The Dental Technician Magazine July 2019

VO L 7 2 N O. 7 I J U LY 2 0 1 9 I B Y S U B S C R I P T I O N

VERIFIABLE ECPD FOR THE WHOLE DENTAL TEAM

THE TECHNICIANS MERIT AWARDS SCHEME Inside this month

www.dentaltechnician.org.uk w w w.d e n t a l t e c h n i c i a n .o r g .u k

NEW PRODUCT FOCUS THE TWISTER ARTICULATOR AND THE NEW SUPER RING PAGE 28

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DIGITAL TECHNOLOGY DIGITALLY SCANNING AND DESIGNING POST AND CORE

BY ANDREW WHEELER PAGE 24-25

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BY UR R S A EC UB C O S SE OL MM CR E LE EN IPT PA A D IO G GU IN N E E G 3

CLINICAL DENTISTRY EDELWEISS PEDIATRIC CROWNS: A NEW APPROACH TO RESTORING PRIMARY TEETH PAGE 16-17

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FROM THE DENTAL TECHNICIANS GREAT BRITAIN FACEBOOK GROUP AND THE DENTAL TECHNICIAN MAGAZINE SEE PAGES 8-9 & 13

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P.16-17

CONTENTS JULY 2019

Editor - Larry Browne FBIDST. FDTA, ITI Fellow, LCGI, RDT. E: editor@dentaltechnician.org.uk T: 01372 897461

Welcome

Designer - Sharon (Bazzie) Larder E: inthedoghousedesign@gmail.com

Focus

Advertising Manager - Chris Trowbridge E: sales@dentaltechnician.org.uk T: 07399 403602 Editorial advisory board K. Young, RDT (Chairman) L. Barnett, RDT P. Broughton, LBIDST, RDT L. Grice-Roberts, MBE V. S. J. Jones, LCGI, LOTA, MIMPT P. Wilks, RDT, LCGI, LBIDST Sally Wood, LBIDST Published by The Dental Technician Limited, PO Box 430, Leatherhead , KT22 2HT. T: 01372 897463 The Dental Technician Magazine is an independent publication and is not associated with any professional body or commercial establishment other than the publishers. Views expressed in this journal are not necessarily those of the editor, publisher or the editorial advisory board. Unsolicited manuscripts and photographs are welcome, though no liability can be accepted for any loss or damage, howsoever caused.

No part of this publication may be reproduced in any form without the express permission of the editor or the publisher.

Thoughts from the Editor

The Technicians Merit Awards Scheme DTGB

Marketing Simplified by Jan Clarke

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Clinical Dentistry Edelweiss Pediatric Crowns

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Company News Shofu/Trycare/ Zirkonzahn Candulor

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Digital Dentistry The Digital Symposium

20-21

Insight Welcome to Dental Doris: Moving on...

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Digital Technology inLab software update 19.0: organize and link digital processes efficiently Digitally scanning and designing Post and Core By Andrew Wheeler

ECPD

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The Twister Articulator / The new Super Ring

23 24-25

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Dental News The award-winning Stars of Dentistry at the heart of the London Dentistry Show!

Milk bottle tops appeal / BADN fellowship award / BDIA Dental Showcase New report addressing Children’s Oral Health Interview: “Mouth cancer is a growing problem”

Classifieds

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THOUGHTS FROM THE EDITOR

WELCOME to your magazine WELL, NOT EXACTLY FLAMING JUNE! l

With the Tennis at Wimbledon fast approaching it really does seem very dim and grim indeed.

The Brexit buffoons are still trying to make sense of it, with the Europeans and the rest of the world thinking we are all completely mad or constantly drunk. Every area of the economy and society is being affected by the uncertainty and now we are being asked to choose a Prime minister from many that would not make it as warm up acts for the sea side shows at Southend Pier. I don’t really know why it can be so difficult. The ruling party should agree with itself with regard to what it needs from society. It should also agree what it should be giving to society and then get on with it. Since the Brexit ghost appeared the rest of the urgent needs in the country have taken a back seat. Is it really worth assaulting the NHS system or ignoring the welfare needs, which are daily becoming more urgent? The politicians are unable to tell the voters what they know they can afford and achieve but refuse to reveal what they cannot. Much of what they cannot is buried under double talk and reference to payments not related to the process. I suppose it is democracy, but it is hard to believe they are in touch with what they claim or indeed the voters.

That’s my rant for now let’s get backs to the dental situation. Dentistry is moving inexorably towards a choice and private system. There seems to be so many complaining about the “System” but continuing to work away at their repair dentistry model, until they discover they can change their focus. More and more are opting to take post graduate degrees, and not just in “Implantology”. All the specialities are offering a way out, for those who are prepared to put in the leg work.

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Digital dentistry is certainly rattling the cage and the whole patient treatment experience becomes so different for both operator and patient. The final product is now being produced at the same quality levels as the analogue systems and in many cases, for a fraction of the time and far less cost in materials. There is of course the upfront investment in both equipment and time. You should learn as much as you can and practice using scanners etc. as much as you can so you can make a good judgement of which system meets your needs. “They don’t all, do it all!” You should know enough before you buy to be sure you are buying the ideal for your circumstances.

But you cannot ignore the technical and clinical potential of these systems. You will be left behind if you do.

The improvement in the “plastics” continues with beautiful composite aesthetically pleasing materials growing on the market. It is hard not to ignore the potential for these materials. They do still require the technician’s skill and judgement to make them consistently surpass the Ceramics and Ceram-metal choices, but they are very much closing the gap. They have the huge advantage that they can be changed, added to or redone chairside, in many more cases than the ceramic options, and the future will demand this.

With undergraduate dentists doing the three dimensional in the Virtual world on computers there is a very obvious lack of understanding of the manufacturing processes or needs. At a time when technicians are ringing their hands in despair of losing, their market share the new generation of dentists needs their

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abilities and experience even more. It is already evident that technicians are again being employed in practices where they have a facility to scan and produce restorations. But the final result needs the knowledge and experience of a professional technician. The future for many of you may well be in clinics, so get as good as you can at what you do and don’t undersell it when the time comes. Be very much the technical consultant so the patients can have a working replacement for their lost tooth or teeth.

Seeing patients during your working career as a Technician, I believe is essential for understanding and improving your creative dentistry. Working with your dentist clients and their patients on an interactive basis is the only realistic way of you learning about the patients’ needs and desires around their replacement teeth.

Even offering on a active basis, Shade taking will improve your knowledge of the process. I truly believe that a technician cannot develop his/her full potential unless they see patients. To the point that the teaching establishments should have some arrangement for every technician student to be in contact with patients through the teaching process. After all we are only making a replacement tooth or teeth. Seeing the environment around the area and the patients smile patterns etc. can really help to improve the students understanding of what it is they are doing.

Knowing anatomy is not enough, seeing it work around the area you are dealing with is essential for a true understanding of the final result.

Larry Browne, Editor

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EXTEND YOUR SUBSCRIPTION BY RECOMMENDING A COLLEAGUE There is a major change in CPD coming soon. The Dental Technician Magazine is a must read. Tell your colleagues to subscribe and if they do so we will extend your subscription for 3 months.

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FOCUS

THE TECHNICIANS MERIT AWARD

SCHEME

It is very easy to feel quietly superior and share the revelation with other technicians but in reality, the surgeon needs to be taken to one side and shown what he does not know. Otherwise the patients are being exposed to the potential of lasting damage.

We are beginning to see the evidence of undergraduate prosthetic teaching on the computer virtual model and it will continue to arise, because there is no real understanding of the technical process in the teaching programmes at almost any Dentist Undergraduate University worldwide. To me that is a fact of modern life and budget control which applies in all corporate type operations is not going to go away. What is the answer? I see it as quite simple, you technicians, who are the experts, must raise your status by being involved in the day to day clinical interaction with the patients. The relationship with the clinician must be closer and more interdependent. He needs your knowledge and you need his clinical knowhow. In the interest of the patient both sides of the fence must change. You can change your clinical colleagues by more direct interaction. More visits to the clinics, more occasions when the clinician is encouraged to bring his restorative queries or indeed his patients to the laboratory.

You must promote your availability and your importance and charge accordingly.

I thought “cap doffing” had gone out with the Victorians but of course it is only too evident across the laboratory world.

Noticeably not in Germany or other areas of central Europe, where qualification an a

“Meister” degree gives immediate status which is respected by the countries’ populace. It won’t happen unless you make it happen.

The future dentist will need your services even more and if you can tell him why ‘You’ and offer the quality and support he needs with an ongoing mutually supportive relationship, I do believe you will see quite a change in your life and your day to day working appreciation.

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ou will read in this issue and if you go online to the DTGB Facebook page, all about the proposed, Technician on Technician Scheme. The idea is you may enter and know, it is not a commercial enterprise but an attempt to get Dental Technicians and Clinical Dental Technicians to appreciate the talent that is around us in UK technical dentistry every day. As the backroom boys, we are seldom seen or even mentioned to the majority of patients and the front of house section of the restoring team often don’t even consider our part in the process.

While I know it would be a pipe dream for our roll to become dominant it should, in my opinion, become more noted and valued.

The process is not going to change because of one award scheme but if it encourages the talent, I know is available, to become recognised it will go a long way towards raising the self-esteem which is so lacking among technicians. A look in on the DTGB site, occasionally will reveal the problems of which we are all aware. The case shown just last week which illustrated an impression tray used completely incorrectly with the clinician criticising the tray manufacture and unaware of his own total ignorance!

Why pay more?

Don’t just sit and moan, wave the flag, brag about it and continue to work closer and closer with your clinical counterpart.

The Digital revolution will continue, and the systems will improve and spread but the need for your technical expertise on materials and methods will, I firmly believe, become more valued and will demand a greater reward.

The lot of the technician is that he will always be working to the prescription of the clinician but with the clear ability and experience of knowing how. Your talent does not have to be only in the dark and where patients are aware of your participation, with almost no exceptions, they are greatly pleased to have met and understood the craftmanship which is needed to make their restoration as they desired. They get to appreciate the value of their individually created restoration and those who were involved in its delivery.

From the beginning of my working life as an apprentice, I was required to see patients about their technical queries, take shades and sometimes explain why we were making what we were making. The restorative process cannot be successful in my opinion, without that interactivity. You as a technician can only learn so much via the work docket and even on the phone. The digital potential for daily interaction is huge but you need to know something about the protocols for each patient and the operating clinician and his team. I am utterly convinced the future, for technical experts working closely with clinicians is good and will become more so as the digital disciplines continue to grow.

The restorative processes are all reliant on good communication and even better co-operation. For too long both sides have decided to ignore, to some extent, the presence of the other. Perhaps our unfortunate history, with the imposition of the NHS and the political strength of the clinician organisations, has in a strange way warped the norms. Undoubtedly our commercial history has been equally damaged by that artificially imposed situation and has clearly created a huge anomaly which is not fit to be examined. The hand skills we have developed over the years will become less in demand but the need for the knowledge and experience will grow, as the poorly advised graduates emerge from the Universities without even being able to recognise a restoration, except on a computer screen.

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MARKETING SIMPLIFIED JAN CLARKE BDS FDSRCPS MARKETING

l Jan qualified as a dentist in 1988 and worked in the hospital service and then general practice. She was a practice owner for 17 years and worked as an Advisor with Denplan. Jan now works helping dental businesses with their marketing and business strategy and heads up the Social Media Academy at Rose & Co.

Web: www.roseand.co Email: jan@roseand.co Facebook: Jan ClarkeTaplin Twitter: @JanetLClarke Instagram: janlclarkeacademy LinkedIn: Jan Clarke BDS FDSRCPS

NEW ISN’T ALWAYS BEST

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ecently I noticed a Facebook post from a dental plan company where they were offering a free electric toothbrush to every patient that signed up in that month to one of their plans. Great, sounds like a super offer. I then started to look at some of the comments and wow were there some unhappy people. “What about us regular patients who’ve been with xxxx for years, don’t we deserve something?” Yes, the general consensus was that those who have been loyal members of this particular dental plan over the years didn’t seem too pleased.

Now we know you can’t please all of the people all of the time but this can be a contentious issue offering great deals to new customers. Just think about banks and satellite TV companies, phone providers, they’ve all been there and upset many an old customer in the meantime.

It’s forever enticing to attract new customers with these golden deals and in large businesses it can work but I think for smaller businesses it can be extremely damaging.

What does it say about the existing customers? Probably that we don’t value you as much as we want new blood and no one wants to feel they are second best.

Smaller businesses rely on loyalty whereas larger ones, particularly if there’s not much competition, perhaps don’t care as much about this area.

WHAT TO DO INSTEAD? Introductory offers may seem appealing but they are probably not a great idea for most smaller businesses unless you also offer them to existing customers.

WHAT ARE YOU TRYING TO ACHIEVE? An important question and one you must consider. What are you trying to achieve? A greater number of regular customers or just more items of work? If it’s more items of work then it may be prudent to look to your existing customer base. If it’s new customers and hence more items of work then you will need

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to consider how your existing customers will respond to any introductory offer. It doesn’t mean you shouldn’t consider an introductory offer just that you need to ensure you are not upsetting your regulars in the process.

HOW DO I DO THIS? Perhaps look at a loyalty bonus rather than introductory offer. Looking after our existing, loyal clients, I feel, is a far more intelligent marketing strategy than introductory offers.

Rewarding loyalty will build loyalty and a loyal customer will tell all about you.

You could offer a discount on a certain value of items of work or particularly a certain item that you want to increase. Many dental practices use several providers for their dental technical work so by offering loyalty discount you may well be moving work to you from another source. The dentist doesn’t need to find any more work, it was always there.

Everyone loves a freebie or a discount, you could even offer a free unit every 10 or so. This then doesn’t preclude you from offering introductory discounts as your existing customers are happy just as long as the introductory offer isn’t as good as the offer they receive from staying loyal to you.

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Your existing customers are a gold mine, don’t ignore that. Many have their own battles and problems in business and you can almost guarantee that they are hoping and trying to carryout more private and cosmetic work. Just try and tune in to their problems and help solve them for them. In the process you just may gain some business yourself.

INFORMATION EVENINGS Offering seminars away from your customers businesses allows them to gain knowledge about your products and they are then more likely to be able to offer these types of services for their patients.

BUILDING RELATIONSHIPS As ever the most important marketing strategy is to build relationships, get this right and you will have loyal customers for years to come.

Introductory offers are a nice idea but looking after the regular customers and empowering them through knowledge is far more preferable.

As ever I am here to help with any of these issues so do email or connect online with me, I look forward to meeting some of you in cyberspace!

30 October 2019

09:30 – 17:00 Venue: 3Shape UK, Reading

Dental technicians

7 HOURS CPD

Dentists

4 HOURS CPD

£95+VAT bring a dentist FREE!*

This unique one-day event brings together a selection of renowned speakers presenting the full 3Shape digital workflow for technicians.

It will include hands-on demos, practical experiences, tips and tricks and an exhibition area showcasing the very latest innovations in technology from the leading manufacturers.

Visit labvision.eventbrite.co.uk to register your interest for FREE *Technician + Dentist dual ticket: must purchase 2 tickets at £47.50+VAT each www.dentaltechnician.org.uk

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FOCUS

SOME OF THE POSTINGS DURING THIS MONTH. IF YOU WANT TO JOIN ANY OF THE CONVERSATIONS,GO ON LINE AT THE FACEBOOK PAGE FOR DENTAL TECHNICIANS GB.

SOME OF THE FEATURED POSTS FROM MEMBERS ON THE FACEBOOK PAGE.

IF YOU HAVEN´T SEEN IT TUNE IN NOW!!

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FOCUS

THE TECHNICIANS MERIT AWARDS SCHEME FROM DENTAL TECHNICIANS GREAT BRITAIN FACEBOOK GROUP AND THE DENTAL TECHNICIAN MAGAZINE Chris Trowbridge, our marketing l manager has done a sterling job in contacting and listening to those of you who

have thrown your hats in the ring, to form and build an organisation which can create an interesting and worthwhile Awards Scheme which recognises the skill and ingenuity of technicians for a truly well-earned award, from those of us engaged in technical dentistry.

I am delighted to confirm the following judges representing these awards categories as part of the brand new “The Technicians Merit Award Scheme.”

Best Ceramics/Crown and Bridge Technician - Judged by Glenn Harger (Bucks Oral Design) Best Prosthetics Technician - Judged by Chris Wibberley (CW Dentures) Best Orthodontics Technician - Judged by Andrea Johnson (OTA and Den-Tech) Best Chrome Technician - Judged by Dave Smith (Phoenix Dental Castings) Best Hospital Tech/Maxfac - Judged by Iain Mur-Nelson (St George’s University) Best Innovative Technician - Judged by Magnus Underhay (MJ Underhay Dental Lab) Head Judge is Bill Sharpling (LonDEC, King’s College London)

A winner from each of the above categories will be chosen by you, our readers and the Facebook group members from nominees chosen by our judges on a quarterly basis!

The response from the above names to being invited to participate has been extremely positive, some even overwhelmed and very flattered!! Bill Sharpling is undoubtedly the best qualified to act as Head Judge and as a reference point for any judges wishing to seek advice etc.

We will be creating a monthly newsletter that will appear in The Dental Technician Magazine and sent out to our email database offering key updates on entries, judges’ feedback, nominees and general news on the awards scheme.

This is a very exciting time and we look forward to seeing all of what you have to offer!

Essentially the idea behind creating this Awards Scheme is to encourage many dental technicians across the UK to showcase their work and achieve recognition by so doing.

All dental technicians can submit their entries to Dental Technicians Great Britain Facebook Group (if you are not a member join now!) or by post to The Dental Technician Magazine.

A website page will also be created on The Dental Technician Magazine website with key information regarding the scheme along with the rules and regulations.

There will also be two other awards that will be voted for at the end of the year rather than on a quarterly basis: Best Sales Representative Best Supplier

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FOCUS

DENTAL TECHNICIANS GREAT BRITAIN AND THE DENTAL TECHNICIANMAGAZINE These are your pages for comment, questions, case pictures, and anything you want to share with your fellow technicians.

DTGB GOES FROM STRENGTH TO STRENGTH COMMENTS FROM ALAN STEPHEN WRIGHT AND OTHER CONTRIBUTORS

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It is clear the interaction and contributions from our members of the group increases month by month, be they the humorous posts by our members.

CASE ADDED!!!!!!!

Or our members exhibiting their cases. Or just aspects of their daily graft. Thank you, James McHugh for your witty contribution.

Thank you all for continuing to support our Technicians voice on the Web. A NEW KIND OF AWARD SCHEME With our partnership with the Dental Technician Magazine we are proud to be associated with the launch of a different approach to an awards scheme. You the technicians choose via the group and the magazine, with an end of year awards programme supported by various manufacturers and supply companies.

We have managed to secure the following personality’s to be the judges for the various categories we have put in place, as a result of your choices they are: Best Ceramics/ Crown and Bridge Technician - Glenn Harger Owner at Bucks Oral Design Studio Ltd. Many years in the trade and brings a wealth of knowledge and experience to the judging panel, and a character unsurpassed. Widely respected by his technical and working colleagues.

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Best Prosthetics Technician - Chris Wibberley They say the apple never falls far from the tree, so we are well supported in this field by a very capable and knowledgeable technician who is well known for sharing and motivating others in the field. Chris also qualified as a CDT and is able to pass on, not just his knowledge of the laboratory processes but the clinical findings and requirements. Acknowledged as a truly amazing young talent who loves passing on his knowhow and interacting with fellow technicians.

Best Orthodontics Technician - Andrea Johnson The powerhouse behind Dentech charity and associated with Veterans Bite back. Andrea is always ready to assist in causes that raise the aspirations of her fellow technicians. And a dam fine Orthodontics technician.

Best Hospital Tech/Maxfac - Iain MurNelson St George’s University HospitalMaxillofacial Dept.

One of the leading Maxillofacial technicians in the Country leading a cutting edge department and team dealing with the day to day dealings with trauma and reconstruction to those in need, and a driving force within the field.

Best Innovative Technician - Magnus Underhay Owner at MJ Underhay Dental Laboratory.Again, another winwin personality to the judging panel, a very capable and approachable technician who is known for helping and motivating others, and runs an excellent study club, helping to bring knowledge and product information within this well supported group. Magnus has worked steadily over many years to continue to improve himself and any other technicians he can help. Technical moderator and peace keeper within the DTGB group.

Head Judge - Bill Sharpling, LonDEC, King’s College London Clinical Dental Technician (CDT).

Bill is the Associate Dean and Director of the London Dental Education

Centre (LonDEC) & a Senior Clinical Teacher at Kings College London Dental Institute.

He has responsibility for running LonDEC, the post qualification training establishment.

Prior to this appointment he was Head of Dental Technology at Guy’s, Kings College and St Thomas’ Hospitals and is currently teacher and examiner for KCL Dental Institutes MSc Aesthetic Dentistry & MClinDent (Fixed & Removable Pros) programmes.

Ex Royal Army Dental Corp technician, and again brings a wealth of knowledge on the whole skill set of Dental Technology, well suited for the position of Head Judge.

Thank you all for your suggestions and support and thanks to these very able personalities that will aid us in launching this new awards scheme and bringing more coverage to our fantastic industry and characters we have within this trade.

This will lead towards an awards evening and again will raise money for the two supported charity’s we support. We hope it will lead to an extra effort in your busy working lives for more of you to try and compete in those areas you know and feel confident with. The more participants the greater the spread of excellence.

DEN-TECH AND VETERANS BITE BACK

Thank you all for your support and interaction with the awards scheme it’s down to you all to vote NOW. Best regards Alan Wright Business Development Manager, Blueprint Dental Laboratories. Head Office, 15b Oakcroft Road, Chessington, Surrey, KT9 1RH. T: +44 (0) 800 228 9828 F: +44 (0) 845 003 6275 M: +44 (0) 7904 413 211 E: alan@blueprintdental.co.uk W: blueprintdental.co.uk

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FOCUS

Best Chrome Technician Dave Smith.

Phoenix Dental Castings. What can be said about David that hasn’t been said or written, another massive plus addition to our panel of judges, brings a wealth of knowledge and service to the trade in general. Can’t think of a better judge on something he has spent many years getting right.

CLINICAL DENTISTRY

EDELWEISS PEDIATRIC CROWNS: A new and innovative approach to restoring primary teeth May 27, 2019 I BY DR. DESIGAR MOODLEY, DR. KUNAL GUPTA, DR. STEPHAN LAMPL

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he management of dental caries in children is necessary because caries is a progressive disease which can eventually damage the tooth and can be detrimental to the permanent teeth and the child’s general well-being. As outlined in this clinical case, edelweiss PEDIATRIC CROWNs are a simple solution which is aesthetic but also functional in providing an effective treatment option for the restoration of decayed primary teeth.

INTRODUCTION The main objective of restorative treatment in the paediatric patient is to repair or limit the damage from caries, protect and preserve the tooth structure, and maintain pulp vitality whenever possible. Although stainless-steel crowns have proved to be successful in clinical treatment, the views of dental practitioners on the use of these crowns differ. The majority of general dental practitioners consider these crowns to be an impractical restorative technique for a busy daily practice and unsuitable for most children. [1] Guidelines on the use of stainless-steel crowns as set out by the British Society of Paediatric Dentistry have largely been ignored, as they do not reflect the views of the majority of general dental practitioners. [1] In recent years, because of increased demand for aesthetics, prefabricated zirconia crowns have become increasingly popular. Zirconia paediatric crowns, however, require a more aggressive approach with subgingival preparation margins to restore primary teeth, which can often lead to pulpal exposure because of the large pulpal chambers and high pulpal horns in primary teeth. Because zirconia crowns cannot be crimped, the clinician must prepare the teeth to fit the zirconia crowns.

Therefore, an increase in preparation and fitting time is necessary. Furthermore, preparation of subgingival margins can often result in gingival haemorrhage, which can compromise the retention of zirconia crowns. [2] To overcome the shortcomings of the abovementioned treatment options, a minimally invasive, highly aesthetic paediatric crown was recently introduced to the market that is produced from a laser-sintered and -vitrified composite. [3] This process improves the flexural strength of the crown to 550 MPa and produces a highly aesthetic glossy surface. [3] Edelweiss PEDIATRIC CROWNs are prefabricated crowns that are contoured to mimic the anatomy of the primary tooth and are supplied in various sizes for both anterior and posterior teeth for different clinical situations.

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Aesthetic but also functional, the edelweiss PEDIATRIC CROWN provides a simple and effective treatment option for the restoration of decayed primary teeth. (Photograph: edelweiss)

CLINICAL CASE REPORT: A 4-year-old girl was referred to the Children’s Dental Center in Gurgaon in India with the complaint of painful teeth when eating and the presence of unsightly maxillary anterior teeth.

Clinical examination showed large carious lesions in the maxillary anterior teeth (Fig. 1).

A radiographic examination showed pulpal involvement of caries in teeth #51 and 61 (Fig. 2).

The objectives of the treatment plan were first to alleviate pain and remove any pathology and then restore function and aesthetics. After rubber dam placement, routine endodontic treatment was performed on teeth #51 and 61 and the root canals were filled with Vitapex (Neo Dental), a resorbable calcium hydroxide-based paste with iodoform. Since aesthetics was a priority, edelweiss PEDIATRIC CROWNs were used to restore the four anterior teeth. Using a sizing gauge (supplied by the manufacturer) to determine the size, the appropriately sized crowns were selected (Fig. 3).

All caries was removed using a round diamond bur, and mesial and distal reduction were achieved with a fine tapered diamond bur to open the interproximal contacts and to begin circumferential reduction. Buccal and lingual reduction were achieved with a round-ended straight fissure diamond point. All margins and the extent of reduction were dictated by the caries and kept to a minimum in order to preserve as much tooth structure as possible. The margins were kept supragingival (Fig. 4).

The crowns were then checked for fit and prepared for the bonding procedure. The inside surfaces of the crowns were lightly roughened

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using a diamond football bur (RA 379), rinsed off and air-dried. Edelweiss VENEER Bond (Fig. 5) was applied to the inside of the crown and light-cured for 20 seconds.

The prepared tooth surface was etched with 37 per cent phosphoric acid for 10 seconds, and bonding agent was applied and light-cured for 20 seconds (Figs. 6 & 7). Edelweiss composite in Shade A0 was added to the inside of the crown and placed over the prepared tooth, the crown was seated firmly and excess composite was removed from the margins (Fig. 8). Incisal edges and labial inclination were then assessed, and final curing was achieved with 20 seconds of light curing (Fig. 9). A recall visit four months later showed no staining of the crowns and good gingival health (Fig. 10).

DISCUSSION Dental aesthetics and retention of the anterior teeth may influence proper psychological development in childhood at an increasingly younger age, particularly through interaction with other children. [4] This is evidenced by an increase in the demand for aesthetics, rather than function, in primary tooth restorations. [5] To satisfy this demand, the market has recently seen a shift away from stainless-steel crowns. Prefabricated zirconia crowns - such as NuSmile, Cheng Crowns and Kinder Krowns - are made of yttrium-stabilised zirconia, which is either milled or injection moulded. Zirconia crowns offer superior aesthetics compared with stainless-steel crowns. However, in vitro fracture load studies, such as by Townsend et al., [6] showed variation in crown thickness and fracture between the zirconia crowns: statistically significant differences were found between the forces required to fracture zirconia crowns by the

CLINICAL DENTISTRY

TOP ROW L TO R: Caries associated with the four front teeth; Radiographic examination revealed pulpal involvement of caries in 51 and 61; Edelweiss Sizing Guide in small, medium and large size for crown size selection; Crown preparations with margins kept supra-gingival 2ND ROW L TO R: Edelweiss Veneer Bond applied to inner surface of the pediatric crown, air dried and light cured; Tooth surfaces prepared with 37% phosphoric acid for 10 seconds; Bonding agent applied and light cured for 20 second; Excess cement removed from margins prior to final cure 3RD ROW L TO R: Front teeth restored with edelweiss pediatric crowns; Four month follow up showed good gingival health and no discoloration of the crowns; Preoperative situation; Postoperative Situation

three different manufacturers, and the increase in force correlated with crown thickness.[6] The forces required to fracture the pre-veneered stainless-steel crowns were found to be greater than those required to fracture zirconia crowns made by any manufacturer. [6] With a flexural modulus of 20 GPa, the behaviour of edelweiss PEDIATRIC CROWNs is similar to that of the natural tooth structure. [3] The edelweiss PEDIATRIC CROWNs imitate the form of natural primary teeth well and mimic the anatomy of the primary tooth.

The mesial and distal margins of the edelweiss PEDIATRIC CROWNs follow the natural gingival margin of the primary teeth, minimising excessive tooth reduction and removing the need to take margins subgingival unless caries dictates extension. Furthermore, because of the minimal preparation needed, there is no risk of iatrogenic damage to pulp tissue of the primary tooth. These prefabricated crowns permit quick and safe treatment with maximum aesthetic results. Should retreatment be required, edelweiss PEDIATRIC CROWNs offer the advantage of being easy to remove, as they can be cut in a way similar to dentine.

The morphology of the edelweiss PEDIATRIC CROWN has similar cuspal features to that of a primary tooth, hence

THE AUTHORS: Dr. Desigar Moodley, Dr. Kunal Gupta, Dr. Stephan Lampl

very little occlusal adjustment is needed. If it is needed, it can be done on the paediatric crown itself and not on the opposing tooth, thus preserving the natural tooth structure, unlike zirconia crowns, for which any occlusal adjustment has to be done on the opposing tooth, causing unnecessary damage to the opposing tooth. Furthermore, the natural abrasion of edelweiss crowns and the flexural modulus similar to that of a natural tooth - may make these crowns more tolerable in the child’s mouth and kinder to the temporomandibular joints.

CONCLUSION The edelweiss PEDIATRIC CROWN provides a simple and effective treatment option for the restoration of decayed primary teeth that is aesthetic but also functional, making it a superior alternative to both stainless-steel and zirconia crowns.

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REFERENCES 1. Threlfall AG, Pilkington L, Milsom KM, Blinkhorn AS, Tickle M. General dental practitioners’ views on the use of stainless steel crowns to restore primary molars. Br Dent J. 2005 Oct 8;199(7):453–5; discussion 441. doi: 10.1038/sj.bdj.4812746.

2. Lee JH. Guided tooth preparation for a pediatric zirconia crown. J Am Dent Assoc.

2018 Mar;149(3):202–8.e2. doi: 10.1016/J. ADAJ.2017.08.048.

3. Edelweiss Dentistry. Breakthrough in pediatric dentistry; 2018 [cited 2019 May 21]. Available from: https://www.edelweissdentistry.com/ wp-content/uploads/2018/02/PedoCrownsBrochure_02_2019_WEB.pdf.

4. Lourenço Neto N, Cardoso CA, Abdo RC, da Silva SM. Oral rehabilitation in pediatric dentistry: a clinical case report. Rev Gaucha Odontol. 2016 Jan–Mar;64(1):87–92. doi: 10.1590/1981863720160001000131064.

5. An SY, Shim YS. Esthetic restoration of deciduous teeth using prefabricated zirconia crown in children with early childhood caries: a report of three cases.

J Dent Hyg Sci. 2018 Jun;18(3):194–200. doi: 10.17135/jdhs.2018.18.3.194.

6. Townsend JA, Knoell P, Yu Q, Zhang JF, Wang Y, Zhu H, Beattie S, Xu X. In vitro fracture resistance of three commercially available zirconia crowns for primary molars. Pediatr Dent. 2014 Sep–Oct;36(5):125–9. doi: 10.1016/00904295(93)90521-B.

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COMPANY NEWS

THE DENTAL TECHNICIAN MARKETPLACE SHOFU: REDISCOVER PFM – AND IMPROVE AESTHETIC RESULTS! w VINTAGE PRO provides new perspectives for PFM restorations: The uncomplicated, light-transmitting and reflecting porcelains of this system allow both professionals and beginners to create ex-cellent aesthetic results using a time-saving technique.

Thanks to their leucite-reinforced crystalline structure, these porcelains fea-ture exceptional brilliance with great depth and high colour and firing stability, making PFM restorations look as if they were all-ceramic – no matter if the frameworks are made of gold-containing, palladium-based or nonprecious alloys or CAD/CAM materials!

VINTAGE PRO meets all requirements a state-of-the-art PFM sys-tem has to meet. An optimised layering system, ideal stackability and sculptability, and high dimensional and firing stability at a temperature of approx. 900°C make this porcelain convenient and efficient to use in everyday work.

The porcelain system is available in 16 standard shades, 4 whiten-ing shades and various light-dynamic auxiliary and effect shades. The system also includes newly developed Powder Opaque and ready-to-use Paste Opaque materials with great opacity and bond strength which allow technicians to quickly and reliably

TRYCARE: KERATOR - WHY PAY MORE? w Trycare offer an extensive range of Laboratory problem solvers including the Kerator Overdenture Attachment System, which is available to fit all the most popular implant systems. What is more it is lower priced than any competitor!

Supplied with a choice of straight or 15° angulation to make it easier to adapt to the aesthetic requirements of the patient, Kerator abutments have the lowest profile of any overdenture attachment (just 1.48mm) which means they are easier to place where space is at a premium. They are available with soft tissue cuff heights from 1 to 6mm. With a choice of retention levels, Kerator overdenture attachments provide excellent retention so that patients can enjoy the comfort and stability that

will transform their lives.

Other advantages include a plastic carrier that provides safer handling and easier placement, plus easier visual checking of the implant’s alignment. Dual-retention which enables increased retention as well as easier

mask metal frameworks and create an aesthetic base for porcelain build-up. Both Opaque types can easily be adjusted or modified and applied in any desired thickness. Paste and Powder Opaque materials en-suring the right base colour and high bond strengths.

For further information please contact Shofu UK on 01732 783580 or sales@shofu.co.uk

pivoting in any direction. Self-alignment which automatically centres the male on the housing attachment, allowing patients to easily seat their overdenture. An extended range of male attachments which allows for insertion up to 40° of implant divergence. A 15° angled abutment which can be used to further extend the allowable divergence. A dual undercut metal housing design that provides sturdier retention within the denture acrylic.

Kerator is supplied in an all-in-one package that contains everything you need at an extremely competitive price.

For more information about Kerator overdenture attachments please contact your local Trycare Representative, call 01274 885544 or visit www.trycare.co.uk/kerator

ZIRKONZAHN’S DIGITAL WORKFLOW WITH THE PLANESYSTEM® AND THE FACE HUNTER 3D FACIAL SCANNER w Zirkonzahn’s workflow can be carried out 100% digitally with an intraoral scanner, or including analogue steps - depending on the dental laboratory’s working procedures - and is based on the accurate record of the patient’s data. Indeed, Zirkonzahn’s workflow is perfectly and exclusively combined with the PlaneSystem® (MDT Udo Plaster, in collaboration with Zirkonzahn), a patient-specific data transfer method that respects and recognises the patient as a person.

The increasing success of this method comes from the innovative yet simple acquisition of patient’s data, which can be transferred 1:1 into the virtual world and vice versa without losing any information. This allows for a better

achievable function and aesthetics design of restorations in the digital world, also thanks to the data merging with the patient’s 3D facial scans acquired with Zirkonzahn’s Face Hunter 3D facial scanner.

The Face Hunter allows to work with the patient’s physiognomy, enabling the user to transfer the facial scan data, together with the models, in the virtual articulator in relation to the individual reference planes recorded with the PlaneSystem®. The Face Hunter is very easy to use - with a single click, it is possible to scan the patient’s face in a few seconds and it can bring many advantages not only to the dental technician but also to the dentist and the patient.

Indeed, by using the patient’s real physiognomy in the workflow, the dental technician can obtain a result that is much more precise and provide the dentist and the patient with a near-photorealistic preview of the definitive restoration, for a concrete idea of the final work during the consultation phase. The patient’s face and expressions scanned with the Face Hunter are imported into the Zirkonzahn.Modellier or Zirkonzahn.Modifier design software and then combined with the scanned models, to design the restoration starting from the patient’s facial features.

Through the CAD/CAM Reality Mode software module, the 3D piece of work can be represented in a very realistic way.

For more information www.zirkonzahn.com LEFT: With the PlaneSystem® and the Face Hunter, patients can be provided with a comprehensive consultation based on 100 % individual and predictable outcomes. Patient-specific information can be transferred to the digital world and vice versa without losing any information!

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DIGITAL DENTISTRY

WHAT DO YOU DO ON YOUR BIRTHDAY?

THE DIGITAL SYMPOSIUM!

F

or many, this is a real day to pick and choose or indeed have the activities chosen for you as a treat. For me it was an opportunity to visit the Henry Schein organised Digital Innovations 19 at the Pullman Hotel in the Euston Road!! Yes, very sad indeed but he ho. While the two days of presentations, talks and workshops was directly aimed at Clinical Dentistry it proved enlightening to have a good look at what is available and being taken up by the Dentists and their clinical support. There really is a growing awareness across the clinical groups of the digital potential for both their work flow and the comfort of their patients. Many are following the advice of their colleagues who have been introduced to digital techniques and equipment, often as associates in the corporate practices, but many as associates in private and mixed practices.

There were well over 300 delegates for whom a really complete programme had been assembled. Speakers were there not just about Digital systems but covering marketing of the practice and building confidence about patient communication and patient comfort.

All I spoke to were very aware of the patient comments around the restorative processes with digital. An Intra-oral scan instead of a great lump of impression material jamming their mouths! As they advance their knowledge

of the systems, they become clearly aware of the potential for advanced radiographic analysis of the patients and generally without delay. The Vista System from Durr Dental was very impressive with first class images and an interesting programme for planning and diagnosis. The available planning and radiographic combinations can often be really quite impressive with the ability to fill the viewing screen with the image. This allows more detailed investigation and measurement of the working parts beyond eye level. As I have reported before, some new scanners can detect caries which is below the tooth surface. And invisible to the naked eye this was the case with the images on display at the booth.

There were several of the Implant companies there with Ken Byrne Heading the BioHorizons and Camlog team. It was an opportunity to reminisce and remember old friends and former times. His heading of the Bio Horizons team has seen a real growth in his market share and awareness of his brands and services. Together with Henry Schein, Software of excellence and MediEstates, as main organisers, they had put a very well interwoven and varied programme of topics which really appealed to the assembled attendees.

Around 300 delegates from dental practices across the UK were greeted by Ben Flewett,

A SELECTION OF PICTURES REFLECTING THE OCCASION WITH SPEAKERS AND STANDS

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Managing Director at Software of Excellence, a Henry Schein One brand, who launched the event by reminding dentists of their preventive responsibilities in the wider health care arena and giving some top tips to improve efficiency and boost business performance.

On the first day the event threw open the stage to the keynote, non-dental speakers and delegates gave a deserved standing ovation to motivational speaker and inspirational trainer Steve Head following his thought provoking and highly entertaining talk ‘Making the 1% Difference’.

Mandy Hickson, a former RAF pilot and only the second woman to fly the Tornado GR4 operationally, followed Steve and shared her incredible stories from the front line, providing a vivid insight into how to communicate and empower to get the best from the whole team in high pressure situations.

“The event has been fantastic. The speakers have been very relevant and the way they address issues has just been wonderful. I’ve learnt a lot about innovation in dentistry, where dentistry’s going in the next couple of years, about marketing and how to brand your practice.

I’ve learnt such a lot in a short time. It’s been brilliant - I’d recommend it absolutely.”

Dr Kolade Orungbemi BDS, Dentist, Globe Dental Practice, Nantwich, Cheshire.

One of the stars of the Dental Innovation Symposium was undoubtedly Primescan, the new intraoral scanner from Dentsply Sirona that has opened up a new chapter in digital dentistry.

This was one of the first chances for UK clinicians to see the new technology in action as Dr Julian Caplan demonstrated Primescan’s speed and accuracy and showcased the range of benefits it brings to numerous clinical situations.

DETAILED PICTURES OF SCANS AND RADIOGRAPHS

Naturally, such a prestigious event attracted support from leading manufacturers and suppliers, led by headline sponsor Dentsply Sirona. The blend of topics and disciplines meant that delegates were able to discuss with the experts, their clinical, digital and business ambitions. And with over 20 exhibitors, including 3Shape, Formlabs and Ivoclar Vivadent as well as Henry Schein companies Software of Excellence, MediEstates, and BioHorizons, the exhibition arena was a hive of activity for the whole two-day period.

“This event is probably the only event in the whole year where innovation and digital dentistry is really put at the forefront. I think it’s a great event that everyone should attend, not only for clinical

tips and tricks which are invaluable, but also for management of practices and how you can improve the patient journey. All of these together makes this a great event and I’d recommend it to everyone.”

Dr Dev Patel BDS PG Cert (Dip), Principal Dentist, Dental Beauty There is no doubt that these focussed meetings covering the business of the two days are very popular and very well attended. In a busy dental practice it is very useful to know that the time you take away from working Chair side, will be worthwhile. A Digital Success!

Twitter: @HenryScheinUK Facebook: HenryScheinUK

TRICODENT The new range of equipment from Ugin Dentaire

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DIGITAL DENTISTRY

Throughout the two-days a series of smaller presentations and breakout sessions, covering a wide range of topics including digital dentistry, practice performance, teamwork, dental implants, orthodontics, lasers, marketing and finance, meant delegates could choose the topics most relevant to their needs. Featuring a first-class line-up of some of dentistry’s leading experts, these sessions built on what had gone before and provided practical tools and perceptive insight into the many different components that go to create a successful, efficient, patient-centred practice.

INSIGHT

WELCOME TO... DENTAL DORIS DENTAL DORIS HAS WORKED IN DENTISTRY FOR MANY YEARS AND LIKES TO MUSE ABOUT ALL KINDS OF DENTAL AND NON-DENTAL TOPICS

MOVING ON…

“Age is an issue of mind over matter. If you don’t mind, it doesn’t matter.” Mark Twain

I

’ve been to two funerals in the past few weeks and although the celebration of lives lived was a positive experience these events have got me thinking that perhaps my priorities are not quite in order and that I should start to look at life differently.

The World Values Survey (WVS), which is an ongoing research project conducted by social scientists around the globe, asked over 83,000 people of all age groups in 57 countries about their feelings on aging. The World Health Organization (WHO) analysed the WVS data and found that 60 percent of survey respondents said that they don’t think older people are respected. Interestingly, the lowest levels of respect for older generations were reported in higher income countries.

These negative attitudes about aging and older people reflected in the WVS can have a significantly detrimental impact on the physical and mental health of older people. A 2002 study by psychology researchers in Yale University’s department of epidemiology and public health looked at the long-term health consequences of ageism. The researchers determined that age discrimination actually has the potential power to shorten lives.

The Yale study followed 660 people age 50 and older (the average age of a dental technician in the UK is 57!). Among the study group, older people who held more positive views about the aging process actually lived 7.5 years longer than people who negatively perceived aging. Older people

who perceive themselves as a burden to others view their very lives as less valuable, which in turn ups their risk for depression and social isolation, both of which have been shown to be “silent killers” for older people.

THE POSITIVE AGING MOVEMENT Of course, some facets of a person's health, good or bad, are genetic and thus out of their hands, but many aspects of health and the aging process, in general, are well within our control. However, as we age, "health" isn't just about the absence of ailments. The concept of "positive aging," also referred to as "healthy aging," is achievable by every older person as we work to make better choices in the nearterm to improve our lives in the long-term.

Positive aging is basically adopting a positive view of aging as a healthy, normal part of life. And it’s the mindset that you will do whatever is needed in order to continue doing the things that you love and are important to you as you grow older.

Since most people don’t have vast monetary resources society must look for ways to enable older people to embrace positive aging and to continue pursuing their passions, and governments should enact health and social policies that facilitate these pursuits. Such expenditures may be viewed by some as extraneous costs to society, but in reality, they are investments in improving older people’s health as they enable older people to continue to make their many positive contributions to the world around them.

10 TIPS

FOR POSITIVE AGING Below are a few tips to help us all to age in a positive way: Stay physically active by doing at least 30 minutes of movement or exercise every day.

1. Exercise your brain by engaging in mentally challenging activities, and never stop learning new things.

2. Adopt an overall healthy lifestyle by eating healthfully, getting enough sleep, managing weight, and not drinking in excess or smoking.

3. Stay connected to other people by nurturing relationships with your spouse or partner, family, friends, neighbours, and others in your community, including young people.

4. Create positive emotions for yourself by practicing positive emotion exercises and learning to feel good about your age.

5. Don’t sweat the small stuff; accept what you cannot do and ask for help when needed.

6. Set goals for yourself and take control of the steps needed to achieve them.

7. Minimise life stress; practice healthy coping techniques and learn to relax and unwind.

8. Have regular medical checkups, take advantage of health screenings, and engage in healthy preventive behaviours.

9. Have a positive outlook for a healthier life.

10. Show the people you live with positive love and affection.

I certainly don’t want to live forever, but I do want to be fit, healthy and active for as long as possible and I really don’t want to be considered too old to do anything!

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ORGANIZE AND LINK DIGITAL PROCESSES EFFICIENTLY

T

he broad range of indications and the easy to use software interface make Dentsply Sirona's inLab CAD/CAM software a central component of the digital workflow in many laboratories. The brand new inLab software 19.0 update offers more design options, better efficient organization of production and enhanced networking with the dental practice.

Charlotte/Bensheim. The continuous development and optimization of the inLab software strengthens professional application opportunities for more productivity in the laboratory. The inLab CAD SW 19.0 Model App now allows laboratories to use both nttrading and ELOS Medtech model analogs when designing implant prosthetic cases. Furthermore, Atlantis® Core Files that are received can now be made into a model, under consideration of the appropriate abutment geometry, so that an analog model is not required for such cases.

The cooperation between Dentsply Sirona and exocad®, which was announced earlier this year, represents a synergistic partnership that benefits the dental laboratory. exocad® users can now take advantage of a validated workflow that utilizes Dentsply Sirona’s high-precision extraoral scanner, the inEos X5. This workflow enables a case to be created in exocad®, then scanned with inEos X5 from inLab software version 19.0 or higher, and designed with the exocad® software* in a fully integrated workflow.

INLAB CAM SOFTWARE WITH NEW PROCESS OPTIONS inLab CAM software 19.0 provides even more efficient production processes, particularly when used with the 5-axis inLab MC X5 grinding and milling unit. For the first time, inLab CAM 19.0 contains an analysis tool that ensures a high-level of reliability by providing a production simulation that previews the final production, on the basis of positioning, sprueing and tool configuration.

The thickness of the walls of the object can also be tested before processing.

For the manufacturing of Dentsply Sirona Digital Dentures, the software update offers freespace milling of the Lucitone® 199 Denture Base disk the provides easier access for the lab technician when bonding Portrait IPN® Denture Teeth in place. Furthermore, 35mm disks in height (of all material classes) can now be processed in the inLab MC X5, including Lucitone 199.

ABOVE: Digital production of prostheses with inLab MC X5 and inLab CAM SW 19.0: processing of disks with a height of up to 35 mm and freehand milling of the bases of prostheses – for easier access to the periodontal pockets when gluing the teeth in place at a later stage.

RIGHT: New process options and analysis functions with inLab CAM SW 19.0: individual sprueing, testing the wall thickness, simulation of production results, tool-compatible machining of the fitting surfaces, and much more.

In the case of restoration data from other CAD software, tool-compatible machining of the fitting surfaces is also possible with the inLab production machines. The inLab MC X5 can now also be used to produce crowns with screw access channels from grinding materials using the wet grinding process, e.g., Celtra Duo, for the manufacture of implantbased restorations.

Be it seamless inLab system integration with automatic data transfer or the import of open data: regardless of which CAD data basis is used, the inLab CAM software has an intelligent query system, and guides the user safely through the manufacturing process depending on the type of restoration. In addition, the extended validated construction info interface with exocad® enables restoration data to be conveniently imported into the inLab CAM software for the first time in a compatible format, where it can be processed with inLab MC X5 or inLab MC XL.*

Connect, directly within the inLab software.

The Connect Case Center Inbox is a new feature. This standalone application gives labs that also, or only, work with other CAD/CAM software flexible access to digital impression data that has been generated from a CEREC digital impression unit, such as Primescan or Omnicam. For further processing in the preferred laboratory software, the Inbox not only generates the inLab format, but for the first time, also the dental project format validated for exocad®, providing model and case data, color information and preparation margins. Other common open data formats, such as STL and OBJ, are also available. Further functions can also be used, such as multiple downloading for the storage of cases in predefined work folders and linking to laboratory management software.

The new Cercon® xt ML disk from Dentsply Sirona – the extra translucent zirconia with a natural color gradient for high-quality esthetic results – has also been validated for production with inLab MC X5.

It can be selected directly in the inLab CAM 19 software or higher going forward.

The Connect Case Center Inbox is subject to license, but customers who upgrade to inLab software 19.0 will receive it for free with the current update. The application can be used on a separate Windows PC, independently of an inLab PC. For the first time, the inLab software 19.0 is also available for download https:// www.dentsplysirona.com/en/explore/lab/ cad-cam-equipment-dental-lab/downloads. html. As usual, the inLab software update 19.0 license (CAD and CAM) can be ordered from specialist retailers.

NEW CONNECT CASE CENTER INBOX FOR ALL DENTAL LABORATORIES inLab users still benefit from the ability to receive digital impressions and order data transmitted through Connect Case Center, formerly Sirona

* available from exocad® 2.3 Matera. Availability may differ between exocad® sales partners – please direct your inquiries to the respective sales partner.

You will find a list of the authorized exocad® sales partners at exocad.com/our-partners/reseller.

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23

DIGITAL TECHNOLOGYY

INLAB SOFTWARE UPDATE 19.0:

DIGITAL TECHNOLOGYY

DIGITALLY SCANNING AND DESIGNING POST AND CORE

BY ANDREW WHEELER I PRECISION CERAMICS LTD INTRODUCTION We have been working with a digital work flow for many years now within the laboratory environment. For the most part it has been a difficult and rocky road, a steep learning curve! Many mistakes have been made, in terms of equipment and quality of work produced but one has to remember that with mistakes come knowledge and wisdom.

When the laboratory purchased a Medit scanner and 3Z wax printer five years ago there wasn’t the support most training was self-taught, by trial and error. However, we made it, and see it as a positive step forward for the business, securing work for the future.

Occasionally a case comes in which requires us to see how it can be integrated within the digital work flow. One of these is the construction of post and cores. New materials have seen the decline of the classic metal post and core, however we do see them from time to time. They prove a challenge to construct them digitally. The guys at Medit have seen the need and integrated a post and core feature that is very successful and straight forward.

Step one The first step is to complete the job definition.

Here we notate the case as a veneer and mark the adjacent teeth. We don’t have an antagonist for this case as the clinician will fit the post and retake the impression for the final crown.

Step two Then the scanning strategy is set in the scanning software, collab. We see the post and core option which needs to be activated. Once done the 3-axis impression scan option opens and we can start to work through the scan protocol.

You can see the amount of data the scanner is able to capture in one scan! We use scan spray as the plastic core is a reflective surface.

Setting the scan strategy

Case Study Using Medit T500 Scanner The aim is to capture the data from a plaster model and a rubberbased impression, and design a post and core digitally. This will then be sent to be printed or milled in a suitably precious metal. We will be using a Medit T500 scanner and Exocad to design the case.

Impression and working model

Step three We then move to the impression scan, using the 3-axis impression scanning arm. This piece of equipment allows us to pick up more information with fewer scans. We don’t use impression scanning on a daily bases but its invaluable on a case such as this.

Once we have marked and edited the impression in the software, we can move on to the alignment stage of the process. By marking three points on the two upper scans we can accurately combine them.

The base is scanned first. We edit the scans as we proceed to limit the amount of information that captured.

The information is merged, the scan is now complete and we move onto the design stage.

This process is very fast and effective, taking no more than five minutes.

The last scan of the model is the preparation which captures the external tooth structure. As you can see, the internal part of the core hasn’t been recorded. We are not concerned at this stage, we will capture the information from the impression.

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The placed tooth is resized as close to the margin line as possible. Once adapted a small amount of free forming is needed and any retention groves are placed at this stage.

SUMMARY This is a good example of adapting everyday work flow to suit the requirements of our clients. Taking forward well-tried techniques and producing them digitally. Manufacturers are listening to technicians and providing the tools and equipment to meet our requirements.

Andrew C Wheeler is the owner of AW Precision Ceramics based in Surrey. www.awprecisionceramics.com

Define the path of insertion and create the inlay bottom. Bearing in mind that we are not using it to design what it thinks is a veneer.

So, we don’t want to create a cement gap in the conventual sense otherwise the core will be too tight. We remove the anticipate milling option in the undercut tab to keep the design as accurate as possible.

This file is now ready to be sent for printing in a burn out material or laser sintered.

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DIGITAL TECHNOLOGYY

Using Exocad we define the margin to the extent of the post. The draw line function controls where we place the margin overriding the automatic margin finder.

FREE VERIFIABLE ECPD As before if you wish to submit your ECPD online it will be free of charge. Once our web designers give it the all clear there will be a small charge.

This will be less than the CPD submitted by post. This offer is open to our subscribers only.

To go directly to the ECPD page please go to https://dentaltechnician.org.uk/dental-technician-cpd.

You will normally have one month from the date you receive your magazine before being able to submit your ECPD either online or by post.

If you have any issues with the ECPD please email us cpd@dentaltechnician.org.uk

4 Hours Verifiable ECPD in this issue LEARNING AIM

The questions are designed to help dental professionals keep up to date with best practice by reading articles in the present journal covering Clinical, Technical, Business, Personal development and related topics, and checking that this information has been retained and understood.

LEARNING OBJECTIVES REVIEW: n Strength of Zirconia n Implant planning n Customised Special trays n Business of Management

LEARNING OUTCOME

By completing the Quiz successfully you will have confirmed your ability to understand, retain and reinforce your knowledge related in the chosen articles.

Correct answers from June DT Edition:

ECPD

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VERIFIABLE ECPD - JULY 2019 1. Your details First Name: .............................................. Last Name: ........................................................Title:................

Address:.............................................................................................................................................................. ................................................................................................................................................................................ ............................................................................................................ Postcode:...............................................

Telephone: ......................................................Email: .................................................. GDC No:..................

2. Your answers. Tick the boxes you consider correct. It may be more than one.

Question 1

Question 2

Question 3

Question 4

Question 5

Question 6

Question 7

Question 8

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Question 10 Question 11

Question 12

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Question 15

Question 16

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Q7.

C.

Q8.

D.

As of April 2016 issue ECPD will carry a charge of £10.00. per month.

Or an annual fee of £99.00 if paid in advance.

Q9.

B.

You can submit your answers in the following ways:

Q10.

D.

Q11.

A.

1.

2.

Q12.

B.

Q13.

B.

Q14.

C.

Q15.

D.

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A.

3. Evaluation: Tell us how we are doing with your ECPD Service. All comments welcome.

...................................................................................................................................................... ......................................................................................................................................................

Via email: cpd@dentaltechnician.org.uk By post to: THE DENTAL TECHNICIAN, PO BOX 430, LEATHERHEAD KT22 2HT

Payment by cheque to: The Dental Technician Magazine Limited. Natwest Sort Code 516135 A/C No 79790852 You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers.

Answers will be published in the next issue of The Dental Technician. Certificates will be issued within 60 days of receipt of correct submission.

www.dentaltechnician.org.uk

VERIFIABLE ECPD AS YOU NEED IT VIA THE DENTAL TECHNICIAN TECHNICIANS AWARD SCHEME Q1 . How many categories have been mentioned

for the Award Scheme?

A. Six. B. Five.

C. Eight.

D. Seven.

Q9. What is the software programme being used for the

Post & Core process?

A. 3Shape.

B. Exocad.

C. Dental wings.

D. ColLab.

A NEW APPROACH TO RESTORING PRIMARY TEETH Q2. What are the stated contra indications for

restoring primary teeth?

A. A low smile line.

B. Soft tissue compromised aesthetics.

C. Large Pulp in danger of exposure.

D. Aesthetic demand.

Q3. What is the traditional material for restoration

of the primary Dentition?

A. Gold.

B. Ceramic.

C. Stainless Steel.

D. Non-precious alloy.

Q4.

A. B. C. D.

What is the material used in the edelweiss PEDIATRIC CROWNs? Methyl Methacrylate.

Laser Sintered and Vitrified Composite.

Zirconia ceramic.

Pressed Glass.

Q5.

A.

B. C. D.

How are the Crowns Cemented to the Primary teeth?

Etched and cemented with Light-cured Edelweiss Veneer bond.

Using composite cement.

Using standard crown cement.

Using Poly F.

Q6.

A. B. C. D.

What has been the aesthetic material used to date?

Zirconia Ceramic.

Vacuum fired porcelain.

Air fired Porcelain.

Composite Resin.

Q7.

A. B. C. D.

What is the contra indication for such material?

Risk of fracture.

Potential pulpal damage during preparation.

Poor aesthetics.

Lack of colour choice.

DIGITALLY SCANNING AND DESIGNING POST & CORE Q8. What is the first step in the process of digital

manufacture in the article?

A. Scan the model.

B. Design the restoration.

C. Complete the job definition.

D. Articulate the models.

Q10.

A. B. C. D.

What must be done to scan the fit surface of the Post & Core?

Impression Scan.

The scan of a wax-up.

Measure the post impression.

Scan a Duralay copy.

Q11.

A. B. C. D.

What Software process is used to define the margins?

ColLab. 3Shape. exocad.

Dental Wings.

LONDON ORAL HEALTH SURVEY Q12. What is the quoted percentage for children under five

who have Caries?

A. 23%.

B. 25%.

C. 32%.

D. 26%.

Q13.

A. B. C. D.

Of the 20 Worst Councils in for Caries in England how many were from London?

10.

16.

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15.

Q. 14. What is the recommended age for all children to

see a dentist?

A. Five years old.

B. One year old.

C. Seven years old.

D. Four years old.

MOUTH CANCER IS A GROWING PROBLEM Q.15. What is the name of the organisation featured in the article.

A. The Oral Cancer Awareness Association.

B. The Oral Cancer Prevention Society.

C. Let’s Talk About Mouth Cancer.

D. The Mouth, Head and Neck Cancer Awareness Society.

Q16. What percentage of patients with mouth cancer in Scotland

will die of the disease within 5 years of detection.?

A. 40%.

B. 50%.

C. 37% D. 63%

You can submit your answers in the following ways: 1. Via email: cpd@dentaltechnician.org.uk 2. By post to: THE DENTAL TECHNICIAN LIMITED, PO BOX 430, LEATHERHEAD KT22 2HT You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers.

Answers will be published in the next issue of The Dental Technician. Certificates will be issued within 60 days of receipt of correct submission.

www.dentaltechnician.org.uk

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ECPD

Payment by cheque to: The Dental Technician Magazine Limited. NatWest Sort Code 516135 A/C No 79790852

NEW PRODUCT FOCUS

NEW PRODUCT FOCUS: NEW THINGS IN WHICH YOU MAY BE INTERESTED

I THOUGHT IT MIGHT BE A GOOD IDEA TO HAVE A FEATURE FROM TIME TO TIME OF NEW PRODUCTS AND PARTICULARLY THOSE ABOUT WHICH I HAVE HAD SOME FEEDBACK. THE FOLLOWING SEEM TO BE VERY POPULAR AS ADDITIONS TO WHAT IS ALREADY ESTABLISHED AND AN EXPANSION OF THE POTENTIAL OF WHAT YOU ALREADY KNOW. THOSE WHO HAVE HAD SOME EXPERIENCE OF THE TWISTER ARTICULATOR ARE PARTICULARLY IMPRESSED BY THEIR TIME SAVING AND ADAPTABILITY FOR THE DIGITAL TASKS NOW FACING ALL OF US. WITH THIS PLASTER AND GLUE FREE OPTION MANY HAVE FOUND A REAL ADVANTAGE IN TIME SAVING AND FOR THOSE WHO THINK THESE ARTICULATORS ARE JUST GIMMICKS TRY MOUNTING A SET OF STUDY MODELS FOR DIAGNOSIS OR DISCUSSION. IT TAKES MINUTES AND CAN BE DONE EVEN DURING A PHONE CALL.

THE TWISTER ARTICULATOR Videos for information: https://www.youtube.com/ watch?v=8S2LGEadLTE

Starter packs are available to try the product: Cost is £47 plus vat. Includes both the Twister and the Twister Plus, silicone bases and adaptors.

https://www.youtube.com/ watch?v=f6bJdIZgeTo

Twister Articulator Plus for analog: A unique and versatile reusable and glueless hinge articulator system, it allows the dental technician to articulate in seconds with a twist of a thumb. The analog Twister Articulator Plus, works with interchangeable adapters that can be mounted on the Giroform, Renfert, Zeiser plates, Itero Milled Models and Armann Girrbach Digital Models. The 3Shape, and Exocad are also catered for with further adapters that are used with pin model systems.

https://www.youtube.com/ watch?v=tbbuxajU4c8 https://www.youtube.com/ watch?v=kXwUVupNq6M https://www.youtube.com/ watch?v=kS5ckEgvshs https://www.youtube.com/ watch?v=zz6mNRiT2vI

The Twister Articulator For Digital: A reusable hinge articulator designed for printed models. The attachment of the articulator is found in the 3shape model builder library, the Exocad model creator library and ZirkonZahn under the name Invent Twister attachment.

This is a re-invention of a familiar disposable articulator but with real “knobs on”. If you are in digital, or even if you are not you would be advised to at least take a look.

YOUR PRESSING ADVANTAGE THE NEW SUPER RING And another innovation from Quintess Denta is the very timely investment ring for the pressable ceramic processes. This is a clever innovation which really speeds up the whole messy process and makes de-vesting a straight forward procedure. Cleverly designed by somebody who understands the process it has a shape which aids safe and quick investing and devesting and is re-usable.

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See the video and understand immediately its advantages. Championed by Ashley Byrne because he found it so very useful. (He confirmed that with me at the recent DTS show in Birmingham.)

Videos for information: https://www.youtube. com/watch?v=blfHTGP_NDA Exclusively available through Quintess Denta. Contact kieran@quintessdenta.com or call 028 6862 8966 for ordering.

l

The award-winning Stars of Dentistry is back at this years London Dentistry Show! Stars of Dentistry will be held within the London Dentistry Show exhibition hall this year. The London Dentistry Show is a two-day exhibition with ‘power lectures’ and Enhanced CPD certificated lectures covering an array of practical and clinical topics for dentists, dental care professionals, practice managers and technicians. 180+ of the greatest companies exhibiting, at the largest London dental event of 2019.

‘I am delighted to be invited to be lecturing amongst the “Stars of Dentistry” at the London Dentistry Show 2019.’ Dr Shiraz Khan.

Brought to you with Belmont as the Diamond Sponsor, this year is no exception with a leading line up of speakers:

Tif Qureshi Dental tectonics and the lifetime patient Shiraz Khan Minimal intervention aesthetics: Resin infiltration and composite bonding Luke Barnett (RDT) Small Design Dentistry-Aka 'Multidisciplinary Restorative Dentistry'- How to do these casses and what to avoid while you're doing it.

Elaine Halley Smiles by the Numbers Dominic Hassall Minimally invasive ceramic and composite veneers, crowns and overlays.

Which should I choose?

DENTAL NEWS

THE AWARD-WINNING STARS OF DENTISTRY AT THE HEART OF THE LONDON DENTISTRY SHOW!

DATE: 13TH-14TH SEPTEMBER 2019 LOCATION: OLYMPIA LONDON Abid Faqir The keys to immediate implant dentistry, a real practice builder?

Julian Webber Implant vs endodontics: clinical controversy, decision making and treatment possibilities for saving teeth.

Please note there is a charge of £79 per Stars of Dentistry lecture, £99 for two lectures or £149 for unlimited access to all lectures in this zone. To purchase your VIP ticket and access the Stars of Dentistry zone, please call our team on 01923 851771. Fill in the general admission free registration form.

For any visitor queries, contact the team via FMCEventsteam@fmc.co.uk

COMPANY NEWS

THE DENTAL TECHNICIAN MARKETPLACE CANDULOR AG: NEW - THE STAY YOUNG COLLECTION w CANDULOR AG launches the new tooth lines PhysioSelect TCR & BonSelect TCR. Young shapes for a new patient and customer generation.

The development and manufacture of artificial teeth has been at the core of CANDULOR for over 80 years. The Swiss company attaches great importance to development feedback from both an internal and external perspective. A vibrant collection was created especially for the new generation of "Best Ager", to match their selfconfidence and agile aspirations.

"Dental technicians, dentists and prosthodontists have motivated us to develop a new tooth line - consisting of proven materials and molds - for the patients of the coming decade and to inspire customers and patients alike." Claudia SchenkelThiel (Managing Director) A piece of Switzerland, also in terms of design.

A rejuvenated design was developed from proven, attractive molds to create 18 maxillary molds - delicate, prominent and universal - and 4 mandibular molds. Layering and surface structure support the young appearance and are a reflection of the patients' attitude to life in our times.

"The objective is to meet contemporary customer and patient expectations. We are very grateful for the feedback from the dentists, dental technicians and prosthodontists involved in this tooth development."

Jody Paul Spalt (Head of Product Management) BONSELECT TCR One for all, all for one.

Be it for tooth-to-tooth or tooth-to-twotooth placement, the BonSelect TCR posterior tooth was endowed with a bifunctional, semianatomic occlusal surface. It can therefore be easily integrated into existing laboratory workflows, particularly when different set-up methods and occlusion concepts need to be implemented. One for all, all for one is possible in 4 sizes with the BonSelect TCR. The red one from CANDULOR The tooth rack which is optimized for the dental storage in the laboratory is a mirror image of the entire brand appearance. The "Red" represents the Swiss flag in the tooth cabinet, which presents the new anterior and posterior teeth harmoniously in both mold and shade.

"CANDULOR supplies its customers all over the world with high-quality, durable and esthetic, natural-looking products. When it comes to tooth selection in the tooth cabinet, quick orienta-tion is essential. We are Swiss, and proud of it, and this should be reflected by the PhysioSelect TCR and BonSelect TCR. Their red beats the usual black and gray." Alexander Ewert (Marketing Director) Made of durable tooth materials.

Adaptation to the alveolar ridge, to abutments and antagonists requires tooth materials that can be processed quickly. But also materials that reliably bond chemically to the base resin, and

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which are plaque resistant and abrasion resistant.

The new PhysioSelect anterior and BonSelect posterior teeth are therefore made of the re-sistant TwinCrossedResin, the 3rd generation TCR material, a modified polymethyl methacry-late (PMMA) variant.

The polymer, but also the matrix, are evenly cross-linked and additional-ly tempered.

This means that the pre-crosslinked polymer is again linked to the matrix and condensed during production. This way the tooth material meets the high requirements for plaque and abrasion resistance.

The new PhysioSelect TCR anterior tooth will be available for trial purposes as from April 2019 together with the BonSelect TCR posterior tooth. More information at candulor.com or live at the IDS. CANDULOR AG, Boulevard Lilienthal 8 CH-8152 Glattpark (Opfikon) Tel: +41 (0)44 805 90 00 Fax: +41 (0)44 805 90 90 Web: www.candulor.com Email: candulor@candulor.ch

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DENTAL NEWS

PLEASE, PLEASE, PLEASE, HELP!! l We just want your plastic milk bottle

tops to help mobilise a four year old, with Spina Bifida. Alan Wright at Blueprint Dental is appealing on the family’s behalf.

You know you are all drinking far too much tea and coffee but at least this way you use up some of the litter and fulfil a child’s dreams.

Just collect them at work and from home and keep sending them to: Alan at Blueprint Dental, Trident Court, 1 Oakcroft Rd, Chessington KT9 1BD, UK Tell your friends and family to pitch in and let’s get the Wheelchair built in record Time!

BDIA DENTAL SHOWCASE

LOCAL DENTAL NURSE AWARDED FELLOWSHIP

l BDIA Dental Showcase returns to the NEC, Birmingham from the 17-19 October 2019. It is a must-attend event in the industry’s calendar, bringing together the trade and the profession from all corners of the UK.

Taking, Plaque Indices and Competency in Fluoride Application. After having worked at St Annes Dental Clinic for several years, Claire has recently taken up a post in the Orthodontic and Oral Surgery departments at Fairfield General Hospital in Bury. She is also a member of the Orthodontic National Group.

l The British Association of Dental Nurses (BADN), the UK’s professional association for dental nurses, is delighted to announce that Claire Kaur RDN has become the latest BADN Fellow.

Claire attended Millfield High School in Thornton, followed by A levels at Blackpool Sixth Form College and then a dental nurse apprenticeship with Beneast Training in 2004, whilst working at Oasis Dental Care in Blackpool. After obtaining the National Examining Board for Dental Nurses NVQ Level 3 Oral Healthcare: Dental Nursing qualification in 2005, Claire continued her education and has been awarded further qualifications in Dental Radiography, Orthodontic Nursing, Oral Health Education, Dental Impression

BADN Fellowships are awarded to dental nurses who have been BADN members for a minimum of 10 years, and who have submitted a portfolio showing evidence of registration with the General Dental Council via a recognised dental nursing qualification; personal professional indemnity cover; a Personal Development Plan; a minimum of three additional post-registration qualifications from a recognised body; as well as evidence of reflective practice, management/supervisory experience, teaching and/or mentoring experience.

Applicants must also have had at least one article published in the dental press and have conducted some form of dental research, during the past ten years.

Applications and portfolios are considered

by BADN’s Executive Committee – following approval, BADN Fellows may use the postnominal letters FBADN. The Fellowship Certificate will be presented to Claire by incoming BADN President Jacqui Elsden at the National Dental Nursing Conference in Oxford on 1-2 November 2019.

LEE MULLINS

“VITA Digital Tooth Libraries with corresponding stock tooth ???”

That could be very good news for those using the system.

Digital dentures here we come!!!

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Familiar to all, it celebrates the best in the industry and allows the whole practice team the chance to explore the latest equipment, services and technology. This year's Showcase will also see the return and introduction of a range of specialist features.

Features for 2019: Dental Update Theatre - Lectures guaranteed to extend skills and competency with practical knowledge to reapply in practice.

CDO Zone - Sara Hurley, chief dental officer England and her team from OCDO, will be on-hand to answer your NHS questions.

Innovation Theatre - Pioneers and practitioners will talk you through the evolution and application of the latest dental products.

Practice Owners' Lounge - A VIP area with tailored talks on a variety of topics, including talent acquisition and boosting commercial sales.

Digital Workflow Showcase - Experts will be on-hand to showcase how a digital practice would run with an entire workflow from beginning to end.

Specialist Zone - Content designed for dentists who specialise in one of the 13 specialities or for dentists who are looking to specialise.

350+ Leading brands and suppliers - No other UK event gathers such a wide range of dental suppliers under one roof.

Registration to attend the Showcase is free! We look forward to seeing you in October. The BDIA Dental Showcase Team

l LONDON, UK: The London Assembly has released a new report addressing oral health inequalities among children in the nation’s capital. The British Dental Association (BDA) has praised the report’s recommendations, which include a call for a media campaign promoting the key messages that NHS dental services for young children are free and that all children need to see a dentist by age 1. The report also calls on the Mayor of London, Sadiq Khan, to encourage all local schools to become sugar-free.

DENTAL NEWS

LONDON ASSEMBLY PRAISED FOR NEW REPORT ADDRESSING CHILDREN’S ORAL HEALTH Mayor of London, Sadiq Khan

Official data has shown that 26% of 5-year-olds in London suffer from dental caries, making the capital the third-worst area in England in terms of oral health outcomes. Furthermore, ten London boroughs have seen a marked deterioration in children’s oral health over the last two years, and children in areas like Camden and Sutton are up to 25% more likely to suffer from caries now than they were two years ago.

When it gave evidence to the London Assembly, the BDA had expressed grave concerns that London had the lowest rates of children attending NHS dental services of any English region. Of the 20 councils with the lowest proportion of attendance, 18 were London boroughs.

Unlike administrations in Wales and Scotland, England lacks a dedicated and properly resourced national programme for children’s oral health. Caries is the most common reason for hospital admissions among young children.

task forces and to involve non-dental health professionals in oral health promotion.

back across the capital, and investment, engagement and education are key.”

The assembly’s report acknowledges that it is imperative to integrate oral health properly into the wider health agenda, notably in tackling problems such as obesity. It is also important to have appropriate dental expertise on other health

The BDA’s Dr Len D'Cruz, an NHS dentist in the London borough of Redbridge who gave oral evidence to the London Assembly, said: “This is precisely the sort of leadership we need to see from authorities in London.

Children’s oral health has been slipping

“Mayor Khan has made a commitment to make London the world’s healthiest city. He now has a clear blueprint to achieve that goal with our children’s teeth. This city can set a gold standard that the rest of England needs to follow,” D’Cruz added.

THE REPORT IS TITLED KEEPING THE TOOTH FAIRY AWAY: CHILD DENTAL HEALTH INEQUALITIES AND IS AVAILABLE FOR VIEWING

BY THE PUBLIC.

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DENTAL NEWS

INTERVIEW: “MOUTH CANCER IS A GROWING PROBLEM”

By Brendan Day, DTI I June 11, 2019

WITH ORAL CANCER RATES CONTINUING TO INCREASE WORLDWIDE, IT HAS BECOME CLEAR THAT MORE NEEDS TO BE DONE TO RAISE AWARENESS AND COMBAT THIS ISSUE. DENTAL TRIBUNE INTERNATIONAL SPOKE WITH DR NIALL MCGOLDRICK, SPECIALTY REGISTRAR IN DENTAL PUBLIC HEALTH WITH NHS FIFE AND THE CONVENOR OF THE CHARITY LET’S TALK ABOUT MOUTH CANCER, ABOUT THE CHARITY’S ORIGINS, ITS MISSION AND MUCH MORE.

FROM LEFT TO RIGHT: Let's Talk About Mouth Cancer's Prof. Victor Lopes; Dr Orna Ni Choileain; Dr Niall McGoldrick; Dr Stephanie Sammut; and Dr Ewan MacKessack-Leitch. (Photograph: Niall McGoldrick)

Dr McGoldrick, how did Let’s Talk About Mouth Cancer get started, and was there anything in particular that led to its creation?

It all started in 2013, soon after my colleague Dr Orna Ni Choileain and I graduated from dental school. We were both working as dental foundation trainees at the Edinburgh Dental Institute and had a shared drive to raise awareness of oral cancer among the public. We had an initial idea and we were introduced to three other colleagues, Dr Ewan MacKessackLeitch, Dr Stephanie Sammut and Prof. Victor Lopes, and from there the idea began to grow.

We all could see first-hand the impact the disease had on people’s lives and on the people around them and wanted to do something active, different and visible to bring change at all levels.

In the early days, we thrived on putting together public campaigns with few resources and little funding. We had to think outside the box and be thrifty to get our campaign off the ground. We used lunchtimes, evenings and weekends to design leaflets, paint backdrops and peruse items in charity shops to find the things we needed. It was really fun, and we quickly began to get support from other dentists and dental care professionals as word spread about our work. All five of us went forward to found the charity in 2014 and we have grown year-on-year. We now provide training for undergraduates and continuing professional development for postgraduates organise regular public campaigns throughout

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Scotland. We have partnered with national and territorial health boards across Scotland to spread our message about oral self-examinations to help promote early detection.

Today, Let’s Talk About Mouth Cancer is a multi-award-winning charity still driven by the same five volunteers, who are now close friends.

We are still true to our humble beginnings, have kept our running costs low and continue to be extremely grateful to patients, colleagues, relatives, students and everyone who has donated or raised funds in any way to help us continue with our work.

What is Let’s Talk About Mouth Cancer’s mission? How do you hope to achieve this?

Our mission is to improve the prognosis of patients with oral cancer through early detection and diagnosis. We are trying to tackle this in a number of ways. Our public campaign is focused on empowering people with the skills and knowledge needed to carry out oral selfexamination to identify this disease themselves and present early. We also counsel the public on reducing risk from well-known risk factors such as tobacco and alcohol. Secondly, we provide training for healthcare professionals at undergraduate and postgraduate level. This work is focused on improving the confidence of healthcare professionals when dealing with a suspicious lesion in primary care and ensuring they are up to date with signs, symptoms and urgent referral pathways.

How big of a problem is oral cancer in the UK and, more specifically, in Scotland?

Oral cancer is a growing problem in the UK, but especially in Scotland. Scotland has more cases of this disease per head of population than any of the other UK nations. Prognosis for patients remains poor, with 50 per cent of those diagnosed losing their lives within five years. Further to this, the inequalities that exist among those who develop the disease and those who do not are stark; the vast majority of people developing oral cancer come from our more deprived communities.

There are issues of social justice that need to be addressed. Improving the environment that people live in, making access to services simpler, making the healthy choice the easy choice and empowering people to care for themselves are just some of the areas that need to be addressed in order to prevent a further rise in the cases of oral cancer.

Society’s current approach of mitigating the circumstances when it is too late will not solve the wider issues.

What steps can individuals take to combat oral cancer?

On an individual personal level, we should all be aware of what is going on in our mouths.

Being familiar with what is normal in your own mouth is important, so that if there is a change you can pick up on it early. We want everyone to be carrying out oral self-examination to help identify what could be the early signs and symptoms of oral cancer. Our website has details on how to carry out a simple fivepoint check in less than a minute. In terms of reducing risk in the first instance: if you smoke, stop; if you drink alcohol, do so in moderation; do not use chewing tobacco and avoid betel quid and areca nut. It goes without saying that leading a healthy lifestyle and having a balanced diet will do wonders for your general health, but it will also reduce the risk of developing oral cancer. The last thing, of course, is to see your dentist as often as recommended.

At the health professional level, we need to be up to date, vigilant and competent in dealing with suspicious lesions. Being familiar with signs and symptoms of oral cancer is important, as is listening to the patient’s concerns and taking him or her seriously, understanding the urgent referral pathway in the area in which we work and being competent in referring appropriately.

Healthcare professionals also have a role in educating patients about reducing risk and

PROSTHETICS DENTAL TECHNICIAN REQUIRED FOR EXPERIENCED DENTAL LABORATORY IN NORTHERN IRELAND

Applicant must be GDC registered and capable of a high standard of work.

Must have experience in casting/trimming models, bites and trays, flasking and setting up.

Great opportunity for the right individual.

Competitive salary dependant on experience, ability and qualifications.

We can offer accommodation.

Please forward CV to damienohare@hotmail.com or call 028 3026 5765

teaching them how to carry out oral self-examinations.

Let’s Talk About Mouth Cancer will be hosting the Global Oral Cancer Forum 2020 (GOCF’20) in Edinburgh in March next year.

What can dentists and other health professionals look forward to at this event?

GOCF’20 takes place over two days - 6 and 7 March 2020 - and the theme is “Reducing risk; prevention, early diagnosis and innovative treatments”. We have lined up a selection of high-calibre international speakers and expert panellists to inform the conversation with attendees from around the world. Our aim is to develop actionable outputs in the global battle against oral cancer.

Unlike other international events, GOCF’20 invites attendees from all backgrounds: dentists, doctors, surgeons, public health practitioners, NGOs, charities, data scientists, survivors and patients to join the conversations and establish new thinking in the challenge oral cancer poses globally. Registrations for the conference will go live soon and all the info is available on the event’s website. We want as wide and varied an audience as possible to join the conversation as we develop these ideas. Come along and be part of the action!

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DENTAL NEWS

Our third approach is through advocacy.

We have lobbied the Scottish Parliament on issues related to human papillomavirus gender-neutral vaccination and our general work has been supported by a Scottish parliamentary motion.

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