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GDC to address FtP backlog / News / The perfect learning solution / Ten reasons to be at Clinical Innovations / CQC - the three M’s / The good old days? / Getting to know you / The incorporation process / Go green for your future / The perio-implant interface / Options for dentures / Effective administration / From windscreens to whitening / Industry News / Getting down the canal / Classifieds

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April 26-May 2, 2010

PUBLISHED IN LONDON
News in Brief
CIC conference
One of the highlights of this
year’s Clinical Innovations
Conference is a presentation by
periodontist Dr Peter Galgut.
The Clinical Innovations Conference (CIC) is being held at
the Royal College of Physicians
on 7-8 May. The talk, which
is being supported by Philips
Sonicare, will highlight the latest periodontial innovations to
help patients achieve superior
results. Dr Galgut qualified as
a dentist in 1971, and gained
an MSc with distinction in
Periodontology in 1983. Subsequently he obtained the MRD
(Membership in Restorative
Dentistry) and also the MFGDP from the Royal College of
Surgeons of England.
James Hull winners
The James Hull Group has announced the winners for its
annual awards programme.
Peter Embling has been named
as practice manager of the year.
Sue Hall won dental nurse of
the year and Pam Swales won
receptionist of the year. Paul
Dutton has been awarded employee of the year and Megan
Howlett-Permain won the
CEO’s award. A spokeswoman
for the James Hull Group said:
‘Peter Embling’s dedication to
dentistry, his ability to develop
and retain a very strong team,
and his sense of humour have
all earned him this well-deserved title.’ The dentist chain
also praised Sue Hall for ‘her
ability to turn her hand to anything in the practice and her
ability to keep her cool under
pressure, even when simultaneously offering management
support to two practices.’
Harald Heymann returns
World-renowned expert Dr
Harald Heymann returns to
London on 16 July to lead a
British Dental Assocation seminar on issues in adhesive and
aesthetic dentistry. The ‘bread
and butter’ issues of adhesive
and aesthetic dentistry, which
is part of the BDA’s Clinical
Expert Series, will consider
the issues facing practitioners
aiming to achieve consistent,
long-term success in conservative aesthetic dentistry, beginning with an evidence-based
overview of what works. The
full-day seminar takes place
on Friday 16 July at London’s
Novotel London St Pancras
Hotel. Dr Heymann is professor and graduate programme
director at the Department of
Operative Dentistry at the University of Carolina in the USA.
He is a consultant to the American Dental Association, the
author of more than 180 scientific publications and editor-inchief of the Journal of Esthetic
and Restorative Dentistry.
www.dental-tribune.co.uk

News

Practice Management

Get the point

New research claims acupuncture can cut anxiety levels

page 2

Ahh! Nostalgia

Jane Armitage remembers the
‘good old days’ of dental nursing

page 12

VOL. 4 NO. 11
Money Matters

No chips

Green foundations

Andy Acton details why looking
at your carbon footprint is vital
for selling potential

From a windscreen repair shop
to dental practice in a few steps!

page 18

pages 24-25

GDC to address
FtP backlog
Additional funding agreed from reserves to help
clear case backlog and ensure capacity for rise in
Fitness to Practise investigations

he General Dental Council (GDC) has agreed an
additional £5.3m of funding to its budget for 2010. The
measure was agreed at its March
Council meeting, it was also decided at that time to make the information public.
The GDC stated: “The GDC
is financially stable, with circa
£14m remaining in our reserves.
The discussions at our last Council meeting were not around our
financial stability, but around
our desire to address some issues
in the regulatory process such as
Fitness to Practise.”
The main reason for the additional funding is a £3.7m deficit in the money needed to bring
the backlog of Fitness to Practise
(FtP) investigations up to date.
There was a 40 per cent increase
in cases in 2009.
Currently, there are more
than 850 cases in the system,
of which roughly 180 are more
than 12 months old. The GDC
received 1,437 new cases in 2009,
which represented a rise of 40
per cent on 2008. Of these, 1,249
(87 per cent) went to assessment
and 852 were referred to the Investigating Committee (IC). The
852 IC referrals represent 68 per
cent of cases assessed and 59 per
cent of cases received. To deal
with these, the IC met 25 times in
2009 and reached a substantive
decision on 562 cases (some of
those referred during 2009 were/

will be considered in 2010). This
already shows a backlog of almost 300 cases for the IC alone.
In addition, data which had
been extracted in July 2009
showed 16 cases which were
more than 24 months old and
had not been listed for a hearing
and 11 which were between 18
and 24 months old and had not
been listed.
The GDC reported: “Since
2007 we’ve seen six per cent more
of our complaints coming from
dental professionals themselves
as well as a significant growth in
complaints from the public. But
the increase in complaints isn’t
just a trend within the GDC. Complaints figures relating to all NHS
services in England went up by
over ten percent between 2007 and
2009. We also clearly have more
registrants now (who can be complained about). With more registrants it is inevitable there will be
more costs involved in taking action if and when things go wrong.
This drives a significant part of
our activity and our cost base and
we have to build our capacity to
deal with this significant increase
in the volume of work in our core
regulatory functions.
The level of delay has been
a cause of concern, as stated in
the proposal document. It is clear
that we are not currently dealing
with all cases in a timely manner and that a new approach is
needed. A significantly reduced

Special feature

throughput time for all but the
most complex cases is desirable
in terms of both patient protection and fairness to registrants
who are practising under the
shadow of an allegation.”
Chair of the Council of the
GDC, Alison Lockyer, said: “We
had a robust discussion at the last
Council meeting about making
this significant investment in improving our regulatory processes.
This will help us address some
of the Fitness to Practise issues
which our CHRE 2009 review is
likely to flag up. Making the investment now will put us in a better position to manage our cases
more effectively. This is essential
for those who are under investigation and to protect the reputation of all dental professionals.”

Other issues facing the Council include:
• Regularisation of the staffing
budget to recognise commitments
made in 2009 - £708k
• Changes to meeting profiles
of Committees and associated
arrangements commissioned by
this Council - £389k
• Proposals for tackling the challenging backlog of Fitness to
Practise allegations where
there is the experience of a
40 per cent increase in volumes
in 2009 - £3,719k
• Recruitment of replacement Legal Advisers for Hearings - £10k
• Revalidation project
funding - £250k
• Overseas Registration Exam
budget regularisation - £170k
• Registration proposals (part
head count/part projects) - £170k
• Customer Advice and Information Team capacity - £57k
• Finance related projects
(x3) - £92k
• Changes to the priorities and the
restructuring for the External
Relations team - (£270k)
The implications for the future financial position of the
GDC will include a look at raising the Annual Retention Fee by
£80-£100 and the use of ‘hotdesking’ in the Council offices to
maximise office capacity. DT

[2] =>

2 News

United Kingdom Edition April 26-May 2, 2010

Acupuncture can help dental phobes

eople suffering from phobia could be helped by
acupuncture, according to
new research.

sedatives. In 14 cases, the treatment had to be cancelled because the patient could not go
through with it.

The study found that five
minutes of acupuncture treatment in the top of the head cut
anxiety levels by more than half.

The patients received the
acupuncture from their own
dentists, who are all members
of the British Dental Acupuncture Society. They had acupuncture needles inserted
into their heads at acupuncture points GV20 and EX6,
which have been reported to
aid relaxation.

Twenty people with an average age of 40 took part in the research, published in the journal
Acupuncture in Medicine.
All had suffered from fear of
the dentist for between two and
30 years.
On previous visits to the
dentist, three patients had had
to have general anaesthetic,
while six others had needed

Using a well-known anxiety
reporting scheme, the Beck Anxiety Inventory (BAI), the patients’
levels of distress were measured.
Scores fell from 26.5 to 11.5 after
acupuncture and all 20 patients
were able to undergo treatment.

Statistics suggest that, in
western countries, phobias afflict
seven to 13 per cent of the population and that women are twice
as likely to suffer from a phobia as men. However, as many
people do not feel comfortable
talking about their phobias, it is
thought that this figure could be
a lot higher.
Dr Palle Rosted and colleagues from Weston Park Hospital in Sheffield and other centres
in the UK and Denmark carried
out the research. They said more
studies are needed but concluded ‘acupuncture prior to dental
treatment has a beneficial effect
on the level of anxiety in patients
with dental anxiety and may offer a simple and inexpensive
method of treatment’.

However, the NHS
Choices website noted
that the study did not
include a control group
of people not receiving
acupuncture to compare against.
This made it difficult to determine
whether any reduction in fear seen in the
treated
individuals
would have occurred
naturally over time.
As no other anxiety treatment was compared, it is also not possible to say whether acupuncture would be any better than other approaches,
such as hypnotism. DT

Changes for dental therapists and hygienists

ental
therapist
and
hygienists are to be allowed to administer
local anaesthetics and supply
fluoride supplements, under
new changes.

The Medicines and Healthcare products Regulatory Agency (MHRA) is to allow dental

therapists and dental hygienists
to perform new functions under
a Patient Group Direction.
These are the administration of local anaesthetics plus
the sale, supply or oral administration of fluoride supplements and toothpastes with high
fluoride content.

The Department of Health
hopes to make the necessary
amendments to the Medicines Act 1968 within the next
three months.

and said: “As an organisation,
that is very much at the heart
of the profession, Dental Protection has long been aware of the
frustration and dento-legal danger created for dental hygienists

and dental therapists created by
existing legislation. I am delighted to hear from the chief
dental officer that this unintended consequence will soon
be removed.” DT

Kevin Lewis, dental director
for the indemnity and risk management advisers Dental Protection, welcomed the change

Clinical Innovations Conference

ducation and training provider, Smile-on, is hosting this year’s Clinical Innovations Conference, along
with the AOG and the Dental Directory.

panel of international experts
with the aim being to update
participants on new technologies, materials and techniques
in dentistry.

Now in its seventh year, the
Clinical Innovations Conference
(CIC) will be held on the 7-8 May
at the Royal College of Physicians
in Regent’s Park, London.

The 2010 conference will
host a line-up of highly prestigious international speakers
alongside exhibitors offering the
latest dental technologies from
around the world.

Promising to be the biggest conference yet, the CIC
programme has been put together in consultation with a

A spokeswoman for Smile-on
said: “Together with the AOG we
have brought together an impressive programme that will be both

inspirational and motivating, preparing your practice for the future and ensuring that you too are
at the leading edge of dentistry.”
After the success of last year’s
CIC, the Clinical Innovations
Conference is growing and the
2010 conference is expecting delegate numbers in excess of 300
highly motivated dentists who
are passionate about learning.
For more information call
020 7400 8989 or email info@
smile-on.com. DT
Clinical Innovations Conference website

Course in sports dentistry

he UCL Eastman has
joined forces with the
London Sports Institute of
Middlesex University and is offering a course for dentists wishing to treat athletes.

• Tooth surface loss and
the relationship with
sporting activity
• The aetiology, prognosis
and treatment of dental and
maxillo-facial trauma

The course will made up of
lectures, seminars and clinical
sessions along with practical and
laboratory skills.

In addition to the dental
and
maxillo-facial
subjects,
there will be lectures and
demonstrations on sports physiology, psychology of sports injury, diet and nutrition, therapeutics and drugs in sport
plus medico-legal aspects of
dental injuries.
The course may be taken
as either an optional module

It will explore:
• The recognition of
neurological injury
• Healing of hard and soft tissues
to include suturing
• Stress and TMJ dysfunction

Published by Dental Tribune UK Ltd
© 2010, Dental Tribune UK Ltd.
All rights reserved.

Dental Tribune UK Ltd makes every
effort to report clinical information and
manufacturer’s product news accurately,
but cannot assume responsibility for

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

Sport courses in dentistry

of the Restorative Dental Practice programme, or as a standalone course.
For further information or
to register for September 2010,
please contact the programme
administrator on 020 7905
1281 or visit www.eastman.ucl.
ac.uk/cpd. DT

Managing Director
Mash Seriki
Mash@dentaltribuneuk.com

Features Editor
Ellie Pratt
Ellie@dentaltribuneuk.com

Director
Noam Tamir
Noam@dentaltribuneuk.com

Advertising Director
Joe Aspis
Tel: 020 7400 8969
Joe@dentaltribuneuk.com

Editor
Lisa Townshend
Tel: 020 7400 8979
Lisa@dentaltribuneuk.com

Sales Executive
Sam Volk
Tel: 020 7400 8964
Sam@dentaltribuneuk.com
Marketing Manager
Laura McKenzie
Laura@dentaltribuneuk.com
Design & Production
Keem Chung
Keem@dentaltribuneuk.com

Dental Tribune UK Ltd
4th Floor, Treasure House, 19–21 Hatton Garden, London, EC1N 8BA

[3] =>

News 3

United Kingdom Edition April 26-May 2, 2010

‘

Going up in smoke

o the General
Dental Council
is dipping into
its reserves to the
tune of £5m to get
through the backlog
of Fitness to Practise
cases sitting in its case files. This
is not the only reason for the
funding; Revalidation, Overseas
Registration Exam regulation,
Customer Advice and Information Team capacity... many of the
facets of the GDC’s regulatory
role need additional funding to
cope with the rise in demand of
the GDC’s services.

‘

Editorial comment

ly) prepare for a trip that would
be the experience of a lifetime,
whilst having to hear about the
doom and gloom of yet more delays in the reopening of the airspace. I have friends ‘stuck’ (being trapped in New York doesn’t
weather and beginning my trip
sound much like stuck to me!) all
to the village of Bukumbi to renover the world and I have been
ovate a community centre and
hearing stories of dental pracprovide support for the charity
titioners forced into expensive
Bridge2Aid with colleagues from
trips via hired cars and EurosSchulke UK and Henry Schein
(and17:18:19
don’t forget the poor
Minerva.A4Itlightbulb
is a CIC
strange
feeling 1 tar
advert-amended-text.pdf
12/04/2010
unfortunates who are stranded
having to mentally (and packing-

in Singapore after IDEM last
week!). In fact the only winners
seem to be the temp agencies
that are doing a roaring trade in
providing cover!
Anyway, back to Bukumbi.
There is still time to support me
and the team - go to www.justgiving.com/bukumbibound. And keep a look
out for my reports from
Tanzania after I get back!
See, ever the optimist... DT

It is good also that the
GDC has decided to share this
fairly critical set of documents
with the public and practitioners
– it gives an air of transparency
to an area of the Council’s operations that can be given to rumour
and conjecture.
Of course the document does
not give happy reading that
one of the ways in which the
GDC will have to fund in
the future is to raise the Annual Retention Fee (ARF) by up
to £100 for dentists (DCPs are
not specified in the document).
In these cash-squeezed times,
anything extra that has to be
paid out will be unpopular; the
flip side is of course that dentists
have had the ARF frozen for the
last couple of years.
C

Interesting times indeed for
37 Wimpole St.
CM

s you read this I will be
(volcanic ash permitting)
acclimatising to the Tanzanian
CY

CMY

Erratum
Dental Tribune has received comment
from Ingenious Media regarding the recently published column “A sensible alternative”, by Michael Lansdell (DT; Volume
4, Issue 6 pg 24-25).
Ingenious was the company featured
in the Mail on Sunday article of 14 February to which Mr. Lansdell refers. There
are two major errors in his piece to which
they object:
1. Mr Lansdell refers to “the Inland
Revenue’s position … [that] the arrangement was principally aimed at tax avoidance”. This is untrue. It is the job of the
HMRC to distinguish between bona fide
trading businesses and schemes aimed at
simply exploiting tax benefits. As a matter
of routine, all of our businesses are subject
to rigorous scrutiny and have been found to
have been operated in the proper manner.
In particular, we have consistently demonstrated that investors have claimed correctly for any losses that they have incurred.
Given our track record, we are completely
confident that HMRC will agree that we
look to make successful films and that our
film businesses are carried out on a commercial basis with a view to profit.
2. Mr Lansdell goes on to state that
“the firm that developed the scheme
had problems of its own …”. Again, Mr
Lansdell has got this wrong, confusing Ingenious with another company mentioned
in the piece (Vantis). Apologies for any
confusion caused. DT

The

Clinical Innovations

Conference 2010 | The state of the Nation
Friday 7th and Saturday 8th May

The Royal College of Physicians, Regent’s Park,
London
World Class Speakers: Julian Webber,
Kevin Lewis, Achim Schmidt, Eddie Lynch,
Basil Mizrahi, Wyman Chan, Trevor Bigg,
Jonothan Britto, Joe Omar, Seema Sharma,
Bruce Bernstein ...many more to come.
Go to www.clinicalinnovations.co.uk
or call 020 7400 8967

Do you have an opinion or something to say on any Dental Tribune
UK article? Or would you like to
write your own opinion for our
guest comment page?
If so don’t hesitate to write to:
The Editor,
Dental Tribune UK Ltd,
4th Floor, Treasure House,
19-21 Hatton Garden,
London, EC1 8BA
Or email:
lisa@dentaltribuneuk.com

[4] =>

United Kingdom Edition April 26-May 2, 2010

Dentist ‘still poses risk
to patients’ - GDC

dentist who refused to give
a woman gas during surgery still represents a risk
to patients, according to the General Dental Council.
David Henthorn told the woman she needed to have her teeth
pulled out, but refused to give her
gas during the procedure, despite
her asking for it.
Henthorn failed to notice the
patient’s ‘severe’ loss of tissue and
gum disease, despite her making frequent visits to his practice
in Slack’s Lane Heath, Charnock,
Lancashire.
The patient told the General

Dental Council (GDC), that her
gums became ‘baggy’ in 2001 and
abscesses appeared in June 2002.
In May 2007, the woman
changed practices after Henthorn
refused her requests for sedation.
She then had to have nine
teeth removed, the GDC heard.
In July 2008, Henthorn was
only allowed to work subject to
conditions, after being criticised
for ‘gross negligence’.
However at a new hearing Jason Leitch, chairman of the GDC
tribunal, said the dentist still represented a risk to patients. He said:

“The committee has determined
that it is necessary for the protection of the public and in your own
interests that your conditional
registration should continue.”
He then re-imposed 10 conditions on his practice for a further
year.
These include informing the
GDC of any professional appointment, allowing it to exchange
information with his employer,
providing the council with contact details of any colleague prepared to take on his practice and
notifying the GDC of any formal
disciplinary proceedings taken
against him. DT

Multi-media dentist guide

eople in Scotland looking for information on
NHS dentists can now
go to a website or watch a
DVD available in 17 different
languages.
The
new
multi-media
NHS services guide has been
launched to raise the profile of
all the major services offered by
NHS Scotland.
The ‘How to use the health
service in Scotland’ initiative
comprises of a website, online videos and resources and
a DVD, available in 17 differ-

ent languages including British
Sign Language, giving information about dentists, family doctors, opticians, pharmacists, and
out of hours services.
There is an introduction
which contains some important
general information, and a short
section on how to give comments, whether good or bad,
about services.

How to use the health service in Scotland website

Nicola Sturgeon, the Cabinet Secretary for Health & Wellbeing said: “Our aim is to put
patients at the heart of the NHS
and make them partners in

their own care. Initiatives like
this will help us achieve this.
Good patient care depends on
understanding patients’ needs
and effective communication is
key to this.” DT

memory decline research

REAKTHROUGH scientific research has suggested there could be a link
between having a low number of
teeth and poor memory.

The study, specifically related to memory decline, examined
the participant’s from a series of
cognitive assessments and their
ability to recall words.
The results showed that people with fewer teeth scored lower than those with more teeth
in the first examination and declined far quicker after further
testing in later years.
Chief Executive of the British
Dental Health Foundation, Dr
Nigel Carter, says this study adds
to a growing list of evidence of
the wide ranging systemic links
relating to poor oral health.
Dr Carter said: “Heart disease, strokes, diabetes, lung
disease and pre and low weight
babies have all been found to
be linked with poor dental

health. This latest research
could highlight yet another worrying risk factor of having poor
oral health.”
Participants were aged between 75 and 98 years old and
were mostly of a high educational background – 85 per cent had
a bachelor’s degree or greater
while 88 per cent were teachers
by profession.
They were assessed by the
Delayed Word Recall test, which
involved the subjects being
presented with ten words,
waiting five minutes and then
testing them for how many they
could remember.
Each participant had their
score recorded in three consecutive years.
Results showed that participants with more than ten
teeth achieved an average recall of 5.5 words at age 75, while
those who had less than nine
teeth only averaged three. By

the age of 90 those who had
more than ten teeth still averaged 5.5 words, however, those
who had between zero and nine
teeth fell dramatically and could
only average a recall of less than
two words.
Low levels of education were
also associated with missing
teeth. While only 14 of the 144
participants were of a lower
education, 86 per cent of these
individuals had less than nine
teeth, compared the 30 per cent
of those with a better education.
The study was conducted at
the University of Kentucky in
America with lead author Pam
Stein and published in the Journal of Dental Research.
They also managed to
establish a link between a
low number of teeth and a person’s genes.
It has previously been proved
that gum disease is the major
cause of tooth loss in adults. DT

[5] =>

[6] =>

6 News

United Kingdom Edition April 26-May 2, 2010

GDPUK launches dental exhibition website

DPUK, a website for dentists wanting to share ideas and informa-tion, has
recently added a dental exhibition
review section to its site.
Everyonewhoisworkingwithin
the dental arena, including the
exhibitors at the events, who are
registered on GDPUK, can access
the section, Dental Show Reviews.
The section has information
about dental exhibitions and conferences and dental professionals
can compare key aspects using a
simple star rating system.

The site benefits from being an

appeal to different people depending on type of
practice, specialist area or if seeking new equipment for the practice or laboratory.

independent source of information.

Exhibition visitors will be
able to rate the events on an ongoing basis so comments will always be up to date and relevant.
Information provided by
organisers, the quality of speakers, general organisation,
value for money and usefulness
are amongst the aspects that
are rated.
Tony Jacobs, owner of
GDPUK, a practising dentist

“This online service helps members of the team
to select the event
visit the website to vote on www.dentalshowreviews.co.uk
most suitable to
their needs and
give preference to the events
in Manchester, said: “We all
rated highly.
know that different events

“We all have to ensure that if
we take time outof the practice,
it is vital to get the maximum return and making a wise choice
about the dental event to attend
is the only way of assisting this.”
Anyone rating a dental event
that they have recently attended,
will be entered into a draw to
win an iPod Nano!
It takes only a few minutes
to register free on the site, visit
www.gdpuk.com to register and
http://www.dentalshowreviews.
co.uk to vote. DT

New diagnostic tool to help early detection of oral cancer

new diagnostic tool to
help detect oral cancer
in its early stages has
successfully been developed
by researchers.

The highly-receptive instrument, which looks similar to a
toothbrush, is able to achieve

extremely accurate results by
lightly touching a lesion on the
tongue or cheek.

or premalignant lesions – results that compared well with
traditional tests.

Trials carried out on the
nano-bio-chip sensor showed it
was 97 per cent ‘sensitive’ and
93 per cent specific in detecting
which patients had malignant

Chief executive of the British Dental Health Foundation,
Dr Nigel Carter, has welcomed the new technology into
the dental practice.

Dr Carter said: “Mouth cancer
is a deadly and debilitating disease that would greatly benefit
from such early diagnostic technology as the nano-bio-chip.
“Currently the best chance of
beating the cancer comes from
early detection, which improves
survival rates to 90 per cent.
“Mouth cancer is a potentially fatal condition that is taking
more lives each year. Without
early diagnosis, chances of survival plummet to 50 per cent.”
If introduced, the brush could
be used by dentists while treating patients in the dental chair
during a regular appointment.
The minimally invasive technique would deliver results in 15
minutes instead of several days,
as lab-based diagnostics do now,
and offer an alternative to often
invasive, painful biopsies.
A larger trial involving 500
patients has been planned, while

researchers hope the eventual
deployment of nano-bio-chips
willdramatically cut the cost of
medical diagnostics and contribute significantly to the task of
bringing quality health care to
the world.
In the United Kingdom, approximately 5,000 people are diagnosed with mouth cancer each
year, claiming the lives of almost
2,000, making it the UK’s fastest
growing cancer.
Mouth cancer has previously
been found to be more common in men than women and
people over the age of 40, though
an increasing number of women
and young people are developing
the condition.
The new nano-bio-chip was
developed by prof John McDevitt
and his team at Rice University in
Houston, Texas.
The study appeared online
in the journal Cancer Prevention
Research. DT

Credit Jeff Fitlow/Rice University

Rice University Professor John McDevitt holds the LabNow device to read nano-bio-chips
that will look for signs of oral cancer and other diseases

[7] =>

News 7

United Kingdom Edition April 26-May 2, 2010

Pensioner banned from
dental surgery for life

pensioner
has
been
banned from a dental
surgery for life, after he
left a hoax bomb outside
the surgery.
Peter McShane, aged 84, put
a ticking clock inside a box with
wires showing and left it outside Bush Street dental surgery in Pembroke Dock in
Pembrokeshire. Police closed off
the area and evacuated nearby
residents from their homes. The
box was destroyed in a controlled explosion.
McShane, who lives very
close to the surgery, was among
those who were asked to leave
their homes, yet he still did not
tell the police that the bomb was
in fact a hoax.
He was caught on CCTV camera and he admitted to leavng the

murder
trial

dentist and his ex-lover,
who have been charged
with murdering their
partners nearly 19 years ago,
have been sent to the crown
court for trial.
Colin Howell, 51, and Hazel
Stewart, 47, appeared at North Antrim Magistrates’ Court in Coleraine, Northern Ireland, and were
told they will be tried for murder
at Antrim Crown Court.
The trial is expected to go
ahead later in the year.
Howell and Stewart, have been
charged with murdering his wife
Lesley, 31, and Stewart’s husband,
31, in May 1991.
Their bodies were found in a
car filled with exhaust fumes at a
garage behind a row of houses in
Castlerock, Co Londonderry.
Howell, who once ran a dental
implant clinic in Ballymoney, Co
Antrim, has been in custody since
his arrest and was sent back to
Maghaberry Prison, near Lisburn.

Stewart was granted continuing bail but she must report daily
to police in Coleraine. She has already handed over her passport.
Howell was known as a top
implant specialist. He did a lot of
lecturing in the Middle East and
was hired by King Abdullah II to
teach his own team of dentists the
latest techniques. DT

hoax bomb and vandalism when
he was arrested.

£187 for dental work in 2007. The
money was later refunded to him
by the surgery, but he still carried out the revenge attack.

Swansea
Crown
Court
heard that the hoax bomb was
His barrister, Georgina Buckthe latest in a string of attacks on
3M_24C LCOS Webinar Advert_ART.pdf
19/4/10
13:47:17
ley, said he was ‘extremely rethe surgery, after being charged

morseful’ and added that he had
not fully appreciated what he
was doing and was shocked by
his behaviour.
McShane received a 34-week
suspended jail sentence and a
curfew order.
Judge Keith Thomas called
him a vindictive man ‘determined to get his own back on
people who had upset him’.

The judge said the offences
would normally attract a prison sentence, and it was only
because of McShane’s age that
he was agreeing to suspend the
jail term.
McShane was also placed
under a 12-month supervision
order, banned indefinitely from
visiting the dental surgery, and
also placed under a curfew between 8pm and 8am for the next
three months. DT

[8] =>

8 MSc Blog

United Kingdom Edition April 26-May 2, 2010

The perfect learning solution
Dental Tribune catches up with online MSc student Elaine Halley

questions either during the
elieve it or not, three
lectures or at breaks. I have
months on and I am
only attended a few lectures
still enjoying the studylive – mostly due to conflicts
ing! The format of the course
of schedule. The lectures are
is that lectures can be viewed
posted on the web a few days
live with a live webcam of
later to be viewed at our leisure.
the lecturer and the opportProjet4_Mise
en page
1 23.03.10
11:52 Page2
They can then be paused at
unity
to type
in the
‘chat’ box

any point to give you time to
write notes or copy down a
slide – there is a running time
on the footnote which allows
you to note down where you
are in a presentation if you
are interrupted and have to restart later. The perfect solution

for distance learning amidst a
hectic lifestyle.
So, inspired by the looming date for handing in my
first assessments, I have been
on a crash course of catch-up.
So far, we’re in Unit 1 – we’ve

DOWNPACK & BACKFILL
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covered Anatomy, Basic disease processes, Diagnostics in
perio, endo and caries detection, foundations of occlusion and foundations of material science. We have had a
variety of lecturers from Manchester and beyond – including Peter Galgut on perio, Prof
Nigel Pitts from Dundee on
caries and Prof David Watts
from the University of Manchester
on
dental
materials. Each webinar is accompanied by critical reading
which for the most part can be
acce-ssed very easily using the
University of Manchester library. The library remote
access is really slick, and I
have been able to create a VPN
link (which means virtual
private
network)
so
that
I can download and print
articles. The technical helpdesk assistance has been
outst-anding
although
my
bill for printer ink has more
than trebled!
At this point, I am (still!)
a few lectures behind but I
have spent an enormous
amount of time in the last
few weeks catching up on reading and lectures. It is amazing how many hours can
whizz by when you are sat
at a computer with headphones
on and a notebook & pen by
your side – even 10-minute
bursts between patients, or
whilst the tea is cooking or
even after the kids are in bed.
‘Mummy’s doing her homework’ is becoming a familiar
tune in our house.

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• Reliable obturation of lateral canals as well as minimal risk of root fractures

Part of the final mark for the
course is made up from continuous feedback from each webinar – and there are self-assessment quizzes to take on-line to
assess your understanding. The
Msc website keeps a log of all
your completed and incompleted tasks, so there is a certain
satisfaction to completing reading, the webinar, the feedback
and the self-assessments – four
items ticked off the list! My only
complaint is that some of the
self-assessments aren’t working, which is frustrating but due
to a technical glitch.
Still – I have five questions to
answer in only 200 words each
for 20 marks before next week.
I’ve worked out that’s 10 words
per mark – not much room for
waffling on then...... better get
to it! DT

About the author

www.dentsplymaillefer.com

Elaine Halley BDS
DGDP (UK) is the BACD
Immediate Past President and the principal
of Cherrybank Dental
Spa, a private practice
in Perth. She is an active
member of the AACD
and her main interest is cosmetic and
advanced restorative dentistry and she
has studied extensively in the United
States, Europe and the UK.

[9] =>

Tribune_feb10:Precision

12/2/10

15:31

Page 1

United Kingdom Edition April 26-May 2, 2010

Ten reasons to be at
Clinical Innovations

Dental Tribune looks at some of the reasons why
this year’s CIC should be in your diary

Get 14 hours worth of
verifiable CPD at one of
the leading conferences
in the country for innovations
in dentistry.

Get your Core Subject
Medical Emergencies certificate with Joe Omar,
who will take you through a session of BLS (basic life support)
on Resus-Ann dummies and
also a demonstration of the correct use of an AED (automated
external defibrillator).
Medical Emergencies has the
reputation of being a rather dry
and theoretical subject. Not so
when presented by Dr Joe Omar.
Dr Omar is a Clinical Lecturer at
the Eastman Dental Institute and
runs a private practice in Dental Anaesthesia and Sedation in
Central London with more than
200 referring dentists.
In his lively and amusing
presentation Dr Omar will explain what constitutes an emergency and engage with delegates
about the time-critical ways to
tackle them. After establishing what problems may arise
in the surgery, delegates will
be shown the vital equipment
needed by every dental practice,
which falls into one of five key
categories; oxygen, resuscitation, drug box, portable suction
and defibrillation. Dr Omar will
then round up by describing the
key conditions likely to be encountered in the dental practice
including breathing difficulties
and choking and the best ways
to treat them.

Have a chance to speak
to the cream of dental
manufacturing and service at the trade exhibition. Representatives from each of the
companies will be on hand to
guide you through the latest innovations designed to make life
easier in practice.
Exhibitors include:
• The Dental Directory
• KaVo
• Enlighten
• Munroe Sutton
• Practice Works
• P&G Oral Health
• Osspray
• Wy10
• Costech
• Sybron Implant Solutions
• NSK
• Dental Protection Ltd
• QSIant

Learn how to manage
endodontic failure with Dr
Julian Webber.

Endodontic success rates
vary considerably around the
world from 50-90 per cent,
which implies that many endodontic treatments are failing.
The management of endodontic
failure is one of the biggest challenges practitioners will face in
modern dentistry, and as a result, many teeth are unnecessarily extracted and replaced with
implants. Widely recognised
as one of the country’s leading
voices in endodontics, Dr Julian Webber will be sharing his
views on how to manage endodontic failure.

Let your hair down and
raise some money as
Smile-on, the AOG and
The Dental Directory host the
glittering State of the Nation
Charity Ball. This will be held
on Friday 7th May at the London Marriott Hotel in Grosvenor
Square, London. The hotel is
situated in fashionable Mayfair
and just minutes from Park Lane
and Oxford Street. Speaking at
the charity ball will be two key
speakers expressing their opinions on ‘The State of the Nation.’
In addition to a delicious meal
and fabulous music, Channel
4’s Slumdog Secret Millionaire
Seema Sharma will provide food
for thought on giving something
back to dentistry.

Have the unique chance
to get ‘Hands-on’ experience in a variety of disciplines including whitening, facial aesthtics and periodontics.

Hear the leading speakers in the subject of
Whitening give their views
on the latest developments.
Speakers include
• Wyman Chan
• Trevor Bigg
• Sia Mirfendereski

has promoted the highest standards of medical practice.
In recent years, the College
has created exceptional conference, meeting and banqueting
facilities and is accredited to
many national and international
organisations such as Unique
Venues of London and the International Association of Conference Centres to name a few.
These facilities are enhanced by
an open display of treasures and
artefacts, making the College a
genuinely unique venue.

Broaden your horizons
with Dr Achim Schmidt
who will be discussing aesthetics and ethics. Dr Schmidt
will be drawing from his experience as a private practitioner in
Munich, Germany and also as a
frequent lecturer at national and
international meetings.

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reactions occur in individuals who are sensitised to
Natural Rubber Latex.

Meet the team at
Smile-on who will be
on hand to demonstrate how they can help with education and development for the
whole dental team using their
extensive library of products.
Come to the stand to hear about
e-learning solutions such as the
MSc in Restorative and Aesthetic
Dentistry, in conjunction with
The University of Manchester.
And as it is Smile-on’s 10th
Anniversary year you will be
able to find out the journey they
have made over the last decade
and their plans for the future of
healthcare learning. DT

The Clincial Innovations
Conference will take place on
Friday 7th and Saturday 8th
May at the Royal College of
Physicians in London.
For
more
information
please contact us on 020 7400
8989 or email info@smileon.com.

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Network with your colleagues and peers from
around the globe in a fantastic venue, The Royal College
of Physicians, Regents Park,
London. The Royal College
of Physicians is the oldest and most prestigious
English medical foundation, incorporated by
Royal Charter in 1518.
Since then, for nearly
500 years, the College

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[10] =>

10 Feature

United Kingdom Edition April 26-May 2, 2010

CQC - the three M’s
Now is the time to look at the three M’s: measure,
monitor and maintain says Seema Sharma

T

his article explores the key
outcomes and performance indicators expected
by CQC in the area of quality and
management. Practice management syst-ems take time to prepare and practices need to start to
think about this now, as there is no
quick fix for poor systems. As CQC
looms ahead for NHS and private
practices, our aim at Dentabyte
is to assist practice managers
and owners to meet the new
requirements by implementing sound management structures that will stand them in
good stead when registration
becomes mandatory.
Defining Quality
Quality is divided into three
domains: Safety, Clinical Effectiveness and the Patient Experience. Practices will be expected to
have a quality policy or statement
and to submit incident reports to
the Care Quality Commission.
These would include near misses
and health and safety breaches.
Measurement, monitoring and
maintenance of quality is best
done with a regular systematic
approach to audit.
Quality indicators for safety
Dental practices have a duty
to ensure that safety and safeguarding patients and team members is a priority at all times. (CQC
Section 3)
Safety is a wide-reaching subject covering general health and
safety, infection control and use of
radiation in dentistry, all of which
should be audited in practice at
least annually.
The Department of Health
have produced a comprehensive
infec-tion control audit tool for
practices to use covering:
• Prevention of blood-borne
virus exposure
• Decontamination
• Environmental design
and cleaning
• Hand Hygienie
• Management of dental devices
eg water lines
• Personal protective equipment
• Waste Disposal
This can be quite daunting to use, but help is available
from trained personnel to assist
with implementation of all safety
measures. All practices should
also be compliant with the new
vetting and barring scheme and
local child protection pathways,
and a range of other health and
safety audits are available from
the author as well as many large
dental organisations.

Quality indicators for clinical
effectiveness
The aim of dental treatment is to
repair the damage caused to teeth
and supporting tissues, and to provide personalised care, treatment
and support to prevent problems
in the future. (CQC Section 2)
A quarterly records audit provides
a sound tool for assessing if the
practice’s clinicians follow a consistent reproducible approach to
care. The audit should include a
range of indicators for each stage
of the patient journey including:
• Patient details
• Patient perceptions
• Detailed clinical records
• Risk assessment from
future disease
• Care Plan incorporating selfcare, professional prevention and
professional treatments
• Documented intervals for
preventive care
• Documented intervals for
recalls (oral health review)
Well kept records soundly
demonstrates
if
longitudinal
health improvements are made
at an individual level, and reflect the quality of the service
and management. Other software based tools are in development and will be useful for practice population measures of clinical effectiveness.
Quality Indicators for the patient experience
Informing and involving the patient at each stage of the journey
through your practice is the key to
keeping the patient at the centre of
your service and ensuring patient
satisfaction, return visits and referral of friends and family. (CQC
Section 1).
Patients want to feel they made
the right decision about visiting
the dentist. As it is reasonable to
expect a high standard of technical skill when visiting any professional, their experience and
satisfaction level is likely to be
determined by their emotional experience on three levels:
Did they like you?
Did they trust you?
Were they impressed by the
service you provided?

It is possible to capture the patient
experience in four easy ways:
1. The satisfaction questionnaire
At the end of a course of treatment
ask the patient at least two key
questions:
• How satisfied are you with the
care you received?
• Would you recommend our
service to friends & family?
A high positive response rate
(>90 per cent) to these questions
indicates a good quality service
and should be the whole team’s
goal at all times.
2. Comments and Compliments
Start to capture comments and
compliments via your website,
by email or in a simple book
at reception, and then make
a point to congratulate individual team members who have
been praised for attention to detail by a patient, and to pull up
and TRAIN those who did not impress. Staff attitude is the single
most important factor in whether or not patients come back or
recommend your practice, and
feedback is evidence of how high
the quality of your service is perceived to be.
3. Complaints Handling
Practices are expected to comply
with GDC guidelines and demonstrate attendance at core CPD
courses in complaints handling.
Successful complaints resolution
is often less about the incident
that upset the patient and more
about the way in which their concerns were addressed. Team skills
need to be developed in listening,
responding, acting and improving
to prevent future problems, and
this can only be done with dedicated time and training over a period of time.
4. Focus groups
Set aside time to invite patients to
a meeting and find out what they
want! The customer is the best
judge of what he or she wants!
Timely reorganisation of management structures in coming
months will ensure that you achieve hassle-free CQC registration
in 2011. DT

Relevant CQC Regulations
The following regulations are relevant to this section:
Regulation 8: Assessing and monitoring the quality of service provision
Do you identify, monitor and manage risks to people who use, work in or visit your
service?
Do you seek professional advice in areas where your knowledge is deficient?
Regulation 17: Complaints
Do your patients know how to compliment or complain about your service?
Do you have systems in place to listen, respond and learn from complaints?
Regulation 25: Statement of purpose
Do you have a statement of purpose and quality assurance that you can give to the CQC?

[11] =>

[12] =>

12 Practice Management

United Kingdom Edition April 26-May 2, 2010

The good old days?
With fewer quality systems and employment laws in place, working as a dental
nurse in the 1970s was a lot easier. But were things really as good as they seemed at
the time? Jane Armitage reminisces

hen I was asked by
the Editor of Dental
Tribune to consider
writing a monthly column it
was suggested that I write topics
on various subjects that you the
readers would find interesting.
With this in mind, I’ve decided
to look back and reminisce at
my own career, hoping some of
you will feel compelled to share
your own memories with me.

‘My surgery life was over, as the hospital
tried to get my medication right.
I continued to work though, but now
as a receptionist’
a paper towel, to name a few.
We worked hard, but when you
look back, exactly what did
we have in place? Where were
the quality systems then? The
Health & Safety Act 1974 had not
yet been introduced, and neither
had COSHH which came later
in 1988.

I left school at the age of 15
with no qualifications. I didn’t
want to continue with any further education – I felt I had
served my time and now I wanted the money. After all, at 15 you
know it all, or at least you think
you do at the time.
My initial chosen career
was to be a train announcer, I
could visualise myself saying in
my Northern accent: ‘The train
arriving at Platform 5 is the
6.20pm to Llanfairpwllgwyngllgogerychwyrndrobwillantlysiligogogoch.’ So off I went to
our local railway station to request an application form. After listening to my request for
a form I was flatly told ‘sorry
we only take people who have
a mobility disability as this is a
seated job.’
Hang on, where was the
Equal
Opportunities
Policy
when I needed it? The fact was,
the wasn’t one. The Equal Pay
Act 1970 had been introduced,
but nothing else, so it was back
to the drawing board for career
ideas. It was while I was on holiday one year in Brixham, South
Devon, that I found my new career path.

‘Good old days’ of dental nursing? Image courtesy of BADN

Talking to the landlady at
our boarding house, she asked
me what did I want to do. I said I
had no idea, and she went on to
tell me about her daughter who
had been working as a dental
nurse in the local practice and
how much she loved it. This inspired me to try dentistry. But
would I be a suitable candidate,
especially as I had once run
away from the dentist as a child,
leaving my dad to explain? Dentists, extractions and Jane didn’t
go together.
Nevertheless, I applied to
a local dental practice for the
position of trainee dental nurse.
The pay was £4.50 per week.
I had arrived. I was loaded,
until my mother mentioned the

word “board”. Suddenly my pay
was reduced to £3 a week and
all the years of being fed and
supported came to a halt. I had
to pay to live and what a shock
to the system it was – as if working wasn’t enough!
A natural talent
Surprisingly, I took to the job
like a duck to water; I loved every minute of surgery work. As it
is now, every day was varied. I
spent my time charting, working chairside, sterilising instruments in either Dettol or
boiling water, I didn’t wear
gloves or eye protection, maintaining the aspirator bottle by
emptying it down the drain,
cleaning the bottle by hand,
collecting blood and saliva on

Failing health
It was during the first 18 months
of my dental nursing that I became ill. I started to have seizures that were diagnosed as
Petit Mal Epilepsy. My surgery
life was over, as the hospital
tried to get my medication right.
I continued to work though, but
now as a receptionist.
Gone were the days I would
work alongside the dentist I had
become attached to. Working
alongside him was a story in itself. I was frightened to death of
him and I quite often received a
smack on the hand while nursing, usually for doing something
I was unaware of, but I enjoyed
the experience all the same.
Gone were the days I would
watch as he accidentally caught
a patient’s toupee on the end of
the high-speed drill, sending it
whizzing around and around,
before placing it back on the patient’s head back to front, as he
apologised profusely. Oh, how I
miss the 1970s surgery days.

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our NHS compliance
anymore".
Dental Air has one of the best customer service reputations in the
dental industry, and with our fast call out times, it is no surprise that
we are the leading supplier of oil-free compressed air packages.

My illness finally took over
and I had to leave dentistry, until
the time came when I was fully
controlled by medication. The
Disability Act was introduced in
1975, which I could have done
with earlier as I had already been
sacked from one position for being epileptic.
The moral of this article is to
give a little insight into how I became involved in practice management, and how the limitation
of employment law has affected
my own life. Were they really
the good old days? Perhaps this
is something we can discuss another day. DT

About the author
Jane Armitage is an
award-winning practice manager and
has almost 40 years
industry experience.
She is currently a
practice manager for
Thompson & Thomas, and holds a Vocational Assessors
award. She is also a BDA Good Practice
Assessor, BDA Good Practice Regional
Consultant, and has a BDA Certificate
of Merit for services to the profession.
She has her own company, JA Team
Training, offering a practice management consultancy service, which includes on-site assistance covering all
aspects of practice management with
a pathway if required for managers to
take their qualification in dental practice management. If you’ve any memories of the early 1970s or any specific
choices of topics you’d like addressed,
call Jane on 01142 343346 or email janearm@tiscali.co.uk.

[13] =>

Practice Management 13

United Kingdom Edition April 26-May 2, 2010

Getting to know you

usually require a ‘Because…’
answer, and such answers can
provide a useful insight into the
patient’s attitudes, priorities,
preferences and behaviour.

A detailed history is an essential element in understanding the
background to a patient’s oral health and planning effectively for
their present and future treatment - Dental Protection

Four specific areas of the pa0.9
tient’s history are worthy of particular consideration in this brief
0.8
overview: 0.7

• Medical history

0.6
• Dental history

Plaque removed (Turesky)

• Personal/social history
0.5
0
30 of60
120 150 com180 210
• History
the 90
presenting
Brushing time (seconds)
plaint (if any)
General observations
Creating any history about a patient is essentially an information
gathering exercise. Specific techniques can usefully be employed
to maximise the effectiveness of
the process. The experienced clinician will choose between the
1.1
available techniques according
to the communication abilities of
1.0
the individual patient that they
0.9
are dealing with.
0.8

Closed questions

0.7
There are times when you need

a definite ‘yes’ or ‘no’ answer to
0.6
a specific question. The first
0.5
stage
screen0 of
30 medical
60
90 history
120 150
180 210
ing may Brushing
be onetime
such
occasion.
(seconds)
Such questions are sometimes
called ‘closed’ questions because there is little or no opportunity to obtain a more detailed
reply from the patient. A direct
‘yes’ or ‘no’ is exactly what you
are looking for. Closed questions
can also be useful when dealing with patients whose answers
tend to stray from the purpose of
the question.

à DT page 14

36
Enamel SMH recovery (%)

Plaque removed (Turesky)

NEW EVIDENCE FOR THE BENEFITS
OF INCREASING BRUSHING TIME
1.0
0.9
0.8
0.7
0.6

35
34
33
32
31
30

0.5
29
To motivate
behavioural
change, it helps if patients
understand the benefits
0
30
60
90 120 150 180 210
0
50
100
150
200
of brushingBrushing
for attime
least
2 minutes twice a day with fluoride
(seconds)
Brushingtoothpaste,
time (seconds)
compared to an average brushing time of around 46 seconds.1

New research results from Aquafresh show that increasing brushing time:
36

Recommend a great
tasting fluoride dentifrice
to encourage your
patients to brush for
longer, for increased
fluoride protection and
plaque removal

35 cantly increases plaque removal
Signiﬁ

• 26% more plaque removal
was observed with brushing
for 120 seconds36
compared
with 45 seconds*2

34
In vivo brushing clinical study 2
33
1.1
32
1.0
31
0.9
30
0.8
29
50
100
150
0.7 0
Brushing time (seconds)
0.6
0.5

120

150

200

180

210

Brushing time (seconds)

Enamel SMH recovery (%)

1.0

‘Why’ questions
These questions, which are a
specific kind of open question,
can be extremely useful. They

1.1

Plaque removed Enamel
(Turesky)SMH recovery (%)

Plaque removed (Turesky)

If, on the other hand, there
is a clear answer – perhaps in a
medical history questionnaire
which has been completed (and
preferably, signed and dated) by
the patient on a particular day,
then there can be no doubt that
the clinician asked the relevant
question and was entitled to
work from the assumption that
1.1
the answer(s) given were correct.

municative patients, or when
you are hoping to gather information of a better quality, and in
greater detail.

they require the patient to provide more information for you
in their reply. This is often helpful when dealing with less com-

35
34
33
32
31
30
29

100

150

200

Brushing time (seconds)

Signiﬁcantly increases ﬂuoride uptake and enamel strengthening
In situ enamel remineralisation clinical study

36
Enamel SMH recovery (%)

efore providing any treatment, it is a clinician’s responsibility to ask the right
questions, in the right way, and to
listen carefully to the patient’s responses. If an important aspect of
a patient’s history does not come
to light in the consultation process,
and problems arise as a result of
this, attention tends to focus upon
the clinical records and what they
do (and do not) contain. In the absence of any evidence that certain
key questions were ever asked, it is
extremely difficult to demonstrate
at a later date that they were.

‘Shopping list’ questions
This approach is a little like a
multiple-choice test, where you
give the patient several possible answers to choose from. For
example ‘What makes the pain

• Surface microhardness
(SMH) increased in a linear
fashion over the period
30–180 seconds*3

34
33
32
31
30
29

100

150

200

Brushing time (seconds)

* p<0.05

References
1. Beals D, Ngo T, Feng Y, et al. Development and laboratory evaluation of a new toothbrush with a novel brush head design. Am J Dent 2000; 13: SpIss 5A–13A.
2. Gallagher A, Sowinski J et al. The effect of brushing time and dentifrice on dental plaque removal in vivo. [Accepted for publication in J Dent Hyg]
3. Zero DT, Creeth JE et al. The effect of brushing time and dentifrice dose on fluoride delivery in vivo and enamel surface microhardness in situ. [Manuscript submitted]
AQUAFRESH is a registered trade mark of the GlaxoSmithKline group of companies.

Open questions
These questions tend to begin with… What? Why? When?
How? etc and because of this,
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[14] =>

14 Practice Management
ß DT page 13

worse?... is it hot things?... or cold
things?... or biting on the tooth?’...
and so on. They can be useful when dealing with patients
who seem not to understand the
meaning of open questions and
can thereby speed up the information gathering process.
Leading questions
These questions tend to be worded
in such a way as either to suggest

the answer or to invite a specific
reply. For example ‘You have been
wearing your appliance, haven’t
you?’ They can be useful when
trying to establish confidence and
communication with a nervous,
quiet, or uncommunicative patient but are of limited value when
seeking specific accurate information, or a more detailed reply.
Medical history
One of the first principles one
learns at dental school is that of

2453 DPL ad A4:Layout 1 10/08/2009 09:18 Page 1

United Kingdom Edition April 26-May 2, 2010

the importance of taking a detailed
medical history before treating
any patient. Most dental schools
have their own design of medical
history questionnaire, and this
shapes the format, style and extent
of any further questioning of the
patient on particular points arising from the medical history.
Many practices, in similar
fashion, take commendable care
in designing and using their own
medical history questionnaires

which patients are asked to complete when attending the practice
for the first time. In most cases
the design provides for the patient
to answer ‘yes’ or ‘no’, to a set of
specific predetermined questions,
and then to sign and date the completed questionnaire. The dental
surgeon then ensures that the
patient has properly understood
all of the questions (for example,
where patients leave one or more
answers blank), and where ‘yes’
answers have been given, further

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questioning of the patient will
allow the details of any response
to be clarified and expanded
upon. Sometimes this highlights
areas where further information
needs to be gathered – perhaps by
contacting the patient’s medical
practitioner, perhaps by asking
the patient to bring any medication they are taking along to the
next visit, so that the precise
drugs and dosages can be identified with certainty.
In several recent cases, the
patient’s medical history has
been at the heart of negligence
claims brought against dentists
and other dental team members.
It is crucially important, for example, to investigate the nature
of heart murmurs, or other functional heart disease, in order to
decide whether prophylactic antibiotics are indicated to prevent
the risk of infective endocarditis.
Infective endocarditis is a serious and life-threatening disease,
and most patients are left with
permanent damage which has
the potential to shorten their life
and/or restrict its quality. Damages in such cases are therefore
very high indeed, often including
a lifetime’s loss of earnings.
Other recent cases have involved, for example, a failure to
take into account certain allergies to drugs (especially penicillin and other antibiotics), or
to recognise the significance of
long-term aspirin medication
predisposing to postoperative
bleedings, or to recognise the potential for drug interactions.
Cases such as these often reveal the fact that although a practitioner might have taken a comprehensive medical history when
the patient first attended as a new
patient, this process has either
not been repeated, or has been
much more superficial, when
the patient has returned for successive courses of treatment. In
the majority of cases, no further
written medical history questionnaire is ever undertaken, and
indeed there is rarely any note
on the record card to confirm
what (if any) further questioning has taken place to update the
patient’s medical history. This
can be a considerable embarrassment when the patient has
attended the same practice over
a large number of years, and the
practitioner is apparently still relying upon the patient’s original
medical history details.
It is self-evident that a patient’s medical status is not static,
and indeed, a patient’s medication prescribed by others may
change from visit to visit – it is
prudent, therefore, to ensure not
only that changes in medical history (including medication) are
regularly checked and updated,
but also that this fact is clearly
recorded as a dated entry in the
patient’s clinical notes.

[15] =>

United Kingdom Edition April 26-May 2, 2010

‘any clinical examination is still only
a snapshot of a
patient’s dental and
oral tissues at a moment in time’
Many practices take medical
histories verbally and if no positive or significant responses are
elicited, an entry such as ‘MH
– nil’ is made in the records.
While better than nothing at all,
this approach carries the disadvantage that it can be difficult or
impossible to establish precisely
what questions were asked of the
patient, in what terms, and what
answers were given. Clearly, a
well structured medical history
questionnaire form, which is
completed, signed and dated by
the patient, and subsequently updated on a regular basis (ideally,
during each successive course
of treatment), is not only in the
patient’s best interest, but is also
the best platform for the successful defence of cases where failure
to elicit or act upon a relevant aspect of medical history leads to
avoidable harm to the patient.
In all cases, the taking and
confirmation of a medical history is the role of the dental surgeon and is certainly a key part
of a dentist’s duty of care. If in
doubt, it may be sensible to defer
treatment pending clarification
of any areas of uncertainty in a
patient’s medical history.
Dental history
However thoroughly it is carried
out, any clinical examination
is still only a snapshot of a patient’s dental and oral tissues at
a moment in time. While it will
provide a lot of useful basic information, the clinician’s understanding of the patient’s presenting condition is greatly improved
by knowing how the patient
reached the present position.
• Is the patient a regular or
irregular attender?
• What treatment has been
provided in the last five years?
• Is there a history of fractured
teeth/fillings?
• Are any teeth painful
or sensitive?
• If so, what causes any
such sensitivity?
• Do the patient’s gums
bleed on tooth brushing or
spontaneously?
• Is the patient apprehensive
about receiving dental care?
• If so, do these concerns
relate to any particular
dental procedure(s) or to the
experience in general?
• Has the patient experienced
any particular problems
associated with treatment
provided for them in the past?
If so, what?

Not only will questions like
those above help to inform the
clinician regarding areas which
may or may not need treatment,
or which should be kept under
review, they will also guide the
clinician regarding the success
(or failure) of treatment approaches that have been tried in
the past. If this knowledge helps
the clinician to avoid repeating
the previous mistakes of other
clinicians, it can also help to
avoid claims and complaints that
might otherwise have resulted.

found affect on an opera singer,
lecturer or telephonist than for
an agricultural worker who did
not depend upon singing for his
livelihood. Similarly, there are
many jobs in which appearance
is important and an adversely altered appearance can either lose
a patient a job or severely affect a
patient’s confidence, particularly
if they have to face the public in
their working life. Awareness of
information such as this is critical when contemplating any aesthetic/ cosmetic procedures.

Social history
The social history should include
details of employment (and interests, hobbies, etc) as well as
other social and family related
information. The patient’s occupation should be included in the
consideration of relevant factors
affecting diagnosis, treatment
planning, consent and treatment,
bearing in mind the fact that this
is an aspect of a patient’s history
that may change as time passes.
It is worth establishing a routine
of checking the patient’s contact
details and employment, when
carrying out a periodic update of
the patient’s medical history.

History of present complaint
When a patient attends with a specific problem it is helpful to know
how long the problem has existed,
when it was first noticed, whether
it has ever occurred before, whether any previous treatment has
sought to resolve the problem and
if so, with what success.

The ability to attend for appointments could affect the
success of complex or extensive treatment, eg crown and
bridgework, implants, long term
periodontal treatment and orthodontics. Certain occupations can
place severe constraints on a patient’s ability to attend regularly
for appointments.
Issues relating to a patients
employment or recreational interests have also been known to
have an impact on treatment:
For example:
• Bruxism in air traffic controllers, marathon runners and
certain other sports players
• Aerodontalgia in (pilots and
cabin crew)
• Stress and its relation to periodontal disease (including episodes of pericoronitis involving
young adults in the armed forces,
or studying for examinations)

If the patient is complaining
of pain, for example, it is helpful
to know what kind of pain it is
(dull ache, or throbbing, or acute
bursts of pain), or how long it
lasts, and what makes it worse
or better and whether it has occurred previously and if so under what circumstances.
Each of these findings needs
to be recorded carefully in the
notes to demonstrate this important part of the diagnostic
process. The significance of this
becomes apparent on occasions
when a mistaken diagnosis is
made. If, however, the diagnosis
is supported by the information
which was available to the clinician at the time, as noted in the
records, such situations can often be defended successfully.
Summary
It will be appreciated that there
is very little value in gathering information from the above
sources if the responses are
not collected and recorded in a
clear and logical fashion. Having a structured and systematic
approach to history taking and
record keeping makes it less
likely that critical information
will be overlooked, or lost.

The outcome of treatment
can have a general effect or a
more specific effect on a given
patient. For example, chronic severe pain, which can arise from
some form of nerve damage, or
TMJ/muscle disturbance associated with dental procedures,
or perhaps a facial paralysis, or
permanent loss of sensation in
the lip or tongue, would all be
likely to reduce the quality of life
for most patients.

Later in the treatment planning process, when it becomes
a little clearer what treatment
possibilities are under consideration, it may be necessary to
explore some aspects of the history in greater depth, in order to
ensure that the patient is aware
of any way in which their treatment (and its prognosis) might
be affected by some aspect of
their history. DT

On the other hand, the loss
of ability to articulate clearly
when speaking or singing, because of a change in anterior
tooth shape, position or angulation, or perhaps because of lingual or inferior alveolar nerve
damage, would have a more pro-

Dental Protection is the world’s largest
specialist provider of dental professional indemnity and risk management for
the whole dental team. The articles in
this series are based upon Dental Protection’s 100 years of experience, currently handling more than 8,000 cases
for over 48,000 members in 70 Countries. Email querydent@mps.org.uk or
visit www.dentalprotection.org.

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[16] =>

16 Money Matters

United Kingdom Edition April 26-May 2, 2010

The incorporation process
Michael Lansdell aims to answer the basic
questions about incorporation that all dentists
operating as sole traders or in a partnership
should be asking

ver since the General
Dental Council (GDC)
amended the regulations
to allow dentists to trade through
limited companies from July
2006, the issue has been clouded
with speculation and misinformation that has deterred many
practitioners from investigating
the possibilities.

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While it’s true that incorporation will not suit every practice, the decision should at least
be made in full knowledge of
the facts. Individual practice
circumstances vary widely, and
objective, professional advice
should always be sought before
a change of status is contemplated. This article is dedicated
to answering the basic questions about incorporation that all
dentists operating as sole traders
or within a partnership should
be asking.
What is incorporation
Incorporation is the process
that transfers the ownership of
an existing sole trader dental
practice or partnership to a limited company (usually newly
formed). Incorporation is now
an option for practice principals
and partners, and also for selfemployed associates.
What is a limited company?
A limited company is a separate legal entity, with its own legal identity, which is owned by
one or more shareholders and
managed by one or more directors. In a sole trader or a partnership, both ownership and
management vest in the sole
trader or partners.
What does ‘limited’ mean?
Assuming the company has not
traded fraudulently or recklessly, and the directors or shareholders have not given creditors
any personal guarantees, their
liability for the company’s debts
is limited to their original investment in the company. This is
usually a nominal sum between
£1 and £1,000.
Are there any special rules
for dental practices?
Yes. The GDC requires that a
majority of the directors in a
dental practice limited company
are registered with the GDC, but
there is no GDC restriction on
who can be a shareholder.
How will I be paid?
Directors in a limited company
may become employees and be

paid a salary as well as receiving
both taxable and tax free benefits. Taxable benefits could include private medical insurance,
a company car etc, while tax-free
benefits (within certain limits)
include child care vouchers and
pension contributions.
Shareholders in a limited
company receive dividends,
which represent their share of
some or all of the company’s net
profit after Corporation Tax has
been paid.
How does the limited company work?
Because it is a separate legal
entity, the company has it own
bank accounts, assets and liabilities, employs staff in its own
name and enters into contracts
in its own name.

‘A limited company
is a separate legal
entity, with its own
legal identity, which
is owned by
one or more shareholders and managed by one or
more directors’
Some limited companies
have a company secretary who is
responsible for keeping the statutory records of the company up
to date and filing fiscal returns.
In smaller companies, such as
dental practices, these duties are
usually carried out by the practice’s accountants.
How do I convert my sole
trader business or partnership to a limited company (incorporation)?
1) Set up a new limited company
at Companies House (usually
done by accountants), with you
and any partners as director(s)
and shareholder(s). The shareholders can also include any one
else involved in the business,
family members for example.
2) Open a bank account in the
name of the new company.
3) Have your practice valued by
a reputable expert, with separate
valuations for the physical assets
(equipment, furniture etc) and
the goodwill.

4) Sell your practice assets and
goodwill to the new company
(freehold land and buildings are
usually excluded) using a sale
of business agreement prepared
by a solicitor. Capital Gains Tax,
normally 10 per cent, is payable
on any profit on the original
practice purchase price.
5) Decide whether the limited
company should immediately
borrow the money to pay you
for the practice, enabling you to
repay non tax-deductible personal debts, a mortgage on your
home for example; or maintain
a loan due to you, which can
be drawn on free of tax until it
is paid off to defray your normal living expenses. If you
choose deferred payments, the
terms should form part of the
sale agreement.
6) All your existing contracts,
including PCT contracts, should
be transferred into the name of
the new company; PAYE registrations should be reregistered
to the new company; and direct debit and standing orders
switched to its bank account.
7) You have now ceased trading as a sole trader, and
your practice is trading as a
limited company.
Of course, this is only a brief
summary of the incorporation
process and cannot take into account individual practice differences. As we stated at the outset,
a limited company may not be
the ideal trading vehicle for everybody, and the value of professional advice cannot be overstated, but for those who do choose
this route, the mechanics of conversion are straightforward. In
later articles we shall be assessing the potential benefits. DT

About the author
Michael Lansdell was
brought up in South
Africa, receiving his
honours degree there
in 1991. He completed
his training with international accounting
firm Deloitte in 1994,
and went on to become a founding
partner at Lansdell & Rose Chartered
Accountants (SA) a year later. Based in
Kensington, London, Lansdell & Rose
deal only on a long-term retained basis, exclusively with owner-managed
clients, generally dentists and doctors,
and specialising in the incorporation
of dental practices. As a client-focused
team, they look for sustainable longterm solutions for their clients that
maximise profits, minimise tax and
build wealth. For more information,
visit www.lansdellandrose.co.uk or
call 020 7376 9333.

[17] =>

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[18] =>

United Kingdom Edition April 26-May 2, 2010

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hatever
their
personal ‘green’
credentials, most
dentists will have heard talk
of the Copenhagen climate
summit in recent months.
But whether you’re a bona
fide eco warrior, or you believe that climate change is
all just a load of hot air, all
practitioners had better sit
up and take notice. Decisions
that emerge from these talks
will affect us all, and the energy efficiency of all commercial properties is now in
the Government’s firing line.

Time to check the green credentials of your practice

Since October 1 2008, all
commercial buildings more
than 50 square metres require,
by law, a commercial Energy
Performance Certificate (EPC)
whenever they are built, modified, rented or sold. According to The Carbon Trust, this is
simply not enough if we are to
hit the Government’s target to reduce CO2 emissions 80 per cent
by 2050. Now, the Trust is calling
for a massive drive to improve the
energy efficiency of commercial
buildings, including the imposition of national minimum standards to improve the energy efficiency rating of buildings from
grade E to grade C by 2020, and
to grade A by 2050.
Inefficient properties
The UK has one of the oldest
and least energy-efficient building stocks in Europe, accounting for nearly half of the UK’s
carbon emissions. Many dentists
will be working in these energyinefficient properties, and if the
Carbon Trust’s calls do not fall
on deaf ears, practitioners will
have to prepare themselves for
making some substantial practice
alterations. But if this all sounds
like too much hard work and
expense, especially with so
many infection-control regulations coming into effect (a contentious issue in themselves),
practitioners should also consider the benefits the EPC can bring
to their dental practice.
All commercial properties
need them, but there are some
specific exceptions, details of
which can be found in the Government’s guidance documentation. EPCs must be provided in
the sales literature for the property, and as such, they act as a
catalyst for improving the energy
efficiency of a building.
Asset ratings
The EPC shows the energy efficiency of a building as an ‘Asset

‘The UK has one of the
oldest and least energyefficient building stocks
in Europe’
Rating’ in bands from ‘A’ for most
efficient, to a less efficient ‘G’ rating. The certificate also gives a numerical indicator of energy performance for each building based
on its standardised use. A Recommendation Report is produced as
part of the EPC process – a computer-generated document listing recommended changes that
could improve the asset rating.
An Energy Assessor can provide
advice and guidance on how best
to improve asset ratings, following an assessment of the property.
Most business owners are deterred by the process of obtaining
an EPC. A software model calculates the property’s energy performance, using data captured
from a site inspection, drawings,
specifications and manuals. A
‘zone matrix’ is then created for
each floor, which takes into account heating, cooling, lighting
and ventilation. This, together
with the shape and size of each
zone and floor are entered into
the software model, together with
details of the buildings construction materials. The energy model
is generated using the Simplified
Building Energy Model (SBEM)
which is a tool approved by the
Government for this purpose.
The main advantage for practice principals that The Carbon
Trust wants to promote is that better ratings translate into higher
perceived value in a market that
is increasingly environmentally
conscious. By installing more
energy-efficient lighting, better
insulation and modern boiler
systems that improve a building’s efficiency, in theory, dentists
should experience shorter void
periods and higher income for
sale prices.

A wise move
Given the pressure on the
Government to get cracking
on their carbon reduction
commitment,
decreasing
your practice’s CO2 output
would be a wise, pre-emptive move to protect your
practice’s future selling
power. For those practitioners who want to take things
to the next level of sustainability, the next stage is to
implement low and zerocarbon technologies. With
fuel costs rising, the viability of these improvements
is increasingly easy to justify
in financial terms.
With an EPC, the potential buyers or tenants will be
able to get an impartial report
of the likely running costs
energy use and the likely
costs of the existing building.
This makes it easier to compare
the likely energy costs of occupying seemingly similar buildings. A commercial EPC will
also allow sellers and landlords
to gain an insight into the areas
where energy performance and
efficiency could be improved
within their property.
However, whether or not
the practice’s value really does
increase along with its ratings,
the dentist has no choice but
to have their surgery rated and
logged on the Government’s
central database, as a commercial EPC is always required before you can lawfully complete
the sale or lease of a non-commercial property. Fines for the
failure to produce an EPC can
be anything from £500 to £5,000
depending on the property’s
rateable value.
Buying or selling a dental practice is a task not to be
undertaken lightly, with many
potential
stumbling
blocks
on the way. The addition of
the new environmental dimension to selling commercial property only serves to make matters that little bit more
complicated. DT

About the author
Andy Acton is director of Frank Taylor & Associates,
independent valuers and consultants
to the dental profession. Andy has
helped a number
of dental specialist banks develop their
services to the dental profession, including NatWest and Bank of Ireland.
For more information, call 08456
123434, email team@ft-associates.com
or visit www.ft-associates.com.

[19] =>

Clinical 19

United Kingdom Edition April 26-May 2, 2010

The perio-implant interface
Periodontal therapy not only promotes good oral health, it is also the cornerstone
for excellent cosmetic dentistry, says Dr Jose Zurdo

hen deciding how to
deal with a periodontally
compromised
tooth in a clinical situation, there
are a number of factors to take
into consideration. These not
only include the prognosis of
both the affected tooth and adjacent teeth, but also the periodontal stability of the rest of
the mouth, all of which play an
important factor in deciding
whether to treat the tooth or to
go ahead with the placement of
implants. Other vital factors to
remember are the patient’s bone
dimensions, their financial restrictions, and any cosmetic implications of treatment.
Early treatment
It is widely accepted among dentists that teeth affected by periodontal disease are unreliable
in the long-term, meaning that if
implant therapy is a consideration, it should be carried out as
early as possible.

Implant therapy is regarded as a safe and reliable method in the treatment of complete and partial endentulism,
however, it is also associated
with technical and/or biological complications, such as periimplantitis.
This
significant
and not infrequent complication
can result in bone and implant
loss, and seems to be more prevalent in periodontally compromised patients.

that clearly needed restorative
treatment and periodontal management. The case has been followed for eight years, which is a
reasonable time to evaluate its
Estetica A4 SELECTED:Layout 1
long-term outcomes.

The Case
This patient was a 47-year-old
male in good general health.
He complained of tooth mobility (particularly tooth 11), which
25/2/09 13:42 Page 1
had triggered his visit to the den-

tist. As a temporary measure, his
dentist had splinted the tooth (Fig
1). Upon examination, dramatic
bone loss could be seen (Fig 2)
with deep pockets and bleeding
on probing (BOP) in all areas. No

previous periodontal treatment
was reported other than occasional ‘scaling and polishing’,
and his oral hygiene was fair.
à DT page 20

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‘There is a lack of
data to act as a
guideline for our
choice of strategy’
In my view, treatment decisions should be based upon
scientific evidence. However,
there is a lack of data to act as a
guideline for our choice of strategy, and we are all guilty of being biased by our own clinical
experience! Our common sense
will often lead us to deal with
clinical issues only within our
‘comfort zone’.
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The
following
article
presents a case that presented
with extremely severe generalised chronic periodontal disease
Fig1

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[20] =>

United Kingdom Edition April 26-May 2, 2010

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ß DT page 19

After lengthy discussions
about the patient’s prognosis
and treatment options, his wish
to avoid removable prosthesis
was made quite clear, although
his cosmetic demands were low.
Extensive implant treatment was
beyond the patient’s financial
means, but he would consider
short arch dentition.
A full clinical examination
was carried out to evaluate the
extent and severity of the disease (pockets, bleeding, mobility, etc). Initial periodontal therapy included the removal of the
‘hopeless’ remaining molars and
tooth 11 (root resection). All remaining single-rooted teeth,
regarded initially as having a
‘questionable’ prognosis, were
subject to a course of non-surgical periodontal therapy.

Despite the impressive radiographic appearance of dramatically advanced
bone loss, the general
mobility
following
initial therapy was
degree 1 and all teeth
were functionally stable. Generally, bleeding and pockets improved substantially,
however a number
of sites in the lower
jaw still presented
deep pockets that
responded well to
periodontal surgeries
(Fig 3). Once full periodontal stability was
obtained (absence of
pockets >4mm, negligible presence of
BOP, good OH and physiological
mobility), a strict maintenance
programme was designed to
prevent reoccurrence of the disease (Fig 4 & 5).
Subsequently, an implant
was installed at 11 with simultaneous connective tissue
graft to improve the quality of
the soft tissue seal (Fig 6 & 7).
The implant was restored three
months later with a cemented porcelain-bonded crown
over a cast-to abutment (Fig
8). The patient has been followed for eight years without
any significant change to his
periodontal and perio-implant
condition (Fig 9). The only
relevant observation was the
deterioration of the conventional fillings present in
the
anterior
region
that
were getting old and needed
replacement.

‘it is increasingly
important to update
our skills in this
area of treatment
and provide a first
class service for all’
Points for discussion
This case illustrates the potential
of structured periodontal therapy (conventional non-surgical
therapy plus localised corrective surgical treatment and longterm care) to change the prognosis of very compromised teeth in
a highly motivated patient.
The prognosis of teeth is not
only dependent on the amount
of bone that has been lost – and
more importantly, what is left
– but also the ability to prevent
further bone loss. Both the patient’s wishes and local or anatomical factors will influence the
dentist’s chances of controlling
the disease.
Despite this, it is very well
documented that in the majority of cases periodontal therapy can be quite predictable.
The feeling of inevitability
that spreads among patients,
and the sense that the battle
has already been lost, is in many
cases, unjustified.
Although often overlooked,
periodontal tissues cannot be ignored. As patients become more
knowledgeable and discerning, it is increasingly important
to update our skills in this area
of treatment and provide a first
class service for all. DT

About the author
José Zurdo has
extensive
experience of general and
specialist practice.
After graduating in
Medicine (Bilbao,
1983) and General
Dentistry (Barcelona, 1986) he completed a Masters
in
Implantology
(NYUCD, 1995), a
Preceptorship
in
Periodontics (Houston, 1999) and an MSc in Periodontics
at the University of Gothenburg (2002)
with the approval of the European Federation of Periodontology. The Swedish
Board of Health and Welfare recognised him as a Specialist in Clinical
Periodontology in 2002. José currently
runs popular, hands-on periodontal
courses and study groups for all dentists interested in extending their skills
in this area. He is running courses at
the DARE training centre in Manchester. Please contact Suzanne@daretobedental.com or call 0161 830 7300 for
more information.

[21] =>

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[22] =>

22 Education

United Kingdom Edition

Options for dentures
Justin Stewart looks at what’s new in the world of denture teeth

very time I go to Dental
Showcase or talk to sales
representatives, I always
hear about the ‘latest and greatest’ new crown material, or new
companies with the patent for
the latest new idea. In comparison, materials relating to den-

tures don’t seem to have changed
much over the years.
However, I am happy to report that there is a new denture
tooth that, in my mind, is significantly different from the rest
of the teeth on the market and

should be of interest to dentists
wanting to give their patients
a choice. In the same way that
we might offer the patient two
or three options for an anterior
crown, why don’t we give patients different options for denture teeth?

Candulor products
There are two new products from
a dental manufacturer called Candulor. The first is a nano-filled
composite (NFC) tooth; it is based
on a urethane dimethylacrylate
matrix with organic filler. Abrasion measurements taken at dif-

April 26-May 2, 2010

ferent universities (Innsbruck
and Regensburg, both in Germany) show significantly better
abrasion values than other acrylic
teeth. The tooth also has a particular natural brilliance; its main
properties are outstanding resistance to abrasion, plaque resistance, colour and oral stability. Its
natural transparency and translucency create an opalescent
cusp, which, in many ways, looks
like a ceramic material. The
tooth is laminated, being a fourlayer tooth, and the neck is made
of PMMA, giving a good bond to
the denture material. From my
perspective, it is great to be able
to offer a patient a much harder
tooth, but one that still bonds
well with the denture based
acrylic, which, for example, is
arguably a potential downside of
using porcelain teeth.
Candulor has an interesting
occlusal set-up where it follows
the idea of the condyle sitting
in the glenoid fossa and they try
to reproduce this in the teeth
they manufacture. This creates
a mortar and pestle effect with
the cusp of one arch lying in the
bowl like fossa of the opposing
arch tooth. Although there are
differing views around the best
denture occlusion, most of us
who do a lot of work in this field
would argue that we are looking for balanced occlusion with
minimal interferences in lateral
excursions.
Good marketing
Overall, Candulor seems to have
hit on a great idea of being able
to provide harder teeth and a really good occlusal arrangement.
Candulor also have a gum-staining kit, and in my view, one of
the best things about Candulor is
that it has great visual marketing
aids for dentists and patients. If
you’re trying to inspire your dental technician to do really good
work, it is helpful to begin with
the end in mind, and Candulor
has produced maps of where
the staining should be placed to
produce the most natural gum
effects. These maps show where
the soft, medium and strong colours should all be placed. When
experienced, the technicians
can very quickly carry out gum
staining at the denture processing stage. DT
For more information about
trying the NFC teeth or gum
staining kits, contact Metrodent
on 01484 466 715.

About the author
Justin
Stewart
was the first qualified Biofunctional
Prosthetic System
(BPS) dentist in the
UK. He is a member of the American
Prosthodontic Society and the British
Society for the Study of Prosthetic Dentistry. Dr Stewart is dedicated to resolving denture-related problems through
teaching and training. For further information, please email Justin Stewart
at enquiries@thedentureclinic.co.uk.

[23] =>

DCPs 23

United Kingdom Edition April 26-May 2, 2010

Effective administration
Keeping on top of your paperwork helps prevent
all kinds of problems says Sharon Holmes

I

recently presented my first
public PowerPoint presentation at the Dentistry Show in
Birmingham. This was a huge
challenge for several reasons.
Firstly, I had never used PowerPoint as a tool. Secondly, the
thought of public speaking was
daunting. Finally, I had to make
the subject of administration
and financial management in
dentistry sound interesting.
So, how does one make administration interesting? The
answer’s simple. You keep it…
simple. Over the past seven
years or so I have learned to
make use of Excel spreadsheets
and Word.

I assumed that what I had to
share was being valued. This I
greatly appreciated – managing a dental practice is not easy
if you are attempting to follow
good practice principals, never

mind all the PCT requirements
being met to hold onto our
much needed NHS contracts.
Firm but fair
It is important to be direct and

audience in quick bursts of information instead of them trying to read your slides. I have
since carried in-house training
on customer care and for the
second time, I used PowerPoint,
which proved to be effective. It
sets a tone for learning, which
made the training more focused
and more enjoyable.

honest as well as approachable. I
have always had a good working
relationship with our staff, based
on these two fundamental parts
of running a successful practice
and a happy team. There is always a solution to every problem, as long as you address them
in a professional manner.
What I did learn about using
PowerPoint was that if you kept
it simple, clean and uncomplicated it held the attention of the

As Winston Churchill once
said, ‘Attitude is a little thing
that makes a big difference’. DT

PracticeWorks
KODAK R4 Practice Management Software

I demonstrated this during
my presentation by sharing the
company’s three most important spreadsheets used at the
end of each month. These are
also the same documents we
give to our bookkeeper monthly and our accountant yearly.
They show turnover for the
month, a bank deposit report
and petty cash report. All three
spreadsheets are used to collate
against each other. The system
is so closely monitored, should
there be an error in any particular area of a transaction on any
particular day, the three sets of
figures will not match, which
is an indicator the administrator needs to locate the error and
correct it.

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Monitoring performance
The above reports are only
three out of 17 month-end reports produced. I use these reports to monitor all the required
Key Performer Indicators that
inform me of the performance
of Dental Arts Studio.
At the beginning of my presentation, I wasn’t sure what my
audience would take away from
my talk to assist them in monitoring their financial performance. I become encouraged to
share my experiences when I
noticed some of my audience
scribbling away on notepads.

About the author
Originally
from
South Africa, Sharon Holmes has
worked in the field
of dental practice
management since
1992. In 2003, she
moved to London
City Dental Practice where after 18
months, was responsible for managing
four practices in the group. The London City Dental Practice is now part of
a mini co-operative group called the
Dental Arts Studio, of which she has
been instrumental in its creation.

Another breakthrough from PracticeWorks
PEARL is the new iPhone or Blackberry application for R4.
No longer are you restricted to viewing your appointments, patient records and images on a computer
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For more information or to place an order please call 0800 169 9692
or visit www2.practiceworks.co.uk/links/pearl.asp

PracticeWorks

www.practiceworks.co.uk

© PracticeWorks Limited 2010

[24] =>

24 Special Feature

United Kingdom Edition April 26-May 2, 2010

From windscreens to whitening
Dental Tribune looks at a new practice which has transformed an old windscreen
repair shop in Blackpool into a fabulous dental surgery

A

former widescreen repair
workshop might seem
an unlikely candidate for
conversion to a dental practice but
that was the choice for Ivory Dental Care to expand their Blackpool

practice back in December 2008.
The growing success of the four
dentist partnership meant the
team had just run out of space
in their existing premises. They
also wanted to be able to offer

new services to attract additional
private patients but their building
was bursting at the seams.
After a long search over nearly
three years and considering lots of

alternatives, the partners settled
on a former windscreen replacement workshop and purchased
the building in December 2008.
The short-term plan for the new
site was to provide two additional

surgeries enabling expansion of
the business from a four to a six
surgery practice.
When asked why they finally
decided on this building Elena
Barlow, the Practice Manager
explains “The location is fantastic, it is just a mile from our
existing practice which makes
working across both sites easy
for the team. The building also
has all important parking facilities which are difficult to find
in the more residential areas
around the town. It is also a vast
space, with plenty of room to accommodate the future needs of
the practice.”
Visualising the potential of the
former workshop must certainly
have been a challenge but Elena
recalls at the time just how convinced she was that it was right
for them. “It gave us the blank
canvas we wanted to be able to
design a practice from scratch.
With such a huge open space to
work with it granted us the freedom to put our imaginations to
work to design a state of the art
practice that would complement
our existing site and reflect the
ethos of the partners.”
Rightly, Elena is very proud
of the building’s transformation,
few would guess its original function. “We replaced the two huge
workshop doors at the front of
the building with floor to ceiling
windows. The massive expanse
of glass gives the whole building,
but especially the reception area,
a feeling of openness and space.”

Ivory Dental - Surgery

Ivory Dental Team

Ivory Dental - R

[25] =>

Special Feature 25

United Kingdom Edition April 26-May 2, 2010

Building, decorating and kitting out a new practice from
scratch meant the team had the
latitude to invest in exactly the
kit they wanted. Much of the
equipment was sourced from
McKillop Dental Equipment Ltd.
Elena explains “We’ve used McKillop many times before and have
always been happy that they
understand our requirements
and deliver on timescales. They
also come very highly recommended locally”.

been tricky, but with plenty of
discussion we were able to work
through differences in priorities
and tastes to come to an end result with which everyone is happy.
Fortunately the original partner
in the practice, Dr Woodhouse
had undertaken refurbishments
in the past so his experience was
invaluable throughout.” This close
involvement of the practice team
ensured the final product was
exactly what they had envisaged.
It also meant the project expe-

rienced few difficulties and was
completed to time and budget.
The new practice now accommodates two new surgeries, an
office for the practice manager,
sterilising facilities, a spacious reception and enough spare room
for the creation of an additional
four or five surgeries as and when
the extra capacity is needed. Elena is clear that the design of the
new building and particularly the
new reception space facilitates

an excellent patient experience.
“All our administrative activities
now take place behind the scenes
which means the receptionists
are dedicated to welcoming and
booking in patients and don’t
need to be distracted by phones
ringing or the hum of photocopiers and printers.”
Since opening at the end of
November 2009 patient numbers
have already increased by nearly
1,000. Across both practices, Ivory

Dental Care now treats nearly 9,000
patients with scope for significant
further expansion in the future.
Elena has no regrets about
the whole project but so far it
has certainly been all work and
no play. “Since the new building
opened work has been non-stop
so we still haven’t had an official
opening celebration for the staff.”
Surely something the Ivory Dental
Care team will work hard to prioritise this year. DT

New cabinetry, x-ray and
sterilising equipment and chairs
were all on the shopping list. Elena is clear about why they chose
the Clesta II Flexible Treatment
Centre and Voyager II Treatment
Centre both from Takara Belmont.
“We wanted chairs that would
look good in a contemporary setting whilst being functional and
reliable. Also, the Voyager Treatment Centre gives us the flexibility of right or left handed use. Our
existing practice uses Takara Belmont chairs and so we knew the
quality of what we were buying. In
the end the toughest decision for
the team was choice of colour! Both
chairs look fabulous against the
all-white decor of the surgeries.”
The main building works were
project managed by the building
contractor but were closely overseen by the partners and Elena.
“We had regular meetings with
the Project Manager on site so we
could keep abreast of the progress
being made, ensure that decisions were taken promptly so time
wasn’t lost and to ensure the work
stayed on track and to our requirements.” She is forthright in her
advice for anyone undertaking a
similar project. “Take time to plan
and then try hard to stick to it. In
other circumstances working with
four partners to agree on the layout, design and decor might have

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[26] =>

26 Chair

United Kingdom Edition April 26-May 2, 2010

A dec 500 Dental Chair
The A dec 500 dental
chair is by far the most
progressive chair created
for the dental treatment
room by A-dec.
When it comes to
optimizing
operator
access
and
patient
comfort, the A dec 500
dental chair makes no compromises. A slim-profile headrest and ultra-thin
backrest provide more leg room, so operators can work in a more comfortable
position. Meanwhile, the anatomically formed backrest and seat cushion cradle
patients by reducing pressure points and providing exceptional support. The
result is a chair that offers streamlined access for the dental team and, at the
same time, comfortable seating for patients.
Discover the integrated capabilities and outstanding ergonomics of the A
dec 500 dental chair as it is designed to deliver a higher level of functionality,
reliability, and customer support than any other dental chair available today.
For more information about the A-dec 500, please call your authorised dealer
or contact us on; 024 7635 0901.

Hygiene Matters
There are many cross infection
hazards within a dental surgery
which necessitate the need for
stringent legislation. Anything
that reduces the risk is therefore
generally well received within
practice. The seamless upholstery
on the Cleo II treatment centre
from Takara Belmont is one such
example; optimum hygiene is
ensured as there aren’t any crevices
for bacteria to escape the reach of
suitable disinfectants.
As well as making for a safer visit, the Cleo II is guaranteed to make your
patient’s experience a comfortable one. The ‘super soft’ upholstery range is
immediately comforting and luxurious to touch, whilst the unique folding leg
rest has benefits for both patient and practitioner. For the patient, it looks a
lot less intimidating when it’s inclined. The practitioner has multiple benefits
including a smaller foot print and a more logical working area.
If you would like to see the Cleo II in situ, without any obligation, you can
make an appointment to visit either the company’s London or Manchester
showrooms. For more information contact Lucy Moscrop (lucy@takara.co.uk).

World-Class dental chairs from
Clark Dental
Clark Dental is synonymous with
providing the ultimate in patient
chair technology and comfort from
the leading manufacturers.
Stern Webber offers a range of
dental chairs, incorporating the
latest innovations to prevent cross
contamination.
The S280TRc, with its suspended patient chair gives plenty of space
underneath the backrest area. The S280Trc embodies the Stern Webber ethos:
materials, systems and design of the highest quality.
Anthos is renowned for dental chairs that exude quality and style. Their Classe
A range has sold over 10,000 models worldwide.
The new Classe A7 provides the unrivalled quality dentists expect from
Anthos, by incorporating both imaging systems as well as hygiene systems
that meet European standards.
The A-Dec 500 dental chair is the epitome of quality, reliability and choice,
with flexible delivery packages to suit the needs of any practitioner. Full left/
right compatibility and a greater range of motion for exceptional positioning
means the A-Dec 500 can easily accommodate current and future needs.
For more information contact Clark Dental on 01268 733146
Email enquiries@clarkdental.co.uk or sales@clarkdental.co.uk

Castellini DUO Dental Chair
With 70 years of experience, Castellini is one of the
leading dental chair manufacturers in the world and
a name synonymous with combining technology and
style.
Constantly striving to provide the best, Castellini
offers a complete range of workstations to accommodate the individual
requirements of any practitioner.
The range of dental units from Castellini includes the DUO, a complete dental
system offering:
• Functional instruments for high quality performance • Immediate control
through a user-friendly console • Tension free instrument levers • Highest in
safety standards and cross contamination control
Available in Continental style delivery, DUO offers programmable instrument
technology, including the pre-setting of the Implantor brushless micromotor
torque parameters.
Programmable internal decontamination modes allow the operator to select
a choice of instrument tubing Rinse times - or the full Autosteril cycle (approx
15mins) via the soft-touch membrane control pad.
Castellini is well known throughout the dental profession for it’s quality,
cost-efficient products. With delivery, installation and 12 months warranty
all included in the price, Castellini units offer the highest standard of dental
equipment. For further information about the comprehensive range of
Castellini products call 0870 756 0219 or visit www.castellini.com

Sitting Pretty After 15 Years!
The Bambach Saddle Seat has successfully
been in production for 15 years. This market
leading seat is the only one of its kind to be
endorsed by the Australian Physiotherapy
Association and for a very good reason.
There are many cheap copies on the market
that do not necessarily have the clinical
papers or experience to back their claims.
Bambach has been proven time and again
over the years with more than 50,000 seats
sold worldwide.
The correct seating position using the
Bambach Saddle Seat can alleviate many
of the problems associated with muscle
fatigue by encouraging an improved sitting posture. This Seat helps to
maintain the natural s-shape of the spine, preventing the discs from being put
under pressure. The hips are kept at the optimum angle, so back and thigh
muscles are at their most relaxed. Bambach Saddle Seats are fully adjustable to
create a bespoke individual stool just for you.
The company are so convinced of the benefits that they are offering you a
free 30-day trial in your own practice. For further information please contact
Bambach directly on 0800 581 108

CEREC® 3D Systems
Why buy CEREC®
from Ceramic Systems?
Looking to improve your profitability, then you
need CEREC® from Ceramic Systems the UK CEREC®
Specialists! Only Ceramic Systems can offer you:• Dedicated Service and Support Engineers •
Countrywide Product Specialists for pre and after
sales support • Low cost finance arranged for you
• User meetings • Dedicated training facility
CEREC® enables Dentists to create high quality and durable chairside allceramic restorations in the most cost effective and efficient way. It is a
computer-aided method for creating precision fitting all-ceramic restorations;
saving Laboratory costs it enables Dentists to design and create all-ceramic
inlays, onlays, partial crowns, veneers and crowns for the anterior, premolar
and molar regions in one visit. Eliminating the need for impressions, CEREC®
utilises a digital impression taking technique to capture the data used to
design the restoration which is then milled in the milling unit.
Combined with adhesive bonding techniques, CEREC® creates biocompatible,
non-metallic, natural-looking restorations from durable high-quality ceramic
materials in a single treatment session - without the need for provisional
restorations.
For further information, contact Ceramic Systems Limited on 01932 582930,
e-mail j.colville@ceramicsystems.co.uk or visit www.ceramicsystems.co.uk

Support Chairs
Ergonomically designed for optimum comfort!
It is universally accepted that maintaining a
correct posture whilst at the chairside is essential
for operator efficiency, comfort and health. This is
particularly important during procedures, where
the clinician spends long periods bent over a
patient, staying relatively still in order to perform
intricate procedures.
Support Chairs’ Support Stools have been
developed for professionals working in sedentary
positions, where both body support and the ability to move freely are essential.
Manufactured to order they meet all the incumbent’s needs including specific
requirements on colours and materials. Support Chairs also offer a wide range
of accessories including new Swing and Swing Mini Armrests.
Easy to fit and convert between left and right handed operators, the Swing
Armrest offers a number of options for varied seating positions and is easy to
use with Support Chairs’ complete range.
The Swing Mini Armrest has the same features as Swing but is smaller.
Designed for use specifically with Support Stool, its smaller size suits their
beautiful and stylish design to perfection.
For further information contact your regular Dental Dealer or Support Chairs
on 01296 581764, fax 01296 586583, email sales@supportstool.co.uk or visit
www.supportstool.co.uk.

KaVo Units, unbeatable value!
KaVo Dental, the specialist
designers and producers of dental
surgery equipment to meet the
needs of the dental professional,
offer a complete range of units
to meet the budgets of the
discerning professional. The new
and outstanding Estetica E70 and
E80 units enhance the already
inspirational range, which currently
includes the Primus 1058 family of units.
All KaVo units are designed to combine superior levels of ergonomics, comfort
and efficiency whilst providing patient comfort and a practical, functional,
relaxed, ergonomical working position for the dental team.
The Primus 1058 is designed to offer all the quality and technology advantages
of a KaVo unit, with the added benefit of working flexibility. This unit allows
for permanent installation in either the right or left-handed position, whilst
offering ideal patient positioning including an offset backrest articulation axis
allowing the facility to adjust the chair for paediatric dentistry.
An exciting range of Gendex imaging products as well as cabinetry to enhance
this comprehensive range of surgery equipment, with the flexibility to fit all
working spaces.
For information regarding the full range of KaVo products, surgery planning,
flexible finance and rental schemes’ available Freephone 0800 218020.

KaVo ESTETICA E80 T/C: Outstanding
ergonomics in its most attractive form.
The ESTETICA E80 from KaVo allows for
a flexible adaptation to the individual
requirements of the dentist and patient,
making ergonomic working a reality.
The innovative suspended chair concept
offers an incomparable increase in freedom
of body and leg movement during treatment
whilst the horizontal adjustability of the unit ensures patient positioning
remains consistent.
Both the dentist’s and the assistant’s elements of the ESTETICA E80 are
provided with a future-proof configuration and an ergonomically perfect
instrument layout.
USB interfaces integrated into the dentist’s and assistant’s elements enable
USB-suitable equipment to be connected to the treatment unit and linked
with ERGOcom 4, at any time.
The ESTETICA E80 is provided with automated, standardised hygiene functions,
which enables simple, time-saving hygiene and prevents maintenance failures.
The ESTETICA E80 combines intelligent pioneering technology, materials and
functions. Thus, it offers the user the maximum in security of investment.
KaVo continues to produce exceptional products based on the needs of their
customers making sure they receive complete satisfaction.
For further information on the full range of KaVo Gendex products, please
contact KaVo on 01494 733 000, email: sales@kavo.com or visit www.kavo.com

Sident Dental Systems
Looking for Sirona Equipment, get it
from Sident!
If you are looking for any Sirona equipment,
get it from Sident Dental Systems, the UK’s
only Specialist Supplier of Siemens /Sirona
equipment. Only Sident Dental Systems
can offer you:• Comprehensive bespoke Project
Management Service for Surgery refurbishments • Factory Trained Engineers •
Product Specialists to advise on design, installation and on-site training • Low
cost finance packages for all products
So if you are considering reequipping make sure you talk to them!
Sirona Specialists, Sident Dental Systems offer the choice from the complete
range of Sirona Treatment Centres, 2D and 3D digital and film based x-ray
apparatus – including the very latest Galileos 3D digital cone-beam equipment,
their extensive range of Sirona handpieces, and auxiliary items including
SiroLaser, SIROEndo and the DAC Universal sterilisation unit.
Wherever possible potential clients are invited to visit The Courtyard, Sident’s
state-of-the-art training and showroom facility in Chertsey, where they will be
able see the complete product range in action.
For further information call Sident Dental Systems on 01932 582900 or email
j.colville@sident.co.uk

Designed to meet your needs
Henry Schein Minerva’s equipment division has expertise in every aspect of surgery
design and installation and in addition they have access to the widest range of
surgery equipment from the world’s leading manufacturers.
The full range of chairs available from Henry Schein Minerva incorporates the Sirona
TENEO - the ultimate chair in terms of style, innovation, craftmanship and quality.
Pelton & Crane’s chair creates a pleasant and comfortable patient experience whilst
the Belmont Voyager is a versatile option that fulfils every function you might need.
Henry Schein Minerva’s ‘Platinum’, ‘Gold’ and ‘Silver’ surgery groups help you
compare every chair based on price, features and value, so you can be certain that
you’re getting the best equipment for your individual needs and budget and a
range of leasing options make your new chair even more affordable.
For more information on the range of chairs available from Henry Schein Minerva
simply call 08700 10 20 41 or visit www.henryschein.co.uk.

[27] =>

United Kingdom Edition April 26-May 2, 2010

How to achieve a perfect class I and II posterior
restoration with DENTSPLY
SDR™ marks the beginning of a new generation of
posterior composites, perfectly complementing
the other products in DENTSPLY’s existing range.
Make sure you achieve perfect results every time by
following DENTSPLY’s step-by-step guide to posterior preparation.
DENTSPLY protocol
Prepare teeth using Hi-Di Diamond Burs, widely recognised as the ‘gold
standard’ in cavity preparation for fast cutting and low risk of fracture. For
successful class II restorations, be sure to use a contoured sectional matrix
system, such as Palodent that can be easily adapted to any residual tooth
surface, alternatively you can use AutoMatrix Bands.
Once the tooth is prepared and cleaned apply Xeno™ V, for an easy, selfetching bond. After light-curing the bond, place the new SDR, a durable
posterior flowable composite base (up to 4mm bulk fill) and light-cure for 20
seconds.
Next, for tough, long lasting restorations with great aesthetics place a capping
composite such as Ceram.X™ Mono and light-cure with the Smartlite PS LED
curing light.
For more information, or to book an appointment with your local DENTSPLY
Product Specialist, call 0800 072 3313, email enquiry-uk@dentsply.com or visit
www.dentsply.co.uk.

Simple and efficient filling
technique with SDR™
Dr. Steve Charlton of
Kingsclere Dental Practice,
Alton, has been trialling the
latest revolutionary new
product from DENTSPLY.
“Using the SDR™ filling
technique has made a
difference to the length of
the procedure involved.” It
is now simply a question
of dispensing the flowable
SDR™ up to just two
millimetres below the margin of the cavity, and then finishing with a single
layer of composite material: it’s certainly a quicker technique.”
“It makes life easier from the point of view of keeping the filling dry, as the
reduced time of the technique means having to keep the area isolated for less
time.”
“As with any new procedure, there is a period of adjusting, but this new
technique was very easy to pick up. I shall definitely be using it in the future.”
DENTSPLY is committed to bringing the most advanced technologies into the
UK dental market, assisting the provision of the highest quality in dentistry.
To arrange for a Sales Specialist to demonstrate SDR in your practice call +44
(0)800 072 3313 or visit www.dentsply.co.uk

Bonding regardless of the light conditions
The light- and dual-curing adhesive system
from Ivoclar Vivadent
ExciTE F and ExciTE F DSC are fluoridereleasing total etch adhesives from Ivoclar
Vivadent. The choice of the product to use
depends on whether or not the curing light
will be able to cure the adhesive.
In addition to being supplied in bottles and single-dose vessels, ExciTE F is
now also available in the new VivaPen delivery form. The amount of adhesive
contained in a VivaPen is sufficient for approximately 120 applications.
Impeded accessibility of the cavity
If the cavity is not accessible with the curing light or if chemically curing
composites are used, the dual-curing ExciTE F DSC (Dual cure Single
Component) material is indicated.
ExciTE F DSC is available in hygienic single-dose vessels in two sizes: “Regular”
for normal preparations and “Small” for micro-cavities and endodontic
applications.
Call 0116 284 7880 now, or speak to your local Ivoclar Vivadent Product
Specialist for more information.

bluephase (G2) “Top Light-Curing
Unit 2010”
bluephase has been named top
curing light of the year 2010 by the
independent US testing institute
“The Dental Advisor”. This is the
second time in a row that bluephase
has been awarded the “Top LightCuring Unit” title. The cordless high-performance LED light with polywave®
LED has outperformed all competitors – many of them newly launched
products – also in the second year.
The testing institute describes bluephase as follows:
• “This is a great light!” • “It’s great to have one light that cures everything!”
• “The sleek design and power are great!”

Contact
Ivoclar Vivadent Ltd, Ground Floor, Compass Building,
Feldspar Close, Enderby LE19 4SE
TEL: 0116 284 7880

Contact
Ivoclar Vivadent Ltd, Ground Floor, Compass Building,
Feldspar Close, Enderby LE19 4SE
TEL:0116 284 7880

Lincoln Street’s First
Velopex Picasso Laser
Lincoln Street in London is
now well and truly on the
map! Their first Velopex
Picasso Laser has been
installed at the Dental
Practice at number 6 which
can now offer all patients
the availability of laser treatments as well as the high quality dentistry
previously offered.
The Velopex Diode Laser contains two lasers: a 10 Watt Gallium Aluminium
Arsenate (GaAlAs) diode laser and a small laser pointer. The GaAlAs laser is ideal
for soft tissue (gum) work – as it does not interact with teeth or bone.

An award we are proud of
The award by “The Dental Advisor” can be specifically used as a unique selling
proposition for the bluephase marketing activities. For one thing, only one
product per category receives the award, and for another, it is remarkable that
an American testing institute has awarded a European manufacturer.

www.cosmeticdentistryguide.co.uk
Providing trustworthy advice on all cosmetic dentistry
procedures
The advent of technology has meant that with just a few
minutes spent on the internet, a patient can be witness to
information on a huge variety of cosmetic dental treatments
and procedures.
It can make treatment planning simpler if a patient has
researched a procedure, and has a clear idea of the results
they hope to achieve. However this is only true if the
information that the patient has been issued with is correct.
Ranked as the number one site for cosmetic dentistry by search engine
Google, www.cosmeticdentistryguide.co.uk is the best way to ensure that you,
and your patients, keep up to date with this ever-evolving industry.

The GaAlAs laser has a wavelength that makes it an ideal way to do minor oral
surgery. Using this laser, an area can be cut with localised haemostasis.
Dr Tan, who is no stranger to lasers said of the Velopex Diode Laser: “This is a
super unit, neat compact and easy to use.”.
Patient feedback continues to be very positive with many patients commenting
positively on the laser.

The Hogies Visor: Essential CostEffective Full-Face Protection
Enjoy high quality and reliable full-face
protection at a great price with the
Hogies Visor.
The refined design provides excellent
peace of mind for the wearer,
preventing the debris, bio-aerosols,
saliva and nasal droplets produced
during clinical work from coming into
contact with the wearer’s face and eyes.
Lightweight and adjustable, the Hogies
Visor promotes optimum comfort with
the perfect fit, even for clinicians who
wear prescription spectacles.
Also, to maintain the condition of the shields themselves, they are packaged
with a protective coating, to ensure optimum quality.
Providing full-face protection that fits within the budget of every practice,
each Hogies Visor frame comes complete with 10 disposable shields (refill
packs of 10 shields are available).
To support the colour scheme and identity of the practice, a number of striking
colours are available, including blue, purple, red, pink, lime, yellow and white.
For more information please call John Jesshop of Blackwell Supplies
on 020 7224 1457, fax 020 7224 1694 or email john.jesshop@blackwellsupplies.
co.uk

Once visitors have researched their planned procedures on the site, and asked
the online-panel any final questions that they still have, the ‘Find a Cosmetic
Dentist’ search facility helps potential patients locate local practitioners, and
directs them straight to the practice’s website.
To find out more visit www.cosmeticdentistryguide.co.uk

Dentomycin: An Effective Adjunctive
Treatment for Periodontal Disease
Dentomycin
Periodontal
Gel
from
Blackwell Supplies is an effective
treatment of moderate to severe chronic
adult periodontal disease, when used in
conjunction with scaling and root planing.
Supplied in easy to use, pre-filled
applicators that allow the delivery of the
gel directly into the periodontal pocket
for immediate effect, Dentomycin binds
to the tooth’s surface and is released slowly to attack the bacteria causing
periodontal disease.
The combination of SRP and Dentomycin can reduce pocket depth by an
average of 42% in just 12 weeks , whilst the anti-inflammatory effect and
the inhibition of destructive collagenases helps promote connective tissue
attachment.
Dentomycin Periodontal Gel from Blackwell provides a cost effective and
proven method of enhancing periodontal treatment.
Since keeping gums healthy is vital to the patient’s overall health, Blackwell
has created a leaflet offering advice and guidance about preventing and
treating gum disease. ‘How healthy are my gums? - Help and advice on your
oral care’ is available free to all practices and patients.
For more information please call John Jesshop of Blackwell Supplies
On 020 7224 1457 or fax 020 7224 1694

Industry News 27

DDU and UCL Eastman Report Successful CPD Conference Initiative
The DDU and UCL Eastman Dental Institute hosted a successful CPD conference
on 19th of March aimed at general dental practitioners and specialists on
clinical and dento-legal best practice in the field of Restorative Dentistry.
The conference, opened by Professor Stephen Porter, Director of the UCL
Eastman Dental Institute and chaired by Professor Andrew Eder, Director of
Education and CPD at the Eastman, brought together experts who shared their
knowledge and advice on Endodontics, Periodontics and Prosthodontics with
approximately 100 delegates.
Conference speakers from the DDU included Dr Rupert Hoppenbrouwers,
Head of the DDU and Dr Bryan Harvey, Deputy Head of the DDU, and Charles
Dewhurst, Head of Legal Services at the DDU. The Eastman’s clinical team
included Professor Kishor Gulabivala, Head of Endodontics, Professor Nikos
Donos, Head of Periodontics and Dr Ailbhe Mc Donald, Head of Prosthodontics.
Following input from a couple of specialist barristers and concluding comments
from Dr Hoppenbrouwers, feedback on the day and the collaborative format
was very positive with topical suggestions received for future meetings.
For further information on future CPD initiatives and conferences covering
other disciplines, please visit www.eastman.ucl.ac.uk or www.the-ddu.com

Kemdent revive the 3 Rs- Recycle,
Refill, Reuse
PracticeSafe and ChairSafe Heavy Duty and
Economy wipes are now even better value
for money. Dental Practices can save up to
25% on their cost, by recycling, refilling and
reusing their tubs. Refill rolls are available in
packs of 4.
The new versatile range of Kemdent wipes
should be used with confidence to clean sensitive and non-sensitive surfaces
within the treatment area and the decontamination area of a Dental Practice.
Surfaces in toilets and waiting areas should not be forgotten. These low odour
wipes are excellent for areas like these.
Chairsafe heavy duty and economy wipes, which do not contain alcohol, are
specially formulated to clean sensitive surfaces and equipment, the leather
and synthetic facings of dental chairs.
Kemdent wipes are low odour, non-drip and durable. They are gentle on the
hands but above all, very effective against harmful bacteria.
Phone Jackie or Helen on 01793 770090 to take advantage of the special offers
on this new wide range of Kemdent wipes or visit our website www.kemdent.
co.uk.

BDA / DENTSPLY Student
Clinician Programme:
“A fantastic opportunity.”
Lisa Durning describes her
involvement in this year’s
Awards:
“I found out just before Christmas
that I had been selected to
represent Manchester Dental
School, which was a great honour.
To be one of the fifteen finalists also felt like a significant achievement.
I had been working on an investigation into how cancer spreads, and the role
of a particular molecule in the loss of cell adhesion, seen in the metastasis
process. The Student Clinician Programme was a great opportunity to share
with a wider audience a topic that I have found fascinating since being
introduced to it during my third year studies.
Being announced the winner came as a great shock as I hadn’t expected to
win. I am absolutely thrilled to win and I’m looking forward to October when
I fly to Orlando to take part in the International Student Clinician Conference.”
I definitely recommend taking part in clinical research and the Student
Clinician Programme. It’s raised my awareness of the opportunities I have
within dentistry.”
For more information about the BDA / DENTSPLY Student Clinician Programme,
contact DENTSPLY on 0800 072 3313 or visit www.dentsply.co.uk

“Tavom’s cabinetry is functional, hygienic
and durable!”
As a market leader in the provision of
high quality, durable and attractive dental
furniture and cabinetry, Tavom can help
create a professional and functional practice
to suit the demands of any client.
Dr Pete Martin of Barrow Street Dental Practice, Merseyside has been using
Tavom’s products for over six years. “The original work surfaces I had installed
are very durable and still look as good as new. The cabinetry is elegantly
functional, hygienic and easy to modify and so is adaptable. The service I
received from our suppliers, RPA Dental, was top-class and highly impressive.”
Using contemporary design based on cutting edge technological research,
Tavom offers practices the widest range of ergonomic cabinetry in a variety
of colours and styles. Working to the practitioner’s specifications, the
knowledgeable team at Tavom deliver an excellent package of customer care.
With over 30 years of experience in design and build, and using the latest in
Computer Aided Design, Tavom can eliminate the worry of refurbishment.
For further information call Tavom UK on 0870 752 1121
Or visit www.tavom.com

[28] =>

28 Industry News

United Kingdom Edition April 26-May 2, 2010

Oral healthcare in people
living with cancer
Do you treat and support patients who are living with oral cancer?
Then this day is for you! Dental Tribune details a CPD meeting
to be held in June 2010 aiming to enhance awareness of the
importance of orofacial signs and symptoms of cancer

meeting on Oral Healthcare In People Living
With Cancer, will be
held in London on 11th June

2010, supported by RCSEd.
The single day CPD meeting,
in parallel sessions, organised
by Professor Crispian Scully

CBE, is given by a European
faculty, and also supported by
the International Academy of
Oral Oncology (IAOO) (www.

Table 1 Faculty involved
Professor Jose BAGAN

Spain

Professor Marco CARROZZO

Professor Luca Di ALBERTI

Italy

Professor Pedro Diz DIOS

Spain

Professor Jose-Pedro FIGUEIREDO

Portugal

Professor Michele GIULIANI

Italy

Professor Miguel GONZALEZ-MOLES

Spain

Dr Tim HODGSON

Dr Vinod JOSHI

Mr Nick KALAVREZOS

Mr Cyrus KERAWALA

Dr Carlos MADRID

Switzerland

Professor Jukka MEURMAN

Finland

Professor Tim NEWTON

Dr Chris NUTTING

Professor Stephen PORTER

Dr Judith RABER-DURLACHER

Netherlands

Professor Crispian SCULLY CBE

Professor Simon ROGERS

Dr Rosie SHOTTS

Professor Isaac van der WAAL

Netherlands

Professor Saman WARNAKULASURIYA OBE

homepages.ucl.ac.uk/~sfhvcms/
iaoo/index.html), and the Multinational Association of Supportive Care in Cancer (MASCC)
(www.mascc.org/mc/page.
do;jsessionid=27FF70316F8
B947314C17F98E86CF D17.
mc0?sitePageId=86907).
The day is aimed at dentists, and specialists mainly
in maxillofacial surgery, oral
medicine, oral surgery, special care dentistry, and otorhinolaryngology, as well as Dental Care Professionals (DCPs),
and the cancer support team.
The Faculty include European
leaders in the field (Table 1).
Supporters include Philips
Oral Healthcare, Elsevier
Publishers, Healthcare Learning Company and HCA.
The objectives are to enhance awareness throughout
the healthcare team of the
importance of early detection
of orofacial signs and symptoms of cancers, and of cancer
prevention. Much oral cancer
presents late, at a stage when
not only is more radical treatment necessary, but the prognosis is also less favourable.
The meeting provides an
overview of the aetiopathogenesis of cancer (carcinoma)
for the healthcare team, a
broad understanding of which
is crucial for coping with issues related to prevention,
diagnosis and management.
The World Health Organisation (WHO), other agencies
and research workers have

Table 2. Challenges that may be faced by the patient with cancer
Many patients

Complications from radiotherapy

Complications from surgery

Pain
Anxiety and other
psychological distress

Disturbed taste, mastication, swallowing and speech
Mucositis
Dry mouth
Osteonecrosis
Trismus
Dermatitis
Scarring
Hearing loss
Laryngeal cartilage necrosis

Disturbed sensation, mastication, swallowing and speech
Scarring
Deformity
Air embolus
Pneumothorax
Carotid blow-out
Chyle leakage
Salivary leakage
Nerve damage

produced a considerable amount
of epidemiological data showing
that oral cancer is increasing,
and in younger patients. Tobacco, alcohol and betel remain the
main risk factors but the role of
human papilloma viruses (HPV)
in oropharyngeal cancer in particular is increasingly recognised, as is the beneficial effect of
diets rich in fruit and vegetables.
Prevention is crucial if there is to
be any serious progress. Prevention of oral cancer involves lifestyle decisions which afford protection not only against cancers
in many sites, but also against
a wide range of other conditions, many of which are equally
life-threatening.
The meeting also highlights
areas of controversy in the
early diagnosis of oral cancer.
Earlier diagnosis is likely to
be achieved reliably only with
the introduction of molecular
studies. Early detection and
treatment should reduce mortality
rate
and
morbidity
from cancers and their treatment. The role of multidisciplinary teams in cancer detection
and management is stressed.
Medical, surgical and technological management advances
have improved the quality of life
- though the five-year overall
survival of the disease has advanced little at most treatment
centres. The basic treatment
modalities remain as surgery,
radiotherapy and chemotherapy
and treatment improvements
are largely directed towards
reducing the complications,
which remain a major issue.
Patients with oral cancer may
be faced with a range of untoward symptoms, from pain and
anxiety, to dry mouth, and disturbed taste, eating, swallowing and speech (Table 2), the
prevention and management of
which are discussed.
The importance of minimisation of such adverse effects from
treatments, and of good support
for the oral cancer patient and
their family is a major focus of
the meeting.
The
peer-reviewed
papers from the meeting are
published in the June issue
of Oral Oncology (www.elsev i e r. c o m / w p s / f i n d / j o u r n a l d e s c r i p t i o n . c ws _ h o m e / 1 0 5 /
description#description),
the
official journal of the European
Association of Oral Medicine, the
International Association of Oral
Pathologists, and the IAOO.
Professor Crispian Scully
CBE, MD, PhD, MDS, MRCS,
BSc,
FDSRCS,
FDSRCPS,
FFDRCSI, FDSRCSE, FRCPath,
FMedSci, FHEA, FUCL, DSc,
DChD, DMed(HC), Dr h.c. UCLEastman, 256 Gray’s Inn Road,
LONDON, WC1X 8LD. UK.
Email: crispian.scully@eastman.
ucl.ac.uk. DT

[29] =>

United
2010
United Kingdom
Kingdom Edition
Edition April
April19-25,
26-May
2, 2010

Advertorial 29
5

DIO Professional Implant Education
Following the success of the UK’s ﬁrst public live theatre at the Dentistry Show,
DIO Implant continues to boldly progress with its mission to change the face of the UK
implant market for the better of everyone. DIO’s Managing Director explains, “For most
patients, dental implants are a necessity. At DIO, we aim to bring the beneﬁts DIO provides
in overseas markets to the UK.”. He continues, “Dental implant treatment should be accessible
by any patient who needs it, without compromising on quality of treatment or jeopardising
the livelihoods of our valued UK implantologists ”.

he next stage of their roadmap is to introduce a dedicated educational programme, designed especially for dentists wishing to
provide the highest standard of care to their patients.

The format of the course addresses both the requirements of practitioners looking to start providing dental implants as well as those who
are already placing implants from other manufacturers.
For non-implant dentists, the introduction days lead on to a one-year,
hands-on and distance learning certificated course, equivalent to approximately 120 hours of verifiable CPD. The course, directed by Sam Mohamed of Smile Lincs, aims to impart everything a qualified dentist needs
to know in order to confidently provide dental implants to their patients.
Introductory two-day course
During an initial two-day course practitioners
are given an overview of the evolution of dental
implants and how they can be integrated into a
normal dentistry practice in the most cost-effective way. The course looks at the basics of dental
implantology, discussing osteointegration, treatment planning principles, radiographic techniques and restorative techniques. It also covers more practical aspects
of dental implantology such as practice setup and marketing and introduces patients to implantology to ensure a good return on investment.
Day 1 is aimed at providing non-implant dentists with an introduction to implant procedures. Practitioners will leave knowing whether
dental implants are both right for them as an individual and a feasible
business proposition for their practice. DIO is also welcoming existing
implant practitioners on the introduction day, which DIO claim exposes
them to a new perspective and allows for non-biased discussions and a
healthy propagation of expertise to all attending.
Day 2 focuses on the clinical and restorative aspects of DIO Implants
in more depth and is therefore applicable to both new an existing implantologists alike.
Once the introductory course is complete, practitioners can confidently decide whether to sign up for the year-long modular course to
expand their knowledge and become implantologists. Mr Forster states,
“Dr Mohamed and I struck a chord – we both have the interests of UK
dentists at heart. Sam has extensive expertise and relentless
enthusiasm. Combine these qualities with a genuine desire to help individuals achieve at the
highest level and you have the ingredients
for success.”
Modular Course
The year-long modular course aims to
provide dentists with everything they
need to know to become knowledgeable
and confident implantologists. The course
includes ten in-depth modules, both theoretical and practical, covering:
• Osteointegration
• Biomaterial in relation to bone orgmentation and
membranes
• How to select suitable dental implant patients

• Treatment planning
• Radiographic techniques in implant dentistry
• Surgical techniques
• Surgical kit orientation
• Possible surgical complications
• Restorative techniques
• CT scanning and computer guided surgery
• Marketing and promoting your new service
Dentists are mentored throughout the course by Dr. Sam Mohamed and his team. Dr. Mohamed is a highly trained dental implant surgeon. Having trained with some of the world leaders in implant dentistry, including Dr. Hilt Tatum Jr., the former president of the American
Academy of Implant Dentistry (AAID), and Prof. Manuel Chanavaz, the
Head of Oral and Maxillofacial Implantology Department at the University of Lille2, Dr Mohamed has been placing implants for over 13 years.
He is a member of both the Association of Dental Implantologists (U.K)
and the AAID.
Dr. Mohamed said, “Practitioners will attend our purpose built once
a month to perform implant surgery under close supervision. This will
give them real, hands-on experience and will quickly build their confidence in their own skills.” To supplement
the hands-on training, Dr Mohamed is providing distance-learning facilities via the
Internet.
Once the course has been completed
practitioners will be awarded a certificate
and logbook showing the number of patients they have treated and the individual details of each case. Most importantly
though, dentists completing the course will
have all of the skills they need to effectively
place implants and treat most patient cases. However, the professional
support doesn’t stop there. Successful implantolgists are supported by
Dr Mohamed’s “Continuing in Excellence” mentor program.
Marketing Assistance
DIO is very much aware that it’s all very well for dentists to learn new
skills and develop new products, but the effort is useless if their patients
are not made aware of the services that are on offer.
So, to help dentists promote their new techniques the
company is providing advice and guidance on marketing techniques that dentists can employ to spread
the word. These can include help with local PR,
website design, brochure and leaflet design and
production, Search Engine Optimisation, the use
of social networking, etc.
For more information on DIO implants and their
training programmes visit www.DIOUK.com or call
0845 123 3996.

[30] =>

30 Events

United Kingdom Edition April 26-May 2, 2010

Getting down the canal
Jan Skrybant reports on Dr David Sonntag course on root canal instrumentation
and obturation made in Germany, at the University of Warwick

many. The file is NiTi in nature
uring Dr Sonntag’s reand is supplied in sizes: 10/04,
cent presentation in
15/05, 20/06, 25/06, 30/05, 35/04,
March at the University
40/04, 25/07.
of Warwick, he began by describing the msc_ad_source_uk.pdf
Mtwo endodontic 1file03/08/2009 15:21:59
The file is manufactured from
manufactured by VDW in Ger-

an “S”-shaped blank and has
therefore two cutting edges allowing it to be very flexible. It is
intended for use at 280rpm. The
first file and each subsequent file
are intended to go to full length.

If greater coronal taper is needed, then the 25/07 is the file to
achieve the greater taper.
The 10/04 and 15/05 are
very useful in shaping the apiMeasuring apical constriction

Students listiening with interest

cal third. The files can have a
“working part” of either 16mm
or 21mm. The latter can be useful in the “long canal” scenario
– working on canines. The files
can be supplied in 25mm and
31mm lengths.
Perfecting techniques
Dr Sonntag described the techniques he has perfected in using these files and the results
were impressive. He demonstrated the re-treating of an upper right first molar which had
a discharging extra-oral sinus,
prominently situated in the
right cheek.
The VDW torque control
drive system was used to prepare the canal with the appropriate torque setting and speed
control. The VDW ultrasonic
was also available for troughing the pulpal floor, especially
for the isthmus between MB1
and MB2.
The afternoon was spent
discussing the obturation of the
canals that had been prepared
by the students. The VDW “Bee
Fill” gutta percha extruder was
demonstrated, which is on par
with the other gutta percha extrusion systems on the market
at present.
To summarise, this was a
very refreshing course on the
VDW endodontic spectrum of
root canal armamentaria.
A word of thanks
Praise goes to Dr David Sonntag
for the tuition; QED for supplying the full range of VDW instruments and files; DP Medical
for supplying the Global microscopes and to Dr Liviu Steier as
course co-ordinator. DT

About the author
Jan Skrybant graduated in November 1972 and has worked in general
practice ever since. He has a particular interest in endodontics, but is not
a specialist. You can contact him by
emailing jan@skrybant.co.uk.

[31] =>

Classified 31

United Kingdom Edition April 26-May 2, 2010

MK & COv2.pdf

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10:38:48

info@medicsfinancialservices.com
www.medicsfinancialservices.com
+44 (0) 1403 780 770

Specialist Dental Accountants
Established over 25 years (FCA, CFP)
-

Chartered Accountants

Tax saving strategies for both associates and principals
Advice on buying/setting up practices
Incorporation reviews - will you save tax?
Help on all financial aspects of running a practice - from increasing
your profits to financing equipment tax efficiently
- Advice to ensure a good deal for both principal and associate

CY

CMY

K

For a FREE, no obligation 1 hour consultation,
Call: 020 8346 0391
Email: mac.kotecha@virgin.net
www.specialistdentalaccountants.co.uk

Very competitive fixed rates - House and Practice
Finance
Surgery Finance - Bank of England Base
(from) + 1.00%
100% Mortgage Finance - House and Practice
Extremely Enhanced Income Multiples

Enhanced income
multiples, market
leading rates & highly
competitive
mortgage solutions

for Dentists

+44 (0) 1403 780 770

Your home may be repossessed if you do not keep up repayments on your mortgage. Medics Professional Mortgage Services is a trading style of Global Mortgages Ltd.,
which is an Appointed Representative of Home of Choice Ltd., which is authorised and regulated by the Financial Services Authority.

To advertise here please contact Sam Volk

0207 400 8964

MPMS 95x50 Dentists.indd 1

on

11/12/2006 21:56:19

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Effective relief from the pain of sensitivity
1 in 3 people suffer from dentine hypersensitivity yet
over half suffer in silence, without seeking advice from
a dental professional1.
Sensodyne effectively relieves the pain of dentine
hypersensitivity with a choice of products to suit your
patients’ needs. With continued use Sensodyne Total
Care F and Sensodyne Mint toothpaste can provide
ongoing and effective pain relief .

Pain relief via
occlusion:

Pain relief via
depolarisation:

Strontium formulations
occlude dentinal
tubules to help build
a barrier of protection2

Potassium formulations
work at the source of the
pain by blocking pain
signals from the nerve3

Strontium acetate,
Sodium fluoride

Potassium nitrate,
Sodium fluoride

Nothing else is Sensodyne
Product Information
Sensodyne Total Care F Toothpaste and Sensodyne Mint. Presentation: Sensodyne Total Care F Toothpaste: Potassium nitrate 5.0% w/w, Sodium fluoride 0.306% w/w. Sensodyne Mint toothpaste:
Strontium acetate hemihydrate 8.0% w/w, Sodium fluoride 0.23% w/w. Uses: Relief from the pain of dentinal sensitivity, an aid for the prevention of dental caries. Dosage and administration:
Sensodyne Total Care F Toothpaste: To be used 2-4 times a day, in place of ordinary toothpaste. Sensodyne Mint: Use morning and night. Contraindications: Sensitivity to any of the ingredients.
Precautions: Sensodyne Total Care F Toothpaste: For children under 6, use a pea-sized amount and supervise brushing to minimise swallowing. Sensodyne Mint: Not to be used by children under
7 years, unless recommended by a dentist. Side effects: Sensodyne Total Care F Toothpaste: Very rarely, isolated cases of hypersensitivity type reactions such as angioedema; oral and facial swelling
have been reported in patients using potassium nitrate containing toothpastes, particularly in patients who are predisposed to hypersensitivity type reactions. Sensodyne Mint: Non-serious allergic
reactions rarely. Legal category: GSL. Product licence number: Sensodyne Total Care F Toothpaste: PL 00036/0103. Sensodyne Mint: PL 00079/0225. Product licence holder: GlaxoSmithKline
Consumer Healthcare, Brentford, TW8 9GS, U.K. Package quantity and RSP (excl. VAT): 45 ml tubes £2.09, 75 ml tubes £3.11, 100 ml pumps £3.65 and Sensodyne Total Care F Toothpaste
100 ml tubes £3.65. Date of last revision: January 2010.

References: 1. Addy M. Int Dent J 2002: 52: 367-375. 2. Claydon L. NCA et al J Clin Dent 2004: 20 (Spec Iss): 158-166. 3. Markowitz K. J Clin Dent 2009 (Spec Iss): 20: 145-151.

Sensodyne and the rings device are registered trade marks of the GlaxoSmithKline group of companies.

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[toc] => Array ( [0] => Array ( [title] => GDC to address FtP backlog [page] => 01 ) [1] => Array ( [title] => News [page] => 02 ) [2] => Array ( [title] => The perfect learning solution [page] => 08 ) [3] => Array ( [title] => Ten reasons to be at Clinical Innovations [page] => 09 ) [4] => Array ( [title] => CQC - the three M’s [page] => 10 ) [5] => Array ( [title] => The good old days? [page] => 12 ) [6] => Array ( [title] => Getting to know you [page] => 13 ) [7] => Array ( [title] => The incorporation process [page] => 16 ) [8] => Array ( [title] => Go green for your future [page] => 18 ) [9] => Array ( [title] => The perio-implant interface [page] => 19 ) [10] => Array ( [title] => Options for dentures [page] => 22 ) [11] => Array ( [title] => Effective administration [page] => 23 ) [12] => Array ( [title] => From windscreens to whitening [page] => 24 ) [13] => Array ( [title] => Industry News [page] => 26 ) [14] => Array ( [title] => Getting down the canal [page] => 30 ) [15] => Array ( [title] => Classifieds [page] => 31 ) ) [toc_html] =>

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