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BSPD receives Colgate and Henry Schein donations to give children diagnosed with cancer essential oral health care kits Every child and young person newly diagnosed with cancer in the UK over the next year will receive a toothbrush, fluoride toothpaste and oral health information. The donations making this possible were announced by the British Society of Paediatric Dentistry (BSPD). Colgate, through its Bright Smiles, Bright Futures initiative, has committed to supplying oral care products for around 4,000 children and young people across all four nations. Henry Schein UK, through its Henry Schein Cares programme, will fund printing of a new oral health fact sheet and supply goody bags containing the Colgate products. Outgoing BSPD President Dr Oosh Devalia OBE made the announcement at the society's Annual Scientific Conference in York. For dental hygienists and therapists, the message behind the initiative will be familiar: dental disease is almost entirely preventable, and the earlier prevention starts, the better. For children with cancer, the stakes are especially high. As a hospital dental consultant, Dr Devalia was often called to see children shortly before their cancer treatment was due to begin, only to find significant decay. Because untreated decay carries a serious infection risk, cancer treatment may then have to be postponed. Cancer therapies can also affect the mouth more widely. Chemotherapy and radiotherapy are commonly associated with mucositis, dry mouth and a higher risk of infection. That makes a healthy starting point and consistent daily care all the more important.

Dr Devalia described good oral health for these children as "not a luxury". She said it is essential to their comfort, their overall outcomes and their ability to tolerate treatment. The cause is a personal one. Dr Devalia's daughter was diagnosed with leukaemia in 2024. Seeing her daughter through treatment, Dr Devalia said, showed her how easily mouth care can slip down the list of priorities during long hospital stays. The experience strengthened her determination to see Mini Mouth Care Matters rolled out nationally. Dr Devalia created Mini Mouth Care Matters (Mini MCM) in 2019 to build evidence-based mouth care into routine healthcare for medically complex children. She was recognised in the 2026 King's Birthday Honours for her contribution to children and young people's oral health. The donations will support the national roll-out of Mini MCM. The programme

trains multidisciplinary healthcare teams to carry out a simple "lift the lip" check, which spots early oral health problems that could affect treatment or quality of life. It also promotes core preventive advice, including brushing twice a day with fluoride toothpaste. Since its launch, the programme has trained professionals in 37 NHS trusts. It has spread beyond hospital wards into health visiting, palliative and end-of-life care, and special educational settings. The model will resonate with hygienists and therapists, whose work already centres on prevention, patient education and early detection. Mini MCM gives nurses, health visitors and other nondental colleagues basic oral health skills. In doing so, it creates clearer routes for referral into the dental team. It also gives DCPs opportunities to support training and share their expertise locally. Each newly diagnosed child will receive

The Peak of Scaling Performance

age-appropriate toothbrushes and toothpaste at the start of treatment. They will also get a printed fact sheet co-produced by BSPD, CCLG: The Children & Young People's Cancer Association, and the Faculty of Dental Surgery at the Royal College of Surgeons of England. The fact sheet features Mini MCM. Young Lives vs Cancer will fill and distribute the goody bags through its social work teams in primary treatment centres across the UK. BSPD also premiered a new video at the conference to support the oral health of children with cancer. It was co-created with CCLG under the leadership of BSPD's Dr Claudia Heggie, and it features Dr Devalia's own children. Emma Van Essen, Scientific Affairs Lead at Colgate-Palmolive, said the donation builds on the company's contribution to the Government's Supervised Toothbrushing Initiative in England in 2025. She said it reflects Colgate's commitment to children facing the toughest health challenges. Victoria Goodall, Managing Director of Henry Schein UK, said oral health can easily be overlooked during long and complex medical journeys. She said the company hoped to make a real difference to families at a very difficult time. Naomi Shefford-Thomas, Health Information Officer at CCLG, said the charity was proud that its information, written by its expert members, would reach so many families. She hoped it would help parents look after their child's mouth during treatment. ■

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CONTENTS

A welcome from the editor

The Probe. Informing the profession since 1959.

As the nights begin to draw in and pumpkins appear in supermarket aisles, we bring you another bumper edition of The Probe, with three hours of CPD starting on page 60 (and an additional two for those of you clutching the physical issue – look for the Brush Up supplement, courtesy of Orajel). But of course, that’s not all. Sara Hurley kicks us off this month on page 8 by asking, despite the movement, whether the system is actually changing, in reference to NHS dentistry. The Oral Health Foundation’s David Arnold prepares us for Mouth Cancer Action Month on page 12 (get those blue lights at the ready) and Andrew Ridout, Principal at Oak House Dental Practice, draws upon his experience of adopting the Dental Therapist Model into general dental practice on page 42. As always, there’s so much more in store than what I have space for here, including some truly fascinating case studies and interviews. So, please do explore all that we have to offer.

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

And when you’re finished reading, don’t forget to check out the latest from The Probe Dental Podcast at the-probe.co.uk/podcast – as well as on Spotify and YouTube – as we’ve had some fantastic conversations recently, including an in-depth look at the united front for general anaesthesia. Look us up or scan the QR code now! APPEARING IN THIS ISSUE Some of the industry experts you’ll find throughout the following pages

Sara Hurley Former Chief Dental Officer, England

News

Viewpoints – The system is moving but is it changing?

Oral Health Foundation – Make Mouth Cancer Action Month count!

Andrew Ridout Principal Oak House Dental Practice

Leon Bassi Senior Clinical Lecturer University of Liverpool

Dr Harry Craig Accreditation candidate BACD

Dr Minesh Patel Dental implant specialist

Chris Mayor Commercial Director Lily Head Dental Practice Sales

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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Dr Farnam Pourreza-Jorshari British Endodontic Society Early Career Group Committee Mbr.

Dr Archana Naik Dentolegal Consultant Dental Protection

CONTENTS... 58

Interview – Leon Bassi on prevention at the heart of oral healthcare The Dental Awards 2026 – Dental Therapist of the Year: Imogen Johnson

Practice – Compliance is a culture

Oral Health – Hormones and health

Treatment – An update on regenerative endodontics

Professions – Adopting the Dental Therapist Model

50 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

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CPD from Philips

CPD from Maintainers Dental Lab

Education – Intraoral imaging in focus

Case Study – Incisor trading

Case Study – Bone augmentation using a titanium mesh

Products

Business & Finance – NHS activity is rising

70 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

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viewpoints

The system is moving but is it changing?

here has certainly been no shortage of heat this summer, meteorological or otherwise. NHS dentistry has generated plenty of its own. The 2026 contract changes have moved from policy announcement into everyday practice.1 Fifty additional dental school places have been allocated to Portsmouth and East Anglia.2 Fresh NHS statistics have landed.3 The Nuffield Trust has published The great extraction: the changing state of NHS general dental services in England.4 MPs’ summer postbags continue to reflect the frustration of patients trying to secure NHS care.5,6 Workforce data, meanwhile, continues to complicate the familiar argument that the answer is simply “more dentists”.7,8 There has been new guidance too: complex-care pathways, a framework for the oral health of our ageing population, a Quality Improvement programme focused on recall, and greater emphasis on prevention, unscheduled care and better use of the wider dental team.1,9 So was summer 2026 the point at which Labour’s manifesto commitment to reform the NHS dental contract finally began to move from promise to delivery?10 The Government certainly presented the 2026 quality and payment changes as an important step towards fundamental reform11. Ministers were keen to demonstrate momentum, with Stephen Kinnock talking about access and expansion of dental training places.2,11 Then came a change in the ministerial team. Dentistry moved from Stephen Kinnock, a Minister of State, to James Frith, a Parliamentary Under-Secretary of State for Health Innovation – a more junior ministerial rank, although that does not itself establish policy priority.12,13 New Secretary of State. New dental minister. New relationships to establish. A pause, perhaps, but not a change in the commitment already made. The destination and the timeframe are on the parliamentary record.11 The question is how the new team now chooses to get there. As part of this, Frith has been out and about, gauging the temperature and mood of the profession and providers, spending time in practice and hearing directly from professional and provider groups.14 In September, he joined the Association of Dental Groups (ADG) at its St James’ event as the group launched Priorities for NHS England Dental Contract Reform.15,16 He has also met the BDA at DHSC, where it pressed its case for the future of NHS dentistry.17 On one point, the ADG and BDA appear to agree: “the current NHS dental contract is not fit for purpose”. But from that shared diagnosis come rather different prescriptions. The ADG’s September paper argues for completing the current round of GDS contract amendments, evaluating their impact and then building further incremental reform from there. It explicitly rejects a “root and branch” approach.15,17 Interesting, because that represents a change of emphasis from its earlier position. In Six to Fix, the ADG described the 2006 contract as “broken” and “no longer fit for purpose”, concluding that it was time for a new NHS contract.18 The BDA, by contrast, has remained consistent. In its meeting with Frith, it pressed for fundamental reform, sustainable funding and a comprehensive workforce plan.17 It has also been clear publicly that the 2026 package contains worthwhile improvements but is “certainly not the final destination”. Its objective remains to phase out the UDA and replace it with a prevention-focused contract.19,20 So these are not simply two organisations choosing different language for the same destination. They represent different constituencies and interests, and they are offering the new Minister contrasting advice about what should happen next. The ADG is essentially asking how the present architecture can be made to work better. The BDA remains focused on the architecture itself being the problem. That is not simply a disagreement about pace. It is a disagreement about what needs fixing. That gives us a useful test for everything else that happened this summer: if the 2026 measures are the first step towards fundamental reform, do they point towards a genuinely different model, or increasingly sophisticated ways of making the existing one work a little better?

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What do the numbers actually tell us?

The latest NHSBSA statistics report 37.6 million courses of treatment in 2025/26, up 6.2% on the previous year. UDAs rose by 5.1%, and 25,419 dentists recorded NHS activity.3 Clearly, dental teams are doing more, but the access picture has barely shifted. Some 18.8 million adults were seen in the 24 months to March 2026, around 40% of the adult population.3 The previous year, 18.0 million adults had been seen, effectively the same proportion. So we have more activity, but no substantial movement in population coverage. These figures largely predate the contract changes introduced from April 2026 and rolled out over the summer.1 It will be important to see whether those reforms begin to change the picture, because the statistics illustrate something fundamental: a service can be very busy without necessarily widening access. Additional activity may still be concentrated among patients already within the system. Activity and population coverage are not the same thing. There is, however, one particularly encouraging signal in the statistics. Dental care professionals (DCPs) led 1.83 million Band 1 courses of treatment in 2025/26, almost one million more than in the previous year.3 That deserves recognition. For hygienists, therapists and other DCPs, this is real progress and momentum worth maintaining, but greater use of the dental team can only improve access where there is NHS-contracted capacity to deploy it. Skill mix is no longer principally a permission problem. It is a system-design problem. This is where geography and legacy matter. Nuffield’s latest analysis shows that the NHS practice footprint itself has been shrinking.4 In places where contracts have been handed back, reduced or lost, there is simply less NHS dentistry for patients to access, however effectively the remaining workforce is used. The question is therefore not simply how much dentistry is being delivered. It is where, to whom and whether somebody currently outside the system can get in. Even then, our national statistics tell us relatively little about whether treatment was completed, continuity established, risk reduced or oral health improved. We have become very good at counting who comes through the front door without knowing what happens next or what the outcome is.

What about those who never reach the front door?

That question came into sharp focus during a panel hosted by mydentist in Chesterfield involving Chief Dental Officer Jason Wong, mydentist leaders and Dentaid Head of Clinical and Policy Catherine Rutland.21 Rutland described people experiencing homelessness, addiction, poverty, abuse and other forms of exclusion, some of whom may never enter a conventional dental practice. In 2025, Dentaid delivered 1,244 clinics, cared for 8,438 people and provided more than 30,000 treatments.22 That is unmet need finding another route into treatment. But if someone then needs periodontal therapy, further restorative work, dentures or simply continuity, where do they go? An episode of treatment is not the same as an ongoing relationship. The route forward has to lead somewhere, and designing that onward pathway is a commissioning responsibility. This leaves us with the uncomfortable question: Is third-sector dentistry providing a bridge back into mainstream care, or becoming the service for people mainstream dentistry no longer reaches? There is an interesting contrast at the other end of the market. While third-sector dentistry is increasingly reaching those with the least access and fewest choices, another group of patients is looking elsewhere for value, speed and cosmetic treatment. The familiar headlines about “Turkey teeth” are now being joined by “Tirana teeth”, as Albania emerges as another destination for lower-cost cosmetic and restorative dentistry.23 These are not equivalent problems, but they do illustrate how differently dental demand is now being met: for some through charitable outreach, for others through an international market.

So the summer picture is wider than NHS activity alone: unmet need, continuing-care gaps and increasingly diverse routes into and around dentistry. Will the 2026 contract changes actually alter that picture?

What do the 2026 contract changes actually offer?

Many of the changes are clinically sensible. The question is whether they materially alter the experience of patients and the profession – or simply help an imperfect system function more smoothly.

Take recall

Year One of the new NHS dental Quality Improvement programme focuses on clinically appropriate recall aligned with NICE guidance.1,24 Participation is voluntary. Practices completing the programme receive £3,400, converted into UDA credit.1 There is good sense in this nudge, but it is incomplete. NICE recommends adult recall intervals from three to 24 months according to risk.24 Extending recall for healthy, low-risk patients should release capacity. The QI programme can improve recall, but it cannot ensure released capacity reaches greatest need. That requires commissioning that connects capacity with population need and incentives for practices to take on new patients or convert urgent attendance into continuing care. Riskbased recall only becomes an access intervention if the capacity released reaches unmet need.

Complex care tells us something too

The new pathways give greater recognition and remuneration to patients with significant caries or unstable progressive periodontal disease.1 All very welcome, but risk, complexity and continuity are not unusual exceptions to dentistry. They are dentistry. If additional pathways and payment modifiers are needed to recognise something so fundamental, perhaps that tells us something about the underlying mechanism. The same tension appears in NHS England’s framework for the oral health of our ageing population.9 Its language is explicitly needs-based, preventive, proactive and partnership-focused. So, while NHS clinical policy increasingly describes a service organised around need and outcomes, the contract and payment architecture still largely describes one organised around activity. Payment does not simply reimburse care. It drives behaviour, service design and the economics of practice. Those same economics shape something else fundamental: where our dental workforce chooses to work, how teams are deployed and how much of their capacity is available to NHS patients. That brings us to workforce.

A growing workforce does not guarantee NHS capacity

The GDC register now contains nearly 48,000 dentists and 84,000 dental care professionals. Dental therapist numbers increased by 21% last year and hygienist numbers by 11%.7 Internationally qualified dentists also outnumbered UK-qualified dentists joining the register for the first time.7 The workforce challenge is not simply one of numbers. There are bottlenecks between registration and NHS delivery. The GDC has made progress on the longstanding ORE constraint,25 but an overseas-qualified dentist wishing

The Probe | October 26

02/10/2026 09:39:37

www.the-probe.co.uk to work in NHS primary care must still navigate the Dental Performers List and, where required, validation and mentorship. The ADG has repeatedly argued that this process is too complex and inconsistent and has again called for it to be streamlined.15,18 Working-pattern data adds another dimension. One-fifth of dentists responding said they provided private care only, with a further 14% spending more than three-quarters of their working time in private dentistry.8 Among DCP respondents, more than a third spent at least 75% of their time delivering private care, while just over a quarter spent at least 75% of their time delivering NHS care.26 Against that backdrop, Government has chosen to expand future supply. In June, it announced 50 additional dental school places, targeted at areas with poor NHS access.2 That is sensible long-term planning, but a training place is not NHS capacity. Those students begin training from 2027 and will not enter practice until, at the earliest, around 2032. Even then, there is little visibility yet on the infrastructure that will convert additional graduates into sustained NHS delivery: the clinical settings, teams, transition support, commissioning arrangements and contracts required to keep them working in the NHS.

And where, exactly, are those additional graduates expected to work?

Nuffield’s analysis shows the NHS practice footprint continuing to contract. Since 2017, England has lost at least 600 practices providing NHS general dentistry; the proportion offering general NHS services has fallen from 64.6% to 55.6%, while practices operating without a general NHS contract have grown by more than 1,000.4 In some of the areas where the NHS footprint has contracted fastest, particularly the South West and East of England, private and specialist provision has grown most strongly.4 That creates an obvious tension. Government is investing in additional future supply while the infrastructure through which that workforce might deliver NHS care is contracting. So the issue is not simply whether we can train or attract dental professionals to so-called “dental deserts”. It is whether there will be sustainable NHS settings in which

viewpoints they can work and whether the NHS can retain both those professionals and the practices that support them. Nuffield’s conclusion is difficult to ignore: dental capacity has not necessarily disappeared. Much of it has moved beyond the NHS. The professional workforce can grow while NHS participation and the NHS practice footprint contract. That is why the workforce question is not simply: How many dentists do we need? Rather, how much of the workforce we already have is participating in NHS dentistry, where, and what would enable more of it to engage in NHS delivery? That takes us back to the contract. Activity-based, dentist-centric payment tends to produce activity-based, dentist-centric delivery. If we want something different, we have to design and pay for something different.

So where does that leave us?

James Frith was asked in Parliament whether Government planned to move away from individual treatment-unit targets towards a capitation-based model funded according to local population health need.27 His answer pointed to reforms already under way and improved activity, but did not identify the longer-term contractual destination.27 That, in itself, leaves an important question unanswered. And it points to a wider set of questions that the profession should now be asking of the new Minister. Seven, in particular: 1. If activity is rising but adult coverage remains around 40%, how will we judge whether reform has genuinely improved access? 2. How will a future contract reward prevention, continuity and completed care – while making NHS dentistry financially sustainable – rather than predominantly counting activity? 3. How will risk and complexity be reflected in payment so that patients and populations with greater need are properly supported? 4. How will commissioners direct sustainable capacity towards communities with persistent unmet need? 5. How will urgent and third-sector care connect people back into continuing mainstream care?

6. How will workforce strategy convert the people we already have – dentists and the wider dental team – into greater NHS participation and capacity? 7. What is the timetable and what is the destination for NHS dental contract reform? That last question matters. Labour promised longterm dental contract reform, prevention and retention of NHS dentists.10 More than two years of a maximum five-year Parliament have passed. Designing, testing and implementing something genuinely different takes time. We already have substantial evidence that the present contract is not fit for purpose. Activity alone is not a measure of success. Access and outcomes are. We would not keep tweaking a treatment plan that was failing to deliver what the patient needed. We would reassess the diagnosis, reconsider the options and redesign the plan around the patient. Why expect less rigour from the system that commissions their care? There has certainly been plenty of heat and perhaps a little haze this summer. What we need now is more light on where reform is heading, and how we intend to get there. As the autumn leaves turn and the first frosts arrive, the sands of time continue to fall through the hourglass of opportunity. The danger is that incremental reform becomes another name for postponement. n References available on request.

About the author Dr Sara Hurley CBE is a former Chief Dental Officer for England and an independent consultant in oral health policy, commissioning and system transformation. She is Programme Facilitator for the ICD Global Oral Health Leadership Institute and a Non-Executive Director of the University of Bristol Temple Quarter Dental Practice. She has a particular interest in throwing light into the darker corners of dental policy and system design.

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viewpoints

Entering Cheetah-Dog Territory

t had been another lovely, albeit hot (think air-fryer temperatures), day in the Dordogne. We were all hoping for a slight respite from the relentless heat during the small hours, having endured a few uncomfortably restless nights directly as a result of our futile attempts to fathom how to turn on the French airconditioning units in the large crumbling villa we were occupying. The nine adults in the family party were cooling themselves at the veranda dining table with refrigerated wine and lager after our meal, while the grandchildren were either cooling themselves with sweaty tabletennis or sitting inside watching YouTube Kids on their iPads via a precariously unstable WiFi connection. But suddenly, the adults were chilled to the bone. Apropos of nothing, during a conversation about the following days’ plans, one of my in-laws said with authority, ‘Did you know, cheetahs are forty percent dog?’ We attributed the remark to ice-cold lager, but no. He was the only adult on apple juice. We were stunned, staying silent, mainly because we couldn’t immediately get on to any AI platform to check the confident statement on our phones because of the aforementioned inadequate broadband and equally poor cellular phone coverage. What was most staggering about the statement was that the utterer was university educated and, on the surface, at least, a fairly normal bloke. Four days later, on the Caen-toPortsmouth ferry as we came within 5G range, it was confirmed, as I suspected, that cheetahs aren’t 40% dog, but by then it seemed churlish to text out-of-theblue to say ‘Cheetahs are 100% feline,’ especially since we knew the in-law and his family were facing a massive delay at the Chunnel – a fitting punishment in my view, for forcing me to ask Claude if cheetahs were only 60% cat. Claude actually laughed at me when I asked. I had to quickly distance myself with something pathetic like ‘A friend told me that.’ The underlying tone in the response from Claude, I could sense, was ‘Yeah. Right!’ The last time I was stunned like that was in the early ’90s when a female patient of mine came in for treatment. She was a newish patient and had four or five carious lesions that needed treatment, and she wanted them sorted out in one session. I took the time, while she was numbing up, to question her about her diet. I was reticent to broach the subject but felt duty- bound. The reason I was cagey about questioning her on her diet was that she was, professionally, an ‘alternative nutritionist’. Call it naivety, but I sort of assumed that someone who worked in or around nutrition would be cognizant of the fact that sugars caused caries, but no. On asking her about her diet – uncomfortably imbibing penetrative death stares from her as I posed my inquiries – she said bitterly, ‘Of course I don’t take processed sugar! What do you think I am? I’m a fully qualified nutritionist, you know!’ That statement questioned everything I had learned up to that point. Was I,

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was the whole of the dental profession, completely wrong? Was there another cause of dental caries that we hadn’t yet discovered? Again, I was like a rabbit in the headlights. Totally stunned. Until she said, ‘I only eat NATURAL sugars, not the refined sugars. They do no harm.’ I didn’t know it at the time, but we were deep, deep in cheetah-dog territory. It turned out that the alternative nutritionist had a tablespoon of honey in her porridge every morning, but only half a teaspoon of ‘the purest honey I can find’ in every cup of tea or coffee she had during the day. ‘My only sin is, I drink a LOT of tea,’ she told me proudly. I never found out or, more accurately, had the energy to find out where her misconception was born (the internet was young and the Google was then known as Yahoo), so I doubt it was generated by a social media post. I never saw her again and I must admit that I wasn’t brokenhearted by this. I assumed she’d managed to find an ‘alternative dentist’. Misconceptions held by some members of the public surrounding dentistry abound. One common misconception is that “There are no NHS dentists anymore.” As we all know, NHS dental services still exist but the issue is access and capacity – finding a practice accepting NHS patients can be difficult in many areas. Another fallacy is that NHS dentists only carry out ‘basic dentistry’ – a slap in the face to the health service dentists who carry out endodontics and provide crowns on the Nash. Then there’s the misapprehension that, “A dentist can just choose not to treat you on the NHS because they want the private fee.” As we all know, the situation is complex and depends on specific contractual arrangements and capacity for NHS work.

The other big one is that, “Dentists don’t do NHS work because they’re greedy.” That’s the hardest one to swallow. I had more than one patient tell me that as a statement of fact over the years and that was well before it became even more difficult for practitioners to break even with only NHS contracts to rely on. It’s difficult enough to dispel misconceptions about the true state of public service dentistry when you have politicians like Rupert Lowe, founder of Restore Britain, claiming on The Joe Rogan Experience podcast that up to 1,000 people can arrive illegally in the UK via small boats per day. That is a wild overestimate. So far, in 2026 (up to the end of July), around 13,000 had arrived – roughly 58 per day. But then Rupert Lowe went on to say of migrants: “You go to the top of the waiting list for dental treatment, which British people don’t get.” This is also false since there IS NO waiting list for NHS dentistry. When Joe Rogan questioned the statement, asking “They get access to dental treatment that the British people don’t get?” Lowe replied “Correct. Correct.” Admirably, the British Dental Association subsequently disputed the claim that migrants are put at the top of NHS dental waiting lists, stating that access is based on clinical need, rather than immigration status. But when you have politicians effectively implying that the NHS dental service access crisis is due to illegal immigrants, misconceptions can turn into ‘facts’ in the heads of the public, fuelling resentment and an ugly turn towards parties like the (and this is MY view) rebarbative Reform rabble. In February 2024, Richard Tice, the then leader of Reform, but currently the Reform spokesperson for Business, Trade, and Energy Policy, said:

“Mass immigration has unleashed an unquenchable torrent of demand for doctors, dentists, A&E, hospital beds, houses amongst others. The British people are paying the painful price for the government’s betrayal on immigration.” So, with statements like these, from Tice and Lowe, I feel strongly that misconceptions surrounding the whole sorry state of dentistry can only grow and disguise the fundamental fact that NHS DENTISTRY IS SERIOUSLY UNDERFUNDED! The only hope is that the newly appointed Under Secretary of State for Health and Social Care with responsibility for dentistry, James Frith, can get a grip on the whole sorry situation. A glimmer of hope is that, in the past, he has recognised the failings of government to address problems in the dental service. Mr Frith has stated previously that years of political failure left people in Bury North (his constituency) struggling to see an NHS dentist, while he has separately welcomed government funding pledges aimed at adding hundreds of thousands of extra dental appointments. He has also advocated for placing more dental resources and training places in areas facing severe shortages. It’s nice that we now have a minister responsible for dentistry who truly recognises the problems facing the health service. Or is that a misconception? n

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

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How to be a menopause-friendly dental practice Jo-Anne Taylor, dento-legal adviser at the DDU, discusses the impact that the menopause can have on women and advises on how dental practices can be a welcoming place for your team and patients

omen and girls made up an estimated 34.4 million (51.0%) of the UK population according t o t h e l a t e s t o ff i c i a l p o p u l a t i o n estimates and all will be affected by the menopause at some point in their lives. Given that 78% of all dental professionals on the GDC register identify as female, it’s certainly not an issue that practices can ignore if they want to retain valuable members of the dental team. U n f o r t u n a t e l y, debilitating symptoms such as hot flushes, sleep disturbances, struggles with concentration, low mood and fatigue can drive women to consider leaving their workplace, especially if they don’t feel supported by their employer and colleagues. W ith this in mind, it’s worth taking steps to make your own practice menopausefriendly so that everyone in the team feels supported and able to continue functioning effectively in their job. On the other hand, a less inclusive approach could easily backfire. A 2023 study of menopause in the workplace by the Chartered Institute of Personnel and Development (CIPD) found that 53% of respondents had been unable to go into work due

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to their menopause symptoms and 18% had not told their manager the reason, with a third of these worried their manager would be unsupportive. Additionally, analysis of HM Courts and Tribunals Service has revealed that menopause-related employment tribunal claims tripled from 64 in 2022 to 204 in 2024 following a ruling by the Employment Appeal Tribunal that menopause symptoms could amount to a disability under the Equality Act 2010. The value of a menopause-friendly approach extends to patients too. While female patients may not mention that they are experiencing menopause symptoms while in the dental chair, it’s in their interests to understand how hormonal changes can affect their oral health and how to address this. Such conversations a re an important part of the holistic and p re v e n t a t i v e a p p ro a c h b u t c a n only take place if the patient feels comfortable and t re a t e d with respect. Any discrimination against patients on grounds such as age, sex and disability would fall short of GDC guidelines and might result in a fitness to practise investigation.

So how can you ensure that your practice is menopause-friendly?

Menopause policies

Having a menopause policy in place a n d c o m m u n i c a t i n g t h i s s o s t a ff know of the support available is a good starting point. Check if y o u r p ro f e s s i o n a l o r g a n i s a t i o n h a s a menopause policy available that you can use as a template.

Make it easy to raise concerns

Fostering an open, inclusive environment where employees feel they can raise concer ns about how the menopause is affecting them with no stigma or embarrassment will help practices in becoming menopause-friendly employers.

Make necessary adjustments

W h i l e m e n o p a u s e i s n o t a p ro t e c t e d characteristic, an employment t r i b u n a l c o u l d f i n d t h a t t h e e ff e c t of the menopause on an employee satisfies the definition of a disability u n d e r t h e E q u a l i t y A c t 2 0 1 0 . W h e re this applies, employers then have a l e g a l o b l i g a t i o n t o m a k e re a s o n a b l e adjustments to premises or to working practices.

Menopause, and perimenopause, affect people in different ways so designing some support that is individual for the employee is advisable. Employers should therefore discuss circumstances on an individual basis with their employee and consider what adjustments can be made to the workplace. For example, ensuring that there is fresh air or temperature-controlled spaces, comfortable desk seating, a private room or space with fewer distractions. If an employee is underperforming and it could be linked to menopause, look at ways that support could be provided.

Staff training

Training managers on how to handle such matters sensitively can also be a good step to take. Having a menopause champion within the organisation might be a way to promote an inclusive environment that supports women through what can be a challenging time and may enable organisations to retain experienced and capable staff that otherwise might feel unable to continue in their careers. n

About the author Jo-Anne Taylor, Dento-legal adviser at the DDU.

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Change is your sign David Arnold, Director of Communications, Oral Health Foundation, on how to make Mouth Cancer Action Month count

p a t i e n t n o t i c e s a s o re patch but assumes it will settle. Another feels a lump and puts off making an appointment. A third has no idea that their dentist checks for signs of mouth cancer during a routine examination. These are the moments Mouth Cancer Action Month asks dental teams to change. Led by the Oral Health Foundation, Mouth Cancer Action Month depends on the support of dental p ro f e s s i o n a l s . I t m a t t e r s t o u s because too many people still live with an unexplained change before seeking help. It matters to your patients and communities because knowing what to look for, and feeling confident enough to ask, can make all the difference. The scale of the challenge is growing. Our most recent published figures show that more than 10,000 people in the UK are diagnosed with mouth cancer each year. Cases have more than doubled over 20 years, while over half are diagnosed at stages III or IV. Regularly checking for changes in the mouth helps save lives. Earlier diagnosis can improve survival chances, may mean less complex treatment and can lead to a better quality of life afterwards. That is why this November’s message is “Change is your sign: remove the doubt, get checked out”. For dental teams, examining the soft tissues of the mouth is already a familiar part of routine care. The campaign is an annual reminder of why it matters to tell patients about that examination. A simple explanation, such as “I’m checking for any unusual changes in your mouth”, helps patients understand what the team is looking for and why they should mention changes between visits. Reinforce the signs patients can look out for themselves: a mouth ulcer that has not healed within three weeks, a red or white patch, or an unusual lump or swelling. These changes do not necessarily mean cancer, but they do warrant assessment. Talking through what you are checking makes early detection part of an everyday appointment.

Bring the message into the practice

Mouth Cancer Action Month need not add a major project to an already busy diary. Display a poster where patients will see it, offer a self-check advice sheet at reception and give the whole team a shared answer to “What should I look out for?” Our campaign pack and educational resources can support conversations in surgeries, waiting rooms and at events. Bunting and blue lips draw attention to the issue and help

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prompt useful conversations to make the message memorable. This year, we would love to see every member of the practice team wearing a Blue Ribbon Appeal enamel badge. It gives staff an easy opening to talk about mouth cancer and shows that awareness is a whole-team commitment. When a patient asks about the ribbon, you might say: “We’re supporting Mouth Cancer Action Month. Do you know what changes to look out for?” Blue Wednesday, 18 November, is a day within Mouth Cancer Action Month when supporters across the country come together to make mouth cancer impossible to ignore. T h i s y e a r, w e ’ re i n v i t i n g d e n t a l practices to light up the outside of their buildings in blue and ask local landmarks, town halls and other public spaces to join them. Imagine someone walking home and seeing their dental practice, then the town hall, glowing blue. They ask what it means, and a conversation begins. If your practice has exter nal LED lighting, taking part may be as s i m p l e a s c h a n g i n g i t s c o l o u r. If it doesn’t, ask a local lighting company whether it can help you create a blue display; our website has a guide to help you plan. Share photos with #MouthCancerAction and explain what the lights stand for. The more places that tur n blue on the same day, the harder the message is to miss.

Reach people who may never see your poster

Some of the most valuable activity happens outside your patient list. Consider working with a care home, homeless shelter or community social club to host a short awareness session. Ask what would be useful for its members, then bring clear information on signs, self-checks and where to seek help. Making time for questions can help your team understand barriers to care and build relationships that last beyond November. Social media offers another route beyond the surgery. A short video from a local dental professional can show where to look during a mouth self-check or explain why a persistent ulcer needs attention. T i k To k , Instagram and YouTube Shorts let you deliver one clear message at a time. Our downloadable templates

and graphics can help if filming is difficult. Add #MouthCancerAction so we can find and share your posts. Taking part benefits practices, too. It helps the team speak consistently about mouth cancer, makes the full value of a dental check-up clearer to patients and strengthens local connections. Everyone can play a part, from starting a conversation at reception to arranging a community visit. Choose what your practice can do well: explain the examinations you already perform, use the resources, wear the blue ribbon, share a video or light up your building. Each action helps someone move from uncertainty to asking for advice. This November, let change be their sign to get checked out. For campaign resources, activity ideas and more information, visit dentalhealth.org/mouthcancer n

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Compliance is a culture – not just a checklist

here are several rules and regulations that modern dental practices must meet to maintain the health and safety of staff and patients alike. For genuine results, it is crucial that this is not simply a tick-box exercise. Instead, practice principals and managers should empower the entire team to play their roles effectively and truly optimise the environment for all. This requires adequate training in and understanding of the guidelines, strict and well-communicated practice-wide protocols, and high-quality equipment that facilitates the highest compliance standards.

reusable instruments. They also highlight the need to maintain equipment like autoclaves on a regular basis, ensuring that cycles are meeting the necessary conditions for instrument sterilisation. Regular in-house testing and cleaning are essential, as are expert evaluations and repairs by external qualified engineers. The latter is also crucial for compliance with the Pressure Systems Safety Regulations 2000 (PSSR), which is required as part of the annual validation process for all autoclaves. Not only are these steps integral to patient safety, but they also maximise product life and reduce the risk of costly downtime due to breakdowns. All these regulations provide a checklist of sorts that can be referred to by practice teams to ensure that they are correctly reviewing, recording, and demonstrating their compliance.

Changing the mentality Meeting the standards

Various regulations apply to the modern dental practice when it comes to maintaining high infection control standards. In England/Wales and Scotland, respectively, HTM 01-05 and SHTM 01-05 set the safety requirements for dental practices. Both mandate the use of key pieces of decontamination equipment such as autoclaves, with washer disinfectors also required in Scotland, which are considered best practice in England and Wales. Both documents outline exactly what is expected of the dental team in terms of cleaning, disinfection, and sterilisation, as appropriate for surfaces, equipment, and

However, this should not be relied upon alone as it must be accompanied by genuine knowledge and understanding to ensure that tasks are fulfilled effectively. A checklist approach to anything creates vulnerabilities in a process. If the only objective is to tick the box and move on, little thought will be given to how the task is performed and why. This could pave the way for cutting corners to save time, in turn reducing the standards achieved. There is even some evidence to suggest that the complacency reached when repeating tasks regularly could increase the risk of accidents and impede safety – although further research is needed in the field to establish a causal relationship. This is particularly concerning in the dental practice when

considering infection control processes – any opportunity for compromised patient safety must be taken seriously and prevented by all means necessary. That said, checklists are still valuable in dentistry. When used as reminders for staff throughout the day, these lists are useful tools in supporting memory and providing a basic record of the protocols followed. Consequently, the aim for dental teams is to change the mentality when it comes to decontamination guides and checklists. Using them as tools to support infection control processes is key.

It starts at the top

Building this culture within the dental practice requires a ‘lead by example’ philosophy. Practice owners and managers should work together to create a collective team mindset that promotes excellence in all areas of the business – from clinical patient care to decontamination. This necessitates effective and continuous communication between team members, as well as support tailored to individuals’ needs, concerns, and responsibilities. The literature firmly establishes a link between strong leadership and enhanced patient safety in dental settings, further highlighting its importance.

Simplifying processes in practice

Another aspect of effective leadership is ensuring that the entire team have the tools they need to fulfil their roles safely and efficiently. This means providing high-quality autoclaves and washer disinfectors, as well as the training and support they need to use them effectively.

Eschmann – the expert in dental decontamination – provides a range of such solutions that encompasses all your needs. For convenience, the industryleading autoclaves can be linked to the innovative MyEschmann Hub & Cloud that automatically records essential cycle information. This makes it a breeze to demonstrate adherence to the regulations. For flexibility, The MyEschmann Hub can be connected to Wi-Fi, Ethernet, or uploaded via USB for automated cycle uploads to the MyEschmann Cloud. All equipment can also be protected by the Eschmann Care & cover programme, which provides access to ongoing support and technical assistance, as well as routine testing, validation, and repairs on relevant equipment. This support, combined with a practice culture that embraces decontamination compliance as a way of keeping patients and colleagues safe, is the key to maintaining exceptional standards across the dental practice. Implementing meticulous decontamination protocols involves more than simply ticking off a checklist – a practice team that understand this is a great one. 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.

The tangible impacts of excellent practice design

he design of any healthcare environment has a direct impact on patient care. It influences how patients feel, how they react to the professional team, and whether they decide to return in the future. The physical surroundings will also affect the quality of care that professionals can deliver and the efficiency of this care provision, as well as the satisfaction, retention, and productivity of staff. The design of your dental practice must be carefully considered. Not only must the environment be functional to support workflow efficiency, but it must also promote calmness, confidence, and trust, elevating the patient experience beyond clinical necessity.

An evidence-based field

There is a growing body of evidence that links workplace design with increased employee productivity, performance, and satisfaction. In a difficult economic climate fraught with recruitment challenges, the positive impact that a motivated team has on staff retention will be important for every practice. Implications have also been published regarding staff wellbeing, with a welldesigned workplace helping to reduce staff sickness and absence. In particular, an ergonomic space should be created that reduces the need for clinicians to stretch or strain their bodies during treatment, which can improve the quality of their clinical work, as well as their quality of life, and personal health. With approximately

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70% of dental providers experiencing work-related musculoskeletal disorders in the UK, the opportunity to minimise their occurrence should be championed by all dental business owners. But that’s not the only way in which the design of healthcare environments can positively influence the patient experience. Firstly, staff wellbeing – both physical and mental – has been linked with improved patient satisfaction. An effective environment, including audio and visual elements, also helps to reduce anxiety, pain, and stress among patients. In addition, design features that ensure privacy can add to an individual’s sense of control over their treatment, which further improves their comfort. The best results are achieved when patients’ feedback is sought and alterations made according to their real-world experiences.

A practical approach

Translating all this into practice means applying core design principles when visualising and renovating your space. From a practical perspective, it’s important to consider the regulations that might guide or restrict alterations to the building itself. For commercial properties like dental practices, the rules pertaining to structure, fire safety, ventilation, access, and electrical safety are among the most important to understand. Liaison with a Building Control Body will be necessary to apply for approval ahead of major works. This is separate to the planning permission needed, which must be

sought from your local council prior to altering the building structure, aesthetic, or purpose. As is true of most legal frameworks and legislation, the language in these documents can be convoluted with technical jargon. Consequently, the advice and support of experts in the field will be invaluable. Collaborating with those who do this every day, who understand the latest changes and the smallest nuances relevant to dentistry, makes the entire process run more smoothly. But the design of your practice must be more than simply compliant with the regulations: it must be optimised to support professional efficiency, promote patient comfort, and to effectively present the practice’s branding. To bring your vision to life it is important to create a mock-up of the different areas to see how they will look and how they will connect. Small alterations can be made at this early stage where needed for enhanced cohesion, or to make the investment work harder for longer. When you work with Clark Dental, you gain access to a team with decades of experience in designing, installing, and maintaining exceptional dental practices across the UK. As a premium service that offers superior products, Clark Dental can help you create a practice that elevates both the professional and patient experience and delivers tangible patient, team, and financial benefits. Create a stunning 3D render of your proposed design in cutting-edge software to better visualise every detail, paving the way for a timely and highly successful project conclusion.

Results you can measure

The design of a dental practice is much more than improvement of the interior aesthetics. It is an opportunity to enhance the workplace for clinicians and the team, to boost job satisfaction and improve staff retention in the long-term. It also positively influences the patient experience, elevating the quality of their care and their comfort throughout their dental journey. A structured approach to practice design, utilising the talents of experts in the field, is important to ensure that all investment delivers results you can really measure. 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, CDO at Clark Dental.

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No phones for you – the cost of missed calls

here are many ways of levelling up your practice revenue, from taking on more dentists to offering a greater range of treatment options and delivering more chairside treatments. But these demand notable investments, and paying for new staff, new technologies and perhaps added building work might be a blow to your business. For a more cost-effective solution to improving your finances, dental practice owners should instead focus on what they already have in place and locate the areas where revenue is potentially lost. A major area for this is the practice phoneline, an often-overlooked source of income that must be valued and supported to enhance your business.

especially true – there is no time to wait for a reply. Every missed call therefore has the potential to impact your revenue and support your competitors, placing your business at a disadvantage. But how much revenue is actually lost from unanswered calls? There is no exact science, but practice owners must be able to find out how many calls are missed on a daily, weekly, monthly and perhaps annual basis, in part because some practices may have slower periods in the year (such as a quiet September when children return to school). To work out the number of missed calls, you should have active reports as well as details on how many of the calls have been followed up – this paints a picture of how many patients have fallen through the cracks.

Missed call problems

How much is a phone call worth?

When a person calls a dental practice, it is likely for one of the following: • To book or manage an appointment (with varying degrees of urgency) • To make an enquiry ahead of an appointment If the person is not already a patient at the practice but is looking to become one, that increases your revenue if an appointment is booked, and that depends on the call being answered in the first place. In the event of a person’s call being missed by the administrative team, 87 per cent are unlikely to ring again or leave a voicemail, instead heading to one of your competitors to receive the help they need. If the person is calling due to an urgent problem, such as tooth ache, then this is

Calculating the cost of a missed call can vary. For instance, imagine your dental practice receives 200 phone calls every week. Of these, 40 per cent / 80 calls go unanswered. If even half of those calls have genuine enquiries, then there is a reasonable chance that 25 per cent / 20 of these would have booked an appointment. How much this is worth is dependent on the average patient lifetime value of your practice, e.g. £1,500. Multiplied by 20, that is £30,000 of revenue that the practice is missing out on – and just one from one week of missed calls. This is especially concerning as new patients are lucrative, with a high first-year value owing to the necessary X-rays, initial treatments and multiple appointments. Converting leads is a crucial part of any business, and being

able to identify the areas where this is failing ensures the gaps are closed. Dental practices that report high numbers of missed calls must then discover why that is – what is causing the calls to go unanswered? There are several reasons, with the leading one most likely to be an over-stretched administrative team. Whether having a high flurry of patients in and out of the practice each day, an understaffed reception desk or inexperienced employees, the margin for missed phone calls is high.

Reception reinforcements

As the patients in the practice are the priority, the admin team should feel confident dealing with immediate tasks and also comfortable that a ringing phone will be answered. This is where an AI receptionist can make a colossal difference; if the admin team are engaged with a patient, the practice can refer the incoming call to an AI system after a designated number of rings, where enquiries are answered and appointments can be booked with ease. For a first-class solution, consider RoboReception AI. Able to increase revenue by taking all the calls your admin team can’t

– including outside of opening hours – the system refers patients to AI Joe, a supportive helping hand designed by dentists to better help dental practices. Whether booking appointments or answering enquiries, integrating RoboReception AI reduces the workload for the admin team, optimising patient care and ensuring no lead is missed. Inefficient workflows can hinder productivity. By highlighting the importance of every phone call to your business, you can better adapt the dental practice to reduce the amount of lost revenue and boost the productivity of your business. 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

About the author Dr Grant McAree (BDS BSc. HONS), Co-founder of RoboReception.

How should practices communicate infection control to patients?

ver since the Coronavirus pandemic, public awareness and fear of fast-spreading and dangerous infections are at an all-time high. Earlier this year, hantavirus, a group of zoonotic viruses that are normally carried by rodents, was featured prominently in the news due to multiple high-profile cases. The risk to the UK population was considered very low, but some patients may have held strong concerns. The same could be said of many potential future viruses. While top-level advice may change on a case-by-case basis, the clinical team can typically follow the same procedures to maintain patient safety. Communicating how some of this is achieved may help put patients’ minds at ease, and foster a safer feeling within the practice. However, rather than bombarding patients with clinical information, it’s important to achieve this in more natural ways.

Open up discussions

Where appropriate, opening up discussions with concerned patients may be ideal. This could be at the reception desk, during appointments, or even online. People could submit questions for a team member to answer, helping alleviate concerns that may otherwise prevent individuals from attending the practice. The use of social media may be the best way to reach these patients, as well as publishing on a practice website.

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By addressing concerns this way, the reassurance may reduce infectionrelated anxieties and mean patients are more likely to attend appointments, supporting their oral health. If a patient has questions in person, it is important to address these calmly and honestly. Detailing infection control measures may put them at ease, but if a professional doesn’t have the knowledge around a non-dental-related virus, honesty is just as important. At the same time, using technical language may only reinforce such fears; speaking to patients in layman’s terms that they can understand is vital.

Sign-post throughout the practice

Patients will pick up on efforts being made within the practice, especially through signs and posters that encourage effective infection control. These can also be an aid to the dental team, as consistent reminders of good practice throughout the day. Whether these are handwashing signage, clinical waste colour code reminders at point of use, or posters detailing PPE requirements, patients may find their presence reassuring.

A clean, organised dental practice

The first thing every patient will look for is a clean practice space, from entrance to dental chair.

This may include helpful hand sanitiser stations at the entrance, inviting visitors to reduce the risk of infections being brought into the practice. Other key elements of infection control will be covered through everyday workflows. This includes wearing PPE, such as face masks and clean gloves, and replacing tools after every use. As well as autoclave systems for sterilising frequently used components to ensure patient-to-patient contamination is kept at a minimum. However, one aspect of everyday proceedings that plays a key role is waste management. This includes in surgery rooms, where waste containers should be situated at the point of use, and in secure areas where larger quantities of waste are stored. The latter should be kept out of sight of patients, and the practice should ensure restricted access is in place. Hantavirus is linked with rodents, and these pests are a problem that must be avoided. To avoid attracting rats and mice, waste containment areas must be kept clean, with regular inspection measures in place. In these areas, hand hygiene routines are particularly important. When disposing of waste items, any contaminants mustn’t be brought back into the practice.

Have confidence with Initial Medical

Initial Medical provides a comprehensive range of hand sanitiser solutions for dental practices, including manual and No-Touch dispensers and Wheelie Bin Sanitiser Station, all designed for clinical safety. These units feature integrated antimicrobial technology to inhibit bacterial growth on the dispenser surface. Using sealed, single-use pouches, they ensure total hygiene compliance and can be paired with 70% alcohol sanitiser in accordance with WHO guidelines. Hand sanitiser stations from Initial Medical can also be placed throughout the dental practice for improved clinical team and patient safety. Many of the unseen tasks of the dental team are vital for protecting patients from infection. Having confidence in the solutions in place throughout your practice is vital, and this will be noticed by patients attending their appointments. To find out more, get in touch at 0808 304 7411 or visit: www.initialmedical.co.uk n

About the author Rebecca Waters, Head of Marketing, Initial Medical & Rentokil Specialist Hygiene.

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The cost of single-use oral care Cutting waste with

he ever-growing impact of and contributions to climate change is something well understood in various areas of the current landscape. The healthcare sector, in particular, is responsible for approximately 5% of global CO2 emissions, with one area less frequently but increasingly being discussed: dentistry. Now an unavoidable conversation in dentistry, sustainability is something that practices are rethinking and managing – from packaging and energy use to clinical waste. Similarly, patients expect the products they are recommended by their dental professionals to reflect these core environmental values. Despite this, one of the most routine areas of daily oral care – the tools we use to clean interdentally and along the gingivae – often escapes scrutiny. The environmental footprint of these small yet frequently replaced items adds up passively, and it is certainly worth examining more closely.

Daily demise

For example, a patient who uses a disposable interdental brush every day, or even every few days, gets through hundreds of plastic items over the course of a single year. When this is multiplied across an entire patient base, and then across a working lifetime, the cumulative amount of waste becomes disturbingly substantial. Most of these products are manufactured from mixed materials that are difficult or impossible to recycle through ordinary household systems, so the majority end up in landfill. For something that is used for less than a minute before being thrown away, the persistence of such waste is alarming. Of course, none of this is an argument against interdental cleaning. The removal of plaque between dentition is well understood, and patients should never be discouraged from maintaining a thorough, consistent routine. Plaque left between the teeth is a significant contributing factor to both caries and periodontal disease, and the spaces a toothbrush cannot reach are where problems commonly arise. The question persists therefore not in whether patients should clean interdentally, but rather, in how to maintain the clinical necessity whilst committing to waste reduction. The answer remains with the kind of tools recommended: those designed to last, rather than those designed to be discarded.

Reusable and reliable

Reusability is the single most effective solution in this predicament. A well-made interdental brush that can be rinsed, dried, and used repeatedly over a period of weeks considerably reduces the number of individual items a patient consumes. The daily routine stays exactly the same with the standard of cleaning remaining unchanged, and yet the waste generated is a fraction of what a disposable approach produces. For patients who want to do the right thing without compromising their oral health, this is the obvious place to initiate change. It also supports a more economical situation for patients over time. This

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presents a strong incentive, as anything that lowers the ongoing cost of a healthy habit makes that habit far easier to sustain. Sustainability and affordability, in this instance, pull in the same direction rather than against each other.

Quality over quantity

There is a quality element to this as well. A reusable tool only delivers on its promise of genuinely reusability if it is built to perform reliably over its lifespan. A brush whose bristles split or whose wire bends after a couple of uses defeats the purpose, forcing earlier replacement and undermining both the environmental and the economic reasoning. Essentially, durability is not a luxury feature but rather, the very thing that makes reusability meaningful. When recommending products to patients, it is certainly worth advising them towards ranges that have been engineered for the purpose of longevity, because a cheap brush replaced constantly is neither the greener nor the cheaper option in the long run. The most sustainable product is invariably the one that is used well and replaced only when it genuinely needs to be.

Recommendations without compromise

This is where the TANDEX FLEXI range excels. FLEXI interdental brushes are built to be reused, with a durable wire core and bristles that hold their shape across multiple uses. Clear colour-coded sizing helps clinician and patient match the brush to the interdental space, improving both cleaning and comfort, and the quality of construction means each brush can be used many times rather than being disposed of after a single use. For patients who want to take it a step further, the WOODI brush offers the same excellent clean with an entirely environmentally friendly design!

A small change with a lasting impact

Sustainability in oral care does not demand dramatic change. It is rather the small, intentional choices that are repeated daily. In particular, the tools that patients use are at the very heart of this intent. For dental professionals, recommending reusable options that clean effectively and last well, allows patients to protect their oral health and reduce their waste at the same time. It is a simple shift, but one that adds up, and the means to make it are already within easy reach, with the right guidance. n 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/

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

digital dentistry

hen practices talk about waste, the conversation often starts with gloves, wrappers and single-use plastics. These matter, but some of the larger inefficiencies sit deeper in the workflow: how impressions are taken, how appliances are produced and how cases move between the practice and laboratory. Digital dentistry, particularly in-house 3D printing, can cut out several of these inefficiencies while also shortening turnaround times.

A better impression

Traditional impressions require material to be mixed, used once and discarded, while trays must be cleaned or thrown away. The impression is then packaged and transferred to a laboratory, where further materials and handling may be required. Many of these items are difficult to recycle, so a few impressions each day can become a significant waste stream over a year. An intraoral scan removes the impression material and many of the associated handling steps. The result is a digital file that can be stored securely, reviewed and transferred without repeatedly moving a physical impression between the practice and laboratory. It does not eliminate every consumable, but it can substantially reduce the material, packaging and transport attached to the conventional process.

Fewer journeys, faster treatment

Physical impressions and appliances often travel between practice and laboratory. If a case needs an adjustment or remake, the journey, packaging and waiting time may be repeated. The operational cost is clear: more handling, more delay and another appointment for the patient. In-house 3D printing can shorten that loop. A practice holding the patient’s digital file may be able to reproduce a retainer, night guard or other appliance without taking another physical impression or restarting the whole external process. In suitable workflows, that can mean a same-day solution and a more dependable patient experience.

Use material where it matters

Milling is subtractive: a restoration is cut from a solid block of material (often called a ‘puck’), and the remaining material is removed. 3D printing is additive, building the object layer by layer and placing material where the design requires it. Printing is not waste-free – supports, cleaning materials and failed prints still count – but a well-controlled workflow can use material more efficiently, particularly when several appliances are nested in one build. Resin handling can also reduce avoidable waste. Depending on the material and its IFU, unused resin may remain in a dedicated covered tank or be filtered and returned to its original bottle. The important point is not simply to save every drop, but to follow the approved handling process so that material is reused without compromising consistency or safety.

Fewer remakes, less waste

Remakes are one of the least visible sources of waste. A poor fit or breakage can repeat the material, production, transport and appointment time of the original case. Accuracy is therefore both a clinical and an efficiency issue. A validated combination of scanner, software, printer, resin and post-processing helps reduce avoidable variability and improves the prospect of getting the result right first time. Digital records also make later replacement simpler. Where the original scan and approved design remain available, the practice may be able to reproduce an appliance without repeating the impression stage, subject to the clinician confirming that the stored data are still suitable for the patient.

A validated ecosystem

For a practice evaluating digital dentistry, a system that has been tested as a complete workflow removes much of the trial and error. SprintRay connects design, printing, validated material profiles and post-processing, with region-specific IFUs and regulatory documentation for the intended dental application. That does not guarantee that every case will succeed, but it gives the team a defined process designed for repeatability.

Efficiency that makes a difference

Digital dentistry will not remove every consumable or journey from dental care. It can, however, reduce physical impressions, cut repeated journeys, use production material more efficiently and make selected remakes faster. The strongest case is a practical one: fewer avoidable steps, fewer failed outcomes and less time spent repeating work. For practices looking to reduce waste without compromising clinical quality, the most credible starting point is not a broad claim. It is a measured digital workflow that improves efficiency case by case, and can show where material, time and journeys have genuinely been saved. For more information on the 3D printing solutions available from SprintRay, please visit https://sprintray.com/en-uk/ n

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

The Probe | October 26

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“It had to be DeNovo – they aligned where no other corporates did.”

fter pouring years of clinical work, team mentorship and patient care into building a successful practice, selling doesn’t necessarily mean wanting to leave the practice behind. But remaining fully independent may not feel right either, particularly as the pressures and risks of practice ownership evolve. When Katie and Malcolm Campbell were presented with the opportunity to sell one of their practices to DeNovo Dental Partners, it offered a different path: the chance to reduce some of the day-to-day pressures of practice ownership while remaining closely involved in the business they had built. Katie shares their experience. “We bought our first practice in 2017 and bought our second practice in 2021. This coincided with the birth of our second child within a matter of weeks. I don’t think we anticipated the level of stress that would come with going from one practice to two and trying to manage that stress whilst having a newborn baby. The second practice was not easy to step into – an established practice with lots of patients to serve, and a dilapidated building that needed a full renovation and refurbishment. The stress levels and quality of life became completely out of kilter at that point. “Malcom and I are complete control freaks and are really obsessed about the detail. For us, the patient journey was really important. We wanted to remain in control as much as possible because we are really proud of what we’ve built and the loyalty of our team. We knew we couldn’t sell to a traditional corporate because it would never have aligned. Additionally, we didn’t feel ready to sell both practices, but we felt that selling one would alleviate some stress. “That’s how we came to meet DeNovo. Initially we were a bit confused by the business model and the shares aspect. But we did loads of research, spoke to the right people, and decided that if we were going to sell, it had to be DeNovo – they aligned where no other corporates did.”

Coming to a decision

Practice owners considering a sale often find there is no single obvious route. For Katie and Malcolm, the decision meant balancing the future of the practice with their family life, their desire to remain involved and the importance of finding a partner that shared their approach. “Selling one of our practices was never part of the plan. We always expected to own and run both practices until retirement. “While we had considered selling to an associate one day, the practice had grown to a point where its value made that unrealistic. The alternative was simply to continue running it ourselves. “W ith two young children, we realised we wanted a better work-life balance and the chance to enjoy more of life now, rather than waiting until retirement. When the opportunity to partner with DeNovo came along, it felt like the right time. It allowed us to step away from many of the day-to-day operational pressures while remaining involved in the practice we’d built. “The business model seemed to suit us, and after chatting it through with Caron Best (Chief Operating Officer, DeNovo), we felt that she had a really good understanding of our businesses. We like the way they handled it; they weren’t pushy, they simply presented the information, and out of all the corporates that we met, we felt most aligned to DeNovo. “Throughout the sale process, Kristen Pope (Chief Integration, Partnership & Communication Officer,

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Katie Campbell DeNovo) was our main point of contact and was excellent to deal with. Communication was always open and straightforward. If we had a question or concern, we could simply pick up the phone, talk it through and get it resolved quickly. “That personal approach really stood out. It never felt like we were just another acquisition, which we’d heard from friends can sometimes happen with larger corporates. Throughout the process, DeNovo stayed true to the way they do business, and everyone we dealt with was approachable, genuine and easy to work with. “The people involved and their cultural values were the most important factor that led us to join DeNovo Dental Partners.”

Now that we’ve joined

For Katie and Malcolm, the experience since joining has provided further reassurance that they made the right decision – not only through the change in their day-to-day responsibilities, but through the relationships they have built across the wider DeNovo Partnership. “We sold our practice at the end of December l a s t y e a r. S i n c e t h e n , w e ’ v e c o n t i n u e d t o encounter members of the DeNovo team and

Malcolm Campbell other Partners too. I’ve found it really refreshing to talk to Partners – everyone is really nice, very easy to talk to, and there’s a collaborative vibe amongst everyone. The team at DeNovo wants to constantly improve. It feels like this is really important to them, and they are always willing to take feedback on board. “The work-life balance we’ve achieved and the people we continue to encounter within DeNovo have reinforced that we’ve made the right decision. People like Emma Delgado Vitória (Operations Manager, DeNovo) and Jack Mole (Finance Manager, DeNovo) are super friendly, approachable, and easy to deal with. Those people continue to reinforce that we’ve joined something that is really good.” Every practice owner’s circumstance, ambitions a n d p l a n s f o r t h e f u t u re a re d i ff e re n t . A t DeNovo Dental Partners, our approach is built a ro u n d re c o g n i s i n g t h a t i n d i v i d u a l i t y c re a t i n g partnerships based on shared ownership and aligned interests, while preserving what makes each practice special. If you’re beginning to think about the future of your practice, get in touch with the DeNovo team for a confidential, no-obligation conversation. https://www.denovo.partners/ n

The Probe | October 26

02/10/2026 10:19:48

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e c n o For e What is the Benefit of ChloroStay 7-Day Mouthwash? s u ek e w a ChloroStay 7-Day Mouthwash is a weekly mouthwash which helps prevent plaque build-up, keep breath fresh and promotes and maintains oral hygiene for up to a week after use – especially in difficult to clean areas, such as between teeth and around orthodontic appliances.

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When should patients use ChloroStay 7-Day Mouthwash?

ChloroStay 7-Day Mouthwash consists of two solutions. When combined, tiny crystals of encapsulated calcium chloride chlorhexidine spheres are formed. These crystals adhere to the surfaces of the teeth and slowly release the chlorhexidine in a low but clinically effective dose over a period of up to 7 days.

ChloroStay 7-Day Mouthwash is a unique mouthwash, developed by a multi-disciplinary team at Queen Mary University of London. Unlike traditional mouthwashes that have a high initial chlorhexidine concentration but are quickly washed away in the mouth, ChloroStay provides low and sustained chlorhexidine release for up to a week.

To provide added protection in difficult to clean areas such as between teeth and around orthodontic appliances. Whenever compliance with a once-aweek regime is easier to achieve or supervise than a regime carried out daily, and for patients who have difficulty in effectively brushing their teeth.

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oral health

Hormones and health – bridging the divide

omen’s health undergoes unique transformations that require specific attention. For instance, the relationship between female sex hormones and oral health is well-documented, though many patients may be unaware of the connection. Dental professionals have a duty of care to support at-risk patients. For women, changes in the body due to intense hormone activity can have a negative impact on oral health. This activity is crucially identified at three defined stages: • Adolescence – puberty is frequently accompanied by exacerbated gingivitis, regardless of dental plaque presence • Pregnancy – hormonal surges increase gingival inflammation and transient tooth mobility • Menopause – the drop in female sex hormones leads to xerostomia, altered salivary flora and bone resorption, contributing to the worsening of periodontal disease How periodontal tissue responds to microbial plaque can be changed by hormones, triggering periodontal disease. Also important to note is the role of oral contraceptives, and the hormonal impact that they cause – research has noted the periodontium changes found in patients who use them, with increased tooth mobility found.

Why menopause?

The sustained time span of menopause (symptoms usually last for 7-9 years) demands that close attention is paid to its

effect on the body. Hormone replacement therapy (HRT) helps manage menopause symptoms by replenishing the low levels of oestrogen and progesterone. Such symptoms include hot flushes, night sweats, interrupted sleep, mood swings, and anxiety and depression. However, HRT is not suitable for patients who have a history of chronic health conditions like cancer, high blood pressure, liver disease or blood clots. For those that are able to receive HRT, the anti-aging benefits can ultimately improve quality of life – but does it affect oral health?

Bone protection

HRT improves fat distribution, lipid metabolism and insulin sensitivity, helping to prevent the progression to diabetes in postmenopausal women. It also preserves and enhanced bone mineral density, mitigating bone loss and reducing the onset of osteoporosis. This extends to the alveolar bone, where compromised bone density can weaken the supporting structures of the teeth and lead to edentulism. This may also make it more difficult for restorative implants to osseointegrate. It is oestrogen that plays a central role in maintaining bone density, so HRT counteracts the bone loss associated with diminished hormone levels, ensuring that the teeth are well-supported.

Tissue troubles

Oestrogen also exerts protective effects on oral tissues, modulating immune responses and reducing inflammation. The gingivae and salivary glands play a key part in

maintaining the oral microbiome, and the presence of oestrogen in HRT may support these soft tissues and alleviate menopauseassociated symptoms like xerostomia and the subsequently higher risk of periodontal disease. A study on postmenopausal women found that most complained of dry mouth throughout the day and night, and that these complaints were massively reduced after HRT. As reduced salivation and a more acidic oral pH promote bacterial growth, HRT intervenes and helps balance the microbiome with increased salivary levels.

Working together

The impact of menopause is far-reaching, affecting daily life on a physical, mental, and emotional level. HRT can help as part of a wider preventive approach to protect at-risk patients – an approach that is tailored to their specific requirements and encompasses the hormonal context. Dental practitioners should help as part of a broader interdisciplinary team, collaborating with general practitioners and gynaecologists to optimise care for women at every stage of their hormonal life.

One aspect to consider is guiding affected patients towards products that are designed to help manage symptoms of the menopause. A trusted signifier of this is the MTick mark of accreditation from GenM, awarded to certified solutions that help patients with at least one of the 48 recognised signs of menopause. To provide oral care support for menopausal patients, recommend the CS 5460 toothbrush from Curaprox, which is now emblazoned with the MTick. Featuring an octagonal handle and angled head for enhanced handling, the toothbrush has 5,460 ultra-fine Curen filaments that are extremely gentle on the soft and hard tissues. Menopausal patients reporting sensitive or bleeding gingivae will benefit from the comfortable yet comprehensive clean provided by the CS 5460, improving their daily oral hygiene routine.

Spread the word

The rise in awareness of menopause and its impact on dental care is worth highlighting, but there is still more to do. By keeping up to date on the latest information, such as the role of HRT and its effect on oral health, dental practitioners are better equipped to give their patients an outstanding quality of care and improve their life. 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 UK.

Enhance brushing compliance with

he toothbrush is the superhero of the daily oral care routine, protecting the tooth surfaces from harmful bacteria day and night. However, 54% of the UK adult population admit to skipping brushing their teeth at least once a week, with this mostly occurring before bed – a time where oral care is most needed. There are many reasons why toothbrushing may be overlooked, from short-term problems like tiredness or having lost a brush, to longer-term impacts such as sensitive gingivae and an unawareness of the importance of oral care. To support patients who admit to skipping toothbrushing, dental practitioners can recommend the innovative products from Curaprox, especially the firstclass offerings of toothbrushes.

Power in every clean

On the sonic front, Curaprox has designed a cuttingedge, fully customisable solution: the Hydrosonic Pro. A collision of sleek Swiss aesthetics and tested science, the powerful hydrodynamics are able to push fluids through the interdental spaces too, helping dislodge trapped food particles. Featuring seven cleaning modes that reach up to 84,000 brush movements per minute, patients can find the setting that feels best for them. For an even more tailored experience, the Hydrosonic Pro comes with three brush heads: Power, Sensitive, and Single. Whilst each uses wonderfully soft Curen® filaments for a gentle cleaning experience, the Sensitive head is ideal for patients reporting bleeding gingivae. This enables them to remove

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harmful particles and protect the gingival margin without feeling discomfort, improving daily compliance. The elegant design of the Hydrosonic Pro also promotes function: Curacurve® technology creates precisionengineered angles that optimise patient handling and contact with the tooth surfaces and gingival margin. Difficult spaces are more easily accessed too, amounting to a comprehensive cleaning experience. Sophisticated yet simple, the Hydrosonic Pro levels-up daily dental care to a professional hygiene standard.

A twist on tradition

The traditional manual toothbrush is basic in design and provides a minimal standard of care. This is why the CS 5460 toothbrush from Curaprox is so distinct: its innovative look blends practicality with scientifically supported hygiene outcomes. Easy to grip, the octagonal handle rests between the fingers, guiding the patient to the correct brushing technique. Simultaneously, the angled brush head targets the tooth surfaces and gingivae, reducing the risk of caries and periodontitis. The Curen® filaments define Curaprox toothbrushes. Made with 5,460 of these ultra-fine bristles, the CS 5460 packs more punch than a standard supermarket toothbrush, and the gentleness does not come at the cost of effectiveness – patients can experience both comfort and cleanliness. The CS 5460 is also special for being the only toothbrush accredited with the MTick from GenM, a stamp of approval that means it helps manage one of the symptoms of menopause – in this case sensitive

or bleeding gingivae. Menopausal patients in particular should be guided towards the CS 5460 to improve their quality of life.

Loaded with bristles

Not all toothbrush bristles are created equally, and some are specifically tailored to meet the unique needs of each patient. The CS 12460 Velvet from Curaprox is ideal for patients reporting sensitivity when they brush. With over twice the number of Curen bristles as the CS 5460, the Velvet delivers unparalleled softness to the teeth and gingivae, removing harmful bacteria and preventing plaque build-up. The gentle brushing sensation adds a genuine feel-good experience to daily brushing, with a finish reminiscent of a professional dental clean in practice.

The ultimate trio

The Hydrosonic Pro, CS 5460 and CS 12460 Velvet are three top-of-the-range toothbrushes that give patients a rewarding hygiene experience. Between the soft bristles and ergonomic designs, the Curaprox solutions can be tailored to a wide variety of patients, leading to outstanding oral care outcomes. Recommend from the range 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 n

The Probe | October 26

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oral health

Small changes, maximum benefit

ifehacks are ever popular online, and encourage patients to rethink their daily routines. As our everyday lives become busier and more stressful, many people may look to these shortcuts as ways to improve their lives with minimal effort. In healthcare spaces, precaution is required. Small changes to the oral hygiene routine can be effective, but they must be safe and clinically proven. Sometimes, however, the ways a patient can make a big difference to their oral health and their smile is by simply engaging in everyday cleaning routines. The lifehacks that come alongside this may include changes to behaviours and cleaning aids in order to optimise the outcomes from their efforts.

Initiating change

In order to provide smile-defining advice to patients, an understanding of their current oral hygiene routine is required. This can vary widely between individuals, with many brushing twice a day and using interdental cleaning adjuncts to outstanding outcomes, but 20% of UK adults clean their teeth just once a day, and another 2% have even more infrequent habits, brushing less than once per day. For these individuals, any small changes should help them engage with a more regular oral hygiene routine. Identifying the reasoning behind such complacency and devising a way to surpass this should be the goal. Repeated oral hygiene instructions and clinician-initiated motivation are known to be vital for reducing plaque index and

For the already engaged patient

improving periodontal health, but no successful outcomes can come unless the patient is actively engaged. The COM-B model helps clinicians understand and improve patient behaviours. It looks at the relationship between capability, opportunity and motivation, and how they cumulate to affect behaviour. Clinicians need to consider if the patient has the understanding and physical capabilities to keep an effective oral hygiene routine, if they have the time and oral hygiene tools available to them, and whether or not the behaviour is already part of a routine, and if it holds importance to a person. For patients who are able to brush their teeth without help, but site a lack of time or forgetfulness, the small change of mentally linking it to another daily behaviour – such as showering, or preparing a bag for work or school – could ensure they brush their teeth more often, having a significant difference on their oral health outcomes. Setting reminders on a mobile phone at regular times may also be a simple but effective nudge every morning and evening.

The majority of patients will already keep regular oral hygiene routines, and so the changes that clinicians can suggest need to be closely tailored to their existing behaviours. One of the most significant changes is simply implementing interdental cleaning alongside toothbrushing. Interdental cleaning 5 to 7 days per week is associated with an increased prevalence of functional dentition amongst adults, with more favourable results than those that performed interdental cleaning on 1 to 4 days per week. There are additional benefits for general health, with a 2026 study showing that toothbrushing combined with interdental cleaning can reduce the risk of dementia. Many patients do not use anything more than a toothbrush in their routine; the Adult Oral Health Survey from 2021 revealed that just 30% of UK adults use dental floss, 21% use interdental brushes, and another 11% use aids such as interdens, toothpicks or woodsticks. It’s important to note that these figures may include patients that use multiple options, further diluting the number of people engaging in some form of interdental cleaning. Interdental cleaning may only extend the oral hygiene routine by a couple of minutes, but the improved oral health outcomes are worthwhile. Patients may be apprehensive, as traditional dental floss may feel difficult to use at first, especially for those with little experience. Access to the posterior dentition may also be complicated for some, which can create frustration and lead

to patients giving up on the routine. To help the behaviour stick, and for patients to reap the rewards, the right interdental cleaning aids need to be recommended.

Solutions they can trust

The Waterpik™ Cordless Pulse water floss is an accessible, easy to implement oral hygiene aid that ensures patients achieve a thorough clean every day. It features 2 pressure settings and 2 flossing tips, including a Tongue Cleaner for fresher breath, and can remove up to 99.9% of plaque bacteria from the treated areas in as little as 3 seconds exposure. With a waterproof design that allows convenient flossing in the shower, and an easy-fill reservoir for everyday use, it can help your patients transform their smiles for the better. The smallest changes and ‘lifehacks’ for your patients are sometimes simply engaging with toothbrushing and interdental cleaning more frequently. Changing the way advice is framed to patients may encourage improved behaviours, and in turn create healthier smiles. For more information on Waterpik water flosser products visit www.waterpik.co.uk n

About the author Anne Symons, Professional Educator at Waterpik.

Commuting and TMD

or many, commuting is an unavoidable part of daily life. Long distances, slowmoving traffic, long-haul flights, or train journeys often mean significant portions of the day are spent in static positions before even arriving at work. While commuting’s impact on the back, neck, and musculoskeletal health is widely recognised, its effect on temporomandibular disorders (TMD) is discussed far less frequently. There is, however, growing awareness of the relationship between posture, muscular tension, and temporomandibular function. Long periods spent driving or travelling could contribute to jaw strain, particularly in patients with existing parafunctional habits – putting dental professionals in a unique position to help reduce their pain.

Static posture and muscular fatigue

Commuting differs from other daily activities because movement is limited for prolonged periods. Driving, in particular, often requires maintaining the same upper body position throughout a journey, with minimal flexibility for head, neck, or shoulder variation. Even public transport users – on buses, trains, or the tube – frequently endure sustained positions, especially given constant phone use during travel. Combined with end-of-day fatigue, posture often deteriorates further during evening travel. Patients commuting with baggage should aim for symmetry in weight loads to avoid

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musculoskeletal pain. A backpack with dual straps, rather than a tote bag or satchel, can better support spinal alignment. Over time, these habits can compound, straining the cervical spine and associated musculature. Poor seating, incorrectly positioned headrests, and slouched posture may all contribute to forward head positioning – and as the TMJ functions closely alongside the head and neck, poor posture in one area can influence tension elsewhere.

Strains of travel

Driving can also encourage subtle muscular guarding. Intense concentration can subconsciously tighten the shoulders, neck, or jaw, particularly in stressful or stop-and-start traffic. Unlike more obvious clenching, these habits are often low-level and long-sustained, making them difficult for patients to recognise. Short journeys alone are unlikely to cause significant issues. However, repeated exposure over months or years may cause muscular fatigue and strain, placing dental professionals as the link in helping patients recognise and alter their habits.

Stress behind the journey

Stress is another factor associated with commuting, in both driving and public transport. Delays and congestion can each increase tension levels, and this heightened stress response often expresses physically – especially across the jaw.

Patients experiencing stress-related parafunctional activity might clench their teeth during concentration or tension, without being consciously aware of it. For some, these symptoms become cyclical, as morning and evening commutes bookend a working day already spent at a desk with reduced movement. Repeated daily, this can establish a continuum of discomfort that gradually becomes more noticeable. Hydration and breathing patterns when travelling may also encourage TMD, as long drives with caffeine and limited breaks can add to muscular tension and fatigue. Some patients may also mouth-breathe during concentration or stress, further affecting jaw muscle activity.

Supporting patients

Dental professionals can identify lifestyle factors that contribute to TMD symptoms. Simple adjustments, such as improved seat positioning, may help reduce strain, and certain tools can also be recommended for rehabilitation. The OraStretch® Press Rehab System from Total TMJ offers a practical solution for patients with reduced jaw mobility associated with TMD, providing controlled stretching in a simple, accessible format. Adaptations are available for a broad range of needs, including edentulous patients, smaller mouths, and those with further limited oral opening.

Travelling with comfort

Although commuting is a normal part of modern working life, its consequences should not be normalised. Prolonged daily travel may contribute to muscular tension and postural strain, with other parafunctional effects also playing a role in TMD. Because symptoms develop gradually, the connection may go unnoticed by patients, putting dental professionals in the perfect position to support them. For more details about Total TMJ and the products available, please email info@totaltmj.co.uk n

About the author Karen Harnott, Total TMJ Operations Director.

The Probe | October 26

02/10/2026 10:22:27

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oral health

The hormone factor Fluoride & oral health Dental pain and hormones across a woman’s lifetime

The great water fluoridation debate

sk most dental professionals whether they factor hormonal status into their clinical assessment of a female patient, and the honest answer is often: not as routinely as perhaps they should. Yet the evidence is there: oestrogen and progesterone exert a significant influence on oral tissues throughout a woman’s life, from puberty through pregnancy to menopause. Gingival epithelial cells carry oestrogen receptors and respond to fluctuating hormone levels, meaning that the oral cavity is, in a sense, a real target of the hormonal effect. Understanding that relationship can make a meaningful difference to how dental professionals interpret symptoms, manage expectations, and advise their patients.

Menstruation and oral health

For many women, cyclical changes in oral health are a lived experience that rarely gets named in a dental consultation. Studies suggest that women may experience variations in gum health across their menstrual cycle: increased gingival sensitivity, a tendency toward bleeding, and in some cases canker sores or heightened susceptibility to oral bacteria during specific phases. Research has also shown that hormonal fluctuations during menstruation can increase tooth mobility, likely due to physicochemical changes in the periodontium. These are perhaps not as significant clinically as other presentations, but they are still meaningful, particularly when it comes to patients presenting with symptoms that don’t correctly correlate with plaque levels and are resistant to standard hygiene advice. If a patient’s gums bleed at a certain time in her cycle, that does not necessarily mean she is non-compliant; she may simply be experiencing a hormonal response that her clinician hasn’t yet considered as a factor. Including menstrual cycle stages as part of a female patient’s oral health history, alongside contraceptive use, can add a layer of previously underutilised context that changes the interpretation of what may have been a puzzling set of symptoms.

Pregnancy: the big challenge

Pregnancy will likely cause the most consequential hormonal shift in a woman’s oral health journey. Elevated oestrogen and progesterone levels exacerbate gingival inflammation significantly, and the scale of the problem is larger than many practitioners appreciate. Studies indicate that up to 75% of pregnant women suffer from gum inflammation, particularly in the second and third trimesters. Pregnancy gingivitis, characterised by swollen, tender gums that bleed easily, is the most common manifestation, but it can go beyond that. In some cases, a localised overgrowth known as a pyogenic granuloma, or pregnancy tumour, develops on the gingival margin, typically painless but alarming to patients who have not been warned it can occur.

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Acute dental pain in pregnancy introduces an additional layer of complexity that GDPs encounter regularly. Pregnant patients are frequently reluctant to take systemic analgesics, particularly in the first trimester, out of concern for foetal exposure. This is understandable, but it can result in unnecessary suffering and delayed engagement with dental care. Topical benzocaine is an example of a local anaesthetic that, when applied to the site of the pain, can be a practical option for shortterm pain relief, generally considered low-risk when used in small, occasional doses during pregnancy. However, it is of course always important for the patient to consult with their GP before decisions like this during pregnancy.

eople seem to be more interested in health and wellbeing today than they ever have been before. The use of fluoride, in particular, has been a topic of much debate in recent years. Google searches for several variations of the term have increased by up to 10-30% in the last 5 years alone. For dental professionals, this presents an opportunity to engage with patients about their dental and systemic health, and help them to make properly informed decisions.

Widespread concerns

The menopausal transition might be well understood in terms of its overall effects, but its oral implications receive considerably less attention – in both medical and dental settings. The decline in oestrogen levels that characterises menopause leads to a range of oral changes that can significantly affect quality of life and, if unrecognised, lead to some form of clinical mismanagement. Xerostomia – dry mouth – is among the most common oral symptoms for menopause, and its consequences can create real discomfort. Reduced salivary flow increases susceptibility significantly to dental caries, and compromises the oral mucosa’s ability to resist acid and infection. Burning mouth syndrome, a condition characterised by chronic oral burning or pain without a visible change in the mucosa, has a well-established association with the menopause transition, and is considered disproportionately underdiagnosed.

Many of the concerns regarding fluoride stem from the potential or current implementation of community water fluoridation. For many, this is seen as a complete loss of control over their personal health, with the choice to consume fluoridated water taken away from them. The controversial solution has been implemented around the globe since its introduction in the US in 1945. Fast forward to 2012 and approximately 378 million people across nine countries had access to fluoridated water. In modern Europe, only Ireland, Poland, Serbia, Spain, and the UK artificially fluoridate their main water supplies. An estimated 10% of England’s population (6 million people) have a fluoridated water supply, including areas in the West Midlands and North East. These tend to be regions with high oral health needs and often reduced oral healthrelated quality of life. Another issue for many people is the potential for negative side effects due to excess fluoride. These include fluorosis, neurological development complications, and more.

Putting this into practice

The evidence to date

Menopause: overlooked oral factor

The common thread is that hormonal context can change the overall diagnosis, and that integrating discussions like these can give the kind of information that will only improve care. With many of these arising issues directly causing discomfort or pain in women, it’s important to consider more than just the visible presentation of symptoms, and keep in mind that dental pain can have plenty of underdiagnosed sources. When it comes to acute dental pain management, Orajel offers practical options that address it quickly. Available in standard and extra strength formulations, which contain 10% and 20% benzocaine respectively, Orajel gets to work in just two minutes, providing localised relief while patients await treatment. The dental consultation is one of the few healthcare interactions that spans a woman’s entire adult life. Used well, this can be a great opportunity to recognise and respond to hormonal fluctuations throughout a lifetime. 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.

To understand both sides of the debate, it’s important to remain abreast of the latest research in the field. Of course, nationwide water fluoridation schemes would never have been rolled out without extensive evidence supporting their benefits. The World Health Organization (WHO) recommends a safe fluoride limit of 1.5 mg/ litre in drinking water, though artificial water fluoridation is typically below 1.0 mg/litre. Strong evidence supports a lack of negative health effects for community water fluoridation at concentrations of 0.7 to 1.0 mg/litre. Systematic reviews demonstrate that water fluoridation leads to a reduction in caries – by up to 35% in deciduous teeth – with the recommended fluoride concentrations helping to strengthen enamel and protect individuals from future decay. There is also evidence that community water fluoridation reduces the incidence of decayed, missing, or failing teeth (DMFT) over time, benefiting children in particular. In addition, studies do not establish a strong correlation between fluoride and developmental neurotoxicity in humans. There is some research linking neurological disorders and IQ damage to fluoride consumption, but the quality of the evidence is low and only applicable at fluoride concentrations above the recommended levels. Interestingly, the positive impact of water fluoridation seems to be lower than it was a few decades ago, indicating that this

may not be the most effective approach to widespread oral health.

The great fluoride debate: Too much, too little, or just right?

For decades, toothpaste guidance has focused on fluoride concentration, recommending conventional formulations that deliver most of their soluble fluoride during and shortly after brushing. Yet concentration alone does not reveal how effectively fluoride is delivered. In response to concerns about safety and autonomy, some patients use fluoride-free toothpastes. Therefore, individuals usually choose between conventional fluoride levels and no fluoride at all. Sustainedrelease technology offers a middle ground, allowing lower concentrations to be delivered gradually. Clinicians should therefore consider both how much fluoride a toothpaste contains, and how effectively – and for how long – it is delivered. It is crucial to be specific when recommending solutions to patients. These should be tailored to their oral health requirements, but also their personal preferences, providing an opportunity to discuss the impact of fluoride and any concerns they may have. BioMin F is an excellent choice, designed specifically to strengthen and protect the teeth. Its unique formula contains approximately 60% less fluoride than the average toothpaste, but with no compromise in health advantages. The solution offers longer-lasting therapeutic benefits by providing a gradual-release mechanism that continuously deposits an optimal concentration of calcium, phosphate and fluoride for up to 12 hours after brushing.

Fluoride done right

The fluoride debate is unlikely to reach a conclusion in the near future, but it is important for dental professionals to appreciate how patients on either side of the fence may feel. It is crucial to share evidence-based information and guidance, but clinicians should also be prepared to discuss suitable alternatives. Whether you are based in a community water fluoridation area or not, appropriate fluoride exposure can have a significant effect on patients’ caries risk. Recommending solutions that they are comfortable with is key to their compliance and improved oral health. The science is clear. The solution is simple. www.biomin.co.uk n

About the author Alec Hilton, CEO of BioMin Technologies Ltd.

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Three becomes one Your new favourite oral care solution and the world’s first total oral care system has landed: the Tahir One Electric Flosser from Tahir Oral Care

atients have different oral care routines. Some may brush before breakfast, some after. Many may interdentally clean, many more may not. No matter when or how patients look after their teeth and gingivae, Tahir One guarantees a comprehensive cleaning experience without having to change what the patient is holding.

The trio deal

A 3-in-1 oral care solution, Tahir One operates as an electric toothbrush, flosser and tongue cleaner. Using a single button operation, patients can alternate between four settings: Floss, Tongue, Sensitive and Deep Clean. These utilise cutting-edge science to deliver first-class oral hygiene outcomes. To improve compliance and support vulnerable patients, the Sensitive and Deep Clean toothbrushing modes simplify daily dental care. Sensitive operates at a lower power level to better clean around inflamed and bleeding gingivae, removing harmful bacteria and restoring the oral microbiome. Deep Clean guides patients with their timings, as the brush uses a tooth-beat timer to show how long the brush should be held on each tooth. Fast-paced, it ensures a total clean.

Brush effectively and easily

A further innovation is the brush head – the bristles are developed by dental professionals from leading universities, providing a scientifically-grounded approach to oral care that remains effective on plaque and gentle on the gingivae. After two and a half years of development, the research has paid off to produce a premium toothbrush. Along with reliable cleaning, Tahir One’s total care extends to whitening, including in the interdental spaces. Whereas string floss users may struggle to access the posterior teeth and have to place their fingers inside the oral cavity (which can cause discomfort for those with ulcers or inflammation), Tahir One makes the inaccessible accessible. It can be placed comfortably on each tooth for a thorough clean, preventing biofilm formation and removing plaque from below the gingival line across both the upper and lower arches. It isn’t just the prophylactic powers that make Tahir One an oral care essential – it has many benefits that support a practical, healthy and happy lifestyle. These include:

2. Ultra-quiet technology

Whether as an electric toothbrush, flosser or tongue cleaner, Tahir One has an ultra-quiet cleaning operation. Whether patients are early-risers or night owls, Tahir One can be used without waking up family members.

3. Travel friendly

As a 3-in-1 solution, Tahir One naturally lends itself to travel, combining all oral care needs into one smart case for optimised packing practicalities. Furthermore, the charging base is portable and the battery life supports up to 2 months of use – perfect for both short and long trips.

4. Reduce waste

A major limitation of string floss is that it is single-use, creating waste. Tahir One combines toothbrushing and interdental cleaning into one product so there is no need for multiple plastic products. Supplied with 90 days of refills, the replacement heads last a long time for extra sustainability.

5. Waterproof

Some patients may brush their teeth or floss in the shower. Tahir One is also waterproof, enabling oral care to continue for those that do, as well as making the product easy to clean. Failing to floss raises the risk of gingival disease, caries and ultimately tooth loss. Tahir One is an invaluable ally for protecting the oral cavity, blending toothbrushing, flossing and tongue cleaning into a practical solution. Simple yet scientifically proven and clinically tested to deliver excellent oral hygiene outcomes – recommend Tahir One today. The Tahir One Electric Flosser is available for patients at tahiroralcare. com and through Harrods. For practice enquiries and professional ordering, visit tahiroralcare.com n

1. Fresh breath

By removing plaque and trapped food debris from the tooth surfaces, Tahir One prevents halitosis, enabling patients to go about their day with confidence in their smile and social interactions.

October 26 | The Probe

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treatment

The safe use of local anaesthetics

ocal anaesthetics (LA) block pain signals for the patient ahead of surgery, with lidocaine, lignocaine, articaine and mepivacaine among the most prevalent. However, a landmark 2025 study confirmed that lidocaine is now the leading reported cause of local anaesthetic-related death worldwide. This is concerning, reminding dental professionals of the high risk of anaesthetics and that dental deaths are still underreported in the data. It is essential that continuing research is shared, enabling clinicians to understand the risks and better mitigate them for improved patient care and predictable surgical outcomes.

but it can take between 4 and 8 hours. The sustained length of time introduces a dosing risk that a 1-hour extraction surgery avoids. Prolonged surgeries demand the initial administration of LA, a top-up when its effect lessens, re-administration for different anatomical regions, and potentially a supplement to support wound closure for postoperative analgesia. Collectively, the dosage of LA is high and this intensifies the risk of LAST. Ahead of a full-arch implant surgery, clinicians should: • Calculate the fractional dose budget before the case (not during it) • Allocate doses by anatomical region: upper right, upper left, lower right, lower left, palate • Assign a named team member to track the running total after every top-up • Use articaine as the primary intraoperative agent to maximise clearance between doses • Have intravenous lipid emulsion (ILE) on site • Ensure a specialist anaesthetist or sedationist is present for compliance

Managing LAST

LAST but not least

Local anaesthetic systemic toxicity (LAST) occurs when the concentration of a local anaesthetic in the bloodstream is too high, exceeding the toxic threshold. Whilst rare, the impact is fast: the brain is affected and seizures, cardiovascular collapse and death are likely to happen within minutes. LAST is not exclusive to hospitals. In dental surgeries, treatments such as routine inferior alveolar nerve blocks and implants may be the scene of LAST occurrence. Further, if the clinician does not know the safe dose or recognise the warning signs, they will be less prepared to manage it and the consequences may be grievous.

Is LAST awareness low?

The 2025 report analysed 55 years of LA reports, dating from 1968 to 2023. Out of 22,050 LA adverse events, there were 1,473 reported deaths. Notably, even after 2010 practice advisories and unlike other anaesthetic alternatives, deaths relating to lidocaine did not fall, establishing it as the leading cause of death among LAs. Knowing the dose is essential to reduce the risk of LAST. This is itself a challenge – how many dental clinicians know the maximum recommended dose of lignocaine for a 70kg adult? The answer is complicated; answering 300mg or 4.4mg/ kg means quoting the product insert. 500mg or 7mg/kg means quoting the British National Formulary (BNF) and the Food and Drug Administration (FDA). Both answers are used in UK dental practice, with a difference of one cartridge for a 70kg adult – but some clinicians may be unaware of the discrepancy at all. It is vital that dental professionals know which reference to apply and why, and it should always be documented. This is particularly important for dental implantologists.

The implant problem

Full-arch or full-mouth implant surgery is an impressive, technically challenging treatment for restoring a patient’s smile,

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Even when taking the necessary steps to control doses and decrease the health risk, clinicians must be able to recognise and manage LAST as it may not be immediately obvious, with 40 per cent of cases presenting atypically. The traditional teaching sequence begins with a metallic taste, then tinnitus, agitation, seizure and cardiovascular collapse. However, LAST may not always follow that order. Some of the earlier signs in the sequence, such as dizziness and agitation, can also be attributed to patient anxiety or an adrenaline reaction, which is why close attention to the symptoms is needed. The management of LAST is sequential and prioritised. Firstly, the injection of LA must be immediately stopped. Emergency services must be contacted and the staff alerted. As general dental practices are unlikely to have ILE, a non-rebreather mask, midazolam for seizures or adrenaline, the priority is to secure the airway whilst awaiting the paramedics and transfer to hospital. For compliant specialist practices, ILE must be stocked on site, however.

Confident in your referrals

Delivering prolonged dental implant treatments comes with a high risk. For complex cases, refer patients to the Ucer Clinic in Salford. Led by Professor Cemal Ucer, an internationally recognised Specialist Oral Surgeon, the talented team deliver outstanding implant treatments with a strong focus on patient care and lifechanging treatments. Local anaesthetics are necessary, but that doesn’t mean they are always safe. By understanding the risks of LAST and how the team can manage it, dental practices can feel more confident in their workflow. Please contact Professor Ucer at ucer@icedental.institute or Mel Hay at mel@mdic.co. Call 01612 371842 or visit www.ucer-clinic.dental n

About the author Professor Cemal Ucer, Specialist Oral Surgeon.

When do you actually need a CBCT?

he question is more complicated than it might appear. Cone beam computed tomography (CBCT) is likely one of the most discussed technologies in the profession, and with good reason. The ability to view anatomy in three dimensions, to assess bone volume and quality before placing dental implants, or to evaluate a complex case from every angle, is a real advantage in practice. The diagnostic information these images can provide is, in many cases, irreplaceable. But the question of when CBCT is actually truly required – rather than simply useful or interesting – is one that the industry is still working through. And the answer, demonstrated in the IRMER principles that govern dental radiography in the UK, may have more nuance than it seems.

delivers a fraction of the dose of a large field selected out of habit or convenience. This is a practical clinical skill that CBCT training should address directly: learning to select the minimum field of view that answers the clinical question, rather than defaulting to larger volumes on the assumption that more data is always better.

The justification principle in three dimensions

Integrating CBCT into a practice workflow

Every instance of radiographic exposure in UK dental practice must be justified: the expected clinical benefit must outweigh the radiation delivered. For CBCT, the dose delivered is substantially higher than for conventional 2D radiography. It varies but is typically several times that of a fullmouth periapical series, and much higher than a single intraoral radiograph. That dose differential does not make CBCT unjustifiable, but it does introduce an extra layer of complexity to the choice. Current guidance from CGDent is that CBCT should not be used as a first-line investigation where conventional 2D radiography would provide sufficient information. The imaging modality should be selected based on need, not convenience, curiosity, or the availability of the equipment. Taking a CBCT to assess a straightforward periapical area that a wellpositioned periapical radiograph would adequately evaluate is likely not justifiable exposure, for example.

Where a CBCT can add real value

Where CBCT moves from useful to necessary is generally scenarios where three-dimensional information will affect the diagnosis or treatment planning in a way that two-dimensional imaging cannot. Dental implant planning is the most commonly cited. Assessment of bone volume, bone quality, and anatomical relationships in three dimensions changes what can be planned and what can be placed with confidence. Complex endodontic cases with calcified canals, suspected vertical root fractures, or resorption, will benefit from the three-dimensional view in ways that periapical radiographs cannot replicate. Orthodontic cases involving impacted teeth are also well-established in terms of indicating CBCT necessity.

Field of view and dose optimisation For practices with CBCT capability, the field of view selection decision is a further expression of the optimisation principle. A large field of view delivers a higher dose than a small one, and captures more, but the case itself should determine which field is appropriate. A targeted small field of view for a single-tooth endodontic assessment

When it comes to potentially incorporating CBCT into the practice, it’s just as important to take workflow and referral into consideration. Which cases will be imaged in-house? Which will be referred? Who will report the images, and what training is in place to ensure findings both expected and unexpected are properly acted upon? A CBCT taken for an implant assessment may incidentally reveal something outside of the immediate or expected anatomical vicinity. There is still an obligation to act on this finding. The Carestream Dental CS 9600 is a versatile 5-in-1 extraoral imaging system combining 2D panoramic, cephalometric, CBCT, 3D facial scanning, and 3D model scanning in a single compact unit. With 14 selectable fields of view from 4 x 4cm to 16 x 17cm, low-dose imaging modes, and AI-assisted patient positioning, it is designed to support the kind of clinically justified, dose-optimised CBCT that current guidance requires. Integration with CS Imaging 8 and CS 3D Imaging Premium supports reporting, planning, and guided workflows within a single environment.

The question of when to use CBCT is complex, current, and a good one to be asking. It’s important, while answering it on a case-by-case basis, to ensure that the available technology is working in harmony with the rest of the practice. 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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treatment

When ortho becomes Finishing fixed an endo issue brace treatment

see a particular kind of referral more often than you might expect: a patient midway through, or recently finished with, orthodontic treatment, presenting with an issue or a finding that has nothing to do with their orthodontist, but everything to do with orthodontic treatment. Orthodontic treatment moves teeth through bone using sustained force – and sustained force, applied to a living tooth, can have dramatic consequences. Most of the time, these consequences are benign and self-limiting, but, occasionally, they are not. Knowing the difference here is an area wherein orthodontists and general dental practitioners can truly change the course of their patient’s treatment for the better.

of pulpal complications during orthodontic movement, because the pulp’s reparative and adaptive capacity has often already been compromised. This is precisely why a thorough preorthodontic assessment matters. If a tooth has a history of trauma or radiographic signs of previous pulpal issue, it deserves specific attention before orthodontic forces are applied to it – and ideally, an endodontic assessment if there is genuine uncertainty about pulpal vitality or long-term prognosis. Identifying a vulnerable tooth before treatment begins is far preferable to managing pulp necrosis mid-treatment, when the orthodontics are already in motion and the options are fewer.

Pre-existing pathologies – unmasked or worsened

Orthodontic treatment sometimes begins without a definitive endodontic assessment of every tooth in the arch, and most of the time that is entirely appropriate. But preexisting periapical pathology, even when asymptomatic, can occasionally become symptomatic under the additional stress of orthodontic force – teeth with apical inflammation can become symptomatic once movement begins.

What this means for the referral pathway Root resorption: the most common ortho-endo crossover

External apical root resorption is, to some degree, an almost inevitable accompaniment to orthodontic tooth movement. Most cases involve minor, insignificant shortening of the root apex that causes no functional problem and requires no intervention. But a minority of patients experience more substantial resorption – and the risk factors are known: pre-existing root resorption, certain root morphologies (particularly short or blunted roots), the magnitude and duration of force applied, intrusive movements, and individual patient susceptibility that we still do not fully understand. The challenge is that significant resorption is often asymptomatic until it is advanced. Routine radiographic monitoring during orthodontic treatment – particularly for patients with known risk factors – is the best defence. When resorption is identified as progressing significantly, the orthodontic force regime usually needs to be reconsidered, and in cases where resorption has compromised long-term tooth prognosis, an endodontic opinion on the tooth’s restorability and longevity is genuinely useful before treatment continues.

Pulpal effects of orthodontic force

Orthodontic tooth movement places the pulp and its blood supply under mechanical stress, and the pulpal response varies from transient and fully reversible to, in rare cases, a process toward necrosis. Teeth that have previously been traumatised – even years earlier, even where the trauma was apparently minor – carry a higher risk

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None of this should discourage orthodontic treatment, which remains overwhelmingly safe and predictable for the vast majority of patients. What it should encourage is a slightly lower threshold for endodontic referral at two key points: before treatment, for teeth with risk factors that warrant assessment, and during treatment, for any tooth that develops symptoms, sensitivity, or radiographic changes that fall outside the expected pattern of orthodontic tooth movement. A quick referral for an opinion costs little and avoids the far more difficult scenario of managing a necrotic or significantly compromised tooth after orthodontic mechanics are already well underway. At EndoCare, we welcome these consultative referrals – whether the outcome is reassurance that nothing further is needed, or active management of a tooth that requires it. The relationship between orthodontics and endodontics is closer than it sometimes appears from either side of the referral letter. Recognising where that relationship matters clinically – and acting on it early – protects the long-term outcome that both disciplines are ultimately working toward. If you have a case where you are uncertain about root status or pulp prognosis ahead of or during orthodontic treatment, please don’t hesitate to get in touch. We’re always more than happy to discuss a case. For further information about the endodontic referral services available from EndoCare, please visit endocare.co.uk n

About the author Dr Michael Sultan, EndoCare.

here is a moment an orthodontist will come to recognise. The patient is in the chair for their debond appointment. Treatment has gone well, the result is aesthetically pleasing, and yet the patient is looking at the results with an expression you weren’t expecting. They are not unhappy, exactly. But perhaps they are not as delighted as you hoped. The end of a course of fixed brace treatment is, for the clinician, the final step. In patient terms, it is frequently something more complicated than that. Managing the final stages of orthodontic treatment, and the patient’s experience of them, is a skill that complements technical ability, and one that deserves more attention than it typically receives in orthodontic training.

A compliance challenge

Compliance is a well-documented issue throughout orthodontic treatment, but it becomes particularly notable toward the end of a course. Even if they have been diligent with oral hygiene, attendances, and elastic wear for the first six months of treatment, patients can become harder to engage as treatment progresses and the visible results plateau. The dramatic changes are behind them; the remaining movements are subtle and patients may struggle to see the point of pursuing. This is the point at which clinical communication matters most. Explaining clearly what the final adjustments are achieving and why they matter for long-term stability helps patients understand that the last phase of treatment is not a formality. The retention of the result depends on it. Patients who disengage at this stage are more likely to debond prematurely, miss the appointments that allow final refinements, and ultimately achieve a result that falls short.

The debond appointment

Not many appointments in orthodontic treatment carry more emotional weight than the debond. Patients have waited months for this moment, and their expectations are shaped by a combination of the treatment goals that were set at the start and images on social media. The first thing many patients notice after bracket removal is the texture of their tooth surfaces. The feeling of residual composite and the roughness of surfaces that have been under brackets for the duration of treatment is unexpected for most patients, and can provoke anxiety about permanent damage. Explaining the polishing process, and the fact that surfaces will feel different a few days later, helps stop it becoming a source of distress. The second common point of difficulty is demineralisation. White spot lesions around bracket bases are a possible complication of fixed appliance therapy, and their visibility immediately post-debond can be a shock to patients. Pre-emptive conversations about white spot risk, good oral hygiene support throughout, and monitoring of at-risk patients are all preferable to explaining white spots to a confused patient in the debond appointment.

Retention

The debond appointment is also the moment at which retention must be thoroughly explained. Patients who have completed months of treatment are, understandably, in a celebratory mood. They are not always ready to hear that the work is not entirely done. But discussing retention is not negotiable – because without it, patients are significantly more likely to be disappointed with the durability of their result, and more likely to attribute any relapse to a failure of the treatment rather than a failure of the retention protocol. The key messages are simple but need to be communicated clearly: teeth move throughout life, and retainer wear is a long-term commitment. Patients who understand from the outset that retention is part of the treatment rather than an afterthought are better equipped for it. Fixed retention, removable retainers, or a combination of both should be selected based on the individual case. Patients who have found compliance challenging during treatment are unlikely to suddenly become diligent retainer wearers afterwards. Honest discussions about retention will produce better long-term outcomes.

An exercise in empathy

Finishing a course of orthodontic treatment well is ultimately an exercise in patient empathy as much as clinical skill. It requires recognising that the patient’s experience of the end of treatment is not the same as the clinician’s. Patients who feel well informed and well supported at every stage of the journey are more likely to be satisfied with outcomes that are exactly what was planned. For clinicians looking to build their skills and confidence across the full arc of fixed brace treatment, from diagnosis through to debond and retention, IAS Academy’s Fixed Brace pathway provides the structured training, hands-on support, and lifelong mentoring that makes the difference between completing cases and completing them well. The end of treatment is not the end of the relationship. It is the beginning of a new satisfied patient who can’t wait to tell others about their experience. For more information or to book, visit courses.iasortho.com/courses n

About the author Dr Tif Qureshi, Founder and a Clinical Director of IAS Academy.

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treatment

Are we there yet? Dr Farnam Pourreza-Jorshari provides an update on regenerative endodontics A

istorically, pulp necrosis has been managed with root canal treatment (RCT), in which diseased pulp tissue is removed and replaced with an inert filling material, permanently sacrificing pulpal function in the process. Regenerative endodontic techniques (RETs), also termed revascularisation or revitalisation, seek instead to restore the vital pulp within the necrotic canal system. This is clinically meaningful: the dental pulp performs formative, defensive and sensory functions that conventional RCT cannot replace. Beyond root development and dentine deposition, the pulp-dentine complex provides immune defence, detects noxious stimuli and confers proprioception. This article reviews the evolution, biological principles and clinical evidence underpinning RETs, while examining the biological barriers that continue to limit predictable pulpdentine regeneration. Nygaard-Østby first demonstrated that a blood clot could be induced within instrumented root canals following chemo-mechanical debridement and enlargement of the apical foramen, resulting in resolution of infection and apical narrowing. A subsequent histological study by Nygaard-Østby and Hjortdal found the new intracanal tissue resembled calcified connective tissue rather than true pulp, but nevertheless established that the canal space could be biologically repopulated. Case reports by Iwaya et al. and Banchs and Trope subsequently built

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upon this concept, culminating in a European Society of Endodontology (ESE) position statement recognising RETs as a viable treatment modality. Although single-visit p ro t o c o l s have been described the ESE recommends a two-visit approach involving minimal instrumentation, irrigation with low-concentration sodium hypochlorite and EDTA, intracanal medication, induction of apical bleeding, placement of a calcium silicate cement and definitive adhesive restoration (Figure 1). Successful regeneration depends on three core components: stem cells, signalling molecules and a scaffold. In RETs, the blood clot serves as a scaffold, while dentine stores growth factors (IGF-1, TGF-β1, BMP-2, BMP-4, BMP-6 and GH), released following demineralisation by EDTA, calcium hydroxide or calcium silicate cements. The responsible cells are stem cells of the apical papilla (SCAP), recruited during over-instrumentation. Consistent with this, Lovelace et al. found that blood induced during RETs contains higher stem cell concentrations than systemic blood, supporting SCAP recruitment as the likely source. Clinical outcomes are encouraging. Periapical healing exceeds 90% , while Lin et al. re p o r t e d c o n t i n u e d ro o t t h i c k e n i n g and lengthening in over 80% of i m m a t u re t e e t h . Tr u e p u l p - d e n t i n e r e g e n e r a t i o n , h o w e v e r, r e m a i n s elusive. Histological studies show t h e c a n a l s p a c e i s m o re c o m m o n l y re p o p u l a t e d b y b o n e - o r c e m e n t u m -

Figure 1. Regenerative endodontic management of a necrotic maxillary right central incisor (UR1) with chronic apical periodontitis, treated in accordance with the protocol described in the European Society of Endodontology position statement (Galler et al. 2016). (A) Pre-operative periapical radiograph demonstrating periapical radiolucency. (B) Preoperative clinical photograph obtained at the initial appointment. (C) Chemical disinfection of the root canal system achieved through copious irrigation with minimal mechanical instrumentation. (D) Removal of the temporary restoration at the second visit, revealing the intracanal medicament, calcium hydroxide. (E) Induction of intracanal bleeding via over-instrumentation beyond the apical foramen. (F) Formation of an intracanal blood clot. (G) Placement of Biodentine over the blood clot. (H) Definitive composite resin restoration placed over the Biodentine, completing the regenerative endodontic procedure.

like tissue rather than genuine p u l p , w i t h Wa n g e t a l . a t t r i b u t i n g radiographic root thickening to cementum-like apposition rather than dentine deposition. Persistent bacterial infection may partly explain this discrepancy. Vishwanat et al. demonstrated that residual Enterococcus faecalis biofilm suppresses odontogenic differentiation of SCAP while promoting osteogenic gene expression, explaining the preferential formation of bone- and cementum-like tissues rather than a true pulp-dentine complex. More recently, Kalimuthu and Neelakantan showed that endodontic pathogens can invade and persist intracellularly within SCAP as protected “Trojan horses”, evading host immunity and antimicrobial therapies while further impairing odontogenic differentiation. These findings suggest successful regeneration depends not only on stem cells, signalling molecules and scaffolds, but also on eliminating negative microbial influences on stem cell fate. Seeking to o v e rc o m e these limitations, Rosa et al. combined stem cells from human exfoliated deciduous teeth with a peptide hydrogel scaffold, generating vascular pulp-like tissue and demonstrating the potential of alter native stem cell-scaffold combinations. Such approaches may provide greater control over recruitment, differentiation and tissue formation than current RET protocols. Interest in extending RETs to mature teeth is increasing. Using enlarged apical preparations, El-Kateb et

al. reported complete radiographic healing of necrotic mature teeth after one year, with 60% regaining positive sensibility, suggesting restoration of immune and neural function. Evidence, however, remains largely confined to single-rooted teeth. Large apical preparations may be unsuitable in multi-rooted teeth, where thin, curved canals increase the risk of perforation or file fracture, making conventional RCT the more conservative option. So, are we there yet? Not quite. Regenerative endodontics has evolved f ro m an experimental concept into a viable treatment for selected cases, yet predictable regeneration of a functional pulpdentine complex remains beyond current capabilities. Future progress requires not only protocol refinement but also an enhanced understanding of the interactions among stem cells, biomaterials, growth factors, and the infected microenvironment. As these biological challenges are overcome, regenerative endodontics has the potential not only to redefine the management of necrotic teeth but also to provide valuable insights for regenerative medicine as a whole. For more information about the BES, or to join, please visit www.britishendodonticsociety.org.uk n

About the author Dr Farnam PourrezaJorshari BDS PGDip, British Endodontic Society Early Career Group Committee Member.

The Probe | October 26

02/10/2026 10:41:26

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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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treatment

Simplifying root canal preparation

oot canal treatment remains one of the more demanding procedures in general practice, both physically and mentally. For these reasons, a clear, repeatable approach to canal preparation can make it more predictable for the clinician and more comfortable for the patient. Uncertainty is a significant factor with endodontics. Most of what determines how the procedure goes happens at one specific stage, which is shaping the canal; this is where time efficiency is difficult to maintain and where procedural errors are most likely to arise. It also largely dictates whether the remaining steps proceed smoothly, as a well-shaped canal makes everything that follows more predictable.

Shaping shapes the outcome

The cleaning and disinfection of the root canal system is, of course, the ultimate goal of treatment, but it is the shaping of the canal that makes effective cleaning possible. A well-prepared canal allows irrigants to reach the apical region, and provides the clinician with a reliable path to working length. Where this stage is compromised, the remainder of the procedure becomes considerably more difficult, with an increased risk of complications such as ledging, transportation, or instrument separation, none of which are easy to recover from once they present. Curved canals present the greatest difficulty in this respect. An instrument that is too rigid will tend to straighten the canal

as it works, deviating from the original anatomy and increasing the likelihood of perforation or apical blockage. Smaller, more flexible instruments reduce this risk, yet reaching working length with them can be time-consuming and requires a meticulous, repetitive technique. For the busy practitioner, this is frequently the point at which a case either progresses smoothly or begins to overrun, and it is therefore the stage where a dependable method is required to offer the greatest benefit.

The value of a streamlined sequence

One of the most effective ways to make preparation more predictable is to reduce the number of decisions the clinician must make at the chairside. An extensive tray of files invites uncertainty as to which instrument should be used next, whereas a defined sequence establishes a clear order of use, with each instrument building upon the work of the one before. This allows professional attention to remain focused on technique rather than on managing the system itself, which is particularly valuable in endodontics, where deviations can arise at any point. Working with fewer instruments also means fewer changes during the procedure, which saves time and reduces the handling that can introduce error. Flexibility and fracture resistance remain central to any modern file system. Instruments manufactured to flex with the canal rather than against it are better able to preserve the original anatomy. An instrument

that can be pre-bent to support a difficult access, then hold that flexed shape rather than springing back, gives the clinician more control where it matters most.

Disinfection

It is worth remembering why the canal is shaped at all, as the purpose is not the shape in itself, but the access that it creates. A canal opened to a consistent, tapered form allows irrigant to flow to the apical third and to be exchanged effectively, which is where the effective disinfection of the root canal system takes place. When shaping is rushed or

inconsistent, both irrigation and the longterm outcome suffers. The HyFlex EDM OGSF Sequence from COLTENE has been designed around this principle of simplicity. It comprises four files, used in a pre-set defined order: Opener, Glider, Shaper, and Finisher. Available in 21mm and 25mm lengths, with a corresponding update for the CanalPro Jeni endomotor, the sequence is intended to reach working length with minimal pecking and a short learning curve, supporting the general practitioner in approaching routine endodontics with greater confidence.

Confidence in routine endodontics

Predictable endodontics begins with predictable shaping. By reducing the number of files in use and following a clear, defined order, clinicians can spend less time deciding what to do next and more time on the technique that protects the canal and the patient. A well-engineered sequence offers a practical route to treating more cases in practice, more confidently. To find out more about the COLTENE HyFlex EDM OGSF Sequence, visit coltene.com, email info.uk@coltene.com or call 01444 235486 n

About the author Vik Sharma, Sales Director, COLTENE Group.

Combatting discomfort in orthodontic care

rthodontics is a big investment for patients, in terms of finance, time and even their own emotions. A study from 2025 found that around 72% of patients beginning care have some level of anxiety associated with the treatment, and a total of 38% of patients had high levels of anxiety. This latter point drops to 22% after 6 months. Still, patients face their fears in hope of improved function and aesthetics following treatment. Clinicians have the responsibility to make the treatment as manageable as possible, helping patients both with and without dental anxiety to have a positive treatment experience. Success may see improved adherence to oral hygiene routines due to increased engagement, leading to the reduced incidence of caries and problems associated heavily with orthodontic care, such as white spot lesions. The alleviation of anxiety would also be an emotional weight off of the shoulders of a patient, leading to improved wellbeing. Clinicians have the ability and responsibility to recommend effective ways to treat and avoid pain. Developing an understanding of the pain associated with different orthodontic aids and safe everyday remedies is key.

Pain during tooth moment

There are a variety of sources of pain experienced by patients during orthodontic treatment. It must first be made clear that

36 36_Probe-October_Treatment.indd 1

some of these discomforts are shared by fixed and removable orthodontic patients; others vary between the treatment modalities. Approximately 90% of individuals are affected in some way, with 30% of patients estimated to consider stopping treatment altogether because of it. It’s also thought to be the number one reason that patients do not follow their recommended oral hygiene routines and appliance usage. The highest levels of pain and discomfort are reported during the first 24 hours of care, especially for those with fixed appliances. Some in the literature report this peak occurs later on, around 1-2 weeks after a fixed appliance is inserted, which can be discouraging. The pressure applied to the dentition and gingival tissue is entirely foreign, and the resulting discomfort can be a significant source of concern due to its unfamiliar feeling. The literature notes that once orthodontic forces are applied to a tooth, inflammatory mediators in and around the periodontal ligament are activated where compression occurs – this is key for osteoclastogenesis, facilitating tooth movement. Nociceptors induce inflammation after being affected by the mechanical stimulation of orthodontic forces, and the chemical stimuli from inflammation, which can further amplify pain; whilst this may decrease with time (until the arch wire is inevitably tightened or a new clear aligner appliance is provided, and the impact on the periodontal ligament is reinitiated), it is still a disconcerting problem that must be highlighted.

Ulcers from irritation

Contact between the gingival, buccal and lingual tissue and an appliance may also be irritating, even resulting in abrasive injuries. Patients with fixed orthodontic appliances are reported to have an increased frequency of traumatic lesions at two and four weeks after placement, compared to those who opt for removable solutions. Ulcers and inflammation are a common problem where mucosal tissue interacts directly with brackets and wires. Clinicians will be able to identify the ulcers as small lesions, white or slightly yellow in colour, which also create a burning sensation and pain. The initial pain of contact between the mucosa and the fixed appliance is therefore amplified as the lesion takes time to heal, often 1 to 2 weeks. Abrasive contact with it in the meantime can be an uncomfortable trigger, and dependent on where the affected site is within the oral cavity, patients may face difficulties and discomfort during speech and mastication.

Prepared to support

Patients should be made aware that such outcomes are common, in order to allay any concerns when pain is experienced – though if extreme discomfort is felt, an individual should speak immediately to their dental team. Treatment and prevention of these sources of pain takes many forms. Over the counter pain relievers may be effective, and patients can also be directed to mix salt and warm water before swirling it

around their mouth, much like mouthwash, to minimise inflammation. If mucosal ulcers are present, an effective antimicrobial mouthwash will aid the prevention of infection, but avoiding their creation altogether is preferred. Clinicians could recommend the Orthodontic Relief Wax from Kemdent, an effective and easy-to-use solution which can relieve pain from fixed brackets and wires. The wax is easily warmed in a patient’s hand and placed over the sources of irritation, creating a barrier. Available in a sustainable tin plate case, which is 100% recyclable, it is an environmentally responsible recommendation for every orthodontic patient. Apprehension towards orthodontic treatments is expected from many patients, but support from the dental team can make treatment a success from the offset. This requires an understanding of the most common sources of pain, and the small recommendations that can counteract them. For more information about the leading solutions available from Kemdent, please visit www.kemdent.co.uk or call 01793 770 256 n

About the author Alistair Mayoh, Marketing Director, Kemdent.

The Probe | October 26

02/10/2026 10:43:05

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linicians cannot accurately predict a patient’s restorative needs until they arrive at the dental practice, and begin their appointment. If smile-defining treatments can be provided on the same day, patients can leave grinning ear-toear. In order to create these moments of joy, dental practitioners must be appropriately prepared and have a wide range of restorative solutions on hand for effective intervention. Solventum, formerly 3M Health Care, is a leading provider of restorative solutions in dental care, amidst so much more. By working closely with professionals to refine composite materials that have reinvigorated smiles for decades, Solventum presents a variety of solutions that fit seamlessly into the workflow and make a complete difference to the lives of patients.

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A new application

The composite restorative uses these three shades to provide an excellent shade match to almost any patient’s tooth, without a complicated shade guide. Gone are the days of innumerable composites in different shades, sat in a drawer waiting for their moment. Now, clinicians can save expense on unused items, and minimise the waste that is created f ro m h a v i n g t o p u rc h a s e s u c h restoratives in excess. A naturally-adaptive opacity helps t o c re a t e a s e a m l e s s t r a n s i t i o n t o t h e n a t u r a l t o o t h s t r u c t u re , whilst once again removing the need for further materials. In this instance, the 3M™ Filtek™ Easy Match Universal Restorative does not need an additional blocker. Instead, at thicknesses greater than 2 m m , i t a u t o m a t i c a l l y re p l i c a t e s the appearance of dentine, and at thicknesses of 0.5-1mm an enamellike translucency is created.

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The depth of versatility is only expanded with the introduction of the Solventum™ Filtek™ Easy Match Flowable Restorative. Its flowable delivery means the solution is indicated for direct restorations, use as a liner or base under direct restorations, and more, with exemplary adaptability. It takes the same three-shade solution and naturally-adaptive formula to ensure each material can be used in tandem for aesthetically pleasing results, without disparate tooth shades at the treatment site. Aside from its leading aesthetic and functional capabilities – the composite is designed for use in posterior restorations, where occlusal forces are a key concern – the Solventum™ Filtek™ Easy Match Flowable Restorative is optimised for virtually bubble-free delivery, thanks to a redesigned syringe.

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professions

Support beyond indemnity Helping internationally qualified dental professionals thrive in the UK

he latest statistical report published by the General Dental Council (GDC) revealed that for the first time, more internationally qualified dentists joined the register in 2025 than UK-qualified dentists. With 53% of registrants having qualified overseas (compared with 47% for UK-qualified dentists), it is clear that internationally qualified dentists are an increasingly vital part of the dental workforce. However, our research shows that these dental professionals experience a stressful time emotionally, professionally and financially. For dental professionals who are new to the UK, many factors come into play in feeling supported to be able to thrive in the workplace, not least of all their choice of indemnifier, and access to appropriate mentoring. Levels of support and practice environments are varied, and it is all too easy to feel isolated. As an internationally qualified dentist myself, I understand how important access to the right support can be when transitioning into UK practice after completing the registration process.

More than indemnity

As an overseas dentist, my career in the UK began as a dental nurse and a dental hygienist before I registered as a dentist. When I first started working in the UK, dental indemnity was not something I had come across before. I thought of indemnity as a tick-box exercise – a legal requirement for GDC registration and an extra cost. And then I received a patient complaint. I had provided a routine composite restoration at the lower right first molar for a patient one morning, and he called me at around 5pm that day. He was very angry that the numbness from his local anaesthetic had still not worn off. I immediately went into panic mode. All the other dentists in the practice had gone home by then, and I convinced myself that the patient was going to report me to the GDC. Then I remembered that my indemnity organisation, Dental Protection, had a 24-hour helpline and I called them. I spoke with a dentolegal advisor and I will never forget the reassurance she gave me. She listened, calmed me down, and as a dentist herself really understood how I was feeling. She also gave me some incredibly helpful advice: she suggested calling the patient back in for a review appointment the very next day to discuss his concerns and options to help with his symptoms. The prospect made me anxious – I told her I wasn’t sure I was prepared to handle another conversation with him given how irate he had been. She gave me some tips on how to manage situations like this and then proceeded to tell me about Dental Protection’s training on handling difficult conversations – along with other learning resources I might find helpful. Until then, I didn’t even know training was available and that it was included in my membership at no extra cost.

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Thanks to the early advice and support from Dental Protection, I was able to navigate this incident. I offered a sincere apology, a prompt specialist referral and booked follow-up review appointments for the patient, alongside maintaining an audit trail to evidence that appropriate steps had been taken. Thankfully, the matter was resolved at practice level. A few weeks later, I went on to explore Dental Protection’s learning resources, and added them to my CPD activities. I also attended events and presentations by Dental Protection speakers. As a direct result I picked up tips and skills and learned how to respond effectively to adverse events – developing strategies to enhance my communication with patients whilst deepening my understanding of the professional principles that guide clinicians in the UK. When I look back, I wish I’d known earlier the wider value of indemnity as a crucial support system. Over the years, Dental Protection has not just provided me with indemnity protection when dentolegal challenges have arisen but also empowered me with training and support to help prevent, de-escalate and manage these situations much more effectively. I now feel lucky to be able to support my colleagues through challenging times as a Dentolegal Consultant at Dental Protection. At Dental Protection, we are committed to developing tailored resources to support dental professionals who have qualified abroad and are either working in the UK or planning to work here. We have recently launched a New-to-UK Practice Hub that includes access to employment contract

checking, dentolegal advice, complaints support, wellbeing support and access to a wide range of resources on Dental Protection’s ‘The Learning Hub’.

The need for a mentor

My mentoring journey initially began by supporting overseas dentists with preparation for the International Registration Examinations, followed by integration into daily working life in the UK, through complaints and GDC Fitness to Practise processes. This soon translated into mentoring of UK dental graduates, nurses, hygienists, and orthodontic therapists – the full spectrum of our dental workforce. It is incredibly rewarding to share the knowledge and insights I have gained over the years and to support colleagues as they begin their careers and continue to grow within the profession. As a registered mentor on the NHS hub and through my mentorship experiences over the years, I have seen the immense impact mentoring can have on dental professionals. We are currently navigating turbulent times within UK dentistry. While this presents challenges for all dental professionals, these can be especially significant for those who trained overseas. The transition to practising in a new country involves adapting to different cultural expectations, systems, and ways of working. Combined with communication challenges, this can lead to isolation and affect both career progression and wellbeing. Mentoring opens up communication channels that can often be the key to resolving them.

The importance of a mentor cannot be overstated. In fact, I believe that facilitating access to a trained mentor is one of the most impactful actions an employer can take towards creating a more inclusive environment where everyone feels supported, valued and respected. I feel disheartened when I hear that mentoring is sometimes perceived as support only for those who are in difficulty or struggling professionally. I feel that this could not be further from the truth. Effective mentoring can be invaluable for all dental professionals at any stage of their career. A trained mentor can not only help you find your career path, but also help you to grow, and find joy and fulfilment in your daily work. I have been fortunate enough to be a part of many of my mentees’ journeys and have learnt from each one of them. Having worked in the dental profession for over twenty-five years, I can honestly say that my indemnity organisation (Dental Protection) and my mentors have been my crucial support network, and I cannot imagine what it would have been like to navigate my professional journey without them. So, please make use of all the support available to you and don’t hesitate to reach out. The right support can make all the difference, but it begins with making the decision to seek it. n

About the author Dr Archana Naik, Dentolegal Consultant at Dental Protection and registered mentor.

The Probe | October 26

02/10/2026 10:51:50

Dental Protection

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dentalprotection.org Always there for you Dental Protection is a trading name of The Medical Protection Society Limited (“MPS”). MPS is a company limited by guarantee in England with company number 00036142 at Level 19, The Shard, 32 London Bridge Street, London, SE1 9SG. Dental Protection serves and supports the dental members of MPS with access to the full range of benefits of membership, which are all discretionary, and set out in MPS’s Memorandum and Articles of Association. MPS is not an insurance company. Dental Protection® is a registered trademark of MPS. For information on MPS’s use of your personal data and your rights, please see our Privacy Notice on the website. 2601097045 05/26

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Adopting the Dental Therapist Model into general dental practice

hen I started my own NHS squat practice back in 1998, dentists began by completing all treatments themselves, including the dental hygiene side. This quickly became quite time consuming, so we engaged the services of a dental hygienist. This greatly benefitted the practice – providing patients with more comprehensive periodontal care and advice, and also giving the dentists more time for restoration and treatment provision. It also increased patient numbers. The main challenge was the limitations of NHS contract funding. Following the introduction of the new NHS dental contract in 2006, we continued this model until 2009, when that contract expired. It became evident then that the new contract provision was no longer sufficient to continue and improve the level of service we strived for. We therefore opted to convert t o D e n p l a n . A l t h o u g h e x t re m e l y daunting at the time, it was by far the best decision for ongoing patient c a re a n d p r a c t i c e d e v e l o p m e n t . W ith improved funding, we were able to increase the dental hygiene provision, thereby enhancing the dental prevention we could offer. This was hugely beneficial to our patients and, over the following decade, we established a very stable patient base, needing little intervention. This was borne out when Covid-19 arrived. We found that not one of our patients needed assistance during the lockdown period. We were able to open as soon as we were allowed to do so and had caught up on patients’ care within just a few weeks. This model of prevention and use of the dental hygienist was proving successful, but as a dentist providing mainly examinations and simple repairs day in, day out, on a large, stable patient base, I was looking for an alternative approach, building on the dental hygiene and preventative model which had worked so well. This coincided with Direct Access being introduced for Dental Therapists in 2022. I decided to follow the Dental Therapist model in General Practice. The scope of practice for the Dental Therapist has evolved over time, and embracing this evolution was key to the new model implementation. By utilising the full scope of practice, the Dental Therapist can provide the following services: • Carry out clinical examinations and develop treatment plans (within their competence) • Prescribe and take radiographs • Perform direct restorations on both primary and permanent teeth • Carry out extractions of primary teeth and perform pulpotomies on primary teeth

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• Provide

preventive oral care, including scaling, polishing, and root surface debridement • Administer local anaesthetic (infiltration and IDB) • Supply and administer certain prescription-only medicines In addition to the introduction of the Dental Therapist into the practice model, I wanted to utilise our Dental Nurses to their full potential. Fortunately, my nurse was keen to develop her skill set and, with practice support, she achieved her Oral Hygiene, Radiography, and Impression-Taking qualifications. This then enabled our Dental Nurse to take on the more in-depth oral hygiene cases and periodontal radiographs from our Therapist, freeing up her time to provide the additional treatments. Our Dental Nurse had the additional time to allocate to these tasks, as my surgery time was reduced. So, the plan was in place, but the next hurdle was educating our large patient base about the new changes. I didn’t feel an “overnight change” would be very well accepted by patients, so instead I opted to inform and educate patients through effective communication (via emails, website and in practice) of the upcoming changes to the practice dynamics. Patients were informed, over time, of the scope of practice of both the Dental Therapist and our enhanced qualified Nurse. This was carried out

over the 12 weeks preceding the implementation. By focusing on the capabilities of the team, the improved streamlining for patients, as well as the enhanced access to appointments, the changes were very well received – but communication is key! Patients are advised that they can see the dentist at any point should they wish, but this has only been utilised by patients in a small minority of cases. Around 90% of our patients were happy to see our Dental Therapist for their routine care. Following the implementation of the changes, my diary as a dentist became very light – the routine examinations and simple restorations were being performed by our Dental Therapist, so I had more time on my hands. I decided to provide tooth alignment to further enhance our practice services. Our Dental Therapist was happy to provide most of the routine treatments, but with the option to refer patients to me, if she desired, for any more complex cases. So, my work pattern has changed. I now focus on more complex restorations, tooth alignment, crown and bridgework, cosmetic dentistry and dentures, with just a “sprinkling” of examinations – but I am still needed in surgery far less, enabling me to increase our patient base and general dental provision by around 30% so far. For my tooth alignment cases, patients are offered a free initial consultation whereby my Dental

Nurse will take the required records ( p re s e n t i n g complaint, d e s i re d change, photos, and mouth scan) and upload them to the portal. I then review this and see the patient for a follow-up face-to-face appointment and run through the procedure and likely outcome. Then I provide the composite bonding and issue the aligners, but patient time involvement is reduced by utilising my Dental Nurse for the provisional records. Through these changes, the practice is more streamlined by utilising the skill set of my staff to optimise treatment provision to patients. The staff are happy because they are more involved in patient care, and the patients are happy because their treatment is more streamlined and they can access me, the dentist, much more readily than before because my time is more available. And as I approach the “twilight years” of my career, I am happier because I can focus on what I consider to be the more interesting and complex cases, as well as spend more time away from the surgery with family, enjoying an enhanced life-work balance. n

About the author Andrew Ridout, Principal at Oak House Dental Practice, Denplan Member Dentist & Practice Advisor.

The Probe | October 26

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professions

What can I stop, keep, improve or start? Examining change within our dental careers and practices

y article next month is on habit stacking – what it is and how we can create habits more easily and for the long term. But before we get to that, it makes good sense to work out which new habits will serve us. I can think of so many good habits I could start to implement, but it’s choosing the priority habits that’s important. If I can pinpoint what will really make genuine improvements by reshaping my days, that’s a huge motivator in itself. By ‘improvement’ I mean a new habit, a new process, a new skill or just doing something more regularly. One of the simplest ways to do this is to ask four questions: What should I stop? What should I keep? What could I improve? And what should I start? It’s a great way to audit some of the key areas of our lives and also to look at potential change in context. You could do a ‘Stop, Keep, Improve, Start’ exercise with others for maximum benefit. You’ll get more context and better understanding with other contributors. For example, you might think it’s OK to stop something in your practice – until you hear how someone else on your team values it. “Let’s stop playing music in the waiting area” might be countered by “I get told daily how relaxing our waiting area is.” Looking at each potential area for change is more valuable when it’s viewed from a number of perspectives. Stop: What are we doing that no longer serves us? It might be a process that has become unnecessary, a meeting that

simply be the next small step towards an improvement or development we’ve already identified. Having curiosity and ambition could spark something really exciting for your future. The important thing is that we don’t need to tackle all four questions at once. Even choosing one thing to stop, one thing to keep, one thing to improve or one thing to start can give us something useful to work on. I like this approach because it takes some of the pressure out of improvement. We don’t have to constantly strive to do more, be better or change everything – which, honestly, is just exhausting. Sometimes progress comes from doing less. Sometimes it comes from recognising what is already good. Sometimes it means making a small adjustment. And sometimes it means having the courage to try something new. Next month’s habit stacking article will help to take us from diagnosis to action. n has lost its purpose or simply a way of working that we continue with because that’s how we’ve always done it. Stopping something can feel like a surprisingly difficult form of change. We’re often much more comfortable adding something than taking something away. Keep: Not everything needs improving. What is already working well? What do we value about the way we work, communicate or care for our patients that we should make sure we retain? What can we learn from these positives and

transfer to other parts of our practice? Improve: This is perhaps where the idea of Kaizen – continuous, incremental improvement – comes in. What works, but could work a little better? This doesn’t have to mean a major overhaul. It might be a small adjustment to a clinical process, a communication habit within the team or simply changing the way we prepare for a particular task. Start: Finally, what have we identified that is worth introducing? It might be something completely new, or it might

About the author 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

We have to get along with each other

am yet to work with a client who does not have “challenges” with their associate(s). It’s something that I reflect on frequently, and I have come to the conclusion that, as George Bernard Shaw said, “The single biggest problem in communication is the illusion that it has taken place.” In other words, “Just because it was said doesn’t mean that it was understood.” In my experience as both an associate (in several practices) and an advisor to more principals than I

with Alun Rees

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

Llevarse bien con los demás

alun@alunrees.com

October 26 | The Probe

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can number, the main difficulties are a lack of comprehension of the other’s role, needs and wants. This isn’t helped by the huge turnaround in opinion that occurs when an associate buys their own practice and becomes a principal. It’s remarkable how the same brain can believe on a Friday that the amount kept back from an associate’s pay to cover “running costs” is excessive, then, as if by magic, on Monday the (new) principal believes the associate’s expectations of earnings show no understanding of the costs of running a dental business! Of course, there are far more problems that occur, but most are due to a lack of communication or of willingness to talk to one another. At this point I would refer you to Stephen Covey’s The 7 Habits of Highly Effective People. Habit 5: “Seek first to understand, then to be understood.” In a smallish practice this should be straightforward: meetings with associates should be timetabled and

ring-fenced, with an agenda, minutes taken and actions agreed. I believe that to send a practice manager to “run” a meeting with an associate, especially if they then have to refer to a principal for a decision, is to treat an associate poorly. I also think that for an associate to always “want because they deserve” shows a lack of willingness to comprehend the running of a dental business. Contracts are there for a reason and cannot and should not be changed on a whim. It has to be a two-way street: an opportunity for the junior party to learn and gain understanding, and also for the principal to share their knowledge and information. As with all things, over time we feel we should understand more and things should appear simpler. The opposite is the case: we all start from a position of ignorance – especially of the other person’s point of view, of their expectations and their long-term hopes and dreams.

Unfortunately, and I do not believe this is unique to dentistry, we can become selfish very easily; it is a lonely existence being “stuck” in one potentially claustrophobic room. Whether you work privately or in the NHS, some days, weeks or months can feel relentless. Small things that can, and should, be dealt with can grow and fester. Resorting to social media (and “groups” can be the worst for this) may well make your problems seem bigger rather than smaller. This article was provoked by the GDC involving itself in associate/principal relationships and what appeared to be a situation where nobody wins – except lawyers. I wrote it whilst on holiday in Spain, where they have a lovely phrase: “llevarse bien con los demás” (we have to get along with each other). n

Further reading

h t t p s : / / w w w. b d a . o r g / n e w s - a n d opinion/blog/england-and-waleswhere-do-nhs-practice-ownersstand-regarding

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professions

Birthday bike ride for charity

he Association of Dental Implantology (ADI) turns 40 in 2027! This spectacular milestone is a cause for celebration for the four decades of research, education and support that the ADI community has provided to dentistry and the thousands of patients who have had their lives improved by the high standard of dental implant treatments promoted by the ADI. To mark the momentous event, four long-time ADI members will embark on an epic bike ride in the lead up to ADI Team Congress 2027, taking place on 15-17 April. Dr Andrew Little, Dr Adam Bzeu, Dr Amit Mistry and Dr Kasia Gurzawska will take on the fundraising challenge of cycling 200 plus miles to the event – and doing so in two days! Beginning in Banbridge, Northern Ireland, “200 Miles to Congress” will see the four ride down the east coast to Dublin where they’ll catch the ferry across to Holyhead, England, and then continue on to King’s Dock in Liverpool, where ADI Team Congress 2027 is being held at the Liverpool Experience Campus (LEX). They will finish the journey at the front doors of the venue, no doubt tired, but ready to celebrate the ADI’s 40th birthday. This is a unique fundraising initiative that reinforces the passion of the dental profession and the 40 years’ worth

of members who have kept the ADI thriving. The chosen two charities connect with the Congress theme of Health and Wellbeing, highlighting the value of a healthy lifestyle, both physically and mentally: • Dentists’ Health Support Trust – supporting the mental health and wellbeing of members of the dental profession (and who are also celebrating 40 years) • Young Lives vs Cancer – providing invaluable support to children, young people and their families facing cancer As a profession, dentistry can be exhausting and sometimes isolating. Communities like the ADI help bring the profession together, providing support and inspiration to ensure the next generation are even more ready to face some of the challenges that come with the role. The wellbeing of dentists, dental technicians, dental therapists, dental hygienists and dental nurses is paramount for both personal and professional satisfaction, and this year’s theme was chosen to start conversations and improve the resources available to each member of the dental team.

Show your support

Every donation made will be split and sent directly to the two charities. The target of £10,000 has been set, with

fundraising beginning already and the hope that we can far exceed this. Donate today: https://www.adi.org. uk/about/200_miles_ to_congress

Plan for the future

ADI Team Congress 2027 is titled “The Future in Focus: Four Decades of Implant Excellence”. It is the perfect event to both look back at the last 40 years of achievements made in dental implantology and look ahead at what the future may bring, from the new technologies and the latest techniques, to changes in how

education is delivered and the benefits available to ADI members. Promising expert clinical education, innovation and an all-round unmissable networking experience, ADI Team Congress 2027 is the place to be. Save the Team date and cheer on Dr Andrew Little, Dr Adam Bzeu, Dr Amit Mistry and Dr Kasia Gurzawska on the road to Liverpool! If you have any questions, please contact claire@adi.org.uk or ania@adi.org.uk ADI Team Congress 2027 15-17 April For more information, please visit www.adi.org.uk/congress n

The career ladder is changing shape

areer progression is vital for all dental professionals, but the journey does not look the same for everyone. The timing and direction of steps taken will depend on a number of factors, including personal commitments and life events, professional ambitions, opportunities, and motivation. Progress needn’t be linear or obvious, but it does require strategic oversight to ensure development remains effective and relevant to the individual.

An evolving identity

For many people, career is an extension of identity. As their job changes, so too do their passions, goals, and how they measure success. For example, major life events in one’s personal life can inspire a shift in professional focus, lead to a restructuring of working hours, or motivate further training in a specialist clinical area. Starting a family may influence career objectives for the upcoming years, or a desire to travel more may result in a move into more locum work. In all these scenarios, personal growth is closely linked with career evolution, as contentment in one area often leads to joy in the other. As a result, it is becoming increasingly important to ensure a positive

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work environment. A recent global study suggested that personal fulfilment is now the second highest priority in the workplace for employees. Research demonstrates that true satisfaction is achieved at work only once challenges have been overcome, highlighting the importance of stepping outside the comfort zone and seeking new experiences in order to grow – both personally and professionally.

The not-so-straight road

Traditionally, career progression has been approached as a fairly linear pathway, with individuals ticking each box in turn as they climb the ladder from beginner to expert. Dentistry has always been a slightly more flexible profession, but it has never offered more versatile and dynamic opportunities as it does today. Firstly, there is research supporting the benefits of lateral career moves, which can increase the chance of progression in new environments or situations. In dentistry, this might be represented by taking a similar role in a new practice – which provides a larger or more diverse patient base, or facilitates advancement of clinical skills. A lateral career step is about laying the foundations for accelerated growth or new opportunities in the future. It might coincide with a decision to change the family’s living situation, a relocation, or a clinical shift into a new specialist field. It is also the kind of move that facilitates rapid skill expansion and diversification of experience, making it perfect for early career professionals, as well as those who are looking to take their capabilities to the next level.

Mapping the route

While the road may not be straight, and sideways steps are positive, it is important not to lose sight of the end goal. Career decisions can be opportunistic, but they should not be completely random. This is why career mapping is so important. Career mapping is a concept that allows individuals to visualise their core career objectives. From here, a structured plan can be created to help fulfilment of these goals. It’s important not to approach this as a rigid guide that won’t tolerate deviation or adaptation. Instead, it should be an overview of the skills that need to be acquired, the type of roles that need to be taken on, the clinical areas that need to be experienced, and the types of mentors that need to be found. Career mapping is a productive way of identifying the available pathways to achieving eventual goals, while maintaining sufficient flexibility to allow for alterations along the way. From a practical perspective, consider the following: • Define the overarching direction of your career for the next 2, 5, and 10 years • List priorities in terms of clinical skill development, network expansion, and experiences • Identify some of the training courses, events, groups, and professional organisations that can help you achieve the above • Keep track – monitor your progress every 6-12 months to hold yourself accountable and maintain momentum • Never be afraid to adapt the plan or make a move to fulfil your potential

At Clyde Munro, we facilitate your career ambitions with a wealth of clinical support and mentorship, ongoing education, and career progression opportunities for all. Work-life balance is promoted with flexible working hours and administrative assistance, plus we equip our practices with cutting-edge digital technologies that streamline workflows. We also provide priority access to a myriad of training courses at the dedicated Advanced Dentistry & Clinical Skills Centre, which features state-of-the-art facilities, worldclass instructors, and learning on diverse topics to support all career aspirations.

Taking control

In today’s world, career progression is not about following a fixed or straight path. Instead, it is about understanding your goals and using a flexible plan to make meaningful decisions at each stage. By seeking opportunities and embracing change, while remaining mindful of the direction of travel, dental professionals can build fulfilling and sustainable careers that accurately reflect their personal and professional ambitions. To find out more about the career development opportunities available at Clyde Munro, please visit https://careers.clydemunrodental.com/ n

About the author Jen Stewart, Talent & Development Coordinator, Clyde Munro.

The Probe | October 26

02/10/2026 11:00:14

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professions

Stack your way to a healthier day

sk any dental professional what’s stopping them from being healthier, and the answer is almost always the same: time. Between back-toback appointments, admin, and the sheer physical demands of the job, wellbeing habits are often the first thing to slip. The good news is that you don’t need more time to build a healthier day. You need better stacking. Habit stacking is one of the simplest and most effective ways to build new habits, and it works because it removes the need for willpower or memory. Rather than trying to squeeze a new habit into an already full day, you attach it to something you’re doing anyway, whether that’s brushing your teeth, sitting down for lunch, or leaving the building. The existing habit becomes the trigger, and the new one rides along for free. Here’s a full-day stack you can start building from tomorrow morning.

Morning: begin before you’re even out of bed

Set your alarm twenty minutes earlier than usual, and instead of reaching for your phone, sit up and spend a few minutes on breathing or meditation. Start with three minutes and build towards twenty over several weeks. Once you’re settled, use the last minute or two to visualise your day going smoothly. This isn’t just a nice idea; it has a real neurological basis. Your brain doesn’t fully distinguish between a vividly imagined experience and a real one, and

October 26 | The Probe

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repeated visualisation strengthens the neural pathways associated with calm, capable performance, a process known as neuroplasticity. If you spend your morning dreading a heavy list or replaying yesterday’s stress, you are effectively rehearsing tension. Rehearse ease instead, and you are far more likely to find it. You create more of your own reality than you realise. Now get up, and while you’re brushing your teeth, stack in some squats or practise standing on one leg. Dentistry is a remarkably sedentary profession for something so physically demanding, and strong legs and good balance matter more than most of us realise for posture and longevity at the chair. Once you arrive at work, say good morning to at least three people and wish them a genuinely good day. It costs nothing, and it sets a tone of warmth and intention that ripples through the whole team before the first patient has even sat down.

Midday: reset and recharge

At the start of your lunch break, thank at least three people for something they’ve done that morning, and mean it. Gratitude practice is one of the most evidence-backed ways to boost mood and connection, and naming what someone did, and the effect it had, is what makes it land. Then stack in sixty seconds of chair squats: stand in front of a chair and sit down and stand up repeatedly. It’s a surprisingly effective mini HIIT session that

Before you leave, thank three people again, this time explaining exactly why you’re grateful. Specific gratitude, rather than a generic thank-you, is one of the simplest leadership tools available, and it’s what makes people feel genuinely seen. At home, protect one hour, phone out of reach, for the people and things you enjoy. Then, before bed, give yourself the best chance of good sleep: no food for three hours before, no drinks for two hours before, and no screens for one hour before. None of these habits need extra time. They simply need a moment you already have. Start with one stack, master it, then add the next, and watch small changes compound into a genuinely healthier working day.

For more of these ideas and practices, visit:

– BREATHE:

www.breathedentalwellness.org

– NAIL-IT in Dentistry:

www.nailitindentistry.com

lifts your heart rate and your energy. Try making it a team activity that bookends the break and watch the whole practice’s afternoon energy shift.

Evening: wind down deliberately

At the end of the day, when fatigue sets in, try some energising breathwork: pump your arms up and down in time with deep, deliberate breaths in and out. It’s a quick way to shake off the day’s tension before you walk out of the door.

– NAIL-IT Leadership:

www.nailitleadership.com n

About the author Dr Rana Al-Falaki, Founder of NAILIT Leadership and NAIL-IT in Dentistry, working with teams and individuals to achieve optimal performance.

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professions

Four-headed wonders

very dental reception desk is secretly staffed by one creature with four heads. I’ve walked into hundreds of dental practices over the years, and I’ve met them in every single one. You’ll know them. One head answers the phone before it’s finished ringing. One head is halfway through a heartfelt chat with Mrs. Pemberton about her cruise. One head is quietly re-alphabetising something nobody asked them to touch. And one head has been doing the exact same job, at the exact same pace, since roughly the Blair government, and will not be rushed by you or anyone else. Four heads. One body. One desk. Constant low-level bickering about whose turn it is to answer the phone. Let me introduce them properly. Head One: The Quick One. Wants it sorted, wanted it sorted five minutes ago, in fact wants to know why it wasn’t sorted before it was even a problem. Multitasks like it’s a competitive sport. Physically pained by faff. Their love language is a short queue. If you want to see them twitch, tell them “let me just double-check that.” Head Two: The Warm One. Has never met a patient they didn’t want to adopt. Knows everyone’s dog’s name, most people’s grandchildren’s names, and at least one person’s entire hip replacement journey in real time. Wonderful with a nervous patient. Less wonderful when there’s a queue of six and they’re asking Barry how his knee’s healing. Head Three: The Steady One. Does the job the same way on a Monday as a Friday, in a heatwave, during half-term, and the week the computer system went down. The practice quietly runs on them and nobody notices until they’re off sick. Doesn’t love change. Will absolutely be the one still doing it properly in 2040.

Head Four: The Careful One. Reads the form. All of it. Twice. Catches the thing everyone else missed before it becomes a complaint, a safeguarding issue, or a very awkward phone call. Gets accused of “not trusting people” when really they just trust paperwork more than they trust vibes, and frankly, fair enough. Four brilliant heads. One deeply confused body, constantly arguing with itself about how fast to walk. The problem isn’t the four heads. It’s that nobody’s introduced them to each other. Left unnamed, this is what happens: Head One thinks Head Two is slow. Head Two thinks Head One is rude. Head Three thinks Head One is a health hazard. Head Four thinks everyone is reckless. Nobody says any of this directly, obviously that would be far too sensible. Instead, it comes out sideways, at volume, near the biscuit tin. I’ve heard versions of this in practice after practice, for years: • “Well, SOME of us actually do our job properly.” • “I don’t have time to babysit.” • “Must be nice to just chat all day.” • “Here we go again.” • “Fine, I’ll just do it myself then.” Translate any one of those and it’s never actually about the thing it sounds like it’s about. It’s I feel like I’m covering for you. It’s I feel unsupported doing this alone. It’s I don’t feel like I can rely on you. Nobody says that plainly, though, because plainly is terrifying, so instead you get a huff, a slammed drawer, and the same argument again next Tuesday, slightly louder. Here’s the same feelings, said in a way that actually gets heard: • “I’ve noticed I’m picking up extra checks... can we go through what’s expected?” • “I’m stretched today, can you take the next two?” • “The queue’s building... can we catch up after?”

AI-generated to highlight a reality

• “This is the third time this week... can

we sort a fix?” • “Can you take this one, or should I?” Same four heads. Same feelings. Wildly different atmosphere. Nobody’s asking the heads to swap This is the bit people get wrong. You do not need to turn your Quick One into a Careful One, or convince your Warm One to stop caring, or drag your Steady One into embracing “disruption.” That’s not the job. The job is teaching all four heads to read each other, so the Quick One’s pace stops sounding like rudeness, the Warm One’s chattiness stops sounding like slacking, the Steady One’s calm stops sounding like stubbornness, and the Careful One’s checking stops sounding like an accusation. Think of it like a sports team. When everyone’s playing their actual position, the Quick One clears the queue, the Warm One calms the terrified patient, the Steady One keeps the standard the same every

single day, and the Careful One catches the mistake before it turns into a complaint letter. That’s a very good reception team. That’s most reception teams, honestly, on their best day. The bad days aren’t a personality problem. They’re a translation problem. Nobody ever sat the four heads down and said “here’s how to read each other, so you stop assuming the worst.” So sit them down. Name the heads. Retranslate the sniping. And watch your four-headed receptionist finally start walking in the same direction. n

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

To infinity and beyond

arolyn and Jane have spent two days in Leicester at the National Space Centre attending the BDIA Conference. Carolyn was speaking, and Jane manning the BADN Community stand – explaining to trade companies the importance of the dental nurse in the dental team. Dental companies (some of them!) have a long tradition of ignoring dental nurses at events, or promoting special offers from which dental nurses are excluded – hopefully, they have now seen the light and realised that dental nurses have a lot of influence over purchasing decisions! That’s also one of the reasons for the BADN Corporate Affiliate Scheme – to encourage dental companies to participate and come to a better understanding of what a dental nurse does and their important role in the dental team. We are revising our Scheme, due to our merger with Community and the transfer of data over to the Community system – so if you have applied to join and haven’t heard from us, we will be in touch! And, current members, we will be contacting you shortly about the merger and the continuation of our Scheme.

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Visit us at Dentistry Show London

Business as usual

Although we have merged with Community, and there will be small changes over the next three years, nothing too major should change immediately. We are still in our offices in Fleetwood; our Journal will continue (contact Ed Hunt at Purple Media for advertising), as will our Coffee CatchUps (contact me if you would like to present a CCU). I am now the National Officer of BADN Community, Jacek is the Operations Officer and Val is the Membership Administrator. Jane Dalgarno is now the Caseworker, advising and representing members in disputes with employers; Carolyn Roberts is Chairman of the BADN Community Committee (formerly the BADN Executive Committee). Plus ça change…

BADN Community will be exhibiting at the Dentistry Show London at ExCeL on 9 and 10 October at stands G5 and 6. I will not be there, due to health issues, but Operations Officer Jacek Drozdek, Chairman Carolyn Roberts and Caseworker Jane Dalgarno will be on the stand over the two days. Carolyn is also one of the three BADN speakers presenting in the Dental Care Professionals Hub – on “The Modern Dental Nurse: Shaping the Future Through Collaboration” on Saturday 10 October at 1015–1100. This session explores the evolving role of the modern dental nurse, highlighting how the profession now extends beyond traditional clinical duties. It also examines the recent merger between the BADN and Community, and how a unified professional voice creates enhanced representation. BADN Community member Hannah Lambourn will be speaking on Friday 9 October at 1145–1230 on “Are You Emergency Ready? Putting Preparedness into Practice”. This highly interactive session gives delegates practical techniques to improve emergency preparedness in their practice. Through live demonstrations, audience participation and realistic examples,

delegates will explore how changes to emergency equipment, team coordination and CPR technique can improve confidence and efficiency when every second counts. And finally, long-time BADN Community member and socialpreneur of Awesome Oral Health CIC, Jo Dawson, will be speaking on Friday 9 October at 1430– 1515 on “Creating hope, taking action and building better futures for you and your patients”. Jo shares how a simple school snack campaign (Raisin’ Awareness) grew into Awesome Oral Health, reaching 21,000 children this year. Drawing on her journey from dental nurse to social entrepreneur, she explores resilience, leadership and behaviour change, showing how small actions and positive communication can improve oral health, careers and communities. n

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

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interview

Turning evidence into prevention In this interview, Leon Bassi discusses why prevention remains at the heart of oral healthcare, and how every member of the dental team can use evidence-based guidance to support better long-term outcomes for their patients You joined a group of experts at the Kenvue advisory board to develop a consensus on preventive oral care. What stayed with you most from those discussions? Leon: I’m a passionate dental therapist, so whenever I get the opportunity to discuss oral healthcare and prevention with likeminded colleagues, I absolutely love it. What really stayed with me from those discussions was that prevention has to remain the cornerstone of everything we do. Every member of the dental team has a part to play, and it reinforced how important it is to use the full skill mix. Dental hygienists and dental therapists, in particular, are well placed to lead prevention and help patients achieve the best possible outcomes. Prevention matters throughout life. If we use the skills of the whole dental team effectively, we really can make a difference. At the end of the day, it’s about helping patients achieve long-term oral health, and the patient gets the best outcome.

Delivering Better Oral Health recommends ‘spit, don’t rinse with water’ after brushing.1 Why are those last two words so important? Leon: Those last two words are really important because they make it clear we’re talking about water. Keeping fluoride in the mouth helps maintain that fluoride reservoir, but saying ‘spit, don’t rinse with water’ also makes it clear there’s an alternative to water.

If a patient chooses to rinse after brushing, that might be with a fluoridated mouthrinse, including one containing active ingredients such as essential oils, depending on the patient’s individual needs.¹,² For me, it’s about giving patients a really clear message. If a patient walks into a supermarket, there’s such a huge range of products that it can be confusing. Oral healthcare is habitual, so if we’re asking patients to change their behaviour, we need advice that’s simple, evidence based and easy to remember. That’s why ‘spit, don’t rinse with water’ really resonates with me.

Sköld and colleagues (2012) found increased salivary fluoride retention following the use of fluoride mouthrinses after brushing.3 How does that fit with the ‘spit, don’t rinse with water’ message? Leon: I think it fits really well. The study showed that using a fluoride mouthrinse containing at least 225 ppm fluoride after brushing can significantly increase fluoride levels in the saliva compared to brushing alone.³ That’s why the paper is so important. For me, it reinforces the message ‘spit, don’t rinse with water’. Rather than rinsing away fluoride with water, there may be situations where a fluoride mouthrinse provides additional benefit. The important thing is looking at the patient’s care needs and optimising their home care. That’s why recommending the right mouthrinse for them is so important.²,³

Leon Bassi is a Senior Clinical Lecturer at the University of Liverpool. Passionate about prevention and improving access to care, his clinical and academic interests include periodontology, evidence-based practice and the role of the Dental Therapist in prevention-based care.

A standard adult toothpaste contains 1450 ppm fluoride, while many fluoride mouthrinses contain much lower concentrations. Why doesn’t fluoride concentration alone tell the whole story when it comes to fluoride bioavailability in the mouth? Leon: Every patient is different, so it’s not just about the ppm of fluoride. Retention time, the formation of a fluoride reservoir and how products are used all play a part.³ For me, it comes back to educating the patient. We need to use patientfriendly language, encourage twice-daily brushing with fluoride toothpaste and recommend evidence-based products that are appropriate for their individual needs.¹ That’s what really makes the difference.

Looking ahead, where does the profession have the greatest opportunity to strengthen preventive care, and how can clinicians help make that happen?

The full expert consensus on preventing oral diseases driven by dysbiotic dental plaque biofilm can be accessed at nature.com/articles/s41415-025-9320-0

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Leon: I think every opportunity counts. No matter how small the interaction, dripfeeding prevention messages is key. Even what feels like a small conversation with a parent or caregiver can influence a whole family, so I think the power of prevention is sometimes underestimated. We need to work alongside the wider healthcare team and keep reinforcing those prevention messages. If we start taking prevention into those wider settings, the world really is our oyster. As our population ages, that’s becoming increasingly important, particularly when

we’re thinking about healthy ageing and reducing the risk of oral frailty.4 Mechanical plaque control will always be the foundation of good oral health, but some patients need additional support. That’s where adjunctive therapies, including appropriate, evidence-based mouthrinses containing fluoride and active ingredients such as essential oils (as found in Listerine Total Care), have an important role when they’re recommended according to the patient’s individual needs.2,5 For me, one of the biggest opportunities is improving equality and equity in oral healthcare. The people who come to the dental clinic aren’t always the people who need us most. We need to reach vulnerable communities and those who face barriers to care, because that’s where prevention can have the greatest impact. n

References 1.

Department of Health and Social Care. Delivering Better Oral Health: An evidence-based toolkit for prevention. 5th ed. London: DHSC; 2025. Chapple ILC, Dommisch H, Figuero E, et al. Principles for Oral Health: Expert consensus on preventing oral diseases driven by dysbiotic dental plaque biofilm. Available at: https://principlesfororalhealth.com/ Sköld UB, Birkhed D, Ellwood RP. Effect of postbrushing mouthwash solutions on salivary fluoride retention. J Clin Dent. 2012;23(3):97–100. Tanaka T, Hirano H, Ikebe K, et al. Consensus statement on oral frailty from the Japan Geriatrics Society, the Japanese Society of Gerodontology, and the Japanese Association on Sarcopenia and Frailty. Geriatr Gerontol Int. 2024;24:1111–1119. Sanz M, Herrera D, Kebschull M, et al. Treatment of stage I–III periodontitis: The EFP S3 level clinical practice guideline. J Clin Periodontol. 2020;47(S22):4–60. This article is sponsored by LISTERINE® UK-LIS-2026-346531

The Probe | October 26

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material achieves more than 80 per cent in only ten seconds. Not only is a higher shine possible, but it takes far less time. Whilst it is obvious the clinician gains valuable time, the greater advantage is what happens after the patients leave the surgery. From that moment, with a conventional filler, the surface of the restoration begins to wear, breaking down and losing its shine. Due to the nanoscopic spherical filler, the breakdown

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You might wonder why Tokuyama materials take the agony out of shade matching. Advanced technology unique to dentistry uses tiny spheres to create structural colour that harmonises with the tooth’s natural shading. With conventional pigment-based VITA shades, you must choose the closest match from a fixed range—a judgement made harder by artificial light and surrounding colours. Tokuyama’s structural colour allows the material itself to harmonise naturally with the tooth, adapting to the subtle gradations of natural tooth colour. Dentists can concentrate upon placing, shaping and finishing, with far greater confidence in the final appearance. This is not simply shade matching approximation. It is optical integration. The same minute spheres preserve the smooth, polished surface through which the structural colour is seen.

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Comparison of filler production methodology Conventional composite filler begins with solid mineral blocks that are crushed and ground into smaller pieces. The result is random particles with irregular sizes, uneven shapes and sharp, jagged edges. Some fragments can be as much as 100 times larger than Tokuyama’s nanospherical fillers. Tokuyama takes an entirely different path. Its advanced sol gel process creates perfectly formed silica zirconia nano pearls. They are not crushed. They are grown. Every sphere is exceptionally smooth, remarkably uniform and precisely 200 or 260 nanometres in diameter. The difference is not just cosmetic. It is fundamental. n

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About the author Phil Mathers, Owner, Trycare Ltd.

The Probe | October 26

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Your complete partner in practice IT and cybersecurity

t Dental Directory, we know that running a practice involves a whole lot more than solely clinical work. In the background, elements that patients wouldn’t give a second thought to are quietly forming the backbone of a well-run practice. From your systems or your patient records to your phone lines or stock, each serve as a fundamental to a seamless working day as anything else in the surgery. That is why Dental Directory has acquired Microminder, an IT and cybersecurity specialist with deep experience in managed services, security, cloud solutions, technical support, and much more across healthcare and beyond.

The one part of your practice we could not support

Our portfolio already covers products, equipment, engineering, in-house pharmacy dispensing, and much more… but now, cybersecurity, data protection obligations and more, are available from the same trusted name of Dental Directory. Microminder collates technical expertise and the specialists behind it.

Nothing changes unless you want it to

If you have bought from us previously, your day-to-day experience with us remains exactly as it is – nobody is being moved onto a new IT provider or having services added to their account by default. What the acquisition of Microminder gives Dental Directory is a default IT route to support you when you ask.

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Why your practice is worth a hacker’s time

The most common reason practices give for not investing in cybersecurity is that they truly believe they are too small to be a target – essentially that they are not financially worth a hacker’s time. In reality, attackers scout exactly that assumption, because they know it usually comes with the most minor protection behind it. With practices possessing patients’ medical histories, national insurance / NHS numbers, race / ethnic origin, payment records, and more, it is certain to declare that hackers would have a field day with any practice’s information. All the information that they could obtain falls under special category data under GDPR and carries extremely serious consequences when they are lost – regardless of the circumstance.

Protecting your team, not just your systems

from appointments to imaging and CBCT systems go down, meaning that every impacted patient must be contacted. This not only means a reduction in earnings, but a whole diminishment in reputation… which can cost the practice a great deal more.

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Microminder’s packages are transparent with all-inclusive availability. The premium support team answers your call in under 30 seconds, and where an issue is not resolved within five hours it escalates and an engineer comes straight to you. Standard support works to a next-day response and packages. Better yet, they are tailored to what your practice actually needs.

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Loyalty to a supplier is both understandable and commendable. However, it is still worth

reviewing your service level agreements and contract pricing from time to time. A setup that functions does not automatically mean it’s the one that serves your practice best.

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IT is the newest part of what Dental Directory supplies to over 12,000 practices across the UK every day. From restorative and surgical consumables to digital equipment, decontamination products and in-house pharmacy dispensing, we are the single supplier relationship that covers everything your practice needs to run. If you are unsure where your IT currently stands, a penetration test is the most direct way to find out, and our team can talk you through what the findings mean. For more information on the products and maintenance services available from Dental Directory, please visit ddgroup.com or call 0800 585 586 n

Microminder runs simulated phishing campaigns across your team, then builds training around the individuals who need it and also offers an AI receptionist which allows calls to be answered whilst staff are being trained together. The AI receptionist also encourages an influx in patient intake – ensuring that the phone can be answered at any point in the day, so no patient goes left unseen.

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THE DENTAL AWARDS

Dental Therapist of the Year: Imogen Johnson 2026’s Dental Therapist of the Year, Imogen Johnson, discusses anxious patients and the oral health of elite athletes You’ve had extensive dental treatment yourself and said that experience shaped how you support anxious patients. What’s one thing you do differently with a nervous patient because you’ve been in that chair yourself? For me, the biggest thing is communication. Having spent so much time in the dental chair myself, I understand how vulnerable it can feel to be the patient, particularly when you’re nervous or you’ve had difficult experiences in the past. That communication starts from the moment a patient enters my surgery. I introduce myself clearly, explain who I am and what my role is, and try to create an environment where they feel comfortable being honest. I take the time to really listen to their previous dental experiences, understand what has contributed to their anxiety, and acknowledge those feelings rather than dismissing them. I also genuinely believe that there is no such thing as overexplaining to a nervous patient. I explain what I’m doing, why I’m doing it and what they can expect to feel at each stage. For me, knowledge gives patients power. The more they understand about what is happening and why, the less frightening and unpredictable the experience can feel. Having been on the other side of the chair myself, I’m also very conscious of giving patients a sense of control. I make sure they know that they can ask questions, stop me, take a break or tell me if something doesn’t feel right. Ultimately, my own experiences have made me very aware that something which feels routine to us as clinicians can feel incredibly significant to the person sitting in the chair. Taking the time to communicate, explain and genuinely listen can completely change a nervous patient’s experience of dentistry.

Your case study patient was a 36-year-old with a fractured tooth and generalised periodontitis who wanted orthodontic treatment but had a history of negative dental experiences. You held off on the orthodontics and prioritised periodontal stabilisation first. Talk us through that decision, and how you got her on board with waiting. This was quite a challenging situation initially because the patient and I came into that first appointment with very different treatment goals. My priority, as a clinician, was to get her to a position of stable oral health, whereas her priority was understandably the aesthetic result and progressing with orthodontic treatment. For me, it was important not to dismiss what she wanted, particularly given her history of negative dental experiences. Instead, I spent time understanding what she ultimately wanted to achieve and then explaining how improving her periodontal health was an essential part of getting her there. What really helped motivate her was understanding the potential consequences of moving straight into orthodontic and restorative treatment without first addressing the underlying disease. She could invest significant time, money and emotion into achieving the smile she wanted but, if we hadn’t established periodontal stability first, we could potentially leave her in a worse position than when we started. So, rather than presenting periodontal treatment as something delaying her aesthetic goals, I tried to reframe it as the foundation that would allow us to achieve those goals safely and predictably. Again, I think knowledge gives patients power. Once she understood not just what I was recommending but why I was recommending it, and how each stage contributed to the result she wanted, our treatment goals became much more aligned. She wasn’t simply being told she had to wait for orthodontics; she understood why we were waiting and became actively invested in improving her oral health first.

You completed an MSc in Sports Dentistry at Eastman UCL and co-founded the South African Sports Dentistry Association – what got you into sports dentistry, and what’s the biggest misconception about oral health and athletes? I first became interested in sports dentistry while I was at university studying for my BSc. I was living with housemates who were competing in sport at a high level, and I was

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constantly watching them consume protein shakes, energy drinks, sports drinks and gels throughout the day – all specifically designed to fuel their training and performance. As a dental therapy student, I started wondering: surely all of this couldn’t be good for their teeth? That curiosity led to several hours of Googling, and eventually I discovered that sports dentistry was an established yet niche field. I became fascinated by this relationship between oral health, sport and performance, and particularly by the fact that something being consumed or done with the intention of improving athletic performance could potentially be having a detrimental effect on oral health. That initial curiosity ultimately led me to completing my MSc in Sports Dentistry at UCL Eastman and becoming involved in developing the field more widely. I think the biggest misconception is the assumption that, because athletes are some of the fittest and seemingly healthiest people in society, they must have excellent oral health. We know from the research that poor oral health is incredibly prevalent amongst athletes, including at an elite level.

You presented your research on the oral health of ballet dancers at the UK Sports Dentistry Association conference – what did that research uncover that surprised you? One of the things that surprised me most was just how many potential oral health challenges exist within ballet, because it isn’t necessarily a sport people immediately associate with sporting dental problems. Ballet dancers are incredibly fit, disciplined individuals, but the demands of training and performance can create an environment where oral health isn’t always prioritised. What I found particularly interesting was the combination of factors involved. Things like fuelling practices, frequent carbohydrate intake, hydration, demanding training schedules and the aesthetic pressures associated with ballet can all potentially influence oral health behaviours. For me, the research reinforced that we can’t make assumptions about someone’s oral health simply because they are physically fit or performing at an elite level. It also highlighted how important it is that our oral health advice is specific to the athlete and their sport. Telling an athlete simply to avoid certain products isn’t always realistic when those products may form part of their fuelling strategy. Our role is to understand their sporting environment and find practical ways of protecting their oral health without compromising performance.

You’re board secretary of the UK Sports Dentistry Association, and later this year you’ll be lecturing in Australia and New Zealand – what’s the one change you’re most keen to see happen in how sports medicine teams approach oral health? The biggest change I would like to see is oral health becoming a routine part of athlete healthcare rather than something we only think about when there is a problem. Elite athletes can have access to doctors, physiotherapists, nutritionists, psychologists and strength and conditioning teams, with almost every aspect of their health monitored, yet dentistry can still sit outside that multidisciplinary approach. I’d love to see us move towards proactive oral health screening and prevention being embedded into athlete care, particularly during pre-season. That gives us an opportunity to identify disease, assess risk and address problems before they potentially interfere with training or competition. Importantly, I don’t think that means every sports team simply needs a dentist sitting on the sidelines. It’s about better integration and communication between dental professionals and the wider sports medicine team. Ultimately, I would like oral health to be viewed in the same way as every other aspect of athlete health and something we protect proactively rather than something we respond to once it starts causing a problem.

At NUYU you play a big role beyond the chair – supporting new team members, reinforcing prevention protocols, contributing to audits – what is the difference between a great clinician and a leader in a practice? I think being a great clinician is about the standard of care you provide to the patient in front of you, whereas being a leader is about helping to raise the standard of care around you as well. For me, leadership doesn’t necessarily mean having a particular title. It can be supporting a new team member when they’re finding their feet, sharing knowledge, reinforcing protocols, contributing to audits or simply being someone that colleagues feel comfortable coming to with a question. I also think good leadership requires you to be open to being challenged yourself. Dentistry is constantly evolving, and being a leader shouldn’t mean assuming that your way is always the right way. It’s about creating a culture where the team can learn from each other and where improving patient care is the common goal. I want my impact within a practice to extend beyond the patients I personally treat. If I can help another clinician or team member develop, improve a process or contribute to a stronger preventative culture within the practice, that potentially benefits every patient who walks through the door.

What does winning the Dental Therapist award mean to you, especially alongside everything else you’ve got going on this year? Winning Dental Therapist of the Year means an enormous amount to me, particularly because dental therapy is still at the heart of everything I do. This year has been incredibly busy, with sports dentistry, lecturing, research and my work with sports dentistry associations internationally, so receiving an award specifically recognising me as a dental therapist feels particularly special. I’m incredibly proud of how much the profession is evolving and of what dental therapists can contribute, not only clinically but through research, education, leadership, and in areas such as sports dentistry. I hope that some of what I’m doing demonstrates that there doesn’t have to be one predetermined career path for a dental therapist. It also made me reflect on how many people have contributed to getting me to this point. I’ve had some fantastic mentors, colleagues, friends and family supporting me throughout my career, so although my name is on the award, I certainly don’t feel like any achievement happens completely on your own. More than anything, it has given me motivation to keep pushing myself and hopefully use the opportunities I’m getting to advocate for dental therapy as a profession, as well as sports dentistry. 

The Probe | October 26

02/10/2026 12:04:50

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02/10/2026 12:05:57

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CPD: TEPE

The Role of the Whole Dental Team in Prevention Tepe is delighted to bring you this article, with the aim of supporting the ongoing CPD needs of dental healthcare professionals in improving and maintaining the oral health of their patients Aims To explore the role of the wider dental team in delivering consistent, effective preventive care, and to highlight how a coordinated, team-based approach can improve patient understanding, adherence, and long-term oral health outcomes. Learning objectives: • Describe the roles and responsibilities of different members of the dental team in delivering preventive care • Recognise the importance of consistent messaging across the dental team to support patient understanding • Identify opportunities to reinforce oral hygiene advice at different stages of the patient journey • Apply practical approaches to improve collaboration within the dental team to support prevention-focused care Expected outcomes: After completing this article, readers will have a clearer understanding of how a team-based approach can enhance preventive care delivery and will feel more confident in working collaboratively to provide consistent, effective oral hygiene instruction and support improved patient outcomes. GDC Development Outcome: A, C Ensuring an entire community of people has bright and healthy smiles is not a one-person job. The proverb “it takes a village to raise a child” can, in many ways, also be applied to oral healthcare. The entire dental team will support patients at different points, depending on the individual’s oral health needs.

To ensure patients have access to the best placed professionals for their needs, team members must understand the impact their colleagues can have on a preventive approach. This demands a recognition of the skills each unique person has, but also a wider comprehension of the professional tasks that may be undertaken by each team member, as laid out in current regulations.

What is skill mix?

All members of the dental team receive unique training that comes together to pull towards a combined goal: the best possible oral health for patients. Skill mix is a concept recognised by the NHS, which aims to maximise the potential of the entire dental team, taking pressure off of dentists whilst improving care for patients overall.i It places a focus on successfully integrating the abilities of dental care professionals, as well as proper utilisation of dental therapists and dental hygienists, and dental nurses. To find success, a skill mix must be appropriately structured around the regulations defining each team member’s responsibilities. The General Dental Council’s (GDC) Scope of Practice guidance is the primary source of information on this matter. It is designed to set out the skills and abilities of each professional, whilst not being an exhaustive list – it is also open to change, with the introduction of new technologies, training, and overall transformations to the way care is provided.ii

60 60-61_Probe-Oct_Tepe CPD.indd 60

The GDC registers clinicians under 7 unique roles. It demands that all professionals understand their own scope of practice, and that of others. The roles include: • Clinical dental technicians • Dental hygienists • Dental nurses • Dental technicians • Dental therapists • Dentists • Orthodontic therapists Every team member plays a key role in preventive care, but professionals should ensure their contributions safely fall under their title, training, competence and indemnity or insurance, in line with

the GDC Scope of Practice. This keeps patients safe, and ensures oral care professionals work to their strengths.

journey but should only provide treatment and guidance that sits within their professional scope.

Influence in preventive care

Dentists

Preventive dentistry is accepted as actions taken by patients and a clinical team to aid and improve oral health, avoiding the onset of disease and similar issues which would require more invasive treatment. It ensures the natural dentition is preserved where possible, and patients remain confident in an aesthetic smile that offers no pain or difficulty in everyday life. Clinicians can support prevention at various points throughout the patient

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

Dentists assess oral health risk, diagnose disease, develop preventive and treatment plans, prescribe and recommend key oral heath interventions, and refer to the wider team for ongoing preventive support where appropriate. If a patient is new to the practice, or returning for a standard oral health assessment, a dentist will likely be their key contact during care. This makes them a key figure in the referral and skill mix process, with the ability to

The Probe | October 26

02/10/2026 15:06:46

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CPD: TEPE CPD Questions

1) Which concept, recognised by the NHS, aims to successfully integrate the abilities of all dental care professionals, according to the article? a) Skill mix b) Teamwork c) Group meetings d) End-of-week reviews

4) What does the NHS say practices have reported when dental nurses undertake extended duties? a) Extended treatment times b) Positive patient experiences c) Reduced communication between clinicians d) Increased patient absences

2) Clinician registration is split into how many different roles with the General Dental Council? a) 3 b) 6 c) 7 d) 10

5) Which figures correctly display the prevalence of dental caries in patients undergoing orthodontic treatment, versus those not partaking in care? a) 5% compared to 10% b) 20% compared to 30% c) 21.5% compared to 31.5% d) None of the above

3) The General Dental Council sets out a framework for dentists assessing which three attributes, according to the article? a) Speed of care, communication, behaviours b) Teamwork, knowledge, time keeping c) Quality of care, patient manner, skills d) Knowledge, behaviours, skills

6) Which of the following may cause an individual’s Scope of Practice to change in the future? a) New technologies b) Training c) Transformations to care approaches d) All of the above

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and paediatric treatment, where it is within their competence and indemnity coverage.

Orthodontic therapists

direct patients to other professionals for preventive support where suitable. As such, these clinicians require a complete understanding of the skill mix approach, and the contributions of their colleagues.

Dental nurses

Dental nurses can reinforce key preventive messages throughout the patient journey, support oral health education, and help patients understand recommendations around the products they use or the routines they keep. With appropriate additional training, competence, indemnity and local government arrangements, dental nurses undertaking extended duties may also help deliver aspects of preventive care. This can contribute to positive patient experiences and a more efficient use of the wider dental team.

Orthodontic therapists can support appliance-specific prevention, including advice on how to clean around braces and wires, and effectively maintain aligners and retainers, while working in line with an orthodontist’s or suitably qualified dentist’s prescription. Patients undergoing orthodontic treatment have been reported to have a lower prevalence of untreated dental caries to those who do not receive such care, with a 2020 study reporting 21.5% compared to 31.5%. iii This suggests that patients undergoing care may be more in tune with their oral hygiene needs, and the work of orthodontic therapists is a key additional benefit.

Clinical and non-clinical dental technicians Clinical dental technicians can advise patients on the care and maintenance of dentures and appliances within their scope.

Dental technicians are usually non-patient facing, but can also contribute indirectly to prevention through their communication with the clinical team about appliance design, maintenance, plaque retention, function and durability.

Consistent communication

Once again, one of the most important parts of an entire team approach is clarity amongst professionals. This applies to understanding the abilities of other professionals in order to facilitate successful referrals, but also on a unified approach to preventive care. At its core, this demands a consistent recommendation for effective oral hygiene routines. The principles can be discussed in team meetings, held regularly to ensure up to date knowledge and also enable discussion for effective changes to the workflow. Alongside twice-daily toothbrushing, clinicians should agree to recommend key interdental cleaning solutions as a team. This includes TePe ® Interdental

Brushes, developed in collaboration with dental experts to ensure high quality and utility for patients. Each colour-coded brush features a unique size, designed to enable thorough cleaning of interdental spaces no matter a patient’s oral health needs. When dental teams recommend TePe ® , they recommend with confidence. All dental professionals have a role to play in preventive dental care. An understanding of their clinical capabilities, and a collective approach to oral hygiene advice ensures patients have access to the best possible outcomes. Find out more about the TePe Interdental Brushes today: https:// w w w. t e p e . c o m / g l o b a l / p r o d u c t s / interdental-brushes n References available upon request.

Dental hygienists

Dental hygienists are central to prevention, providing periodontal care and oral health promotion, alongside tailored oral hygiene instruction, plaque control advice, interdental cleaning guidance, and behaviour change support,

Dental therapists

Dental therapists can provide preventive care and oral health education, whilst instilling preventive measures throughout restorative

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

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CPD: PHILIPS

From instruction to insight: Can real-time brushing feedback support behavioural change and better home plaque control? Philips is delighted to bring you this article, with the aim of supporting the ongoing CPD needs of dental healthcare professionals in improving and maintaining the oral health of their patients Effective plaque control depends on more than brushing twice a day. The challenge is translating professional advice into consistent daily practice. As a new powered toothbrush introduces real-time feedback on coverage, pressure and brushing behaviour, could this help close the gap between practice and home?

Aims To examine the clinical and behavioural challenges associated with effective home plaque control and consider how realtime brushing feedback and personalised guidance may support patient self-care between dental appointments. Learning objectives: • Explain why adherence to twice daily toothbrushing advice does not necessarily equate to effective plaque control. • Recognise the clinical outcomes reported for the Philips Sonicare Next-Generation DiamondClean 9900 Prestige in plaque removal and gingival health compared with manual toothbrushing. • Describe how real-time information on brushing coverage, pressure and technique may support patient engagement and behaviour change. • Consider how technology-supported self-care can be integrated into contemporary preventive and periodontal management alongside professional instruction. GDC Development Outcome: A, C There is a familiar discrepancy in dental practice between what patients report and what clinicians observe. Many patients brush twice a day and genuinely believe they are cleaning effectively, yet all too often plaque persists at particular sites and gingival inflammation returns in much the same distribution from one appointment to the next. It is tempting to interpret this simply as poor compliance, but the reality is often more complex. Toothbrushing is a learned motor behaviour and an ineffective technique can be repeated just as consistently as an effective one. A patient may habitually overlook a lingual or posterior surface, give insufficient attention to the gingival margin or apply excessive pressure without being aware that anything is wrong. This matters because contemporary periodontal management places considerable emphasis on the patient’s own contribution to disease control. The BSP implementation of the European S3-level evidence-based treatment guideline for stage I–III periodontitis adopts a stepwise approach in which behaviour change, effective supragingival plaque biofilm control and management of relevant risk factors are integral to the initial phase of treatment. ¹ The guideline was developed specifically to adapt the European recommendations to UK clinical practice. The challenge is that oral hygiene instruction and oral hygiene performance take place in different environments. A clinician can disclose plaque, demonstrate technique, identify sites requiring greater attention and explain why change matters. The patient must then reproduce that advice independently, morning and evening, often for months before their technique is professionally reassessed.

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Professor Iain Chapple captures this shift when he says that “We don’t talk about oral hygiene instruction anymore; we talk about coaching.” His distinction is important. Instruction transfers information; coaching recognises that effective self-care is a behaviour that needs to be understood, practised, reinforced and sustained. From a periodontal perspective, Periodontist Dr Sulaman Anwar makes a complementary point: “The issue is not simply whether a patient brushes twice a day, but whether they are disrupting plaque effectively in all the areas that matter. Patients can be very diligent and still repeatedly miss the same sites.” Frequency is relatively easy for patients to report, whereas effectiveness is

considerably more difficult for them to judge. This raises an important clinical question: if patients cannot readily see how well they are performing the behaviour we have prescribed; how can we help them recognise when that behaviour needs to change?

Examine clinical evidence and effect on behavioural change When considering whether to recommend a powered toothbrush, clinicians need to examine established evidence demonstrating its efficacy. Studies show that the Sonicare Next-Generation DiamondClean 9900 Prestige delivers up to twenty times more plaque removal and up to fifteen times healthier gums

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

compared with a manual toothbrush.2 Clinical efficacy establishes what the technology achieves when used effectively. For patients, however, achieving these benefits also depends on effective and consistent use at home. This makes usability and adherence an essential part of the clinical value of a powered toothbrush, alongside its demonstrated efficacy. So rather than focusing solely on the mechanics of powered cleaning, the 9900 introduces information about brushing performance directly onto the toothbrush itself. Philips describes third-generation AI and spatially aware guidance used to follow brushing coverage, with a 12-segment Mouth Map on the handle identifying areas which require further attention.

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CPD: PHILIPS CPD Questions 1) Why does twice-daily toothbrushing not necessarily indicate effective plaque control? A. Toothbrushing frequency has no relevance to oral health. B. A patient may brush regularly while repeatedly missing sites or using an ineffective technique. C. Patients undergoing periodontal treatment should brush only once daily. D. Powered toothbrushes eliminate technique-related differences.

2. Within the BSP implementation of the S3-level periodontal The AI uses more than 18,000 brushing patterns to identify where the toothbrush is cleaning. If more brushing is needed, the light ring at the base of the handle remains yellow. Blue means the user has completed the segment indicating to move on to the next. A light ring provides real-time guidance relating to coverage, pressure and scrubbing, while smart pressure sensing can adapt intensity when excessive pressure is detected.2 A green light shows that the correct pressure is being applied. A slow-fading purple light indicates too little pressure, while a strong purple light indicates too much pressure. The clinical significance of the brush is achieved because of the combination of advanced new brushing technology and the sophistication of the feedback and information it provides. Conventional oral hygiene instruction relies largely on retrospective feedback. Plaque is disclosed or inflammation identified during an appointment, technique is reviewed and corrective advice is given. On-device feedback shortens that interval. If an area has received insufficient attention, the patient can be alerted while still brushing and therefore has the opportunity to return to an overlooked site. Similarly, pressure feedback can draw attention to an excessive-force habit at the moment it occurs rather than several months later. The principle is familiar within dentistry. Plaque disclosure has long been useful because it converts something that may be largely imperceptible to the patient into visible information that can be acted upon. Intraoral photography can perform a similar function by making clinical findings easier to understand. Real-time brushing guidance applies the same principle to behaviour, making aspects of the patient’s own performance visible at the point when modification remains possible. Chapple’s own experience while trialling the 9900 illustrates the point graphically. Despite considering his oral hygiene routine meticulous, the Mouth Map on the brush handle indicated that an area around his lower anterior teeth required further attention. He returned to the site and consciously altered his brushing the following morning, subsequently describing the feedback screen as “A game changer in personalised biofeedback”. If an

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experienced periodontist can identify an unnoticed gap in his own routine, it is reasonable to consider how frequently comparable blind spots may occur among patients. Pressure provides another pinch point. In discussing a problem she frequently encounters in practice, Dr Chinwe Akuonu notes that excessive brushing may contribute to tooth wear, gingival recession and sensitivity. A patient may associate vigorous brushing with superior cleaning without recognising how much pressure they habitually apply. A pressure sensor cannot diagnose the cause of recession or determine an appropriate treatment strategy, but it can draw attention to a modifiable behaviour while it is occurring. The distinction is important: the clinician provides diagnosis, interpretation and individualised care, the device provides the guidance to ensure they are adhering to the advice.

Extending periodontal support beyond the surgery For patients undergoing periodontal treatment or supportive periodontal care, the relationship between professional treatment and daily self-management is particularly relevant. Long-term periodontal stability is closely influenced by what happens during the weeks and months when patients are responsible for their own plaque control. This is reflected in the BSP treatment pathway, where motivation, self-performed plaque biofilm control and behaviour modification are incorporated from the beginning of therapy rather than being treated as optional additions after professional intervention.¹ Dr Anwar describes the potential value of feedback in this context: “Periodontal stability depends heavily on what happens between appointments. We can provide excellent treatment in practice, but if plaque control at home is inconsistent, maintaining those results becomes much more difficult. Feedback that helps a patient understand where their technique could improve can make the advice we give in surgery more actionable.” The word actionable is important. Advising a patient simply to “improve their oral hygiene” defines an objective without necessarily explaining how it should be achieved. Advice directed towards a particular site, coverage problem or aspect of technique is more useful, but it still relies on the patient reproducing that advice correctly once the clinician is absent. Real-time feedback offers a means of reinforcing personalised professional guidance between appointments.

guideline, patient self-care and effective supragingival plaque biofilm control form part of: A. The initial phase of periodontal therapy. B. Surgical periodontal treatment only. C. Supportive periodontal care only. D. Treatment for stage IV periodontitis only.

3. What is the principal purpose of the 12-segment Mouth Map discussed in this article? A. To diagnose periodontitis. B. To measure periodontal probing depths. C. To provide information about brushing coverage and identify areas requiring further attention. D. To replace professional plaque disclosure.

4. Which statement best reflects the clinical role proposed for real-time brushing feedback? A. It replaces professional oral hygiene instruction. B. It independently diagnoses the reason for inadequate plaque control. C. It may reinforce personalised professional advice by providing feedback while the patient is brushing. D. It should routinely be recommended to every patient. From information to supported self-care

Real-time brushing guidance offers an opportunity for preventive dentistry to help patients become more accurate and confident observers of their own behaviour. By making brushing patterns visible and providing timely, constructive feedback, technology can support greater awareness, reinforce positive habits and encourage continued engagement with oral self-care. This feedback can work alongside an understanding of each individual’s motivations and circumstances, while strengthening the professional relationship that supports meaningful behaviour change. In this way, feedback can be viewed as a valuable component of a wider process of professionally supported self-care, helping patients build confidence, develop effective routines and sustain positive oral health behaviours. Seen in this context, the NextGeneration DiamondClean 9900 Prestige is clinically relevant not only because it is more intelligent, but because it aims to make the patient better informed

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

about what happens during brushing. The clinician establishes the diagnosis, identifies the areas of concern and agrees what behaviour needs to change. The technology then helps the patient recognise how to make that change and reproduce it effectively at home. The longstanding challenge in prevention has rarely been a lack of information about what patients should do. It is translating that knowledge into effective, repeatable behaviour when nobody is watching. Real-time brushing feedback offers a means of closing that gap.

Request a professional trial unit

Dental professionals wishing to experience the new brush and consider how real-time guidance might complement their own patient conversations, can request a trial unit of the Philips Sonicare Next-Generation DiamondClean 9900 Prestige. https:// acc.philips.co.uk/c-m-pe/dentalprofessionals/products/toothbrushes/ diamondclean-smart n References available upon request.

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CPD: MAINTAINERS DENTAL LAB

Dentistry’s Next Competitive Edge: Speed, Social Media and the On-Demand Patient Maintainers Lab explores how on-demand consumer culture and social media are reshaping what patients expect from cosmetic and orthodontic treatment, and how the right laboratory partnership can turn that shift into sustainable practice growth

Aims This article examines how on-demand consumer culture and social media are reshaping patient expectations of speed and aesthetics, and sets out the practical, commercial response available to general dental practices, including how a structured laboratory partnership can convert that shift into safe, sustainable revenue. Learning objectives: • Understand the emergence of the ‘on-demand patient’ and how this shift in consumer culture has reshaped expectations of treatment speed across the aesthetic and orthodontic market • Recognise how social media and a culture of perfectionism are shaping patient demand, self-perception and the accuracy of information patients bring to consultations • Identify practical steps for building sustainable new revenue streams, including recurring revenue and patient conversion tools, while maintaining clinical governance • Evaluate how a structured laboratory partnership can help practices respond to both the speed and the imageconscious demands of the on-demand patient, across their full appliance range. GDC Development Outcome: A, B Patients now expect ‘now’

Across almost every consumer sector, the expectation of immediacy has moved from a premium option to a baseline requirement, and dentistry is only beginning to feel the full force of it. 96% of consumers now cite fast delivery as a key purchasing factor and, among 18 to 34-year-olds, 56% expect same-day delivery as a matter of course. This is the ‘Amazon effect’: sector-leading service quickly becomes the baseline everywhere it appears, including in patients’ expectations of their dentist. The UK cosmetic dentistry market reflects this shift, projected to grow from £214 million in 2024 to £284 million by 2029, with clear aligner searches up 89% year on year and implant enquiries up 67%. Practices offering next-day or same-week turnaround on aligners, retainers or whitening trays, rather than the traditional multi-week wait, are meeting patients on the timelines the rest of their consumer lives have already trained them to expect.

Speed as standard, not exception This is precisely the gap a lab partner needs to close. For digital cases submitted by 2pm, Monday to Thursday, Maintainers Dental Lab dispatches its retainer, night guard, sports guard and whitening tray range next-day as standard, with no additional fees; that same commitment to speed extends to Glee clear aligner treatments, delivered within 7 to 10 working days. This is what turns expectation into operational reality rather than a marketing promise.

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The filter effect: social media and rising aesthetic expectations

The smile has become one of the most scrutinised features in the age of the front-facing camera. A study published in Scientific Reports found that 72% of patients were motivated by influencer posts when choosing cosmetic dental treatment, and in the UK, social media

influences 73% of cosmetic dental decisions among patients aged 25 to 45. Among orthodontists, 38% report adult patients explicitly influenced by celebrities and influencers, and 70% now research treatment online before booking, though 40% of that content is inaccurate or misleading. ‘Snapchat dysmorphia’ describes patients seeking treatment to

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

resemble their own filtered selfies, and the ‘Zoom effect’ sees 86% of dermatologists reporting patients citing video calls as the trigger for a cosmetic enquiry. At the extreme end, ‘looksmaxxing’ has driven a 26% rise in male face and neck procedures since 2024. Patients increasingly arrive having already decided, via social media, what they want.

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CPD: MAINTAINERS DENTAL LAB CPD Questions 1. What best explains the ‘Amazon effect’ now reaching dental aesthetics? a) Patients have stopped comparing providers online b) The expectation of immediacy has moved from a premium option to a baseline requirement across consumer culture c) NHS dental fees have fallen d) Aesthetic treatments have become clinically simpler

From filtered selfie to supervised treatment plan

The answer is not to compete with social media on speed alone, but, in the case of clear aligners, to convert that interest into an assessed treatment plan just as quickly. A same-day online assessment, followed by a treatment plan from a registered orthodontist within 24 to 48 hours, turns social-media-driven curiosity into a warm, pre-informed lead rather than an unmanaged expectation.

The digital workflow behind next-day turnaround None of this is possible without a shift already under way in how cases are captured and produced. Intraoral scanners have become both more powerful and more affordable, letting practices capture precise three-dimensional data and transmit it to a lab instantly, removing the distortion risk of a physical impression and the days a courier used to add to the process. The result, for practices, is faster treatment planning, fewer remakes and a shorter patient journey from consultation to appliance in hand. On the lab side, that same digital file lets a technician design a bespoke appliance using CAD software and produce it via three-dimensional printing, a process that has moved rapidly from novelty to necessity across the sector and now underpins clear aligners, bespoke retainers and surgical guides with a precision manual methods cannot match. Where a conventional lab process might once have taken weeks, a digital workflow integrating 3D printing can collapse that to days, or, for advanced providers such as Maintainers Dental Lab, to a genuine next-day turnaround: receiving a scan, designing the appliance and dispatching it same day for delivery next-day is already a working reality, not a future ambition.

Next-day as standard

This expectation of speed applies well beyond cosmetic cases. A broken retainer or worn night guard feels just as urgent to a patient as an aligner, and a slow turnaround on either risks the same loss of confidence. Maintainers Dental Lab is built to deliver on that promise reliably, not just occasionally. Every partner practice is assigned a dedicated account manager

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for onboarding and ongoing clinical and commercial support, with access to Maintainers University for training and to branded patient marketing materials to help convert demand into booked treatment.

Beyond the appointment: turning turnaround into recurring revenue

Whitening shows how immediate this expectation has become. In the UK, 84% of adults aged 18 to 35 already engage with whitening products, and the decision to start is often impulsive, prompted by an event or simply a moment of motivation, rather than planned weeks ahead. A patient quoted a one-to-two-week wait has time to lose interest or shop around. A practice that can say ‘start tomorrow’ rather than ‘come back next week’ converts that moment before it fades, turning speed itself into a point of differentiation. Retainers, night guards and whitening trays are also inherently repeatable products; a maintenance or membership plan built around them can insulate a practice from appointment-led income volatility, with 82% of practices introducing such plans reporting a revenue increase within the first year. Response speed still matters: patients contacted within five minutes of an enquiry are ten times more likely to convert than those contacted later, yet the average practice response time remains 47 hours. Glee, Maintainers’ clear aligner system, is a natural extension of this same infrastructure rather than a separate product with that continued commitment to speed of turnaround.

Five practical steps to prioritise now 1. Audit turnaround times for lab work especially ones linked to aesthetic procedures and orthodontics like retainers and whitening trays against current, not five-year-old, patient expectations. 2. Review your practice’s social media presence, given how much social media plays a part in a patient’s decision making, your voice on social media is important. 3. Build clear consultation protocols for patients whose expectations have been shaped by modern filtered images or influencer content. Retainers, night guards, sports guards and whitening trays dispatched nextday as standard for digital cases submitted by 2pm, plus Glee aligner cases within 7-10 working days. Visit maintainers.co.uk or call 0800 707 6212.

2. Which statistic illustrates the scale of social media’s influence on cosmetic dental decision-making in the UK? a) 40% of orthodontic patients ignore online information b) Social media influences 73% of cosmetic dental decisions among patients aged 25 to 45 c) Only 5% of patients research treatments before booking d) Influencer content is rarely inaccurate 3. What does ‘Snapchat dysmorphia’ describe? a) A rise in gum disease linked to selfie-taking b) Patients seeking treatment to resemble their own filtered selfies c) A decline in interest in cosmetic dentistry among younger patients d) A technical fault in video consultation software 4. What does Maintainers Dental Lab guarantee for digital retainer, night guard and whitening tray cases submitted by 2pm, Monday to Thursday? a) Delivery within five working days, for an additional fee b) Next-day dispatch as standard, with no additional fees c) A minimum two-week production window d) Dispatch only for aligner cases 5. What combination of factors distinguishes genuine next-day lab capability from a marketing claim? a) Low price alone b) A confirmed submission cut-off, guaranteed turnaround days and no hidden fees c) A lab’s years trading, regardless of current performance d) Whether the lab is based in the UK 4. When choosing a lab partner, check whether next-day turnaround is offered as standard or at an additional cost, and what the actual submission cut-off is. 5. Put a fast, structured follow-up process in place for aesthetic enquiries; response speed converts patients as reliably as price

Converging, and converging now A culture of impatience and a culture of visual perfectionism are converging on the same patient, at the same time. Practices

that pair fast, professionally supervised treatment with a lab partner proven to deliver on turnaround are not simply keeping pace: they are building a more resilient, less appointment-dependent business around it. The market has changed. The on-demand era isn’t coming to dentistry, it’s already here. Patient expectations have changed too. They know what they want, and they want it now. The question is simple: is your practice ready to change with them? Those that act now will be the practices patients find first, and return to most. 

Read the full white paper This article draws on Maintainers Dental Lab’s white paper, ‘No Waiting Room: The Rise Of NextDay Dentistry’, produced with Working the Future. For the full deep dive into this topic, including UK demographic trends, and a list of sources for this CPD download “No Waiting Room” for free at maintainers.co.uk/maintainers-no-waiting-room.

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

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education

Intraoral imaging in focus: Shaping the future of dental practice With intraoral imaging now an established part of everyday dental practice, Amy Hayes explores how that expectation is reaching clinical education and what it means for the wider profession

ntraoral cameras are now a familiar part of modern dentistry, supporting clinical assessment, documentation, referrals and conversations with patients. Now that same expectation is beginning to shape how students are trained. That feels particularly timely as dental education expands, with the government announcing in June the first sustained increase in dental school places in England in nearly 20 years. From 2027, 50 additional undergraduate places will be available at the University of East Anglia and the University of Portsmouth.¹ As attention turns to training more clinicians, there is also a question about how closely their education reflects the way dentistry is practised today. Digital technology, communication and the ability to explain and justify clinical decisions are all part of that picture. With this in mind, a new national initiative from Acteon UK is giving students structured experience of intraoral imaging and asking them to apply it through evidence-based clinical case studies.

C50 intraoral camera, educational support and a structured case study framework. Students develop anonymised clinical case studies, which are reviewed by an eight-member national panel spanning clinical practice, education, research and digital dentistry. The emphasis is on applying the technology rather than simply learning how to operate it. Students need to consider what they are seeing, how it fits into the wider clinical picture and how to communicate their findings clearly. Dr Amit Patel, Specialist in Periodontics and Implant Dentistry and one of the judges, said: ‘Diagnostic imaging and patient communication go hand in hand. The case study format encourages students to think critically about what they are seeing and explain it clearly, helping them to develop the clinical judgement and communication skills expected of today’s graduates.’

The case for visual communication

Assessment in action

The value of intraoral imaging extends well beyond simply capturing a picture. A study published in the British Dental Journal (BDJ) in January 2026 identified six principal applications for intraoral cameras: diagnosis, patient education, documentation, referral and professional communication, teleconsultation and student education.² The research also highlighted the importance of training and developing the skills needed to use intraoral cameras effectively. For patients, one of the clearest benefits is being able to see what the clinician is discussing. Dr Raabiha Maan, a dentist with a special interest in aesthetic and restorative dentistry and a member of the Illuminate judging panel, said: ‘When a patient can actually see what you can see, the conversation completely changes. It builds trust, helps patients understand their own oral health and makes them part of the decision-making process.’ The image provides a shared point of reference, while clinical judgement determines what it means and how it should inform care. Developing those skills during training helps students understand how to use the technology appropriately within clinical decision-making and patient communication.

Bringing imaging into training

Illuminate is a free national educational initiative supported by Acteon UK, giving participating institutions access to an Acteon

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At the Greater Manchester Hygiene and Therapy Programme, that experience has been built directly into the curriculum. Bobby Mills-Pew, Programme Lecturer and Clinical Supervisor, said: ‘When we looked at what Illuminate offered our students, the decision to integrate it into our formative assessment was a no-brainer. Intraoral imaging is increasingly central to how clinicians diagnose and communicate with patients, and we wanted our second-year cohort to develop those skills in a structured, meaningful way before they qualify. ‘Making it part of formative assessment means every student in the cohort engages with the technology and completes a case study – not as an add-on, but as a genuine part of their learning. This ultimately prepares the students for the real world with an additional skill they can utilise in their careers from the outset. We are very much looking forward to seeing what they produce.’ That is the important difference: students are being asked to use the technology, explain their thinking and reflect on how it contributes to care, with the benefit of supervision and feedback while they are still learning.

More than technical ability

For Dr Bhupinder Dawett, whose work spans clinical practice, research

and education and who also sits on the Illuminate judging panel, preparing students for practice means developing a broader set of skills. He said: ‘Preparing graduates for contemporary practice requires more than technical ability alone. Students need to develop the confidence to assess evidence, communicate effectively and think critically about the decisions they make.’ The Illuminate case study format is designed to support exactly that, asking students to connect an image with a patient and clinical situation, explain their reasoning and submit their work for independent review. Giving students that experience during their education means they can develop clinical judgement, communication skills and technical confidence together before they enter practice.

Skills that carry forward

What students learn during training will shape what they bring into practice. A graduate who has already used intraoral imaging for clinical assessment, documentation and patient conversations arrives with experience that can be developed from the outset. For employers, the first step is recognising those existing skills. Asking new clinicians which technologies they have used, how confident they feel and where further support would be helpful can make onboarding more purposeful. Practices also need the right systems around the technology, with clear protocols for image capture and storage and a shared understanding across the team of how images can support communication, documentation and referrals. From there, teams can build on that experience together. Established clinicians bring clinical context and judgement, while newer graduates may bring fresh insight into how familiar technologies are being used in education and modern practice.

From training to practice

Giving students structured experience with intraoral imaging helps connect their education with the clinical, digital

and communication skills they will use in practice. For Bobby, that is exactly the point: ‘We want every one of our students to leave with skills that make a real difference in practice – and being able to communicate clearly with patients using intraoral imaging is one of them.’ Intraoral cameras are already familiar technology across much of dentistry. What is changing is when clinicians begin learning to use them, with programmes such as Greater Manchester’s now bringing that experience directly into formal assessment. For the profession, that means the next generation may arrive already accustomed to using them as part of patient communication, documentation and clinical reasoning. For practices, educators and the wider dental team, the opportunity is to build on that experience and make full use of the skills these clinicians bring with them. To find out more about Acteon Illuminate, visit acteon.foleon.com/uk/illuminate. n

References 1.

Department of Health and Social Care. Brand new dental school places in ‘dental deserts’. Available at: https://www.gov.uk/government/news/brand-newdental-school-places-in-dental-deserts. Accessed 16 September 2026. Haji Seyed Javadi S, Jamieson L, Fazli M et al. Intraoral camera utilisation: a multi-perspective study on applications, challenges and future directions. BDJ 2026: https://doi.org/10.1038/s41415-025-9110-8. Accessed 16 September 2026.

About the author Amy Hayes is Global Clinical Education Manager at Acteon Group and a qualified dental hygienist and therapist, combining clinical experience with a focus on professional education and supporting dental teams in delivering high-quality patient care.

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EDUCATION

The difference is real

here is a strong case to be made for online education. Its benefits are many, including its accessibility, flexibility, cost effectiveness and overall ease. However, it is still only a substitute for in-person learning – nothing beats the real thing. Among dental professionals, CPD is vital for career progression, enhancing your skill set and clinical knowledge so that the daily workflow is performed in a safe and efficient way. Face-to-face interactions are an excellent way for clinicians to not only achieve the hours of CPD required to be GDC compliant, but also to actively engage with the educational content in a way that online alternatives are sometimes limited by. For dental practice owners, it is worth considering the many advantages of face-to-face learning for the dental team, especially sessions delivered in-practice.

Business benefits

The benefits of in-person learning extend to each employee and the business as a whole. Learning that is aimed at the whole practice, such as infection control, improves the daily workflow by reminding each member of the dental team of the correct protocols. It also means that, if someone is ever unsure of what to do about something in this area, a colleague can quickly help as they too would have completed the training. The dental team are therefore empowered in their knowledge and can perform their duties efficiently, boosting practice productivity, reducing delays and ultimately increasing revenue.

Great Price

Questions and answers

Dentistry spans an enormous breadth of research and development – there is a lot to learn and a lot to prove that you have learnt it. When hearing about new products, skills, techniques or changes in legislation it can be overwhelming, which is why so many educational sessions finish with the opportunity to ask questions. In an online space, such as a webinar, this can be difficult. Attendees may feel less confident to speak up virtually as the social cues are more limiting; no eye contact, no pointing, no raising a hand. In-person learning eliminates this communication barrier, placing dental professionals in a more dynamic environment that promotes discussion and where they can raise their hand and speak to the educator with greater ease. This also helps the educator gauge understanding and address concerns promptly, rather than waiting for the end of the session. Answers are received quicker and the impact is that engagement with the group is a lot stronger.

Tailored teaching

For those leading a CPD session, in-person education provides a flexible space to tailor the teaching to the audience. A personalised approach can further improve engagement. For instance, tying certain topics into the local culture of the dental practice. This can add a level of fun and relatability, making it easier for you and the team to recall the information afterwards. Customised sessions also support those with different learning styles, as the session leaders can accommodate individual needs and preferences to optimise the educational journey for each participant.

Networking

Face-to-face education is a brilliant networking opportunity. Dispensing with some of the formalities of online learning (especially pre-recorded videos), in-person meetings are more personal and allow professionals to connect. You may be able to build contact lists, find suppliers, be introduced to marketing agencies or hear about upcoming events from other dental professionals – each can help grow your business. Face-to-face learning therefore brings the dental profession closer together for a more reliable, social and mutually beneficial experience.

October 26 | The Probe

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Great Quality

Subject of interest

Infection control is a vital component for a safe, functional and successful dental practice. In-person education in this area is invaluable, making a difficult subject seem simple and accessible. To support the team, dental practice owners should consider the Dentilearn in-practice CPD session from Dentisan. Delivered by one of the infection control experts, there is the choice for a 1-hour or a 2-hour training session, covering such topics as hand hygiene, practice inspections and making sure you have the correct documentation for the records. Specific topics can also be selected in advance to ensure the needs of your team and practice are met, and all are delivered in an interactive and refreshing educational session. The benefits of in-person education are many, making it the best channel for helping you and your team grow your knowledge and skills. From boosting your network to increasing workplace efficiency, face-to-face education is a reliable way of achieving success. For more information about Dentisan, please visit https://dentisan.co.uk/ Book your in-practice CPD by emailing your request to the expert in your area: For the Midlands, North Wales & North of England, contact Jenny: jenny.nixon@getinge.com For the South of England, Wales & Channel Islands, contact Anne: anne.harris@getinge.com For Scotland, Ireland & Northern Ireland, contact Holly: holly.dickinson@getinge.com 

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

Made in Great Britain

OPTIM Interdental brushes are precision made in the UK, using high tensile strength, plastic-coated, stainless-steel wire at the core, which helps to prevent the brushes from buckling, even on the smallest sizes. They are the same colour coded sizes that practices/ patients are already familiar with and are very competitively priced. For more information or to request a sample, simply speak to your dealer, scan the QR code or visit

https://optim-idb.uk/survey/

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Case Study

Incisor trading

Dr Harry Craig presents a Full Case Type II Accreditation submission for the BACD: the replacement of a single central upper incisor crown in a complex, heavily restored dentition.

Fig. 1 Pre-op upper right central

incisor crown Fig. 2 Masking of dark stump and retraction

cord placement Fig. 3 Visual shade prescription for lab Fig. 4 Crown 1 try in. Note heightened value

in incisal third Fig. 5 Crown 2 try in with improved incisal

third value 5

71-year-old male patient was referred by a local colleague with a clear brief: his upper right central incisor crown had fractured palatally and needed replacing. The patient was keen to fix it, not least because, as he put it, his wife had been asking him to get it done for some time. The crown had originally been placed following dental trauma in his younger years, with the tooth having undergone endodontic treatment before receiving the crown. On examination, his periodontium was healthy, with minimal calculus and a low periodontal risk. The wider picture, however, was complex: a guardedprognosis UL2-4 bridge, numerous heavily restored posterior teeth, and a lower partial cobalt-chrome denture all could have benefitted from treatment. We discussed all of this at length. The patient understood the bigger picture, but due to financial reasons opted only to address the UR1 at this time.

Case preparation

The diagnostic process for a single central crown demands particular attention. Matching one central incisor to another is arguably one of the more demanding aesthetic challenges in restorative dentistry – any discrepancy in shade, value, or character is immediately obvious. To give the laboratory the best possible information, clinical images were taken immediately

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on arrival at the first appointment, before dehydration could affect shade accuracy. Photographs at the correct exposure, underexposure, and greyscale were all captured and annotated before being sent to the lab alongside the intraoral scan. Trans-sulcular probing confirmed a normal crest height of 3mm from the gingival margin – reassuring, as minimal gingival management was planned during preparation. A pre-operative polyvinyl silicone (PVS) impression was also taken at this stage as a blueprint for the temporary.

Beginning treatment

Upon sectioning and removing the existing crown, secondary caries was revealed at the margins. This was removed and the preparation extended apically towards the gingivae. The post showed no mobility on assessment and was left in situ rather than risk further root damage in attempting removal. To manage the dark underlying structure, the post was sandblasted, etched, and bonded before being masked with white opaquer followed by an A3 body shade build-up. This is a step worth emphasising: masking the post with resin rather than relying solely on the ceramic optimises subsurface scattering through the restoration and reduces the risk of a greyed gingival margin in the final result. A two-cord retraction technique was used before an intraoral scan was taken with

Fig. 6 Post-op close-up

the TRIOS 3. A temporary crown in A3.5 Luxatemp was fabricated from the original PVS impression and adjusted to a good fit.

Fitting the crown

The lab’s (Byrnes) preference was monolithic zirconia; a sensible choice when it comes to masking a dark root, though value management becomes critical. At the first try-in, the value was too high against the contralateral central incisor, and the temporary had displaced the gingival margin slightly apically. Both issues were photographed and annotated, the crown was returned to the lab, and the temporary was adjusted. By the second try-in, the gingival margin had returned to its natural level and the crown’s value was considerably improved, so we agreed to cement the crown. Following isolation with Optragate and sandblasting of the preparation, the crown was luted with RelyX Unicem dual-cure self-adhesive resin cement. Occlusion was verified with both 200µm and 20µm articulating paper to confirm no interference with the envelope of function. The patient returned one week later: the occlusion required no adjustment, gingival healing was progressing well, and he was pleased.

Reflections

Single central crown cases are unforgiving. The contralateral tooth sets a standard

that the restoration must meet in terms of shade, value, and character, and there is no hiding. In this case, I believe this to be a positive outcome, especially in the specific characteristics of the craze lines – though I will note the incisal third value is marginally lower than the natural tooth’s, and the blue halo in the contralateral central is not fully replicated. Both are observations for future cases of this type. I am grateful to the laboratory team at Byrnes for their skill and patience across multiple iterations. For dentists approaching similar cases, two things proved decisive: thorough pre-operative documentation – including greyscale and underexposed images to guide lab character matching – and the willingness to send the crown back rather than cement a compromise. Mentorship within the BACD community has been equally important in developing the approach to complex aesthetic cases. For more information about the BACD, please visit www.bacd.com n

About the author Dr Harry Craig is an Accreditation candidate for the BACD, where he also serves as Chair of the Young Membership Committee.

The Probe | October 26

02/10/2026 12:14:36

Redefining Digital Dentistry EVOLUTION IN DIGITAL WORKFLOWS

DR. SHAAM SHAMSI

PROF. RIAZ YAR

PROF. ADAM NULTY

DR. AHMED SAAD

DR. ANDREA BEVILACQUA

DR. ENRICO ZARA

DR. AHMAD ALLHASSINY

DR. HÉCTOR FERNÁNDEZ

Whitworth Art Gallery, The University of Manchester

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www.the-probe.co.uk

Case Study

Dental implant placement in a jaw with through-and-through lesion Dr Minesh Patel describes a complex case in which bone augmentation using a titanium mesh was undertaken to restore a maxillary alveolar ridge with a through-and-through lesion and provide a lasting dental implant solution

Fig. 1a Initial situation lateral view Fig. 1b Initial situation occlusal view Fig. 2a CBCT reveals through-and-through lesion Fig. 2b CBCT reveals through-and-through lesion

hen a patient experiences a complex dental extraction, bone density may be compromised. In extreme cases, this may result in a through-andthrough lesion – in which both the buccal and palatal wall are compromised. This can make treatment complex, with fewer options available for effective and long-lasting restorative solutions. Titanium mesh has helped to expand the indications of guided bone regeneration due to its mechanical properties and biocompatibility. It enables clinicians to repair alveolar ridges with large bone defects, delivering stable bone augmentation results. Traditional membranes, when applied to large defects, may be limited by their stiffness, making them difficult to maintain blood supply. Due to its good plasticity, on the other hand, titanium mesh can adapt to bony defects through bending

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and shaping – enabling highly stable osteogenesis and achieving bone augmentation in both horizontal and vertical directions.i

Patient background

A male, 24-year-old patient presented to the practice with a missing UR3. As a result of orthodontic treatment, the patient had developed dental ankylosis – his UR3 had fused to the jaw bone. His tooth was removed at the oral surgery centre, requiring an aggressive extraction, and he was given a partial denture as a temporary solution. The patient is a professional cricketer and, due to his age, his main aim was to preserve the longevity of his dentition, with a long-term, permanent solution. Otherwise, the patient had good oral health, was compliant with treatment, but was nervous, so measures needed to be taken to manage this throughout the process.

Fig. 3

flap lifted

Fig. 4

PRF membrane harnessed

Fig. 5

Bone grafting material placed

Fig. 6

titanium mesh placed

Fig. 7

PRF membrane placed

Fig. 8

BioHorizons Tapered Internal Implant placed

Fig. 9a Final restorative outcome Fig. 9b Final restorative outcome

Assessments

CBCT scans were taken, which revealed the extent of the buccal defect, with very minimal bone remaining at the UR3 site. This was a through-andthrough lesion which would make treatment challenging, with neither a buccal or palatal wall available to provide stability.

Treatment planning

All options were discussed with the patient, taking into account the need for a long-lasting solution, the limitations due to the througha n d - t h ro u g h lesion, and the patient’s dental anxiety. The option of doing nothing was discussed, but not recommended in this case, especially as the patient was in his early twenties. The advantages and disadvantages of options such as bridges and partial dentures were also

discussed but not recommended, as they would not necessarily offer the desired long-term solution. As such, there were two options for bone and soft tissue augmentation, followed by delayed implant placement. The option of a block bone graft was explained to the patient, which would involve h a r v e s t i n g b o n e f ro m t h e l o w e r jaw and placing it into the surgical site. However, due to the extent of the bone loss at the UR3 region, achieving blood supply would have been unreliable using this method. The more favourable option of bone augmentation with autograft and bovine grafting material using titanium mesh was selected. It would require no donated human bone and no secondary surgical site, and this method would enable us to achieve a reliable blood supply using the surrounding tissue.

The Probe | October 26

02/10/2026 12:16:42

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Case study

treatment provision

As the patient was nervous, treatment was provided under sedation, helping to keep him calm and comfortable throughout the process. A flap was raised and plasma rich membrane was harnessed to enhance tissue healing and regeneration. Bone was harvested from the patient’s palate, where a small complication occurred – bleeding wouldn’t stop at the harvest site, requiring stitching and packing to stem the bleeding. The autograft was mixed with bovine grafting material and the platelet-rich fibrin (PRF) liquid, and packed into the UR3 area. Titanium mesh was then used alongside a guided membrane technique to secure the bone grafting material, held in place with titanium tacks – two buccally, two palatally. PRF membrane was then placed over the titanium mesh to provide added coverage, accommodating the increased bone volume. Prolene 5-0 sutures were excellent for securing this, and good gingival thickness was achieved. CBCT imaging showed that the fullness of the bone had been restored.

The site was left to heal for 6 months, during which time the patient was provided with a carbon fibre temporary restoration. A BioHorizons Tapered Internal 3.8 x 15 mm implant on a 3.5 platform was placed. This implant was selected as it required minimal drilling and allowed for good primary fixation. Axion Dental Lab provided a custom abutment cast in zirconia to improve aesthetics, which was a concern due to the region it was in. Occlusion was adjusted to establish group function and distribute occlusal forces rather than relying on canine guidance – therefore reducing the impact on the new implant.

Outcome and case appraisal

My patient and I were extremely happy with the treatment result. Due to his age, it was important to create a longlasting outcome. There were a number of factors that contributed to this being a challenging case: the surgical site was located in the smile line, there was a severe lack of bone, and we wanted to achieve a

good gingival margin, implant angle, and occlusion for a functional and aesthetic outcome. Additionally, the patient was required to be engaged in a lengthy treatment, meaning maintaining compliance was a potential obstacle. This was also a complex and technically difficult case, requiring the implant to be placed solely in grafted bone. As such, it required very high-quality bone and soft tissue augmentation. Usually, when providing a graft using a titanium mesh, there is one wall to work with – in this case neither the buccal or palatal wall was available. Further to this, handling titanium mesh is very difficult. It’s important that clinicians undergo mentoring and training prior to attempting this, because it is tactically more difficult to place pins, and practitioners must be comfortable with raising a palatal flap. For product information or further education from BioHorizons and Camlog, please visit https://theimplanthub.com/  References available upon request.

about the author Dr Minesh Patel qualified from Cardiff in 1986 and has been placing dental implants for 32 years. He gained his MFGDP in 1996, the Diploma in Implant Dentistry in 2005, his MSc in Implantology in 2006, and his MSc in Restorative and Aesthetic Dentistry in 2016 from Manchester University. Dr Patel holds a primary qualification in Dental Law and a PG Cert in Education both from Bedfordshire University. He is also an accredited Mentor for the Association of Dental Implantology. Dr Patel has been awarded as course director for Implantology at Warwick University, and is the Surgical Module Lead for block grafting, sinus grafting and soft tissue grafting for the Masters students. Dr Patel is an examiner for the Diploma in Implant Dentistry at the Royal College of Surgeons of England.

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October 26 | the Probe

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advertisement features

Why OsteoBiol® GTO®’s handling isn’t just convenient, it’s clinical

ou’re mid-procedure, working against the clock. Does the graft material need mixing and hydrating? Does it slump out of the defect the moment you place it, or wash away as soon as blood reaches it? Do you end up reaching for a membrane just to keep it where you put it? None of this is the hard part of bone augmentation. It’s a distraction, and it shouldn’t be what you’re thinking about while you’re trying to rebuild bone. OsteoBiol® GTO® comes pre-hydrated, straight out of the syringe. There’s no mixing, no waiting for hydration to soak in, no guessing whether it’s ready. You pick it up and it’s already where it needs to be.

Engineered to stay exactly where you place it

What holds it together in a malleable sticky consistency before placement and gives it stability once it’s in the defect is a component called OsteoBiol® TSV Gel. It gives OsteoBiol® GTO® ideal stickiness and the ability to adapt to the shape of whatever you’re working on, whether that’s a socket, a ridge, etc. Once it’s placed, it stays placed. OsteoBiol ® TSV Gel is a heterologous gel diluted in aqueous solution containing a biocompatible synthetic copolymer that gives OsteoBiol ® TSV Gel thermo-

reversible and thermo-gelling properties. This biocompatible synthetic copolymer gives the gel its thermosensitive behaviour, meaning it responds to the body’s temperature once it’s placed. This is part of why it settles and stabilises the way it does, rather than just sitting loosely in the defect. Collagen is also embedded within the Dual-Phase OsteoBiol ® GTO ®’s xenogenic bone granules, and the added OsteoBiol® TSV Gel builds on that further.

See the handling for yourself

Watching this video https://www.osteobiol.com/ science/video/osteobiolgtor-video - tells you more than any of this text can. That’s the point. It’s not a claim you have to take on faith it’s something that you can see for yourself!

Collagen improves handling and also supports healing

Here’s the part that’s easy to miss. Collagen Gel makes OsteoBiol® GTO® easy to handle. Collagen also stimulates the natural healing process. Once it’s in place, that collagen matrix helps blood clot around the granules and draws in the cells responsible for repair and regeneration.

Supporting soft tissue healing and angiogenesis

It’s also been shown to support gingival cell proliferation, which in addition, to how well the soft tissue heals around the graft, not just the bone underneath it.

So, the handling and the biology aren’t two separate features bolted together. They come from the same material doing what collagen naturally does, whether that’s holding its shape in the defect or giving the body something familiar to build on. That soft tissue effect isn’t just observed; it’s being measured directly. Research from Aix-Marseille University found that OsteoBiol® GTO®’s higher collagen content led to notably stronger periodontal ligament cell activity compared to other materials tested, alongside the strongest recruitment of the blood vesselforming cells needed to support healing around the graft.

Evidence for bone regeneration

For those who want the science behind it, a 2025 in vitro study compared OsteoBiol® GTO® against other collagenic bone substitutes on human oral osteoblasts. OsteoBiol® GTO® and OsteoBiol® Gen-Os® combined with TSV Gel were the strongest performers for cell adhesion, collagen deposition, and markers of new bone formation, alongside a related collagen gel comparison group. On gingival healing specifically, a study from Aix-Marseille University group tested OsteoBiol® GTO® directly on human gingival cells through a barrier membrane, alongside OsteoBiol® Gen-Os® and Anorganic Bovine Bone. OsteoBiol® GTO® significantly increased gingival cell proliferation and wound colonisation compared to both the control and Anorganic Bovine Bone, and it drove the strongest angiogenic response of all three materials, with greater growth factor secretion and new blood vessel

formation than the control. It also triggered the strongest recruitment of the stem cells needed to support bone healing underneath.

Why this matters in everyday surgery

So, what does this actually mean day-today? It means the same reliable handling, the same confidence, whether you’re performing a sinus lift, a ridge preservation, or dealing with a peri-implant defect. That consistency matters more than it might seem on paper. The fewer variables you’re managing mid-procedure, the more attention you actually have left for the part that needs it, the surgical site itself, the patient, the outcome.

Less time managing the material

None of this is about OsteoBiol® GTO® doing something that is not science-based. It’s collagen doing what collagen already does, handling and healing, just packaged in a way that makes your task easier instead of adding to your workload. For more information, visit www.trycare.co.uk/osteobiol-by-tecnoss n

A-dec® 500 Pro Package: The Peak of Connectivity and Ergonomics

n today’s ever-evolving dental environment, connectivity and flexibility both play an essential role in enhancing practice efficiency and patient care. The A-dec® 500 Pro Package represents this approach seamlessly integrating advanced technology, ergonomic design and customisable features. From intelligent software updates to patient-centered comfort, this package is designed to support practice growth while delivering a reassuring experience for both dentists and patients.

Advanced Integration

The A-dec+ app offers unparalleled connectivity within the 500 Pro Package. This updatable software ensures practices stay at the forefront of technology by offering real-time updates, new clinical features and seamless integration across multiple operatories or locations. The intuitive, 7-inch Dynamic Screen 7 (DS7) touchscreen allows dentists to customise settings, such as chair positionings and procedure-specific configurations, syncing these preferences across numerous practices. On-screen messaging facilitates communication between operatories without disrupting workflow, enhancing team coordination and efficiency.

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Patient Support

Patient comfort is dominant with the Package’s A-dec 500 Dental Chair. Its close proximity design and adjustable headrest ensure optimal positioning for each and every patient. The Stingray-shaped, ultrathin backrest and supportive armrests accommodate diverse body types, ensuring optimal positioning for patients and maintaining healthy posture for dentists. Additional features, such as the toe-board tilt and gentle hydraulic motion, provide a calming patient experience, reducing anxiety and nurturing positive interactions. With a sturdy structure supporting up to 500 pounds (227kg), this chair promotes stability and ease of access, making it the ideal asset for high-volume practices.

Streamlined Workflows

A-dec’s ambidextrous 500 Pro Delivery System is designed for versatility and efficiency. Its intuitive interface supports a broad range of dental procedures, including hygiene, general restorative, endodontics and implantology. Rotary modes, real-time Apex locator visuals and integrated implant capabilities streamline complex procedures, providing dentists with precision, control and confidence.

example, upgrading to A-dec’s Continental delivery system suspends tubing and hoses, improving infection control and reducing risk of cross-contamination. Upholstery options, along with various accessories such as surgical lights, cuspidors and monitor mounts, enable full personalisation. A-dec’s Dream in 3D tool enables users to visualise and design their perfect dental equipment set up in a fully interactive 3D space. This flexibility ensures practices can evolve over time, incorporating new preferences and technologies as needed. The Delivery System’s balanced tubing, adjustable handpiece holders and in-plane switching screen technology all ensure a smooth, ergonomical experience for dentists and team members. Featuring flexible arms with radius delivery, the 500 Pro Delivery System also maximises efficiency while maintaining a clutter-free workspace.

Customisable Design

A-dec offers tailored options, allowing practices to personalise their setup. The different delivery system options – Continental, Traditional or 12 O’clock - each come with unique features to suit various workflows. For

Future-Ready Practices

The A-dec 500 Pro Package is built for high-volume practices and dentists seeking maximum integration and ergonomic excellence. Its robust design, combined with the software-driven platform, provides a solid foundation for growth and innovation. With reliable support, advanced features and a focus on patient and dentist comfort, the A-dec 500 Pro Package is an investment for practices’ futures. For more information, visit https://uk.a-dec.com/packages#500-pro. Alternatively, reach out to your local A-dec Territory Manager. n

The Probe | October 26

02/10/2026 12:19:48

GTO

The sticky xenograft • GRADUALLY RESORBABLE • HIGH ADAPTABILITY • STIFFENED BY BODY TEMPERATURE • POSITIVELY INFLUENCES GINGIVAL HEALING

WHY CHOOSE GTO®? GTO® is sticky, gradually resorbable and osteoconductive(1). GTO® is a Dual-Phase sticky xenograft characterised by high adaptability to the recipient site and high stability once grafted. GTO® allows adequate new bone formation(2-5) and socket volume preservation when used for GBR(5) in post-extractive sockets with delayed implant placement and even in cases of compromised post-extractive sockets. In combination with Lamina®, GTO® can also be the appropriate choice for the treatment of horizontal defects(2) (e.g. knife-edge ridges). Thanks to its stickiness and ease of handling, GTO® can be used to regenerate bone around peri implant dehiscences(6). Thanks to its high collagen content(1), GTO® allows an excellent rate of new bone formation(3-4), delivering adequate graft volume preservation(6), healthy new bone tissue and, ultimately, a successful implant rehabilitation(3-6). GTO® is a mixture of heterologous collagenated corticocancellous granules and TSV Gel, the component that provides its sticky properties(7).

HOW TO HANDLE GTO®? GTO® has been conceived as a universal biomaterial, easily adaptable to any bone defect. It is ready-to-use, pre-hydrated and remains stable in the defect site. Thus, clinicians can skip the hydration step with saline or blood, saving time and decreasing the risk of accidental exposure to pathogens.

300 international papers on OsteoBiol®

Scan to view publications

References 1. Jeanneau C et al. Materials, 2024; 17(3):625 2. Lopez MA et al. Am J Dent, 2024 Sept;37(SIA):41A-44A 3. Canullo L et al. J Dent, 2024 Aug 31 4. Passarelli PC et al. Am J Dent, 2024 Sept;37(SIA):9A-12A 5. Cinquini C et al. Clin Implant Dent Relat Res, 2025 Aug;27(4):e7008 6. Menini M et al. Dentistry Journal, 2024; 12(7):198 7. Taniguchi Z et al. Int J Oral Maxillofac Implants, 2024 Oct 4;0(0):1-28

Available from Trycare 01274 88 55 44 www.trycare.co.uk dental@trycare.co.uk TRYCARE | SUPPLIES. SPECIALITIES. EQUIPMENT. ENGINEERING.

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Products

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Margin elevation bands for deep restorations Garrison’s Slick Bands™ Margin Elevation Bands allow for proper adaptation and seal of deep margins so that a composite margin elevation can be performed. The deep margin elevation technique is a useful, non-surgical 2-step approach to treating deep localized margins. With the Margin Elevation bands, the technique has been significantly improved for an easier, faster, and more predictable application. The clinical scenario benefiting from a deep margin elevation: A deep localized margin which makes isolation during delivery difficult and unpredictable. The margin elevation technique allows proper isolation and elevation of the deep margin areas prior to restoring with an indirect partial coverage restoration (inlay or onlay) or a direct class II treatment

with a sectional matrix system. The Margin Elevation bands come in a pack with 50 bands and allow proper adaptation and seal of deep margins so that a composite margin elevation can be performed. The Margin Elevation Bands can be used with your high-quality Tofflemire or Siqveland retainer to provide the best gingival adaptation and contour for the deep margin areas. The margin elevation matrix is trimmed in height to allow improved adaptation to deep margin areas. garrisondental.com

New COMPO-JECT™ – designed for easy and controlled application The new COMPO-JECT™ from RØNVIG Dental is a lightweight, ergonomic composite dispensing gun for easy and controlled application of filling materials in standard unit-dose tips. Its integrated gear mechanism ensures smooth extrusion, even with high-viscosity composites, while helping to reduce strain on the hand and wrist. A unique clip-in lock system enables quick and secure tip replacement without piston retraction: simply insert the tip and start working. The tip rotates freely for optimal access and remains firmly fixed during application. COMPO-JECT™ is manufactured from

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High level decontamination The ability to destroy resistant micro organisms is vital for high level instrument disinfection. Bossklein are pleased to announce that IDactiv QUANTUM now has proven efficacy against two new highly resistant forms of microbial contamination – TB (EN 14563) and C diff. (EN 17126) Tuberculosis is caused by Mycobacteria, which are more resistant to chemical disinfection due to the structure of their cell wall. C.difficile forms highly resistant spores which can survive conditions that would eliminate many other micro organisms. These two are amongst the most challenging microorganisms encountered in instrument decontamination, this sets IDactiv QUANTUM apart from competitors.

At Bossklein, we believe that effective infection control starts with evidence, that is why we continually invest in testing and development. 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, serverdependent 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

An epic birthday bike ride

One simple change, genuine results

The Association of Dental Implantology (ADI) celebrates its 40th birthday in 2027! To mark the momentous event, four long-time ADI members will embark on an epic bike ride in the lead up to ADI Team Congress 2027, taking place on 15-17 April. Dr Andrew Little, Dr Adam Bzeu, Dr Amit Mistry and Dr Kasia Gurzawska will take on the fundraising challenge of cycling 200 plus miles to the event – and doing so in two days! From Banbridge in Northern Ireland to King’s Dock in Liverpool, the four will take on “200 Miles to Congress” to raise money for two brilliant charities: Dentists’ Health Support Trust and Young Lives vs Cancer. The Congress theme of

For exceptional at-home oral hygiene that will help your patients achieve genuine results, recommend the Cordless Advanced water flosser from Waterpik™. By simply implementing this easy step into their daily routine, your patients will be able to remove up to 99.9% of plaque from treated areas in just three seconds. This is especially important because the water flosser facilitates access below the gingival margin and between the teeth – where toothbrushing and traditional flossing can’t reach. The Cordless Advanced water flosser features a 360º rotating tip to make handling even easier, especially for those with limited dexterity. There are also four compatible flossing tips available to

Health and Wellbeing is highlighted by the ADI’s support of these two invaluable organisations. Every donation made will be split and sent directly to the two charities Donate today: https://www.adi.org.uk/ about/200_miles_to_congress If you have any questions, please contact claire@adi.org.uk or ania@adi.org.uk ADI Team Congress 2027, 15-17 April Join the ADI today! adi.org.uk

Clear and compatible Are you looking for an open, single image management system that is compatible with your hardware? The CDR Onepix from Clark Dental is the answer, designed to work clearly and seamlessly with other technologies for a flexible workflow. Able to collect and manage all your practice’s images with ease – regardless of the imaging devices used – the Onepix logically links each patient examination with customisable mapping tools, making it easier to gain a quick and comprehensive overview of each patient. Every file is stored in the DICOM format, the medical standard where all patient data is embedded in the image. Among the many benefits is the ability to stack multiple images in the same map location; to search functions by modality, region and tooth number; to visually

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illustrate predefined tooth markings; and the storage of digital impressions to help centralise all patient images. With a range of advantages and compatibility with an expansive collection of intraoral sensors, cameras, scanners and CBCT units, the CDR Onepix from Clark Dental speeds up computer tasks to enable more focused patient care. Find out more today. For more information call on 01268 733 146, email info@clarkdental.co.uk or visit www.clarkdental.co.uk clarkdental.co.uk

meet different patient needs, whether they have restorations, fixed orthodontic appliances, implants or periodontal concerns. Three water pressure settings ensure that individuals can customise their experience for maximum comfort as well. It was even named as a Telegraph Best Buy for 2026, showing just how popular the solution is becoming nationwide. Help patients make one simple yet powerful change to their oral hygiene routine – recommend the Cordless Advanced water flosser from Waterpik™. waterpik.co.uk

“The right tool for the right case” – the IAS academy builds versatility Dr Swati Anand came to the IAS Academy Fixed Level 1 course to build a solid foundation in the mechanics, and left with exactly that. “My motivation came from recognising the limitations of aligner-only orthodontics,” she says. “Not every case is suitable for aligners, and even when they are, treatment can be slower and less predictable. Developing fixed appliance skills felt essential for offering comprehensive orthodontic care rather than relying on a single modality.” Her goals were also to improve confidence in case selection and bracket positioning, and gain clarity on the theory behind both fixed and aligner therapy. All were met. “The course provided clear, structured teaching that made

fixed appliance principles feel logical and applicable in practice,” she says. “The hands-on elements, clinical demonstrations, and faculty guidance were particularly valuable.” Dr Anand left with greater confidence. “I now feel better equipped to offer evidence-based orthodontic options to my patients, and to choose the right tool for the right case. “The IAS Academy provides structured, ethical, and clinically relevant training that genuinely supports safe orthodontic practice. I would recommend it absolutely.” Tel: 01932 336470 (Press 1) courses.iasortho.com/courses

The Probe | October 26

17/09/2026 15:34:58

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Simple, safe and effective sharps storage Confidence in your waste workflows relies on safety at every step. The Eco Sharps Bin from Initial Medical reduce the risk of harm whilst keeping your practice compliant at every step. Made from puncture-resistant plastic, these used sharps containers minimise the risk of needlestick injuries. A sealed lid with a disposal door ensures items cannot be accessed after disposal, in line with current guidance. You can choose from a range of sizes, 0.5 to 32 litres, and we can provide colour-coded signage to suit your needs. If you are unsure which size will suit your workflow, the Initial Medical team will be sure to help.

Each Eco Sharps Bin is made from at least 40% recycled plastic, further supporting efforts to protect the environment. Contact the Initial Medical team to learn more, or visit our website. To find out more, get in touch at 0808 304 7411 or visit the website today www.initialmedical.co.uk

initialmedical.co.uk

A supreme sensor Achieve excellent image quality with the Xios Supreme AE, supplied by Clark Dental to decrease diagnosis time and deliver an exceptional standard of intraoral care. Built with flexibility in mind, the Xios Supreme AE is a leader in its class, equipped with multiple functions and features like varied cable lengths, sensor sizes and connectivity options. This ensures adaptability with your daily workflow, supporting a practical application and easy integration. Ideal for general dentistry, endodontics, restorative treatments and hygiene procedures, utilising the Xios Supreme AE bolsters chairside diagnosis with its premium image quality. The sensors

are available in three sizes too, encompassing paediatric patients, single tooth images for smaller adults, and adult bitewing and single tooth images. Proven image sharpness, ease of use and patient flexibility – the Xios AE Supreme is a first-class solution for your dental practice. Find out more 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

Reap the rewards The Solventum™ Filtek™ Composite Warmer Kit allows a little warmth to make a big difference. The solution is designed for use with warming-indicated Filtek™ Dental Restoratives, and can heat up to six capsules and one flowable syringe simultaneously. Its simple implementation produces many benefits for clinicians: • Easy-to-use one-button solution • A 10-minute fast start, and two minutes to heat composite means faster workflows • Warmed composite held for up to one hour, to avoid treatment interruption • Suited flowable syringes can be heated up to 25 times, minimising excessive waste • A hand-held design preserves worktop space

The portable holder can also be moved whilst retaining heat, for simple use throughout the workflow. The Solventum™ Filtek™ Composite Warmer is also a Red Dot Product Design Winner, acting as a simple to use and stylish addition to the practice. You can find out more about restorative solutions from Solventum when you contact the team today. For more updates on trends, information and events follow us on Instagram at @ solventumdentalUK and @solventumorthodonticsemea solventum.com/en-gb/home/oral-care/

3-in-1 and one-for-all A total oral care system that helps achieve a 100 per cent clean – Tahir One is a powerful solution for daily oral care. A comprehensive 3-in-1 experience awaits patients who integrate Tahir One into their hygiene routine. Functioning as an electric toothbrush, electric flosser and electric tongue cleaner, the cutting-edge system improves hygiene outcomes and reduces the risk of oral disease. Using a single button, patients can switch between four professional modes: Floss, Tongue, Sensitive and Deep Clean, with the latter able to guide the user tooth by tooth, ensuring every tooth gets the deserved amount of attention. Optimised for comfort and compliance, Tahir One delivers excellent performance,

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giving patients an invaluable solution with which they can be proactive in keeping their smile clean, healthy and therefore happy. The Tahir One Electric Flosser is available for patients at tahiroralcare.com and through Harrods. For practice enquiries and professional ordering, visit tahiroralcare.com. tahiroralcare.com

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Managing dental pain in the polypharmacy patient When pain in polypharmacy patients requires management, the decision tends to be more complex. NSAIDs carry risks. Paracetamol may interact with other medications. Orajel® Dental Gel and Orajel® Extra Strength provide an effective and practical alternative: fastacting topical relief containing 10% and 20% benzocaine respectively, acting locally at the site of pain in just two minutes with minimal systemic absorption. For patients where systemic analgesics require caution, topical benzocaine is a safe, evidence-appropriate bridge to definitive dental treatment. Learn more

about Orajel® today. For essential information, and to see the full range of Orajel® products, please visit https://www.orajelhcp.co.uk/ orajelhcp.co.uk

“Pain free. No issues since” – patients praise EndoCare’s specialist care A recent patient has highlighted the exceptional experience their elderly mother received at EndoCare – from the moment they arrived to the completion of her root canal treatment. The patient praised the welcoming reception staff at the Richmond practice, noting the warmth and practical support on arrival. Dr Federico Foschi, Specialist Endodontist, was described as ‘so informative’, with the procedure carried out ‘promptly and pain free’. EndoCare is a specialist private endodontic group with practices in Harley Street and Richmond. Our team of Specialist Endodontists brings decades of

experience to even the most complex cases, supported by cuttingedge technology and a patient-first approach that extends across every touchpoint – clinical and otherwise. We keep referring dentists informed throughout, ensuring a truly collaborative relationship going forward. Learn more about how EndoCare can help today. For further information, please call 020 7224 0999 or visit the new website www.endocare.co.uk. endocare.co.uk

SprintRay 3D printing – consistently flawless performance “I was looking for minimal possible errors. I have tested so many printers and SprintRay is by far the best… the Pro 2 3D printer is faultless every time.” After testing countless printers, Dr Haris Stratakis, the founder of Positeeth in Bristol, sourced the printer that stands second to none when it comes to delivering fast and reliable in-house crowns. “Every other printer failed at some point” he explains, “the SprintRay Pro 2 3D printer hasn’t failed once.” The Pro 2 is designed to be the most accurate 3D printer on the market; the patentpending Optical Panel Technology offers 35µm resolution and zero distortion. Used daily within his practice for 3D printed composite bonding, the Pro S guarantees consistent precision

for the most aesthetic results – maximising patient satisfaction insurmountably. “It’s the best quality I’ve ever seen,” he adds. “It’s so reliable that I have never had to contact customer support with issues or breakages – but if I ever do, I know the team is super-friendly.” The SprintRay Pro 2 3D printer is next generation, delivering unprecedented accuracy and throughput. Find out more about taking your workflows to the next level, contact the team today! sprintrsy.com/en-uk

Tandex brought smiles around Copenhagen’s lakes in support of SMILfonden On 5 June 2026, Tandex hosted Smiles around the Lakes in Copenhagen, a charity event held in aid of SMILfonden. Families, friends, colleagues, and supporters came together around the city’s lakes for an afternoon of community and shared purpose. Some chose a relaxed walk, while the more energetic took on the route at a run. The atmosphere was warm and full of life from start to finish, with plenty of smiles along the way. Most importantly, the day helped support children living with serious and chronic illnesses across a range of diagnoses. Every step taken and every donation contributed to a cause close to the hearts of all involved.

A huge thank you to everyone who took part, donated, volunteered, and helped make the day so memorable. Tandex is giving dental professionals the opportunity to win a free FLEXI Educator kit by answering just a few questions! Enter the quiz by 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/. tandex.dk

The Probe | October 26

17/09/2026 15:35:15

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business & finance

Buyer demand surges as competition for quality dental practices intensifies

pecialist business property adviser, Christie & Co, has launched its Dental Market Review 2026, revealing a dental sector entering a new phase of confidence, with corporates, private equity investors (PE) and larger group operators returning to the acquisition trail and competition intensifying for the highest-quality practices and groups. Drawing on Christie & Co’s transactional data, valuation activity, consultancy projects and a survey of more than 27,000 dental professionals, the report highlights growing patient demand, strengthening goodwill values, renewed investor confidence, and a clear “flight to quality” among buyers. The report shows that demand continues to outstrip supply for the most desirable opportunities, with 57 per cent of accepted offers in the first six months of 2026 completing at or above asking price. Improved lending conditions, stronger profitability, and growing confidence among acquirers have contributed to a resurgence in market activity, particularly from corporate and larger group operators.

Competition intensifies for highquality practices

The report highlights a significant resurgence in market activity. Independent buyers remained the dominant force throughout 2025, accounting for 77 per cent of offers received. However, corporate and larger group operators have returned more confidently in 2026, so far accounting for 50 per cent of offers. Demand continues to exceed supply for the most desirable opportunities, with 57 per cent of accepted offers in the first six months of 2026 completing at or above asking price. Goodwill values are also strengthening, supported by investment in technology, infrastructure, patient experience, workforce retention, and operational resilience. Practices and groups demonstrating strong financial performance, stable clinical teams, and clear growth opportunities are attracting the strongest buyer interest. While private dentistry remains a key growth driver, the report also identifies a renewed demand for NHS and NHS-led mixed practices following recent contract reforms. Corporate operators and larger dental groups are increasingly attracted to businesses offering stable contracted income alongside opportunities to expand private services over time. This revival has broadened the pool of active buyers and supported the boost in pricing across the transactional market.

Practice owners remain confident and invest for growth

Despite ongoing workforce and cost challenges, sentiment across the profession remains broadly positive, according to a survey of more than 27,000 dental professionals. Almost four in 10 respondents (39 per cent) said they feel positive about the sector, compared with 30 per cent

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who feel negative and 31 per cent who remain neutral. Confidence is also being reflected in investment plans, with 61 per cent of professionals intending to invest in new technology and equipment over the next 12 to 24 months, while 32 per cent plan to recruit additional staff.

Demand rises for both NHS and private dentistry

One of the report’s most significant findings is continued growth in patient demand across the profession. Christie & Co’s survey reveals that almost two-thirds (65 per cent) of dental professionals reported increased demand for NHS dentistry over the last 12 months, while 45 per cent also reported growing demand for high-value elective dental treatments. The findings demonstrate the continued importance of NHS provision while highlighting the strength of the private dental market – reinforcing the sentiment that one cannot coexist without the other. At the same time, the overall UK dental market value is forecast to reach approximately £15 billion by 2027/28, with much of that growth expected to come from private-pay services.

Workforce challenges persist but reasons for optimism emerge

Recruitment and retention remain the biggest operational challenge facing the sector. However, the report identifies several developments that could improve workforce supply in the years ahead.

For the first time, internationally qualified dentists accounted for the majority of new registrations in 2025, representing 53 per cent of all new entrants to the profession. Changes to the Overseas Registration Examination (ORE), reforms to the Licence in Dental Surgery (LDS) pathway and expanded training capacity are expected to further increase the number of dentists entering the workforce. Reflecting this optimism, more than four in five survey respondents (82 per cent) believe recent changes to training and examination pathways will help increase the delivery of NHS and/or private dentistry in the future.

CMA review creates questions but investor confidence remains intact

The report also examines sector views on the Competition and Markets Authority’s review of private dentistry. While 39 per cent of respondents said they were concerned about the investigation, the majority (56 per cent) described themselves as neutral or unsure, suggesting uncertainty rather than widespread alarm. Christie & Co believes that greater pricing transparency and consumer communication requirements are more likely outcomes than any structural intervention in what remains a highly fragmented market. Paul Graham, Managing Director - Medical at Christie & Co, comments, “The dental market has entered a new phase. After a period where independent buyers led much of the activity, we are now seeing larger dental groups, corporates, and private

equity-backed investors return with greater conviction and compete aggressively for the highest-quality opportunities. “What is particularly notable is that this increased demand is not being driven by speculation or financial engineering. Buyers are being attracted by strong underlying fundamentals, growing patient demand, improving profitability, and the long-term resilience of the sector. As a result, quality practices and groups continue to attract significant interest, often generating competitive bidding and achieving premium values. “We are also seeing a broader range of buyers targeting NHS and mixed practices than at any point in recent years. Recent contract reforms, combined with the opportunity to develop private income streams over time, have strengthened the appeal of these businesses and expanded the active buyer pool considerably. “Whilst challenges remain around workforce, cost pressures and access to care, the overwhelming message from this year’s review is one of confidence. Demand remains strong, capital is available, and well-run practices continue to be highly sought after. For owners considering their options over the next few years, market conditions remain exceptionally favourable for quality businesses.” To read the full Dental Market Review 2026 report, visit: christie.com/ sectors/dental-practices/ market-review/ n

The Probe | October 26

02/10/2026 12:21:56

25-27 NOVEMBER 2026 | COVENTRY

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COURSE DETAILS vssacademy.co.uk/courses/cadaver-course

24/09/2026 17:48:24

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business & finance

The tooth hurts, but the back hurts more Why dentists need income protection

n his 1999 number one hit ‘Everybody’s Free (To Wear Sunscreen)’, one of the pearls of wisdom Baz Luhrmann dispenses is: “The real troubles in your life are apt to be things that never crossed your worried mind – the kind that blindside you at 4pm on some idle Tuesday.” Expectation is important in the human experience. When things happen that we don’t expect, we can experience the extremes of our emotions – everything from joy to heartbreak. The things that hit us hardest are often the things we least expect. No one expects to be unable to work through ill health. Everyone thinks they’re indestructible. Until they’re not. Suddenly, they’re blindsided at 4pm on some idle Tuesday with the news that they’re going to be unable to work and, consequently, unable to earn money for a significant period of time due to a serious health issue.

Planning for the unexpected

I’ve spoken many times in previous articles about the importance of planning. A lot of the time, it’s about planning for the future through saving and investing. It’s vitally important to plan for the worst, too. This is where protecting your income can come in. Why dentists are particularly at risk In Wesleyan’s income protection claims data for 2025, the most common claim from dentists was for musculoskeletal reasons (making up 38% of claims). By comparison, claims for the same reason by hospital doctors and GPs made up only 25% and 11% of their totals, respectively.

The reason for this is that dental work often involves repetitive movements, prolonged static postures and awkward positioning while treating patients. Musculoskeletal disorders are one of the most significant occupational health risks for dentists, with neck and back pain being particularly prevalent. The next most common income protection claim from dentists at Wesleyan in 2025 was as a result of tumours, accounting for 13% of claims. Of course, this isn’t necessarily specific to dentistry. The equivalent claim figures for tumours among hospital doctors and GPs were 16% and 19%, respectively. But a tumour is something that can be diagnosed at any time, for anyone, so this underlines the general risk in this area.

The mental health factor

The third most common reason for claims from dentists was mental health. Dentists aren’t necessarily uniquely predisposed to mental illness because of dentistry itself, but the profession combines several re c o g n i s e d psychological s t re s s o r s : highprecision work, anxious patients, time pressure, business responsibilities, professional isolation and chronic physical strain. Together, these factors can increase the risk of burnout, anxiety, depression and s t re s s - re l a t e d d i s o rd e r s , potentially leading to long periods of being unable to work.

What happens when the income stops?

For the vast majority of people, a loss of (or significant reduction in) income would have a major impact on their

standard of living and their ability to support their loved ones. The move away from NHS dentistry over recent years means that many dentists are no longer eligible for sick pay from the NHS, so that safety net has been removed. Many people would say that their house is their most valuable asset, but I would argue that it’s actually you – and your ability to earn money.

Your most valuable asset could be you

For example, if we look at a dentist over the course of a 35-year career, earning £100,000 a year over that period, that’s up to £3,500,000 of income that could be lost if that dentist were diagnosed with something serious and became unable to ever work again. This, of course, doesn’t account for factors such as inflation, but it illustrates the point well. If you had a physical asset worth £3,500,000, would you insure it? I suspect that you would.

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.

What’s your plan B?

Your income is vital to your standard of living. Given the increased risk of losing income due to accident or sickness posed by the nature of dentistry, it’s important to consider your plan B should life not go as you planned. The decision to protect your income or not is entirely yours, of course. But, as food for thought, I’ll finish with a further quote from Baz Luhrmann’s song: “Your choices are half chance, so are everybody else’s.” The question is, do you want to take that chance? n

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 | October 26

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BUSINESS & FINANCE

NHS activity is rising. Is your practice value rising with it?

HS dental activity is rising. More treatments are being d e l i v e re d , m o re U n i t s o f Dental Activity (UDAs) are being completed and more dentists a re re c o rd i n g N H S a c t i v i t y. B u t does a stronger national picture mean your NHS practice is becoming more valuable? The latest NHS Dental Statistics for England show 37.6 million courses of treatment were delivered during 2025/26, an increase of 6.2% on the previous year. UDAs also increased by 5.1% to 76.8 million, while 25,419 dentists recorded NHS activity, up 3.1%. But rising activity does not necessarily mean an equivalent increase in NHS capacity, nor that p a t i e n t s a re f i n d i n g i t e a s i e r t o access routine care. For practice owners, the figures provide useful context, but national statistics can only tell you so much about the position of your own business. Tw o p r a c t i c e s o p e r a t i n g w i t h i n the same NHS market, with similar contract values and comparable t u r n o v e r, c a n h a v e v e r y d i ff e re n t values when they come to market.

What does the national picture mean for your practice?

Market statistics help explain the environment in which a practice operates, but they do not determine what an individual business is worth. P ro f i t a b i l i t y, s t a ff i n g , contract performance and the extent to which the practice relies on its principal can all influence how a potential buyer views an opportunity. Contract performance is particularly important. A practice that can reliably deliver its NHS activity, without persistent underperformance or clawback, gives a buyer greater confidence in the maintainability of that income. The 2026 reforms are also changing the economics of delivering some NHS care, including changes to urgent and unscheduled c a re , complex-care pathways and the way some treatments are rewarded. If those changes allow a practice to deliver its NHS contract more sustainably and at a better m a r g i n , t h a t c a n f e e d d i re c t l y i n t o p ro f i t a b i l i t y. L o w e r c l a w b a c k exposure, more predictable contract delivery and improved ear nings can all strengthen the financial profile sitting behind a valuation. F o r m i x e d p r a c t i c e s t h e re m a y b e a s e c o n d c o m m e rc i a l b e n e f i t . I f N H S a c t i v i t y c a n b e d e l i v e re d m o re e ff i c i e n t l y, t h i s c a n c re a t e additional c h a i r- t i m e c a p a c i t y. Where that capacity is then converted into established private o r p l a n i n c o m e , t h e re s u l t c a n b e h i g h e r m a i n t a i n a b l e p ro f i t a b i l i t y.

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Higher maintainable earnings, dependable NHS income and demonstrable private growth can all strengthen the proposition to a buyer. The more useful question for an owner is therefore: how is your own practice positioned within today’s market?

What are buyers looking for in an NHS dental practice?

Across the market, we continue to see appetite for strong NHS and mixed practices. But the presence of buyers does not mean every practice will be viewed in the same way. A n N H S c o n t r a c t c a n p ro v i d e an attractive foundation, offering recurring income alongside established patient demand. Buyers, however, also want confidence that the income and profitability they are acquiring can be maintained following a change of ownership. That means looking beyond headline contract value at factors such as: • NHS contract value, UDA rate and historic performance • Maintainable profitability • Associate availability and stability • Reliance on the principal to deliver clinical activity • Private and plan income • Staffing and operating costs • Premises and tenure • Compliance • Opportunities for future growth For mixed practices, genuine private growth potential is also important. But buyers and valuers will distinguish between potential and realised performance. Available chair time on its own does not necessarily increase value; a track record of converting that capacity into additional profitable revenue is far more persuasive.

Ultimately, buyers are looking at the business behind the NHS contract: how sustainable it is, how dependent it is on its current owner and how confidently it can continue to perform after a sale.

A valuation can give you something particularly valuable: time

Practice owners sometimes associate a valuation with the point at which they are ready to sell. But understanding your value earlier can be much more useful. A p ro f e s s i o n a l d e n t a l p r a c t i c e valuation can help you understand what is driving value today, what may be holding it back and where there may be opportunities to strengthen profitability or buyer appeal before a future sale. If you identify something affecting value when you are already preparing to sell, your ability to change it may be limited. Identify it two, three or even five years earlier and you have more time to act. For an NHS or mixed practice, that might mean understanding whether contract delivery is consistent across the year, whether under- or o v e r p e r f o r m a n c e i s c re a t i n g r i s k , what margin is being achieved from NHS activity and whether available capacity is being used effectively. The most useful outcome of a valuation is not always the number. Sometimes it is identifying an opportunity you still have time to act on.

NHS dentistry is changing. Do you know where your practice stands?

The latest NHS Business Services Authority (NHSBSA) figures cover the financial year ending 31 March 2026. They therefore largely reflect

activity before the latest NHS dental contract and payment reforms began to take effect. It is still too early to judge the longer-term impact of those reforms on the dental practice sales market. What matters commercially is how any changes translate into sustainable performance at practice level. If reforms improve contract delivery or profitability, or create capacity for established private growth, those improvements may ultimately influence value. For owners considering a future sale, that makes understanding the individual position of their business more valuable than following national trends alone.

National statistics can tell you what is happening across NHS dentistry. A valuation can tell you where your practice sits within that market.

Selling a dental practice is rarely a decision made over night. Whether a sale is likely within the next 12 months or remains several years a w a y, u n d e r s t a n d i n g y o u r v a l u e early can give you more time, more information and more options. At Lily Head Dental Practice Sales, we provide confidential, no-obligation dental practice valuations alongside practical insight into the factors that could influence your future sale. Know your value. Understand your options. Plan your next move with confidence. 

About the author Chris Mayor, Commercial Director, Lily Head Dental Practice Sales.

The Probe | October 26

02/10/2026 12:25:59

TANDEX FLEXI and TANDEX PREVENT Gel TANDEX FLEXI is a specially designed interdental brush with an ergonomic grip. The flexible grip makes it easy to reach for all patients even interdental spaces in the back of the mouth.

TANDEX FLEXI gives an efficient and gentle treatment for both teeth and gums. It includes 11 different sizes so there are brushes to suit small interdental spaces or more complex bridge and implant spaces. Your dentist or dental hygienist will help you find a size that is right for you.

TANDEX PREVENT Gel is a specially developed gel with 900 ppm fluoride and 0.12% chlorhexidine. Strengthens enamel and protects against plaque and cavities. It provides effective cleaning between the teeth. An antibacterial gel designed especially for use with interdental/gum brushes.

For more information visit https://tandex.dk/ To request samples and place orders, please visit DHB Oral Healthcare at https://dhb.co.uk/

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24/09/2026 17:52:22 03/11/2025 11:10

www.the-probe.co.uk

BUSINESS & FINANCE

How to sell a dental practice

Step 2: Marketing and the Sale Process

ollowing on from my previous article on the valuation process and ensuring that the valuation is maximised, we now look at finding the right buyer for you. Sales particulars will be produced to provide the potential buyers with all the relevant information, and your agent can also make sure that you have everything in place ready for selling.

Who are your Potential Buyers?

After completing a valuation of the practice, looking at both an ‘associate-led’ and ‘principal-led’ model, we have now identified who your practice would be suitable for. If the practice works best under a principal-led model, then the likely buyer is a new owner-occupier who is going to work in the practice. However, where the associate-led model gives the better value, then this can be sold to a Corporate, mini-Corporate or an owner-occupier. Whilst there often used to be a thought that a practice over £1.5m–£2m+ needed a Corporatestyle buyer, this is certainly not the case any more. The banks have been willing to lend significantly higher amounts over the last couple of years, and we have seen a number of instances with firsttime buyers raising in excess of £2.5m with only a 5% deposit. As such, it is better to find the best person that suits you and your practice.

Differences of Corporates vs Individuals

Corporates can be an attractive option for many as they generally have funds ready to purchase, and the legal process is often much quicker due to them having a team of staff dedicated to the purchase. However, with a Corporate there will likely be a tie-in for the principal and an element of the sale proceeds to be deferred – often with targets to be met. With an owner-occupier, they would generally pay the full price upfront and may not need the principal to remain, although in larger practices we do tend to manage to allow the principal to stay if they wish to remain post-sale. Smaller groups can also be the best of both worlds, as they generally think like an owner-occupier but have some level of backing or experience like a Corporate.

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Finding Buyers

This is where a specialist dental sales agent can add significant value. Whilst most dentists will know the large Corporate household names, there are a large number of lesser-known Corporates and new entrants in the market. A significant amount of an agent’s time is spent speaking with these types of buyers, understanding what they are looking for and also understanding their ‘push points’. Some Corporates may be less concerned about the deferred amount or, say, turnover-based targets. An agent will be able to find suitable buyers based on your preferences. If we are looking for an individual buyer, then having an agent who is active in the market is key to ensuring that your practice gets to those people who are looking. Most agents will have thousands of active buyers registered with them looking for practices, which would then be broken down per location and practice type that those buyers are looking for. I am also a strong believer in giving a client a number of offers to choose from, as this ensures that you can maximise an offer and also compare terms, which can be key. With multiple offers, the price and terms can often be negotiated even further to ensure that you get the best offer. It is also important that we have all of the details of the offer which may affect your decision-making, as without this you may then proceed to the legal work to find out you are not happy to accept some requirements.

withdraw the application if the legal process is not finished in time; put it in too late and you may have to put your sale back by months. Another job of the agent is making sure that the buyer has finance agreed, that their bank instruct the valuation early doors, assisting with the supplying of information and ensuring that they have everything needed to maximise the value, so it doesn’t fall short of the agreed price. The work of an agent for this element is often not considered, but invariably there will be significant hours spent making sure that the sale and the timing stay on track.  Next issue: Step 3: You’ve sold your practice. What next for your money?

Sale Process

The job of an agent is not complete once a buyer has been found. The sale will need to be managed as there are many people involved in the transaction (seller, buyer, two sets of commercial solicitors, two sets of property solicitors, buyer’s bank and bank valuer). The process has a lot of moving parts, and the agent will try to ensure that all parts of the process are completed at the correct time. Put your CQC application in too early and you may need to

About the author Martyn Bradshaw is a Director of PFM Dental. PFM Dental provides: valuations and sales, practice finance, accountancy, legal, and financial services advice to dentists. If you are purchasing a dental practice, we can provide all the assistance that you need.

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business & finance

Exploring the dental locum recruitment market

s a result of changes to the NHS contract in England, some practices feel more confident about hitting their targets, leading to a reduced demand for locum dentists. Many temporary urgent care contracts that had been issued to locums were pulled at the beginning of April 2026 – changes to the underlying contract meant that urgent care was being covered by existing staff instead – meaning locums started to lose work at this time. Locum dentists, dental hygienists, and dental therapists offer practices a myriad of benefits when it comes to flexibility in managing patient lists and covering absence of permanent staff.

What practices are seeking

Amongst UK dental practices, there is still a demand for locum dentists. For example, if a practice is seeking a permanent associate, they may look to employ a locum in the meantime. This enables the practice to continue to provide consistent care for their patients in the interim. Locum positions can range from long term to short term, with some requiring a number of weeks to cover planned sick leave, a number of months to cover maternity leave, or a week or two to fill the gaps during annual leave or half terms. Demand is particularly healthy during school holidays, with additional peaks in January to March as practices re-open after Christmas and ensure they are able to meet their UDA targets for avoiding NHS clawback. That said, there is still demand throughout the year, including for assistance covering urgent dental care, with opportunities for locum dentists to work in the evening for an hourly rate seeing additional patients.

Regional discrepancies

In addition to the challenges associated with urgent dental care, there are a number of differences to consider when it comes to locations in the UK. Some regions are commonly more difficult to recruit for than others, for example, areas like Hertfordshire and London are generally easier, whilst more rural or coastal practices may struggle to fill full-time positions, like Yorkshire, County Durham, or Cornwall. Whilst this presents difficulties, bringing in locum dentists in areas where it’s traditionally more difficult to hire a fulltime associate helps to bridge the gap. In the short term, locums who do not live locally may be happy to travel for work, especially when aspects such as travel and accommodation costs are compensated. This is particularly true when a locum is struggling to acquire work in their local area, due to low demand.

What locum dentists offer

The flexibility that comes with locum dentistry offers numerous benefits for both parties. If a dentist is considering taking on locum work for the first time, it can be helpful to remember that they are not tied into a notice period in the same way as a permanent member of the team. However, it also means that if the dentist and practice develop a good working relationship, they might consider transforming to a permanent position. There’s no one size fits all with locum work – some locums offered a permanent contract will accept straight away, others might work at the same practice as a locum for years, without the need to transform to permanent. Additionally, locum dentists will respond to the different types of work required, such as emergency dentistry, demand in prisons, increased need at corporates, or even upcoming dental groups hiring locums through an agency whilst their recruitment team grows.

Support through the process

Dental Elite has an experienced locum recruitment team, laser-focused on matching dentists to the ideal practice and the best location to suit both parties. This can be particularly helpful for practices who feel more comfortable using a specialty agency to recruit the ideal person. Additionally, the Dental Elite team work hard on behalf of locum dental professionals to find them the best fit, contacting practices (whether they’re advertising or not) within their commuting distance to collate the best range of options. This helps to save both parties time and overwhelm often associated with traditional recruitment and job searching. Sometimes, practices may feel put off by hiring locums, if they have previously had bad experiences. That’s why Dental Elite do not just place a locum in a practice and step away. The experienced team recommends setting up an introductory call first, to help both parties establish a good fit, and keep communication lines open to support both dentist and practice to achieve the best possible outcomes.

Reacting to fluctuating markets

Ultimately, it’s important to be aware that demand for locum services goes in cycles, reacting to various market changes. It’s likely that demands will escalate as practices calculate that achieving their NHS contract is now more lucrative than it once was. For example, if a locum dentist carries out eight unscheduled care appointments in a day, at a rate of £80, they’ll generate £640 in income. This highlights that the contract changes have actually made locum services more equitable, especially when we consider the additional UDAs completed in addition to urgent appointments. For more information on Dental Elite, visit dentalelite.co.uk, email info@dentalelite.co.uk or call 01788 545 900 n

About the author Lisa McCusker, Senior Locum Controller, Dental Elite.

The importance of knowing your audience

f you have or are thinking about settingup a new dental squat or rebranding your current practice, there is a deluge of considerations to be made: what are the brand colours? What will the aesthetic of the business reflect about your values? What treatments do you want to focus on offering? To answer all these questions, you must consider who your target audience is. In a world of algorithms and tailored communication channels, you may have found yourself wondering ‘why am I seeing this?’ in response to a certain advert or video; how has that been connected to you? There is no exact formula for identifying and interacting with your target audience, but it is vital for dental practice owners to consider such demographic data as the age, gender, occupation and lifestyle of the patient base that you want to attract. This then informs the look, style and ethos of your dental practice.

Keeping things aligned

A patient can learn a lot about a business by the branding of the building, the interior design, the interactions with staff, the technology in use and the overall

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atmosphere. When these are all in line, they can become invisible to the patient; nothing too distracting or overbearing – just a strong focus on patient care. When making a major business decision, it is crucial to remember who the target audience is. If a new change aims to attract more patients and grow revenue, but will alienate the existing patient base, then that could be high risk. For instance, consider the transformative impact of advanced technology. Whilst younger demographics are perhaps more likely to accept and embrace state-ofthe-art equipment, older patients may be warier – a delicate balance is required to make sure your patients all feel welcomed and understood.

Integrating technology

Introducing an AI receptionist to your dental practice is one to weigh. The benefits are many: the admin team are freed up from smaller tasks, no phone calls are missed, information is available 24/7, patient care improves, revenue increases. However, there may be some patients, particularly older generations, who may feel uneasy with interacting

with artificial intelligence, especially when it comes to booking appointments and ensuring they will get the care they need. So, if your practice’s target audience does skew older, an AI receptionist may not initially feel right – but there are some further considerations to make. For starters, it’s essential that you choose the right AI receptionist tool that works for you and your patients. In this case, a patient whose call is referred to an AI system can still request to speak to one of the admin team, particularly in the event of a medical urgency as AI receptionists cannot legally triage emergency appointments. Furthermore, a well-designed AI receptionist is patient, polite and friendly; the idea of talking to

one sounds harder than the reality. For the best experience, patients shouldn’t feel like they are talking to a robot at all. When making decisions that will affect the dental practice, it is worthwhile to ask your patients. Do they think the change will improve their experience? This engagement gives you a better understanding of who your audience is, how best to help them, and the decision you must make to achieve this. 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

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

The Probe | October 26

02/10/2026 12:29:45

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