DT ASEAN No. 2, 2022

Cover / Editorial / Contents / Mussel-inspired compound enhances adhesion of dental filling material / New research outlines vaping’s unique connection to periodontal disease / Enlisting dentists to help tackle obesity / 4D-printed clear aligners found to show promise / Simple and inexpensive—xylitol chewing gum reduced preterm births in research / FDA approval marks major step for Second Opinion AI software / World News / Regional News / Interview: Dental therapists as answer to racial inequities in oral healthcare / Business / ADVERTISER INDEX

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Vol. 1. No. 3, Apr-Jun 2022

COVID-19 pandemic:
Young dentists concerned, doubtful
about their future in dentistry
3D printing: Study examines
dentists’ user experiences and
spending

Image source: Freepik

Dentists providing cosmetic
injectables to require licence

[2] =>

[3] =>

Dental Tribune ASEAN

EDITOR’S MESSAGE

Publisher
FBI Publications (M) Sdn. Bhd.

e have come to the
second issue of Dental
Tribune ASEAN in
2022! Throughout the
period, we have received so much love
and feedback from our readers that
we are truly grateful and appreciate.
As we’re coming into April, we have
witnessed a few key events around the
world. From the number of COVID-19
cases exceeding 300 million worldwide,
the 2022 Winter Olympics, to the
increase in global food prices.
Unilever’s family of oral care brands
has launched the “Don’t Wait Until It’s
Too Late #TalkToADentist” campaign
which aimed to tackle the inequality of
access in conjunction with the World
Oral Health Day on March 20. This
campaign also premiered a film that
centered on the importance of taking
precautions early to prevent tooth loss.
Unilever also provided t free dental
check-ups and consultations to tackle
barriers to access such as distance and
dentist availability.
In the local scene, Malaysia has ups
regulation of dental services effective
January 1, 2022. This regulation was
made by the Minister of Health to
ensure the quality of dental services
and patient safety are guaranteed. This

Marketing Communication
Nur Izyan binti Dzulkifli
izyandzul@fireworksbi.com
Publication Manager
Vanny Lim
vanny@fireworksbi.com
Assistant Editor
Atthira Zawana
atthirah@fireworksbi.com
Susan Tricia
Editor
is also because dental treatment
is popular with medical tourists
to Malaysia, but the quality has
always been an issue. The new Act
also requires only qualified and
registered practitioners to provide
dental services.
Dental Tribune ASEAN will be
circulated in dental exhibitions,
seminars, and even webinars across
ASEAN
providing
additional
mileage for advertisers of the
magazine and reaching out to new
subscribers. Visit our website at
asean.dental-tribune.com for more
updates. Let’s do our part and get
vaccinated.

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Susan Tricia
Official Magazine of

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Dental Tribune International GmbH and FBI Publications (M) Sdn Bhd does not, via
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individual patients and methods of practice are personal decisions, and the responsibility
for these decisions rests upon the shoulders of the attending dental practitioner.

[4] =>

4Dental Tribune ASEAN

CONTENTS
World news

17

Dentists providing cosmetic injectables to require
licence

18

18

COVID-19 pandemic: Young dentists concerned,
doubtful about their future in dentistry

20

British government loses key vote on dental age
checks for undocumented immigrants

Clinical news

6

21

Mussel-inspired compound enhances adhesion of
dental filling material

Romanian dental community comes together to
help Ukrainian refugees

8

22

New research outlines vaping’s unique connection
to periodontal disease

Polish dentists in solidarity with Ukraine

10

Applied dentistry research declining, study finds

Enlisting dentists to help tackle obesity

24

26

Innovations

Oral health study of dental students highlights
wider demographic issues

12

27

4D-printed clear aligners found to show promise

14

Australian Greens unveil plans for universal dental
policy

Simple and inexpensive—xylitol chewing gum
reduced preterm births in research

Regional news

16

28

FDA approval marks major step for Second
Opinion AI software

Fifth Malaysia International Dental Show 2022

In the hot seat

30

Interview: Dental therapists as answer to racial
inequities in oral healthcare

33

Business

33

GlaxoSmithKline announces name of independent
healthcare company

34

Dentsply Sirona announces new 3D-printing
solution, partnership with Google Cloud

35

36
Dental Tribune ASEAN | Apr-Jun 2022

Candid takes on the aligner market from a new
angle

36

3D printing: Study examines dentists’ user
experiences and spending

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[6] =>

CLINICAL NEWS

Mussel-inspired compound
enhances adhesion of dental
filling material
By Franziska Beier, Dental Tribune International
A mussel-inspired compound has been found to improve the durability of the resin–dentine bond and the longevity of dental fillings.
(Image: C E Newman/Shutterstock)

Moisture is one of the greatest challenges for dental fillings, as
it reduces adhesive performance. To overcome this obstacle,
researchers from the Faculty of Dentistry of the University of
Hong Kong (HKU), Wuhan University and Peking University
Shenzhen Hospital turned to nature and found an answer in a
mussel-derived compound. After studying its performance in
various tests, they found that the compound can improve the
durability of the resin–dentine bond and thus the longevity of
dental fillings.
Dental fillings are clinically challenging, since the restoration’s
success is affected by factors such as the moist environment of
the oral cavity and mechanical stress caused by chewing. Failure
of the resin–dentine bond results in increased visits and costs
for the patient.
Lead researcher Dr Cynthia Kar Yung Yiu, clinical professor of
paediatric dentistry at HKU, explained in a press release that
mussels need to maintain their adhesive properties under harsh
conditions, such as humidity, extreme temperature changes and
pH values, and mechanical shocks—circumstances similar to
the conditions in the oral cavity.
The wet adhesion property of mussels has long been of interest
to scientists, and several studies have focused on how this
quality could be used in clinical practice. Such applications have
included surgical protein glues for wound closure, microneedle
bandages for cardiac tissue regeneration and materials for drug
delivery.
The properties of mussels have also been widely used in dental
applications. As reported by Dental Tribune International,
mussel-derived solutions have enhanced dental implant
coatings, helped create more biocompatible implants, advanced
the treatment of dentine hypersensitivity and inspired the
development of tougher products for restorative dentistry.
Evaluation of clinical performance
The wet adhesion property of mussels is attributed to a
Dental Tribune ASEAN | Apr-Jun 2022

derivative of the amino acid tyrosine, called dopa, in the mussel
adhesive protein which the marine organisms secrete to stick
to surfaces in moist environments. The research team evaluated
the performance of a mussel-derived compound based on this
(DMA) as a functional monomer in dental adhesives regarding
the durability of the resin–dentine bond.
The team compared the durability of the control group with
three solutions containing different concentrations of DMA
in various tests. The results showed that DMA successfully
linked with dentine collagen, polymerised with the adhesive
without affecting the degree of conversion or elastic modulus,
strengthened the integrity of the resin–dentine interface,
prolonged the durability of the bond and inhibited the activity
of endogenous metalloproteinases, which are involved in the
degradation of collagen and of the resin–dentine interface. The
findings indicate that DMA can polymerise with resin monomers
without hampering the adhesive’s mechanical strength and may
prevent bond failure caused by a sudden change in stress.
Co-author Dr James Kit Hon Tsoi, associate professor of dental
material science at HKU, summarised the research findings and
gave an outlook for the future: “This research discovered that
DMA is effective in strengthening the resin–dentine bond and
improves its durability. The cytotoxicity is also similar to the
resin monomers in traditional dental adhesives. It is believed
that this compound may be commercialised in the future.”
Remaining challenges
Despite the performance of DMA, the researchers raised
concerns about its limited shelf life. During testing, the DMA
solution turned a faintly yellow colour after two months, a
characteristic that would prove unpractical for clinical usage.
Thus, future studies may consider adding antioxidants to the
DMA solution in order to avoid this effect.
The study, titled “Enhancing resin-dentin bond durability
using a novel mussel-inspired monomer”, was published in
the September 2021 issue of Materials Today Bio.

[7] =>

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[8] =>

CLINICAL NEWS

New research outlines
vaping’s unique connection to
periodontal disease
By Anisha Hall Hoppe, Dental Tribune International

The first longitudinal study on vaping has shown that e-cigarettes have deleterious effects on periodontal health. (Image: Rommel Canlas/
Shutterstock)

Smoking tobacco has long been known to be detrimental to oral
health, but the risks of newer simulations of smoking such as
vaping are less well-known though they are often believed to
be healthier alternatives. Now, researchers from the New York
University (NYU) College of Dentistry have completed the first
study on the oral health of users of e-cigarettes. They found that
vaping created a unique periodontal microbiome, compared
with that of non-smokers and conventional cigarette smokers,
and that participants who vaped experienced a worsened state
of periodontal disease at the end of the study.
The study compared the bacterial composition and cytokine
concentrations of the subgingival plaque in conventional
cigarette smokers, e-cigarette users and non-smokers over the
course of six months. The participants in all groups exhibited
some evidence of periodontal disease at baseline.
In the e-cigarette users, the detected cytokine levels indicated
inflammation, but some cytokines were at lower levels than
expected. The researchers believe this was possibly due to the
Dental Tribune ASEAN | Apr-Jun 2022

strains of bacteria present in those who vaped but not present in
those who smoked or who had never smoked. The researchers
hypothesised that it was possible that these bacteria were
actively supressing the immune reactions that would normally
have been expected.
Co-author of the study Fangxi Xu, a junior research scientist
at NYU, said in a press release: “Vaping appears to be driving
unique patterns in bacteria and influencing the growth of some
bacteria in a manner akin to cigarette smoking, but with its own
profile and risks to oral health.”
Even worse was the finding that clinical in the e-cigarette
smokers. This was measured in the same groups of participants
but in a separate, earlier study.
Lead author of the most recent study Dr Scott Thomas, an
assistant research scientist at NYU, said of the findings:
“E-cigarette use is a relatively new human habit. Unlike smoking,
which has been studied extensively for decades, we know little

[9] =>

about the health consequences of e-cigarette use and are just
starting to understand how the unique microbiome promoted
by vaping impacts oral health and disease.”
More long-term research is needed for dentists to feel comfortable
offering counsel to their patients regarding e-cigarette use.
E-cigarettes and alternative tobacco products fall under the
umbrella of what some call tobacco harm reduction.
Dental Tribune International reported that a survey of
German dentists by the German subsidiary of Philip Morris
International (PMG), a cigarette company moving towards
smoke-free products, found that 58% of the respondents did
not feel informed on the subject of tobacco harm reduction and
that 69% were not aware of the concept.
Dr Charilaos Avrabos, then PMG’s manager of scientific and
medical affairs, claimed in a 2018 press briefing regarding the
survey that “it is clear that e-cigarettes are not risk-free products;
neither are tobacco heating devices. For non-smokers, these are

not products that offer any benefits. For smokers, who use the
most damaging form of nicotine delivery continually over a
period of years, switching to these products can make a huge
difference by reducing the amount of harmful substance.”
However, PMG’s claims seem to be contradicted by the findings
of the NYU research and the results of a 2020 study on vaping’s
effect on periodontal health. Senior author of that study Dr
Purnima Kumar, professor of periodontics at Ohio State
University, said: “If you stop smoking and start vaping instead,
you don’t move back toward a healthy bacterial profile but
shift up to the vaping profile. Knowing the vaping profile is
pathogen-rich, you’re not doing yourself any favours by using
vaping to quit smoking.”
The recent study, titled “Electronic cigarette use promotes
a unique periodontal microbiome”, was published in the
February 2022 issue of mBio.

Dental Tribune ASEAN | Apr-Jun 2022

[10] =>

10 CLINICAL NEWS

Enlisting
dentists
to help
tackle
obesity

UK researchers are working with dentists to assess how they could
deliver weight management interventions to their patients—
something that general practitioners and nurses in the country have

By Jeremy Booth, Dental Tribune International

been doing for some time. (Image: Yuriy Golub/Shutterstock)

Most of the UK population visit their dentist annually, and
researchers from Loughborough University think that this
primary care health service could be harnessed to help address
the growing problem of obesity. A new research project is
investigating the role that dentists could play in reducing obesity
in the UK, and the researchers are hoping to hear from dental
practitioners who are interested in being involved.

Prof. Daley said in the press release that the case for dentists to
become involved in reducing obesity was strong, owing to the
fact that they, like general practitioners, are part of primary care
health services and are ideally positioned to screen for obesity
and help in reducing the condition. She explained: “They
typically consult with most of the population at least yearly,
meaning they could routinely embed efficient monitoring of
weight into dental health services and offer interventions at
scale to both adults and children.”

The World Health Organization (WHO) says that the
prevalence of obesity has nearly tripled since 1975, and the NHS
says that, in the UK, around 25% of adults and 20% of children
aged 10 to 11 years are considered obese. A press release from
Loughborough University explained that, for some time, general
practitioners and nurses in the country have been raising the
subject of weight management during patient consultations.
Dentists have been overlooked in this process, however, despite
the fact that they already deliver messages to their patients
concerning behavioural changes such as smoking cessation and
lowering sugar consumption.
In a study led by Dr Amanda Daley, professor of behavioural
medicine in the School of Sport, Exercise and Health Sciences
and director of the Centre for Lifestyle Medicine and Behaviour
at the university, researchers are working with dentists in
order to assess how they could deliver weight management
interventions to their patients.
Dental Tribune ASEAN | Apr-Jun 2022

She added: “If we are serious about reducing obesity in the
population it will require an ‘all hands on deck’ approach,
including active advocacy from dental health professionals.”
The research will run for two years, and dentists who are
interested in becoming involved with the project are encouraged
to contact the research team using the email address climb@
lboro.ac.uk.

“If we are serious about reducing
obesity in the population it will require
an “all hands on deck” approach”
– Prof. Amanda Daley, Loughborough
University

[11] =>

Dr Jessica Large, a dentist who is involved with the project, said
that it was important to consider how all health professionals
could help to reduce obesity in the population and that dentists
might be able to help.
She explained: “Routine body mass index screening for children
and healthy weight discussions are already ongoing in some
hospital dental settings, with positive feedback from families
and dental teams. I am looking forward to exploring the wider
acceptability amongst the profession and public.”
Prof. Daley outlined the context for a potential intervention
by dentists in the reduction of obesity in an opinion piece
published in the British Dental Journal in January, which can
be viewed here.

Whereas obesity was once primarily a concern in high-income
countries, the health condition is steadily on the rise in lowand middle-income countries. According to WHO, most of the
global population now live in countries where more people die
from conditions related to being overweight than those who die
from conditions related to being underweight.
Devex reported in April last year that the prevalence of obesity
was increasing annually in African countries—18.4% of women
and 7.8% of men on the continent were living with obesity in
2021, up from 12.0% and 4.1% in 2000, respectively. According
to the development news organisation, addressing the obesity
problem on the continent is difficult owing to a lack of
understanding about the condition. “Obesity has just not really
been understood as a health challenge,” Johanna Ralston, chief
executive officer of the World Obesity Federation, told Devex.

Obesity steadily on the rise
Dental professionals around the world will no doubt be
monitoring the research, given the extent to which the prevalence
of obesity is increasing. According to the US Centers for Disease
Control and Prevention (CDC), 42.4% of adults in the US were
obese in 2018, up from 30.5% at the turn of millennium. As well
as causing health conditions that are among the leading causes
of preventable death in the country, the financial cost of obesity
is considerable. The CDC estimated that medical costs related
to obesity reached US$147.0 billion (€103.6 billion) in 2008.
Dental Tribune ASEAN | Apr-Jun 2022

[12] =>

12 INNOVATIONS

Researchers have added data in the literature concerning the use of shape memory polymers as a novel material in clear aligners.
(Image: Ancapital/Shutterstock)

4D-printed clear aligners found to
show promise
By Jeremy Booth, Dental Tribune International
A study led by researchers at the University Hospital Bonn has
found that 4D-printed orthodontic clear aligners can apply
biocompatible orthodontic forces in order to move teeth. The
technology of 4D printing is based on the 3D printing of shape
memory materials. The 4D aligners are clear aligner trays that
are 3D-printed using shape memory polymers (SMPs), and the
implications of this novel material in clear aligner therapy could
include reducing the cost of treatment and its burden on the
environment.
Clear aligner trays are made of various types of polymers and
are typically designed to move a tooth within the range of 0.2
to 0.3 mm—or to rotate it by 1° to 3°—before being replaced
by successor trays. As the authors of the study point out, this
stepwise treatment model requires more time and a higher cost
for materials than treatment using fewer trays would. Naturally,
for both patients and manufacturers, the use of successive plastic
clear aligner trays also carries with it ethical concerns related to
the environment.
Dental Tribune ASEAN | Apr-Jun 2022

Various studies have examined applications for SMPs in
medical materials, including for orthodontic applications. The
researchers, however, sought to add to what they perceived
was a lack of data in the literature concerning SMPs and tooth
movement by measuring the forces generated by the 4D aligners
and thereby their suitability in the treatment of malocclusion.
The researchers, from dental faculties in Germany, Egypt and
the UAE, used a biomechanical system in order to use forces to
correct the malposition of a maxillary central incisor (Tooth 21)
in a custom-made typodont model using 4D-printed aligners.
The generated forces were measured at different temperatures,
and the clear aligner trays were made of ClearX v.1.1 material in
the two thicknesses 0.8 mm and 1.0 mm. The forces delivered
were quantified using an orthodontic measurement and
simulation system (OMSS).

[13] =>

“[Practitioners]
still report some
drawbacks to
aligner use”
They found that the 4D-printed aligners were capable of
achieving significant tooth movement within the range of
2.5 mm ± 0.5 mm, with little variation between the two
thicknesses. In the OMSS simulations, it was found that the
range of maximum forces delivered varied according to the
different temperatures tested (37°C, 45°C, 55°C) but that they
were all within the range of acceptable physiological orthodontic
forces, as reported by the literature.
In contrast to other studies, the researchers found that using a
thicker aligner had no effect on the generated force except at the
higher temperature of 55°C.
AD

The authors highlighted a number of limitations to the study,
such as its focus on the isolated movement of a single tooth
and not on a complex clinical case and the fact that it did not
account for intra-oral conditions and factors such as humidity
and salivation. They concluded, however, that the 4D aligner
was capable of moving teeth using biocompatible orthodontic
forces.
They wrote: “Although orthodontic aligners have been studied
in several aspects and great progress was done in orthodontic
treatment by aligners, practitioners still report some drawbacks
to aligner use.” They explained that these drawbacks included
the limited movement achieved by single aligner trays, which
necessitated changing regimes. They concluded: “Therefore,
we believe that if a method could be applied to decrease the
number of the aligners per treatment, together with a method to
accelerate the biological movement of the teeth, that would be a
quantum leap in the field of orthodontics.”
The study, titled “Potential application of 4D technology in
fabrication of orthodontic aligners”, was published online on
28 January 2022 in Frontiers in Materials.

[14] =>

14 INNOVATIONS

Simple and inexpensive—xylitol chewing
gum reduced preterm births in research
By Franziska Beier, Dental Tribune International
Studies have shown a link between maternal periodontal disease
and preterm birth—delivery before the 37th week of pregnancy.
However, scaling and root planing in pregnant women have
not been shown in randomised trials to be successful in
preventing preterm birth, despite improving periodontitis. A
recent multicentre randomised controlled trial by researchers
in the US and Malawi has investigated a different intervention:
chewing gum containing xylitol, which is known for reducing
caries. It found that daily usage of the gum before or in early
pregnancy significantly reduced the number of preterm births.
The study, the largest of its kind, included 9,670 women from
eight healthcare centres in Malawi—the country with the highest
known preterm birth rate (18.1 per 100 births)—and was
conducted over six years. All of the eight health centres provided
the participants with perinatal and oral health education and

four of the health centres additionally administered the daily
use of xylitol chewing gum.
The research team found that the daily intake of xylitol gum
significantly reduced the risk of preterm birth (12.6% compared
with 16.5% in the control group) and hence reduced the
likelihood of birthweight of less than 2.5 kg (8.9% compared
with 12.9%).
“Using xylitol chewing gum as an intervention prior to 20 weeks
of pregnancy reduced preterm births, and specifically late
preterm births between 34 to 37 weeks,” commented lead author
Dr Kjersti Aagaard, Henry and Emma Meyer chair in obstetrics
and gynaecology at Texas Children’s Hospital and Baylor College
of Medicine in Houston, in a press release.

A study conducted in Malawi—the country with the highest preterm birth rate in the world—has investigated whether chewing xylitol gum
would improve the periodontal health of pregnant women and thereby lead to a decrease in premature deliveries. (Image: Kristina Bessolova/
Shutterstock)
Dental Tribune ASEAN | Apr-Jun 2022

[15] =>

Xylitol is a sugar alcohol that occurs naturally in fruits and vegetables and is commonly used as a food additive and sugar substitute.
(Image: Danijela Maksimovic/Shutterstock)

She added: “What’s unique about our study is that we used a
readily available, inexpensive, and palatable means to reduce
the risk of a baby being born too soon or too small. There is
some real science behind the choice of xylitol chewing gum to
improve oral health, and our novel application to improving
birth outcomes is exciting.”
According to Dr Aagaard, the results are consistent with
longstanding evidence linking oral health status to preterm
birth. In the future, the researchers would like to conduct similar
studies in other parts of the world, including in the US, to find
out whether the study results can be reproduced in settings
where there may be a lower burden of preterm birth tied to oral
health.

Around 15 million babies, which is more than one in ten births,
are born prematurely each year, according to the World Health
Organization. Preterm babies are of higher risk of dying shortly
after birth or of suffering from lifelong health problems.
The study was presented at this year’s annual meeting of the
Society for Maternal-Fetal Medicine. The study abstract, titled
“LB 1: PPaX: Cluster randomized trial of xylitol chewing gum
on prevention of preterm birth in Malawi”, was published
online in the January 2022 supplement of the American
Journal of Obstetrics and Gynecology.

Dental Tribune ASEAN | Apr-Jun 2022

[16] =>

16 INNOVATIONS

FDA approval
marks major step
for Second Opinion
AI software
By Jeremy Booth, Dental Tribune International
Second Opinion, an artificial intelligence (AI) diagnostic tool
that assists in dental radiography, has been cleared by the
US Food and Drug Administration (FDA) for use by dental
professionals in the country. This milestone follows the recent
approval of the software by health regulators in Australia and
New Zealand and the granting of the European CE mark. The
software was developed by Pearl, and the company’s founder
and CEO, Ophir Tanz, said that the clearance was a major step
for dentists, who are now free to shift into the AI paradigm in
their everyday clinical practice.
Pearl is a leader in developing AI solutions for use in dentistry,
and its Second Opinion tool is a real-time pathology solution that
assists dentists in accurately detecting and diagnosing common
dental conditions using dental radiographs. A computer vision
platform that can identify and measure an array of pathologies,
the software highlights potential areas of interest and provides
dentists with a second set of eyes.
The FDA cleared the software in early March, and a press
release from Pearl explained that the agency’s strict efficacy
requirements had been exceeded by the clinical studies that
formed the basis of the company’s application for market
approval.
In total, Pearl submitted four clinical studies to the healthcare
regulator, and each of the studies featured a dataset of more
than 2,000 images that were interpreted by dozens of expert
dentists and radiologists. Pearl said that the studies showed
clear advantages for the experts using Second Opinion software.
Those who had used the AI software had identified 36% more
lesions than those who had worked without AI assistance.
The company said that the FDA clearance marked an important
step in the adoption of technology-assisted dental care. Tanz
commented in the press release: “This clearance is a major
milestone not only for our team and for the many dentists,
Dental Tribune ASEAN | Apr-Jun 2022

Pearl submitted clinical studies to the FDA that showed that clinicians who
used the Second Opinion AI-driven software identified 36% more lesions
than those who worked without AI assistance. (Image: AshTproductions/
Shutterstock)

advisors and partners who have contributed to Second Opinion’s
development, but also for dentistry itself.” He explained that AIassisted technology brought with it a paradigm-shift in dental
technology that he said would add value across the entire
healthcare sector. “Because x-rays are a regular part of every
dental patient’s experience, the first place most people will
encounter the power of medical AI technology will be in their
dentist’s chair. Second Opinion’s FDA clearance has made that
possible,” he added.
Prof. Markus Blatz, a key opinion leader in restorative dentistry
and digital innovation, said in the press release: “The benefit
that Pearl’s AI brings to patient communication in the dental
operatory—and the trust that follows—cannot be overstated,
and it is in that area that Second Opinion’s impact will be most
immediately felt.”
Pearl’s co-founder and chief technology officer, Cambron
Carter, added: “State of the art algorithms that currently assist in
the detection of cancerous lesions can now be applied to detect
many more frequently occurring dental diseases. The standard
of care in dentistry is about to level up.”
Speaking to Dental Tribune International, Tanz predicted that,
as dental patients reap the benefits of AI-assisted technology,
dentistry itself would become a model for the rapid adoption
of AI in other medical fields. “So, at the same time as today we
welcome the future of AI-powered dentistry, we also welcome
an AI-powered future for all of healthcare,” he said.
In October last year, Second Opinion was provided with
market authorisation by Australia’s Therapeutic Goods
Administration and New Zealand’s Medicines and Medical
Devices Safety Authority. Earlier in 2021, it received the
European CE marking, and it is already being used daily by
dentists in North America, Europe, Australasia, South America
and the Middle East.

[17] =>

WORLD NEWS 17

Dentists providing cosmetic injectables to
require licence
By Brendan Day, Dental Tribune International
A steady rise in the popularity of non-surgical cosmetic
procedures such as injections of dermal fillers and botulinum
toxin has resulted in UK dental practices increasingly offering
these services. A new amendment to the Health and Care
Bill currently before the British parliament would see the
introduction of a licensing scheme for the performing of such
procedures. Though the details are yet to be ironed out, Secretary
of State for Health and Social Care Sajid Javid has stated that the
scheme would provide “patient safety by making it an offence
for someone to perform these cosmetic procedures without a
licence”.
In a clinical dental context, a substance like botulinum toxin
can be injected into overactive muscles to reduce their activity
levels. As a result, it has been used to treat a variety of conditions,
including bruxism and temporomandibular joint disorders,
and even to promote the osseointegration of dental implants.
However, its positioning as a purely cosmetic procedure has
become increasingly common in recent years, leading to
multiple governmental and regulatory bodies issuing reports
and warnings.
In July last year, the All-Party Parliamentary Group on
Beauty, Aesthetics and Wellbeing released a report with
17 recommendations regarding the provision of these
procedures, including the proposed establishment of a licensing
scheme. This was followed months later by the outlawing of
the injection of dermal fillers and cosmetic botulinum toxin
treatment, along with their advertising, for under-18-year-olds.
The new amendment to the Health and Care Bill would
provide the health and social care secretary with the ability to
create a licensing programme for providers of these cosmetic
filler procedures. According to the Department of Health and
Social Care, the breadth and detail of this programme “will
be determined via extensive engagement including a public
consultation”.
“While most of those in the aesthetics industry follow good
practice when it comes to patient safety, far too many people
have been left emotionally and physically scarred after botched
cosmetic procedures,” said Javid.

An amendment to the Health and Care Bill currently before the
British parliament would see the potential introduction of a licensing
programme for providers of cosmetic filler procedures. (Image:
dimid_86/Shutterstock)

He continued: “We’re doing all we can to protect patients from
potential harm, but I urge anyone considering a cosmetic
procedure to take the time to think about the impact on both
their physical and mental health and ensure they are using a
reputable, safe and qualified practitioner.”
Last year, the British Dental Association (BDA) cautioned
dentists to make sure that they are appropriately insured to
provide certain filler procedures to their patients.
“Our policyholders are indemnified for the use and
administration of facial cosmetic injectable procedures above
the lower border of the mandible,” noted Dr Len D’Cruz, head
of indemnity at the BDA.
“The use of injectable cosmetic treatments in the perioral area is
a useful adjunct to dental treatment when provided by a suitably
trained dentist. In addition, your patients are protected by your
indemnity arrangements and a process for managing complaints
if anything should go wrong,” he added.

Dental Tribune ASEAN | Apr-Jun 2022

[18] =>

18 WORLD NEWS

COVID-19 pandemic: Young
dentists concerned, doubtful about
their future in dentistry
By Jeremy Booth, Dental Tribune International
Dental Protection says that the vast backlog in patient
treatments—a lingering consequence of the pandemic—is
negatively affecting the well-being of nearly half of the young
dentists in the UK. The organisation surveyed UK dentists
having up to five years of work experience and said that the
findings were particularly worrying.

Dental Protection said that its snapshot survey of more than
2,000 dentists who had qualified in the last five years showed
that 37% of respondents were worried about the impact of
COVID-19 on their personal well-being. Close to half (49%)
said that treatment backlogs were affecting their mental health,
and one-third said that pent-up demand was resulting in the

The COVID-19 pandemic has taken its toll on young dentists in the UK and many are now doubtful about their future in the dental field.
(Image: LightField Studios/Shutterstock)
Dental Tribune ASEAN | Apr-Jun 2022

[19] =>

need to work additional hours. Just under half (49%) said that
they did not feel optimistic about their future in the dental field.
Comments from anonymous respondents drew attention to
the fact that the situation was resulting in negative interactions
between patients and oral health professionals. “The backlog is
a worry because patients take it out on the dental staff and not
the NHS who set how we work within the system,” one young
dentist commented. Another said: “I can’t cope anymore. I’m
moving practice but if the situation with people’s rudeness
doesn’t improve I will be leaving healthcare.”
Dr George Wright, senior dental educator at Dental Protection,
said in a press release that the pandemic had led to a “plethora of
challenges” for dentists, such as the expectation that they adhere

to the public health guidelines that have affected the operating
capacity of dental clinics, resulting in treatment backlogs and,
consequently, patient complaints.
Dr Wright said: “We know this is challenging for members, both
from a professional and personal perspective. The cumulative
effects of stress have affected the well-being of the whole dental
team—and as this survey shows, the impact on the mental
well-being of newly qualified dentists is also significant.” He
emphasised that it was particularly worrying that nearly half
of the young dentists surveyed did not feel positive about
their future in dentistry. “We know that clearing the backlog
is an overwhelming prospect for the whole dental team, but
it is imperative that these young dentists—the future of the
profession—feel supported and engaged by the whole system so
they can continue in this rewarding profession,” he added.
NHS plan may not alleviate stress in the short term
The Dental Protection survey was conducted between
18 November 2021 and 4 December 2021 and predated the
NHS’s January announcement of its plan for addressing the
backlog.
The service said that it will put muscle behind efforts to clear the
backlog by injecting an extra £50.0 million (€60.4 million) into
the creation of new appointments. It said that the cash would
create up to 350,000 additional NHS dental appointments, for
which vulnerable groups will be prioritised. These groups include
children as well as people with autism, learning disabilities or
mental health problems, according to an NHS news bulletin.
Naturally, funding alone will not provide dental care, and NHS
dentists will need to fill the extra appointments by working
more hours. The NHS said: “Dentists involved in the scheme
will be paid more than a third on top of their normal sessional
fee for delivering this care outside of core hours, such as early
morning and weekend work.”
Commenting on the “much-needed boost”, Minister for
Primary Care Maria Caulfield said: “Through the pandemic, we
have prioritised urgent dental needs, vulnerable patients and
free treatment for children and thanks to the hard work of staff,
the delivery of urgent care is back to pre-pandemic levels. We
are now working with the dental sector to recover and reform
services and this £50 million boost will help with that recovery.”
Dr Wright encouraged young dentists who were experiencing
stress to contact Dental Protection’s counselling service, which
is available to the organisation’s members around the clock.
Dental Tribune ASEAN | Apr-Jun 2022

[20] =>

20 WORLD NEWS

British government loses key vote on dental
age checks for undocumented immigrants
By Anisha Hall Hoppe, Dental Tribune International
was “very intrusive and could be retraumatising”. Other groups,
such as the Council of Europe Children’s Rights Division, have
called into question the ethicality of the proposal, stating that
age checks were not sufficient cause to expose an individual to
ionising radiation to merely supplement the verification process
already conducted by social workers. The group cited a report by
the Council of Europe in which it was emphasised that it would
be a conflict of medical ethics to expose individuals to radiation
for non-medical purposes.
For new rulings on migration cases, the home secretary has the
authority to choose the scientific methods of age assessment to
be used, according to Part 4 of the Nationality and Borders Bill.
The BDA lobbied extensively for amendment, emphasising the
importance of using validated scientific methods in migration
cases. Dental radiographs are not considered a valid or accurate
method for assessing age, according to the BDA.

The British Dental Association is making strides in ensuring that
only scientific methods deemed ethical and accurate are used to
perform age checks of undocumented immigrants. (Image: Eugen
Haag/Shutterstock)

The British Dental Association (BDA) is celebrating the victory
in the House of Lords of the passing of a key amendment
challenging a government plan to use dental radiographs to
verify the ages of undocumented migrants. The issue has been
on the radar of the BDA since 2016 after a politician suggested
using radiographs to check that incoming refugees were not
adults posing as children. The BDA was quick to condemn this
method of assessment as inaccurate and unethical.
Supporters of the use of dental radiographs claim they will help
social workers verify that migrants are the ages they allege,
and that no adults would be taking advantage of resources or
services reserved for children.
When the use of radiographs was first suggested, Dr Ruth
Allen, the chief executive of the British Association of Social
Workers, said that the use of medical tests for age verification
Dental Tribune ASEAN | Apr-Jun 2022

Within the proposed amendment, the BDA submitted the
requirement “that any scientific method used for determining
age has to first be deemed both ethical and accurate beyond
reasonable doubt by the relevant dental, medical and scientific
bodies”. To that end, amendment sponsors also pressed the
minister to make sure that dental organisations would be part of
the Age Estimation Science Advisory Committee.
Lord Alex Carlile, a British barrister, and crossbench member
of the House of Lords said: “Age assessment techniques must
be proportionate and fair. If any intrusive measures are to be
taken—including dental X-rays—that must be based on proven
evidence of scientific reliability, not vague opinions that it might
add something.”
The new Clause 64A, a combination of the key amendments on
scientific methods of age assessment, won the majority support
of the members of the House of Lords from all parties and must
go on for approval in the House of Commons, a chamber of
publicly elected members of the UK parliament.

[21] =>

WORLD NEWS 21

Romanian dental community comes
together to help Ukrainian refugees
By Dental Tribune Romania & Moldova

It is estimated that more than 70,000 people have fled to Romania from Ukraine since the beginning of the Russian invasion. (Image:
mady70/Shutterstock)

As Russia’s aggression against Ukraine has continued,
humanitarian responses too have intensified, spreading to
more and more countries. Now representatives of the Society
of Esthetic Dentistry in Romania (SSER) have stepped up to
organise various forms of assistance for Ukrainian refugees.
Since the outbreak of the war in Ukraine, thousands of
Ukrainian citizens have been crossing the border with Romania
every day. The representatives of SSER, together with members
of its student organisation, SSER young, logistically supported
by Trident dental clinic and MagnaPharm Romania, both in
Bucharest, travelled on 4 March to the busiest border crossing
point between Romania and Ukraine, near the town of Siret,
to help Ukrainian refugees by distributing urgently needed
gear, such as tents and sleeping bags, as well as clothes and oral
hygiene products.
“I am amazed how our community has stood united and
shown solidarity with those in need,” said Dr Florin Lăzărescu,
associate director and dentist at Trident and corporate director
of SSER. “Over the last seven days, we have seen demonstrations
of empathy not seen in years. Hundreds and even thousands of
people are offering help to refugees from Ukraine. Also, the
authorities have acted effectively and are being very helpful.
The Romanian border is wide open to all Ukrainians and so
are our hearts. We will continue to help as long as needed,
because unfortunately this is only the beginning of the major

humanitarian crisis we will face. In coming weeks and months
and maybe even longer, more people will need our help, and we
need to be prepared for that.”
Through its branches in many cities in Romania, including
Bucharest, Cluj-Napoca, Iași, Timișoara, Brașov and Galați, and
through SSER members from all over the country, SSER aims
to support other efforts to help Ukrainian refugees who have
arrived in the country by offering free emergency dental services.
Recently, a similar humanitarian initiative was launched in
Poland.

Dr Florin Lăzărescu (second to left) and his team travelled to the
Romania–Ukraine border to bring supplies to refugees. (Image:
SSER)
Dental Tribune ASEAN | Apr-Jun 2022

[22] =>

22 WORLD NEWS

Members of the Polish dental community offer free urgent dental care to refugees from Ukraine. (Image: Zerbor/Shutterstock)

Polish dentists in solidarity with
Ukraine
By Dental Tribune International
In response to Russia’s aggression against Ukraine, many
humanitarian actions have been taken to help the civilian
population. Among them is the Polish dental community’s
offer of free urgent dental treatment to Ukrainian refugees. On
28 February, a website was launched with a database of dental
offices offering this assistance to Ukrainian refugees who arrived
in Poland after the Russian attacks began.
This spontaneous action began on a popular social media
channel for Polish dentists. One of the first dentists to offer help
was Dr Kazimierz Szulist of Impladent dental clinic in Nakło
nad Notecią in Poland. The initiative quickly gained allies,
and the list of dental offices ready to welcome those in need is
growing very fast.
“It is a simple gesture of solidarity, but very important. Although
today it seems that dental assistance may not be the first need for
people fleeing Ukraine, we know very well that it may change
soon. Adults and children will be in need. Therefore, we have
created a website (www.dentysciukrainie.pl) with a map of
Dental Tribune ASEAN | Apr-Jun 2022

dental offices offering free dental help to Ukrainian refugees,
to help locate the facility closest to where they are staying,”
explained Krzysztof Powolny, commercial operations director of
eastern Europe, Asia and Australia at the ACTEON Group, the
initiator and coordinator of the campaign, in a report by event
staging company Exactus. “We have translated the website into
Ukrainian, and we appeal to all media, including national and
local media, for help in reaching those in need,” he implored.
Almost 50 dental offices in various parts of Poland have already
expressed their willingness to treat Ukrainian citizens free of
charge. Others can join the project using the form on the website.
The campaign is supported by Polskie Towarzystwo
Stomatologiczne (the Polish dental association), the
ACTEON Group, Marrodent, MEDIF, Biomedix, Exactus and
ewidentniepr.

[23] =>

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[24] =>

24 WORLD NEWS

Applied dentistry research declining,
study finds
By Luke Gribble, Dental Tribune International
professional and patient are served by or benefit from this
research,” lead author Dr Puck van der Wouden from the
Academic Center for Dentistry Amsterdam explained to Dental
Tribune International (DTI).

In a recent study, researchers have found that there has been a
decline in dental research in applied science, as opposed to basic
science. (Image: Africa Studio/Shutterstock)
A focus on academic excellence has resulted in a science system
that incentivises scientists to publish in high-impact journals,
often basic science journals, rather than application-oriented
journals, possibly resulting in a shift from practical usefulness
of knowledge, or academic drift. In a recent Dutch study,
researchers looked at this phenomenon in the dental field. They
found evidence to suggest that academic drift has been moving
the research agenda in dentistry away from dental healthcare.
Non-dental research output by dental research institutes in
all seven studies included in the study increased from 33%
in 1998–2000 to 40% in 2014–2015. Furthermore in all the
countries, dental institutes published relatively more in nondental journals in the period studied. As a result, research
published in dental journals declined compared with total
research published, falling to under 50% in most countries and
26% in England.
“Our findings suggest that the dental research portfolio is
influenced by academic drift, as the focus on basic science
has increased at the expense of research that directly serves
oral healthcare. As the activities of dental research institutes
increasingly focus on non-dental research, and more specifically
on basic science, the question arises whether the oral healthcare
Dental Tribune ASEAN | Apr-Jun 2022

The pressure on researchers to pursue exciting science at the
cost of real-world progress might best be summed up by the
phrase “publish or perish”. While this pressure to publish and its
impact on academic drift were not directly investigated by this
study, Dr Van der Wouden noted that “much has been written
about the perverse incentives of researchers pursuing academic
excellence, also within the medical research field. This excellence
often has been translated in an emphasis on publications in
journals with high impact factors and/or high reputation. For
researchers in a relatively small domain, with relatively low
impact factor journals, like the dental research field, the options
to redeem their research efforts (in terms of publications in
high impact factor journals) within the research field itself are
limited. Possibly, this has contributed to the academic drift
within the dental research field. It would therefore be interesting
to further explore whether research institutes in larger research
fields show similar publication and citation behaviour.”
“Applied sciences and in particular research addressing local or
regional needs and practical challenges are considered outside of
what is conceived as the frontier of science,” said the researchers
in their paper. “As a consequence, the dental research field
may partly move away from the more practical questions that
emerge from everyday dental care practices.” Local health issues
may be left unstudied because researchers have less incentive
to investigate, since the so-called top journals will not publish
the work and the lesser-known journals do not provide the
same reputation boost, negatively affecting care of the regional
populations involved.
“It is likely that the research needs of patients and
oral healthcare professionals are subordinate”—
Dr Puck van der Wouden, Academic Center for
Dentistry Amsterdam

[25] =>

Neurosurgeon Dr Paul Kalanithi said, “Science, I had come to
learn, is as political, competitive, and fierce a career as you can
find, full of the temptation to find easy paths.” In the broad field
of science, it is well documented that the pursuit of a career of
academic excellence can sometimes lead to irrelevant or even
useless research. As noted in the Times Higher Education article,
in 2009, Sir Iain Chalmers and Prof. Paul Glasziou calculated
that “85% of research funding [is] wasted because it asks the
wrong questions, is badly designed, not published or poorly
reported”, equating to a wasted US$170 billion globally per year.
In a 2016 article on the news site Vox, 270 randomly surveyed
professionals from several science areas highlighted seven
core issues that research faces: the influence of money, poorly
designed studies, lack of replicated studies, a broken peer
review system, paywalls inhibiting researchers from accessing
information, poor communication with the public and high
levels of stress on young academics.

Speaking specifically about the role of money, Dr Van der
Wouden noted that “Within the Netherlands, there are no
scientific funding programmes for oral healthcare studies. The
financing system for oral healthcare (most oral healthcare for
adults is paid out of pocket in the Netherlands) and the character
of oral disease (high prevalence but not life-threatening in most
cases) are reasons why public funding in dental research is
rare. Many studies within the dental research field are funded
by industry. Therefore, the research portfolio for the large part
is determined by funders and researchers. It is likely that the
research needs of patients and oral healthcare professionals are
subordinate.”
[...] the publish or perish mentality could one day be
detrimental to the integrity of science as a whole
The researchers noted in their study too that academic drift
from dental into non-dental fields is not reciprocal. Dr Van
der Wouden explained this with reference to the topic of
dental phobia: despite it being of relevance to many patients
in dentistry and to most oral health professionals, much of the
research on the issue is published in psychology journals. “Our
analysis of citations has shown that, in general, such flow of
knowledge from other fields into dentistry is scant. At the same
time, the citations of non-dental research from dental institutes
in other research fields is also scant. Hence non-dental research
from dental institutes appears to remain isolated,” she further
explained.
At a time when the effectiveness of science and the researchers
behind the wheel of change are paramount, the publish or
perish mentality could one day be detrimental to the integrity of
science as a whole. However, although academic drift occurred
over the period between 1998 and 2015, thus weakening the
advancements of dental care, the researchers noted that “more
recently the societal relevance of research has gained a more
prominent place in evaluation and funding systems, which
has resulted in a new paradigm of ‘translational science’.”
However, because this paradigm shift is slow, it remains to be
seen whether the underlying causes of academic drift will be
reversed. They emphasised that the dental research community
and policymakers need to establish a balance between research
that achieves scientific progress and research that serves dental
care.

Puck van der Wouden (Image: Supplied)

The study, titled “Evidence and consequences of academic
drift in the field of dental research: A bibliometric analysis
2000–2015”, was published on 17 January 2022 in BDJ
Open.
Dental Tribune ASEAN | Apr-Jun 2022

[26] =>

26 WORLD NEWS

In a recent study, researchers from Japan investigated the oral health of first-year dental students and found several issues that highlight a
broader problem among the country’s adolescent population. (Image: siriwat sriphojaroen/Shutterstock)

Oral health study of dental students
highlights wider demographic issues
By Dental Tribune International
Over the past few decades, Japan has put a tremendous amount
of effort into improving the population’s oral health. However,
in a recent study, researchers investigated the oral health of
first-year dental students and found a significant percentage
of participants had dental caries and gingivitis, something that
might highlight a broader issue among Japan’s youth.
“Although since 2011 local authorities in Japan have
implemented various efforts to promote oral health across all
age groups, based on the Act concerning the Promotion of
Dental and Oral Health, oral health problems in young people
have gone unnoticed and remain unaddressed,” said lead author
Dr Kumiko Sugimoto in an interview with Dental Tribune
International.
Dr Sugimoto is an emeritus professor in the Department of
Oral Health Care Education at Tokyo Medical and Dental
University. Along with her team, she examined the oral health
of 108 first-year dental students at the university. It could be easy
to assume that the oral health of students entering the dental
field might be considerably better than the general population;
however, the study’s results underscore the significance of the
issue. According to the paper, 43.5% of students had dental
caries, and half the group had gingivitis. In a 2020 Statista survey
of more than 3,000 Japanese young people aged from 12 to 18
and over, nearly 60% reported oral hygiene issues, including, but
not limited to, yellow staining, plaque and dental caries.
Elaborating on the oral health issues of Japan’s youth in general,
Dr Sugimoto said: “The opportunities for receiving annual
check-ups decrease after high school because, up until that
Dental Tribune ASEAN | Apr-Jun 2022

point, they are mandatory.” Many students go to universities,
colleges and vocational schools once they leave school. “Young
people start living alone and leave parental supervision, which
may link to irregular diet and poor oral hygiene habits,” she
explained.
Another element of importance is the structure of Japan’s
healthcare. Dr Sugimoto said: “Japanese universal health
insurance covers treatment of oral diseases but not preventive
care, and most Japanese people visit dental clinics only when
they have dental problems.” COVID-19 has caused added
disruption, and the issue does not appear to be improving. As
noted by Dr Sugimoto, since the beginning of the pandemic
fewer people have visited the dentist, as many are trying to avoid
the risk of COVID-19 infection. “The number of young people
facing economic hardship has also been rapidly increasing
owing to the pandemic, and this may be another reason for the
decrease in visits,” she continued.
Speaking on how the oral health issues facing Japan’s youth
could be improved, Dr Sugimoto noted the importance of
oral health professionals getting more information out to the
public. Especially crucial are the professionals engaged in work
at universities and educational institutions who are in close
contact with students and can help raise awareness regarding
the importance of dental check-ups and general oral health.
The study, titled “A survey of oral health status, subjective
oral symptoms and oral health behaviors among first-year
dental students at a Japanese university”, was published in
the January 2022 issue of the Journal of Oral Science.

[27] =>

WORLD NEWS 27

Australian Greens unveil plans for
universal dental policy
By Brendan Day, Dental Tribune International
for all individuals who are eligible for Medicare. In addition, the
Greens have pledged that they will provide fee-free university
dentistry courses to meet the expected surge in demand for
members of the dental profession.
Though the Greens are not expected to challenge Australia’s
two major parties for a parliamentary majority at the election,
there is a chance that the party could hold the balance of power
if neither the Coalition nor the Labor party is able to form a
majority government. This last occurred in Australia in 2010
and, as Bandt noted in his speech, saw the Greens help secure
free dental care for children and low-income earners as part of a
deal made during the government’s formation.

The Australian Greens political party has announced that it will
seek to expand Medicare to include universal free dental coverage
if it holds the balance of power after next month’s federal election.
(Image: Inside Creative House/Shutterstock)

Though Australia’s government-funded universal healthcare
system, Medicare, covers the cost of many public health
services, dentistry is, by and large, excluded from this. Ahead of
the country’s upcoming federal election on 21 May, the Greens
political party has announced a swathe of policies—chief among
them the expansion of Medicare to include universal free dental
coverage.
On 13 April, Greens party leader and federal member of
parliament for Melbourne Adam Bandt explained that the
policy, which would cost an estimated A$77.6 billion (€53
billion) over the next decade, would be funded by a proposed 6%
additional tax on billionaires in addition to a super profits tax on
corporations. According to the party’s website, the policy would
ensure that routine and therapeutic dental services, including
regular check-up and dental cleaning, crowns, oral surgery, and
orthodontic, periodontic and prosthodontic treatment, are free

ADA asks parties to address oral healthcare
inequalities
Bandt’s announcement came a week after the Australian Dental
Association (ADA) called for the country’s major political parties
to make dentistry a focal point of their election campaigns. In
a press release, the ADA highlighted the oral health burden
carried by the elderly and disadvantaged groups, including
those of an Aboriginal and Torres Strait Islander background,
calling on the parties to address these disparities and prioritise
their oral healthcare.
As Dental Tribune International detailed in 2020, only 53%
of the Australian population possess health insurance that
includes dental coverage, forcing many patients to bear the
burden of dental expenses directly. Furthermore, a 2020 report
from the Australian Institute of Health and Welfare found that
even patients with private health insurance that covers dental
treatment can still be subject to considerable and varying outof-pocket costs. Whereas the median out-of-pocket cost for
a complete crown was found to be A$786 (€537) with private
health insurance, some patients paid as little as A$26 (€17.76),
while others were charged as much as A$1,989 (€1,359).

Dental Tribune ASEAN | Apr-Jun 2022

[28] =>

28 REGIONAL NEWS

Fifth Malaysia
International
Dental Show 2022
After two years, in which the event could not take place as usual
owing to the SARS-CoV-2 pandemic, the Malaysia International
Dental Show (MIDS) will be held as an in-person event in
2022 again. Jointly organized by MAHSA University and the
Malaysia Dental Industry Association, MIDS 2022 is a leading
international dental show in the ASEAN region and an open
platform that encourages collaboration, networking, and growth
among the dental community.
The definition of the dental community comprises dental
professionals, dental hygienists/nurses/assistants, dental
technologists/laboratory owners, government dental bodies,
dental schools of universities, dental suppliers, media, and
dentists/dental industry suppliers’ associations from Malaysia
and the Asia Pacific/ASEAN region.

•

•
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their knowledge of modern dentistry.
Network with dentists, dental hygienists, dental nurses/
assistants, practice managers, dental technologists, and
laboratory owners.
Witness the display of the latest dental technologies and
the most innovative products in the market.
Enjoy special offers and promotions on products and
services to be given by suppliers during the exhibition.

Positioned as the Dental Exhibition & Conference in ASEAN
Economic Community, the event will be officiated by the guest
of honour, Khairy Jamaluddin Abu Bakar, Minister of Health,
Malaysia.

MIDS 2022 will be held from 20 to 22 May 2022, 8:30 a.m.–
6 p.m at Sunway Pyramid Convention Centre, Bandar Sunway,
Petaling Jaya, Selangor, Malaysia. It features both scientific
conferences and trade exhibitions.

“In order to take MIDS 2022 to a higher level, we’ll continue
to feature professional speakers from around the world”,
says Dr. Kacharaju Kranthi Raja, Deputy Dean (Research,
Postgraduate and Clinical Services), Faculty of Dentistry of
MAHSA University and organizing chairman of the scientific
conference.

The main objectives of MIDS 2022 are to enhance the skills
and knowledge of dentistry among dental professionals and to
collaborate with dental suppliers in promoting the growth of the
industry symbiotically.

MIDS 2022 features three workshops and 15 lectures presented
by 15 distinguished international speakers from India, the
Philippines, Thailand, and Malaysia. Some of the key topics
include:

Held under the theme “Dentistry Advancement and
Technologies”, the show features about 100 booths by
international and local exhibitors showcasing the latest dental
materials, products, and technologies. It is expected to draw a
crowd of over 1,500 delegates/visitors comprising private and
government dental professionals, exhibitors, trade visitors, and
industry/association leaders from Malaysia and overseas.

•
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•

At MIDS 2022, delegates will have the privilege to:
•

Learn from the industry’s top-notch speakers and improve

Dental Tribune ASEAN | Apr-Jun 2022

•

Facial aesthetics - arts and science
Periodontal therapy in general dental practice
Understanding the principles and philosophy of clear
aligners
Effective distalization with clear aligners
Treatment of challenging cases using an in-house clear
aligners
Predictable outcome for porcelain veneers, crown & overlay
Simplifying the practice of restorative dentistry with dental
composites
Management of large periapical lesions in endodontics

[29] =>

Fifth Malaysia International Dental Show 2022 will be held from 20-22 May 2022, 8:30 a.m. - 6:00 p.m at Sunway Pyramid Convention
Centre (SPCC), Bandar Sunway, Petaling Jaya, Selangor, Malaysia.

•
•
•
•
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Variables in shaping of root canals
Non-surgical endodontic retreatment
The use of densah burr in maxillary sinus lift procedure
The role of concentrated growth factor in contemporary
implant therapy & practice
Dental implant vs tooth transplantation in adolescence
Clinical tips for successful restoration of fractured and
attrited teeth
Artificial intelligence in dentistry-a new frontier

In addition, dental professionals will earn CPD credits for
participating in the conference and workshop.
Dental undergraduate students are encouraged to participate at
a special student rate of USD150.00.
MIDS 2022 is endorsed by the Malaysia External Trade
Development Corporation.
Supporters:
•
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•

Malaysia Convention & Exhibition Bureau
College of General Dental Practitioner, Singapore
Persatuan Juruteknologi Pergigian Malaysia
Malaysia Dental Technologist Association
DenTech China
Asia Pacific Dental Industry Association
National Association of Dental Traders Inc., Philippines
Taiwan Dental Traders Association
Indonesia Association of Dental & Oral Health
Industry
Malaysian Private Dental Practitioners’ Association
Islamic Dental Association of Malaysia

•
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ClearSmile
AltisPro
Kerr
Dentsply Sirona
Bintang Saudara
One Dental

•

WOODPECKER

Media partners:
•
•
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•
•
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DENTAL ACCESS
DENTAL ASIA
Trade Winds
MALAYSIA SME
DENTAL NETWORK ASIA
INFODENT
Dental Tribune ASEAN

Social media partners:
•
•

DentistNearby.com
Findentist

For more information about MIDS 2022, kindly contact:
Mr. Chin, Show Secretariat
Mobile/WhatsApp No:
+6016 – 225 8823.
Address:
Unit 713, Block A, Kelana Centre Point
No 3, Jalan SS7/19, Kelana Jaya
47301 Petaling Jaya, Selangor, Malaysia
Email:
enquiry@mids.com.my & secretary@mids.com.my

Speaker sponsors:
•
•
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Ivoclar
NDENT
COLTENE
Dental Tribune ASEAN | Apr-Jun 2022

[30] =>

30 IN THE HOT SEAT

Interview:
Dental therapists as answer to racial
inequities in oral healthcare
By Franziska Beier, Dental Tribune International
We partner with local, state and national advocates to leverage
and build power so that all people can influence decisions that
affect their health. Health systems are not likely to be accountable
to people without a fully engaged and organised community
voice. That is why we work every day to ensure people’s interests
are represented wherever important decisions about health
and healthcare are made: in communities, state houses and on
Capitol Hill.

The 2019 graduating class of dental therapists from the Alaska
Dental Therapy Educational Program at Ilisagvik College,
which is Alaska’s only tribal college. (Image: Community
Catalyst)
A recent study by Community Catalyst, a US non-profit health
organisation that advocates for health equity and justice,
emphasises how dental therapy can significantly improve access
to oral health in underserved communities. Dental Tribune
International spoke with co-author Kasey Wilson, a senior
policy analyst with the organisation’s Dental Access Project, to
find out how dental therapists have improved the relationship
of underserved communities with dental services by providing
trustworthy and culturally respectful care.
Ms Wilson, could you tell us a bit more about the
organisation Community Catalyst and your position within
the organisation? What is the Dental Access Project?

Kasey Wilson, a senior policy analyst at Community
Catalyst. (Image: Kasey Wilson)
Dental Tribune ASEAN | Apr-Jun 2022

As a senior policy analyst, I provide research and policy
support to community groups and health advocates working
on improving access to dental care and oral health. The Dental
Access Project is focused on supporting the identification and
implementation of effective local solutions that improve oral
health access and community health outcomes.
How does structural racism have an impact on the
oral health of people from various racial and ethnic
communities?
Structural racism has an impact on oral health directly as well
as via access to care and broader social determinants of health.
It is widely documented that experiencing racism presents a
unique form of chronic stress that can cause a variety of health
problems. Many of these, including heart disease, diabetes and
inflammatory responses, are also associated with oral health
problems. Once dental disease develops, treating it requires
access to timely, accessible care, which can be expensive. When
it goes untreated, dental disease can have an impact on the
ability to work or go to school, compounding existing economic
inequalities that are, themselves, driven by structural racism.
Structural racism also affects things like who has access to care,
where dental providers are located and who has access to dental
professional education. Some racial and ethnic communities
face greater barriers to accessing dental care and have poorer
oral health outcomes as a result. The dental profession is also
disproportionately white, meaning that patients from these
communities, and black and indigenous patients in particular,
are less likely to be able to see a provider who represents their
race, ethnicity and/or culture, which is also shown to have an
impact on health outcomes.

[31] =>

therapists are enabling dentists and community clinics to see
more publicly insured patients, reduce patient wait times and
divert emergency room usage. Dental therapists work as part
of the existing dental team and may also be dually educated as
dental hygienists.

Asiah Gonzalez, a dental therapist and member of the Swinomish
Tribe, at her workplace at the Swinomish Dental Clinic in La Conner
in Washington. (Image: Community Catalyst)

As described in your study, Alaskan Natives are an
example of communities who, for a long time, did not
have proper access to dental care. Then leaders decided
to take action and found a solution: dental therapists.
Could you please explain what exactly dental therapists
are and what they do to serve their community?
Dental therapists are highly trained oral health practitioners
who work with dental teams in a similar way to that in which
physician assistants work with medical teams. They provide
education and preventive services and undertake common
dental procedures such as filling cavities and, in limited cases,
removing teeth. Through the remote supervision of a dentist,
dental therapists can also deliver care in settings that better
meet the needs of underserved communities, such as mobile
clinics, schools and senior centres. Where employed, dental

What has changed for the Alaskan Native community
regarding dental care since the leaders started to work
with dental therapists?
Alaska Native leaders were the first in the nation to bring dental
therapists to the US. When the first dental therapy education
programme opened in Alaska, they based their training
on community-centred models abroad. The dental therapy
programme operates on a model of training local people to
provide the care their community needs and offering that
training in a local context. This increases the likelihood that
providers will stay in their local communities to practise.
Members of communities who, for generations, had received
only intermittent care from itinerant providers—and who often
experienced pain and trauma associated with that care as a
result—or who had no access to care at all, now can see a dental
provider regularly in their own communities.
In places where dental therapists work, both children and adults
have better access to preventive care and more people are keeping
their natural teeth. Communities are highly satisfied with the
care they receive, saying that they now know more about oral
health and regard dental therapists as having improved their
quality of life.

Daniel Kennedy, the first dental therapist to work in a tribal community in the lower 48 (the 48 contiguous US states, excluding Alaska and
Hawaii) and the first dental therapist to work in Washington, at the Swinomish Dental Clinic in La Conner. (Image: Community Catalyst)
Dental Tribune ASEAN | Apr-Jun 2022

[32] =>

32 IN THE HOT SEAT

Aurora Johnson—one of the first dental therapists to begin practising in the US—gives oral health education to a class of children in a tribal
community school in Alaska. (Image: Community Catalyst)

Dental therapists often work within their own home
community and are thus responsive to cultural and
community norms. Does this increase the patient’s trust
in the dental therapist and thus in dental care?
That is exactly right. They represent the language, culture
and experiences of their patients, and this has transformed
communities’ relationships with dental care. More trust comes
from having a provider who understands and respects their
patients’ culture and also from regularly accessible care in
general. When communities can expect that a provider will
be there, month after month, year after year, that consistency
builds trust as well.
The model of employing dental therapists is a cycle of
consistency, representativeness and trust that was borne of tribal
leadership and can be adapted by and for diverse communities
across the country.
Are dental therapists employed in other regions too?
Dental therapists have been practising around the world for
over a century, and a large body of evidence shows that they
provide effective, quality care. As a result of their positive
impact on Alaska Native communities, dental therapists have
been authorised to practise in at least some settings in 11 other
US states. Minnesota was the first state to allow dental therapists
to practise statewide, and they have been doing so for a decade
with positive results similar to Alaska. Dental therapists have
improved access to care for underserved populations and have
helped dental clinics see more publicly insured patients.
Are there any other future aspirations for improving oral
healthcare access to underserved communities that you
would like to share with us?
Expanding the oral health workforce—and especially increasing
the diversity and geographic distribution of providers, which
Dental Tribune ASEAN | Apr-Jun 2022

dental therapy helps to do—is only strengthened by related
efforts to improve access to care and achieve oral health
equity. Improving access to coverage by making dental benefits
mandatory for adults in all US state Medicaid programmes and
adding a comprehensive dental benefit to Medicare is critical.
So also is giving people a choice in the type of care they receive
and where they receive it. This includes better integration of oral
healthcare into medical settings—like fluoride being provided
in paediatricians’ offices—and prioritisation of less invasive
approaches to treating dental caries that are more likely to allow
people to keep their teeth and avoid the dental drill.
Is there anything else you would like our readers to
know?
Continuing to evaluate how and where structural racism shows
up in access to care and health outcomes is critical in achieving
oral health equity and health justice more broadly. In addition
to the policy solutions we have already talked about, ensuring
that communities have a say in decisions that affect their oral
and overall health is also integral. This means that people who
are most affected by a problem must lead the charge in coming
up with the solutions.
The study, titled “Undoing structural racism in dentistry:
Advocacy for dental therapy”, was published online on 11
January 2022 in the Journal of Public Health Dentistry,
ahead of inclusion in an issue.

[33] =>

BUSINESS 33

GlaxoSmithKline announces name of
independent healthcare company
By Brendan Day, Dental Tribune International

Pharmaceutical giant GlaxoSmithKline has announced that its healthcare business will be called Haleon once it becomes a separate
entity. (Image: Golden Shrimp/Shutterstock)
In 2018, GlaxoSmithKline (GSK), one of the world’s largest
pharmaceutical companies, outlined its intention to separate its
consumer healthcare portfolio into an independent entity. This
is set to take place in mid-2022, and GSK has now revealed that
the new company will be called Haleon.
The separation of GSK’s healthcare business, which is subject to
approval from shareholders, will take place via a demerger of at
least 80% of GSK’s stake in the business to shareholders later this
year. According to a press release issued by GSK, Haleon’s name
is derived from the words “hale”, an old English word meaning
“in good health”, and “Leon”, a name associated with strength.
Included in Haleon’s portfolio will be the paracetamol brand
Panadol, the non-steroidal anti-inflammatory Voltaren and the
toothpaste brand Sensodyne.

“Introducing Haleon to the world marks another step in our
journey to become a new, standalone company,” said Haleon
CEO designate Brian McNamara. “Our name is grounded in our
purpose to deliver better everyday health with humanity and to
be a world leader in consumer healthcare. We are on track to
launch Haleon in mid-2022 and our business momentum is
strong.”
Emma Walmsley, GSK CEO, added that “Haleon has enormous
potential to improve health and well-being across the world with
strong prospects for growth, and through listing will unlock
significant value for GSK shareholders”.

In January, GSK revealed that it had recently rejected three
takeover offers for its consumer healthcare business from
multinational conglomerate Unilever, including a bid of
£50 billion (approximately US$67 billion). GSK said that
Unilever had undervalued the business and forecast annual
organic sales growth of 4 to 6%.
Dental Tribune ASEAN | Apr-Jun 2022

[34] =>

34 BUSINESS

Dentsply Sirona announces new
3D-printing solution, partnership
with Google Cloud
By Dental Tribune International

To help improve digitial dental workflows, Dentsply Sirona has entered into a new partnership with Google Cloud and launched a new
medical-grade 3D-printing solution. (Image: Michael Vi/Shutterstock)

Global dental industry leader Dentsply Sirona has announced
that it will be taking a number of steps to improve digital
workflows for dentists, dental laboratories and patients across
the world. Among these steps are a new partnership with Google
Cloud and the launch of a new medical-grade 3D-printing
solution. The company has invited dental professionals to
participate in a virtual event on 4 March to find out more about
these developments.
The collaboration with Google Cloud will feature a suite of new
digital dentistry solutions that, according to Dentsply Sirona,
will help both dentists and dental laboratories regardless of
whether they are just starting their digital journeys or have
some experience under their belt. The solutions will be based
on six key principles, which include the provision of highquality 3D dental imagery visualisation, the creation of digital
workflows that allow for fast and easy data sharing between
dental practitioners and laboratories, and the maintenance of
stringent data protection and security standards.
Christian Martin, managing director of the Alps region at
Google Cloud, noted in a press release: “Dentsply Sirona is
transforming the dental industry. At Google Cloud we believe
that we have the right expertise, capabilities and services to
strongly support Dentsply Sirona in its vision for the future of
oral healthcare.”
Dental Tribune ASEAN | Apr-Jun 2022

“This exciting collaboration will allow us to deliver on our
promise: empowering millions of customers by proudly creating
innovative solutions for healthy smiles,” said Don Casey,
Dentsply Sirona CEO. Both Casey and Urs Hölzle, senior vice
president of engineering at Google, will be interviewed as part
of the event taking place on 4 March.
Primeprint: An advance in automated printing
Dentsply Sirona will also launch Primeprint, a 3D-printing
system for dental practices and laboratories, at the online event.
The company stated that Primeprint, which is optimised for
dental applications, possesses a high level of automation that
allows it to run the entire printing process and deliver accurate,
reproducible results using biocompatible dental materials.
“Dentsply Sirona has always been a pioneer in digital dentistry,”
Casey further commented in the press release.
He added: “Whether it was virtually inventing dental imaging,
creating intra-oral scanning or creating single-visit dentistry,
Dentsply Sirona has led the way. Starting with the announcements
today, Dentsply Sirona will again look to transform dentistry
with new devices and AI-supported solutions and services.”

[35] =>

BUSINESS 35

Candid takes on the aligner market
from a new angle
By Anisha Hall Hoppe, Dental Tribune International
format L1 printers, CandidPro enables organisations to save
money in the production of parts of all sizes and to prototype
as needed.

Candid is a relative newcomer to the clear aligner market, but
has already experienced enough success with its products and
partnerships to be able to switch customer bases completely. (Image:
Shutterstock/Vershinin89)

Clear aligner company Candid has historically pitched its
services as being for orthodontists only, using that exclusivity
to further its reputation for its end-to-end platform. After
announcing a partnership with 3D printing technology
company Carbon last year, Candid has made some major
changes. Perhaps most notable is the transition from originally
working only with orthodontic practices to now offering clear
aligner manufacturing to dental practices as well, according to
an interview with Candid co-founder and CEO Nick Greenfield.
Though slowed somewhat, sales of clear aligner systems grew
continually during the SARS-CoV-2 pandemic. According
to data gathered by Fortune Business Insights, the market is
heading into a period of incredible growth, estimated to reach
US$10.04 billion (€9.11 billion) by 2028 at a compound annual
growth rate of 19.7% during the 2021–2028 period.
Over the last two years, many medical practices have been forced
to reduce dramatically the number of elective procedures they
offer, and in many cases, orthodontic treatment fell into this
category. However, the demand for at-home tooth alignment
has continued to grow. As previously reported by Dental
Tribune International, there are now more options than ever for
dentists who have decided to offer clear aligner treatment for
their patients, especially as more practices are opting to create
their aligners in-house and brand and sell them directly to their
patients.
In response to this demand, Candid and Carbon announced
their collaboration in offering dental and orthodontic practices
the new CandidPro programme in 2021. Thanks to Carbon’s
proprietary Digital Light Synthesis process and powerful large-

Philip DeSimone, chief product and business development
officer at Carbon, said in the press release: “Carbon’s L1
production system will enable Candid to efficiently and reliably
produce millions of highly accurate aligner models and deliver
bespoke solutions for each patient at scale.”
Other clear aligner providers have also developed large-scale
manufacturing processes, but CandidPro’s scalability indicates
an emphasis on customisation for the individual practice or
organisation.
When Candid started out, its business model centred on
business-to-consumer aligner offerings with a treatment
programme using patient smartphones to monitor tooth
alignment progress at home. At the start of 2022, Greenfield
told Dental Economics in an interview that it was abandoning
this strategy altogether in favour of a full focus on a business-tobusiness approach with CandidPro.
Greenfield noted that more patients preferred to start their
treatment with a dentist or orthodontist rather than directly
from a Candid stand-alone facility.
The CandidPro programme results were so impressive that
Candid announced at the start of the year that it would close all
of its more than 40 facilities in order to focus on working with
both orthodontic and dental practices.
“We’re seeing patients who are self-scanning every two weeks.
They have 85–90% compliance in wearing their aligners and
wear them for 20–22 hours a day,” Greenfield said.
Greenfield also emphasised that the new model offers patient
triage support and that a remote orthodontist based at Candid
headquarters could manage treatment planning for dentists
“who don’t feel comfortable moving teeth” owing to infrequent
practice.
CandidPro providers are now present in all 50 states, said
Greenfield, and international expansion will be coming soon.
Dental Tribune ASEAN | Apr-Jun 2022

[36] =>

36 BUSINESS

Researchers have found that most dental professionals use their 3D-printing device at least every two days and the vast majority
use it at least once per week. (Image: YAKOBCHUK VIACHESLAV/Shutterstock)

3D printing: Study examines dentists’
user experiences and spending
By Jeremy Booth, Dental Tribune International
The use of additive manufacturing in dentistry is widespread in
dental markets; however, there is a lack of information about
the practical aspects of how dental specialists are using 3D
printing and the amount they are spending on it. A study led
by researchers at Semmelweis University in Budapest sought
to establish the facts about 3D printing in dentistry in order to
characterise its use.
Dental Tribune ASEAN | Apr-Jun 2022

According to the study, additive manufacturing experienced
a price revolution around 2010. The technology had already
existed for nearly two decades, but lower prices brought 3D
printing within reach of consumers and professional groups,
and dentists and dental laboratories were some of the core
investors in early compact 3D-printing solutions.

[37] =>

More than a decade later, 3D printing is being used in every
field of dentistry, including in prosthodontics, orthodontics,
implantology and maxillofacial surgery. The authors stated,
however, that “little knowledge has been collected from the
specialists in this technology’s physical usage”. The researchers
therefore investigated key aspects of use, such as the types of
3D printers and software being used, the number of units on
hand in dental settings, and the accessibility and cost of the
technology for dental professionals.
They found that respondents mostly used their 3D printers
to create models for designing prosthetics. The second most
common use was in the area of orthodontics, followed by the
creation of sectional cast models, surgical guides, castable waxes
and splints. At the lower end of the usage spectrum, dental
professionals used the technology to create restorations such as
dental bridges, crowns, inlays and permanent restorations.
The majority (63.3%) of respondents said that 3D-printed
models were more accurate than those made using cast model
techniques. Most respondents (72.5%) said they used their
printing device at least every two days, and 92.5% used it at least
once per week. More than one-quarter (25.8%) of respondents
used more than 20 l of additive printing material every year,
and 55.0% said that they had spent US$5,000 (€4,500) or less on
their printing device.

the most preferred, followed by those made by Medit, Dentsply
Sirona, Align Technology and Planmeca.
One of the surprise findings of the research was that only 51.7%
of respondents had received training on how to use their 3D
printer from the device manufacturer, and it was highlighted that
most respondents had not been able to familiarise themselves
with 3D printing during their dental education. Regarding
becoming adept with the technology, the researchers noted that
social media was a significant source of information, problemsolving and networking opportunities related to 3D printing in
dentistry. They wrote: “Social media is essential. It is currently
having a significant impact on the healthcare industry, and it is
also an excellent tool for helping specialists exchange experience
and knowledge. In addition, if one needs help, it seems to be a
faster method for receiving it than the official support system.”
It was found that newly graduated dentists and younger dentists
were faced with fewer technical obstacles when adopting the
technology. The researchers wrote: “They learn the critical steps
of digital dental treatment during their education, including
digital impression taking, intra-oral scanning, and additive
manufacturing. This new generation of dentists has enormous
potential to develop digital dentistry. The working process and
patient experience can be created together, as the patient can
follow the whole treatment via digital dental tools.”

The most common 3D printers owned by the respondents were
those made by Formlabs, NextDent and Asiga, and the top three
criteria that respondents looked for when choosing a 3D printer
were accuracy, price and recommendations. When it came to
satisfaction with the potential of their 3D printer, respondents
were most satisfied with devices made by Asiga and NextDent.
On the topic of price and material, devices made by Anycubic
scored the highest. When it came to speed, users of NextDent
devices were the most satisfied. Only three respondents said that

The study identified environmental factors related to additive
manufacturing as a concern within the dental community.
They said that there was a lack of studies that investigated the
full ecological footprint of digital dental workflows, including
the complete life cycle of additive manufacturing processes, in
comparison with more traditional dental technologies.

they were dissatisfied with their device.

120 dental professionals from 20 countries. This sample was
comprised of 68 dentists, 29 dental technicians and 23 CAD/
CAM specialists who were mainly based in Hungary (23.7%),
the US (18.4%) and the UK (7.9%). Most of the respondents
owned one 3D printer and the study participants, on average,
had more than three and a half years of experience using the
technology.

One of the surprise findings of the research was that
only 51.7% of respondents had received training
on how to use their 3D printer from the device
manufacturer
For CAD processes, the most commonly used software was
made by exocad, followed by those made by Meshmixer and
3Shape. The respondents used intra-oral scanners almost
as often as they used their 3D-printing devices, and the two
technologies were often used together. Among the intra-oral
scanners used by the sample group, those made by 3Shape were

The findings were based on an online survey that was conducted
between 1 January 2020 and 1 January 2021 and completed by

The study, titled “User experience and sustainability of 3D
printing in dentistry”, was published online on 9 February
2022 in the International Journal of Environmental
Research and Public Health.

Dental Tribune ASEAN | Apr-Jun 2022

[38] =>

38

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[39] =>

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[40] =>

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[cover] => DT ASEAN No. 2, 2022

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Table of contents

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