Dental Tribune UK No. 2, 2023

Leadership: It is not about you, it is about them / Dental practice management software market is now worth £1.2 billion, and is growing / UK NEWS

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The World‘s Dental Newspaper
Published in London

uk.dental-tribune.com

Vol. 13, No. 2

UK NEWS

A new study shows how chewing
properly may improve blood sugar
levels in patients with Type 2 diabetes.

Technology helps drive reputation and extend care beyond the
chair, with the latest FollowApp
Care app.

A graduate at the University of Bath
develops a smartphone app that
scans dental plaque and can flag potential oral hygiene issues.

Page 5

Page 7

Page 2

Leadership:
It is not about you, it is about them
By Dr Bhavna Doshi, UK
Having spent my entire career in
multiple leadership positions, this
has made me more cognisant of
dental practice owners falling into
the pitfalls of what leadership is
not.
Throughout my 30 years of business experience, in both my own
companies and helping grow
practice owners' businesses, I became intrigued that the same
questions kept popping up. Whilst
many had really invested consid-

erable time and efforts in becoming good and strong leaders — socialising with their teams, awarding bonuses, promoting democracy, delegating or immersing
themselves
into
leadership
courses — the truth of the matter
was that many still struggled to
get their team to do the work they
were 'meant to do' without having
to oversee or micromanage them.
And therein lies the issue!
The fact that a small business such
as a dental practice offers the

owner a tremendous insight into
team and patient dynamics and
provides a real opportunity to see
what is going on at ground level, it
can also make owners hypersensitive to any mismatch in motivation
levels and vision-sharing amongst
their team members, which can
contribute to an unhealthy working environment. If the leader
senses that their staff are misaligned despite having put 'everything' in place, all parties can end
up frustrated and stressed, and
subsequently not in the best posi-

tion to blossom within the workplace.
I have held a variety of leadership
positions and observing other
dental leaders, this has made me
more cognisant of owners falling
into the pitfalls of what leadership
is not. Looking at business from
the singular perspective of the
owner's point of view is a mistaken
mindset, and I feel it is high time
we change that erroneous thinking of it being all about the leader,

when actually it should also be
about the team.
This ultimately creates the best
optimal environment for all, including patients.
So, I have written a 'one-stop'
book about leadership. In fact, I
would rather call it a toolkit which
systemises leadership, with actions the reader can take at the
end of each chapter. It is not theoretical; it is a practical guide for
success distilled into a formula
that actually works.
▶ Page 2

Dental practice management software market is
now worth £1.2 billion, and is growing
The dental practice management
software industry is poised for significant growth and transformation in the near future. With advancements in technology and increasing digitalisation, dental
practices are adopting software
solutions to streamline their operations, improve patient care, and
enhance overall efficiency.
Dental practice management software offers a wide range of features, including appointment
scheduling, patient records management, billing and invoicing,
treatment planning, and communication tools.
These software solutions help
dental practices automate manual
tasks, reduce paperwork, and improve accuracy in managing patient information. In addition, the
integration of electronic health records (EHR) and digital imaging
capabilities further enhances the
capabilities of dental practice

management software. The near
future will witness continued innovation in areas such as artificial intelligence (AI), teledentistry, and
patient engagement tools, providing dentists with advanced tools
to enhance diagnosis, treatment
planning, and patient communication. As dental practices increasingly recognize the benefits of
adopting digital solutions, the
dental practice management software industry is expected to witness significant growth and revolutionise the way dental practices
operate and deliver care to their
patients.
The dental practice management
software market (PMS) in terms of
revenue was estimated to be
worth £1.2 billion in 2023 and is
poised to reach £1.8 billion by
2028, growing at a CAGR of 8.6%
from 2023 to 2028 according to a
new report by MarketsandMarkets. The overall growth is said to
be because of the rising in de-

mand for cosmetic procedures
and the technological advancements in dentistry, which in turn,
increase the footfall at dental
practices.
The dental PMS market is segmented into cloud-based, webbased and on premise software.
The cloud based segment is forecasted to grow at the highest
CAGR during the forecast period.
The primary driver of this market is
flexible, scalable, and affordable
nature of cloud-based technology.
Additionally, advantages such as
remote access, low upfront costs,
and data security also contribute
to the high growth of the segment.
Due to the rising awareness of
dental disorders and their treatment, and the rising footfall in
dental clinics in developing countries due to increased dental tourism, the dental clinics segment occupied the largest share of the
market in 2022. The other end
users segment is expected to grow

at the highest CAGR during the
forecast period. The growth of this
segment, which is mainly due to
DSOs, can be chalked down to increasing private equity funding for
DSOs, and benefits of economies
of scale offered by DSOs, among
other factors.
Dental PMS advantages:
· Improved efficiency: Dental practice management software automates various administrative tasks
such as appointment scheduling,
patient records management, and
billing, reducing the need for manual paperwork and streamlining
workflows. This improves overall
efficiency, allowing dental professionals to focus more on patient
care.
· Enhanced patient experience: The
software enables seamless communication between dental staff
and patients, offering features
such as automated appointment

reminders, patient portals for accessing information and making
online payments, and secure messaging systems. These tools enhance patient engagement, satisfaction, and convenience.
· Accurate and centralised patient
records: Dental practice management software provides a centralized database for storing and
managing patient records, including medical history, treatment
plans, and diagnostic images. This
allows for easy access to up-todate patient information, improving accuracy in diagnoses, treatment planning, and continuity of
care.
▶ Page 3

[2] =>

UK NEWS

Dental Tribune United Kingdom Edition | 02/2023

▶ Page 1 - Leadership: It is not about
you, it is about them

I have tried and tested the actions
over many years working with
businesses across the healthcare
sector (primarily dental, but also
pharmaceutical and optical). My
philosophy is win-win-win for the
owner, team member and patient.

ing fears and misconceptions. I
have written the book from a clinician's viewpoint, understanding
what challenges my peers face on
a daily basis, as I have been there
too.
My mission with this book, which
is published in June, is to bridge
the gap between the focused
self-motivated leader and team
members who may have very different needs. It is about deeprooted values which chime with
you and with which you can align
all team members. Although primarily aimed at leaders or people
aspiring to a managerial position,

In my book entitled Lead to Grow, I
talk about establishing a positive
team culture that is aligned with
the business vision. If practice
owners can help their team members reach their best potential,
they will feel psychologically, emo-

methods need to be adapted for
comprehensive understanding. It
is the responsibility of the leader
to figure this out so that the information on the business vision and
tasks requested from them are
fully understood. How many of
you really know how your staff like
to communicate? Do you really
know if they have understood everything you say to them? Do you
know if they need any more information? Do they need more training? What do you know about
them? Have they got any self-limiting beliefs? What do you know
about their personal life that could
impact work? Do you know how

tionally and physically safe, which
will subsequently make them happier, more likely to initiate creativity and ultimately engender strong
loyalty. This grounding needs to
be put into place in any business to
help move your business forward.
Team members need to understand what the leader wants and
vice versa. The reality is that people learn or take action in different
ways, and hence communication

leaders, this completely aligns
with my philosophy of win-winwin aiming at patients, practices
and teams altogether.
My book will be available on my
website www.dentalwealthbuilder.
com and on Amazon
from June. I am
excited
to
r e c e i v e
feedback
f r o m
readers as
t h e y
implement
this
new
approach in
their practices.

About Royal
Philips

your team members can best work
collaboratively and cohesively together?
This book is designed to give practice owners practical information
which can be easily implemented,
helping them truly connect with
their teams at a level which is reassuring and safe for them. Simple
things like creating organised
communication structures, united
values and systems, and alleviat-

anyone wanting to become an invaluable member of the team, and
encourage their leaders to behave
in a collaborative way, can benefit
from reading this book.
In parallel with this, I will continue
working with more practices to
fine-tune their leadership skills
through an exclusive partnership
collaboration with Philips. As the
company's mission is to pioneer
new breakthroughs as market

Royal Philips is a leading health
technology company focused on
improving people's health and enabling better outcomes across the
health continuum from healthy living and prevention, to diagnosis,
treatment, and home care. Philips
leverages advanced technology
and deep clinical and consumer
insights to deliver integrated solutions. Headquartered in the Netherlands, the company is a leader in
diagnostic imaging, image-guided
therapy, patient monitoring and
health informatics, as well as in
consumer health and home care.
Philips' health technology portfolio generated 2016 sales of €19.5
billion and employs approximately
81,000 employees with sales and
services in more than 100 countries. News about Philips can be
found
at
www.philips.com/
newscenter.

Dr Bhavna Doshi
As CEO of Dental Wealth Builder
(DWB), Bhavna primarily focuses
on Practice Profitability and Growth
Solutions. Her strategic techniques
have been tried, tested and proven
to work and have optimised
revenues for many colleagues.
The comprehensive DWB
coaching programs have
been uniquely designed
for associates, practice
owners and dental
teams.
Having been in the
dental industry for 30
years, she has collated
an impressive résumé of
various leadership roles.
She has worked as a
successful practising dentist,
principal to multiple award-winning practices (in dentistry and
healthcare), a business coach and
mentor, a judge for the UK
National Private Dentistry Awards,
director for the Perfect Smile
Advanced Training Institute, an
international keynote speaker,
author for multiple publications.
She also works as a consultant &
coach for multiple dental practice
groups conducting a variety of
programs for their practices and
for various suppliers within the
dental industry.
Bhavna provides a unique
perspective that combines clinical
dental know-how and entrepreneurship with focused business
fundamentals. Her mission is to
empower dentists’ and their teams
with easy to accomplish strategies
that makes owning or working in a
dental practice highly rewarding.
Her main areas of expertise are:
success strategies, entrepreneurship, practice growth & profitability,
successful associateship, motivational transformational leadership,
cost-effective marketing, gaining
comprehensive case acceptances,
communication skills and inspiring
teams.
She now works entirely as a
business coach, consultant and
mentor in the healthcare industry.

Health care providers are recommended to check the teeth of patients with type 2 diabetes (T2D),
in a new study conducted by the
University at Buffalo.
The study, published in PLOS ONE,
demonstrates that patients with
T2D who have full chewing function have a blood glucose level
that is significantly lower than patients whose ability to chew effectively is impaired.

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The retrospective study looked at
data gathered from 94 patients
with T2D who had been seen at an
outpatient clinic in a hospital in Istanbul, Turkey. The patients were
divided into two groups: the first
group included patients who had
good "occlusal function" —
enough teeth placed properly and
making contact in such a way that
a person can chew their food well.
That group's blood glucose level
was 7.48. The second group
couldn't chew well, if at all, be-

cause they were lacking some or
all of those teeth; their blood glucose level was almost 2% higher, at
9.42.

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Experts suggest this is because
nutrients that are important to reduce blood glucose levels include
fibre, which is obtained in large
part through chewing appropriate
foods. Chewing also has been reported to stimulate reactions in
the intestine that lead to increased
insulin secretion.

All rights reserved. © 2023 Dental Tribune International GmbH. Reproduction in any manner in any language, in whole or in part, without the prior written
permission of Dental Tribune International GmbH is
expressly prohibited.

"Our findings show there is a
strong association between mastication and controlling blood glucose levels among T2D patients,"
said University at Buffalo researcher Mehmet A. Eskan. This
study did not find any independent variables that could affect
blood glucose levels among the
subjects because there were no
statistical differences among subjects regarding body mass index,
sex, smoking status, medications,

responsibility for the validity of product claims or for
typographical errors. The publisher also does not
assume responsibility for product names, claims or
statements made by advertisers. Opinions expressed by authors are their own and may not reflect
those of Dental Tribune International GmbH.

Ability to chew properly may improve blood sugar
levels in patients with type 2 diabetes

or infection as indicated by white
blood cell count at the baseline.

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[3] =>

UK NEWS

· Streamlined billing and insurance
claims: The software simplifies billing and insurance claim processes,
reducing errors and improving accuracy. It automates the generation of invoices, tracks payments,
and helps dental practices manage insurance claims efficiently,
leading to faster reimbursement
and improved revenue cycle management.
· Data analytics and reporting:
Dental practice management software often includes robust reporting and analytics features that
provide valuable insights into
practice performance, financial

metrics, patient demographics,
and treatment outcomes. This
data helps dentists make informed
decisions, optimize practice operations, and identify areas for improvement.
· Compliance and data security:
Dental practice management software ensures compliance with industry regulations such as HIPAA
(Health Insurance Portability and
Accountability Act) and provides
data security measures to protect
patient confidentiality and sensitive information.
· Integration with digital imaging
and EHR Systems: Many dental
practice management software
solutions integrate with digital im-

aging systems and electronic
health records (EHR), allowing for
seamless access to radiographs,
intraoral images, and other diagnostic data within the software
platform. This integration enhances treatment planning and
improves collaboration among
dental professionals.
Overall, the adoption of dental
practice management software
offers numerous advantages,
ranging from increased efficiency
and patient satisfaction to improved financial management and
data-driven decision-making. As
the dental industry continues to
embrace digital transformation,
the dental practice management
software market is expected to

▶ Page 1 - Dental practice management
software market is now worth £1.2b, and
is growing

Dental Tribune United Kingdom Edition | 02/2023

grow and evolve, providing even
more advanced features and ben-

efits to dental practices worldwide.

Greening the dental practice
© Shutterstock / elenavolf

Simple eco changes every practice can adopt

By Dr Sulaman Anwar, UK
Dental practices are not particularly green. According to the Eco
Dentistry Organisation, clinics
generate 4.8 million lead foils, 28
million litres of toxic X-ray fixer, 37
tons of mercury waste, 1.7 billion
sterilisation pouches and 680 million non-recyclable chair barriers,
light handle covers and patient
bibs every year.
However, there is a raft of new
products and technologies which
make it easier for dental practices
to eliminate waste, and there are a
number of other ways to green up.
These initiatives will bring additional benefits beyond improving
the practice's eco credentials.
Consumers are becoming environmentally savvy. They're also
making purchasing decisions
which chime with their beliefs; a
practice which can demonstrate its
sustainability awareness policies
and communicate them in practice, on their website and social
media will reap the rewards of its
greening efforts.
The Nielsen Global Corporate Sustainability Report found that 66%
of the people they surveyed stated
they would be willing to pay more
for sustainable goods. A further
study conducted by Harris Interac-

tive found that 82% of adults claim
to be well-informed about brands
with a strong track record for sustainability. Businesses — and dental practices are businesses —
wishing to thrive, attract and retain patients would do well to take
steps to adopt a more sustainable
approach.

3. Use eco-friendly cleaning products, hand wash and cream.

Periodontal specialist Dr Sulaman
Anwar was keenly aware of the
need to make environmentallyconscious changes at the dental
practices where he works. Here he
details changes he has made to
bring about an immediate
difference to his green footprint.

6. Go paperless wherever possible.
Only print necessary documents
and use recycled printing paper
when printed material is produced.

Some of the swaps were easy to
source and implement, while others — like finding a new energy
supplier — take a little more research. However, all have been extremely worthwhile and the response to them has been extremely enthusiastic, from colleagues and patients alike.

8. Offer fair trade or eco-friendly
tea and coffee (for both patients
and staff).

Simple eco changes every practice
can adopt:
1. Change all gas and electric suppliers to those offering 100% renewable energy.
2. Change plastic patient cups to
stainless-steel cups that can be
sterilised and reused.

4. Use either biodegradable or recycled plastic bin liners (except
practice clinical bags).
5. Use recycled toilet paper in both
patient and staff lavatories.

7. Don't offer plastic shopping
bags — give paper bags instead.

9. Change all lightbulbs to LED alternatives.
10. Sundries — stock and recommend eco-friendly toothpaste
tabs, change toothbrushes, interdental brushes and tongue cleaners to bamboo and eco-friendly
alternatives.
11. If you have space install a potted garden to encourage bees/native wild life.

12. Change children gifts and
stickers to plastic free items and
eco-friendly alternatives.
13. Recycle batteries, coffee pods
and actively encourage recycling
paper at reception/office.
14. Initiate a recycling scheme
which encourages patients to
bring their plastic
dental
products
back
with them
to be recycled;
interdental
brushes,
dental
floss cartridges,
tooth picks and
manual
toothbrushes can all be returned. Consider initiating a Terracycle scheme
and the practice can also select a
charity to benefit from all the returned plastics.
Dr Anwar is now keen to hear from
other practices all about the
schemes they have initiated. For
more information, please visit his
Instagram page @dr.sulaman and
share your green practice suggestions.

Dr Sulaman Anwar
is a registered specialist periodontist with a master’s degree in
periodontology. He also has a
special interest in sedation and the
management of anxious patients.
He is a fully specialist registered
member of the British Dental
Association, European Federation
of Periodontology, British Society of
Periodontology, American
Academy of Periodontology,
International Academy of
Periodontology and the
Royal College of Surgeons,
Edinburgh
Dr Anwar sits on the
interview panel for the
dental undergraduate
programme at King’s
College London. His focus
on helping others has led
Sulaman to undertake various
voluntary roles including a
placement with the Royal Flying
Doctor Service of Australia, and is
he involved in rolling out an oral
health promotion campaign
targeted at young school children.
Dr Anwar is one of only a few
dentists in the UK able to perform
the Pinhole Surgical Technique. He
also has a strong interest in the
environment.

[4] =>

UK NEWS

Dental Tribune United Kingdom Edition | 02/2023

Work smarter in 2023:

How to take advantage of digitally driven patient conversations
© Shutterstock / Pan Andrii

seriously, the patient didn't have
any back teeth. The iTero scan revealed periodontal problems, and
showed that the patient needed
back teeth, but didn't want false
teeth, so Dr White and his team
were able to treat her with dental
implants. "As in this case, what
we've discovered time and again
through this process is that there's
a co-discovery going on and that
the best idea in the world is always
the patient's idea... as they ask
questions and come up with the
solutions, they end up with something that they wanted, not something we told them they needed.
And that is massive."

Dr Marcos White and dental therapist Cat Edney discussed the benefits of patient communication
using latest technology at a recent
Digital Excellence Series educational webinar — the first in the
2023 series of presentations from
dental experts and practitioners
created by Align Education.
Dr White from Huddersfield and
Edney from London shared their
experience with digital dentistry
and how they have been able to
use digital tools to enhance the
treatment experience of every patient, whether they are new to, or
a long-time patient of a practice.
Central to this is making full-use of
technology — particularly the
iTero™ intra-oral scanner — to
create focused patient journeys,
educate patients, and empower
practice teams.
"Imagine finding out you can better care for patients, have better
record keeping and deliver more
predictable results, all with skills
you already have and a tool you already own," said Dr White. "For
over 200 years, dentists have seen
teeth one at a time in the reflec-

tion of a very tiny little dental mirror on a stick, and patients haven't
been able to see anything that we
were seeing. Now we both can see
the whole dentition. The iTero
scanner's touchscreen allows us to
demonstrate our observations to
the patient in a way they understand. For the first time, they see
their own problems on screen in
colour. It gives them a new perspective."
Dr White's practice now uses six
iTero scanners, and he describes
that the very first immediately
made a significant difference. "We
saw 33% growth over 12 months
with the first iTero scanner we ever
bought. The reason it worked was
because it prompted greater case
acceptance — more people said
yes to larger treatment plans. Digital tools impress patients, they
create stories. The sheer act of
showing patients their problems
and the solutions on-screen blows
their mind and builds their confidence in you," he told delegates.
He used a recent example of a patient who arrived at his practice
wanting new veneers, but more

Teamwork approach
Vital to successfully boosting efficiency is the involvement of the
wider practice team to scale practice operations. Treatment coordinators (TCOs) and hygiene therapists in particular, have a wider
role to play, explained Dr White, as
they can also help to build patient
relationship through conversation.
Dental therapist Edney, of Greenwich Dental Health in London
echoed this analysis: for her, building patient loyalty is based on holistic understanding and use of
technology. She explained that
holistic care includes understanding general patient health, their
personal situation, and any major
life changes, is the key to unlocking hidden patient value.
When Edney started using the
iTero Element 5D imaging system,
she began having more in-depth
conversations with her patients.
She noticed that they were looking
at their mouth and self-diagnosing, feeling there was something

wrong, and the scanner gave her
the opportunity to show them and
demonstrate the changes that
were happening.
Now, she and the team she works
with, use the iTero scanner to build
comprehensive profiles of all patients to help to unlock oral health
conversations - and create loyalty.
This includes understanding what
is happening in their lives, such as
if they're having a baby, changing
jobs, or getting married. "The way
we do that is just to build a basic
profile that outlines who they are
and their social history. It's a very
small document that's easily accessible by the whole team and it
all relates back to their oral health
and their dental care."
Edney was keen to stress in the webinar that treatment coordinators
(TCOs), hygienists and therapists
are well placed to build patient
trust and fosters loyalty to the
practice.
"When you take your patient out
of the dentist's chair and put them
into somebody else's chair within
your team, whether it's a TCO, a
dental hygienist or a therapist, the
conversation often changes. Patients act and speak differently
when they're speaking to a different member of the team, because
our conversations often centre
around improving or maintaining
their health. We're not just talking
about their mouth. Team members are well placed to build patients profiles: assess, explain, and
communicate with them and maximise their awareness of their dental needs thanks to digital tools.
With the iTero scanner we can take
screenshots of the treatment, annotate those screenshots so the
whole team can see what discussions there have been. This is a key

Dr Marcos White
qualified from Leeds Dental
Institute in 2000. Marcos is an
international lecturer for iTero and
Invisalign products which is a
massive reflection on his experience in Invisalign clear aligners and
digital scanning technologies.
He runs courses for other dentists
to see how to best utilise iTero and
Invisalign clear aligners in their
practices.

Cat Edney
qualified from King’s College
Dental Hospital in 2008 in the dual
qualification of Dental Hygiene and
Dental Therapy.
She now has over ten years’
experience working in specialist
private practice. With her focus on
providing personalised care for
patients, Cat takes a holistic
approach to dental disease
prevention and treatment.
She lectures nationally and runs
hands-on Therapist courses
focusing on providing gold
standard training and ongoing
support.

feature that facilitates the communication, so it's easier for the rest
of the team to answer questions
from patients if they know what is
planned for them."
Dr White concludes that this new
way of working also has other
benefits. Creating time for a digital
scan enables automated diagnostics and builds a bank of data per
patient as well. "Scans equal history and that equals loyalty. We've
now got circa five years of scans
for some of our patients. It creates
a bond with your patient that they
won't want to lose."
To view the free webinar, please
visit www.iTero.com/des.

Philips, with its clinically proven
range of sonic toothbrushes and
powered interproximal flossing
device, has a natural affinity with
the aims of the British Society of
Periodontology and Implant Dentistry (BSP). So much so the company has become the latest partner sponsors of the society to help
it to achieve more of its strategic
objectives to promote public and
professional awareness of periodontology and implant dentistry
and to achieve its vision of "Periodontal Health For A Better Life".
Paula Dunn of the BSP commented: "As a charity, we rely on
funding from organisations like
Philips to enable us to succeed in

our aim to advance all aspects of
periodontology and dental implantology and promote the importance of gum health to dental/
medical professionals, undergraduate students, patients and the
public.
We wish to extend our sincere
thanks to Philips for becoming a
partner sponsor and providing the
society with funding to support
many of our planned activities this
year. Their help and support will
enable us to achieve more of our
strategic aims and objectives to
benefit and support our members,
the wider dental profession, patients and the public."

The periodontal care continuum
periodontists have recommended
the Philips Sonicare brush to patients for over 30 years. It has a
legacy of 119 independent researchers affiliated with 25 universities producing 60 published
manuscripts and abstracts evaluating and attesting to Sonicare's
superior performance. Its range of
sonic toothbrushes has been clinically proven not only to reduce
overall plaque and interproximal
plaque, but also reduce gingival
inflammation and probing depth
in the course of regular use over
six months. A recent six-month
clinical study demonstrated that
the Philips Sonicare was clinically
proven to improve gingival health

better than a manual toothbrush
in patients with stage I/II periodontitis post non-surgical treatment. Likewise the company's new
Power Flosser with its unique
X-shaped nozzle creates four wide
streams of water to remove up to
99.9% of plaque in treated areas.
The Quad Stream covers nine
times more surface area and requires less technique than an oral
irrigator with a single stream nozzle, for a faster, more effective and
more comfortable clean versus
manual floss.
Emilee Walby for Philips adds
"Philips shares a common vision
with the BSP to help its members
find ways to help tackle the incipi-

Philips becomes a partner sponsor of the British
Society of Periodontology and Implant Dentistry

ent and intransigent periodontal
disease. We have had long standing working relationships with a
number of its faculty members, so
extending our support to the society once more is a natural step for
us. We look forward to attending
its events, meeting as many of the
Society members as possible, and
connecting in other ways through
the BSP."

[5] =>

UK NEWS

Dental Tribune United Kingdom Edition | 02/2023

How a new ‘golden age’ of dentistry is being driven
by technology, extending care beyond the chair
AI is and how it can be used following the advent of ChatGPT, but
a lot of people are still nervous
about their data being used to
build algorithms, and to create AI.
I believe those concerns are unfounded in dentistry... it can support dentists' ambitions to improve outcomes for their patients
and the performance of their business. So, I don't think there's much
reason, if any, to be fearful.

Dr David Holmes

"UK dentistry sits at the forefront
of innovation, and many British
practices are outpacing their Australian and US contemporaries
when it comes to early adoption of
technological advances, such as
digital scanners and use of artificial intelligence (AI) to power patient care". So says Dr David
Holmes, founder of FollowApp.
Care, the pioneering technology
which enables dental practices to
create exemplary patient follow-up protocols, triggers new appointment bookings and online
reviews. Here he discusses why
more clinicians should embrace
this new 'golden age' of dentistry.
"As innovators, the international
perception of UK dental groups is
particularly high. I work a lot in
Australia, and they reference UK
companies and talk about how
they are further ahead, particularly
in terms of practice co-ownership
and they way they market themselves. When looking at the US,
there are a number of ambitious
UK dental support organisations
(DSOs) which are rapidly consolidating much in the same way as
the US. Then, looking at the way
we are innovating and harnessing
data and to create exemplary patient communications, I think
there are many learnings and opportunities for dentists worldwide
to use AI to better serve their patients just as forward looking
practices in the UK are embracing.

Recently there's been a huge step
forward in understanding of what

For instance, AI can help practices
drive much better online reviews
— something that many dentists
don't pay enough attention to.
Having a Google rating is like having a star rating on your digital
front door; every time someone
opens your door, they walk past
that score. When people see a
score of 4.78 or 4.95, they think
you are a quality organisation.
Drop below that — to 4.6 or 4.0
and they might start to be a little
concerned. If you drop to between
four, to 3.8 or below that's really
hard and doesn't necessarily reflect the service or quality of care
you offer, or the happiness of your
patients. They might love you, but
a few negative reviews online will
mean those patients are walking
past a three-star, digital front
door.

Technology can help
to drive reputation
and extend care beyond the chair
One of the things we discovered
recently in the FollowApp.Care
community was the belief that
people loathe dentists. A major
dental provider gave a presentation that cited a study reporting
that dentistry has a customer satisfaction Net Promotor score of
one — something that FollowApp.
Care calls a loyalty score. This
couldn't be further from the truth.
The top performing practice we
work with has a score in the mid to
high 90s... even the lowest scoring
practice is still above brands such
as Apple, which would be in the
60s or 70s. I take a lot of pride in
bursting these bubbles and trans-

forming peoples' perception of
themselves and the profession.
Most of the time, as dentists, we
are just desperate to please our
patients and technology is here to
support that. But it needs to be
seamless and transformational —
ten times better than the status
quo. I was taught that no news is
good news but creating an open
channel of communication flips
that on its head; reaching out to
patients after every visit to make
sure they're ok gives you a huge
amount of peace-of-mind. Asking
for feedback results in a constant
flood of positive feedback, plus it
helps you to manage when things
don't go well.
The catchphrase of one of our
partners in Australia is "extending
care beyond the chair" and it
drives huge value for them in making sure their patients are okay
post-procedure and avoids unnecessary complications.

The 'golden age' of
dentistry

I'm excited by technologies that
are transformational and all of a
sudden people are understanding
it and can see the benefits. With
the advent of digitisation and AI
advancements, data is becoming
more accessible for clinicians to
optimise the way they run their
practices. This makes me more optimistic about the future of dentistry.
"When I first graduated my mentor told me the golden age of dentistry was ahead of us... he was
right. I'm now hearing that again
with the advent of digital technology and the transformational
changes being brought about by
AI automation — and I'm very excited to spend the rest of my career developing new applications
in this space."

How FollowApp.Care
works
1. Integration
Integrates with your practice management system to automatically
extract the data needed to ensure

appointment notifications trigger
patient communications
2. Communication
Makes patients feel cared for,
while checking up on post procedural health, requesting feedback
and prompting reviews.
3. Results
Results are analysed and collated
in the FollowApp.Care web application where clinics can resolve
flagged issues or sit back and
watch FollowApp.Care work for
them by garnering improved Google reviews.
More than 5,000 dentists have already used FollowApp.Care —
predominantly in the UK and Australia, and millions of patients have
connected with them through the
app.
For more information, please visit
https://www.followapp.care.

[6] =>

UK NEWS

Dental Tribune United Kingdom Edition | 02/2023

Evolving business systems into 2023 and beyond
An article series on five basic systems to improve practice management—Part 3: Patient experience

In previous articles of this series, I
have referenced the seminal work
The E-Myth Revisited by Michael
Gerber. I looked at financial systems in Part 1 and at practice marketing in Part 2. In this third article,
I would like to address the patient
experience with reference to the
things you need to deliver that will
make your patients advocates and
ambassadors for what you do.
I am going to take it as a given that
every dentist strives to achieve the
very best in clinical care, so my
scope in this article is to share with
you what I consider to be moments of truth in the modern patient experience. Let me define a
'moment of truth' in this context: a
moment of delight or disappointment that has a disproportionate
effect on the patient.
For an example outside of dentistry, imagine arriving at a local
five-star restaurant for an anniversary dinner with your loved one to
be told by a disinterested maître d'
that your reservation is not on the
system and there are no tables
available. This would be a moment
of disappointment with a disproportionate effect as said dining
partner stares at you in disbelief!
Now, imagine arriving unannounced at a favourite hotel asking for a short-notice reservation
and being informed that, even
though the hotel has no rooms,
the reception team will call similar
hotels in the city, reserve a room,
guarantee the hotel's rack rate and
order a complimentary cab to take
you there. This would be a moment of delight with a disproportionate effect, since it would make
you a lifetime fan and customer of
that hotel.
These two stories are of special
relevance because they happened
to me, so I have first-hand experience of the emotional reaction in
both instances. I never visited the
restaurant again, and I have regularly used the hotel group since—
and perhaps most importantly, I
never miss an opportunity to share
my experience with family, friends
and colleagues.
Online reviews have turbocharged
the speed and distance that this
bad or good news can travel, placing unparalleled power in the
hands of the consumer—your patient. One cannot avoid the reality
that both reading and writing reviews have become embedded in
society and applicable to all demographics. In the world of dentistry, the Google review has become a dominant weapon for the
patient and a force for good if
practices recognise their influence
and seek to deliver a patient experience that generates positive
feedback.

Let me now share with you my six
moments of truth in the patient
experience and comment on each.
They are:
· first digital contact;
· first human contact;
· first assessment or consultation;
· treatment plan presentation;
· treatment coordination and delivery; and
· end-of-treatment review.

hours, and do you have an online
booking system?
3. Social media. Do you use multiple platforms in a responsible way
to deliver my golden rule on marketing—80% patient stories, 15%
team stories and 5% oral health
education (see my previous article
in Dental Tribune UK & Ireland
1/23)?
4. Blog. Do you write a regular

By Chris Barrow, UK

3. Patient lounge—not waiting
room, since nobody likes waiting.
Is your patient lounge an area in
which patients can detox from the
outside world, relax and prepare
for their appointment while watching videos (with subtitles) of patient testimonials?
4. Toilets. An untidy or ill-maintained toilet puts concerns of unhygienic treatment and thus risk of
treatment failure into patients'
minds I cannot stress how important this is.
5. Delays. If a patient arrives late or
a clinician is running late, do you
have efficient protocols in place to
deal with the consequences
calmly?
6. Journey to the surgery. Are patients left to make their way to the
surgery room or are they escorted
by a nurse or a clinician who works
on building the relationship during
the few moments spent together?

First assessment or
As attracting new patients can be difficult and expensive, dental professionals should seek to
provide them with an all-round positive experience.

consultation

Regarding each of these moments,
I am going to share with you a
quick checklist of things to do or
features to offer. You will then be
able to compare what you currently do with what I suggest.

Whether it is with a treatment coordinator or a clinician, this is the
first in-depth communication
about the patient's problems or
needs. At the conclusion of that
first conversation, does the patient feel understood and appreciated? To quote an adage, "people
don't care how much you know
until they know how much you
care".

First digital contact
Most new patients, irrespective of
background or need, are going to
check you out online before they
make human contact. This means
that you must be easy to find and
you must answer in just a few seconds the most important question
that any new patient has.
What is that question? I rarely get
the correct answer when I ask this
at workshops. Most people will respond with references to price, location, access and experience. In
fact, most patients want to know
whether people like them visit
your practice, because undergoing dental treatment can be stressful and they want to be reassured
that they will be among likeminded patients. If your website
home page features photographs
of the practice or stock photographs of bright young things, do
not be surprised if implant patients rarely show up.
Regarding the first digital contact,
consider the following areas and
suggestions:
1. Organic search. If a friend refers
a prospective patient to your practice over dinner, when the prospective patient subsequently
searches for you online are you
easy to find?
2. Website. Does your website reassure prospective patients that
people like them visit your practice? Bonus points for 2023: does
your website include a chatbot
feature so that patients can communicate outside of practice

practice blog that provides oral
health education, answers FAQs
and establishes you as the local
expert, thus driving patients
through inbound marketing to
your door?
5. Practice newsletter. Before the
prospective patient visits, can the
patient sign up to your monthly
patient newsletter and read stories about similar patients?
6. Google reviews. Do you have
more than 100 reviews (so that
Google's algorithms can see you)
and growing, the majority of which
have five-star ratings (because everyone eventually gets a one-star
review) and are full of praise for
what you do?

First human contact
It has been said that first impressions last a lifetime. Recognising
the value of this, a client of mine
once gave the head of her frontof-house team the official title of
managing director of first impressions. Another client recently
shared a story of a front-of-house
team member arriving late for
work and thus missing a new business enquiry that resulted in
£25,000 of work going to a nearby
competitor. You may think the patient in this case a bit flaky, but we
live in a post-COVID world of diminishing patience, and we all
must be on our game.
Regarding the first human contact, consider the following areas
and suggestions:
1. Telephony. Do you have a frontof-house training manual that
covers all FAQs and agreed answers?
2. Front desk. Have you separated
your front desk from telephony so
that patients arriving in the premises can have the undivided attention they deserve?

Regarding the first assessment or
consultation, consider the following areas and suggestions:
1. Introductions. Did the patient
feel that the person performing
the assessment or consultation introduced himself or herself properly and understood the patient?
2. Consultation. Did the patient
feel that, as well as undergoing a
thorough clinical examination, the
patient was consulted on needs,
problems, challenges, fears—and
desired outcome?
3. Smile check. Besides collecting
data, did the person performing
the assessment or consultation
connect with the patient's feelings?
4. Dental health review. Were the
benefits of long-term preventive
care explained to the patient as
well as the solution to the patient's
immediate problem?
5. Targets. Could the patient and
person performing the assessment or consultation agree on targets for the desired outcome?
6. Next steps. Was there a call to
action at the end of the conversation and clearly defined next
steps?

Treatment plan presentation
A treatment plan is a purchasing
decision for the patient and, other
than for pain relief, may sit alongside comparable decisions financed from a limited budget.

Compare a £3,000 investment in a
new computer, white goods, home
improvements, a holiday or a business-class flight—with a dental
treatment plan—and you will soon
realise what I mean.
On visiting a new client, I always
ask for an example of a treatment
plan for a mid-sized financial investment—say a few thousand
pounds. Even now, I am regularly
horrified at the archaic nature of
treatment plan presentation—
printouts from practice management software that are impossible
for laypeople to understand or
lengthy word-processed documents that focus more on risk than
reward, as they are driven by compliance and litigation considerations. My most innovative clients
see the treatment plan as an audiovisual experience for the patient and not just another document to plough though in the endless pile of work to be done.
Regarding treatment plan presentation, consider the following
areas and suggestions:
1. Executive summary. Given that
we are all short of time, do you
provide a one-page summary of
the problem, the diagnosis, the
recommended solution, the benefit of the solution and the investment?
2. Narrative. Have you embraced
video technology (e.g. Loom) to
provide a narrative recorded on
camera so that the patient can review your recommendations and
share them with any other significant decision maker?
3. Visual. Do you use intra-oral
photography, radiography and,
most important of all, intra-oral
scanning as an integral part of
your presentation?
4. Options. Do you give the patient
options for treatment and options
for payment?
5. Financial conversation. Do you
always link the financial investment to the desired outcome—
and not to the treatment modality?
6. Small print. For compliance purposes, do you keep the small print
where it belongs—as an appendix?

Treatment coordination and delivery
We reminded ourselves earlier
that undergoing dental treatment
is a stressful experience for many
patients—not a choice they would
make to spoil themselves. The
practice team is duty bound to
make it as pleasant as it can be,
even thinking about delivering
nice surprises along the way to
sugar the pill.
Regarding treatment coordination
and delivery, consider the following areas and suggestions:

[7] =>

UK NEWS

Dental Tribune United Kingdom Edition | 02/2023

1. Free assessment. Do you allow
prospective new patients to have a
no-charge, no-obligation assessment with a treatment coordinator
(on video or face to face) before
they pay to see a clinician? A good
treatment coordinator can triage
the patient—either out of the
practice if not a good fit or to the
correct clinician depending on the
treatment requirement.
2. Consultation room. Whether it is
a treatment coordinator or clinician meeting, are the physical surroundings comfortable and is
there access to audiovisual equipment and data that will help the
patient to understand the treatment options and outcomes?
3. Options meeting. Do you present options to patients at a meeting designated for that purpose
and with the aforementioned audiovisual aids?
4. Supporting technology. Do you
embrace digital workflows as well
as digital communication?

5. Smile design. Do you embrace
the latest treatment planning
technology to show patients before and after artistic impressions
before they commence treatment?
6. Third-party evidence. Do you
reassure patients by regularly
sharing with them case studies of
successful delivery to patients in
their demographic?

End of treatment review
The following is some repetition
from my second article (but necessary) in that a patient reaching the
end of a course of treatment that
improves self-confidence provides
a golden opportunity to capture
the patient's happiness.
Regarding the end-of-treatment
review, consider the following
areas and suggestions:

1. Preparation. Do you reference
your end-of-treatment review at
the point of sale (when the patient
agrees to proceed) and again
close to the end of the treatment
pathway? Do you book the endof-treatment review as a set appointment with your treatment
coordinator or clinician?
2. Referral cards. Do you give patients at least three practice business cards with a QR code to your
website landing page for new patients?
3. Follows. Do you ask patients
who are regular users of social
media to follow your business
platforms?
4. Google reviews. Do you give patients a Google review card (again
with a QR code) and ask them to
scan it and write reviews for you?
5. Testimonials. Do you ask patients whether they will consent to
short video testimonials in which
they describe their experience of
working with you?

6. Membership. If you offer a dental membership plan, do you ask
patients to join at their end-oftreatment review?
These six moments of truth offer
multiple opportunities to deliver an
experience
that will enrol
the patient
as another
u n p a i d
member of
your sales
force. New
patients are
sometimes
tough and expensive to attract. It is thus
prudent for dental practices to
seek to deliver continuous moments of delight that have a disproportionate effect. I cannot
think of a better way to ensure job
satisfaction for all your team—or a
better way to grow your business.

Chris Barrow
has more than 50 years of work
experience and has been active as
a consultant, trainer and coach to
the UK dental profession for over
25 years. His main professional
focus is through his Extreme
Business company,
providing coaching and
mentorship to
independent dentistry
around the world via
virtual consultancy,
practice visits, a
workshop programme and an online
learning platform. His
blog, Thinking
Business, enjoys a
strong following. During
the COVID-19 pandemic,
Barrow created the Regeneration Coaching Programme to help
practices to survive lockdowns and
to bounce back higher after their
return to work. More information
on his work can be found at
www.coachbarrow.com.

Arriving at your happy place in dentistry

How journaling can enhance general well-being and support dental professionals in their daily work
© Shutterstock / Yulia Grigoryeva

The reflective practice required by
the GDC refers to professional reflection, deemed necessary for
professional growth that is an essential element for all dental professionals registered with the
GDC. However, it does not include
personal reflection. Keeping a
combined personal and professional journal could support dental professionals' well-being and
have a positive impact on their
personal and professional life,
which although may be defined as
being separate are inherently interlinked.

The benefits of journaling

By Victoria Wilson, UK
Throughout the year our continuing professional development requires us to reflect on the changes
we want to bring about in our professional lives, and this may on occasion lead to us thinking about
our personal lives. For the purpose
of this article, I will explore how
keeping a journal through combining professional reflective
practice and personal reflection
can be utilised by dental professionals to enhance their individual
well-being, throughout a year's
cycle.
Keeping a journal is something
that has been of interest to me for
many years. I have explored it,
stopped writing and started again,
and discovered that whenever I
keep a journal I have observed a
positive shift. I seem to be more
productive and progressive in my
personal and professional life, fac-

ing less resistance and more flow
in all areas.

Keeping a journal for
dental professionals
As dental professionals, our
well-being is of paramount importance so that we can thrive and
provide the best possible care to
our patients. I firmly believe that
there is always an opportunity to
enhance our state of well-being
through utilising protective measures, such as a journal. Journaling
is the private recording of one's
experiences, observations, feelings and attitudes in order to explore and reflect on these. It is thus
a reflective practice, reflection
being the "active persistent and
careful examination of the truth
and the facts that surround it".1
Everyone would concur that dental professionals are regularly exposed to innumerable challenges. 2

In order to continue providing
care that meets the standards set
by the General Dental Council
(GDC) for UK-registered dental
professionals or equivalent registry bodies, dental professionals
need to implement and utilise
supportive means to reduce the
negative impact of the challenges
they face.
The GDC supports reflective practice as a way to manage dental
professionals' growth and well-being and for that reason requires
reflection after participation in
continuing professional development (CPD) activities.3 The GDC
states that employers should encourage teams to make time for
reflection as a way of aiding development, improving well-being
and deepening professional commitment.4 Health regulators now
consider reflection to be an essential aspect of clinical practice.1

The true beauty of keeping a journal is that the writer is free to make
it what he or she wants it to be. It
simply allows you to understand
your thoughts and feelings more
clearly. Keeping a journal can have
a positive impact on various areas
of life, some of which I will outline
in this section.
Depression and anxiety
Numerous studies have shown
that journaling can reduce overall
levels of depression.5 A study
showed that writing in a journal
can be as effective as cognitive
and behavioural therapy for reducing the risk of depression in
young adults.6 Journaling can promote acceptance and mindful acceptance in particular—which is a
valuable and effective way of freeing ourselves to move forward.7 In
addition, study findings have suggested that accepting our feelings
is linked to improved psychological health and positive therapeutic
outcomes, including improved
mood and reduced anxiety.8
Memory and creativity
Some use journaling as a means to
capture ideas, organise their lives

and keep track of their goals.
Keeping a journal helps you create
order and organise your mind and
offers the added benefit of improving your memory and cognitive skills.9 By unburdening the
brain, you can think more clearly,
spot patterns and unleash your
creativity.10
Improved sleep and overall health
As a result of reduced stress and
better mental health, your physical health will improve too. It has
been found that journaling can
help improve sleep and immune
function, and even enhance physical health.11
Some people even employ journaling as a form of meditation and
a way to regulate emotions, as it
causes actual changes in the brain,
embedding life lessons and helping us to remember them.11
Self-knowledge
Journaling is a good way to increase self-awareness. This is supported by science and personal
experience.12, 13 By using your journal to reflect on your thoughts, actions and emotions, you will be
able to react more positively to
the world around you.
Journaling is a way of keeping
track of who we really are while
shaping our own narrative, irrespective of who is listening. How
many of us really understand
themselves, know who we really
are, what really fulfils and drives
us? If we all knew ourselves better,
this could be part of the chain of
taking positive strides every day to
make better decisions that align
with our authentic selves and aspirations.

▶ Page 8

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UK NEWS

Dental Tribune United Kingdom Edition | 02/2023

How to journal
Everyone is different and there is
no right or wrong way to journal.
What is advised frequently in the
literature, however, is to just start
and allow yourself to be your own
guide. Your writings can be pages
long or just a few sentences. If giving an account in a journal does
not suit you, you could use other
forms, such as mind mapping or a
fish-bone diagram.14 Gillie Bolton
is a leading authority on reflective
practice and offers excellent resources for further reading.15
The following sets out guidance in
steps on how to start journaling:
1. Your perception—regard your
writing time as your personal relaxation time not as a task.15 It is a
time when you can de-stress and
unwind.10 It is time for your selfcare, self-reflection and selfgrowth. Your personal reflection
can contribute to your daily journey of growth and the gift of living
life and thriving every day. You are
doing something good for your
mind and body.
2. Your why—identify why you
wish to commit to journaling and
dedicate your time to journaling.
3. Your vision—begin by writing a
list outlining all the benefits you
envisage journaling could bring to
your life.
4. Beginning—through understanding your perception of, your
why for and your vision for journaling, you can begin to journal in

order to realise the opportunity it
offers you.
5. When to journal—write every
day. Try to find yourself 15 minutes
of protected time when you will
not be disturbed. This may be
challenging in the beginning, but
once you have established a time
this will help you with writing regularly.
6. Constraints—avoid imposing
constraints such as spelling and
grammar on your writing. It is your
own private place to express your
feelings however you will without
regard to what others might think.
7. How long to write for—write
continuously for 6 or 7 minutes
about whatever comes to mind
from your day. Write about topics
or events you are reflecting on, including your thoughts and feelings that may be positive or negative. This is intended to help you
learn to look further than what immediately comes to mind.16
8. Prompting questions—use
these questions to help jump-start
your writing:
· When did you feel most engaged?
· When did you feel most distant?
· What action by another person
did you find most affirming or
helpful?
· What action did you find most
puzzling or confusing?
· What surprised you most?17
9. Structure—you do not need to
follow any particular structure, but
if you prefer to start with some

structure, the following could
guide you:18
· Define a specific situation on the
basis of your answer to the questions of 'Who?', 'What?' and
'Where?'.
· Describe your emotional state
(How did this make you feel?).
· Try to make sense of the situation
(Why did this happen?).
· Describe a possible personal development arising from this kind
of situation (Could you have done
something in a different way?).
· Reflect on how this realisation
could be put into practice in the
future.
· Try to think of the consequences
of this realisation and try to encourage yourself.
10. Review what you have written,
uncritically.
It is essential that patient anonymity is maintained throughout your
journaling, and this is a requirement for all professional reflections and writing. Among the information that must not be mentioned is age, sex, gender, job title,
ethnicity, ward or practice you saw
the patient at or medical condition.19 It is advised to check with
your regulatory body and indemnifier for guidance in this regard.

sionals. Patients will benefit from
your enhanced well-being, so I encourage you to take the steps that
allow you to focus on your well-being first. If a journal could be an
opportunity for you, I would encourage you to explore it and employ it to identify your needs and
make
positive
changes.

Victoria Wilson
holds a BSc and a diploma in
dental therapy and diploma in
dental hygiene awarded by the
Royal College of Surgeons of
England in the UK. She has over
ten years of experience as a
dental hygienist and therapist,
beginning in the National Health
Service and private sector in the
UK and progressing to the
private sector in the UAE.
She is passionate about her
work and fully committed
to oral health promotion
around the world.

If
you
keep a
journal,
you are
in good
co m pany!
Albert
Einstein,
Leonardo Da
Vinci, Thomas
Edison, Charles Darwin
and Marie Curie were a few famous journal keepers.

She founded the Smile
Revolution and Smile
Revolution Growth Hub,
driving innovations in oral
health promotion and
leadership. In 2019, she
launched the Smile Revolution
podcast, which has over 13,000
listeners around the world, and
developed the Smile Revolution
Thrive, the first subscription-based platform dedicated to
enhancing the well-being of
dental professionals daily. In
addition, she is a qualified yoga
instructor and mental health
first-aider.

Editorial note: Payam Husain, a
dental hygienist based in Leuven in
Belgium, co-contributed to this article.

More information can be found
at
www.smile-revolution.net.

References:

Conclusion
Employing journaling for professional and personal reflection
could have a positive influence on
the well-being of dental profes-

Lack of fluoride in rural areas is
© Shutterstock / Alexandra Morosanu

impacting children

Since being first introduced into
Australia in 1953 improve dental
health, water fluoridation has
been shown to reduce tooth decay
by 26-44% in children and adolescents and by 27% in adults.
Now a study has found that onethird of rural towns in Victoria,
Australia do not have access to fluoridated water, resulting in high
levels of decayed, missing and
filled teeth, particularly in children.

The study, led by Dr Virginia Dickson-Swift at La Trobe University
and published in the Australian
Journal of Rural Health found that
the lack of access to fluoridated
water led to people in these towns
having higher than the average of
preventable hospital admissions
due to dental conditions in children aged 0-9 years; more than
50% of children aged 0-12 years
living in these rural non-fluoridated regions had above-thestate average rates of decayed,

missing and filled teeth; and 78%
of children aged 0-5 years had
above-the-state average.
Dr Dickson-Swift said while fluoride occurs naturally in all Australian water supplies, in most places
the levels are too low to help prevent or reduce tooth decay.
"Community-based water fluoridation is a cost-effective and equitable initiative that is supported by
overwhelming scientific evidence

and internationally recognized as
one of the most successful public
health interventions over the past
20 years, supported by groups like
the World Health Organization,"
Dr Dickson-Swift said.

· Recent analyses have shown that
water fluoridation in Victoria
saved about A$1 billion over a 25year period through avoided costs
from dental treatment and days
absences from work/school.

Fluoridation of community water
supplies is cost effective:

· It particularly benefits children
and those on lower incomes who
tend to have higher rates of tooth
decay and less access to dental
treatment and other forms of fluoride, however there are population-wide benefits.

· Every dollar spent on fluoridation
saves between A$7 (£3.76) to A$18
(£9.67) due to avoidance of treatment costs.

[9] =>

UK NEWS

Dental Tribune United Kingdom Edition | 02/2023

A smartphone app that scans dental plaque and can flag potential
oral hygiene issues has been
launched by a University of Bath
Mechanical Engineering graduate.
The Testmyteeth app allows users
to perform a scan of their teeth to
measure the levels of plaque
build-up, one of the primary
causes of dental disease, and to
highlight areas where users are
failing to brush adequately.
The app was developed by Integrated design engineering graduate James Russ, who was supported by the University's Enterprise and Entrepreneurship programme, which helps staff,
students, graduates and local entrepreneurs with their enterprise
ambitions. The University has a
strong track record in creating
spin-out companies and sharing
its research expertise with the
business world. In March, University of Bath entrepreneurs were
shortlisted for 10 National StartUp
Awards.
"I was in my first year of university
when I had trouble with my wisdom tooth — the treatment ended

up costing over £100 of my limited
student budget. This was particularly frustrating as it could have
been easily prevented had I taken
better care of my oral hygiene. It
inspired my vision for a dental app
to assist patients at home," Russ
said.

University of Bath graduate launches innovative
smartphone app to test dental plaque

He set to work on the Testmyteeth
app after completing an industrial
placement in the design and development team at innovative
household appliances manufacturer Dyson, an experience he calls
'fast-paced and exciting'.
"Oral disease affects around 3.5
billion people worldwide and I
thought it would be great to have
an app that focuses on the preventative side of dentistry. Using AI,
Testmyteeth will tell you areas
where you have missed when
brushing and highlight plaque accumulation," Russ said.
"More than that, we'll also provide
educational guides on how to improve your brushing technique
and what the early signs of tooth
decay and gum disease look like,"
he said.

While his studies helped with the
practical side of building an app,
Russ developed his business acumen through opportunities such
as Dragons' Den, part of the University's enterprise offering.
Bath students pitch their start-up
to a panel of alumni donors for investment but, unlike the television
show, there are no equity or stakes
taken. He said the experience gave

him the confidence and the means
to turn Testmyteeth into a reality.

to what I've been able to achieve in
a year," he said.

"Additionally, since graduating, I
was granted a University of Bath
Alumni Innovation Award and
that's been a game-changer. It enabled me to work on the business
full-time, teach myself full stack
app development, and build the AI
which drives the app. The support
has made such a huge difference

Russ joined business leaders, academic experts and student entrepreneurs at the University's second annual Enterprise Day event in
March to share business and research expertise, and showcase
their start-up successes.

Interceptive orthodontic treatment or two-phase orthodontic
treatment, begins while the child is
still growing, and has most of their
primary teeth. The goal is to direct
a child's growth and development
in order to amend or prevent
problems with the size, position or
spacing of the teeth or jaws, so
that further orthodontic treatment
to align the teeth is easier down
the road. In cases like a severe
under bite or overbite, for example, when the face and jaw are fully
developed, it is much harder to
manipulate them and get optimal
results, and waiting until adulthood could mean the need for jaw

Dr Neil Counihan

surgery or extraction of adult
teeth.
Specialist orthodontist Dr Neil
Counihan is one of only a handful
of UK specialists offering a new, pioneering and contemporary interceptive treatment for young children using Invisalign First clear
aligners rather than more intrusive
braces. These are specifically designed for early intervention in
younger patients with a mix of primary and permanent teeth.
According to Dr Counihan among
the orthodontic issues Invisalign
First can successfully treat is protruding teeth: "If a child has a trauma-prone profile, they have a high
incidence of damage to teeth. If
they chip or crack their teeth, or in
the worst case, require endodontic
treatment to save the tooth, we
know that the lifespan of that
tooth is significantly shortened."
Dr Counihan graduated from
King's College Hospital, London in
1988 and he went on to study at
the prestigious New York University in the US. His knowledge and
skill with non tooth extraction and
pain-free treatment for children
and adults have helped to establish his reputation as one of the
country's leading orthodontic

specialists. He is a regular international speaker and lecturer and
judge of the Private Dentistry
Awards.
Says Dr Counihan: "Invisalign First
offers me more options to treat
children permanently without
having to extract teeth. It allows
me to treat younger children,
manage the eruption of permanent teeth and, significantly,
achieve predictable expansion of
their jaws while they are in a growing phase. All this is achieved with
comfortable and discrete clear
aligners rather than old fashioned
twin block braces which are intrusive, uncomfortable, affect the
speech and have a doubtful compliance level."
The treatment was developed
building on the same proven Invisalign clear aligner technology,
comfort and convenience developed by Align Technology for
adults and older teenagers.
Rather than using putty impressions, Dr Counihan explains that
Invisalign First treatment begins
with an iTero intraoral scan to create a digital 3D impression of the
child's teeth, followed by a series
of clear aligners.

A new first step in transformative orthodontics
for young children

"It helps that I'm able to show both
children and their parents a vision
of what their teeth will look like at
the end of this phase of their treatment and give them a definite
time period in which this will be
achieved. If the Invisalign First system says treatment will take 20
weeks, it will take 20 weeks. So far
we've had exceptional results: The
children enjoy wearing their aligners and they can see the improvement week by week which encourages them to comply."
Dr Counihan underlines that Invisalign First might not be an applicable treatment for every child
but is particularly suited to com-

plex orthodontic cases requiring
specialist expertise. "I'm really impressed and pleased with the results that I've achieved for my Invisalign First patients. I believe it is
changing orthodontics and means
we can now correct severe malocclusions earlier in the child's
growth cycle.
He encourages concerned parents
to make an appointment directly
with him at Twoth, the newest dental and facial aesthetics practice in
London's St John's Wood: visit
https://twoth.com or call 0204 538
6330.

[10] =>

UK NEWS

Dental Tribune United Kingdom Edition | 02/2023

The new Invisalign Professional
Whitening System revolutionises
teeth whitening with an all-in-one
solution that enables Invisalign
trained doctors to straighten and
whiten teeth at the same time. The
system is optimised for invisalign
aligners and vivera retainers, powered by ultradent's opalescence
tooth whitening systems
Doctors in the UK trained in the Invisalign System now have access
to a professional whitening system
with the Opalescence PF whitening formula from Ultradent. The
Invisalign Professional Whitening
System — powered by Opalescence — is optimised for use with
Invisalign clear aligners and Vivera
retainers and offers the great
whitening outcomes and streamlined practice experience dental
professionals expect during active
tooth movement with Invisalign
aligners, as well as during passive
retention using Vivera retainers.

A convenient option
for doctors and patients
Invisalign providers can straighten
and whiten teeth simultaneously,

even with attachments in place1,
so there is no need to wait to
whiten until the end of alignment
- unless that is the practice's typical workflow, or the patient's preference.

Align Technology introduces first professional
whitening system in the UK

• All-inclusive: no whitening trays,
gingival
barriers,
specialised
lights, cheek retractors, or other
equipment needed to start whitening treatment.
• No cold storage requirement and
a long shelf life, making delivery
and storage as easy as possible for
the practice.
"A brighter, whiter smile is an important part of the Invisalign patient journey. In fact, a survey of
Invisalign practices2 shows that
half of their patients ask for teeth
whitening during or after they
complete Invisalign treatment,"
said Raj Pudipeddi, Align Technology chief product and marketing
officer, and SVP and managing director of the Asia Pacific Region.
"We believe that by providing an
all-in-one solution that combines
a leading teeth-whitening system
with the most advanced clear
aligner system in the world, we enable Invisalign trained doctors to
enhance their patients' treatment
experience with a seamless work-

The Invaslign Professional Whitening System for at-home treatment.

flow that also enables practice efficiency and growth. We're very
excited to partner with Ultradent
to offer the first professional whitening system optimised for use
with Invisalign clear aligners and
Vivera retainers.
"We're honoured to partner with
Align to make the top professional
teeth whitening products available to more clinicians and patients around the world," said Ultradent President and CEO Dirk
Jeffs. "Providing Align with teeth
whitening products, ideal for use
with Invisalign aligners and Vivera
retainers, is a considerable step
toward our mission of improving
oral health globally and we look

forward to pursuing this mission
together."

Early feedback
Dr Mark Hughes from London, UK
commented that "A positive benefit of this new system is that tooth
whitening can be contiguous with
alignment — so straightening and
whitening take place at the same
time. Another big benefit is having
an Invisalign branded and endorsed whitening treatment which
I can use for my Invisalign patients
while they have their attachments
on."
Dr Nishan Dixit from London, UK
adds "Patients have been reassured that the product has been

specially formulated to ensure it
isn't abrasive and will not damage
their Invisalign aligners." Whilst Dr
Elaine Halley from Perth, UK felt
that "Invisalign and Opalescence
are known and trusted brands —
this gives the team the reassurance and confidence to offer tried
and tested products from a reputable company." Dr Mohsen Tehranian from London, UK concluded
that "The most important benefit
is that the gel has been formulated
at an optimised viscosity for tooth
whitening use in Invisalign aligners"
The Invisalign Professional Whitening System powered by Opalescence can be easily ordered
through the Invisalign Doctor Site
by dental professionals in a single
click once doctors have approved
the ClinCheck treatment plan of
their patients. The solution cannot
be ordered directly by consumers
and is available only through Invisalign trained dentists.
1. Kwon SR, Wertz PW. Review of the
Mechanism of Tooth Whitening. J
Esthet Restor Dent. 2015 SepOct;27(5):240-57.
2. 2017 online survey of Invisalign
doctors, data on file at Align Technology.

Obstructive sleep apnoea can create a whole wave of problems that
can affect our health. The risk of
concentration loss and accidents
because of sleep deprivation is
also heightened. Some of the
mental problems that can arise include depression and anxiety; the
physical problems however comprise a longer risk list, which includes heart disease, heart attack
and/or stroke, weight gain, and
high blood pressure.
If your patient is a 'mouth breather',
then they are more likely to suffer
with sleep apnoea or snore than a
natural 'nose breather'.
Learning to breathe through the
nose has many benefits in addition
to curbing snoring. According to
experts, the nose acts as an incredibly effective natural filter and
removes 98-99% allergens, viruses, bacteria and pollutants.
Tim Ives, a dental hygienist and
specialist for mouth breathing-related conditions, says "Our nose is

a very effective natural filter and
does a great job at keeping many
airborne viruses at bay. Our noses
filter 98% of bacteria and allergens
so breathing through our noses is
recommended if you're looking
for viral protection."
Mouth breathing patients can expect their smell and taste senses
to be impacted, with appetite and
satiation levels distorted. This can
greatly affect someone with dietary struggles or weight problems.
Mouth breathers are also at risk of
limiting nitric oxide, which increases oxygen absorption in our
lungs by 10-25% and can kill bacteria, viruses, and other germs.
Depriving ourselves of this gas can
cause a lot of health concerns. In
fact, nitric oxide has been found to
help memory, it can assist the immune system in fighting off bacteria, regulate blood pressure, reduce inflammation, improve sleep
quality, increase endurance and

strength, and assist in gastric motility. On top of all of that, nitric
oxide has been shown to have cardiovascular benefits.

The correlaton between mouth breathing and
snoring
There is a vital nervous system that
connects our lungs and heart to
our noses. Mouth breathing can
have adverse effects on our cardiovascular health which can bring
about altered heart rates, blood
pressure issues and an increase in
stress responses.
"Mouth breathing is not difficult to
fix once it is brought to the attention of patients", says Tim. "It's important to know where the issue
stems from. Is it an ingrained habit
or is it caused by nasal inflammation or blockage? Difficulty in nose
breathing can be caused by a
number of different issues — the
most commonly blocked sinuses,
flu, colds, seasonal allergies. Xlear
Nasal Spray can help by cleansing
and moisturising the nasal airway,
allowing you to breathe better. It
can also both combat and prevent
these conditions by preventing

contaminant adhesion to the nasal
passageways."
"Xlear, contains xylitol for its natural bactericidal qualities and
grapefruit seed with its toxicity to
viruses, are at a significantly lower
risk for contracting respiratory infections. It is recommended that

you use Xlear's Nasal Spray once
in the morning and once at night
for ultimate protection against airborne contaminants, and if you do
get ill, use Xlear up to four times
daily to recover faster."

[11] =>

UK NEWS

Dental Tribune United Kingdom Edition | 02/2023

the mistakes he had previously
made and witnessed.
Amo is now the co-founder of the
award-winning Broadway Dental
Boutique. He has been nominated
as a finalist at the prestigious Private Dentistry Awards 2017-2019
and The Dentistry Awards 20172019 for Best Young Dentist. Outside of the clinic Dr Amo is an ambassador for Philips Oral Heath,
and has a passion for dental technology and self-investment.
He shares his insights with us:

Dr Amo Sohal is the principal dentist at Broadway Dental Boutique.
He completed his dental degree in
2014, before finding a practice in
Crawley — where he began as a
receptionist, working for free, before making his way up.
During this time, he worked as a
dental nurse, a hygienist and finally a dentist. In 2016 an opportunity arose to buy the practice,
which he grabbed with both
hands. Dr Amo's experience working his way up through the practice was invaluable. When he
bought the practice, he began to
add his own input and learnt from

Who inspired you to become a
dentist, and who continues to
inspire you?
I realised my passions centred
around science, physics, innovations, helping people and working
with my hands. Dentistry seemed
like the best avenue for me to
choose, to give the best of myself
to the world. I am inspired by the
way dentistry combines science,
innovations (dentistry and new
technology is forever advancing)
and helping people. It amazing
how we can fix people's problems,
sometimes in one visit. But going
on full journey with a patient,
where many are nervous to smile
and then seeing them leave at the
end of treatment with smile ear to

ear and tears of joy is a huge inspiration. It is a pleasure to be able to
give back people's confidence.
What were your expectations
the beginning of your career?
Have these been exceeded?
I didn't have many expectations.
No one offered me a job when I
first graduated. I am a UK citizen,
but I studied abroad, as there were
no spaces in UK dental schools.
Nobody would offer a job to an
overseas qualified dentist, and prioritised dentists who graduated
from the UK. I went door to door
for months on end, and I finally
got a position to work for free as a
dental reception, even though I
was a fully qualified dentist. My
expectations were understandably low. However, I have since
bought the same dental practice.
When I bought it, it was a two surgery clinic, with the second room
open one day a week. We are now
a busy, six surgery private practice,
with plans to extend to eight
rooms.
My advice would be not to take no
for an answer. If you have the passion, hard work and the dedication
you will succeed; I guarantee it!
See each failure as one step closer
to success.

What would you like to pass on
to the next generation of dental
professionals?
Invest in yourself. Self-investment
is the best investment. Once you
find your passion in dentistry, then
re-invest in your passions. Take
additional courses and do further
education. It is much easier to
keep up your passion, hard work
and dedication to a skill/craft
when you are doing what you love.
This is vital when you have those
'bad days'; we all do and it's the
passion that allow you to rise
above them. Also invest in
non-clinical skills; many dentists
focus solely on the clinical side. Instead you should also skill up on
non-clinical skills, and treat the
patient as a person, and not just a
bunch of teeth.
Would you do anything differently if you could start again?
Nothing, all of my past has led to
the present. I often do wonder if I
should have stood firm and not accepted a dental reception role for
free. Would I have been better off?
Maybe in the short run but I believe all the challenges that you
can overcome simply conditions
you to be more resilient in the future. Resilience is a fantastic skill to
have.

What is your proudest achievement?
Building and growing my team,
and creating a happy, safe and relaxed environment where people
can come to work. And of course
seeing the confidence back on my
patients' face when they smile at
the end of their treatment plans.
What are your favourite products to use with your patients?
I would struggle without Philips
Sonicare. It helps maintain my patients' oral hygiene, and cosmetic
work. My passion is teeth straightening, and Sonicare also helps
keep all the attachments clean.
I am an Invisalign Diamond Provider, and it is my recommendation as a system for teeth straightening, having previously used labial fixed braces, lingual fixed
braces and alternate clear aligner
companies. My iTero scanner as
gives me the great accuracy of records need to plan teeth movements.
I also like using Dental Monitoring
as it allows me to give an extra
level of care to patients with
weekly check in via a patient dedicated app.

The Aligner Dental Academy launches e-learning
and peer-to-peer support
April saw the official launch of the
Aligner Dental Academy — a
world-first, online portal offering
educational content and expert,
peer-to-peer support and mentorship for dentists delivering Invisalign clear aligner therapy.
The academy is the brainchild of
founders Dr Barry Buckley and Dr
Raman Aulakh and merges their
Aligner Global Community (AGC),
the support and education platform they launched in 2021, and
their Aligner Consulting, educational and advice forum.
Already the Aligner Dental Academy boasts the fastest-growing,
industry-specific
peer-to-peer
community, developed for dentists by dentists. It has 10,000-plus
clear aligner practitioner members
from 112 countries around the
globe with access to more than 80
hours of e-learning content covering both clinical and non-clinical
topics.
The launch saw Dr Buckley and Dr
Aulakh explain the Academy

ethos, aims and ambitions in an
hour-long live webinar that also
featured top Invisalign providers,
while the Academy's Director of
Business Development Patrick
Schoeman gave a guided tour of
the portal along with a detailed
explanation of the different membership levels.
Said Dr Buckley: "Our mission is
that the academy becomes a
badge of excellence and commitment to best-practice for GPs in
aligner therapy. We're going to do
that through gold-standard, continued education, mentoring and
career support, as well as a recognised accreditation pathway,"
which he stressed doesn't currently exist for aligner therapy.
He added that alongside the
e-learning courses is a "massive
resource
library"
containing
e-books, documents and presentations from a host of expert
guests, while members can also
share case photographs to gain
advice from fellow dentists.

Dr Aulakh added that the Academy also recognised that dentists
are extremely busy so offers flexible learning. "Learning should be
on-demand. And we should have
autonomy over what we want to
learn, so if dentists have a special
interest specifically in ClinCheck or
Attachments or IPR, or even more
on the business side, it should be
available." He also stressed the
community aspect of the Academy: "We're a very strong network... We have doctors coming to
us at the start of their journey and
others who are a lot more advanced, and all of us are part of
something so no one every feels
alone."

The webinar also included contributions from Academy members,
including Dr Ronan McCann
who talked about its benefits. He
said: "I've been a gold member for
a year and half now and I've just
used it more and more. The flexibility is probably one of the most
attractive things to me — whether
you just want to share a case and
go back in six hours to see what
comment you have under it, or you
want some one-to-one mentoring... It's all there for you. And the
accreditation is really attractive.
We naturally want to better ourselves and go on courses, but
sometimes it can be quite hard to
show off what you know, so the accreditation is important for a lot of
dentists and will be well deserved
too."

1. Academy member: This tier is
open to all qualified GDPs committed to best-practice GP aligner
therapy through gold-standard
continued education, mentoring,
and career support.
2. Accredited academy member:
This tier is the gold standard for
professionals leading initiatives
within the profession. Accredited
members must demonstrate a
high standard of knowledge, experience, and development. Dentists must apply to become a
member.

creditation

3. Academy Fellow: Becoming an
Academy Fellow is the ultimate indicator of significant professional
experience and expertise. Academy fellow members have shown
evidence of outstanding contributions and performance in dentistry. Application is also required
for this tier.

The Aligner Dental Academy offers three incremental tiers of
membership:

To find out more about the
Aligner Dental Academy, go to
www.alignerdentalacademy.com.

Membership and ac-

[12] =>

UK NEWS

Dental Tribune United Kingdom Edition | 02/2023

Fourth EAS congress shows how important it has
become for orthodontics

The fourth European Aligner Society (EAS) congress, held from 11 to
13 May at the Centro Congressi
Lingotto in Turin, was a remarkable event. Attended by 1,095
people from 67 countries, it was
the society's most well-attended.
In addition, 22 exhibitors made the
trip to Italy to present their products.
Travel and other pandemic-related
restrictions somewhat limited attendance at EAS's events in Malta
and Portugal. The lifting of restrictions has been a relief for many
who really value in-person education, people like Dr Dorottya
Frank, an orthodontist from Hungary, who tries to attend as many
events as she can, especially to improve her knowledge of aligner
treatment, and Drs Maria Soledad
Urzua and Carol Weinstein, both
from Chile, who come to meetings
in Europe once a year. They were
really pleased with the congress
and believe that Europe has gained
tremendous momentum in aligner
education and development, surpassing the US, in their opinion.
EAS President Dr Tommaso Castroflorio and EAS Scientific Chairman Dr Francesco Garino gave the
opening addresses. The EAS congress is held to celebrate the progress made in the development of
aligner technology, which has
changed the lives of millions of
people around the world, and EAS
members represent more than 60
countries. Dr Castroflorio was,
justly so, very happy with the high
attendance at this fourth con-

gress, compared with just over 300
participants at EAS's first congress
in Vienna in Austria in 2016. To
him, "EAS has become a platform
where researchers and clinicians
can start new initiatives, exchange
their experiences and learn from
one another." He added: "It is only
through this spirit of collaboration
that we can move the boundaries
of orthodontics and of aligner orthodontics forward." He thanked
the presenters having accepted
the invitation by EAS to share their
experience and knowledge with
the attendees, giving them inspiration to advance to "the next
level" of aligner orthodontics,
which to him can only be achieved
by collaborating with one another.
In the spirit of sustainability, Dr
Castroflorio invited attendees to
download the United Nations'
AWorld app, a guide on living in a
more sustainable way, with less
paper and less plastic.
On the first day, attendees could
participate
in
pre-congress
courses and workshops, and for
the first time, a dedicated programme was offered for the practice team. "Without the staff there
is no practice!" said Dr Garino. One
of the workshops was not specific
to the dental field, but beneficial
to all attendees. In it, Dr Ben Bernstein, a psychologist also known as
'The Stress Doctor', shared his
unique approach to recognising
and reducing stress to improve
performance and health.
On the same day, 12 aligner companies held workshops in different

sessions, giving participants the
opportunity to attend as many as
they wished. These workshops are
always a favourite because participants can learn about new technologies in more depth, and explore how to put them to use in
daily practice.
Satellite symposia and plenary
sessions by 29 speakers made up
the programme for the second
and third days. These covered the
congress topics of 3D diagnosis,
biomechanics, open and deep
bite, 3D printing and in-office
aligners, auxiliaries and aligners,
early treatment, orthodontic surgery, artificial intelligence (AI),
multi-disciplinary treatment, orthodontic and restorative care and
digital planning, and the future of
aligner orthodontics.
Among these presentations was
Dr Ravindra Nanda's one on materials, bio-mechanics, 3D printing
and temporary anchorage devices
(TADs) in aligner treatments. It is a
given that you cannot move teeth
and apply force without biomechanics, and it is difficult to know
how much force is applied with
aligners. In complex cases, according to Dr Nanda, aligner treatment
requires the use of TADs and auxiliaries. It is also important to identify the length of time needed for
certain types of movements.
Dr Nanda asserted that aligner
systems are effectively the same,
since all aligner manufacturers use
the same material and exploit the
same type of tooth movement. Ac-

cording to Dr Nanda, many companies do not perform the research for their product, universities do, and practitioners too often
follow the company's recommendations without the requisite basic
information. He feels that orthodontists should decide on treatment plans rather than accept
company treatment plans blindly.
Therefore, it is necessary to look
for evidence-based data from research before adopting any system or treatment plan.
Another highlight was Dr Nikhilesh Vaid's paper on orthodontic
care driven by AI. Dr Vaid does not
believe that AI is a magic pill. He
cited a study comparing DentalMonitoring and conventional
monitoring of clear aligner therapy in terms of treatment efficiency and patient experience that
found no clinically significant differences between the groups.1 He
asked whether we know enough
about the ethical principles of the
use of AI and to consider the warning of its "profound risks to society
and humanity", as asserted in an
open letter signed by hundreds of
the best known names in technology, including Elon Musk.
In the poster competition at the
congress, first place went to Dr
Tarek Elshazly et al. for their poster
titled "Experimental and numerical
study of the effect of trimming line
design on force generation by orthodontic aligners".
Established in order to promote
clinical excellence, EAS's European

Board of Aligner Orthodontics
(EBAO) nominated four honorary
members to EAS and the EBAO:
Drs Robert Boyd, the first to introduce new technology for aligners;
Dr Giovan Battista Garino, the first
to introduce cases treated with
aligner orthodontics to the Angle
Society of Europe; Dr Giuseppe Siciliani, a former director of the
University of Ferrara in Italy, the
first European school to introduce
aligner orthodontics to the curriculum for residents; and Dr Ravindra Nanda for his pursuit of advancing orthodontics. The 15 clinicians who passed the EBAO examination were awarded the EBAO's
first clinical excellence certificates.
The congress ended with a riverside party. During the three hours
of eating, music and dancing, participants could enjoy themselves
and interact with each other as
well as the congress speakers.

The fifth EAS congress will take
place in Valencia in Spain on 1 and
2 March 2024.

[13] =>

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L
P
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UK NEWS

Dental Tribune United Kingdom Edition | 02/2023

Friendly floss launches to the dental profession

New to the dental market in 2023,
friendly floss is a stainless-steel
flossing device for those who care
about oral hygiene and the environment. It's the brainchild of
Giles and Leslie Edwards, sustainability entrepreneurs focused on
reducing plastic waste. friendly
floss is kind to teeth and the
planet, can be used with any floss,
is made from food grade stainless-steel, and can be cleaned in
the dishwasher.
Giles, working with his wife Leslie,
decided to invent a reusable
flosser after watching Sir David Attenborough's Blue Planet II and
seeing the devastating impact of
plastic on wildlife. The couple have
spent many hours over the last
four years working to bring
friendly floss to market. There
were more than 20 iterations of
the device before they settled on
the stainless-steel version rigor-

ously tested for size, shape, functionality and material to ensure
conformance with General Product Safety Directive. Dental professionals and consumers at home
and abroad are already buying the
product either via the bespoke
website or on Etsy.
Early feedback from the dental
profession has been positive. Dentist Dr Ben Atkins commented:
"Cleaning between your teeth is
essential to good hygiene. The
more options there are for patients the better. This is a great
piece of kit."
Dental hygienist, Rupi Gill, commented: "As encouragement of
flossing is a priority, many of my
patients feel disheartened by the
impact many dental tools have on
the environment. Having tried and
tested friendly floss, it is refreshing to find a flosser that is not only

effective and kind to the planet
but will also stand the test of time."
This is exactly the kind of response
they were hoping for. Their priority
was to design a product that is effective yet simple, attractive, durable and easy to clean in a dishwasher or sink, for repeated use.
Giles explained: "Many years ago I
came across a pigeon with a plastic bag tied around her neck and
since then it's been my ambition to
reduce plastic waste."

sumers to live more thoughtfully,
so the consequences of their buying decisions rank more highly
than pure convenience. reuseus
promotes a 'make once, use many
times' approach rather than 'make
many times, use once' and friendly
floss is the first product listing.

He describes how moved he was
by the plight of the pigeon, an
image that still haunts him: "She
was gradually being strangled. I
managed to catch her, carefully
cut off the plastic and see her
safely fly off."

The decision to make a dental tool
was inspired by an episode of the
BBC's Blue Planet II in which viewers saw how albatross chicks were
dying after consuming small
pieces of plastic, fed by their own
parents. Giles said: "We were already determined to lead more
eco-conscious lives. Sir David Attenborough inspired us to invent a
way to replace single-use plastic
floss picks, and so friendly floss
was born."

The couple created a platform for
reusable products, called reuseus.
Their mission is to encourage con-

On using friendly floss he said:
"There are four ways to thread
friendly floss; once you have found

your preferred way, ideally using a
biodegradable brand of floss, you
can control the tension of the floss
and rotate the floss during use.
The carefully designed shape allows access to all teeth while protecting gums. This gives you a better flossing experience every day
while never needing to buy a plastic floss pick again. Each person
who buys friendly floss can save
over 1000 floss picks in three
years."
To reduce the company's impact,
friendly floss is sent out in sustainable packaging made from a single piece of fully recyclable kraft
card that folds in on itself for delivery and display.
Friendly floss can be bought via
https://www.friendlyfloss.com or
Etsy, price £15.99.

New research highlights the link between oral
health and your overall health

Awareness of the broader impact
of oral health on other health conditions is strikingly low, with only
11% of people recognizing this
crucial link.
Poor oral health has been linked to
an increased risk of pregnancy
complications, dementia, heart
problems, strokes, and men's sexual health problems. The Oral
Health Foundation's research
found a third of patients sometimes skip tooth brushing at night.
Research indicates that poor oral
health can contribute to various
conditions that extend beyond the
mouth itself, including:

5. Men's sexual health problems:
Surprisingly, 13% of people recognize the connection between oral
health and men's sexual health
problems, highlighting the need
for awareness and preventive
measures.

Research, carried out by the Oral
Health Foundation, and shared as
part of National Smile Month, reveals the critical link between oral
health and overall well-being, including heart disease, strokes, dementia, pregnancy complications,
and men's sexual health.

1. Pregnancy complications: Studies show a significant correlation
between oral health and pregnancy complications, with 31% of
people acknowledging the potential impact.
2. Dementia: Research suggests a
connection between oral health
and dementia, highlighting the
need to prioritize oral hygiene for
brain health. Approximately 11%
of individuals recognize this relationship.

3. Heart problems: Maintaining
good oral health is crucial for cardiovascular health, as poor oral
hygiene has been associated with
an increased risk of heart problems. Remarkably, 40% of people
are aware of this connection.
4. Strokes: Studies indicate a link
between poor oral health and the
risk of strokes, emphasizing the
importance of oral hygiene in
stroke prevention. Approximately
1 in 5 people understand this relationship.

Dr Ben Atkins says: "As dentists, we
have the power to prevent serious
health problems. It is crucial for
patients to realise the significance
of oral health and take it seriously,
for neglecting it can lead to the
development of severe complications and real health issues."
The Oral Health Foundation is a
leading organization promoting
oral health worldwide. Through education, research, and advocacy,
they empower individuals to prioritize their oral health and make informed decisions. With a collaborative approach, they work towards
improving access to dental care and
reducing the prevalence of oral diseases.

Dr Ben Atkins

Research carried out online by Research Without Barriers - RWB. All
surveys were conducted between
5th May 2023 and 11th May 2023.
The sample comprised 2,008 UK
adults.

[15] =>

UK NEWS

15

Dental Tribune United Kingdom Edition | 02/2023

Researchers develop technology to use generative
AI in smart manufacturing of dental crowns

The team, led by Dr James Tsoi, Associate Professor in Dental Materials Science collaborated with colleagues from HKU Faculty of Engineering's Department of Computer Science to take a leap
forward for the next-generation
AI-designed dental prosthesis
production workflow.
The researchers developed a generative AI algorithm that uses a
true three-dimensional (3D) deep
learning approach, producing personalized dental crowns with high
accuracy that mimic the morphology and match the materials required for the biomechanics of
natural teeth. Biomechanical finite
element analysis revealed that by
using lithium silicate, the AI-designed crown can come very close
to achieving the expected lifespan
of natural teeth. In contrast, the
two existing methods of designing
dental crowns result in crowns that
are either too large or too thin,
and fall short of matching the
same lifespan as natural teeth.
The results have been published in
the journal Dental Materials in an
article titled "Morphology and
mechanical performance of dental
crown designed by 3D-Deep Con-

volutional Generative Adversarial
Network (3D-DCGAN)."
Currently, the computer-aided design and manufacturing (CAD/
CAM) digital workflow has significantly improved dentistry but still
has its challenges. From the design
to the manufacture of dental pros-

The smart manufacturing method
developed by the research team
can meet the challenge and help
replace the conventional approach
to designing personalized dental
crowns.
"We used a 3D-DCGAN approach
to 'teach' the AI algorithm 'good'

comparable to a natural tooth—
both morphologically and functionally," Dr Ding added.
Researchers make use of generative AI to design personalised dental crowns. The 3D-DCGAN AI-designed crowns were compared
with natural teeth and with two

theses, the process is labour intensive, time-consuming, and generates health and environmental
hazards during the 3D printing
and milling processes. The software uses a 'tooth library' that
contains predefined crown templates to assist in generating prosthetic designs but further adjustments are still needed by the operator to meet individual conditions.

high accuracy that can not only
mimic both the morphology and
biomechanics of natural teeth, but
also operate without any additional human fine-tuning, thus
saving additional costs in the production process," said principal investigator Dr James Tsoi.
"Many AI approaches design a
'look alike' product, but I believe
this is the first project that functionalize data-driven AI into real
dental application. We hope this
smart manufacturing technology
will be the stepping-stone for driving Industry 4.0 in dentistry, which
is vital to meet the challenges of
aging society and lack of dental
personnel in Hong Kong," he
added.

© Shutterstock / Hakim Graphy

Leading researchers from the Faculty of Dentistry at the University
of Hong Kong (HKU) have developed a novel smart manufacturing
on dental crowns by using generative artificial intelligence (AI) that
leverage dental manufacturing
technology.

designs by feeding the algorithm
with over 600 cases of natural and
healthy dentition. The algorithm
improves the quality of the design
through internal competition between a generator and a discriminator," said Dr Hao Ding, a co-investigator on the project.
"During the training process, natural teeth morphological features
were learned by the algorithm, so
that it can design dental crowns

other conventional CAD methods
of crown design methods. The results revealed that the generative
AI-designed crowns had the lowest 3D discrepancy, closest cusp
angle (morphological feature), and
similar occlusal contacts (functional feature) as compared to natural teeth.

Dr Tsoi said the breakthrough
marks an important step towards
leveraging the dental industry in
Great Bay Area, which sees an annual US$3.3 billion revenue for
producing 25%-30% dental prosthesis globally, and to align with
the National 14th Five-year plan in
developing new forms of industrialization and informatization viz.
smart intelligent manufacturing.
Clinical trials for using this generative AI for dental crowns are underway. The team is also working
on the applicability of this tool in
other dental prostheses such as
bridges and dentures.

"This demonstrates that 3D-DCGAN could be utilized to design
personalized dental crowns with

© Shutterstock / GaroManjikian

Bredent announces hands on implant workshops

Implant company bredent has announced that it is organising two
hands on workshops at the combined congress of the European
Association for Osseointegration
(EAO) & German Association of
Oral Implantology (DGI) in Berlin,
Germany on 30 September.
The morning workshop (9.00 to
13.30) will feature the company's
SKY fast & fixed therapy and will
cover aesthetics in full-arch restorations for titanium and zirconia

implants in using a digital workflow. It will be presented by Dr Luis
Bessa (Portugal) who has been
treating patients for the last ten
years, focusing on implantology,
facial reconstruction and orthognathic surgery. Dr Bessa will be
joined by Dr Florian Göttfert (Germany) who is a certified specialist
from the German Academy of Aesthetic Dentistry as well as being a
restorative dentistry, endodontics
and laser dentistry certified dentist.

The event presents an opportunity
for the lecturers to demonstrate
how to achieve aesthetic and functional results in the full-arch restoration with digital smile design,
3D-implant planning, prefabricated temporary prostheses, static
guided surgery, and CAD/CAM
produced restorations.
The afternoon workshop (14.00 to
16.30) will look at bredent's Bone
Growth Concept beyond platform-switch with Prof. Jörg Neu-

gebauer (Germany), Dr Florian
Obadan and dental technician Vasile Bacila (both from Romania).
Attendees will be presented with
typical clinical situations from single tooth in the aesthetic zone to
full-arch restorations. The lecturers will cover the scientific basis of
the Bone Growth Concept, its clinical indications, the surgical and
prosthetic demands to achieve
bone growth, and the advantage
of immediate restoration for it.

For more information about the
EAO/DGI congress and these
workshops, visit and register at:
h t t p s: //co n gr e s s .e a o.o r g /e n /
sponsors/industry-hands-on
h t t p s: //co n gr e s s .e a o.o r g /e n /
congress/registration

[16] =>

UK NEWS

Dental Tribune United Kingdom Edition | 02/2023

Dentistry and aesthetics

"Why should women just accept that by a certain age they can no longer considered attractive?"
"Telling women they should be
happy with the way they look isn't
empowerment, it's suppression,"
says dental surgeon turned facial
aesthetics clinician and women's
advocate Dr Jaskaren Midha.
Dr Midha is an award-winning facial aesthetics clinician and ardent
supporter of global aesthetics
company Sinclair's MaiLi MyPower
initiative, which campaigns for
women to live without judgement
and shame. After qualifying as a
dentist in 2009 from Leeds University, she transitioned to practicing
full-time facial aesthetics some
seven and half years ago. "I moved
because it let me combine my passion for the science of anatomy
with beauty and helping people to
feel and look great," she explains.
Dentists, she says, are in a unique
position because when patients
receive cosmetic work in particular, it gives them a chance to examine the face as a whole. And frequently when people have had
dental work, such as Invisalign
treatment or whitening, it can
break down the barriers and they
then go on to seek other facial
aesthetic treatments. "For instance, when they have Invisalign
treatment, it slightly plumps out
their lips, so when they finish their
alignment they tell me they feel
like they've "lost their lips".

"Even having something simple
like tooth whitening will prompt
compliments, which then give
them the confidence to consider
treatment for a deep line around
their mouth that's been bothering
them for a long time," she adds.
Dr Midha's work brings her into
contact with women from all walks
of life who seek treatment for numerous different reasons, and she
stresses that many feel under
pressure — perhaps more today
than in previous eras, to remain
young-looking. "I think the goalposts have changed and we're expected to look a certain way for a
lot longer," she adds.
She is speaking following the publication of MaiLi My Power's revealing survey that questioned
10,000 women in seven countries
— the UK, Germany, Spain, Mexico, Saudi Arabia and UAE. It found
that 97% of respondents believe
women face judgement for how
they look, 61% have experienced
negative comments or abuse
about their appearance and 96%
believe women are judged for
having cosmetic treatments that
alter their appearance.
"The study also found that 90% of
women taking part believe they
should be able to do whatever
they like with their appearance

"I have family in America, Canada
and India where people tend to be
more open and laid back about
aesthetic work... I think they celebrate it a bit more. In the UK however, she adds that patients often
tell her they've only told one close
friend they're having work and
don't want anyone else to know,
plus they feel guilty about having
it done at all. Dr Midha explains
that part of the issue might be that
treatment is not regulated in the
UK as it is in other countries. "I've
had patients tell me they've
booked a treatment online and arrived at 'the clinic' to find they're
being treated in someone's
kitchen!" she says.
and I 100% agree with that. It's
your body, your life, so you should
be able to make decisions without
ever feeling bad about them... Society tries to dictate to us what's
appropriate and what's not, but if
something makes you feel good,
then why not?"
While Dr Midha acknowledges
that times have changed and aesthetic work, such as Botulinum
toxin and dermal fillers, is increasingly accepted, she says in the UK
in particular many women still feel
the need to keep any facial work a
secret for fear of harsh, and uninvited, judgement.

However, while women in the UK
might still be reticent about telling
friends and family they've had a
procedure, they're now much
more likely to thoroughly research
the treatment, doctor and clinic
before going ahead. "It's more
empowering to say, 'I've done my
research, I know why I'm going,
and I know who I am going to'."
There are still barriers to women
being more open about cosmetic
work, however. Dr Midha says
she's experienced many negative
comments under her Instagram
before and after posts, often from
men. "And I still remember a pa-

tient who had her lips done. She
had a small swelling that only
lasted for about a week, but in that
time her husband's friend told her
they looked awful. She came to
see me three weeks later and while
the swelling had gone and she
loved her lips, she was still considering having the filler removed because of that unsolicited comment... I think people say things
but don't realise the impact their
comments are going to have on
that person for a really long time
because often people have sought
treatment because of an insecurity
to begin with."
She is also keen to point out that
not all treatments are purely to reverse the signs of aging. "I had a
lady with a cleft lip who was really
shy and talked with her hand over
her mouth. We did a little lip filler
and she said it gave her so much
more confidence."
For Dr Midha that confidence sits
at the heart of what she loves
about facial aesthetics. "When
women come to me, it's about a
feeling. They won't remember
what I've said to them, but they'll
remember how I've made them
feel."

Giving dental practioners bespoke ways to study
infection control in a post-pandemic world

Post-pandemic, the Care Quality
Commission underlines the necessity of incorporating effective infection prevention and control
into everyday practice1. "Good
management and organisational
processes are crucial to make sure
that high standards of infection
prevention are developed and
maintained," it states, highlighting
the need for a practice IPC policy
that's accessible to all staff and
updated regularly. It also stresses
there should be specific requirements for higher risk procedures
and mandatory staff training with
frequent updates, adding that
each practice should also have an
IPC audit programme in place.
This heightened need for top level
infection prevention and control in

dental surgeries is targeted by the
MSc in Clinical and Diagnostic Oral
Sciences (CDOS) in Dental Infection Control at the College of
Medicine and Dentistry (CoMD) —
the only Level 7 course to focus on
the needs of dentists rather than
the more general courses suited to
other healthcare settings.
Course director Prof. Noha Seoudi
says: "Delivering dental care safely
by implementing best practice infection prevention and control has
always been very important for
patients and the dental team caring for them. We equip our students with the knowledge they
need to be leaders in this field."
As well as the bespoke educational
content, the unique MSc in CDOS
in Dental Infection Control programme is 180 credits course that
offers dental students unrivalled
flexibility in the way they study,
when and for how long. The programme can be undertaken as a
one-year, full-time course, or two
years part-time or via blended
learning.
"In the blended learning version of
the programme, we work around

the student with evening and
weekend classes, plus we offer online access to all learning resources," adds Prof. Seoudi.
"The Level 7 programme acts as a
building block to enhance and further develop practitioners' careers. Once they've completed
their MSc, they can go on to do a
PhD, and potentially build their academic career. Equally, they will be
equipped with enhanced knowledge and skills to lead on dental
infection prevention and control,
either in the UK, or in their home
country if they are from overseas,"
says Prof. Seoudi.
The course arms students with the
theoretical knowledge and expertise they need to confidently Lead
on dental infection prevention and
control. It is delivered by renowned international academics
and experts in the field, who teach
dental professionals how to effectively apply theory to practice in a
safe learning environment. It includes a mix of lectures, seminars
and practical workshops (blended
and full-time course) including access to local decontamination facility and simulations, as well as

contemporary ways of learning
evidence-based medicine and
problem solving.

year full time MSc programme:
The Advanced Clinical and Diagnostic Oral Sciences.

Students also have the opportunity for discussion with their peers
from other courses, giving them a
multidisciplinary approach and
ability to develop sound judgement based on evidence.

This course will give students en-

.The MSc in Clinical and Diagnostic
Oral Sciences in Dental Infection
Control comprises:
Four clinical modules:
1. Principal Module: Infection
Control and Decontamination
2. Advanced Module: Dental
Infection Prevention and Control
3. Immunology and Infection
Module
4. Optional Module
Three research modules:
5. Research Methodology I
6. Research Methodology II
7. Research Dissertation
All modules can be studied separately as CPD modules. Furthermore the three branches of the
Clinical and Diagnostic Oral Sciences can be combined in a three-

COVID-19 highlighted that infection prevention and control (IPC)
post-pandemic is just as vital in
dental practice as during the hight
of the pandemic. At the same time,
the Department of Health, via the
Health Technical Memorandum
(HTM) 01-05, requires that each
dental clinic appoints a decontamination lead with the appropriate
knowledge and skills.

hanced knowledge and skills in
Oral Medicine, Oral Microbiology
and Dental Infection Control along
with an extensive research experience. This could open multiple avenues for clinical academic career.
To find out more about CoMD's
MSc Dental Infection Control and
the wider MSc programme, visit:
h t t p s : //c o m d . o r g . u k /c o u r s e /
m s c-in- clinic al-an d- dia gn ostic-oral-sciences.
1. CQC - https://www.cqc.org.uk/
page/dental-mythbuster-38-infection-prevention-and-control

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[cover] => Dental Tribune UK No. 2, 2023

[toc] => Array ( [0] => Array ( [title] => Leadership: It is not about you, it is about them [page] => 1 ) [1] => Array ( [title] => Dental practice management software market is now worth £1.2 billion, and is growing [page] => 1 ) [2] => Array ( [title] => UK NEWS [page] => 4 ) ) [toc_html] =>

Table of contents

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Leadership: It is not about you, it is about them / Dental practice management software market is now worth £1.2 billion, and is growing / UK NEWS

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