The Dental Technician Magazine August Issue Online

VO L 7 1 N O. 8 I A U G U S T 2 0 1 8 I B Y S U B S C R I P T I O N

NATIONAL DENTAL NURSING CONFERENCE 16TH & 17TH NOV

CHRIS CURTIS & MELISSA MEAD SHARING THEIR LIFE CHANGING EXPERIENCES

VERIFIABLE CPD FOR THE WHOLE DENTAL TEAM

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MARKETING SIMPLIFIED PARTIALS OR NO PARTIALS?

BY ANDREW BARRS12 PAGE 16-17

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COMPANY PROFILE MY VISIT TO JOHN WINTER, HALIFAX

BY LARRY BROWNE, EDITOR PAGE 20-21

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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

MARKETING SIMPLIFIED WHAT IS EVERYONE ELSE DOING?

BY JAN CLARKE PAGE 6

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Inside this month

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CONTENTS AUGUST 2018

Editor - Larry Browne FBIDST. FDTA, ITI Fellow, LCGI, RDT. E: editor@dentaltechnician.org.uk T: 01372 897461 Designer - Sharon (Bazzie) Larder E: inthedoghousedesign@gmail.com 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.

Welcome Thoughts from the Editor

Marketing Marketing Simplified by Jan Clarke

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Dental News The National Dental Nursing Conference Oral health – where do we go from here?

Dental Tribune news Rheumatoid Arthritis and Gum Disease

8-9 18 26 - 27 30

Case Study

By Dr Hassan Maghaireh and Dr Victoria Ivancheva

10 & 12 - 13

Insight Looking back with John Windibank FOA Dental opinion from Sir Paul Beresford, BDS. MP Dental Technicians: Dangerous role of WW2: Part Four by Tony Landon

14 - 15 19 22 - 24

Digital Technology Partials or no Partials? That is the question for CDT’s by Andrew Barrs

16 - 17

Company Profiles

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

John Winter, Halifax

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20 - 21

Company News 27

CPD

Classifieds

28 - 29 31

The only condition is that they have not subscribed to the magazine for more than 12 months. Just ask them to call the Subscriptions Hotline. With four colleagues registered that means your subscription would be extended for a year free of charge.

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THOUGHTS FROM THE EDITOR

WELCOME to your magazine DEALING WITH THE HEAT! l Wow it’s certainly warm. I have had a few reports of how much many of you are suffering with the heat and how its making life difficult to maintain the waxes as you want them. With all the other effects of too much latent heat while just sitting at the bench or working with the traditional methods for chrome and castings procedures. We are now into the school holidays and with this climate who needs to go abroad? Just think of all those wonderful seaside places around our coast and lots of provided entertainment for the kids. And no language barrier!! A long car journey perhaps or indeed a train trip just to keep it simple. I don't for one minute believe there will be much of a change to our travelling habits but who knows.

Not one single comment has come through to me about my editorial in the July edition. It was not written with any other reason but to try and get some response from the profession, which includes you! I was fairly outspoken and direct but unless someone shows they are caring what do we do when the audit comes to call and we make the usual excuse of, “it was him not me”. We are all responsible for what is placed in patients’ mouths. Our registration require that none of us turn a blind eye to poor or damaging work if we know it exists.

Of course that means rocking the boat but I think many of you realize the boat needs rocking. How else can we ever get change?

The BDIA show is coming up and despite all our comments regarding the past meetings there is little or nothing arranged for technicians. Of course we will be lumped into the bag of the digital dental changes and offerings just to make sense of them but no attempt to include us a part of the “Team”.

I did not see any references to CDT’s within the programme as quoted and so it will be a hawk around to meet one or two dentists and to comment on various stands appealing to the clinical aspects of modern dentistry. I use the word modern but fail to see any movement in attitude than that maintained from the beginning of the BDIA all those years ago. DTS has certainly stolen their thunder on exhibitions and shows,

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because they see the whole team as valuable target market where the BDIA have an old fashioned, them and us, attitude. Strange how we are encouraged to think of the Team approach to restorative dentistry but the very companies that advocate this are among those numbered as the policy makers at the BDIA. Of course many of the companies who deal in digital hard and software are always hoping they will not be held liable if they knowingly supply a dentist with in house manufacturing equipment and sundries without insisting they register with the MHRA as capable and trained to carry out the treatment, which is required by law. So if you want to see what the local dentist is being encouraged to use or are particularly interested in the clinical processes by all means go to the BDIA, but I really don't think you will get much stimulus for your on going career. It might be good place to meet with possible clients but it a long shot.

Nothing in life is really New!! Going back through my meagre collection of back issues of the DTM I found a front page headed.

“Illegal Milling situation clarified by the MHRA and the GDC.” An article from

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November 2013 put together by Barry Appleby, then President of the Dental Technologists Association (DTA). He shows in the article that at least 750 Dentists were working illegally. I wonder if the number has changed very much? I suspect not and I further suspect the BIDA are deliberately ignoring the law because it may interfere with sales. This of course would implicate the sales and supply team in being partners in crime. Within the article Barry showed that dentists who were making restorations for their own patients in house had been led to believe they were not covered by the legislation. That of course is not the case.

There are in fact very few exemptions and none of them cover dentist manufacturing without registration and evidence of the training required. The notable exceptions are local authority and teaching hospitals or universities. But the situation there is also a bit clouded with some registering, even their technicians, while others appear not to register anybody. Are they in fact teaching those that need to know what the law is? Or are they in fact encouraging illegal dentistry by not paying too much attention to the MDD regulations? I am sure it will all come out in the wash. Keep watching these pages!!

Larry Browne, Editor

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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

WHAT IS EVERYONE ELSE DOING?

The rights and wrongs of checking the competition!

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arketing doesn't have to be difficult.

Yes, there are all sorts of systems and technicalities that would appear to make marketing a dark art. Ultimately marketing is about making your business as accessible as possible to your ideal client.

2) A local business networking group - this is probably quite simple and the quickest way to join like-minded people. It does take time to build trust and open up so persistence is required. Results will not happen overnight.

I make no apologies for repeating this definition of marketing but I feel for most dental business it is increasingly relevant.

“Marketing is everything a company does, from how they answer the phone, how quickly and effectively they respond to email, to how they handle accounts payable, to how they treat their employees and customers. Done right, marketing integrates a great product or service with PR, sales, advertising, new media, personal contact. In other words, marketing is not a discipline or an activity it is everything a company is at least if the company wants to be successful” B.L. Ochman.

In the previous edition I talked about looking at your business from your clients perspective and I would encourage every one of you to attempt this but what about looking at other businesses? Over the years, as a practice advisor for Denplan and a vocational trainer, I was incredibly fortunate to be able to visit many dental practices as both an assessor and visitor.

I can honestly say that, whilst I helped to give suggestions to aid in the running of practices, I always came away with at least one great idea to put into try out in my own practice.

With this in mind, I am a great advocate of peer review and would encourage you to participate in this in someway by:1) Joining an online forum for dental technicians perhaps one with dentists in too 2) Joining a local business network group with a variety of businesses 3) Joining a study group/business development group solely for dental technicians

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Many times in business we tend to be protective over our ideas and products but by sharing ideas we can gain so much: • business development • career development • renewed enthusiasm and vigour for your business • reflection on business practices and new innovations All these groups will give you all of the above but a small group of like-minded individuals you can trust and where you can open up in a non-judgemental way to, will arguably help you the most.

If you are in any doubt as to whether such a group is for you, I would get you to ask yourself these questions: • how do I make decisions about my business?

• who do I talk to about my business?

• where do I go to get perspective on my business/life?

HOW DO YOU GO ABOUT FINDING SUCH GROUPS? 1) Joining an online forum - these are plentiful, the secret is finding the right group for you. Facebook has many dental groups and you probably won't know the group is for you until you post and put your head above the parapet! Just give it a try.

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3) Join a study group/business development group solely for dental technicians. This type of group will more than likely give you the best chance to develop your business, your leadership and your life. They are more difficult to find although several companies organise these types of "clubs". They are usually UK-based and will require some travel. Most companies who organise these groups, like our include "Club Connect", will not allow close geographical competitors together. Over time, I do believe that groups such as these help you in so many aspects of your business and life.

You can, of course, organise your own group, in fact you may already participate in some form of peer review. It can be extended to cover business development, marketing and planning.

We spent time looking at your business from your clients perspective, it is now time to look at other businesses. Learn what others do that work, what doesn't work and which ideas you can take from them and apply to your business.

By putting heads together and sharing these experiences with each other you can leapfrog years of learning, mistakes, tears and frustrations.

If organising a small peer review group is of interest please email me and I will attempt to facilitate this for you. Email jan@roseand.co 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!

DENTAL NEWS

THE DAY THAT CHANGED MY LIFE

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DENTAL NEWS

TWO OF THE SPEAKERS AT THE NATIONAL DENTAL NURSING CONFERENCE, TO BE HELD AT THE BLACKPOOL HOTEL CONFERENCE CENTRE AND SPA (FORMERLY THE BLACKPOOL HILTON) ON FRIDAY 16 AND SATURDAY 17 NOVEMBER, WILL BE SHARING THEIR LIFE CHANGING EXPERIENCES. CHRIS CURTIS Chairman of the Swallows Head and Neck Cancer Charity, Honorary Senior Lecturer at the School of Health Sciences at the University of Central Lancashire, and World Cancer Advocate, vividly remembers the day he was diagnosed with throat cancer.

The Conference will offer 8 hours of verifiable CPD over the two days. Dental nurses, and other members of the dental team, can attend either or both days.

There is a discounted rate for current BADN members, for student dental nurses and for those booking before the end of September.

His presentation “From Cancer to the Palace in Six Years” (which meets GDC development outcome A) aims to provide awareness and education on head and neck cancer; a patient insight to the cancer pathway, and education from a patient’s view, as well as an insight into the challenges in survivorship and the side effects of cancer and cancer treatment.

There will also be an optional informal dinner at local restaurant Twelve (www.twelve-restaurant.co.uk) for delegates and guests.

MELISSA MEAD Ambassador for the UK Sepsis Trust and campaigner, lost her one year old son William to sepsis – a condition of which, at the time, she was completely unaware.

Upon discovering the shocking statistics, she felt compelled to campaign for better recognition, diagnosis and treatment of sepsis amongst health care professionals.

Her presentation “Together We Can Beat Sepsis” (which meets GDC development outcome C) aims to widen attendees’ knowledge and understanding of sepsis and looks at the role we all have to play in driving down the number of avoidable deaths.

MORE INFO AND A RESERVATION FORM IS AVAILABLE AT

www.badn.org.uk/conference To join: www.badn.org.uk/sign-up

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CASE STUDY: BY DR HASSAN MAGHAIREH AND DR VICTORIA IVANCHEVA

CASE STUDY

IMPLANT-RETAINED MAXILLARY OVERDENTURE FOR FAILING UPPER BRIDGES

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assan Maghaireh and Victoria Ivancheva, of Clarendon Dental Spa and treatmyimplant.com aesthetic implant referral services, present a clinical case using Roxolid Tissue level Straumann implants and Novaloc over-denture abutments, for a patient who was given his smile, confidence and chewing abilities back, which has reflected on his general well-being.

INITIAL SITUATION A 75-year-old male patient had multiple bridges built over the last 12 years. He presented with multiple abscesses and root decays that had developed under his latest long span bridge which needed to be accessed for root canal treatment. It was advised that a new bridge would not be successful due to deep cracks in the supporting roots ,so there was a necessity to look for alternative options.

It was also explained that it was in the patient’s interest to consider a removable full arch option instead of a fixed option due to his age and reduced manual dexterity , therefore the decision was made to make an implant-retained over denture which would be the most suitable and predictable treatment option.

TREATMENT PLAN The plan was to secure an implant-retained denture in the upper jaw using four implants, requiring full dental clearance of the upper jaw and two temporary dentures.

Also two temporary mini implants at the UR7 and UL7 area were used to help in retaining the upper conventional denture. The patient was aware that these were temporary implants and will need to be removed at a later stage. They are mainly aimed to help in retaining the upper temporary denture to reduce any discomfort during chewing and speech.

The patient was aware that he might need to wear the denture for eight weeks before placement as an early placement protocol was preferred in this case, and possibly 8 - 12 weeks after implants placement ignorer we allow for full integration of the upper implants. He was happy that the temporary denture would be very useful to help with chewing and eating, but

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more importantly will act as a communication tool between the patient, dentist and the lab technician, in order a final aesthetic try-in will be matching the patient’s expectation.

EXTRACTION OF UPPER TEETH AND FIT OF TEMPORARY DENTURES Eight weeks after the removal of the top teeth were allowed to achieve good soft tissue healing and to get rid of any remnants of infection. A new temporary denture was prepared , taking in consideration the patient’s notes and meeting his aesthetic expectations.

This new temporary denture was later used as the prosthetic envelop for the implant placement and used also as a guide to prepare the clear hard acrylic surgical guide. A CBCT was taken with the surgical side in situ which helped in planning the case carefully.

SURGICAL PROCEDURE The patient consented for placement of four upper implants to retain the overdenture.

Pre-op 2gm Amoxicillin and Corsodyl mouthwash were given. Green towels and

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standard cross-infection control measures were implemented and 12ml 2% lignocaine with adrenaline injections were administered.

Four small flaps were raised at each implant site and four osteotomies prepared using Straumann® drills with sequential drilling under copious irrigation. No perforation was noticed.

The products used were as follows: • Straumann UL2: 3.3 x 12mm RN, 25 Ncm, 5.5 x 4.5mm Healing Abutment,

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CASE STUDY

•

GBR used to cover the thin labial bone using cerabone® and Jason® membrane

•

4/0 Monocryl and Prolene Sutures

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Straumann UR6: 4.1 x 6mm RN, 20 Ncm, 5.5 x 4.5mm Healing Abutment

•

4/0 Monocryl and Prolene Sutures

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Straumann UL6: 4.1 x 12mm RN, 20 Ncm, 5.5 x 4.5mm Healing Abutment

•

4/0 Monocryl and Prolene Sutures

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Straumann UR3: 3.3 x 12mm RN, 25 Ncm, 5.5 x 4.5mm Healing Abutment

•

4/0 Monocryl and Prolene Sutures

POST-OPERATIVE The temporary denture was eased off and soft relining was used to complete the denture fit.

Post-operative instructions were given to the patient verbally and in writing: •

Rx: Amoxicillin 500mgs TDS 7/7, Corsodyl mouthwash, Ibuprofen 400mgs qds 4/7.

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RESTORATIVE STAGE: A new chrome-cobalt (Cr-Co) over denture was prepared by the CDT following the usual work-flow; • • • • •

primary impression secondary impression using special tray gothic arch tracing and bite registration try in stage to conform to the aesthetic try in agreed at the assessment stages of this treatment.

Once a final Cr-Co denture was prepared with satisfactory extension, support and retention, the healing abutments were replaced with Novaloc abutments maintaining them with 2 mm supra-gingival height to avoid mechanical overload. All the Novaloc abutments were torqued to 35Ncm as per Straumann recommendations.

Novaloc housings were fitted on the abutments with white sleeves underneath to block undercuts and Variolink cement used to pick the housings into the fitting surface of the metal frame of the final denture.

The denture was polished and checked for full support, retention and extension.

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Occlusion was checked and adjusted and post operative care instructions were given.

It was also discussed and agreed with the patient to convert the temporary denture into a temporary acrylic implant over denture to be used as a back up prosthesis whenever a repair is needed for the final CrCo implant over denture in the future. This offered the patient a peace of mind.

Annual reviews were arranged and 3 years on, it is confirmed that the over-denture and his implants are in good condition.

CASE STUDY

CONCLUSION The patient was very satisfied with the final result. He gained his confidence back at the workplace. It’s worth mentioning that being a business owner made public speaking something he does on a regular basis. He is also now enjoying the food he has been unable to eat for a long time.

Using 4 upper implants with Novaloc abutments and PEEK inserts, not only offer the patient full functional abilities, but also a long term stability and very minimal wear and tear ability due to the design of the Novaloc abutments and high wear resistance of the Novaloc inserts. It is also considered as a good practice to prepare for complications and have a secure back-up prosthesis made and always ready.

This denture was prepared by the CDT; Jonathan Hughes at Hughes Lab - Harrogate.

ABOUT THE AUTHORS Dr Hassan Maghaireh BDS, MFDS (Ed), MSc Implants (Manchester). Hassan Maghaireh maintains a private aesthetic implant referral practice in Leeds and Yorkshire, accepting referral from dentists and self referrals from the public (www.treatmmyimplant.com). Dr Maghaireh acts as a mentor and a lecturer in Implantology at The University of Manchester, he is also the head of the scientific committee at the British Academy of Implant & Restorative Dentistry (BAIRD). He completed five years training in various maxillofacial units in the UK, gaining his membership in the Royal College of Surgeons in Edinburgh by Examination in 2005.

He then gained a Clinical Master’s degree in Implant Dentistry from the University of Manchester winning the best clinical presentation award in 2007. Hassan published many clinical studies in peer reviewed international journals. He has special interest in

bone grafting in the aesthetic zone, peri-implant soft tissue management, immediate loading in the aesthetic zone, and managing aesthetic complications. He is also actively involved in the oral health group of the Cochrane collaboration, updating evidence-based systematic reviews on various dental implant-related topics.

The dual nature of his clinical and evidencebased training makes Dr Maghaireh a frequent author of dental literature, and a sought-after lecturer nationally and internationally.

Dr Victoria Ivancheva is the restorative dentist in Dr Maghaireh’s Implant team in Leeds, United Kingdom . She has completed her Master degree from Medical University Sofia and since then she has devoted her time for managing comprehensive aesthetic restorative cases including dental implants and full mouth rehabilitation. She graduated

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form the BAIRD Implant course 2018 and presented various implant and restorative lectures at Manchester University , Baird academy in Dubai and in Leeds. She is part of the scientific committee of BAIRD Academy and scientific committee of iLed congress 2018 Dubai and also coordinator of the poster competition committee of the congress.

Her passion for the profession led her to participate in numerous of conferences and symposiums all over the world. She attended the International Congress of Medical Sciences where she won first prise for Dentistry poster competition. As an active member of ITI organisation she takes part regularly in the annual regional meetings such as Young ITI Dentist Days April 2018 workshops and study club activities. Upon similar initiative she is the head of the project Young BAIRD graduates.

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LOOKING BACK JOHN WINDIBANK FOA INSIGHT

MEMORIES OF AN OLD CODGER 15 THE 1970´S

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977 a time of change and turbulence for UK limited, with Jim Callaghan a new prime minister and Margaret Thatcher the leader of the opposition.

Industrial action was endemic in the country, the IRA were really getting going with bombs in London's West End and inflation stood at a 3-year low of 15.8%. Geoff Boycott was scoring his one hundredth hundred and Clive Sinclair was showing off his 2" TV and was just about to revolutionise the world with the his FX80 personal computer, but more about computers later on.

The Central Council for Health Authority Dental Technology was into its fourth year, Rod Snape had been Chairman for the last two years and he had found that Working 24/7 on call had limited the time he could spare to do the job for us and stood down. Rod also resigned his Whitley Council seats and I was asked to take on both jobs and taking over from a man like Rod was a hard act to follow. Rod Snape and I became firm friends over the years he was a very impressive man who excelled in everything he touched, he had won technology awards been head of Dental Technology in Uganda and Canada. Rod had been on the executive committee of IMFT, Principal Chief at Peterborough General Hospital and much more. After his early retirement with a heart condition he founded and was chairman of the local allotment and gardening society and resurrected the

WHITLEY COUNCIL PTB/B COMMITTEE STAFF SIDE CC 1984.

LEFT TO RIGHT: ANO minute Secretary NALGO - Paul Smith NALGO - Mr Thorp NALGO - Jimmy Duncan USDAW Chairman Ray Harris NALGO Secretary - John Windibank AUEW/TASS - Jim Hughes AUEW/TASS – Mr Briggs USDAW - Len Comber AUEW/TASS - Harry Eastwood USDAW taking the photo.

bowls club. Rod died in 2006 and it was a privilege to know him.

The Whitley Councils Professional and Technical B Council B committee(PTB/B) dealt with pay and grading issues for Dental Technicians and I had now fallen into a position to follow through on one of my obsessions and that was proper recognition for Orthodontic Technicians within dental technicians PTB/B grading structure. At the start of the Heath Service there were dental technician’s senior technicians’ surgical technicians and two chief grades. The grades had been tinkered about with over the years and at one time the senior grade was done away with and a technician’s grade of about 14 increments was introduced.

The surgical grade became a maxillofacial technicians grade, but things had changed and Orthodontics was the growth part of our technology and I wanted that recognised. I spent some time outlining my ideas to introduce senior grades for Orthodontics, Crown and Bridge and Prosthetics and linking these to advanced qualifications, I then submitted the

proposals to my union. My union discussed the issues and agreed on a set of proposals that I took along to Central Council and with further discussions.its members took the proposals back to their unions. With everyone in agreement they were submitted to the PTB/B committee and the proposals were concluded with a Whitley Council agreement in 1980 which linked senior grades to advanced qualifications.

The post of secretary of PTB/B had swapped around between the unions over the years, but when I was involved the post was always provided by National and Local Government Officers Union (NALGO). These were bright young graduates keen to get on, they prided themselves as professional negotiators and accumulating secretary posts helped their profile. They mostly didn't stay long and each in turn needed to be informed about the job and its aspirations, but their biggest obsession was to attract more members to their union and holding the position of secretary they were able to do this very effectively.

JOHN WINDIBANK FOTA Senior Chief Technician at West Hill Hospital, Dartford, Kent. l Represents OTA at CCHADT & Regional Delegate l

PASSED POSTS: Member of the first steering committee that founded the OTA. l Founder Member of the CCHADT l Member of the Whitley Council and Committees for 15 years. l Dental Technology l

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Representative on the National Health Service Training Advisory Board l Member of the City and Guilds Dental Advisory Board l Member BTEC Dental Technology Higher Awards Advisory Board l Member DTETAB Representing MSF l Teacher of Orthodontics at Maidstone & Medway Technical College. l Vice Chairman OTA

Chairman CCHADT Education Officer l Minutes Secretary l First Treasurer l Member of SLC Dental Advisory Committee l l

HONOURS: Fellow of the OTA AE Dennison Award for services to Dental Technology

l l

very verbal and sharp and there is one moment from our work together that's worth repeating. Len and I were called to a PTB staff side meeting, this one happened to be in a committee room of the Great Hall in the Houses of Parliament. A member of the committee who was rarely at our meetings was encouraging the unions present to agree to strike action and he was getting some support. Len intervened in the discussions with a fierce repudiation for such action and you could see the relief on the faces of those present who had been reluctant to show solidarity to a colleague. Bert Spanswick the Chairman quickly wrapped up the discussions to a relieved committee, declaring that there was not a consensus for action. I wasn't entirely trusted by Len and I was kept at arm’s length over discussions taking place at the General Dental Counsel(GDC), but more of that soon.

Len Comber was Chairman of AUEW/ TASS Dental section and of his local Conservative Party group. He was chief technician of at the Central Dental Laboratory situated in Highbury London and for football buffs just round the corner from the old Arsenal FC stadium.

Len had an opinion on everything, was

Pay is an issue for all groups then as now and health service Dental Technicians, who at the start of the health service had the longest training qualifying period of all the technical groups, felt theirs was inadequate. There were lots of opinions of how to correct the shortfall and pre and post war, statutory registration was

thought to be the answer, especially by the traditional craft unions. Other groups considered improving our status was the answer and always combined with these objectives, especially in the NHS, training, education and standard levels were thought to be holding us back.

In 1948 legislation was drawn up for a parliamentary act to register Dental Technicians, but that process was opposed by the British Dental Association and the process was stopped. The GDC Unions in response started the voluntary Dental Technicians register to continue with our objective for statutory registration. I was shown a copy of the proposed registration act by an impressive man who dedicated his life to our technology and I knew him as Johnny Johnson. Johnny was a let’s get it done sort of man, he was secretary of the USDAW Kent branch, a member of the staff side of GDC and he with the Kent Technical Collage had started Dental Technology classes in Maidstone. When Mr Johnson wanted to run an advanced orthodontic course I was recommended to him by Bert Aldridge (secretary of the OTA) and we ran a very successful class there. Johnny was the voluntary registers registrar, until it was handed over to DTETAB in 1984, but more of that later.

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INSIGHT

The longest standing members of the committee were Jimmy Duncan representing the Union of Shop Distributive and Allied Workers (USDAW) and Len Comber of the Amalgamated Union of Engineering Workers / Technical and Scientific Staff (AUEW/TASS).

Jimmy was the chief technician at Dundee Hospital and he impressed me with the great work he was doing there, I was told he was on a Labour Party candidate short list and extremely positive and firm when presenting arguments. When the chairman of the committees or councils were absent, Jimmy was always the stand in choice and was a very capable chairman.

To get to meetings mostly in London, Jimmy used to take the sleeper from Dundee and arrive fresh in the morning.

Jimmy didn't see the point of Central Council and thought all dental technicians should join his union, we often disagreed but I liked Jimmy Duncan.

DIGITAL TECHNOLOGY

PARTIALS OR NO PARTIALS? THAT IS THE QUESTION FOR CDT’S

BY ANDREW BARRS 16

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Is this workable for CDTs? Should the law be changed to allow CDTs to increase our scope of practice?

As a former President of the BACDT I know it was our job as an association to ask our memberships their views on different matters and how they wanted me and the board to represent them moving forward.

One question that was always asked to the members was about partial dentures and surprisingly or unsurprisingly, depending on your view point, direct access regarding partial dentures always came quite low on people´s priorities. Many CDTS not currently in the BACDT don´t seem to agree with this and some even think, with their current qualifications, there should be the right to make partial dentures without any involvement of a Dentist.

In a recent email sent to BACDT members and I quote: BACDT would like to confirm that the association has consistently promoted the right for a patient to be able to choose whether they directly see a Dentist or a Clinical Dental Technician for a partial denture. We have been told very clearly that the opportunity for full direct access will continue to be limited until the current under-graduate courses for Clinical Dental Technology include partial denture direct access and that this is approved by the GDC. Once this has been achieved, this will allow for a post-graduate CPD course to be established based on the under-graduate course content, thus allowing current GDC registered CDTs the opportunity to work directly with the patient for full/full and partial dentures. We are keen that all of our members are aware of the current status quo and understand the reasoning behind any perceived procrastination on this subject by BACDT. As always we are still pushing for the opportunity and indeed our Board members will continue to raise this issues with the educators and regulators alike. There was a meeting held recently at the DTS which I attended and there were many opinions about partial dentures.

One individual said and I quote: “You can´t make money working legally” I didn´t respond to that comment but I thought to myself god help us. If this is our professions opinion what hope do we have moving forward. Let me reply to that comment now and say Working legally can and should enable you to earn a very good living if you are professional and charge appropriately.

My opinion is that as a profession we do need to strive for partial dentures going forward otherwise our industry will die but I also feel

that CDTs haven´t thought things through about partial dentures and how the GDC might implement them.

Currently it seems that CDTs who do not get a Dentist to see their partial Denture patients can save money and sadly it would appear they don´t have a close working relationship with many Dentists.

Granted it can be difficult initially to get a good working relationship going with a Dentist but I guarantee when you find someone you can work with both you and them will be very happy. Firstly you are fully covered legally. They get an extra £50 and usually a lot more work besides and they free up their surgery time for more productive work other than dentures.

I think there are 4 main factors that CDTs need to consider regarding partial Dentures rather than just thinking it is their right and they are being hard done by.

1. PROFESSIONALISM 2. TRAINING/EDUCATION 3. CQC REQUIREMENTS 4. COSTS TO IMPLEMENT 1. PROFESSIONALISM. Sadly with the amount of prosecutions currently of CDTs running at approx 3% !!

That´s not many I hear you say, but let´s put it another way There are currently around 360 CDTs. There are approximately 40,000 Dentists. There are clos to 40,000 nurses and there are Approx 5000 Dental Technicians.

So 3% of the overall prosecutions is a huge number. Way to many. Sadly it seems the majority of those prosecutions are for working beyond their scope of practice. But there are a number of cases for not keeping proper records, failing to correctly record medical history and to obtain proper patient consent.

From 2007 the GDC have given us Full Full dentures (that inreality has taken the best part of 30 years and over 20 years since I started my George Brown diploma) and they could well be seeing how we are handling that responsibility! If they are, sadly we are not doing very well are we, if current prosecutions are anything to go by. If we can´t be seen to be professional now why should they increase our scope of practice?

We´ve all got to be part of the Dental team and at the moment being part of that team also means, and rightly so, working closely with a Dentist. And let´s say the average a CDT is paying that Dentist £50, then take it from me that is a small price to pay, and can so easily be added to the cost of the Denture.

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2. TRAINING/ EDUCATION. Dentist are trained to degree level, we are not and whichever way you want to look at it we are not taught as much or don´t know as much about natural teeth as they do. Besides the law says we can´t currently make partial dentures. Our training isn´t currently up to the GDC requirements to allow us to do partials dentures directly. Sadly there is no longer any KSS training in place now and the only college that is offering any sort of CDT training is Uclan who in reality have no interest currently in offering further training in that area. So until this changes we can´t move forward.

3. CQC. Now if as a profession we want and manage to get the GDC to agree CDTs direct access for partial dentures the next step is going to be signing up with the CQC and if you ask any Dentist what their thoughts are, it´s time consuming and expensive. Do we want all the extra paperwork and cost? A Dentist colleague of mine spent a fortune bringing his surgery up to scratch to comply with CQC and he spends a huge amount of extra time and cost dealing with protocol.

4. COST TO IMPLEMENT. So let´s weigh up the costs given you´re paying your friendly Dentist only £50 for every partial Denture patient you see against all of the other costs to enable you to have direct access and be allowed to make partial dentures. Training - let´s say a post graduate top up course costs £5000, then all the extra time spent training, hotel accommodation, traveling etc. Also the Cost involved to make your Clinic CQC compliant.

Then the cost of implementing it month on month, possibly another member of staff.

Radiographic (X ray) equipment and regulations involved, Decontamination room etc, etc. The list and the cost goes on and on and let´s also not forget all the extra responsibility.

I currently pay dental protection £2000, let´s add partial dentures onto our policy and the cost suddenly trebles because that 3% of CDT prosecutions suddenly becomes 8% as I can see many CDTs not complying properly.

What happens in 4 years time when the patient you made a partial Denture for today suddenly comes back to you and says “That Denture you made me caused me to loose 3 more teeth and it´s your fault.”

Suddenly, finding a good dentist to work with, paying him/her £50 per patient. Letting them get the patient dentally fit, with fillings, crowns etc. and then you as a CDT can charge the correct money doing the one thing you are good at and are trained to do. Making dentures, that £50 suddenly becomes a small price to pay. Think of it as Double Indemnity.

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DIGITAL TECHNOLOGY

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urrently as we all know the current regulations set by the GDC states that Clinical Dental Technicians can only make partial dentures with an oral health certificate/ prescription from a Dentist.

DENTAL NEWS

ORAL HEALTH WHERE DO WE GO FROM HERE?

ON 15 MARCH, JOHNSON & JOHNSON HOSTED THE OH! PANEL AT THE BRITISH DENTAL ASSOCIATION IN LONDON

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haired by Stephen Hancocks, it brought together eight key opinion leaders in dentistry: Ben Atkins; Julie Deverick; Penny Hodge; Tim Newton; Anthony Roberts; Julie Rosse; Nicola West; and Helen Whelton.

A vision was agreed by The Panel as something all dental professionals should work by to help improve patients’ oral health: “The ultimate outcome is to improve oral health and therefore systemic health.

The vision is that every dental health care professional, upon seeing a patient with gingivitis and / or periodontitis, can and will: • Make a diagnosis and communicate the relevance of the condition to the patient.

Explore risk factors and modify behaviour for successful outcomes.

• Help every patient who receives the diagnosis to improve their oral health for life.’

Julie Deverick commented: ‘I’m excited about the vision in the statement, because it’s something we can all now bring to our Societies and to our profession.’

Johnson & Johnson have an on going commitment to the vision statement, and will work with that in mind, ensuring that all professional communications support the concept, to the benefit of the profession and patients.

THE OH! PANEL l The OH! Panel was a natural extension of The OH! Challenge, which was launched at the 2017 British Dental Conference and Exhibition. At the event, dental health care professionals (DHCPs) were invited to undertake a simple survey, created to test

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their knowledge in relation to key oral health topics. This provided valuable data for the creation of a communications programme to support DHCPs in keeping their knowledge current.

In total, 464 dental health care professionals took part in the survey.

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Overall, the average score amongst all participants was 51%.

Further key findings included: • 46% did not know that gingivitis and periodontitis are a continuum of the same inflammatory disease • Only 44% knew the updated BPE guidelines for code 3 sextants.

DENTAL OPINION FROM SIR PAUL BERESFORD, BDS. MP

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sking a Parliamentary Question PQ in Parliamentary speak - is a bit like chasing a bouncing rugby football. Because it is not round it almost never bounces straight. That is unless you are an All Black when it always bounces to your convenience. At least that is what it seems.

Timing is important but rarely works out.

Ideally it is best if it is topical and fits the cycle of departmental questions.

You then put your question together. It must set out what you want and be short. If possible it is good if it is a leading question.

Make it tight so the minister cannot, if he or she wishes, walk around the answer you want.

You then submit the question and hope.

There are always to many questions so there is a ballot, which I do not often win. Even if you are listed you need to be in the top 10 or so to be sure your question will be called.

Having heard the Joint Committee on Vaccination and Immunisation, had suggested to the Department of Health that HPV vaccination should be extended to boys and not having had a response from ministers the time was right. The question was carefully constructed in Parliamentary Speak and submitted. To my astonishment the question was ballot as number 5. Absolutely ideal.

The next task is to guess the reply and construct the supplementary as each questioner has the first shot at a supplementary. That question can be key and draw extended information from the minister. If it is too long the Speaker will cut you off, generally before you have got the key point out.

I guessed the minister would announce the vaccination would be extended to boys but I felt I needed to put in a shot for men and also to try to get a boosted start to the program.

SIR PAUL BERESFORD. BDS. MP. Dual UK/NZ nationality. New Zealand born, bred and educated, with post graduate education in UK. Worked as an NHS and private dentist

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If one knows the minister it’s sometimes worthwhile telling the minister your likely supplementary question so that a more positive and useful reply can be forthcoming.

I know Steve Brine and slipped the base text of my supplementary to his PPS and hence office. It is rare that all this works as anticipated but all went like clockwork as the extract from Hansard printed below shows.

Sir Paul Beresford (Mole Valley) (Con) What assessment he has made of the potential merits of extending the provision of the HPV vaccine to boys. [906609] The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine) Our expert group, the Joint Committee on Vaccination and Immunisation, issued its final advice on HPV vaccination for boys on 18 July.

I have carefully considered its advice, and I wanted to tell the House first that the Government will introduce a nationwide HPV vaccination programme for adolescent boys. This will bring clear health benefits for boys, providing them with direct protection against HPV infection and associated disease, including a number of cancers.

INSIGHT

SUCCESS ON HPV FOR BOYS implementation of the programme, including with regard to the issue that he raises, which makes a lot of sense and for which there is precedent from the girls’ programme. I will of course consider the advice and confirm the implementation plan as soon as possible.

Firstly, the HPV programme extension was announced. Secondly, a shot in for men and head and neck cancer was landed and thirdly the boosted program for 14 - 18 year old boys was essentially agreed. A discussion with Steve Brine indicated a commencement in September 2019.

It has taken five years but at last we are there. Results from a similar program in Australia shows that after a very few years the decline in genital warts is marked with a considerable saving.

Of course as dental professionals it’s the decline we will get in head and neck cancer that will be the huge winner but is a few decades away.

A very special welcome to this very good news.

Sir Paul Beresford I declare an interest as a very, very part-time dentist. I am delighted by the response, but given the importance of head and neck cancer prevention for both sexes, but especially for males, who are twice as susceptible, will the Minister supplement this programme with a catch-up programme, as was done for girls in 2008, to make the vaccine available for 14 to 18-year-old boys?

Steve Brine I thank my hon. Friend for welcoming this.

The British Dental Association has been key in lobbying on this issue, as has—I give credit where it is due—The Mail on Sunday, which has campaigned on it for a long time. I have asked NHS England and Public Health England to work together to advise me on the

in East and South West London. Private dentist in the West End of London then and currently in a very part time capacity in South West London. l Councillor including Leader of Wandsworth Council moving to the

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House of Commons.

A Minister in the John Major Government, MP for the then Croydon Central, then elected as MP for Mole Valley as a result of the boundary changes for the 1997 election.

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COMPANY PROFILES COMPANY PROFILES

MY VISIT TO

JOHN WINTER,HALIFAX

A VERY INTERESTING AND INFORMATIVE EXPERIENCE LARRY BROWNE. EDITOR

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his month I have managed to get to see around the John Winter Company in Halifax Yorkshire.

At the recent Dental Show in Birmingham they occupied the stand opposite and it was clear they had a real appeal for many who came with a great deal of banter and interest in their collection of products and services. They recently agreed a distribution deal with Shofu and for some of us in the south their name will become much more familiar. In the past I associated the company with the supply of Plaster and other dental stones with no idea of their background. There was someone called John Winter who set the company up some 50 years ago as a Foundry supplier. In short supplying moulding materials such as investment, plaster of Paris, sand and various necessary sundries for the casting of car parts, such as engines, brakes and various other vital metal components for the Aerospace industry. In an age of the Digital design and manufacture the need for casting remains a growing demand.

I met with the sales manager Brendan Foster who has a wealth of knowledge on the overall company but in particular the dental side. Brendan has a long pedigree working within the dental field and will be a familiar face to many. It was clear, during our long visit, his commitment to what he does and his love for the interaction between his clients and his company. Brendan began working within the modelling departments of several dental laboratories and developed a sense of the organisational process required to make them work and to keep them efficient and profitable. He learned a great deal about the various materials we all rather take for granted and joined John Winter as a sales rep, after telling them their materials were good but they needed a Dental sales representative who knew what and how they were used. He is very hands-on and direct in his wish to be helpful.

Consequently, over the years he has developed some of the companies own plaster mixes which are made to produce the best and most

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CLOCKWIDE FROM TOP LEFT: John HQ. Halifax 1; Engine Casting; Brendan chats with colleagues; Stock for all, Pick a colour

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suitable plaster for the specific modelling or moulding need. Blue, Yellow, White etc.

COMPANY PROFILES

They sell almost all varieties of plaster and stone mixes from very hard to very accurate and a combination of both. Why not pick your own lab colour? There is a measurable air of people enjoying their jobs and interacting with each other. From the Managing Director, Dale Lister, to the girl who met me at reception Trish. Clearly, a happy mix of talent and youth, all sharing a general history and many years working, with the company.

A perceptibly happy ship!!

I, like many of you, I am sure, did not realise the size of the John Winter dental catalogue, which has grown over the years and now provides a full range of useful laboratory sundries, many of which are sourced from Europe. The introduction of the Shofu distribution will, I am sure, increase the companies profile and their undoubted appeal to their customers. Having a first class porcelain and ceramics portfolio available really completes the circle for the companies offerings.

Brendan is a real enthusiast very focused and aware. Especially about the staff he has around him. He is delighted with the performance of every member of his team and proudly talks about their apatite for responsibility and their achievements. Many of those involved appear young but it would seem are very able indeed to handle the sales and organisation of their daily working lives.

The Sales Team on the dental side lead by Brendan (Sales Director) include Stevie Avis as (Sales Manager) Zoe Gul who combines Sales and Marketing with Stephanie Clissitt who looks after Sales. During my visit I was introduced to the members of the Foundry Department led by Adam Bennett (Sales Director) supported by Carol and Paula with Lisa looking after Import and Export. To avoid duplication, the Accounts Department, deals with both sides of the business, with Tracy (Financial Manager) and Jonny (Credit Control) responsible for the Foundry and the Dental accounts. With a shared warehouse for both operations, well managed by Samantha Padgett (Operations Manager) with Transport being managed by Mathew. The responsibility for buying, is taken by Darren and his assistant Jacy.

Many of you may know John Winter for their Laboratory furniture and fittings via the Italian Tavom brand. The have fitted all types of dental laboratories from the single man to the very large Dental Hospital in Manchester.

Quite a demanding requirement with a lot of shelving being made specifically for the busy hospital set up. Special drawers had to be designed to meet the individual need of the department to ensure efficiency together with security. If I sound enthusiastic, it is because the visit was so welcoming and the

CLOCKWIDE FROM TOP LEFT: More stock; Cardboard Baler; and more stock; Tavom Lab Furniture; 3D Printing.

extent of available, good quality sundries for Laboratories, was a real surprise. I fully understand now why they had such an enthusiastic response at the DTS in Birmingham. They have just introduced their range of CADCAM and digital Equipmant and their was a great deal of interest in their 3D printers, which were offered at affordable

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prices and with a good selection. Their latest Printer model (pictured) is causing quite a stir I know we will be seeing and hearing a lot more about their services in the near future. Thank you Brendan and your very friendly and helpful staff for tolerating me throughout the day. A really, fulfilling and friendly visit.

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DENTAL TECHNICIANS INSIGHT

DANGEROUS ROLE OF WW2 PART FOUR

BY TONY LANDON

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ourteen days after D Day it was still not possible to complete all the pre-planned temporary wire mesh airstrips for mass air transported evacuation of the most severely injured and maimed servicemen back to British hospitals. The worst storm experienced in living memory of the French folk living in Normandy struck right across the battle areas from the 19th to the 22nd of June. Gale force winds blew continuously for the full four days preventing any cargo planes bringing in much needed ammunition supplies or ferrying out severely wounded causalities.

At the end of June and onwards through July metal strip runways had been sufficiently laid and improving flying weather for much of the time led to returning Dakota cargo planes (Americans referred to these robust planes as C-47 Skytrains or Goony birds) were fully utilised to provide not such

comfortable ambulance flights for as many as 600 seriously injured servicemen per day. The wounded were strung up along the planes’ fuselage in make shift litter slings.

Air evacuation at once proved its worth in the survival rates of the battle maimed.

Flights back to southern British airfields took approximately ninety minutes. General Kenner reported, "Soldiers wounded in the morning are often on the operating table of a general hospital in the UK within 10 hours."

Maxillofacial patients were always given high priority for air evacuation as the medical Authorities fully well knew early intervention by their specialist maxillofacial teams was essential when dealing with mutilated oral cavities. They were accompanied, on these

C-47 Skytrain

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converted flight ambulances the olive drab coloured Dakota supply planes, by the Flying Nightingales, nurses of the Air Evacuation Service.

The then famous Australian war correspondent Alan Moorehead noted this much needed air evacuation service not only improved the wounded man’s chances of survival but it was an important moral and resolution builder for soldiers still fighting.

Maxillofacial injured servicemen would be transferred to specialist hospitals in Britain such as the Queen Victoria Hospital in East Grinstead, which is thirty miles out of London. Here they were under the care of a team which included a plastic surgeons, oral surgeons, an anaesthetist, and specially trained assistants, along with a team of dedicated maxillofacial dental technicians whom all undertook a lot of patient exacting work to facilitate rebuilding individual

Unique to an individual patient’s circumstances permanent fixation was fabricated by casting silver splints or making appliances out of a dental resin. Where there was sufficient natural maxilla to mandible occluding teeth in-situ these fractured jaw patients would have their teeth wired together to immobilise the fractured bone ends, thus allowing them to heal back together in their correct alignment. These patients would have their meals liquidised so they could suck their food through straws or via the edge of a tilted spoon. Where the facial injuries were not too long-term Mr Archibald McIndoe, (later knighted for his work at the Queen Victoria Hospital in East Grinstead) a civilian plastic surgeon to the Royal Air Force, was appointed in July 1939 to run the new Centre for Plastic and Jaw Surgery. There were three dedicated wards for the various maxillofacial patients.

A WW2 qualified Tech Corporal in the U.S. Army. Note the bold T under the corporal shoulder two stripes

Ward I for dental and jaw injuries with a separate dental hut as a base for surgery and treatment. Ward II for women and children, most of whom were air raid casualties or who had inherited conditions that the London hospitals did not have capacity to deal with. Ward III for officers and the most severely burned and injured service personnel.

At the outbreak of WW2 the Ministry of Pensions assumed overall responsibility for the Queen Mary to be known in the future as the Roehampton Hospital on areas of the Roehampton estate in south west London.

During the WW2 Roehampton hospital extensive wards that totalled 700 beds dealt with maxillofacial injuries and fractures as well as the rehabilitation of amputees. This hospital suffered bomb damage in 1940 and 1944.

The RAF Dental Branch pioneering reconstruction facial work acted as a model for the specialist hospital services to follow. Dental maxillofacial specialists were posted to all RAF hospitals. These centers acted as referral points. The Royal Army Dental Corps quickly followed by the Royal Navy, all having their own maxillofacial dental specialists. Their extremely high standard established the inclusion of maxillofacial specialists in dental hospital services in all the major cities of Great Britain and Ireland.

EXAMPLE OF ONE MAXILLOFACIAL SUFFERING CASE Private Louis Kalil, of the U. S. Army Intelligence and Reconnaissance Platoon, 394th Infantry Regiment, 99th Infantry division was in the famous eighteen man patrol that held up the German tank and half-track vehicle thrust during the opening twenty four hours of the winter 1944’s Ardennes, Battle of the Bulge.

On this important entry from Germany into Belgium Louis sustained a horrific jaw injury from an enemy’s rifle fired grenade that did not explode. However this grenade’s forceful impact fractured Louis’s jaw in three places and forced some of his lower teeth into his palate where they became firmly embedded.

A fellow U.S. soldier rubbed Louis’s face over with freezing snow then sprinkled sulphur powder over the wounded area, then wrapped gauze bandages around his head and face leaving just one eye exposed. No morphine was available to deaden the sheer pain. But it was so numbingly cold in their covered fox-hole, the oozing blood was freezing which stemmed its flow over Louis’s shattered face.

The German offensive troops captured him and along with his other platoon soldiers and imprisoned them in an abandoned café in Lanzerath, Belgium. Still no morphine was administered there or during his transfer to a hospital train or on his long agonising journey through Germany, eastward through the Ruhr

INSIGHT

soldier’ lives. Their mutilated wounds would be thoroughly cleaned and nonviable tissue and bone fragments removed. It was during the war years that penicillin and other antibiotics came to the fore, making surgical procedures safer. In the hands of specially trained personnel dedicated maxillofacial treatment added to comforting the traumatised patient with the expectation of minimizing facial disfigurement.

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INSIGHT

valley area. He had been placed out in the open between carriages where the icy conditions he felt, would kill him, but they also deadened the maddening pain from his embedded teeth and smashed jaw. Eventually Louis was taken to a hospital in bombed Hanover City where medical attention was provided to him nine days later on, Christmas Day 1944. Louis had gangrene. The German medics removed his original soiled stiffened bandages, drained the gangrene poisons and then wired his mouth up.

They attached rubber bands which they clipped up to an encasing head strap to hold his lower jaw in place.

In January 1945, Private Louis Kalil was transferred by hospital train to the infirmary at Stalag XIB POW camp at Fallingbostel, a hundred miles north of Hanover. Here Louis received some medical attention from captured British medical staff that attended all injured American POW’s in their camp’s infirmary. By April 1945, Louis and all POW’s were awaiting their liberation by the approaching Russian troops. However to their intense joy the British Second Army tanks and Bren gun carriers stormed into the camp. Louis was given a new uniform to replace the tattered one he had worn for the past four months at least. He was with other injured soldiers flown in a returning Lancaster bomber to hospitals in the Brussels area. Louis needed major facial reconstructive surgery. Louis was then flown to England, then onto Scotland to recuperate for a month.

His flight home to North America with other recuperating soldiers was filled with drama as their converted Douglas C-54 Skymaster, 4 engine, U.S. Army Air Forces transport aircraft had one engine catching fire which forced them to land in Newfoundland. Then a day later they had a horrific flight through an electrical storm which again forced the pilot to land short of his planned destination at Bradley Field in Connecticut. For Louis it would be an enduring series of six operations over fourteen months for the specialist American medical teams to try and improve on his maxillofacial injured face before he eventually felt he could face his parents back in his home state of Indiana. Ref **

Island, during the Battle of the Scheldt, he was commissioned in the field becoming a 2nd Lieutenant. Later he attained the rank of Captain. He was subsequently awarded the Military Cross for crossing into enemy territory for three days' reconnaissance and artillery fire directing onto prime enemy targets. Peter King DSO, MC and Private Cuthbertson's exploits have been documented in a book, The Amateur Commandos, and a film released in 2002, Two Men Went to War, was based on their initial attempts to sabotage the German forces on the French occupied coastline.

Fig. 7

REMARKABLE STORY OF DENTAL CORPS PERSONNEL Peter King DSO, MC born in Caxton, Cambridgeshire, England, joined the Dental Corps in March 1939 prior to WW2. He served as a non-technician. He did however excel as a weapons instructor. Having spent two years in this role he was promoted to become a drill sergeant at the Dental Corps' depot.

In 1941 he applied to be transferred to a fighting unit. This was refused. He became so frustrated that he and another soldier, Private Leslie Cuthbertson took matters in their own hands; they planned and executed an unofficial and unauthorised raid on enemy occupied France.

On German territory in 1945, Number 121 British General Hospital with its small mobile Number 5 maxillofacial unit reported the constant admissions of soldiers with mutilated lower jaws, and or such gaping holes in their faces that they could only breathe though tracheotomy tubes punched through their throats. The task of caring for such disfigured patients was painstaking and harrowing for the nurses who needed to be in constant attendance.

In April 1942, these two soldiers stole weapons and grenades and also a motor-boat from the south west of England. They landed on the French coastline, where they promptly attempted to damage a railway line using one of their hand grenades. They attempted other provoking activities against the enemy. After three days, King and Cuthbertson took a French motor boat to return to English shores.

Their choice of vessel let them down to such an extent they were hopelessly adrift in the English Channel for twelve days until picked up by a British Air Sea Rescue Service launch.

They were initially thought to be and were subsequently treated for a short time as spies.

Both soldiers were court-martialed in July 1942. Although King lost his sergeant's rank, he was posted to a Commando training base as a private. On completing his course, he was allocated to No. 4 Commando, on the request of its commander, 15th Lord Lovat who had heard of his French adventures. King was a highly successful recruit to the Commandos, becoming a Troop Sergeant Major of C Troop before the D Day landings.

Towards the end of WW2 it was recorded over the four month period up to May 7th when Nazi Germany surrendered in 1945, 4,907 casualties with head and neck injuries were flown out of Northern European battle zone.

The No. 4 Commando unit landed near Ouistreham a sea side town, port on Sword Beach early on D Day. King was prominent in the fighting across Normandy and during further distinguished actions in Flushing on Walcheren

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The U.S. army dental detachment WW2 personnel ranks. The U.S. army chain of command was the dental detachment personnel who were commanded by the division dental surgeon who in turn functioned directly under the orders of the division surgeon. A dental attachment was made of 12 officers. One division dental surgeon, one prosthodontist, ten general operating dentists.

There was also listed one clerk for the divisional dental surgeon, one Dental technician grade 3 who would be in charge of the laboratory. He would be addressed as Staff Sergeant Technician. This rank was established on January 8th 1942. His shoulder badge would have appropriate three stripes with the lower stripe encasing a bold T. Fig.7 One Sergeant dental technician grade 4 who would be a laboratory assistant and truck driver.

He would be addressed as Sergeant Technician.

Another sergeant dental technician responsible for administration and supplies, and ten dental technicians grade 5’s who were Tech Corporals.

To effect the classification of all jobs performed

by United States of America Armed Services enlisted men, and so all military personnel would recognize whom they were addressing, Military Occupational Specialties (MOS) were given a specification serial number on a scale from 001 > 999. Numbers below 500, designated military occupations having corresponding occupations in civilian life. Thus U.S. Dental Laboratory Technicians were MOS 067.

The U.S. Army role and occupation description of a Dental Mechanic, or a Dental Laboratory Technician was documented as; fabricates and repairs partial and full dentures to replace missing teeth. Makes plaster-of-Paris casts from wax impressions and sets artificial teeth individually in wax.

Manipulates an articulator to bring castings of the upper and lower jaws together to ascertain that each artificial tooth is properly set. Processes vulcanite and plastic materials and completes dentures by hand trimming with knife, file, or sandpaper and polishing on buffing lathe. Makes bridges, splints, metal clasps, crowns, and inlays by making moulds for dentures and casting and soldering parts according to required specifications. Repairs broken dentures and bridges.

TAKEN FROM INTERNATIONAL DENTAL TRIBUNE. JULY 2018

l A recently published paper By Dr. Eriberto Bressan et al. Looked at 39 patients with 160 Implants with Conus retention for the full Mandibular Overdentures.

patient recorded as having Mucositis, which was successfully treated.

The study was over three years and concluded that Conus retention was a worthwhile design for the over denture.

The study showed that 134 of the 160 implants did not show any bone loss. Four implants were lost and the complication free percentage of restorations was 71.8%.

This was a study over just three years and while the health of the Implants may be satisfactory the complications with the restorations from a Technicians point of view (28.2%) seems rather high.

No information on the design of the frameworks nor the veneering material was available. In the commercial world this could be an expensive indulgence.

The study particularly focused on marginal bone loss, which was found to be very low indeed. Restorative complications included veneer fracture 4.

Framework fracture 3. Loss of retention 2. And reline needed on 2. With one

The Conus retention allowed removal and repair and indeed reline but it is a warning on the potential of technical problems with Overdentures on Implants.

Easy retrieval such as Conus Crown retention is a major advantage.

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FORTUNE 500 LIST DENTAL TRIBUNE INTERNATIONAL MAY 29, 2018

l The annual Fortune 500 list has been in publication since 1955. Ranking America’s largest corporations by total revenue for their respective fiscal years: The list is compiled and published by Fortune magazine. This year’s list has shows Henry Schein has risen five places, from 243 to 238, cementing its position as one of America’s largest corporations for the 15th year.

The Company first appearing on the Fortune 500 list in 2004, at No. 487, with net sales of $4.1 billion, By 2017 that had risen to $12.5. billion.

Since going public in 1995, the company has enjoyed steady growth of 15 per cent.

“Since our founding in 1932, Henry Schein has been guided by our mission to help officebased health care professionals build stronger practices so they can focus on providing clinical care to their patients, while also giving back to the communities and professions we serve,” said Stanley M. Bergman, Chairman of the Board and CEO of Henry Schein.

Bergman went on to say that the company is pleased to have attained its highest-ever ranking and that “more than 22,000 Team Schein Members remain more committed than ever to leveraging our strengths, forging new partnerships, and building on the trust that will allow us to ‘help health happen’ for years to come.”

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DENTAL NEWS

A LOOK AT CONUS RETAINED IMPLANT BORNE OVERDENTURES, AFTER THREE YEARS OF LOADING

DENTAL NEWS

RISKS OF DENTAL TOURISM HIGHLIGHTED BY ADA FROM DENTAL TRIBUNE INTERNATIONAL. JULY 13, 2017. SYDNEY, AUSTRALIA l With the cost of dental treatment presenting a significant barrier for many Australians, more and more are considering dental tourism, travelling to another country to undergo a dental procedure.

With this in mind, the Australian Dental Association (ADA) has been prompted to issue a warning about the risks that may accompany this decision.

It’s about saving money,” said Dr Michael Foley, Vice Chairman of the ADA’s Oral Health Committee. “While it’s true you may save some money in the short term, the reality is that things can go wrong and all those expected savings can quickly disappear and end up costing more than the holiday itself. ”In addition to procedural complications, dental tourists may be subject to less-stringent quality standards and lower-grade materials in comparison with Australian dentistry.

If a patient is dissatisfied with dental work performed overseas, it can be extremely difficult to repair satisfactorily and may lead to the extraction of the affected teeth the ADA cautioned.“Complex procedures - medical or dental - should not be done over the course of a holiday,” said Foley. “If you have the need for a complex medical treatment or procedure, it is best done in Australia where you can be assured of the safety and quality standards in place, and of the certainty of follow up.”

Australian dental tourists tend to travel to a wide variety of places for cheaper procedures, from South-East Asian hotspots like Bali and Thailand to eastern European destinations. Though it is in no way illegal to have dental procedures performed away from Australia - and the initial cost of the treatment may be relatively cheap - there can often be unforeseen complications that are unable to be handled effectively in the time span of the period abroad, the ADA warned.

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COMPANY NEWS

THE DENTAL TECHNICIAN MARKETPLACE VITA EVEN CLOSER TO YOU: YOUR TRUSTED PARTNER IN THE UK

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VITA has been the reliable partner of technicians and dentists around the globe for over 90 years, providing both materials and technology. VITA’s aspiration is to inspire and support professionals to be able to deliver the most esthetic, functional and long-lasting restorations with an efficient protocol to their patients. To accomplish this mission, VITA provides precise communication means between the dental lab and practice, based on an accurate digital and visual tooth shade determination.

With its high quality, metal-free restoration materials and reliable equipment for shade reproduction, VITA enables technicians and dentists to achieve clinical and economic success. Get in touch with your ‘perfect match’ on Facebook or get more detailed information from our representatives and on www.vita-zahnfabrik.com VITA Specialist Mr. Shane Kent Mobile: +44 7387 0879 82 Email: s.kent@vita-zahnfabrik. com Order Department & Customer Service Mrs. Nicole Vogt Tel: +49 7761 562-281 Email: n.vogt@vita-zahnfabrik.com

ACTEON GROUP ACQUIRES PRODONT HOLLIGER

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At the heart of France and a region known worldwide for its metal and in particular its blades and knives, Prodont Holliger manufactures reliable, leading-edge tools that are designed by dentist for dentists and technicians for technicians.

Carried by a passionate team of skilled engineers, their unique competence knows no bounds and rigor and precision are key words in every aspect of R&D, production and delivery.

Explore the wide range of dental laboratory products from handheld instruments and discs for working with all types of materials, to the new Protorch 4, one of the most reliable and constant burners on the market, with a precise and adjustable flame and automatic piezo ignition.

For more information, a product catalogue or demonstration, call Acteon UK on 01480 477307 or email info.uk@acteongroup.com

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

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

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

4 Hours Verifiable CPD 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

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Correct answers from July DT Edition:

CPD

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VERIFIABLE CPD - AUGUST 2018 1. Your details First Name: .............................................. Last Name: ........................................................Title:................

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B.

Q8.

C.

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

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

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B.

You can submit your answers in the following ways:

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2.

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C.

Q16

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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.

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VERIFIABLE CPD AS YOU NEED IT VIA THE DENTAL TECHNICIAN OVER DENTURE ON IMPLANTS Q1. Why was an over denture chosen for this case.?

A. Fixed Bridgework was too expensive.

B. Because of the Patient’s age and lack of dexterity.

C. Following up on a monthly offer.

D. The Clinician decided.

Q2.

A. B. C. D.

Were any teeth extracted before starting?

The patient was already edentulous.

The remaining upper teeth were to be incorporated.

A full upper clearance was carried out.

The old Bridgework was left in situ.

Q3. What did the patient wear after the extractions?

A. The original denture with soft lining.

B. The original denture with temporary implants.

C. No denture was worn.

D. Immediate denture fitted after extraction of

remaining teeth.

Q4.

A. B. C.

D.

What guide was used for implant placement?

Vacuum formed clear plastic with some holes drilled.

A clear copy of the satisfactory immediate denture.

A specially constructed clear surgical guide prepared from new set-up.

No Guide was needed.

Q5.

A. B. C. D.

Of the chosen implants what diameters were they?

All Four were 4.5. mm.

Two were reduced diameter 3.3.mm. two were 4.5.mm One wide bodied and three 4.5 mm.

Two wide bodied and two standard diameter.

Q6.

A. B. C. D.

How many dentures were made altogether for the treatment?

One. Two. Three.

Four.

CONUS CROWN OVERDENTURES Q7. What was the overall Complication rate after 3 years?

A. 10.7 %.

B. 23.7% C. 28.2% D. 19.6%

FORTUNE 500 LIST Q9. How many places has Henry Schein risen in the

Fortune 500 List?

A. Seven.

B. Four.

C. Six. D. Five Q10.

A. B. C. D.

How much had the Net Sales Figure Grown since 2004?

4.3 Billion dollars.

7.2 Billion dollars.

12.5. Billion Dollars.

15.0. Billion Dollars.

RHEUMATOID ARTHRITIS AND GUM DISEASE Q 11. What has been identified as the active constituent

causing the potential change?

A. The Amino acid arginine.

B. The Amino acid citrulline.

C. The Bacterium Levitus.

D. The Bacterium Gingivalis.

Q12. How many Ibdivuals took part in the test?

A. 48.

B. 32.

C. 26.

D. 106.

MY VISIT TO JOHN WINTER. Q13. When was the company formed?

A. 120 years ago.

B. 65 years ago.

C. 37 years ago.

D. 50 years ago.

Q14.

A. B. C. D.

Who was their first dental sales Rep? Adam Bennett.

Samantha Padgett.

Stephanie Clissitt.

Brendan Foster.

Q15.

A. B. C. D.

Other than ental Sundries, what are the Company known for?

Dental Equipment.

Dental Investments.

Tavom Laboratory Furniture.

Polishing sundries.

MARKETING SIMPLIFIED Q16. What is recommended to improve your own

company self awareness?

A. Getting price lists from other labs.

B. Phoning all your clients.

C. Joining a dental forum group.

D. Boosting your PR. Programme.

Q8. What percentage of the Implants failed?

A. 1%.

B. 2.5% C. 3.2%.

D. 1.9%.

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.

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DENTAL NEWS

RHEUMATOID ARTHRITIS AND GUM DISEASE AMSTERDAM, NETHERLANDS I DENTAL TRIBUNE INTERNATIONAL I JULY 2, 2018

I

n recent years, increasing attention has been given to aspects of oral health in patients with rheumatoid arthritis (RA), especially related to associations with periodontal disease. The results of a study conducted at the University of Leeds in the UK, and recently presented at the Annual European Congress of Rheumatology (EULAR 2018) in Amsterdam, demonstrated increased levels of periodontal disease and disease-causing bacteria in individuals at risk of RA. The study found there was an increased prevalence of periodontal disease in patients with RA and could be a key initiator of RA-related autoimmunity. Autoimmunity in RA is characterised by an antibody response to citrullinated proteins in which the amino acid arginine has been converted into the amino acid citrulline, altering the proteins’ structure. The oral bacterium Porphyromonas gingivalis is the only human pathogen known to express an enzyme that can generate citrullinated proteins.

The study included 48 at-risk individuals (positive test for anti-citrullinated protein antibodies), 26 patients with RA and 32 healthy controls. The three groups were balanced regarding age, sex and smoking.

“It has been shown that RA-associated antibodies, such as anti-citrullinated protein antibodies, are present well before any evidence of joint disease. This suggests they originate from a site outside of the joints,” said study author Dr Kulveer Mankia, clinical research fellow at the university’s Institute of Rheumatic and Musculoskeletal Medicine. “Our study is the first to describe clinical periodontal disease and the relative abundance of periodontal bacteria in these at-risk individuals. Our results support the hypothesis that local inflammation at mucosal surfaces, such as the gums in this case, may provide the primary trigger for the systemic autoimmunity seen in RA.”

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