perhaps attributed to perceived cognitive decline) is a common misconception. In reality, older adults have better routines, such as daily medication intake, and higher self-regulation. Along with the ability to delay gratification, older patients are actually well suited to develop new habits, especially those that help their health. By boosting awareness of the role that interdental cleaning can play in reducing oral disease, tooth loss and general health problems, elderly patients

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was very interested to come across a headline recently that suggested ChatGPT had diagnosed a rare condition and saved a woman’s life. It adds fuel to the already widespread conversation about the role of artificial intelligence (AI) in modern healthcare. As dental professionals, we have broadly accepted that AI is here to stay and we accept the benefits it affords. However, we remain aware of its limitations. Has the time come to discuss AI in more detail with our patients in order to educate and support them in its use when it comes to improving health?

technology in the practice every day. It would be hypocritical of us to promote our cutting-edge AI-supported facilities, only to tell patients that AI is dangerous. Instead, they should adopt a similar approach to us. AI is a second opinion, a verification, a tool for idea generation. It should not be relied upon solely, without personal judgement, additional fact checking, or professional insight. With a hybrid approach, AI-driven platforms could be used more effectively to accelerate diagnostics and put patients’ minds at ease.

The story in question

can be more proactive with their oral care and maintain a consistent quality of life.

Making it easy

One possible challenge with encouraging flossing is that older patients may report sensitivity in the soft and hard oral tissues, have reduced hand or arm movement, and have weaker eye sight, all of which can impair interdental cleaning success. To help at-risk patients and support a comfortable cleaning routine, electric flossers are recommended for their ease of use and excellent outcomes. Eliminating the need for using both hands and avoiding the sometimes-tricky coordination of string floss, electric flossers are more practical for older patients. Recommend Tahir One from Tahir Oral Care to achieve optimal hygiene outcomes among at-risk patients. A three-in-one solution that acts an electric toothbrush, flosser and tongue cleaner, it delivers a truly comprehensive cleaning experience. With the Sensitive and Deep Clean settings, patients can tailor their oral care to meet their specific needs, ensuring every tooth is given equal attention and plaque build-up is prevented. Protect against oral disease with the total cleaning power of Tahir One and support older demographics to reduce the risk of oral disease.

Meeting the challenge

As the UK’s population continues to age, healthcare providers must rise to meet the challenges that it poses. The interconnected nature between oral disease, edentulism and chronic health conditions is notable, and setting realistic goals for older patients to maintain their teeth and gingivae can increase motivation and form a long-lasting, positive habit. For practice enquiries and professional ordering, visit tahiroralcare.com. n

About the author Stefan White, Founder and Managing Director of Tahir Oral Care.

The news story that provoked this chain of thought was about a young woman who struggled with her health for many years. Her medical history combined with new symptoms led to misdiagnoses by doctors, who were struggling to determine and treat her condition. In putting her symptoms into ChatGPT, it produced a list of potential causes, one of which a doctor thought plausible and confirmed the diagnosis upon genetic testing. The implications of this being in the general media are multiple. Firstly, it does highlight the positive impact that AI can have in supporting healthcare provision. Secondly, it shows how useful a resource AI-assisted platforms can be for individuals who are conducting research. They are highly accessible tools for people who want to engage more with their health and perhaps take some control when it comes to modifiable risk factors for common conditions.

A risky business

However, this is only one side of the story. Though it is developing at a rapid pace, current AI capabilities fall short of a consistent and accurate medical diagnosis. A study led by the Oxford Internet Institute and Oxford University found that use of Large Language Models (LLM) gave individuals no more or better information than a traditional online search – or their own judgement. It showed that most people didn’t know what to tell the AI model in order to get the advice they wanted. It also demonstrated the variety in answers that LLMs can give to the same situation, based on slightly different presentations of the facts. When a combination of good and bad guidance was issued by the AI platform, users struggled to determine which was which. The issue here is that a growing number of people in the UK are treating AI-driven tools like a digital doctor. Almost one in 10 are now using AI-powered chatbots for health advice. Approximately 37% of UK adults are turning to the same platforms for mental health and wellbeing support. As such, a considerable proportion of the population could be exposed to inaccurate and unreliable medical advice at any given time.

Blurred lines

Despite the risks, it is unrealistic to expect the disuse of AI, especially given the current economic climate and widespread waiting times for medical care. Instead, I am of the opinion that we need to educate patients on how to use it safely and effectively. After all, dental professionals use AI-assisted

A second opinion for the second opinion?

Putting AI to the test for myself, it seems to provide fairly relevant advice if asked what to do with persistent pain following endodontic treatment. It recommends returning to the clinician for further assessment and even suggests retreatment as a potential outcome. However, clinical diagnosis will require much more than written (or verbal) information, potentially necessitating further radiographic investigation. Even then, retreatment can be complex and requires specialist skills to deliver. As ChatGPT is inadequate in such a situation, the specialist team at EndoCare would be more than happy to help. We have several decades of genuine experience in the field, offering a broad range of advanced endodontic procedures from microsurgery to retreatment. Our referral process is quick and simple – just complete the form on the website to get started.

Embracing opportunity – safely

AI is not something to be feared, but it is not yet ready to be trusted explicitly without outside influence. When used safely, modern platforms provide a helpful resource for people to educate themselves about the risks and symptoms of health conditions. The key to preventing inaccuracies and misinformation from causing any harm is understanding that recommendations should always be confirmed by the relevant professional. For further information about the endodontic referral services available from EndoCare, please call 020 7224 0999 or visit www.endocare.co.uk n

About the author Dr Michael Sultan, EndoCare.

The Probe | November 26

30/10/2026 14:31:49

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29/10/2026 10:55:11

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introduced their own “universal” shade options, none possess the advanced, foundational science pioneered by Tokuyama. Omnichroma’s proprietary 260-nanometre spherical fillers are precisely engineered to generate structural colour within the specific red-to-yellow spectrum of natural teeth. As light passes through the composite, it combines with the reflected light of the surrounding tooth structure, allowing a single paste to seamlessly integrate across all 16 VITA Classical shades without a single added pigment or chemical dye.

Omnichroma Class IV restoration by Dr Marco Bambace, Italy

This is a distinct departure from the passive optical blending traditionally known as the ‘chameleon effect’. Instead, Omnichroma relies on the same physics governing the play of colour in a precious opal or the iridescence of oil on water—where the microscopic structures themselves actively generate the colour. The result is a single, advanced formulation that offers a truly infinite solution to the entire VITA range. Estelite Color: freedom in the detail Estelite Color adds scope for individual characterisation through a selection of tints and opaquers. Applied beneath or between composite layers, these allow you to introduce subtle fissure colour, develop a local optical feature or mask underlying discolouration. A small, carefully placed addition can help you reproduce the particular characteristics of an individual tooth. Your eye. Your hands. Your judgement. Your palette. Tokuyama brings the technology. You decide where to take it. n

Find out about Estelite

Find out about Omnichroma

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ESTE L ITE

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Case Study

Staged custom fibre post technique Dr Wahab Shakir talks through a staged custom fibre post technique. It relines a parallel post with heated composite to match the canal shape, reducing resin volume and C-factor, improving adaptation and minimising shrinkage stress compared with a standard fibre post alone. This supports a metal-free post and core with favourable stress distribution and preserves ferrule-dependent fracture resistance compared with cast metal posts. Rationale for a custom fibre post

Over-flared canals create a mismatch between post and dentine, increasing luting resin thickness and the configuration factor (C-factor) in the post space, raising shrinkage stress, gap formation and microleakage. Relining a fibre post with composite reduces the cement layer, shifts the main bonding interface towards the composite to dentine interface, improving sealing and stress distribution. Preheating enhances flow, conversion and mechanical properties while bonding well to the fibre ParaPost.

Steps 1 to 4: Post space preparation and isolation

Drill the post hole to a length and width matching canal depth: • Maintain at least 4 to 5 mm of gutta-percha apically to preserve the apical seal. • Enlarge the canal with the colourcoded drills until the post space approximates the canal diameter at working depth, avoiding unnecessary removal of radicular dentine. • Eliminate undercuts and smooth sharp line angles so the custom post can be withdrawn and resealed without locking. A smooth, tapered space reduces stress concentrations and gives uniform resin thickness. Coat the canal walls with a thin film of glycerine and dry the excess. This separating medium lets the relined post be removed after initial cure for extraoral completion.

Steps 5 to 8: Conditioning the post and creating the composite sleeve

Check the fit, remove the fibre post, then wipe with alcohol and silanate it. Confirm it reaches length without binding, with space for relining. Alcohol and silane increase bondability, improving adhesion of composite and resin cement to glass-fibre posts. Heat composite to 50 degrees centigrade and adapt putty around the post end. Preheated composites show greater fluidity and wetting, enhancing adaptation and conversion, which translate into higher microhardness and flexural strength. The heated plug gives intimate contact with the canal walls, minimising voids, and subsequent luting resin. Insert to working length and light cure for 10 seconds. This partial cure stabilises the shape without locking the composite to dentine, thanks to the glycerine barrier. Staged curing reduces shrinkage stress by prolonging the pregel phase. Remove the assembly and fully light cure extraorally for maximum conversion without C-factor shrinkage pulling away from the dentine.

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Steps 9 to 12: Try-in, flowable addition and adhesive optimisation

Cleaning and etching the composite and post improve retention of further layers. Re-applying glycerine permits a second in-situ adaptation step while still allowing removal for final extraoral curing. • Roughen the composite with a diamond bur, etch for 20 seconds with active motion, dry, then place unfilled resin to improve compatibility with the bonding system and core material. • Syringe a thin layer of flowable composite onto the post and reseat for a light cure to refine the fit and fill micro-voids. Keep flowable thin to avoid excess shrinkage; the two-stage build minimises additional resin. • Remove the post, light cure once more, then re-etch, wash, dry and place unfilled resin. Rinse the canal with copious water and use ultrasonics to remove glycerine and debris, improving dentine cleanliness and hybrid-layer formation. Dry well with paper points.

Adhesive cementation, core build-up and ferrule

Apply Parabond conditioner and adhesive (A and B), massaged into the canal and tooth surface with excess removed, enabling chemical and micromechanical bonding to root dentine. Pre-treatment is critical because bond strength to root dentine is lower than to coronal dentine, given the high C-factor and difficult access. Cement the post with ParaCore under vibration. ParaCore acts as both a dual-cure cement and core material, simplifying the sequence and allowing light transmission through glassfibre posts for deeper polymerisation. Gentle vibration expresses excess material and reduces voids, improving adaptation along the post. Build up the core with ParaCore or composite. The same resin system creates a homogenous post and core complex, associated with favourable stress distribution and reduced catastrophic root fracture compared with metal posts. Dual-cure materials ensure polymerisation even where light access is limited. Prepare the tooth with an adequate ferrule. A circumferential ferrule of at least 1.5 to 2.0 mm of sound tooth s t r u c t u re s i g n i f i c a n t l y i n c re a s e s fracture resistance, independent of post system. Greater ferrule height l e a d s t o l e s s f a i l u re o n l a t e r a l loading and more favourable fracture patter ns, whereas its absence is linked to early failure.

Fig 1 The prepared post space on the model, showing the canal opening at working depth Fig 2 In-situ preparation under rubber dam isolation Fig 3 BRILLIANT EverGlow composite and adaptation Fig 4 The fibre post relined with a custom composite sleeve adapted to the canal form Fig 5 The prepared canal isolated under rubber dam, ready for try-in of the custom post Fig 6 Flowable composite applied to refine the fit and fill micro-voids Fig 7 The custom post tried in under rubber dam, ready for cementation Fig 8 The custom post seated in the canal during cementation Fig 9 Post fully seated, with excess material expressed under gentle vibration Fig 10 Core built up over the luted post using the same resin system Fig 11 The core prepared, with a clear collar of sound tooth structure for the ferrule Fig 12 Close view of the ferrule, at least 1.5 to 2.0 mm of circumferential tooth structure Fig 13 The finished post and core preparation alongside the adjacent dentition Fig 14 The definitive custom post and core in situ, viewed intraorally Fig 15 The definitive post and core from a second intraoral angle

About the author

Biomechanical outcome and clinical implications

The protocol yields a metal-free glassfibre custom post that closely matches the canal anatomy, limiting luting resin thickness and reducing C-factordriven shrinkage, marginal gaps and leakage compared with a thin parallel post in a wide canal. These posts have an elastic modulus closer to dentine and, with an adequate ferrule, show improved fracture resistance and more reparable failure modes than cast metal posts, supporting a more conservative restoration. n

Dr Wahab Shakir, BDS PGCert PGDip MClinDent (Cosmetic and Restorative Dentistry) is Principal Dentist of Museum Dental Suites and a postgraduate lecturer for Tipton Training Academy. He qualified at Newcastle University before moving into private practice in London, he has an MClinDent, PG Certificates and PG Diploma in Restorative and Operative Dentistry from Tipton Training, the latter earning him the Best Dentist Award. He has a particular interest in cosmetic dentistry, minimally invasive techniques, and the management of TMD and tooth wear, with a strong emphasis on prevention and conserving natural tooth structure.

The Probe | November 26

30/10/2026 14:34:50

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Case Study

Treating vertical and horizontal bone loss Dr Selvaraj Balaji presents a complex case of implant placement achieved with predictable hard and soft tissue augmentation techniques

Fig. 1 Presenting situation radiograph showing loss of vertical and horizontal bone height Fig. 2 Close proximity of alveolar nerve Fig. 3 Pre operative treatment site Fig. 4 Three sections identified along lingual flap Fig. 5 Lingual flap advancement Fig. 6 Autogenous bone harvested Fig. 7 Harvested bone particulated Fig. 8 PTFE membrane placed and secured with lingual master pins Fig. 9 PTFE membrane secured

female patient in her 70s attended the practice in 2019 in substantial dental pain. She also had a loose LL6 tooth and was missing her LL7,8. An initial assessment was conducted, revealing a hopeless prognosis for the LL6, which was extracted as part of the emergency appointment. The patient was keen to continue her dental journey by restoring the gaps in her dentition, so we scheduled for her to return three months later for a comprehensive evaluation of the restorative options available. A CT scan demonstrated significant horizontal and vertical bone loss in the area, putting the alveolar crest very close to the dental foramen and alveolar nerve. This did not mean that dental implants were not possible, but additional considerations would be required. For example, with only 3mm of bone, short implants were not an option. This left us a choice between implant placement with nerve lateralisation in order to create sufficient space for restoration, or implant placement alongside vertical bone augmentation with a block graft or particulate bone and a PTFE membrane. All these treatment options were discussed in full with the patient, as were no treatment and dentures as other possibilities. She expressed a preference for an implant with bone augmentation so that she may enjoy the benefits of a longterm fixed restorative solution. A full suite of clinical photographs, radiographs and a CT were taken to inform the treatment plan. These were used to digitally plan where bone grafting would be most important, as well as the final position, angle and depth of implant needed to facilitate stable, functional and aesthetic

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restorations. The plan also incorporated a soft tissue graft, which would be performed after bone augmentation and implant placement following a staged approach for the best result in this case. The advantages, limitations and risks of each procedure involved were outlined and the importance of oral hygiene emphasised before the patient gave fully informed consent to proceed.

A staged treatment approach

On the day of surgery, a safety flap was raised and extended two teeth away from the defect mesially. One crestal incision was made in the keratinised mucosa and one oblique incision made towards the coronoid process. I used a modified lingual flap technique that is divided into three different zones and steps; the first is the retro molar region, the second the high mylohyoid muscle attachment area, and the third is low mylohyoid muscle attachment area. By working in three separate regions, this allowed the use of three different techniques to advance the lingual flap without damaging the vital structures behind, including the lingual nerve and submandibular glands. Once the buccal and lingual flaps were raised, autogenous bone was harvested from the ramus of the mandible using a piezomed instrument and a safe scraper. The harvested bone was particulated using a bone mill. The bone graft was prepared with 60% autogenous bone and 40% xenograft. A PTFE membrane was selected, shaped and secured into place with master pins inserted lingually first. The graft was loaded into the defect, with the membrane folded buccally and secured with further master pins.

Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 16 Fig. 17 Fig. 18

Buccal flap advamancement Flap closed with PTFE sutures tension-free Post bone augmentation PTFE membrane exposed and removed Two implants placed Free gingival graft tissue placed using a strip graft technique Implants exposed after healing for three months Implants restored Post treatment radiograph

The buccal and lingual flaps were checked for passive closure, and it was decided to further release the buccal flap by using a mucoperio elastic technique. The soft tissue was then closed with PTFE sutures, ensuring the connective tissue met connective tissue. The patient was given standard post-operative oral hygiene and dietary instructions upon conclusion of the appointment. Approximately eight months later, the PTFE membrane was removed and two implants (4.2mm x 9mm) were placed in the pre-planned positions, angles and depths. A further two months after this, the patient returned for a soft tissue graft designed to increase the amount of keratinised tissue around the implants. The strip graft technique was performed, using a free gingival graft tissue that was harvested from the palate. At the recipient site, a split thickness flap was raised and apically repositioned. The graft material was placed on top of the periosteum and left to mature for three months. At this point, treatment was concluded with the restoration phase. The implants were exposed, impression copings placed and a new impression taken for the fabrication of the implant-retained crowns. These were fabricated and loaded.

Discussion

Treatment options were restricted in this case due to the lack of bone available. The size of the defect ruled out short implants immediately. Doing nerve lateralisation is also a high-risk procedure, so is often not the first-choice for patients. In addition, the crown would be too long compared to the neighbouring crown, so cleaning and maintaining the implant in the long-term

can be difficult for the patient following this approach. The methods used instead were selected because they provided more predictable results. The modified lingual flap techniques also allowed us to advance the lingual flap enough to cover the graft for tension-free closure. This is essential for the soft tissue health, as well as the function and aesthetics of the implant in the long-term. The five-year follow-up of this particular case demonstrates the stability of the results achieved. Dr Balaji provides industry-leading training courses on both hard and soft tissue management around dental implants with the ASHA Club. For more information about how you could elevate your skills with the support of experts, please visit www.ashaclub.co.uk or call 07974 304269 n

About the author Dr Selvaraj Balaji: BDS, MFDS RCPS(Gla), MFD SRCS(Ed), LDS RCS(Eng) Since he obtained the BDS Degree, Dr Balaji has worked in Maxillo-facial units in the UK for several years and gained substantial experience in surgical dentistry. He is the principal dentist of The Gallery Dental Group which is made up of Meadow Walk Dental Practice and The Gallery Dental & Implant Centre. Dr Balaji is also the founder of the Academy of Soft and Hard Tissue Augmentation (ASHA) and runs courses, lectures and study clubs in the UK and around Europe for aspiring implantologists.

The Probe | November 26

30/10/2026 14:36:42

www.the-probe.co.uk

DENOVO

Retain autonomy, share ownership, choose DeNovo

or practice owners considering the future of their dental practice, finding the right partner is about more than the transaction. It’s about what happens next – to the practice, the team and the role they want to continue to play. For Helen and Jim Braden of Braden Dental Care, retaining their autonomy and remaining actively involved in the practice were important considerations when exploring their options. Helen shared her first impression of DeNovo, “The biggest thing we were interested in was keeping our autonomy.” Jim echoes this sentiment, adding, “The majority of group models promise that you’ll have nothing to do with the practice going forward. However, we saw the value in retaining our knowledge, having spent years and years building the practice up. Remaining at the practice was, therefore, important for us.” “We had a look at a few different options to begin with, and had some groups and individual buyers who were interested. We knew there would always be other options, so we looked into each one,” shares Helen. Jim adds, “The moment at which we knew we wanted to partner with DeNovo was when we realised the flexibility involved moving forward: that we wouldn’t be restricted in terms of a timeframe. Everyone knows that life changes, and this allows for a flexibility that wouldn’t have been possible with somebody else.”

A true partnership

The DeNovo model is based on shared ownership. Partners retain an interest not only in their own practice but also become shareholders in the wider DeNovo group – creating shared participation in its future success. Jim describes this: “Initially, I was surprised to hear that part of the payment for the practice is given as shares, so you actually do become a part owner and a DeNovo shareholder. This means that we all have a shared responsibility, which simply doesn’t exist in other group models. I was surprised that there is also the potential for uplift when practices are doing well – this is unusual in the UK.” For Helen and Jim, becoming part of DeNovo was also about the community of Partners they were joining. Helen describes how this community reassured her that they were making the right decision: “I felt at ease because we talked to other people who had already joined DeNovo and heard their experiences.” Jim explains, “For me, it came down to autonomy. We chatted to existing partners who reassured us that, whilst DeNovo offers help procedurally, they do not enforce specific rules. This meant that we could continue to make decisions for our patients and practice and knew that this wouldn’t change six months down the line.” Helen adds, “Day to day, nothing has changed. We are still running the business!”

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Great Quality

Great Price

Helen and Jim Braden Jim continues, “Another important factor for us was the possibility of being a part of something bigger. Historically, people who sold to groups became a cog in the machine. This is not the case with DeNovo – we feel like we’re part of a wider community.”

Made in Great Britain

Forward-thinking

The right partnership also needs to support where a practice is going next. For Helen and Jim, that meant building on what was already successful while creating further opportunity for the future. Jim explains how DeNovo aligns for them: “It absolutely does insomuch as nobody is making us change anything. Our practice is a success in its own right because of the way we have been running it already. By joining DeNovo, we have unlocked further growth and potential without the overhaul you’d expect with other practice sales pathways.” “The fact that we joined DeNovo proves that it aligns with our practice vision,” Helen adds. “We have received positive feedback from the team too,” Jim continues. “It feels as if no one is aware of any big change in terms of operations. It’s natural for staff to worry about potential changes and how they will be impacted, so it has been nice that this hasn’t been an issue.” Reflecting on his experience of DeNovo and the team, Jim shares: “DeNovo is a relatively small group that is expanding in the UK, and the team are very engaged, passionate and positive. They do honestly seem to have a shared vision that is realistic and motivational, and they are conscious of partnering with likeminded individuals, which is reassuring.” If you’re considering the future of your dental practice and want to understand what shared ownership could mean for you, contact DeNovo for a confidential, no-obligation conversation.

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39 30/10/2026 14:37:40

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professions

Case study: Alleged failure to obtain informed consent Paula Conwell, Litigation Solicitor at Dental Protection, analyses a recent dental negligence claim which Dental Protection successfully challenged in court

his case study from the Dental Protection files relates to the treatment options a dentist provided to a patient for restoring a fractured upper left lateral incisor tooth (“UL2”). The patient alleged that they were given two options for treatment: root canal treatment and crown or bridge at UL2 to UL4, utilising the UL2 as an abutment tooth. The patient decided to proceed with the bridge. Following the treatment, the patient was advised by another dentist that the bridge was not fitting well and would fail. The bridge was subsequently removed by this dentist, the UL2 extracted and replaced with an implant-retained crown. The patient alleged that the dentist who undertook the treatment failed to advise of the poor prognosis for the bridge because of the use of UL2 as an abutment tooth. They also alleged that the dentist did not advise them of the third treatment option that would offer a permanent solution – which was to extract the UL2 and replace it with an implant-retained crown. The patient alleged that they would have opted for an implant-retained crown had it been offered. It was also alleged that the dentist failed to appreciate that the patient wanted a permanent solution. The dentist denied liability on the basis that all treatment options were discussed with the patient, including replacing the UL2 with an implantretained crown. The risks and benefits were also discussed. Informed consent was obtained before they commenced treatment for the bridge at UL2 to UL4. The dentist explained that the bridge was a long-term solution that provided a good function and, although it was not failing, the patient voluntarily opted to have the bridge dismantled by another dental practitioner. There was a reasonable expectation that the bridge would last the duration of the patient’s life expectancy. The patient also did not acknowledge that crowns on top of implant fixtures require periodic replacement with additional costs and annual maintenance fees. The dentist did not write down the option of an implant in the records because the patient had commented that her husband was concerned about the costs of another implant, and this was personal information. Furthermore, they maintained that the UL2 was suitable as a bridge abutment and as such the bridge did not have a poor prognosis. Prior to trial, Dental Protection made an application to strike out the allegations relating to “permanent solution” because it was agreed by the experts that there is no permanent solution in dentistry.

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The patient made a cross-application to amend the pleaded case to replace the word “permanent” with “the solution treatment with the longest prognosis and lowest risk of failure”. Neither application was successful. The Judge referred to the patient’s application, which he dismissed, as it would have changed the entire basis on which the claim had been brought. This highlights the importance of pleadings. In considering the expert opinion provided, the Judge was critical of the expert witness put forward by the patient’s legal representative. He was concerned that the expert did not have a good understanding of the decision in the case of Bolam and was not able to explain his reasoning for his opinion that the UL2 was not suitable for a bridge support. The Judge did not accept the expert’s evidence that he had considered an x-ray. He had not referred to it in his report, and this radiograph was crucial to the case because it showed that the UL2 had a good root structure and supragingival tooth structure available. The expert conceded this in cross-examination. The Judge was also concerned about how the expert had received their instructions. They referred to receiving instructions via a portal and were asked to respond to a number of questions. The Judge referred to the expert as having drawn conclusions without considering the dental notes and referred to the relevance of the radiograph.

In our experience at Dental Protection, many patients often dismiss the importance of radiographs. When it came to the expert witness put forward by Dental P ro t e c t i o n f o r t h e t re a t i n g d e n t i s t , t h e J u d g e w a s i m p re s s e d . The expert agreed that it would have been a breach of duty not to offer an implant as this was a suitable option. However, in their opinion, due to the amount of tooth structure available at UL2, it was a less suitable option and there was no risk of a poor outcome for the bridge utilising the UL2. The expert referred to the fact that the bridge did not fail and its removal was elective. The Judge was satisfied that the dentist did offer an implant and this was discounted by the patient because of the costs and the suitability of the UL2 to support the bridge. The bridge also provided the benefit of restoring the heavily filled UL3 and UL4. The Judge was also satisfied that there was no discussion relating to a “permanent solution”, there being no such thing in dentistry. The claim was dismissed.

Dental Protection support

The member was supported by a Dentolegal Consultant in responding to the initial complaint. Assistance was then provided by the claims team when the member received a letter from the patient’s solicitors requesting the dental records. A letter of claim followed, and Dental Protection responded, denying the claim.

When court proceedings were issued, I stepped in as one of Dental Protection’s in-house lawyers, liaising with experts and instructing a barrister to defend and represent the member at the trial, where we were successful.

Learnings

There is a general misconception that “if something is not in the records, it did not happen”. I have in fact heard an expert say this at a different trial. While keeping records is crucial, we succeeded at trial in this case despite the member failing to enter into the records that they had provided the patient with the option of extracting the UL2 and restoring the space with an implant-retained crown. However, it is always advisable to ensure that all reasonable treatment options are discussed along with the risks and benefits of the treatment options and entered into the records. n Dental Protection’s Learning Hub hosts Consent modules and a wide range of resources aimed at helping dental professionals manage their risk and support professional development. These can be accessed at any time at no extra cost for Dental Protection members, and can be used to count towards a dental professional’s CPD.

About the author Paula Conwell, Litigation Solicitor at Dental Protection.

The Probe | November 26

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professions

Beyond resilience Why dentistry needs more peer support

hroughout my career, one thing has remained constant: dentistry is a profession built on people. We spend our days caring for patients, supporting colleagues and doing our best to deliver safe, high-quality care, often in challenging circumstances. Yet despite working as part of teams, many dental professionals can still find themselves feeling isolated when they need support the most. W h e t h e r i t ’s d e a l i n g w i t h a d i ff i c u l t c l i n i c a l situation, managing an unhappy patient, adapting to change or balancing the demands of work and home life, there are times when we all need someone who understands. Not someone with all the answers, but someone who listens, relates to our experiences and reminds us that we’re not facing things alone. This is where peer support can make a real difference. We often talk about resilience within dentistry, and understandably so. Resilience is important. However, I sometimes wonder whether we place too much emphasis on individuals being resilient and not enough on the role of teams in supporting one another. Being part of a supportive network can often be just as important as any personal coping strategy. I n m y c u r re n t ro l e , I h a v e t h e p r i v i l e g e o f working with dental professionals from a wide variety of backgrounds and settings. One thing I see time and time again is the willingness of people within our profession to help others. Dental professionals are often the first to offer advice, share experiences or step in when a colleague needs support. The challenge is that many of those same individuals can be reluctant t o s e e k s u p p o r t f o r t h e m s e l v e s . T h e re c a n be a perception that asking for help is a sign

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of weakness, particularly among experienced professionals who are used to being the person others tur n to. In reality, recognising when support is needed and reaching out for it demonstrates s e l f - a w a re n e s s a n d p ro f e s s i o n a l i s m . N o n e o f u s a re i m m u n e t o d i ff i c u l t d a y s , c h a l l e n g i n g situations or periods where the pressures feel greater than usual. Peer support doesn’t have to be formal to be effective. Sometimes it is a conversation over a cup of coffee after a difficult clinic. Sometimes it is a colleague checking in after a challenging patient interaction. Sometimes it is knowing there is someone at the end of the phone who understands the realities of working in dentistry. The impact of these seemingly small interactions should not be underestimated. When people feel supported, they are more likely to speak openly about concer ns, share lear ning from mistakes and seek advice before problems escalate. This benefits not only individuals but also the wider team and, ultimately, patients. Creating environments where people feel psychologically safe enough to ask questions, admit uncertainty and lear n from one another is essential for both wellbeing and patient safety. Leaders have an important role to play in creating these environments, but peer support is not solely the responsibility of managers or senior team members. Every member of the dental team can contribute to a culture where support is normalised. This can be as simple as making time for meaningful conversations, checking in on colleagues, celebrating successes and recognising when someone may be finding things difficult. Often, the most valuable thing we can offer another person is our willingness to listen without judgement.

Peer support can also extend beyond the walls of our individual workplaces. Professional networks, mentoring relationships, local dental groups and professional associations all provide valuable opportunities to connect with others who understand the unique challenges of working in dentistry. These connections can help reduce feelings of isolation, broaden perspectives and provide reassurance during times of uncertainty. As the profession continues to evolve, with increasing demands on dental teams, fostering s t ro n g p e e r s u p p o r t n e t w o r k s w i l l b e c o m e even more important. We cannot remove every pressure that exists within dentistry, but we can ensure that people do not have to face those pressures alone. For me, peer support is not a wellbeing initiative or a box to be ticked. It is something that should be woven into the fabric of every dental team. It is about creating workplaces where people feel valued, supported and able to bring their whole selves to work. After all, dentistry has always been a team effort. By looking after one another with the same care and compassion that we show our patients, we can build stronger teams, healthier workplaces and a more sustainable future for our profession. Sometimes the most powerful support we can offer isn’t a solution or an answer. It’s simply being there for each other. n

About the author Lianne Scott-Munden, Clinical Services Lead at Denplan.

The Probe | November 26

30/10/2026 14:40:32

www.the-probe.co.uk

professions

The foundations of a thriving career in implantology

esire for dental implants is growing in the UK and across the globe. In response, the number of clinicians providing related services is rising. However, dental implantology offers much more than simply a means to meet patient demand. Getting involved with the discipline is also an opportunity to build a long and prosperous career.

The T&Cs for development

According to the GDC’s Safe Practitioner framework, all dentists must be able to “explain the use of implants as a treatment option, including their outcomes, limitations, and risks”. However, the actual delivery of treatment must be preceded by sufficient education in the field. The Standards for the Dental Team clearly dictate that clinicians must have undergone training that provides appropriate knowledge and skills to ensure the safe and effective provision of care. Principle 7, in particular, highlights the importance of aligning with current evidence and authoritative guidance, as well as working within personal limits. Effort must be made to constantly update clinical knowledge and skills, with a record of related activities integral for continued GDC registration. Specifically tailored to implantology, the Training Standards in Implant Dentistry reiterate the importance of dentists establishing an “evidencebased and patient-centred approach” with regards to material and technique selection. This further necessitates high-

November 26 | The Probe

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quality professional training that equips practitioners to optimise clinical outcomes.

A springboard for genuine growth

Within this regulatory framework, clinicians have an opportunity to kick-start exponential personal and professional growth. With training and support, clinicians can learn the skills required to provide implants to a wide range of patients. Not only does this afford greater variety and interest during each working week, but it is also often stated to be a highly rewarding branch of the profession. Implant placement significantly improves patients’ quality of life, and happy patients certainly make for a happier professional team. For this reason and others, clinicians who wish to focus their practice on a single field – such as dental implants – often experience increased job satisfaction.

Steps for success

As already mentioned, high-quality training in the field is crucial for professional progression. Choosing the right provider and the right

type of training course will be vital in setting up for success. For the most effective and supported development, it’s important to undertake a combination of theoretical and hands-on instruction, accruing experience in real-world situations under supervision as capabilities are advanced. Several programmes exist in today’s world – both objective assessment and subjective recommendation will contribute to the final decision. Consider also the format and structure of the teaching, the reputation of the training provider, the calibre of the instructors, and the relevance of the resulting qualification for your current needs and future ambitions. If the course is sponsored or supported by a particular system manufacturer, care must be taken to ensure that the training is evidencebased and not sales-led. Further still, the clinical support and mentorship available should be investigated in detail prior to commencing a course. In an advanced field like implantology, it is vital to have access to ongoing guidance and case supervision to ensure skills can be implemented in a practical, safe and effective way. Modern technology makes communication with mentors much easier than it once was, so these should be incorporated into the training.

Be part of something bigger

More than this, getting involved with dental implantology means joining a dynamic and growing network of professionals who are passionate about delivering exceptional

patient care with innovative surgical and restorative techniques. Camaraderie and friendship are particularly accessible within the Association of Dental Implantology (ADI). This community of likeminded professionals is actively sharing best practice, exploring new techniques, and pushing boundaries to deliver ever more predictable and effective implant care to patients. The ADI Fellowship Pathway accurately reflects the different career stages, designed to support individuals according to their needs, and to recognise those who have invested heavily in their development to reach a high level of expertise in the discipline. Membership benefits include various educational opportunities, 50 free patient leaflets, access to relevant journals, discounts on innovative record keeping technologies, and so much more. These are just a few of the elements required to build a long and successful career in implantology, but they provide an excellent foundation to work from. With adequate training and education, supported growth, and a community to turn to for advice and guidance, clinicians can really thrive in the discipline. For more information about the ADI, visit www.adi.org.uk n

About the author Dr Zubair Sacranie, ADI President-Elect.

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professions

Weather warning PM approaching

fter spending six hours navigating Storm Austen on the M1 recently, I was mulling over how often we check our own mood forecasts in practice. I’ve lost count of the number of practice managers who’ve told me they eat lunch at quarter to four, if they eat it at all. Most of them have unblocked a toilet. Plenty have a drawer full of phone chargers nobody has claimed since 2019. And nearly all of them can spot a problem in their practice from 50 paces. Ask them to look at their own leadership, though, and it goes a bit quiet. We’re very good at checking things, if we haven’t managed the art of delegation yet. Fridge temperatures, decon logs, GDC registrations, next week’s diary. I’ve yet to meet a PM who puts “have a look at how I’m leading” on the compliance calendar. It just doesn’t occur to us. There’s always something more urgent, and it’s usually beeping.

The team reads you first

Like it or not, your mood sets the weather in the building. The team will look at your face before they look at the diary. If you come in tense because the card machine’s playing up again, reception picks it up within about five minutes and the nurses aren’t far behind. I’ve watched a whole mor ning go sideways because a manager walked in without saying good mor ning. She wasn’t cross with anyone; she just had a lot on. But nobody knew that.

Knowing how you come across, rather than how you think you come across, is half the battle.

Stuck in the middle

Most PMs sit between an owner with big plans and a team who’d quite like to get through Tuesday. It’s a tricky spot, and it’s where a lot of us get flattened. If you don’t know what you tend to do under pressure, you’ll keep doing it. Some of us avoid. Some take everything on ourselves. Some go very quiet and build another spreadsheet. Be honest with yourself. When the owner overrules you in front of the team, what do you actually do? And that lateness conversation you’ve been meaning to have since August – are you still waiting for the right moment? I hate to break it to you, but it isn’t coming. What comes instead is a formal process and a lot more paperwork.

Confidence comes from doing

I used to think confident managers were just made that way. Thirty years in, I’m fairly sure they’re not. They prepare, they make a decision, they do what they said they’d do, and they hold their hands up when they get it wrong. Then they do it all again the next day. The confident feeling tur ns up later, usually when you’re not looking. Looking at your leadership profile tells you which of those you’re good at, and which ones you’ve been quietly side-stepping.

That voice in your head

“Who am I to tell a dentist what to do?” I hear some version of that in almost every room I train in. The answer’s simple enough. You’re the person responsible for how the practice runs, and being clear with people isn’t bossy. Being vague with them is far less kind.

The bits you got right

There’s something else PMs rarely do, and that’s notice what went well. The crisis you sorted before anyone found out about it. The nurse you nearly lost and didn’t. When you look properly at how you lead, you start to see the skills behind those moments, and then you can use them on purpose instead of hoping they tur n up.

Yes, it takes time

I know you haven’t got any. But an hour spent understanding how you lead will save you a lot of avoided conversations and late-night WhatsApps further down the line. You don’t need to have every answer. You do need to be the person who doesn’t walk past a problem, including the ones that start with you. Stay calm, be clear, and hold the standard kindly. Teams follow the manager they trust. The spreadsheet, however lovely, comes a distant second. n

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

From chairside to chair

arah Saleem has become the new Chair of the BADN Education Committee. As a qualified dental nurse and the founder of iCare Dental Nurses Training Solutions Ltd, Farah is currently employed as a general practice dental nurse in Manchester. Farah qualified in 2013 after completing the National Diploma in Dental Nursing while working as a Dental Receptionist. After working as a dental nurse for three years, Farah successfully applied for a Senior Management role at another dental practice, where she remained for six months. During her time there, she completed a sedation training course with SAAD, which allowed her to expand and further her skills as a dental nurse. Working there exposed her to the daily running and management of dental practices and what is involved in the running of a successful business. In 2015, she decided to leave her

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position as Senior Manager and began working as a locum dental nurse. In her four years working for a dental nurse agency, she worked across Greater Manchester and also travelled to Jersey to work as a dental nurse.

During her time as a locum dental nurse, Farah was approached by a fellow dental nurse who was in the process of setting up a course teaching the National Diploma in Dental Nursing and asked her to join as a dental tutor. She completed a course with ALISON (Advanced Lear ning Interactive Systems Online), obtaining a diploma in teaching skills for educators. She was only with this Dental Training School for a short time, but it was during this time she decided she would like to open a training academy teaching herself to teach the next generation of dental nurses. iCare Dental Nurses was founded in 2018, and Farah enjoys teaching students in a classroom environment, which is not something widely offered in the North West of England. She also wanted to expose the dental nursing role to people who may not have considered this as a career, largely due to the lack of classroom courses

available. Farah uses her experience as a dental nurse when teaching her students, hoping they will enjoy working as dental nurses as much as she does and strive to become valued members of the practices and communities where they work. Farah is an ambassador for dental nurses in her own right as she is so passionate about her own dental career, where this has led her, and the opportunities it has given her. Therefore, she wants to share this journey with others so they may benefit from such an amazing career. As the Chair of the Education Committee, Farah is also a member of the BADN Community Committee. n

About the author Pam Swain MBE is Chief Executive of BADN.

The Probe | November 26

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PROFESSIONS

Stronger together – no one truly goes it alone

hroughout history, few discoveries or inventions have been the result of a single person’s work in isolation. Most milestones have been influenced by a number of individuals, with the work of many people contributing to the final breakthrough. Take the famous electric light bulb as an example – Thomas Edison is credited with its discovery in 1879, but the Menlo Park Laboratory and everyone working there were critical in its development. Similarly, Sir Alexander Fleming is known for discovering penicillin – while he was the one to notice mould growing, he was only able to do this following collaborative work with Sir Howard Florey and Ernest Boris Chain. All three received the Nobel Prize in Physiology or Medicine back in 1945. More recently, Steve Jobs was inspired by a visit to Xerox PARC before developing smartphone technology that propelled Apple to the top of the field. All of these situations demonstrate that collaboration, shared thinking, and the coming together of expertise are essential for true development and innovation – no matter the field. This is as true in dentistry today as it was in scientific research more than 100 years ago. For the modern dental team, establishing opportunities to facilitate this engagement with others, to learn from peers, and explore challenges with likeminded professionals is crucial.

Peer-to-peer learning

There is a body of evidence to support the benefits of peer-to-peer learning and the different techniques available. For instance, reciprocal peer tutoring is a promising

educational tool, encouraging interest, enthusiasm and engagement among medical students as they take on teaching roles or learn from other students during their study. There is also merit in peer mentoring as a supportive scheme that helps individuals improve their experience and performance, with research indicating links to improved emotional wellbeing and self-confidence for students. It has also been suggested that peer-assisted learning affords the greatest advantages when applied to clinical training and the development of practical skills. This is especially relevant in dentistry given the hands-on nature of postgraduate training requirements.

Support, guidance, recommendation, and ideas

Of course, having the chance to learn with and from colleagues is not just about the practical progression of skill and ability. It also provides an invaluable source of support. In a profession where mental health challenges are common, the importance of active intervention – including peer support – is being studied more and more.

As such, peer-led mental health support is growing in popularity and effectiveness, though it remains a fairly underutilised solution, even among university students. Having access to a network of individuals who can be trusted to provide honest feedback, sympathetic advice, and emotional support is, therefore, crucial for all dental professionals. These relationships also offer a chance to discuss common challenges, share stories, and generate new ideas for overcoming obstacles or enhancing business management. While intangible in nature, these conversations and connections are often key to unlocking the changes that can make or break a practice and a professional.

For the fun of it

Beyond the professional benefits, being part of a dedicated community within dentistry also delivers opportunities to socialise and have fun with likeminded colleagues. This is just as important as building professional relationships, and many individuals will make friends for life when attending industry events. Such connections contribute to a content working life – and this joy has wide-reaching benefits for clinicians, their practice, and their patients. Happy workers are more likely to be productive, increasing earning potential and ensuring a more efficient and streamlined daily routine. There is also evidence linking professional and patient satisfaction in healthcare.

team members to be part of a professional organisation like the British Academy of Cosmetic Dentistry (BACD). Tailored to those with an interest in ethical cosmetic dentistry, BACD membership provides access to a ready-made community of likeminded professionals who believe passionately in collaboration, motivation, support, and genuine friendship. Various educational and social events throughout the year and across the nation provide an opportunity to engage with colleagues, industry experts, and more, to discover emerging clinical trends, explore new technology, and discuss personal experiences. Whether you are facing difficulties in the practice, are worried about the future, or looking for advice about an upcoming change, you will find people to support you at the BACD. Few people in the history books were alone in making the discovery they are so well known for. All the greats had a support network behind them, contributing expertise, ideas, and assistance. Being part of a community in dentistry is just as important for all members of the team as they build a career. For further information about the British Academy of Cosmetic Dentistry, visit www.bacd.com 

About the author Dr Carol Somerville, President of BACD.

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patient plan direct

NHS conversion: the numbers are only the beginning

By Matt Hadman, Head of DSOs, Patient Plan Direct

hen considering an NHSto-private conversion, it is useful to start with the numbers. How many patients would need to join a membership plan? How much private treatment income would be needed to contribute to replacing existing NHS earnings? Could the figures support the future you want?

Marie, Head of Client Services at PPD Our online Path to Private Practice Review gives practice owners a starting point. By entering key financial information relevant to their practice, they can receive a tailored report that drops instantly into their inbox, showing the estimated plan patient numbers and private treatment income required to replace their NHS income. Think of it like a mortgage agreement in principle: an indication of what might be possible. The next step, however, is to have a detailed conversation with someone who can explore your circumstances and help shape your personal and professional objectives. For a dental practice, that means looking beyond the numbers, as they’re just the beginning. It’s important to clarify: • Who do you want to care for? • How should the patient experience be shaped?

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• How

will appointments, communication and the wider patient journey evolve? • What investment, training and technology will support that ambition? Signing patients up to a private dental membership during a conversion is important (as, on average, that will make up c.40% of your current NHS annual income). But it is only one milestone. The l o n g e r- t e r m c h a l l e n g e i s c re a t i n g an environment where private membership becomes part of everyday practice life, supported by a practice team who understands and believes in it.

Team engagement deserves attention

The team is integral to conversion success. They need to understand why a move from NHS to private dentistry is being considered in their practice, what it means for their roles and how it can benefit patients. They also need a safe space to ask questions and raise their concer ns. Training should also build their confidence, so when the time comes to communicate the change to patients, they can explain the benefits confidently.

Shula, Client Services Coordinator

Today’s Dental, one of our biggest clients, offers a useful example. Several of its Welsh practices converted from NHS to private dentistry this year. The group brought these practice teams together for a discovery day, to discuss not just the upcoming NHS conversion, but the two years ahead, positioning the conversion within a broader longterm vision for each practice. Lisa McKinnon, Chief Operations Officer at Today’s Dental, describes Patient Plan Direct’s guidance as an integral part of that bigger picture. We aligned with the company’s goals, which are regularly measured and reviewed together. That approach matters: conversion becomes a step towards shared objectives, rather than an isolated project.

Choosing the right plan support

Who can help you achieve a successful conversion, and continue working alongside you over the next five-plus years? Initial admin fees and launch support are relevant, of course, but so are ongoing engagement, practical guidance and a relationship you can trust. So, choosing support from a plan provider requires thorough consideration. At Patient Plan Direct, we combine technology with personal support. Seamless patient sign-up and plan management integrations can improve efficiency, while a dedicated manager helps practice owners and their teams embed membership into the practice. Ongoing training, in-practice reviews and guidance support that process as the practice and its plan grow. Technology keeps evolving, and practices need to understand where it can help support growth. Equally,

Alice, Business Management team human conversations remain essential: listening to concer ns, reviewing progress, identifying opportunities together and finding solutions. Since 2009, that combination has been central to how we support our clients.

Long-term partnerships equal success

If you’re exploring what a conversion could look like for your practice in 2027 and want an indication of the plan membership and private treatment income needed to replace your current NHS income, explore our Path to Private Practice Review online: patientplandirect.com/path-to-private Book a meeting and use those figures to guide a call with our conversion team. Let’s discuss your vision for your practice, and we’ll share information on how our personal support and plan options will help you get there. n

The Probe | November 26

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Path to Private Practice Review Could an NHS-to-private conversion work for your practice? Find out today. Scan to begin your review:

patientplandirect.com/path-to-private info@patientplandirect.co.uk

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professions

Habit stacking in practice Examining change within our dental careers and practices

ositive change doesn’t always need a grand plan. As a lifelong devotee of personal development in all its forms, I am a big fan of habit stacking*. It’s a simple concept: rather than trying to introduce a completely new behaviour, we attach it to something we already do regularly. The existing habit becomes a trigger or reminder for the new one. For example, after making your morning coffee, you might add in the habit of drinking a small glass of water. After brushing your teeth, you might spend two minutes stretching. Or, once you take your seat at your desk or on the train, you might take five minutes to map out the day ahead. The important thing is that the new habit isn’t floating around waiting for you to remember it. It becomes part of something that is already established. If you consider the shape of your typical day, there will be so many opportunities for habit stacking. Even if you don’t consider yourself to be a creature of habit, there will be things you do habitually without you even noticing – because they’re embedded in your routine. We’re likely to be more conscious of new habits because we’re having to remember and integrate them. Habit stacking can be the gateway to more wholesale change. Reshaping how we behave needs discipline, motivation or perhaps a completely new routine. But creating new rituals that follow on from established tasks makes them much more likely to stick.

Habit stacking isn’t about adding more work. It’s about finding opportunities to build improvement into things we are already doing. It’s about making small changes, repeated consistently. It’s consistency over intensity and it’s a far kinder way for us to introduce change and manage our goals. Whether we are thinking about personal development, teamwork, patient care or clinical practice, positive change rarely comes from doing something once. It comes from doing the right things consistently. Perhaps that’s what makes habit stacking so powerful. Eventually, the new habit doesn’t feel like a new habit at all. It simply becomes part of what we routinely do – like making the coffee or checking our phone. *Credit: I first came across habit stacking in James Clear’s amazing book ‘Atomic Habits’, which I’d recommend, along with his weekly newsletter, 3-2-1 Thursday.

About the author

Our brains are very good at recognising patterns and following familiar sequences. Once a behaviour becomes habitual, we don’t have to consciously decide to do it every time. By linking something new to something familiar, we are making the process of change more manageable. This can be particularly useful in a professional environment, where many of

our working days are already structured around established routines and processes. A specific point in a clinical workflow could become a cue to check something important. A team meeting could naturally become the prompt for a new communication habit. Finishing one task could become the reminder to prepare for the next.

Dr Dhiraj Arora BDS MJDF RCS (Eng) MSc (Endo) PG Cert CE. Owner of evo endo, with three practices (limited to endodontics) in Twickenham, Gerrard’s Cross and Slough. Dhiraj is a passionate teacher and ambassador for all things endo. Follow him on Instagram: @drdij_evoendo

he health economist Martin Buxton once observed that it is always too early to evaluate a new technology, until suddenly it is too late. After half a century in dentistry, I can only say he was being kind. I qualified in 1978, and I have watched a great many things arrive with a fanfare and settle in without anyone quite noticing when the question “does it work?” stopped being asked. One of the “new” materials in my final year was stuff called “glass ionomer”; an old hand on the clinic said it would be “a nine-day wonder”.

with Alun Rees

D E N T I S T R Y T O D AY

Too early, until it’s too late (Buxton’s Law)

alun@alunrees.com

50 50_Probe-November_Professions.indd 1

Take the six-monthly “recall” or “just-a-check-up”, as it is still called in many practices. Generations of patients were told to come back every six months, and generations of dentists, myself included until I saw the light, said it with total conviction. It was a lovely rhythm, but it turned out to have little evidence behind it. But the NHS “allowed” a claim for it. When NICE finally examined it, their conclusion was that the interval should depend on the patient’s risk, not the calendar. By then the habit was fixed, and so were most appointment books. Or what about wisdom teeth? The cause of training, employment (and blocked beds), for several generations of oral surgeons. For years the prophylactic removal of “impacted” third molars was close to routine. Nobody could say precisely what we were preventing, but the thinking was that it was better to be safe. NICE finally advised against removing symptom-free teeth around the end of the last century. Many people had been through the

procedure by then, some left with a numb lip for their trouble. Don’t get me wrong, the new has often been splendid and dentistry is always embracing change. Implants have transformed what we could offer a patient who would once have faced a lifetime of denture-wearing oral gymnastics. But it took years of widespread use before peri-implantitis and the long-term maintenance burden were properly understood. That is Buxton’s Law at work: the evidence arrives when the technique is already in thousands of mouths. Then there is amalgam. We placed it for nearly two centuries on the strength of “it has always worked”, and it took environmental pressure, not clinical doubt, to bring it to its long-overdue review. I have several amalgam-restored molars that were successfully treated before I started at dental school and see little point in inviting “iatrodontic” complications for a prettier tooth. In case you think I am suggesting “distrust the new”, remember

the old has been just as guilty. Antibiotic prophylaxis before dental treatment was gospel until it was curtailed in the 21st century, when the argument simply started again in the opposite direction. Dogma can sit in a surgery as comfortably as a shiny new gadget. So I find myself, at this nonclinical stage of my career, with a simple, fairly modest creed. When something new arrives, whether it’s a scanner, an aligner, a laser, a clever algorithm or yet another clever marketing method, I try to ask, “What is it for, who says so, and how and when will we know if it doesn’t work?” And when something old is defended with the words “we have always done it this way”, I ask exactly the same questions. Buxton’s Law can’t be beaten, but it can perhaps be softened. The sooner we ask the awkward question, the less likely it is that we will be asking it too late. In other words, “neither be the first, nor the last, on the block with anything”. That’s (one of) Rees’s Laws. n

The Probe | November 26

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PROFESSIONS

Dental trauma starts with first aid

he British Society of Paediatric Dentistry (BSPD) and Dental Trauma UK (DTUK) recently announced a formal collaboration, bringing their clinical expertise and educational resources closer together. It is a welcome development in a field where timely, consistent management matters. For an avulsed permanent tooth, however, care begins before a dental professional is involved. The first person able to help is more likely to be a parent, teacher, coach or first aider. What happens during those first few minutes may influence the prognosis before the patient reaches the dental chair. That makes its immediate management a matter of first aid.

Before the patient reaches us

The International Association of Dental Traumatology (IADT) recommends immediate replantation of an avulsed permanent tooth when this is safe and appropriate. If that cannot be done, the tooth should be protected from drying out and transported in a suitable medium while urgent dental care is arranged. An avulsed primary tooth should not be replanted.1 These actions do not require a diagnosis or detailed knowledge of dental trauma. They require someone at the scene to recognise the situation, follow clear instructions and know where to seek urgent help. In 2024, the IADT and the Academy for Sports Dentistry published dedicated guidance on dental-trauma first-aid education.2 This reflects an important

reality: clinical guidance cannot improve an outcome unless the essential parts reach the non-dental people expected to act first.

Knowledge, confidence and responsibility

A London study of schools and casualty departments found that school staff who had previously received advice about avulsion were three times more likely to say they would attempt replantation than those who had not.3 Respondents also described uncertainty about their ability and concerns about the consequences of intervening incorrectly. The study was published in 2007 and cannot provide a precise picture of current UK preparedness. Its underlying lesson remains relevant: recognising that a knocked-out tooth is urgent does not necessarily leave someone prepared to manage it. Reviews of educational interventions have generally found that teaching improves dental-trauma knowledge. They also expose the limits of education delivered in isolation. Knowledge may decline after the initial intervention, methods vary considerably, and most studies measure answers to questionnaires rather than behaviour during a real emergency.4 Preparedness therefore requires more than awareness. People need concise instructions, confidence in their role and access to the right information when the injury occurs. A lecture remembered vaguely several years later is unlikely to be enough.

Bringing dental trauma into first aid

Avulsion management begins at the scene, so dental trauma should be considered within mainstream first-aid preparedness rather than communicated only through dental channels. The first aider’s role should remain deliberately limited. Teachers, parents and coaches should not be expected to make complex clinical judgements. They need a small number of safe, memorable actions: distinguish between primary and permanent teeth, handle an avulsed tooth carefully, prevent it from drying out and arrange urgent professional care. Dentistry has a practical role in making those actions part of first aid. The profession should establish how dental trauma is currently addressed by major training providers, work with them to produce clinically consistent advice and support reinforcement beyond a single teaching session. Dental practices should also review the instructions given when a school, parent or sports club calls about an injury. Good action at the scene achieves little if the route to urgent dental care is unclear. The practical route is to incorporate this limited but important dental emergency into the first-aid structures people already use. The new BSPD–DTUK collaboration strengthens the professional foundations for trauma care. The wider opportunity is to ensure that this expertise travels beyond dentistry. Guidance is most valuable when it can be understood and used by the person beside the injured patient.

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Where decisive action is required before a dentist is present, dental trauma belongs within first aid as well as dentistry. Our profession has a role in making that happen. 

References 1.

Fouad AF, Abbott PV, Tsilingaridis G, Cohenca N, Lauridsen E, Bourguignon C, O’Connell A, Flores MT, Day PF, Hicks L, Andreasen JO, Cehreli ZC, Harlamb S, Kahler B, Oginni A, Semper M, Levin L. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol. 2020 Aug;36(4):331–342. doi: 10.1111/ edt.12573. Epub 2020 Jun 13. PMID: 32460393. Tewari N, Abbott PV, O’Connell AC, Mills SC, Stasiuk H, Roettger M, et al. The International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD) guidelines for prevention of traumatic dental injuries: Part 10: First aid education. Dental Traumatology. 2024; 40(Suppl. 1): 22–24. https://doi.org/10.1111/edt.12931 Addo ME, Parekh S, Moles DR, Roberts GJ. Knowledge of dental trauma first aid (DTFA): the example of avulsed incisors in casualty departments and schools in London. Br Dent J. 2007 May 26;202(10):E27. doi: 10.1038/bdj.2007.328. Epub 2007 Apr 13. PMID: 17435696. Nowosielska M, Bagińska J, Kobus A, Kierklo A. How to Educate the Public about Dental Trauma – A Scoping Review. Int J Environ Res Public Health. 2022 Feb 21;19(4):2479. doi: 10.3390/ijerph19042479. PMID: 35206665; PMCID: PMC8872546.

About the author Dr Yousuf Ibrahim BDS, General Dental Practitioner and Founder of ToothRevive.

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treatment

Advancing endodontic Minimising patient and outcomes with pulpotomy clinical risks Dr Phil Tomson, Past President of the British Endodontic Society (BES), discusses the value of managing irreversible pulpitis with pulpotomy, the factors to consider during case selection, and what its implementation in general dental practice could mean for practitioners and patients alike

pulpotomy is a clinical procedure whereby part of the inflamed pulp is removed. Subsequent to its removal, a layer of biocompatible material is applied – a calcium silicate cement, such as Biodentine XP from Septodont – allowing the remaining pulp to heal. Pulpotomy is a far simpler procedure than traditional root canal treatment and could be appropriate for most patients with irreversible pulpitis. Clinicians of any experience level can provide it, including new graduates, with advantages for both dentists and patients.

Factors affecting decision making

Pulpotomy should be considered whenever vital pulp is under threat – when it becomes exposed if the dental decay has entered the pulp or if the pulp is inadvertently compromised during caries treatment even in cases of what is known as irreversible pulpitis. The rise of vital pulp therapy, and pulpotomy specifically, has been a major advance in managing endodontic disease in the last 5-7 years. Evidence suggests that it can be performed on patients with irreversible pulpitis – those with prolonged, gnawing pulpitic pain. Traditionally in such cases the only option for treatment has been the choice between root canal treatment or extraction – pulpotomy provides clinicians with another option.

Benefits all round

When compared to conventional root canal treatment, pulpotomy is far quicker, simpler, and can be provided by any dentist. So, when patients come in with the classic symptoms of irreversible pulpitis, this can and should be the first port of call. As such, pulpotomy is potentially a definitive treatment that can be provided within an emergency appointment slot in comparison to more complex root canal treatment which in most cases, is unlikely to be achievable in such situations. Compared to traditional root canal treatment, pulpotomy is also more costeffective, requiring less chair time to complete the procedure. Additionally, it preserves the blood supply and pulp – the tooth’s natural defence system – allowing it to respond and protect the tooth going forward. This is a fantastic outcome for patients, especially considering that root filled teeth are more vulnerable to high biting forces, and that rates of bruxism rose

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during the COVID-19 pandemic and have persisted since then. This pairing creates a risk of treatment failure that, where at all possible, should be avoided. Pulpotomy is particularly beneficial for younger patients, especially those between 6 and 11 years of age. This is because their roots are still developing at this age, so a pulpotomy would preserve sufficient pulp to enable this crucial process to complete.

Raising the profile of pulpotomy

The goal of the British Endodontic Society (BES) is to promote and advance endodontics. Pulpotomy for definitive treatment marks the most impactful change in our ability to carry out endodontic treatment since the introduction of NiTi files in the early 1990s. Currently, there are over 49,000 registered dentists, according to the General Dental Council, and only 349 of these are endodontic specialists. General dental practitioners are the professionals who see most of the disease, so it is important that they know about this transformative procedure and feel confident to provide it to their patients. Increased provision of pulpotomy procedures will, ultimately, increase tooth retention amongst the population and an estimated 60,000-80,000 fewer conventional root canal treatments will be provided as a consequence within the NHS. Additionally, the pulpotomy procedure provides another treatment modality within the restorative cycle, meaning that should it fail, the option of conventional root canal treatment is still available, as is extraction. Overall, this will help patients to retain as much of their natural dentition as possible for as long as possible. Expanding the awareness and use of the pulpotomy will bring the conservation of natural tooth tissue, maintain pulp viability, and add an extra treatment modality in the restorative cycle. It is a definitive treatment possibility in an unscheduled appointment, which incurs a lower cost, which is easier for the clinician to perform and is thought to be the patient preference when compared to extraction and root canal treatment. However, this expansion will ultimately only be possible with a change in culture, knowledge, and the education surrounding it. For more information about the BES, or to join, please visit www.britishendodonticsociety.org.uk or call 07762945847 n

About the author Dr Phil Tomson, Past President of the British Endodontic Society (BES).

odern dentistry is all about delivering exceptional outcomes in the safest, most predictable, and conservative way. The treatment workflow requires a significant amount of time to be spent assessing the clinical situation in order to determine the best possible solution for that specific patient. This process includes identifying any potential complications, and then designing the treatment plan to avoid them completely or mitigate their impact on the final outcome. Both patient and clinical factors should be incorporated to optimise the result and ensure a smooth treatment journey.

Managing patient factors

When it comes to the patient, there are several risk management strategies to consider. The first is to effectively control patient expectations so that they know exactly what to expect both during and after treatment completion. By understanding what patients desire from their care, professionals will be better informed of their priorities and can plan treatment accordingly. Given that management of patient expectations is directly linked to their satisfaction with the outcomes achieved, the entire process is crucial for delivering dentistry to the standard that each patient anticipates. This also entails supporting patients to ensure their aims are achievable, and in the best interests of their oral health. Social media in particular may create unrealistic expectations for treatment outcomes, and patients should be aware of the difference a given intervention will make. Other patient-related risk factors involve their lifestyle habits and commitment to ongoing oral hygiene maintenance. Smoking, for example, is linked with a 140% higher risk of implant failure compared to treatment in non-smokers. It also negatively impacts periodontal health, increasing the risk of periodontitis, whether the patient is undergoing any kind of active treatment or not. As you will know all too well, poor oral hygiene also has a substantially negative influence on longterm oral health and treatment outcomes. To mitigate these risks, a relationship needs to be built between patient and practitioner. Effective communication is the cornerstone of establishing this rapport, helping patients to place trust in their dental team. Technological developments have been instrumental in strengthening this relationship, in turn increasing patient engagement with their oral healthcare and boosting their satisfaction. With improved patient communication comes better education, which has also been found to reduce the risk of litigation against dental professionals. Though not a new concept, this bond remains key in the delivery of exceptional patient care today.

Overcoming clinical challenges

Another area of risk is that of clinical complications. For instance, common problems to arise alongside implant therapy are peri-implantitis (affecting

approximately 10% of implants), and bone loss greater than 2mm (6%) within five years. Orthodontic treatment is often associated with root resorption, while common risks of endodontic include iatrogenic perforation, ledge formation, and canal blockage, among others. In many situations, the skill and confidence of the practitioner may impact the success of treatment and the avoidance or management of complications. This is why it’s so important for professionals to complete ongoing training and education, updating their knowledge and capabilities according to the latest evidence-based techniques and technologies. Meticulous assessment, diagnostics, and treatment planning are also vital to minimise the incidence of these adverse events. This is crucial no matter what type of treatment is being provided, how complex it initially seems, and which clinical techniques are to be implemented. Reliable diagnostic imaging is crucial for this stage in the treatment process. For more complex treatment therapies involving implants, oral surgery, or advanced endodontics, for example, 3D imaging will be crucial, emphasising the importance of access to high-quality equipment. When you choose solutions like the CS 9600 CBCT scanner from Carestream Dental, you will benefit from the world’s most intelligent CBCT system – a scalable, 5-in1 solution that is easy to use, AI-powered, and capable of delivering crystal-clear images from a broad range of volume sizes. A low-dose imaging mode further reduces risk for the patient, enabling imaging with up to 85% less radiation exposure than 2D panoramic images.

Safer and more predictable care

Ultimately, there will always be risks associated with any dental treatment. However, it is the dentist’s responsibility to minimise the risks associated as much as possible with meticulous assessment, diagnostics, planning, and execution. The goal is to offer highly predictable clinical solutions that deliver excellent outcomes in a safe and efficient way. Patient communication is vital in order to address lifestyle and other modifiable risk factors, as well as to manage their expectations and ensure informed consent. 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

About the author Nimisha Nariapara, Trade Marketing Manager at Carestream Dental.

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RAPID RELIEF AT THE ROOT OF PAIN1-3 4 IN JUST RAPID RESPONSE Clinically proven to get to work in under , relieving acute 4 dental pain. TARGETED RELIEF Benzocaine provides effective relief right at the source of dental pain.1-3 TRUSTED TOLERANCE Orajel’s non-systemic formula is well-tolerated with minimal risk of side effects.1,2,4 WILL ORAJEL BE YOUR RECOMMENDATION FOR TARGETED, RAPID PAIN RELIEF?

UNDERSTAND THE SCIENCE BEHIND ORAJEL WATCH THE MODE OF ACTION VIDEO Provides up to 2 hours of relief.4 Adverse events should be reported. Reporting forms and information can be found at https://yellowcard.mhra.gov.uk/. Adverse events should also be reported to Church & Dwight +44(0) 808 175 6410 Orajel Dental Gel (GSL). Benzocaine 10% w/w. For temporary rapid relief of toothache pain associated with presence of open carious lesions and direct exposure of a vital dental pulp. Orajel Extra Strength (P). Benzocaine 20% w/w. For temporary rapid relief of toothache pain associated with presence of open carious lesions and direct exposure of a vital dental pulp. Church & Dwight UK Ltd., Premier House, Shearway Business Park, Pent Road, Folkestone, Kent, CT19 4RJ. Information about this product, including adverse reactions, precautions, contra-indications, and method of use can be found at: https://www.medicines.org.uk/emc/product/1230/smpc https://www.medicines.org.uk/emc/product/1229/smpc REFERENCES: 1. Orajel Dental Gel. Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/1230/smpc Accessed: November 2024 2. Orajel Extra Strength. Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/ product/1231/smpc Accessed: November 2024 3. Lee, H-S. Recent advances in topical anesthesia. J Dent Anesth Pain Med. 2016;16(4):237–244. 4. Hersh, EV, et al. An evaluation of 10 percent and 20 percent benzocaine gels in patients with acute toothache. J Am Dent Assoc. 2013;144(5):517–526. O035 | April 2025

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CPD: GC

Luting cements made easy with one simple choice Aim:

To enhance understanding of luting cement selection and cementation protocols for indirect restorations in the context of increasing dental activity, supporting efficient clinical care, tooth preservation and predictable outcomes.

Learning objectives: • To compare the properties and clinical indications of self-adhesive resin and resin-modified glass ionomer luting cements • To explain how restorative material, preparation retention, isolation and aesthetic requirements influence cement selection • To describe when additional adhesive steps are required, including tooth and restoration surface preparation, for conservative indirect restorations GDC anticipated learning outcomes: B,C August 2026 saw the latest release of statistics for NHS dental activity in England for the NHS Year ending March 2026.1 Although this data is limited to England, it represents the largest population across the UK, so it can be considered directional in terms of an overview of overall activity. This latest data showed:

• There were 37.6 million courses of

treatment (COTs) delivered, over 6% more than NHS year ending March 2025 1 • Dental care professionals (DCPs) also played a greater role in the delivery of NHS provision as dental hygienists and dental therapists are now permitted to lead on dental activity within their General Dental Council (GDC) scope of practice.2 This DCP-led activity accounted for over 7% of the total COTs to NHS year ending March 2026. This is double the percentage of the previous year and accounts for around 2.78 million COTs. Dental therapists were reported as delivering 98% of this DCP-led activity1 Additionally, and as part of the UK mixed dental economy, there has been a reported increase in independent/ private dental provision, however the clinical activity within this type of provision is not published. Overall, the data suggests the amount of clinical activity is increasing chairside.3 This means dental professionals now have an even greater need for quality materials to support the optimal delivery of their clinical care. GC has a long history of developing the materials that become part of everyday dentistry. Many of the products you already know, and trust have grown from GC’s pioneering expertise including the long-established Fuji range, built on GC’s innovations in glass ionomer technology. We continue to innovate with fibre-reinforced composites, high-

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strength injectable composite materials, glass hybrid restoratives and reliable luting cements.

Luting cements The demands placed on luting cements have evolved alongside restorative dentistry. Secure retention and an effective marginal seal remain essential, but clinicians must also consider preservation of tooth tissue, increasingly diverse restorative materials, aesthetic expectations and the practical demands of everyday treatment. Cement selection is therefore part of treatment planning from the outset. The chosen material must suit the restoration, the remaining tooth structure and the conditions under which cementation will take place.

Reliable luting cements are a particularly relevant example of how GC’s expertise supports the changing needs of everyday clinical practice, including minimally invasive dentistry and the simplification of inventories at this time of increased clinical activity Clinicians therefore need cementation options that support both conservative adhesive treatments as well as routine crown and bridge work. Two complementary materials within GC’s portfolio meet these needs: • G-CEM ONE, a universal selfadhesive resin cement • GC FujiCEM Evolve, a resin-modified glass ionomer cement The move towards minimally invasive dentistry has also increased the importance of adhesive luting. Where

To complete the questions and gain one hour of CPD, visit cpd.the-probe.co.uk/

clinically appropriate, bonded partialcoverage restorations allow dentists to preserve tooth tissue that might otherwise be removed to accommodate a full crown. In these cases, the cement and bonding protocol form an integral part of the restorative design.

GC’s G-CEM ONE GC’s G-CEM ONE system accommodates both retentive preparations and situations requiring additional adhesion, including veneers and onlays, when used with the appropriate protocol. GC G-CEM ONE is a dual-cure, universal self-adhesive resin cement. Its clinical appeal lies in the flexibility to use a simplified self-adhesive approach for suitable cases, and with GC G-CEM ONE Adhesive Enhancing Primer or G-Premio

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BOND when additional adhesion is required. This allows clinicians to work with a familiar cement system across a broad range of indirect procedures. Its self-curing capability is particularly relevant beneath restorations that restrict light transmission, while its colour stability and wear-resistant margins support aesthetic applications. This versatility depends on following the protocol for each indication: • For veneers and onlays, enamel etch and then follow with G-CEM ONE Adhesive Enhancing Primer or G-Premio BOND • Restoration surfaces would also require preparation appropriate to their material Understanding these distinctions enables clinicians to make effective use of a universal system while retaining the steps needed for dependable adhesion.

CPD: GC GC FujiCEM Evolve Alongside adhesive resin cementation, resin-modified glass ionomer cements continue to meet important clinical needs. Their development combines the chemical adhesion and moisture tolerance associated with glass ionomer technology with the contribution of a resin matrix to improve mechanical performance. GC FujiCEM Evolve brings this approach to contemporary crown and bridge work, with relevance to suitably retentive metal-based and zirconia restorations. For the dental team, FujiCEM Evolve’s benefits are tangible with paste-to-paste delivery, a choice of hand mixing or auto mixing, and a tack-cure option to facilitate excess removal. Its moisture tolerance is useful where isolation is challenging, although contamination control remains necessary. In suitable cases, cementation without separate tooth etching and bonding provides a straightforward workflow. These characteristics make it a practical option for routine indirect restorative care.

CPD Questions 1. In the context of increasing dental activity, which approach best supports appropriate luting cement selection? a. Using the same cement for every indirect restoration b. Choosing a cement based solely on speed of placement c. Considering the restoration, remaining tooth structure and cementation conditions d. Selecting a cement based only on aesthetic requirements 2. Which type of restoration is most likely to require an adhesive resin cement protocol? a. A bonded partial-coverage restoration that depends on adhesion for retention b. A metal crown with adequate retention and resistance form c. A zirconia crown on a suitably retentive preparation d. A conventionally retained metal-based bridge 3. Why is the self-curing capability of a dual-cure resin cement useful beneath some restorations? a. It removes the need for restoration surface preparation b. It supports setting where light transmission is restricted c. It eliminates the need for contamination control d. It makes additional adhesive steps unnecessary in every case 4. Which statement about resin-modified glass ionomer luting cements is correct? a. They are suitable for every veneer and onlay b. They require separate tooth etching and bonding in all cases c. Their moisture tolerance eliminates the need for contamination control d. They can be suitable for metal-based and zirconia restorations with adequate preparation retention

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Relevance to modern dentistry

References

The relationship between these two materials is particularly relevant to modern dentistry. A conservative restoration that depends on adhesion calls for an appropriate resin cement protocol. A zirconia crown with adequate retention and resistance may be well suited to a resin-modified glass ionomer cement. FujiCEM Evolve’s contribution is therefore different from that of adhesive resin cement: it provides a practical cementation option where the preparation and restoration already support conventional luting. For patients, the outcomes that matter are preservation of natural teeth, comfort, appearance and lasting function. For clinicians, achieving those aims requires materials that combine appropriate performance with manageable clinical procedures. By offering adhesive flexibility through G-CEM ONE and convenient resinmodified glass ionomer cement through FujiCEM Evolve, GC provides clinicians with one simple choice of two reliable and complementary ways to meet all their luting needs whilst supporting simplifying practice inventories.

1. h t t p s : / / w w w . n h s b s a . n h s . u k / statistical-collections/dental-england/ dental-statistics-england-202526 (accessed 16th October 2026) 2. https://thamesvalley.hee.nhs.uk/ wp-content/uploads/sites/5/2025/04/ Scope-of-Practice-Dental-Hygienistand-Dental-Therapist.pdf (accessed 16th October 2026) 3. BDIA Spotlight 2025 n

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Scan the QR code to find out more

About the author Debby Ward, Sales Manager Operatory, GC UK Ltd.

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CPD: A-DEC

Reducing Complexity through Connectivity Allan Wright explores how thoughtful equipment choices, clear routines and practical monitoring can help dental teams manage instrument decontamination and dental unit waterline care with greater consistency and confidence.

Aims and objectives The aim of this article is to explore practical approaches to instrument decontamination and dental unit waterline maintenance, with a focus on helping dental teams manage essential processes consistently and efficiently. On completing this CPD session, the reader will: • Understand the importance of clear, repeatable processes for instrument cleaning, sterilisation and dental unit waterline care • Recognise how equipment design and automation can help reduce unnecessary manual steps • Understand the relationship between routine waterline treatment, monitoring and shock treatment • Appreciate how clear protocols, appropriate equipment and defined team responsibilities can support consistent day-to-day maintenance.. Learning Outcome: B, C Dental teams carry considerable responsibility for instrument decontamination, sterilisation and dental unit waterline care, all while keeping the clinical day moving smoothly. With several stages, various pieces of equipment and shared responsibilities involved, even familiar routines can place significant demands on time and attention. Well-designed systems can help ease some of that pressure by making essential processes clearer and more repeatable. Straightforward controls, practical prompts and equipment designed around the task can support the team without adding unnecessary complexity, particularly where several people share responsibility for decontamination and maintenance.

Maintaining a consistent instrument journey Effective sterilisation starts before an instrument reaches the steriliser, making the cleaning stage an important part of the wider decontamination process. In a busy practice, this needs to be a process the team can carry out reliably throughout the day, with enough clarity around settings and procedures to avoid unnecessary variation. The A-dec Fortis+ Ultrasonic Cleaner offers six preset cycles tailored to common applications, including instruments, burs, impression trays and prostheses, alongside adjustable time and temperature settings. Visible status information and straightforward controls help teams follow a defined process without having to recreate settings each time, while routine care still includes cleaning the tank, replacing cleaning solution and following the manufacturer’s instructions. That same consistency needs to continue as instruments move through the broader decontamination process, with clear records supporting what has taken place along the way. At the

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sterilisation stage, the Fortis+ Class B Dental Steriliser records key information and combines programmable cycles with digital traceability, allowing information to be stored, searched and transferred. This makes sterilisation records easier to access and review as part of the overall process. Equipment care also forms part of that workflow, with maintenance notifications and built-in video guidance prompting routine tasks that can be completed in-house, helping practices to bring equipment maintenance into an established working pattern rather than relying solely on memory.

Keeping steriliser performance on track The water supplied to a steriliser also matters because mineral content in mains water can contribute to limescale, deposits and corrosion over time. Considering water quality alongside the sterilisation process can therefore help practices protect the equipment and support reliable performance. The Fortis+ Water Filter supplies demineralised water directly from the local supply to the steriliser, helping protect long-term performance while giving the team one less separate issue to manage manually.

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Looking at decontamination in this wider way can also help practices see how each stage connects with the next. Those connections are worth considering in terms of whether they make the process easier or more difficult for the people carrying it out.

Explore A-dec’s cleaning, sterilisation and dental unit waterline maintenance solutions at uk.a-dec.com/clean-andmaintain, or speak to your local A-dec Territory Manager about the needs of your practice.

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Getting waterline care right The same principle applies to dental unit waterlines, where effective care involves more than a single action. A-dec’s ICX approach focuses on three connected stages: 1. Routine maintenance 2. Monitoring 3. Shock treatment when required. ICX tablets are intended for routine dental unit waterline treatment and are added to an empty self-contained water bottle before filling. Water quality should then be monitored regularly, with ICX Renew providing shock treatment when bacterial levels exceed the practice’s established action level. Understanding that distinction can help teams see waterline care as an ongoing process rather than a task completed in isolation. Routine treatment has one purpose, monitoring tells the team what is happening within the system, and the results determine when additional intervention is required. That clarity becomes particularly useful where several people share responsibility across different surgeries. When everybody understands what happens routinely, how water quality is checked and what should follow an unsatisfactory result, the team has a clearer common process to follow.

Reducing repeated manual steps Practices can also consider whether every part of a routine still needs to depend on repeated manual intervention. A-dec Maintain provides an integrated approach to dental unit

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CPD: A-DEC waterline treatment, continuously treating the system with a hydrogen peroxide-based solution while dedicated test strips allow levels to be checked weekly. One 750ml bottle lasts for approximately 30 to 40 working days, depending on usage. Water quality monitoring remains part of the protocol and, where results exceed the relevant action level, shock treatment is still required. This distinction is important because automation should sit within a defined maintenance process rather than replace professional oversight. What it can do is reduce the number of repeated manual steps the team needs to complete, which may be particularly useful where responsibilities are shared across several surgeries or members of staff. A more integrated set-up also gives practice leaders an opportunity to look again at who does what. The team should be clear about which elements happen automatically, which still require checking, how results are recorded and who takes action when monitoring identifies a problem. That shared understanding can be just as important as the technology itself.

Streamlining everyday waterline care Simple changes to equipment design can also make an established process easier to carry out. The A-dec Flush Dock provides dedicated positions for handpiece tubing and A-dec syringes, allowing waterlines to be flushed or purged while leaving the user’s hands free for other tasks. When paired with compatible A-dec delivery systems, timed settings can help teams follow defined periods consistently and reduce the need for somebody to remain with the equipment throughout the process. The Flush Dock can also be used when purging waterlines following ICX Renew treatment, bringing another part of the maintenance routine into the same practical set-up. For a team responsible for several surgeries, these practical details can make a real difference to how workable a protocol feels in practice. An essential task still needs to happen, but equipment that is straightforward to set up and use can make it easier to incorporate into the rhythm of the working day. Clear protocols remain essential alongside the equipment, with written procedures, appropriate training and defined responsibilities helping everybody understand what

CPD Questions 1. What does the A-dec Fortis+ Ultrasonic Cleaner offer to support different cleaning applications? a. One standard cycle for all instruments b. Six preset cycles tailored to common applications c. Automatic selection of cleaning solution d. A single fixed time and temperature setting

2. What three elements form the basis of A-dec’s approach to dental unit waterline care? a. Routine maintenance, monitoring and shock treatment when required b. Routine shock treatment, sterilisation and filter replacement c. Monitoring, sterilisation and equipment servicing d. Water replacement, filter replacement and routine sterilisation

3. According to the article, what can automation help reduce as part of routine waterline care? a. The need for water quality monitoring b. The number of repeated manual steps the team needs to complete c. The need for clear protocols d. Responsibility for preparing and maintaining surgeries

4. What do practices still need alongside equipment that makes a process easier to follow? a. Clear written procedures, appropriate training and defined responsibilities b. A separate maintenance process for every team member c. Daily changes to established protocols d. One person responsible for every waterline task needs to happen, when it should happen and what to do if something changes. The strongest systems bring those elements together, so the process, the equipment and the people responsible for it all work in a co-ordinated way.

Reviewing the whole process When cleaning and maintenance systems are working well, they can easily disappear into the background of the clinical day. That makes it worth looking at the complete workflow periodically rather than waiting for a problem to draw attention to one part of it. A useful review could consider whether: • The route from instrument cleaning through to sterilisation is clear and repeatable • The team can access and review sterilisation cycle information easily • Water supplied to sterilisation equipment is being managed appropriately • Everyone responsible for dental unit waterlines understands the routine maintenance protocol • Water quality is monitored at defined intervals and results are acted upon • Responsibilities remain clear when several team members or surgeries are involved

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• Equipment maintenance prompts

and checks are incorporated into existing practice routines. Questions such as these can help identify where unnecessary steps, uncertainty or reliance on individual memory have entered an established routine, as well as where thoughtful equipment choices could make responsibilities easier to manage. With this in mind, A-dec’s Fortis+ sterilisation range and dental unit waterline solutions have been developed around clear, repeatable processes, from instrument cleaning and cycle traceability through to water treatment, monitoring and routine equipment care. Technology continues to sit alongside training, professional judgement and well-developed protocols, with each playing its own part in helping teams maintain a reliable clinical environment. For practices, the goal is ultimately a practical one: processes that everyone understands, that fit naturally into the working day and that do not depend on one person remembering every step. n

About the author Allan Wright is A-dec UK’s Territory Manager for Scotland and Ireland.

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CPD: VOCO

I’ve exposed the pulp! What do I do now? Aim: To update the dental team on the management of deep carious lesions with vital pulp therapy (VPT), with a focus on the clinical handling of VOCO MTA vpt in its application capsule form.

Learning objectives: • Describe the principles of selective caries removal and the main forms of VPT • Explain why MTA-based cements are preferred to calcium hydroxide in many VPT cases • Outline the activation, mixing and delivery steps for the MTA vpt capsule • Identify the covering-layer options and the common handling errors to avoid • Discuss VPT prognosis and consent with patients GDC anticipated learning outcomes: A, C Deep caries is a daily challenge in general practice. When a lesion approaches the pulp, removing every trace of soft dentine often means exposing it, and an exposed pulp has traditionally pointed towards root canal treatment. Over the past two decades, evidence has shifted towards a more biological approach. Where bacterial challenge is controlled and a durable seal is achieved, the pulp can heal. Vital pulp therapy encompasses the procedures designed to make that possible.

with light pressure, taking care not to damage the foil seal. Then activate by pressing the plunger end of the capsule slowly down onto a hard surface, such as a table, as far as it will go. Prepare the capsule only when the field is ready, as the plunger must only be inserted and the capsule activated directly before use. 3. Mix. Load the activated capsule immediately into a high-frequency mixer with at least 4,000 oscillations per minute and mix for 30 seconds. Working time and consistency can vary with the type of mixer and the mixing time, so it is worth confirming that your amalgamator or capsule mixer meets the specification.

Diagnosis and selective caries removal

A deep carious lesion is typically one extending into the inner third or quarter of dentine radiographically, close enough to the pulp that complete excavation risks exposure. Diagnosis should combine pain history, sensibility testing, percussion, palpation and periapical radiography, along with an honest assessment of restorability. The traditional split between “reversible” and “irreversible” pulpitis is increasingly viewed as a blunt instrument, as many symptomatic teeth respond well to VPT when inflammation is confined to the coronal pulp. Current guidance, including the European Society of Endodontology position statement, supports selective caries removal. Infected dentine is removed from the periphery to hard dentine for a good seal, while excavation over the pulp is limited to avoid exposure. Depending on the outcome, the options are: • Indirect pulp capping: no exposure, with the remaining dentine covered by a bioactive material • Direct pulp capping: a small exposure is covered directly • Pulpotomy: the inflamed coronal pulp is removed and the remaining healthy pulp is covered

Why MTA? Calcium hydroxide long served as the standard capping material, but it dissolves over time, lacks mechanical strength and tends to produce dentine

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bridges with tunnel defects, which may permit microleakage. Mineral trioxide aggregate (MTA) is a hydraulic calcium silicate cement that sets in the presence of moisture, releases calcium and hydroxide ions and forms a stable, biocompatible seal. Studies report high success rates for MTA in pulp capping and pulpotomy. Earlier MTA products, however, were criticised for slow setting, awkward handling and, where bismuth oxide was used as the radiopacifier, tooth discolouration.

MTA vpt: the material MTA vpt is a third-generation MTA cement. VOCO describes it as a biocompatible, radiopaque, hydraulic, self-curing cement, indicated for indirect pulp capping, direct pulp capping and pulpotomy after removal of affected coronal pulp. It is monomer-free, free of bismuth oxide, releases calcium and hydroxide ions, and has a high pH of around 12, which is known for its bacteriostatic effect. It turns from blue to white after curing, which makes it easy to see during placement and avoids staining of the tooth. It is supplied as a hand-mixed powder and liquid or as a pre-dosed application capsule (a pack of 25). The capsule is of

particular interest because pre-dosing standardises the powder-to-liquid ratio, reducing the variability that can occur with hand mixing, and the material can be delivered directly into the cavity. The capsule dimensions are compatible with conventional glass ionomer mixing devices.

Using the MTA vpt capsule step by step

The following reflects the manufacturer’s IFU. Always follow the instructions supplied with your own product. 1. Prepare the field. Complete caries removal and achieve haemostasis if the pulp is exposed. MTA vpt is applied as the first layer on the dentine, so no adhesive, bonding agent or additional liner should be used beforehand. The area must be sufficiently dry, and standing moisture, especially saliva, should be removed, although the dentine should not be over-dried either. Rubber dam isolation is strongly recommended.

4. Load the applicator. Remove the capsule from the mixer immediately and insert it into an application device such as the AC Applicator. Lift the cannula until it reaches its stop, then express a small amount of paste onto a mixing pad and discard it. 5. Place the material. Apply the paste directly into the cavity, no later than 10 seconds after mixing finishes, by compressing the applicator lever slowly and evenly. The cannula can be aligned by rotating the capsule in the holder. Slight leakage of cement beneath the cannula is expected for technical reasons and is not considered critical. Place the material passively over the pulp and surrounding dentine without forcing it into the tissue. The intraoral working time is at least 3 minutes, but avoiding unnecessary delays between activation, mixing and delivery is essential. 6. Cover immediately. Directly after placement, carefully cover the MTA vpt, without pressure, with a thin layer

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2. Activate the capsule. Remove the capsule from its bag only immediately before use. Insert one of the enclosed liquid plungers into the capsule body

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CPD: VOCO MTA vpt capsule: Case Study

Figure 1: Initial Presentation. Primary caries on Lower Left Second Molar.

Figure 2: Initial Partial Quadrant isolation of Lower Left

Figure 3: Cavity Preparation and Caries Excavation Lower Left Second Molar. Nil Exposure and Indirect Pulp cap indicated.

Figure 4: Placement of VOCO LC dam, VOCO MTA vpt Capsule and GrandioSO Heavy Flow White Opaque.

Figure 5: Bonding Protocol completed with VOCO Futurabond U and GrandioSO Unlimited Shade A2

Figure 6: Final Completed Indirect Pulp Cap and Completed composite restoration lower Left Second Molar[MM2.1]

of flowable light-curing liner, flowable light-curing or self-curing glass ionomer, or flowable composite. No conditioning or adhesive should[MM1.1] be applied before this layer. The remaining cavity is then restored with a material strong enough to withstand occlusal load. The cement’s multistage reaction means there is no need to wait for it to set fully before covering it. 7. Clean up and store. MTA vpt is highly alkaline, so avoid contact with the eyes and mucous membranes. Rinse instruments with cold water before residues cure. Store the product dry between 4°C and 23°C.

Contraindications and common pitfalls MTA vpt contains tricalcium aluminate and polyvinylpyrrolidone, so it should not be used in patients with a known hypersensitivity to these ingredients. Common errors with capsule systems include activating the capsule too early, delaying between mixing and delivery, using an underpowered mixer, placing bonding agent or liner beneath the material, and pressing the covering layer into the cement. Each can compromise handling or the seal. Poor haemostasis is another frequent cause of failure. If bleeding cannot be controlled within a few

minutes, the remaining pulp may be more inflamed than assumed, and further tissue removal or root canal treatment should be considered.

Conclusion Selective caries removal, careful case selection, effective haemostasis, a biocompatible capping material and an immediate, well-sealed restoration form the foundation of successful VPT. The MTA vpt application capsule offers a pre-dosed, direct-delivery route to that goal, but it rewards a disciplined workflow: activate late, mix correctly, deliver quickly and cover straight away. n

CPD Questions 1. Which of the following should NOT be placed on the dentine before applying MTA vpt? a) Nothing; the material goes on first b) A bonding agent or additional liner c) Rubber dam d) Haemostatic agent, if the pulp is exposed and bleeding 2. According to the manufacturer’s instructions, how should an activated MTA vpt capsule be mixed? a) By hand on a pad for 60 seconds b) In a high-frequency mixer of at least 4,000 oscillations per minute for 30 seconds c) In a slow-speed amalgamator for 10 seconds d) It does not need mixing once activated November 26 | The Probe

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3. After mixing, within what time should the MTA vpt paste be applied into the cavity? a) Within 10 seconds of the end of mixing b) Within 1 minute c) Within 5 minutes d) Within 10 minutes

4. Which of the following is an appropriate covering layer over MTA vpt, applied immediately and without pressure? a) A heavy-bodied amalgam b) A zinc oxide eugenol temporary c) A flowable composite or glass ionomer d) Nothing; it must be left exposed for 24 hours to set

To complete the questions and gain one hour of CPD, visit cpd.the-probe.co.uk

About the author Ash qualified from Cardiff University in 2012 with Honours. He then went on to complete Senior House officer roles in Oral Surgery and Restorative Dentistry at Guys’ Hospital, London. He has also completed numerous postgraduate courses focusing on Aesthetic and Restorative dentistry. He has won numerous Aesthetic Dentistry awards and has gone on to publish many articles and lectured nationally and inter nationally in this field. He is a Key opinion leader for many companies within the dental industry and has been invited to become a VOCO fellow helping to create innovations in new generation dental products. In 2018, he won Best Young Dentist South West. More recently in 2023, Best Young Aesthetic Dentist and has since been invited to Judge at the Private Dentistry Awards. He is a passionate educator. He is involved in training dentists in his field of special interest with his popular Magic of Dentistry hands-on workshops. His unique delivery of highly engaging workshops with a magical twist have enhanced the delivery of CPD. More recently, Ash has been invited to lecture at prestigious events on the inter national stage at IDS, Cologne and as a key note speaker at Conferencia Magna in Mexico.

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oral health foundation

Why mouth cancer prevention needs more than awareness

very November, dental teams help bring mouth cancer to public attention. We explain the warning signs, encourage patients to report changes and remind people why getting checked matters. That work is essential. But alongside asking whether people recognise the disease, we must ask whether we are doing enough to reduce the number developing it. Our new report, Tobacco, Alcohol, HPV: Closing the Risk Factor Gap, funded by Bupa Dental, examines that question through existing research, public awareness surveys and government policies. Its central finding is that established risk-reduction measures are applied inconsistently. Opportunities to help people stop using tobacco are being missed. England’s alcohol strategy needs updating. HPV vaccination is leaving substantial numbers of young people unprotected at their first opportunity. These problems have different causes and require different responses. Together, they expose a weakness in how we approach prevention: advice, services and policy too often fail to support one another.

What follows a conversation about tobacco?

Dental professionals understand the relationship between tobacco and oral disease. Asking about smoking is a familiar part of taking a patient’s history. The harder question is what happens with the answer. A northern England study published in 2018 found that 79% of dental professionals said they always asked about smoking, but only 17% said they referred patients for cessation support. This regional study cannot tell us what every practice does today. It does, however, highlight a gap worth examining.

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Recording tobacco use identifies a risk. Offering appropriate help creates an opportunity to reduce it. Whether that happens depends partly on the professional’s confidence, but also on the availability of services and the ease of making a referral. We should therefore be careful not to interpret missed opportunities simply as a failure of professional motivation. A clinician may understand the risk well but lack a clear, reliable route to support. The report also highlights smokeless tobacco. Advice and services must reflect the products people actually use, including paan containing tobacco, gutka and zarda. Resources developed with South Asian communities would help make that support relevant and accessible. Stronger tobacco controls remain necessary. So does practical help for people already using tobacco. Dental teams need to be connected to that provision.

Alcohol exposes the limits of advice alone

The alcohol findings raise a broader policy question. How much can we reasonably expect individual conversations to achieve when the national response remains incomplete? England’s last alcohol strategy is woefully old (2012). The report also cites the 2024 Drinkaware Monitor, in which only 17% of adults could state the drinking guideline. There is clearly work to do on public understanding. Dental teams can contribute by explaining the relationship between alcohol and mouth cancer and helping patients consider their drinking. But the environment in which those decisions are made also matters. The report cites a Scottish evaluation associating minimum unit pricing with a 13.4% reduction in deaths wholly

attributable to alcohol. This was an assessment of alcohol harm overall, rather than mouth cancer specifically. Its relevance is that it demonstrates the potential contribution of policy alongside individual support. Our recommendation is for an updated alcohol strategy for England that explicitly addresses cancer, supported by action on pricing, c l e a re r health information and accessible services. For dentistry, the implication is straightforward. We should support prevention in the surgery and use our professional voice to advocate for policies that back up the advice we give.

Vaccination needs a second opportunity

HPV, an established cause of oropharyngeal cancer, requires a different discussion. In England in 2024/25, more than one in four Year 8 girls and around one in three boys had not received the HPV vaccine at that stage. These figures should prompt questions about delivery. Are families receiving clear information? Can young people who miss vaccination access a catch-up appointment? Are services reaching communities where uptake is lowest? Dental teams can help explain why vaccination matters for cancer p re v e n t i o n . Responsibility for improving coverage, however, extends across vaccination services, schools, general practice and public health. The report recommends catchup opportunities and targeted action in areas with low coverage. Improving the national figure should go alongside narrowing geographical differences, so that progress reaches those currently missing out.

Make prevention a shared responsibility

Across all three areas, the report asks us to think beyond the consultation while recognising its value. Dental teams need practical training and current referral information. Patients need services they can access. Government and commissioners need to create the conditions in which reducing risk becomes a realistic part of everyday care. That requires clarity about responsibility. If everyone is encouraged to support prevention but nobody owns delivery, gaps are likely to persist. The report therefore sets out recommendations with proposed responsibilities, timescales and measures of success. Progress should include whether people reach cessation support, whether alcohol policy changes are delivered and whether vaccination gaps narrow. This Mouth Cancer Action Month, “Change is Your Sign: Remove the doubt, get checked out” remains an important invitation to patients. Recognising changes and seeking assessment can help identify disease earlier. Alongside that message, we need a sustained commitment to helping fewer people develop cancer in the first place. The evidence gives us a direction. Our task now is to connect professional practice, accessible services and public policy closely enough to act on it. The report is available at dentalhealth.org/mouth-cancer-risk-report. n

About the author Dr Rachael England, Head of Policy and Advocacy, Oral Health Foundation.

The Probe | November 26

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Dentists’ Provident, always by your side. None of us know what the future holds. Having to take time off work because of an illness or injury can have a serious effect on your finances. This is where we come in – our income protection plans can help take away the worry by replacing the income you lose, until life gets back to normal. For over a hundred years, our members have trusted us to give them peace of mind when they need it most. Isn’t it time you did the same? To get a quote for an income protection plan please visit www.dentistsprovident.co.uk To discuss a new plan just for you or review your current plan please contact our member services consultants on 020 7400 5710 or memberservices@dentistsprovident.co.uk

Protecting your lifestyle. Securing your future. Dentists’ Provident is the trading name of Dentists’ Provident Society Limited which is incorporated in the United Kingdom under the Friendly Societies Act 1992 (Registration Number 407F). Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority in the United Kingdom (Firm Reference Number 110015) and regulated in the Republic of Ireland by the Central Bank of Ireland for conduct of business rules (Firm Reference Number C33946). Calls are recorded for our mutual security, training and monitoring purposes.

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events

Dentistry Show London 2026 unites dental community with record numbers

entistry Show London 2026 has once again confirmed its place as the capital’s leading dental event, with this year’s show at ExCeL London welcoming record numbers of delegates across two inspiring days (9–10 October). Under the theme “Gain more, grow faster, get ahead”, 4,500 dental professionals from across the UK and beyond came together to tackle the real-world challenges facing the profession and discover the solutions set to shape its future. The programme featured more than 100 renowned speakers delivering cutting-edge clinical and business content across six theatres, giving every member of the dental team the chance to build a day around their own interests and goals. Delegates benefitted from over 100 hours of enhanced CPD, with sessions tailored for the entire dental team – from practice owners and associates to therapists, hygienists, dental nurses, technicians and practice managers. With content spanning clinical excellence, practice growth, leadership, wellbeing and the latest in digital dentistry, there was something for everyone, whatever their role or stage of career. A few highlights included: • ‘Live a fulfilled dental life’ – Speaker Jaz Gulati drew on eight years of podcast conversations with dentists to explore why some lose their passion while others stay fulfilled for decades, and the habits that keep the happiest dentists growing. • ‘Beyond the smile: exploring the oral-systemic link and its role in overall health outcomes’ – Speaker Victoria Sampson explored the links between oral health and conditions such as heart disease, diabetes and cognitive decline. It also covered practical strategies for prevention and early detection. • ‘What makes patients choose your practice? Standing out in a competitive landscape’ – Chaired by Trishala Lakhani, Dr Manrina Rhode, Mark Topley and Lucie Simic explored what drives patient choice, from team culture and communication to brand, patient experience and business strategy. • ‘Her journey in dentistry: thriving through careers, life and everything in between’ – Chaired by Trishala Lakhani, Sarika Shah, Cat Edney and Ruth Baidoo looked at often-overlooked career topics. These included how to apply for and choose the right roles, how to handle setbacks and change, and why financial literacy matters.

• ‘Six months since the contract reform: what

has changed and what’s next for the future of oral health’ – Jason Wong gave an update on the latest policy and guidance changes affecting clinical practice. Alongside the world-class education programme, delegates explored the latest innovations from more than 180 leading suppliers and manufacturers. The exhibition floor was buzzing throughout both days, with visitors taking advantage of exclusive show offers, live product demonstrations and hands-on training, and getting a first look at the new technologies, materials and services set to make a difference in their practices. “Every year we set out to build a programme that reflects what the whole dental team is really talking about, and this year’s show delivered exactly that,” said Senior Content Producer Océane Amoa-Thompson.

“From packed clinical sessions to honest conversations about wellbeing, leadership and the future of the profession, the energy in every theatre was incredible. It’s the speakers and delegates who make Dentistry Show London what it is, and we’re hugely grateful to everyone who shared their expertise, asked questions and joined in the conversation. We’re already looking forward to building on that next year.” Beyond the busy theatres and exhibition floor, the show once again proved to be a valuable meeting point for the profession. Over the two days, delegates caught up with familiar faces, met new contacts and exchanged ideas with colleagues from across the dental team, making the most of a rare chance to step away from the surgery and connect with like-minded professionals.

Coming up

The next event in the national dental calendar will be the British Dental Conference & Dentistry Show (BDCDS), co-located with Dental Technology Showcase (DTS) at the NEC Birmingham on 14–15 May 2027. The events bring the whole dental industry together – from dental professionals and practice teams to dental laboratories, technicians and suppliers – for two days of education, innovation and networking. Register your interest at birmingham.dentistryshow.co.uk and the-dts.co.uk. n

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THE DENTAL AWARDS

Dental Hygienist of the Year: Rhianna Clarke 2026’s Dental Hygienist of the Year, Rhianna Clarke, on understanding and shifting the patient perspective to steer oral health outcomes, and how volunteering led to a new appreciation for life’s ‘simple pleasures’ You started your career at St George’s working with head and neck cancer and complex medical patients – what from those early years still shows up in how you practise today? Working at St George’s really shaped the clinician I am today. I was exposed to some incredibly complex patients very early in my career, particularly people going through head and neck cancer treatment, and patients with significant medical conditions. I remember feeling so young when I went to the interview and thought I had zero chance – always apply for these things even with doubt! The biggest thing I took from that is that you can never look at someone’s mouth in isolation. There’s always a person behind the patient, and their medical history, their experiences and their anxieties all influence how they engage with dentistry. It also taught me the importance of communication. When someone is already dealing with a lot medically, dentistry can feel like another thing being added to an already overwhelming situation. I think I’ve carried that with me throughout my career – listen first, understand the person, and then work together to find a treatment plan that’s clinically right but also right for them. Working within the NHS can be very challenging, but the 10 years I spent there have made me who I am today.

The lovely thing was watching that change over time. She went from being quite disengaged and fearful to taking real ownership of her oral health. For me, that was probably more rewarding than any clinical measurement.

She had generalised periodontitis with several teeth of poor prognosis, and you were weighing endodontic treatment against extractions and periodontal management – she was too dentally anxious to consider root canal treatment, so you went with extractions and periodontal therapy instead. How did you approach that conversation with her, and how did you get her on board with the decision? It was very much a shared decision. I didn’t want to sit there and say, “These teeth need to come out”, because for someone who is already dentally anxious, that can feel like another loss of control. We talked through the options, including endodontic treatment, what that would involve, and the potential benefits and limitations. But we also had to consider her – her anxiety, the prognosis of the teeth and the wider periodontal picture. Ultimately, we decided together that extracting those teeth and concentrating on periodontal treatment was the most realistic option for her. I think the important thing was helping her understand that choosing extractions wasn’t a failure or taking an easier route. It was about finding a treatment plan that was going to give her the best chance of getting healthy and, crucially, one that she felt able to cope with. Once she understood that, she really got behind the treatment.

Probing depths dropped from 61 sites to 33 sites at 4mm+ – that’s a huge shift. What do you put that down to, and what’s your plan for the remaining pockets?

A patient came to you extremely anxious, disengaged and fearful, with little trust in dental care after previous negative experiences, what was the turning point where she started to trust the process and actively engage in her own treatment? I think the turning point was when we stopped trying to rush the process. She had understandably developed a lot of fear around dentistry, so I wanted her to feel that she was in control. Initially, that meant listening to her and understanding what had happened in the past, rather than immediately focusing on everything that needed to be treated. We broke things down into small steps. I made sure she understood what we were doing and, importantly, why we were doing it. I think consistency was key. She gradually realised that she could come into an appointment, tell me if she was worried, and be listened to. There were still hurdles along the way, but I made sure to focus on step 1 OHE [Oral Health Education, British Society of Periodontology (BSP) S3 Clinical Guidelines] before continuing to give us the best possible chance of a successful treatment outcome.

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For me, that change really demonstrates the impact of getting the patient on board with their treatment. It wasn’t one magic intervention. It was a combination of professional periodontal therapy, improving her home care and, probably most importantly, changing her relationship with dentistry. Once she understood what was happening and felt comfortable with the process, she became much more engaged. We still have 33 sites at 4mm or greater, so there’s definitely more work to do. I’ll be looking at those sites individually and assessing how they’re responding, rather than simply focusing on the number. Some may continue to improve with ongoing non-surgical management, while others may need further intervention or referral. For me, the goal isn’t just to make the numbers look better – it’s to get the patient to a point where her periodontal health is stable and maintainable long term.

You’ve volunteered with Dentaid in refugee camps in Greece – what was that experience like, and has it changed how you practise back home? It was an incredibly humbling experience. It really taught me a lot and to be grateful for the things we see as ‘simple pleasures’ in life. You meet people who have been through circumstances that are almost impossible to comprehend, and you’re there providing something as basic as dental care. But for that individual, being listened to, having their pain relieved and being treated with dignity can mean so much.

It really reminded me how much we take access to dentistry for granted. In everyday practice, it’s very easy to focus on treatment plans and clinical outcomes, but not everyone has the same resources, health literacy or circumstances. I think it made me even more conscious of meeting patients where they are. I try not to make assumptions about why someone hasn’t looked after their teeth or hasn’t engaged with dentistry. There is usually a story behind it, and understanding that story can completely change how you approach the patient.

What does winning this award mean to you at this point in your career? It honestly means a huge amount to me. I’ve been fortunate to have quite a varied career – from working in secondary care with complex patients, through to teaching and postgraduate education, and now building my own career as a self-employed hygienist and therapist. I’ve always cared enormously about doing a great job for my patients, but you don’t necessarily expect that to be recognised outside of the clinic. So, to have my work acknowledged in this way is incredibly special. I’m also at an exciting point in my career. I’m thinking about what I want the next chapter to look like and how I can use the experience I’ve gained to support other clinicians as well as my own patients. Winning this award has given me a real confidence boost. It’s made me stop and appreciate how far I’ve come, and it’s made me even more excited about what I can do next. 

The Probe | November 26

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LEADING THE PROFESSION FOR OVER 60 YEARS

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Products

SEND YOUR LATEST PRODUCTS TO: lorna.reekie@purplems.com

Garrison Dental Solutions Introduces 3D Fusion™ Ultra Adaptive Wedge The wedge is the first to fuse two materials together to produce the perfect combination of adaptability and retention. The 3D Fusion™ Ultra Adaptive Wedge has a patent pending design that combines a Soft Face™ Versmold with a firm inner core and advanced mechanical features to produce a wedge with improved adaptation to interproximal irregularities. Further, while insertion and separation are significantly improved with this design, supple retentive fins help to prevent back-out, even when wet. Providing enhanced adaptation and separation, the 3D Fusion™ Ultra Adaptive Wedge works in concert with the 3D

Fusion rings and bands. It effectively enables the practitioner to complete their restorative procedure, resulting in an improved clinical outcome. The wedges are available in an assortment kit as well as a range of sizes (extra-small, small, medium, and large).

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Planmeca PULSE™ – taking your digital workflow to another level Planmeca offers a complete platform for CAD/CAM dentistry where all of the elements work together seamlessly. From scanning and designing to milling and printing, we provide a complete ecosystem that creates connectivity and removes compatibility issues. PULSE™ brings together five core strengths - Precision, Usability, Liberty, Speed and Ecosystem - to give you a smooth digital workflow and boost productivity in any surgery setup. You can expect accurate and reliable results at every step, with easy to use hardware and software. Along with the freedom to collaborate with external partners or manage

everything inhouse, faster processes for a better patient experience and the possibility of offering same-day treatments. All wrapped up on one complete ecosystem for CAD/CAM dentistry, which means support is simplified too. For more information about Planmeca CAD/ CAM products, email enquiries@planmeca.com

Following the colour code Clinical waste management keeps patients and dental professionals safe. The colour code is an essential part of this, and Initial Medical, a specialist waste management service based in the UK, ensures practice teams have access to a wide variety of effective solutions. This includes free-to-download Colour Coding Guide posters, available on the Initial Medical website. Each poster details the types of items that can be present in a particular waste stream, and they can be displayed at the point of disposal to provide in-the-moment guidance. This enables clinicians to be confident in their knowledge of which bin to place each waste item in, and ensures

What better way to celebrate a 40th anniversary year than ADI Team Congress 2027! Marking four decades of continual excellence in the field of dental implantology, ADI Team Congress 2027 will be a calendar high point, delivering an unmissable, in-depth educational programme for all members of the dental implant team. Taking place on 15-17 April and themed “The Future in Focus. Four Decades of Implant Excellence”, the event will reflect on the progress made by the ADI community over the years whilst looking ahead to see what the next era of dental implantology will bring. Held at the LEX, Liverpool, Team Congress 2027 is a must-attend for all those with an

interest in dental implants, from students at the start of their journey to seasoned professionals. Between the lectures, hands-on workshops, international speakers and trade exhibition, there is a rich variety of ways to enhance your knowledge and skills. When adding the exciting social events and networking opportunities, attending is a no-brainer! To book your place at ADI Team Congress 2027, please visit https://www.adi.org.uk/association_ dental_implantology_congress/ ADI Team Congress 2027, 15-17 April. adi.org.uk/congress

High performance awaits Legendary reliability and a smart performance await clinicians with the A-dec Performer eVo treatment centre, now available at Clark Dental. Designed for minimal maintenance, the Performer eVo bridges comfort with predictable clinical outcomes, ensuring both patient and dentist are satisfied with the experience. Seamlessly integrating into your dental practice, the treatment centre can be positioned and customised to meet your practical and aesthetic preferences. For a comprehensive treatment experience, the Performer eVo package includes the A-dec Radius delivery, which keeps dental instruments within natural

reach for both left and righthanded users; the Performer eVo light, enhanced with a touchless on/off sensor for easy cleaning; and a pair of durable Performer eVo stools that support a healthy posture and reduce disc pressure and muscle pain. clarkdental.co.uk

the practice’s waste compliance obligations are followed. Initial Medical also provides a wide array of colour-coded waste containers, from clinical waste bags to sharps bins. You can learn more about effective clinical waste guidance by contacting the Initial Medical team. To find out more, get in touch at 0808 304 7411 or visit the website today: www.initialmedical.co.uk initialmedical.co.uk

Reduced packaging, less waste For dental practices increasingly looking at the environmental impact of the products they purchase, packaging efficiency is an important consideration. Bossklein has reduced the size of the outer pack used for both its Spectrum and Easy Tips, delivering a straightforward packaging improvement designed to reduce material use without affecting the product. Bossklein Tips are disposable 3-in-1 air/ water syringe tips designed for dental procedures, with separate air and water channels and a secure fitting. The singleuse format also supports infection control protocols by helping to reduce the risk of cross-contamination between patients.

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Four decades of implant excellence

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This simple change forms part of Bossklein’s “Future First” approach to more considered product development, where relatively simple improvements can contribute to reducing material consumption across its range. For more information call 0800 132 373 or visit www.bossklein.com. bossklein.com

Sensei Cloud brings practice management into the modern era Managing a dental practice has never been more complex, and the systems clinicians rely on need to keep pace. Sensei Cloud, Carestream Dental’s cloud-based practice management solution, brings scheduling, clinical workflows, billing, reporting, and patient engagement into one connected platform, accessible securely from anywhere. Designed for practices of all sizes, Sensei Cloud replaces fragmented, server-dependent systems with a single intuitive interface and real-time performance dashboards. Automated billing tools and integrated insurance functionality reduce administrative overhead, while centralised data makes it straightforward to monitor and act on practice performance as it happens.

For practices managing multiple sites, Sensei Cloud centralises data across locations without added complexity, supporting consistent workflows and clearer oversight at every level. Find out how Sensei can revolutionise your workflow today. To find out more about Sensei Cloud, visit gosensei.co.uk For the latest news and updates, follow us on Facebook and Instagram @carestreamdental.uk gosensei.co.uk

Brighter restorations without the fake white look: XBL joins the BRILLIANT range COLTENE has extended the BRILLIANT range with XBL, a new Xtra Bleach shade brighter than the existing Bleach (BL) shade – available for BRILLIANT EverGlow universal composite and BRILLIANT Crios reinforced composite CAD/CAM blocks. With whitening increasingly popular, XBL gives clinicians another option for matching very bright dentitions and restoring brighter smiles. Developed within the existing submicron hybrid filler technology, XBL avoids the flat, opaque appearance that very light composites can present, and layers with the translucent and opaque shades wherever internal characterisation is required.

Introduced across the direct and indirect materials at the same time, it allows a composite restoration and a milled Crios restoration to sit side by side with seamless integration. Now with an exclusive deal of buy two get one free, contact the team to find out more! For more information on BRILLIANT Xtra Bleach shade and the wider BRILLIANT range, email info.uk@coltene.com, call 0800 254 5115 or visit www.coltene.com. coltene.com

The Probe | November 26

THE FIRST COMPLETE, VALIDATED, SAMED-DAY WORKFLOW FOR FLEXIBLE PARTIAL DENTURES The SprintRay workflow is the first end-to-end chairside solution for flexible partial dentures. You don’t need a second visit. You don’t even need prior 3D printing experience. Close the gap and make your patients smile with confidence when they leave your chair.

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Scan. Print. Deliver. In as little as 2 hours.

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Products

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Precision intraoral imaging for everyday practice Style that serves The intraoral radiograph is the most frequently taken diagnostic image in general dentistry – and the Carestream Dental RVG 6200 is designed to make every one of them count. With a pixel pitch of 19.5 microns, the RVG 6200 delivers high-resolution images that support reliable detection of early-stage caries, periapical pathology, and bone level changes in everyday practice. Available in size 1 and size 2, the sensor features rounded corners and a flexible cable for patient comfort across busy clinical lists, and achieves diagnosticquality images at optimised dose levels in line with IRMER principles. Seamless integration with CS Imaging 8 ensures images are captured, processed, and stored within a single workflow, with compatibility across a wide range of third-

party practice management systems. For practices prioritising diagnostic quality and dose efficiency in their everyday imaging, the RVG 6200 delivers both. For more information, visit the Carestream website 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 carestreamdental.co.uk

In a busy surgery, inconvenient storage quickly becomes frustrating. If instruments and materials are not where the dental team expects them to be, even simple tasks can involve unnecessary reaching, searching or moving around the room, interrupting the efficient sequence of treatment. Supplied and fitted by Clark Dental, Edarredo cabinetry is designed around the practical demands of dental surgeries, without compromising on style. Purpose-designed storage can keep frequently used items close to hand, reduce clutter and organise the working environment, with surfaces and construction suited to the hygiene and infection-control demands of a modern clinical setting.

“Excellent quality and very easy to work with”

Spoilt for choice

Dr Bertrand Napier has been using COLTENE materials for a number of years, and the results speak for themselves. Combining BRILLIANT Crios reinforced composite blocks with a chairside CAD/ CAM workflow, he continues to deliver strong, aesthetic restorations in a single visit. Reflecting on a recent restorative case, Dr Napier said: “Working with COLTENE products for many years now I can honestly say that the materials, BRILLIANT Crios and the range of other BRILLIANT composites, are excellent quality and very easy to work with. Crios and chairside CAD/CAM (CEREC) are a great match for restorative cases like this as they allow us to use the

Packed with functions and features, the Hydrosonic Pro is the cutting-edge toothbrush from Curaprox that answers the everyday oral care needs of your patients. Patients can tailor the Hydrosonic Pro to meet their unique preferences. Seven cleaning levels enable users to control the speed and power to a comfortable level, with the capacity to reach up to 84,000 brush movements per minute. As the Hydrosonic Pro uses ultra-fine Curen filaments, each setting delivers an exceptionally gentle clean to the teeth and gingivae. A trio of brush heads enhance outcomes for more specific patient needs: Power delivers a traditional clean, Sensitive is ideal for those reporting bleeding or sore gingivae, and Single supports implant care.

best articulator available – the patient’s own mouth and jaws – and also a staggered approach to treatment using robust interim restorations with good aesthetics and strength for function.” BRILLIANT Crios gives clinicians a reliable, milling-friendly material with excellent aesthetics and the mechanical strength needed for lasting function. Discover more today, contact the team. For more information on COLTENE, visit www.coltene.com, email info.uk@coltene. com or call 0800 254 5115. coltene.com

With a choice of layouts, finishes and configurations, Edarredo cabinetry can also be tailored to complement the wider aesthetic of the surgery, from clean and understated to bold and contemporary. Clark Dental can help bring every element together into a scheme that feels intentional, distinctive and built to last – get in touch today. For more information call Clark Dental on 01268 733 146, email info@clarkdental. co.uk or visit www.clarkdental.co.uk clarkdental.co.uk

Able to cater for a range of patient requirements, the Hydrosonic Pro elevates daily oral care to a professional standard of cleanliness. Alongside its stylish aesthetic, the toothbrush can last two weeks on a full charge and is easy and lightweight to travel with. Recommend Curaprox products like the Hydrosonic Pro today and level-up your patients’ oral health. To arrange a Practice Educational Meeting with your Curaden Development Manager please email us on sales@curaden.co.uk. For more information, please visit www. curaprox.co.uk and www.curaden.co.uk. curaprox.co.uk

Stay unique with DeNovo

Dental Directory has you covered on consumables

At DeNovo Dental Partners, we celebrate the individuality that makes each practice unique. We actively seek out practices with personality, strong local reputations and their own way of doing things — because we believe those differences matter. Just as importantly, our shared ownership model is designed to protect that individuality once a practice joins DeNovo. Partners retain autonomy over the day-to-day running of their practice, including their team, patient experience, community relationships and clinical approach. Rather than changing what makes a practice successful, we help

Dental Directory’s consumables range covers the everyday essentials every practice gets through. The range spans from gloves, masks, and infection control to cups, needles, bibs, and saliva ejectors – including the extensive own-brand Unodent line. Reliability and value is a key factor to consider when ordering items used so frequently within the practice – availability across the whole basket matters as much as the price of any one item. As such, Dental Directory’s vast, consistently in-stock range and dependable delivery mean a practice can order everything it needs in one place, delivered at one time.

enable future growth while preserving the identity and culture built over years of hard work. If you are exploring what comes next for your practice, discover how DeNovo can help you protect your legacy while building long-term value. Arrange a confidential, no-obligation conversation today.

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Outstanding professionalism, knowledge and dedication Dr Ritcha Gobin purchased her practice with the assistance of DE Finance. She shares her experience in a recent 5-star Google Review: “I cannot recommend Tommy highly enough. He played an instrumental role in supporting me through the acquisition of my dental practice, and his professionalism, knowledge and dedication were outstanding from start to finish. “Throughout the entire process, Tommy was incredibly responsive, proactive and always available to answer my questions. He kept everything moving efficiently, communicated clearly at every stage, and made what could have been a very stressful experience feel much more manageable. “What stood out most was his genuine commitment to helping me achieve a

successful outcome. Nothing ever felt like too much trouble, and I always felt supported and well informed. “Thanks to Tommy’s hard work and guidance, I successfully completed the acquisition of my first private dental practice. I am truly grateful for everything he did and would have no hesitation whatsoever in recommending him to anyone looking for a knowledgeable, trustworthy and dedicated professional. For more information on Dental Elite visit www.dentalelite.co.uk, email info@dentalelite. co.uk or call 01788 545 900. dentalelite.co.uk

Browse the full consumables range at ddgroup.com. For more information on the products and services available from Dental Directory, please visit ddgroup.com or call 0800 585 586. ddgroup.com

Save more teeth: seek specialist assessment before extraction Too often, teeth are lost not because saving them was impossible, but because the information available at the time of the decision was incomplete. Without the kind of CBCT imaging capabilities specialists like EndoCare have access to, the full picture remains unseen. Specialist endodontic assessment changes what is knowable, and therefore the outcome. EndoCare, the specialist private endodontic group with practices in Harley Street and Richmond, urges general dental practitioners to refer complex or uncertain cases for specialist assessment before making the decision to extract. The evidence for preserving natural dentition wherever clinically viable is consistent and

compelling. A roottreated tooth with a well-fitting crown, in a healthy periodontium, offers long-term survival rates that compare favourably with dental implant replacement in many patient groups. Extraction should be a considered clinical decision, not a default response to complexity. For further information about the endodontic referral services available from EndoCare, please call 020 7224 0999 or visit the new website www.endocare.co.uk. endocare.co.uk

The Probe | November 26

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Restore balance

IAS Advanced Diploma: September course module opens

For patients in need of an oral health boost, the Perio Plus range of mouthrinses from Curaprox restore the balance of the oral microbiome. There are four solutions in the Perio Plus family: Balance, Forte, Regenerate, and Zero. Each contains an innovative Citrox®formula that is derived from bitter oranges and loaded with natural enzymes to support the teeth and gingivae. To combat halitosis and support orthodontic patients, Perio Plus Balance provides long-lasting freshness and reduces the risk of tooth decay. Its unique formula includes 0.05% chlorhexidine to remove harmful bacteria, whilst a protective film is left over the teeth, gingivae and oral mucosa. Delivering on both taste and

The second module of the IAS Advanced Diploma takes place on 9–12 September 2026 at IAS Academy HQ in Surrey, as part of the comprehensive two-year programme leading to the College of General Dentistry’s Diploma in Primary Care Orthodontics (DipPCOrth). The IAS Advanced Diploma is the most comprehensive orthodontic training programme available to UK GDPs, covering all appliance systems alongside radiography, biomechanics, multidisciplinary care, and the management of complex malocclusions including extraction cases. With 154 CPD hours delivered across six modules over two years, the programme combines interactive lectures, hands-on practicals, online webinars, and one-to-one specialist case

outcome, Perio Plus Balance is suitable for long-term use. Curaprox offers a superb portfolio of oral care solutions – the Perio Plus range is able to support the specific needs of at-risk patients. Discover the benefits today. To arrange a Practice Educational Meeting with your Curaden Development Manager please email us on sales@curaden.co.uk. For more information, please visit www.curaprox.co.uk and www.curaden.co.uk curaprox.co.uk

supervision. The College of General Dentistry recognises the IAS Advanced Diploma training as its preferred provider in preparation for the CGDent DipPCOrth qualification, the most significant recognition of the programme’s academic rigour and clinical standards. Applications for future Advanced Diploma intakes are accepted on a rolling basis, so visit the website to learn more. For more information or to book the course, visit https://courses.iasortho.com/ courses or call 01932 336470 (Press 1) courses.iasortho.com/courses

Hormone-induced dental pain: a simple solution

Support around the clock

The dental pain that can come with fluctuating hormones is an oftenoverlooked symptom throughout a woman’s life. Rising oestrogen and progesterone levels during the menstrual cycle and perimenopause can heighten gingival sensitivity, increase inflammation, and leave patients more vulnerable to acute dental discomfort at specific and often predictable points. When pain strikes, your patients need relief they can trust – fast. Orajel Dental Gel contains 10% benzocaine, a proven local anaesthetic that gets to work in just two minutes, providing targeted relief at the site of pain. For more acute discomfort, Orajel Extra Strength

The difference between a dental practice with 24/7 patient support and one that doesn’t is simple – revenue. RoboReception AI is designed by dentists for dentists, helping to streamline the daily workflow and ultimately improve the practice’s bottom line. By answering incoming calls around the clock and responding to online enquiries, RoboReception’s AI Joe ensures that calls aren’t missed, appointments are scheduled, and revenue is made. Alleviating simple tasks from the administrative team, RoboReception AI reduces the workload and enables the staff to focus on in-practice patient care. This in turn creates a seamless patient experience

delivers 20% benzocaine for greater relief with the same rapid action. Recommend Orajel. Visit the website today to learn more. For essential information, and to see the full range of Orajel products, please visit https://www.orajelhcp.co.uk/

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Expert support for complete certainty Infection control is an absolute essential, so it’s important that the equipment you rely on decontaminate your instruments remains compliant and safe. This is for the ultimate benefit of your patients, your team, and you. Eschmann offers unrivalled service and support through its Care & Cover plans, in addition to dedicated support from a nationwide team of engineers. This includes: • Annual Validation & Pressure Vessel Certification . • Annual Service & Software Upgrade • Unlimited Breakdown Cover • Unlimited Parts & Labour • Nationwide On-site Support • Enhanced CPD User Training • Technical Telephone Support

Eschmann is an expert in infection control solutions, with over 190 years of continuous innovation. Protect your practice with Eschmann and be certain that your equipment is compliant, running with optimal efficiency and minimal downtime. Find out more today when you speak to the team. For more information on the highly effective and affordable range of decontamination solutions available from Eschmann, please visit www.eschmann.co.uk or call 01903 753322. eschmann.co.uk

Raise the standard of brushing with the ADVANCE from TANDEX The toothbrush a patient reaches for matters more than many realise, and the ADVANCE from Tandex is engineered to raise the standard. It’s innovative V-shaped bristle cut targets the gumline for optimised plaque removal, whiles 51 closely set, rounded bristles clean thoroughly and gently. The long, thin neck means every tooth is easily within reach, making the ADVANCE especially useful for patients with orthodontic appliances who need to clean carefully around wires and brackets. Comfort has not been overlooked either. The rubber-coated, ergonomically shaped handle benefits all patients, and

offers support to those with limited dexterity or reduced hand strength, including patients living with arthritis. Available in soft and medium, discover how the ADVANCE can transform your patients’ brushing results today! TANDEX is giving dental professionals the opportunity to win a FREE FLEXI Educator Kit by answering just a few questions! Enter the quiz by scanning the code or following this link https://form1.tandex.de/ tandex.dk

from the first booking to walking out of the practice. RoboReception AI is also reliable and compliant, fully aligning with DTAC and DCB0129 standards and making your practice’s DCB0160 deployment seamless. Discover how RoboReception AI can change your practice and put it ahead of competitors with first-rate, 24/7 patient support – get in touch today. To find out more visit www.roboreception. co.uk or call us on 07511 085684 Book a demo at https://calendly.com/ roboreception/roboreception-demo-1 roboreception.co.uk

Streamline digital dentistry with the SprintRay Duo Kit Chairside production of restorations is made more efficient with the SprintRay Duo Kit, an extension of the SprintRay Pro 2 system designed to support streamlined in-practice workflows. Thanks to the exclusive split-build platform and dual resin tank system, the Duo Kit allows clinicians to print two different resins in a single job, streamlining workflows immensely. With downtime completely minimised, same-day dentistry can be brought to practices everywhere, guaranteeing happier patients and staff. When combined with SprintRay’s extensive range of remarkable restorative materials, the Duo Kit lets practices

fabricate everything from crowns and dentures to retainers and night guards. Expand your practice’s capabilities. Contact the SprintRay team today! For more information on the 3D printing solutions available from SprintRay, please visit https://sprintray.com/en-uk/ sprintray.com/en-uk

Ease the pressure with DeNovo Dental partners Owning a successful dental practice should not have to mean straining under the pressure of running a business. DeNovo Dental Partners supports clinicians across the UK with its shared ownership model. For Dr Ben Goode and Dr Ursula Mulholland, selling their practice was never about retirement: “We loved dentistry,” Ursula explains. “What we didn’t love was the constant pressure of running every aspect of the business. We were proud of what we’d built and didn’t want to hand it over to someone who wouldn’t value it in the same way.” “We were told this wasn’t a typical sale,” Ben says. “It was a shared ownership

approach where we would remain involved, still have skin in the game, and help shape not only our practice’s future but the wider company too. That was exciting.” Contacts us today for a no-obligation chat, to find out if DeNovo Dental Partners is the right move for you too.

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The Probe | November 26

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business & finance

Brace yourself Financial advice may be more valuable than you think

n his 1892 play Lady Windermere’s Fan, Oscar Wilde uses the phrase “a man who knows the price of everything and the value of nothing”. This is something financial advisers experience from time to time. We can sit in front of someone who feels that advice is too expensive, who has found cheaper ways to invest online, or who thinks they can do it themselves with the help of AI. In fair ness, financial advice companies haven’t always done particularly well at articulating the intangible benefits of advice. This has led some people to choose advisers based solely on who charges the least, or to decide not to use a financial adviser at all.

• The volatility of investment returns

Understanding the cost of financial advice

Making your money work harder through tax planning

There are different ways to charge for financial advice. Fees can be based on a percentage of assets under management (for example, an annual fee of 1% of a portfolio’s value). Alternatively, they might take the form of a flat fee or retainer (for example, £3,000 per year, regardless of portfolio size). Fees could also be based on an hourly rate or a project fee, representing a direct payment for a specific financial plan. The fees are explicit and immediately felt by the client, whereas the value of the advice may not become apparent for many years. It’s therefore understandable that some people struggle to appreciate the benefits those fees can bring.

It’s about more than picking the right fund

The value of financial advice goes far beyond selecting the right fund. A good adviser won’t fall into the trap of looking only at low fees and strong past performance, which could be easy to do. Past performance isn’t always a good indicator of future returns, and a low-cost fund can prove expensive if it isn’t aligned with your financial goals and overall strategy. A p ro f e s s i o n a l adviser looks beyond these headline measures, assessing whether an investment is fundamentally sound, suitable for your circumstances and aligned with your long-term objectives and attitude to risk. Many other factors contribute to b u i l d i n g a n d p re s e r v i n g w e a l t h . These include: • Diversification – Spreading your money across different types of investments so you don’t put all your eggs in one basket • Appropriate asset allocation – Spreading your investments across different asset types, such as shares, bonds, cash and property

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– How much and how quickly the value of an investment rises or falls over time • Alpha and Sharpe ratio – Measures used to assess how well an investment performs relative to its risk These help an adviser assess whether a fund manager is generating returns that justify the risks being taken, or whether strong performance might simply reflect a rising market. T h e f u n d m a n a g e r ’s e x p e r i e n c e a n d t e n u re a re a l s o i m p o r t a n t considerations alongside many other factors. Investments can go down in value as well as up, and you may get back less than what you put in.

Advisers also keep tax efficiency firmly in mind. They can help clients make the most of their ISA and pension allowances, while considering estate planning strategies to mitigate potential inheritance tax liabilities and reduce the tax burden on loved ones, where appropriate and legally possible. Advice in these areas may have an impact on how much wealth you accumulate over your lifetime and how much you ultimately pass on to the next generation.

In a separate study conducted by Vanguard, 86% of advised clients reported having greater peace of mind when thinking about their finances compared with managing them alone. The same study also found that taking advice can save people time, with 76% of advised clients saying that advice saves them time. These findings highlight that the value of advice isn’t measured solely in pounds and pence. Confidence, peace of mind and the freedom to spend less time worrying about money are valuable benefits in their own right.

The value of keeping your emotions in check

Can AI really replace a financial adviser?

Financial advice also involves behavioural coaching, helping clients respond calmly to market downturns and periods of uncertainty. In effect, advisers can act as an emotional circuit breaker, helping clients remain invested rather than immediately selling their investments to “save money”. Panic-driven decisions can mean missing out on potential subsequent recovery. While remaining invested during periods of volatility may benefit some investors, future performance and outcomes cannot be guaranteed.

Better financial wellbeing and peace of mind

The benefits of financial advice may extend beyond investment performance. Research suggests that people who receive advice may also experience better mental wellbeing. According to research from November 2021 conducted by HSBC’s insurance business, nearly three-quarters (74%) of UK adults who had sought regulated financial advice reported average or above-average mental health. A similar proportion (72%) of those who reviewed their financial plan annually reported the same. The figure rose to more than three-quarters (77%) among people with a comprehensive retirement plan.

A few months ago, I wrote about the dangers of relying on AI for financial advice. In that article, I discussed a study by Investing Insiders which found that AI tools answered financial questions correctly only 56% of the time, with 44% of responses containing inaccuracies, misleading information or outright errors. Performance was even worse for investment and pension queries, where more than half (52%) of the answers were incorrect. These findings highlight the risks of relying on AI alone for financial advice, particularly in complex areas such as investing and retirement planning. While AI can be a useful tool for researching financial topics and improving general understanding, it can’t necessarily replace the personalised judgement, ongoing support and accountability that a professional adviser provides.

Price is what you pay; value is what you get

I’ll finish with another quote, this time from Warren Buffett, widely regarded as one of the world’s most successful investors: “Price is what you pay; value is what you get.” When it comes to financial advice, perhaps this is the most important

point of all. The fee is easy to see, but the value may reveal itself over many years through b e t t e r d e c i s i o n s , g re a t e r f i n a n c i a l re s i l i e n c e , i m p ro v e d t a x e ff i c i e n c y and the peace of mind that comes f ro m k n o w i n g y o u h a v e a p l a n . The real question isn’t simply how much financial advice costs. It’s what that advice could be worth to you over your lifetime. n To speak to a Specialist Financial Adviser from Wesleyan Financial Services, visit wesleyan.co.uk/dental or call 0800 107 6748. Charges may apply. You will not be charged until you have agreed to the services you require and the associated costs. Learn more at wesleyan.co.uk/charges.

We s l e y a n F i n a n c i a l S e r v i c e s L t d (Registered in England and Wales No. 1651212) is authorised and regulated by the Financial Conduct Authority. Registered Office: Colmore Circus, Birmingham B4 6AR. Telephone: 0345 351 2352. Calls may be recorded to help us provide, monitor and improve our services to you.

About the author Having vast experience as a dental Specialist Financial Adviser (SFA) over the years, Simon Cosgrove is now a Dental Regional Manager at Wesleyan Financial Services, guiding a team of dental SFAs to support dentists, their families, and their practices with financial planning to secure their financial future.

The Probe | November 26

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business & finance

Dental Practice Market 2026 Confidence returns, values hold firm, explains Abi Greenhough, Managing Director of Lily Head Dental Practice Sales

he dental practice market remains resilient, with favourable conditions for many practice owners considering a sale. Buyer demand, funding availability and renewed interest in NHS dentistry are creating opportunities across several parts of the market. Our latest market analysis at Lily Head Dental Practice Sales shows broadly stable general practice valuation multiples, higher median goodwill within our dataset and growing competition from emerging regional dental groups. But behind these headline figures is an important message: not all practices are experiencing the market in the same way. While general practice valuations have remained relatively stable, developments in NHS dentistry and specialist markets, particularly orthodontics, are creating a different picture for some owners. For principal dentists and practice owners, understanding these changes can help them recognise opportunities, assess their practice’s value and make informed decisions about the future.

Practice values remain resilient, but not uniformly

Our analysis of the first six months of 2026 shows that the median owneroperated valuation multiple increased slightly from 3.4x in the equivalent period of 2025 to 3.5x. The average remained unchanged at 3.7x. However, we have seen a contrasting picture in orthodontics, which we have considered separately from the general practice market. Integrated Care Boards (ICBs) are addressing longstanding contractual uncertainty by directly commissioning 10-year Personal Dental Services (PDS) contracts for orthodontic providers previously operating under rolling arrangements. This greater contractual security is giving affected practice owners more confidence in the future of their businesses, while providing a clearer pathway for those considering an exit. This renewed confidence is also attracting buyer interest. In the first six months of 2026, our analysis indicated an average increase of 55% in the values of mixed orthodontic practices within the cohort reviewed. This is a significant development, although it reflects a specific segment of the market rather than a wider increase in dental practice values.

Buyer competition is creating opportunities

One interesting development is the growing influence of emerging regional dental groups. Alongside established corporate buyers and independent dentists, these groups are becoming increasingly competitive, particularly for selected NHS and mixed practices that fit their acquisition strategies.

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Access to a wider range of lenders is helping credible groups pursue acquisitions, creating additional competition in certain areas of the market. In two recent mixed-practice opportunities handled by Lily Head, one in South London and another in North London, we received 15 offers across the two sales. The agreed outcomes represented 8.4x and 8.0x EBITDA respectively. These are exceptional examples rather than general market benchmarks, but they demonstrate the competition that can develop for attractive practices. Demand for NHS and mixed practices has also strengthened. Changes to NHS remuneration, greater opportunities for treatment delivery across the wider clinical team and improved prospects for achieving contracted activity are helping to strengthen the investment case for NHS dentistry. We are also hearing fewer concerns about recruitment. While staffing remains challenging in some locations, easing recruitment pressures are helping to restore buyer confidence in the sector. Importantly, the highest offer is not necessarily the strongest. For practice owners considering a sale, the amount payable at completion, deferred payments, funding certainty and any requirement to remain involved can all influence the attractiveness of an offer.

Deal structures are evolving alongside buyer demand

Buyers and lenders are increasingly focused on how a practice will perform after a change of ownership. This is also reflected in how some corporate buyers are structuring transactions. Alongside traditional earn-out arrangements, we are seeing structures that include growth-related consideration, longer deferred payment periods, extended commitments from former principals and shared ownership. These arrangements are designed to protect business performance and maintain continuity following an acquisition. However, they also introduce different financial considerations and levels of ongoing involvement for practice owners. Understanding the balance between upfront payment, future commitments and personal risk is therefore an important part of evaluating any offer.

Preparation influences the eventual outcome

Understanding value is important, but achieving a successful transaction involves more than agreeing a price. Our analysis of completed transactions found a median period of 242 days between signing the memorandum of sale and legal completion. That is approximately eight months after a buyer has been agreed, before accounting for the time needed to prepare and market a practice. Challenges can arise around property arrangements, NHS contracts, financial

information, workforce matters and due diligence. Although not every delay can be avoided, early preparation can help reduce unnecessary complications and maintain buyer confidence.

Looking ahead: Understanding value creates opportunity

The dental practice market is presenting encouraging opportunities for owners considering a sale. Stable general practice valuations, increased competition from emerging groups, renewed interest in NHS dentistry and significant movement within specialist markets all point towards an active and evolving market. However, the differences between individual practices reinforce why understanding value should be an ongoing consideration rather than something left until retirement approaches. At Lily Head, we regularly speak with principals who are not yet ready to sell but want to understand their options. These

early conversations can provide valuable insight into the factors influencing their practice’s value and the opportunities available to strengthen their position. You don’t need to be ready to sell to start planning for the future. Understanding where your practice stands today can help you make better business decisions, protect the value you’ve built and approach the future with greater confidence. Source: Lily Head Dental Practice Sales, Dental Practice Market Report 2026. Findings are based on selected transaction, valuation and market-assessment evidence. Goodwill figures exclude property. Market statistics should not be treated as national valuation benchmarks. n

About the author Abi Greenhough, Managing Director of Lily Head Dental Practice Sales.

The Probe | November 26

30/10/2026 15:16:17

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BUSINESS & FINANCE

Step 3: You’ve sold the practice. What next for the money? How to sell a dental practice

ou have just sold your dental practice, and your bank balance now has a few extra zeros! How much do you keep in cash and how much do you invest for the medium to long term? What is the best way to take a regular income and should you be considering inheritance tax mitigation? These are all key questions that you might need some guidance on…

Holding cash on deposit

A healthy amount of cash on deposit is advisable. However, the exact amount will depend on individual needs. You may have some significant planned expenditure within the first couple of years post-sale, so this should be held in easily accessible cash deposits. Get the best rate by using one of the comparison websites and favour banks that are UK regulated. As of 1 December 2025, the UK Financial Services Compensation Scheme (FSCS) deposit protection limit is: • £120,000 per eligible person, per authorised bank/firm. • It applies across all accounts you hold with that banking licence, not £120,000 per account. • Certain temporary high balances—for example, proceeds from selling a home or an inheritance—can receive protection of up to £1.4 million for six months. Cash is important for short-term needs; however, it is worth noting the FCA’s historical analysis of cash versus risk-based investing. For the 10 years from 2012–2021, £1,000 held in a cash savings account grew to around £1,050, whereas £1,000 invested in a portfolio tracking global equities (MSCI World) grew to approximately £3,500. After inflation, those figures were about £863 for cash versus £2,876 for equities. This is historical performance, not a forecast, and the periods chosen can materially affect the comparison.

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Future-proofing your income, investment and inheritance planning options with offshore bonds

Whilst you are likely to first fill up your own and your partner’s ISA allowances, these are limited to £20,000 each in any given tax year. Topping up pensions may also be a wise strategy but comes with annual limits. An offshore investment bond may be a useful investment vehicle for larger amounts. Unlike a traditional savings account, an investment bond allows capital to be invested across a range of underlying assets, such as equities, bonds and multi-asset funds, providing the potential for long-term growth. One of the key attractions of an offshore bond is its tax treatment. The underlying investments can grow largely free from income and capital gains taxes within the bond, allowing returns to compound over time. Tax is generally considered when withdrawals are made or the bond is surrendered, although the precise treatment depends on the investor’s individual circumstances. Offshore bonds can also offer considerable flexibility. Investors may be able to take regular withdrawals, change underlying investments without immediately triggering a personal tax charge, or assign the bond as part of longerterm financial planning. The latter may be helpful for intergenerational planning. For example, the bond could be assigned to a trust as part of inheritance tax mitigation. There are a variety of trusts available and it is important to take advice on the most suitable options for your circumstances. The above information is not intended to be considered financial advice. As with any investment, an offshore bond carries investment risk, charges and potential tax implications. Its suitability depends on factors including investment objectives, time horizon, risk tolerance and personal circumstances. The value of investments can fall as well as rise, and you may get back less than

you originally invested. Past performance is not a reliable indicator of future results. Investment returns are not guaranteed and the value of an investment may be affected by market conditions, charges, inflation and, where applicable, currency movements. The level of risk and potential for loss will vary depending on the investment selected. You should consider your financial circumstances, investment objectives and attitude to risk before investing and seek appropriate financial advice where necessary. 

About the author Jon Drysdale has many years’ experience as an Independent Financial Adviser including over 18 years as a Director of PFM Dental. As a key member of the Wealth Management team, Jon’s experience and expertise include a high level of technical knowledge on the Lifetime and Annual pension allowances.

The Probe | November 26

30/10/2026 15:17:21

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29/10/2026 11:47:44

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business & finance

Which dental practice model is most profitable? NHS vs Private vs Mixed

or many dentists, buying a practice is the biggest investment they’ll ever make. Naturally, they want to know which type of practice is likely to deliver the strongest financial return. But, with the NHS, private and mixed models all offering different advantages, the answer isn’t always obvious.

NHS: Safe bet or yesterday’s model?

Despite the 2006 contract reform and the introduction of the unit of dental activity (UDA) system, NHS dentistry continues to be the ‘bread and butter’ income for many practices. Demand for NHS appointments is at an all-time high, providing a relatively predictable income stream. According to Dental Elite’s Benchmarking Report, although average turnover for predominately NHS practices fell to £641,824 in 2026 they retained the highest EBITDA (Earnings Before Interest, Taxes, Depreciation and Amortisation) margin (25.72%), supported by proportionally lower material, laboratory and core clinician costs. Recent contract changes, including revised payments for urgent dental care and fluoride application, may improve profitability for some NHS practices and have already increased buyer interest in the sector. Contrastingly though, the UDA system continues to dissuade some dentists from remaining within what many perceive to be an increasingly challenging system. Limited pricing flexibility and contractual constraints make it difficult for practices to respond to rising costs. These financial pressures have made NHS careers less attractive to many clinicians

which, in turn, has contributed to ongoing recruitment challenges for predominantly NHS practices. For the right buyer, these trade-offs may be outweighed by the security and predictability that an NHS practice can offer, as well as a commitment to providing accessible NHS care. Recruitment also remains strong in some areas of the UK where the NHS is thriving, especially near dental schools (for example Birmingham, London and Liverpool). This highlights the importance of considering local market conditions when evaluating a practice.

Private: More revenue, more risk?

For many dentists, private practice is the ultimate goal. The attraction is often greater clinical freedom, affording them the ability to shape their practice around their own philosophy, from fee-setting and treatment times to introducing new services and investing in advanced technologies. Cosmetic dentistry, facial aesthetics and CBCT imaging can all diversify income streams, while many now offer bespoke membership plans rather than relying solely on traditional schemes. That freedom, however, comes at a price. The Benchmarking Report found that predominantly private practices incurred the highest laboratory costs as a reflection of turnover (7.46%), higher spending on dental materials (6.24%), alongside private fee-per-item associate payouts of approximately 46% — considerably higher than the typical payout on core NHS revenue. Despite generating impressive revenue per surgery, these higher operating

costs meant they recorded the lowest EBITDA margin (14.88%) of the three practice models. Although readers should be cognisant that this report takes into account all types of private practice from larger multi surgery sites to high grossing principal-led sites which often have significant EBITDAs (20%+) to smaller low grossing single-handed private practices and recently opened squat practices where often lower overall revenues depress the EBITDA. Generally speaking, there are more of the latter than the former which returns a lower overall result for predominantly private practices. For ambitious buyers with a strong entrepreneurial vision and an appetite for business growth, private practice can offer exciting opportunities. Financial success, however, depends on much more than high treatment fees alone.

Mixed: The sweet spot for buyers?

For many dentists, a mixed practice offers the best of both worlds, combining the security of NHS income with opportunities to grow private revenue. This appeals to buyers looking for both financial stability and future growth. According to the 2026 data, mixed practices generated the highest average turnover (£1.19 million), the highest EBITDA in cash terms (£270,178) and the greatest revenue per surgery. Growth was driven largely by an increase in private fee-per-item income, helping mixed practices outperform both NHS and private models overall. For buyers looking to balance financial stability with future growth,

it’s unsurprising that the mixed model continues to prove so attractive.

So which model is most profitable?

The answer depends on how profitability is measured, as well as a buyer’s goals, appetite for risk and long-term vision. The team at Dental Elite can help identify and evaluate opportunities that are right for you. While predominantly NHS practices achieved the highest EBITDA margin in the 2026 report, mixed practices generated the highest turnover and EBITDA cash, making them the strongest overall performers in absolute financial terms. Meanwhile, private practices continue to appeal to buyers seeking greater clinical freedom, despite the additional operating costs that can place pressure on profitability.

Thinking of buying?

Ultimately, there is no one-size-fits-all answer. The most profitable practice is the one that aligns with your financial objectives, clinical philosophy and longterm ambitions. Whether you want to build a thriving cosmetic practice, expand implant services or simply provide highquality NHS care to your local community. For more information on Dental Elite, visit dentalelite.co.uk, email info@dentalelite.co.uk or call 01788 545 900 n

About the author Luke Moore, Co-founder of Dental Elite.

The business blow of failing to be compliant

or dental practices, compliance extends across a series of disciplines. This includes data protection, health and safety standards, infection control, indemnity insurance and correct documentation. A more recent consideration to add is the role of AI – is the software being used safe, and does it meet the necessary standards? A good, reliable dental practice won’t even notice the benefits of being legally compliant – business will run as usual. But for the dental practice that has failed to meet government regulations, one enforcement challenge can cause catastrophic damage.

Technology oversights

The penalty for using non-compliant technology in a dental practice is dependent on the issue at hand. This is split into two categories: if it involves patient data or if it involves medical or dental hardware. Compliance with the Data Protection Act 2018 and the UK General Data Protection Regulation is mandatory for dental practices. NHS practices are especially vulnerable if found to fail in this regard – the maximum penalty is £17.5

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million or 4 per cent of the annual turnover in the preceding financial year, if patient data is not correctly handled. That is a devastating blow to the business. In 2025, the Information Commissioner’s Office (ICO) collected seven times more data protection-related fines than it did across the whole of 2024 from less than half the number of cases, emphasising the need for stronger regulations, practice compliance and staff understanding.

Trusting your sources

Use of counterfeit or unregulated physical equipment or software is even more damaging: the fines are unlimited, with the added impact of professional suspension from the GDC and even criminal prosecution. The concern is that such products are often found in plain sight. AI receptionists are a good example: whilst useful tools to support the administrative team, some systems may overreach what they are legally allowed to do by triaging emergency patients. In doing this, the AI receptionist is acting as a medical device. If it is not registered as one but continues to perform such tasks, the ramifications can be huge, involving

the Medicines and Healthcare products Regulatory Agency (MHRA). The MMD Act enables the MHRA to deliver compliance, suspension, safety and information notices – if any of these are breached, the guilty party is liable to 6 months of imprisonment. Compliance is no joke.

like administrative assistants. If you do have any concerns about the compliance of products, you can report suspect medical devices to the MHRA. This will lead to positive action that protects patients and the dental team. In a world of new technologies and exciting opportunities, it is paramount that dental practices meet regulation standards to reduce any risk of non-compliance and the business-busting penalties that come with it. To find out more visit www.roboreception. co.uk or call us on 07511 085684 Book a demo at https://calendly.com/ roboreception/roboreception-demo-1 n

Staying in the right lane

Practice owners have a duty to protect their staff and their business. Ensuring the dental team are adhering to the recommend protocols prevents any lapses in compliance. Further, you should only purchase equipment and software from tried and tested suppliers who are able to show you that the legal frameworks have been met. This is especially true for AI technologies

About the author Dr Grant McAree, Co-founder of RoboReception.

The Probe | November 26

30/10/2026 15:18:25

OUR NETWORK OF CERTIFIED AJAX DEALERS INSTALL DENTAL CHAIRS ACROSS THE UK

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