DT UK 1810

SHAs to be axed by 2012 says Dept of Health / News / MSC Blog / Rise and fall of new Budget / It’s never too late to build a dream team / Question time for Tory policy / Half Brained website? / Cosmetic Tribune / Learning Curve / Back to the Egg; Part I / Industry News / Anniversary celebrations / Classifieds

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Table of contents

July 12-18, 2010

PUBLISHED IN LONDON
News in Brief
Top of the pops
The University of Manchester’s School of Dentistry has
topped the league table of dental schools in the Times Good
University Guide for 2011.
Manchester beat off competition from the 13 other UK dental schools in the table to take
the top spot. Head of School,
Professor Iain Mackie said:
“This is brilliant news which
reflects the efforts of everyone.
Last year we were ranked third
in the list, so this move to first
place truly reflects a whole
School effort.” The Times Good
University Guide recognises
excellence in teaching and research with much emphasis
on the satisfaction and experience of students.
Digital dental technology
Sirona, developer of hightech dental equipment, has
launched its digital dental impression technology,
Cerec Connect, in the UK as
part of a wider international
roll-out. The system allows
optical digital impressions of
teeth to be taken and translated
into digital 3D models, which
can then be transmitted instantly to a laboratory for the
creation of restorations. According to Sirona, which has
already successfully launched
Cerec Connect in Germany
and the US, the technology is
quicker and more accurate
than conventional impressions and casting, as well as
providing greater control to
dental technicians.
Thumb-sucking clinic
Britain’s first thumb-sucking
clinic has opened, promising
to help break the habit as well
as repair the damage that is
caused by sucking your thumb.
Dr Neil Counihan has opened
Metamorphosis centre in West
London after years of treating
people whose jaws and teeth
have been badly affected by
the habit. Most children stop
sucking fingers or thumbs between the age of three and six,
when it causes no damage. But
those who continue risk affecting their jaw development
and the position of their teeth.
The clinic has a range of metal
devices which can be fitted in
the mouth plus more conventional plastic ‘thumbguards’
which cover the thumb itself
and which children find hard
to remove. The clinc also sells
products such as finger and
thumb puppets which come
with story books to reinforce
anti thumb-sucking messages. Traditional remedies to
discourage the habit include
putting mustard on the fingers
or coating nails with special
bitter-tasting polish.
www.dental-tribune.co.uk

News

Cosmetic Tribune

News

10 years and counting

Healthcare learning company
celebrates 10 years

page 2

VOL. 4 NO. 18

Fellowship award

Clinical

Back to the Egg

University of Manchester Professor receives teaching accolade

ABB not ABC
Tif Qureshi deails the latest
treatment sequence

Prof Serota continues his look at
the Endo Implant Algorithm

page 7

pages 18-20

pages 23&26

SHAs to be axed by 2012
says Dept of Health
Decision welcomed by Southampton residents opposing water
supply fluoridation plans

A

ll Strategic Health Authorities (SHAs) are to be
abolished by 2012.

The Department of Health
(DH) broke the news to the SHAs
through a Q&A document which
said: ‘‘Subject to legislation, the
NHS commissioning board will
become fully operational from
April 2012, removing the need
for separate statutory strategic
health authorities’’.
The Department of Health
claims that the new independent
NHS board will combine functions
currently provided by the DH and
SHAs, and deliver those in a much
more streamlined way.
The move has been welcomed
in places such as Southampton
where the SHAs decision to approve water fluoridation has been
vehemently opposed.
Stephen Peckham, chairman
of Hampshire Against Fluoridation, said he is encouraged
by the news, particularly as
those now in office are not keen

to force fluoridation without
proper public consultation.
All fluoride schemes across
the country are currently on hold
while the courts examine the
decision by South Central SHA
in February 2009 to add fluoride
to the water in 200,000 homes in
Southampton and parts of Hampshire. The judicial review is to be
heard in the Autumn, according
to the new Health Minister Simon Burns.
Southampton resident Geraldine Milner is arguing that the
SHA should have listened to the
views of residents before giving
the scheme the go-ahead, after 72
per cent of 10,000 people consulted
said they were against the idea.
In response to a question in
parliament from Dr Julian Lewis
over the government’s fluoridation policy, Conservative MP
for New Forest East, Mr Burns
said: ‘‘Section 58 of the Water
Act 2003 empowers Strategic
Health Authorities (SHAs) to
contract with water undertak-

ers to fluoridate a water supply
after conducting public consultations. It is essential that any
consultation gives people a real
opportunity to make their views
known and that those views are
taken into account before a final
decision is made. The decision

by South Central SHA to approve
the fluoridation of water supplies to the Southampton area is
the subject of a judicial review,
which is likely to be heard in the
autumn, and so due to the legal
challenge the Department is unable to comment.’’ DT

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The move to abolish SHAs has been welcomed by opponents of water fluoridation

[2] =>

2 News

United Kingdom Edition July 12-18, 2010

Murderer gets £44k in
compensation for poor dental care

he Court of Appeal
has reduced a triple murderer’s compensation to
£44,500 after he sued over inadequate dental care in prison.
Michael Steele, serving life
for a triple gangland killing, was
awarded £66,400, after suffering
toothache for nearly seven years.
The Home Office appealed
against the award made in 2009.
The appeal judges reduced his
original damages to £25,000

and with interest and £16,000
for Steele’s ‘pecuniary loss’,
the total payout comes to £44,500.
The court heard how Steele
‘sustained damage to his teeth
while playing rugby football’.
Steele said in his submission that his pain and suffering
was aggravated by the fact
that he was locked up for much
of the day and had nothing to
do other than think about
his toothache.

The court ruled that the
original damages award was
out of line with cases of other
types by ‘quite a substantial
margin’.
The Appeal Court heard how
Steele’s fillings fell out at Belmarsh Prison soon after he was
given his three life sentences.
Since then, while being moved
between high security prisons,
Steele has suffered ‘persistent
severe pain’.

DCPs who fail to pay in time will be
removed from the register, warns GDC

ental care professionals
who fail to pay their annual retention fee by the
end of July will be removed from
the register, warns the General
Dental Council.

Dental
care
professionals (DCPs) who haven’t yet
paid their annual retention
fee (ARF) to the General Dental Council (GDC) are running
out of time.

Payments must be received
on or before 31 July 2010 if they
want to remain on the GDC’s
register and eligible to work.
No payments can be processed after the deadline.
All dental care professionals
must be registered with the GDC
to work in the UK, giving patients reassurance that they are
meeting GDC standards.

For the third year in a row
the fee is £96 for dental nurses,
dental technicians, dental therapists, dental hygienists, clinical
dental technicians and orthodontic therapists.
The GDC’s head of registration, Gurvinder Soomal, said:
‘‘The GDC has more than 57,000
DCPs on its register and we want
to thank those who have already
paid this year’s ARF.

‘‘We now want to make
sure
that
every
dental
care professional who wants
to stay on our register understands they must pay by 31 July.
If you haven’t paid yet please
get in touch as soon as possible. If your employer normally
pays for you – check they’ve
done so again this year. If you
lead a team, check whether
your colleagues are up to date.
You can also let us know if you have

Judge Edward Bailey last year
ruled the Home Office had been
negligent in failing to give him
the dental treatment he needed
and awarded him £66,400 damages, including £250 for every
week of toothache endured.
Lady Justice Smith, sitting
in the appeal court, called it ‘a
bad case involving persistent
severe pain over nearly four
years, together with more moderate pain for two years and some
significant deterioration in the
general condition of his teeth’.
Steele was jailed in 1998
for shooting dead ‘Essex Boys’
Patrick Tate, Anthony Tucker
and Craig Rolfe as they sat in a
Range Rover. DT

decided to take a career break
or not to stay on the register.’’
Any DCPs who fail to make
the payment will be removed
from the GDC’s register and
will no longer be able to work
legally in the UK.
If they decide to apply to
rejoin the register they will have
to pay a higher fee of £120.
If you have any questions, you
can contact the GDC customer
advice and information team
on 0845 222 4141 or by email
information@gdc-uk.org. DT

Smile-on celebrates 10th anniversary

mile-on celebrated its 10th
anniversary in style aboard
the luxury Thames cruiser,
the Silver Sturgeon.
Friends
and
colleagues
enjoyed a spectacular meal,
while being entertained by a
Jazz Quartet, on a trip down
the Thames.
A spokeswoman for Smileon said: ‘‘The event provided
the company the opportunity
to say thank you to all those
who have helped the business grow over the past decade

to become the UK’s leading
healthcare learning provider.
‘‘Those who attended looked
back over the journey the company had taken over the last
ten years and shared some very
special highlights.’’
As the boat sailed along the
Thames, partygoers took par
in a charity auction of which
the proceeds will be split between
the three charties nominated by
Smile-on’s directors: Cancer Research UK, Age Exchange and
Three Faiths Forum.

The Smile-on spokeswoman
added: ‘‘Smile-on offers practitioners a variety of courses designed to inspire, motivate and
encourage clinical excellence in
dentistry. The business is already
looking forward to the future and
hopes for another fruitful ten
years of creativity, professionalism, enterprise, trust and most
importantly – education.’’
For
more
information
about Smile-on and its healhcare
education programmes please
call 020 7400 8989 or email
info@smile-on.com DT

Partygoers had a night to remember on the Silver Sturgeon

Dentist who faked death arrested
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
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but cannot assume responsibility for
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Editor
Lisa Townshend
Tel: 020 7400 8979
Lisa@dentaltribuneuk.com

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.

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Tel: 020 7400 8969
Joe@dentaltribuneuk.com

Sales Executive
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Tel: 020 7400 8964
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Dental Tribune UK Ltd
4th Floor, Treasure House, 19–21 Hatton Garden, London, EC1N 8BA

dentist who is alleged to
have faked his own death
has been arrested in connection with a £1.8m fraud.
Police have revealed that
Neil McClaren, 46, previously
known as Emmanouil Parisis, was arrested in Peterhead,
Scotland. Police said his arrest
followed a complaint from the
NHS and other financial institutions that money had been
wrongly paid out following McClaren’s alleged death last year.
In total, three people have

been charged with conspiracy to
defraud financial institutions in
excess of £1.8m.
McClaren appeared at Exeter Magistrates Court with his
wife,
Stiliani
Theodoropoulou and sister-in-law Nikoletta
Theodoropoulou.
Emmanouil
Parisis
was
previously listed as a dental
practitioner at St John’s Dental Centre in Barnstaple. The
court heard that the former dentist faked his own death so his
wife and sister could claim

£1.8m in life insurance.
Prosecutors claimed McClaren’s death certificate and
travel documents were faked so it
looked as if he had died while on
a trip to Jordan.
Neither McClaren nor his sister-in-law applied for bail. It was
requested for Stiliani Theodoropoulou, but was refused.
The case has been committed
to Exeter Crown Court, where
a preliminary hearing took place
on Friday 9 July. DT

[3] =>

News 3

United Kingdom Edition July 12-18, 2010

Editorial comment
Learning and growing
Dental Tribune has
been in Glasgow recently, attending the
International Symposium of Dental
Hygiene. More than
1,300 delegates were
registered, and this
international meeting certainly
lived up to its billing! Speaking
with many of the delegates there
was a real sense of coming together and learning from each
other.

I really enjoyed the lectures I
attended – watch out in future issues for a write-up!
The Smile-on 10th anniversary celebration was held recently
on a luxury boat on the Thames.
It was a fantastic evening, as

the weather was perfect and the
company... well it was pretty
good too! There was a real mix
of guests on board, all enjoying
the occasion. There were a few
surprises too, with Singing Dentist Andrew Bain entertaining the
guests and a moving rendition of

Rudyard Kipling’s If by actress
Ruth Rosen. The aim of the event
was both to celebrate 10 years of
Smile-on but also to say thanks
to everyone who had supported
the company along the way. From
the happy smiles on people’s
faces as they collected
their limited edition
anniversary watches
and went off into the
London night air, I’d
say it was mission
completed.

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

Effective enamel defence.
Superior plaque control.*
Combined.

‘Perverse
incentives

’

n a recent exchange in the
House of Commons, the
new Parliamentary UnderSecretary of State for Health,
Anne Milton, gave her response
to MP, Sir Paul Beresford, who
said the biggest disincentive in
the contract is ‘its targets, its
units of dental activity (UDAs),
its clawbacks’.

W
NE

Ms Milton thanked Sir Paul for
‘highlighting the perverse incentives in the contract’ and said: ‘‘It
is absolutely critical that we take
those out of any new contract.’’
The British Dental Association
has already begun formal meetings with the new dentistry minister to discuss the issues facing
NHS dentists.
Speaking afterwards, Ms
Sanderson said: “This was a
constructive introductory meeting that afforded an opportunity
to discuss briefly the issues confronting dentistry in this country.
We look forward to continuing
this dialogue and discussing in
greater depth the issues that have
been raised.”
John Milne welcomed commitments on the reform of general dental services. He said: “I
am pleased to report that the new
Minister has committed to continuing the reform of NHS dentistry
in England. He has pledged to review the progress so far and then
take reform forward. Importantly,
he has also committed the new
government to discussing change
with the profession and to the piloting of long-term change.”
Peter Bateman also gave a positive verdict on the meeting and
said: “This meeting provided an
early opportunity to raise some of
the key issues confronting the salaried dentists who treat the most
disadvantaged patient groups. A
dialogue has begun and I look forward to discussing how care for
vulnerable people will develop.” DT

Choosing a mouthrinse has often meant

to formulations with twice the fluoride.1,2 Add

choosing between effective enamel

this to its ability to kill bacteria associated with

protection and effective plaque reduction.

dental caries3,4 and reduce plaque by up to

Until now. New Listerine Total Care Enamel

52% more than mechanical methods alone5

Guard contains 225 ppm fluoride with high

and you can see why you should consider

uptake and comparable re-hardening in vitro

adding it to certain patients’ oral care routines.

TOTAL CARE ENAMEL GUARD
All-round protection for enamel
05849
*Superior to other daily-use mouthwashes
1. Study 103-0193. Data on file 1, McNEIL-PPC, Inc. 2. Study 103-0196. Data on file 2, McNEIL-PPC, Inc. 3. Tanzer JM et al. J Dent Ed 2004; 65(10): 1028-37.
4. Data on file A, McNEIL-PPC, Inc. 5. Sharma NC et al. J Am Dent Assoc 2004; 135: 496-504.

03024_ocdlis_Dent_Tribune_WP_A4_fa1b.indd 1

6/24/10 3:22 PM

[4] =>

4 News

United Kingdom Edition July 12-18, 2010

NI pay award ‘unrealistic’

orthern Ireland Health
Minister
Michael
McGimpsey has announced the pay award arising from the recommendations
of the Review Body on Doctors
and Dentists (DDRB) pay for
2010-2011.

element of certain items of service will be increased by 0.9 per
cent to reflect increase in GDP
practice expenses.”

He revealed that “there will
be no increase in net income
for
independent
contractor
General Dental Practitioners
(GDPs). However, the expenses

The British Dental Association in Northern Ireland
called the uplift to practice expenses ‘minimal’ and criticised
the funding of Health Service

Salaried dentists working in
Trusts are to receive a one per
cent pay increase.

for dentistry in Northern Ireland
as ‘unrealistic’.
Claudette Christie, BDA director for Northern Ireland, said:
“The basis of this announcement
is simply unrealistic. Northern
Ireland’s dentists have provided
health service care to 900,000
people in the communities
they serve this year. Salaried
dentists working in Trusts treat
some of the most vulnerable patients in the community. For den-

tists to fulfil their responsibilities
to these patients it is important
they are properly supported.”
She added: “The idea that
practitioners can reduce practice
running costs does not reflect
the reality of a situation where
practices face sharply escalating costs. This approach by the
Department of Health, Social
Services
and
Pulic
Safety
(DHSSPS) is particularly disappointing given their acknowledgement in evidence that in
view of a new contract continuing to be some way off,
then efficiency gains should

not be sought in practice in
Northern Ireland.
“With dental practices as
small businesses at the cornerstone of communities across
Northern Ireland, dentists are all
too aware of the difficult financial
circumstances we all confront.
“But as clinicians, employing
highly skilled staff, they’re also
aware of the absolute importance of maintaining standards
for their patients and investing
in the care they provide. Today’s
announcement does little to support those aims.” DT

New dental training centre appoints leadership team

he new £9m University of
Portsmouth Dental Academy has appointed its
senior leadership team.

of clinical studies/senior lecturer in integrated dental education and multi-professional
care, together with new business
manager, Sophie Dampier.

Sara Holmes, newly apThe new Dental Acamy is
pointed Dental Academy dithe shared vision of the Unirector, is joined by clinical
versity of Portsmouth and
directors,
John
Weld
and
King’s College London Dental
Sarah Hartridge, and DavInstitute
(KCLDI),
id
Radford
of KCLDI 4has3/6/10
A5 Techs
SELECTED:Layout
16:48
Page 1 and is due
to open in September.
been seconded as director

The collaboration will see
final year undergraduate student
dentists from KCLDI and dental
care professionals from the University training together in teams
in a state-of-the-art facility.

and nurses in teams that will
prepare them all for the transition to general dental practice.
By teaching in a team-based primary care setting we’re breaking
new ground in dental education.”

Sara Holmes commented:
“We’re pursuing a model of
health education where final
year dental students work alongside dental therapists, hygienists

Students and staff will work
with dental professionals and
health organisations in the area
in a joint endeavour to raise the
oral health of communities in

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and around Portsmouth, Hampshire and the Isle of Wight.
The Dental Academy will
also offer a proactive and
dynamic programme of continuing professional development training events to local
dental care professionals and
there will be opportunities for new
research on integrated dental
team training. DT

Too much regulation
says Dental Protection

ental Protection is calling for less regulation,
after being inundated
with inquiries from anxious dental professionals.

tration – that there are too many
hoops for practitioners to jump
through, often resulting in a duplication of effort and with no
real justification in most cases.

The indemnity insurance
provider has found there has
been an unprecedented demand
for its advisory services.

“The evidence base for many
of these new requirements being
imposed upon dental practices is
sketchy or non-existent. We desperately need a more balanced,
logical and measured approach
whereby any additional layers
of governance are scientifically
based and targeted where they
are justified and most needed,
rather than being applied across
the board.”

Its team of 48 dento-legal advisers has opened 3,700 new case
files since the start of the year,
as well as responding to almost
10,000 helpline calls over the
same period.
Prominent within this additional workload are concerns
about the rapid proliferation of
guidelines, governance, scrutiny
and accountability from many
quarters, and the time and costs
involved. HTM 01-05, PCT/LHB
practice inspections, HIW registration and inspections in Wales,
and the fast-approaching Care
Quality Commission registration
are all part of today’s compliance
demands, and General Dental
Council revalidation is not that
far away.
In response, director of Dental Protection Kevin Lewis, has
called for more reasonable and
proportional regulation of the
dental healthcare environment.
He said: “The controls are out
of control. There is a widespread
feeling in the profession – and a
growing sense of anger and frus-

He added: “The current environment is wasting the time, energy and money of many practitioners who are already doing an
excellent job for their patients.
“At a time when the new government is proposing that highperforming schools should be inspected less often and freed from
unjustified bureaucracy, the current excesses in the regulation of
dental health professionals are
impacting upon morale, deflecting effort and resources and ultimately not serving the best interests of patients.
“Now that many NHS practices are effectively operating
on fixed incomes, any unnecessary expenditure in one area
may need to be funded by cutting
back on more constructive expenditure elsewhere.” DT

[5] =>

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[6] =>

6 MSC Blog

United Kingdom Edition

July 12-18, 2010

Students in Residence

Elaine Halley details the first residential course for the MSc in Restorative and
Aesthetic dentistry, held recently in London

he first residential for
the Msc
was held at
the Strand Palace Hotel in London in mid-May. The
flight down was an excellent
opportunity for me to catch up
on the background reading so I

arrived feeling well prepared!
The residential was compulsory for all students and started
with an overview of the remainder of the course by Fiona
Clarke from The University of
Manchester.

The diversity of the student group was evident – I met
students from Kenya, India
and Qatar, as well as the many
different nationalities working
in the United Kingdom – it
made for fascinating lunch-time
conversations! There is also

a real mix of age-groups and
experience, from young NHS
associates to the not-so-young
(myself included) private practice owners.
For many of us, learning
about the thesis was nerve-

wracking but essential! We are
to start thinking about possible
topics for this research project
which will be a structured
clinical review rather than a
clinical or laboratory based
project. This is to fit in with the
distance-learning nature of the
course. Fiona advised us that
the thesis comprises the last
six months of the course starting in May 2011 but we should
start collecting references and
sources as we come across
them. We will be assigned a
tutor in due course who will
make suggestions and offer
guidance but this is a major
undertaking – there was some
nervousness about the unknown nature of this expressed
by participants.

UKP00246

*Chemically compatible with methacrylate based adhesives and composites. **Limited samples available

This nervousness was quickly overtaken by the realisation
that this is a clinical MSc – we
seem to have had it fairly easy
in the first unit which has consisted of lectures and assessments. Now, the dentistry is
really going to be evaluated –
we have 26 clinical cases to
submit for Units 2 and 3 of the
course! A lot of time was spent
on photography and being
sure that we could all take
the correct photos and are able
to upload them onto our learning plan and send them to be
evaluated. I am pleased to report that after a slight panic
about how to attach my flash, my
photography
came
flooding
back to me – I managed fine
although must book myself in
for a whitening after seeing my
caffeine tinged lower incisors on
the big screen!
The clinical cases so far
include six whitening cases,
simple orthodontics, restoration of the endodontically treated teeth and single tooth indirect restorations. I think we are
going to have lectures in the
practical techniques but at this
point I’m not sure. The current
unit’s lectures are mostly about
communication, legal recordkeeping etc – we have two with
Kevin Lewis coming up on
Thursday.

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After photography, Chris Orr
covered treatment planning and
shade taking with an eye-crossing exercise in matching values
on the computer. All of this with
Covent Garden beckoning outside and an ash cloud to disrupt
our homeward travel – the joys
of CPD. DT

About the author
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.

[7] =>

Tribune_june:Precision

14/6/10

14:49

Page 1

United Kingdom Edition July 12-18, 2010

Prof wins National Teaching Fellowship

dental professor from The
University of Manchester has won the National
Teaching Fellowship and an
award of £10,000. Prof Nick Grey
(pictured, right) in the School
of Dentistry was chosen from
nearly 200 nominations submitted by higher education institutions across England and Northern Ireland.
The award of £10,000 from the
Higher Education Academy may
be used for Fellows’ professional
development in teaching and
learning or aspects of pedagogy.
Prof Grey has a major role
in developing all aspects of the
teaching and learning agenda and
his main role within the School of
Dentistry is in teaching. He has
been heavily involved in the development of the new curriculum
in Manchester, with an emphasis
on learning outcomes in the delivery of teaching and learning.
He has encouraged a team approach to learning to broaden the
student experience across all dental care professions, and has been
involved in the recent collaboration with Manchester Metropoli-

tan University, which teaches students of dental technology.

Prof Grey is an examiner for
the Royal College of Surgeons
and a member of their Advisory
Board in Restorative Dentistry. He
has lectured nationally and internationally and co-authored one
textbook. In 2007, he was awarded
‘Teacher of the Year’ for his efforts

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in enhancing the learning experience for students.
In 2009, Nick was promoted
to professor of dental education
and also associate dean for teaching and learning in the Faculty of
Medical and Human Sciences.
The National Teaching Fellowship Scheme (NTFS) aims to
raise the profile of learning and
teaching in higher education and
recognises and celebrates individuals who make an outstanding
impact on the student learning experience.

Prof David Bartlett, head of
prosthodontics at the Institute, has
been chosen by his peers to join
the oldest speciality organisation
in prosthetic dentistry.
The Academy, based in the US
and founded in 1918, consists of

a small group of prosthodontics,
all of whom are elected by their
peers. There are only two British
members, Profs Harold Preiskel
and David Bartlett.
The Academy has amongst
its members, prominent academic and clinical practitioners,
mainly from North America,
and its mission is to support and
promote the art and science of
prosthodontics to the profes-

sion and the public. All associate
Academy members are mentored during a three-year period
and eventually become fellows
after a final vote from the membership.

Meditech, a UK manufacturer
of emergency resuscitation systems, has developed a kit to help
dental practices meet the recommendations of the Resuscitation
Council (UK), recommendations
endorsed by the GDC. The kit
is being sold through Dental
Directory.
Meditech
Managing Director, Chris Buckenham
said: “Dental Directory have the
contacts and support structure to

enable dental practices to easily
implement this solution”.
The kit contains all the equipment recommended except the
drugs and defibrillator: Portable
oxygen cylinder (D size) with
pressure reduction valve and
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with tubing; Basic set of oropharyngeal airways (sizes 1,2,3 and
4); Pocket mask with oxygen
port; Self-inflating bag and mask
apparatus with oxygen reservoir and tubing (1 litre size bag)
where staff have been appropriately trained; Variety of well fitting adult and child face masks
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The Academy contains many
of the most prominent North
American prosthodontics and
has amongst its overseas fellows,
those from Australia and one other European. DT

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Prof elected to specialist academy
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Prof Grey said: “The award is
especially pleasing to receive, as
it is a testament to the great importance the University of Manchester places on excellence in
teaching and learning. I am very
fortunate and grateful to be part of
a School, Faculty and University
that have enabled and encouraged
me to achieve this.”
Prof Colin Stirling, vice-president of teaching and learning at
Manchester, said: “Nick has contributed enormously to the strategic development of teaching,
learning and the student experience in his school, and across the
Faculty of Medical and Human
Sciences where his expertise in
assessment, feedback, and student
communication have been of immeasurable value to other schools.”

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[8] =>

8 Budget Special

United Kingdom Edition July 12-18, 2010

Rise and fall of new Budget

National Association of Specialist Dental Accountants looks at the
impact of the coalition government’s Emergency Budget

s a result of Chancellor
George Osborne’s first
Budget, VAT is going up,
Capital Gains Tax is going up
and the Annual Investment Allowance is decreasing, according to The National Association

of Specialist Dental Accountants
(NASDA).
But it is not all bad news.
The hike in Capital Gains Tax
- up from 18 per cent to 28
per cent - has been offset by

continuation of Entrepreneurs’
Relief, which has been retained and actually extended to
cover lifetime gains of up to
£5m. This will keep the tax rate
on dental practice sales and
incorporation at 10 per cent.

Also, large practices and corporate groups with profits more
than £300,000 will see tax rates
reduce from 28 per cent to 24
per cent with a series of one per
cent reductions starting on 1
April 2011.

The increase in VAT will not
directly affect dental practice income, but the cost of dental supplies and services will rise as
a result of the higher VAT rate.
Some patients may feel that they
have less money to spend on dental care as they pay out more VAT
on many essentials.
The reduction in tax relief on
dental equipment will be unwelcome news for any dental practice planning an overhaul and
for the trade. The main rates of
annual allowances will go down
by two per cent (to 18 per cent or
eight per cent ) and the Annual
Investment Allowance limit will
reduce from £100,000 to £25,000
in April 2011. Dentists who have
practice refurbishment in mind
should consider doing this before
next April and probably before
January to save VAT and maximise tax reliefs on spending.
The personal allowance - the
amount all taxpayers can earn
before they are taxed - will be
increased by £1,000 to £7,475 for
those aged under 65 next April.
However, the basic rate limit
will be reduced so that higher
rate taxpayers do not benefit from
the increase in the personal allowance. Dental nurses should
benefit from this tax break, which
is worth £200 per year to basic
rate taxpayers.
The new chancellor has
shown his support for employers
with changes to National Insurance Contributions (NICs). The
threshold at which employers
start to pay NICs on employee
wages will increase by £21 per
week from 6 April 2011. This will
produce an annual saving of up to
£140 per employee.
In an incentive to new businesses, plans have been announced to reduce NICs payable
by new employers. This could give
a boost to squats and will apply to
business starting after 22 June
2010, although the relief will not
be fully implemented until September 2010 at the earliest. The
countries and regions which will
benefit will be Scotland, Wales,
Northern Ireland, the North East,
Yorkshire and the Humber, the
North West, the East Midlands, the
West Midlands and the South West.
Company tax rates are to be
reduced - from 21 per cent o 20
percent from 1 April 2011 - which
may provide an incentive to some
dental practices to incorporate.
Tax payable on incorporation has
not gone up as had previously
been thought.
However, some in the profession will feel the brunt of higher
taxes on a personal level as gains
on sale of quoted shares, second
homes and other investment assets will be hit by the new tax
rate, thus adding 10 per cent to
some tax bills. DT

[9] =>

Feature 9

United Kingdom Edition July 21-18, 2010

It’s never too late to
build a dream team
says Seema Sharma
If it wasn’t for the people...
ental practices set out planning to have the right staff
with the right skills, qualifications, experience and knowledge to look after patients and the
practice. Somewhere along the line,
things go wrong for many, teams
malfunction and emotions run high.
When one of my own practice managers has a bad day at the ranch
nine out of ten times the complaints
are about a team member who did
not pull their weight or a process that went wrong which could
have been prevented with some preplanning or effort on the part of a
team member.

STEP 2: Tighten up on Rotas
Unplanned absence is the bane of
every practice manager’s life! Persistent offenders need to be encouraged
to take ownership of the disruption
caused to patients and the practice,
without the practice manager having
to turn into an ogre.

So what goes wrong? Dental
practices are busy places and time
is at a premium! There are few other professions where everyone has
to be on stage from the moment they
arrive to the moment they leave. As
small businesses, we do not have
the capacity to have “floating” staff,
receptionists have no respite from
phones, and nurses are in with patients all day. Any spare time a nurse
has is likely to have to be spent on
decontamination these days!

STEP 3: Repeat the mantra Smile you’re on stage!
Encourage a culture of accepting that
everyone is human but when the team
is at work, personal problems are left
outside the front door. It is important
for the practice to be supportive of individuals with personal problems, when
appropriate, but to know how to ensure that they do not impact on patient
care. By taking the time to understand
individual strengths and weaknesses,
and acknowledging that life outside
work can imbalance emotions, practice managers command respect, instead of demanding it.

D

All problems therefore end up
at the practice manager’s door, who
can easily find that fire fighting
chews up half of his or her time.
Rebuild your dream team in five
simple steps
It’s worth reviewing the processes
that are in place for “people management”, to see where things can
be improved. A good leader creates
vision for the practice and a good
manager knows how to implement
that vision by selecting appropriate
team members for each role, and
nurturing their individual strengths.
In many smaller practices the leader’s and manager’s roles overlap,
and the owner and manager work
closely to implement the vision.
Each time we recruit, we try to
get “the right person” but if you feel
let down by your team, there are five
steps that practice managers can
put in place to create the culture
that they want within the practice.
STEP 1: Create a
team manual
Each time a new team member is
recruited, there is potential for miscommunication and disruption to
the practice. It is possible to minimise this by taking the time to develop a dedicated staff handbook or
team manual as a handy reference
tool. This should include day to day
operational procedures, code of
conduct, practice policies and procedures, health and safety, infection
control, information governance
and local child protection pathways.

Most managers are familiar with
PLANNED holiday charts to organise rotas, but try putting up an UNPLANNED leave chart. Mark planned
absence in GREEN and unplanned
absence in RED and without saying
too much you will find that persistent
offenders are embarrassed into mending their ways.

STEP 4: Re-induct using CQC as
your goal
Tell the team that you are getting organised for Care Quality Commission
registration, which all practices are
affected by from October 2010, and focus on the first two sections – patient
information and involvement, and personalised care, treatment and support.
(If you are not up to speed on CQC yet,
email seema.sharma@dentabyte.co.uk
to find out the outcomes that are expected from dental practices)
CQC registration provides a timely
reminder that teams should be able to
demonstrate:
• Practice culture and values – it is key
to ensure team members understands
the vision created by the leader of
the practice.
• Organisational structure – outline of
each team member’s role as an individual and within the team
• Policies and procedures – tell the
team about your new team manual!
STEP 5: Appraise and develop
Staff training needs should be identified and supported, with protected
time for learning and development
to optimise the team’s skills, happiness, performance and staying power!
Ideally a practice should have monthly meetings for clinical governance
training and practice management,
to keep the team aligned. The quality
of the service being provided by the
team should be audited regularly
and training arranged to align the

skills and work of those who are not
on track.
Key tips for practice managers
• Define individual roles
• Create clear job descriptions for
all roles
• Ensure advertisements clearly
outline the role which the candidate
is applying for
• Treat all applicants equally by
using template interview forms
and processes
• Offer the job in writing and provide
written terms and conditions ( contracts or licences)
• Conduct thorough
pre-employment checks
• If the new staff member has a probationary period, ensure
the details are outlined in the
offer letter
• Put new staff members through an
induction process
• Provide all team members with a
staff handbook /team manual outlining practice policies
and procedures
• Organise and record all staff
training and continuing
professional development
• Monitor individual
performance
• Conduct annual appraisals for all
team members
• Ensure that all team members have
personal/professional development
plans to maintain and develop their
individual skill sets
• Be aware of the human resource legislative frameworks around working
times, holidays, rest breaks, disciplinary procedures, stress, disability etc
• Maintain an accurate HR record for
each team member
Tomorrow’s Manager
So how does a practice manager fit all
this in ? Tomorrow’s practice manager
needs to learn to work smarter not
harder, to run a smooth practice and
maximise the team’s potential. Email
the author at seema.sharma@dentabyte.co.uk for a job description for the
practice manager of the future, then
set about developing your skill set.
Your knowledge will translate into an
increased bottom line and a stress free
practice, your boss will be happy! DT

About the author
Seema Sharma qualified as a dentist but
gave up clinical work
after 10 years in practice to go into full time
practice management.
Today she runs three
practices,
including
one which is a multidisciplinary specialist
centre. Seema established Dentabyte Ltd to provide affordable
“real-world” practice management programmes to help practice managers and
practice owners keep pace with the changing clinical and commercial environment
facing them today. Visit www.Dentabyte.
co.uk to register for updates on practice
management or email Seema at seema.
sharma@dentabyte.co.uk to find out more.

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[10] =>

10 Feature

United Kingdom Edition July 12-18, 2010

Question time for Tory policy
Addressing an audience of general dental practitioners at Addenbrookes Hospital,
Cambridge, Secretary of State for Health, Andrew Lansley, outlined the Conservative Party’s policies on NHS dentistry. Neel Kothari reports

irstly, wherever possible,
people should have equal
access to NHS services.
Although NHS dentistry has
always been different in that
dentistry has not always been
free at the point of delivery, in
general, we believe NHS dentistry should be part of a service funded through general
taxation, and wherever possible,
people should expect to have

away from an NHS designed
from the centre and then handed
out to public and move towards
a service designed around the
public’s needs.
The next principle is that
we should, wherever possible,
seek to maximise beneficial
health outcomes. Where dentistry is concerned like other areas in the NHS I want us wher-

‘I had met with many dentists involved with
PDS pilots and it seemed to me on the face
of it the new contract was designed to be
based on the experience of the PDS pilots.’
equal access to NHS dental
services. This does also mean
that we do not want to go down
the path of separating NHS
dentistry into two parts, for
those people who cannot afford
private dentistry and for those
people who cannot access NHS
dentistry, we firmly would like
to give everybody a sense that
they do have access to NHS
dentistry.
Secondly, we want have a
service centered around patients
and address what they are looking for, their expectations and
their needs. We want to move

MP Andrew Lansley: ‘‘The NHS is an
organisation based on 1.3 million
personnel, the great majority of whom
are health professionals and should be
treated like professionals.’’

ever possible to move away from
a service that is focused on inputs, ratios, processes and procedures and into a service that is
orientated on outcomes.
The last of the principles I
will try to apply is to do with
the working professionals within the NHS. The NHS is an
organisation based on 1.3 million personnel, the great majority of whom are health professionals and should be treated
like professionals. All of you
have [addressing the audience]
professional judgements, professional competencies and qualifications often acquired over a
considerable period of time
with a considerable amount
of effort on your part and we
should respect this and try
and deliver the best possible
service by recognising in every walk of life the best way of
achieving any outcome is to have
a positive engagement with the
staff who are trying to deliver
it. This is not done by competing or by making life more difficult for staff. Managing to deliver an outcome is about managing with and through people
who work in the service.
The history of the current
NHS contract
If we go back to the point at
which there were PDS pilots
and dentistry was contemplat-

ing what the new contract
would look like (not the one we
currently have), I had met with
many dentists involved with
PDS pilots and it seemed to me
on the face of it the new contract was designed to be based
on the experience of the PDS
pilots. To a considerable extent
we were quite supportive of the
pilots and felt optimistic that
this was to be the case. What of
course happened was that the
new contract seemed to almost
ignore them.
So why did all of this happen?
‘I think this rather an interesting question and I don’t pretend
that I have any special knowledge of this, but I have talked
to plenty of people who do, including many dentists involved
with PDS pilots and those involved with subsequent discussions with the DoH about the
new contract. The conclusion
they have reached was that it
didn’t happen for a very simple
reason: finance. When the Audit
Commission came in and looked
at the PDS pilots, they concluded that if you actually concentrate on capitation and
delivering better health outcomes for patients, the net outcome is that you do fewer procedures. This reduces the capacity
to charge patients, which relates
to a shortfall on patient charge
revenue. Based on second hand
information this shortfall in finances eventually led to the PDS
pilots being torpedoed.
Dentists now share along
with GPs in the results of a
government that has become
completely obsessed with being able to tell the public that
they are going to have increasing access to services, and that
access seems to be the only measure that matters. I’m not saying
that access doesn’t matter, but I
certainly do resist the proposition that access is the only measure that matters. Introducing
the new dental contract allowed
PCTs to have control over the
dental budget and was aimed
to allow PCTs to go out and buy
more access.

MP Andrew Lansley

In the short run this did
precisely the opposite, as 1,000+
dentists said we really don’t
want to go down the path of
this new contract. Dentists will
understand about some of the
perversities of the new contract
probably better then I do. I
find it very strange when you
go around the country and ask
dentists ‘how much are UDA’s
worth here?’ and you get very
different results in different
parts of the country and sometimes you can have very different
results within the same PCT area.
It is also very perverse how
the UDA structure creates a
powerful incentive to pull a
tooth out rather then carry out
proper root canal work as well
as many other perverse incentives. Understandably so, wherever you look in the NHS and
beyond, if you create a structure of financial incentives you
should not be surprised if people
respond to them. So if you create a structure that has perverse

incentives you should not be
surprised if people behave in
perverse ways.
From the public’s point of
view this has not delivered; we
are still in a position where overall the public’s access to NHS
dentistry is less now than it was
just prior to when the new contract was introduced. DT

About the author
Neel Kothari qualified as a dentist
from Bristol University Dental School in
2005, and currently
works in Cambridge
as
an
associate
within the NHS. He has completed a
year-long postgraduate certificate in
implantology at UCL’s Eastman Dental
Institute, and regularly attends postgraduate courses to keep up-to-date
with current best practice. Immediately post graduation, he was able to
work in the older NHS system and see
the changes brought about through
the introduction of the new NHS system. Like many other dentists, he has
concerns for what the future holds
within the NHS and as an NHS dentist,
appreciates some of the difficulties in
providing dental healthcare within this
widely criticised system.

[11] =>

Practice Managment 11

United Kingdom Edition July 12-18, 2010

Half Brained website?
Iain Scott highlights how dental websites need to
focus not only on aesthetics, but also on function

Y

ou may be aware that
the different sides of the
brain are responsible for
different functions; the left half
of the brain is logical, analytical and objective, whereas the
right half is random, intuitive,
creative and subjective. In the
majority of people, one side of
the brain is dominant leading to
distinct personalities and skillsets: left brained people tend to
be methodical, organised, technical, deep thinkers, while right
brained people are geared towards being creative, abstract
and conceptual thinking.
Looking around our studio,
I see developers typing away,
brows furrowed in concentration, writing the lines of code and
planning the infrastructure that
makes our websites work. Clearly they are left brained. Across
from me I can see David, our lead
designer; he’s leaning back in his
chair, focusing on his sketch pad,
thinking about design concepts
and ideas for one of our current
projects, creativity oozing from
him: clearly he’s right brained,
guided by his imagination and
powers of visualisation.
Not a team effort
It is amazing how many dental
websites I see that have clearly
been put together by only a designer: they’ll be visually exciting, quite often with striking
graphics or animations, but lack
easy navigation, the structure is
not intuitive and they are virtually invisible to the search engines.
Alternatively there are many that
have been put together by only
a developer or programmer: the
website design will be laid out
in an orderly fashion, there may
be one or two graphics, but nothing creative. On the other hand,
it will probably do well from an
SEO point of view (attraction)
as the content will be well organised, and it’ll have been built
with future updates in mind.

For both types of websites, I’d
describe them as being only half
brained, not through any fault of the
site author, but just because of the
way the human brain functions.

About the author
Iain Scott is managing director or
website design agency, Base Creative.
He will be speaking at the BACD Conference, Esthetics Meets Aesthetics, on
23–25 September 2010 at the Hilton
London Metropole. To register, visit
www.aacd.org.

Are you happy with your
website?
So look at your website objectively: is it only half brained or have
you achieved that rare website
nirvana? That is, a fully brained
website with both beautiful web
design and excellent technical functionality. If you have,
you’ll be attracting and converting more patients than you can
deal with, which I’m sure you’ll
agree, is a great situation to find
yourself in. DT

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[12] =>

[13] =>

Cosmetic Tribune
perio Tribune

perio Tribune

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are missing...

perio Tribune

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All-ceramic

Ethics of Aesthetics

ABB not ABC

A new look at some ‘old’ technology by Neil
Photay and David Hands

Roger Matthews speaks to Professor Richard Ibbetson on the ethics of cosmetic dentistry

Tif Qureshi details the latest treatment sequence

page 15

pages 16-17

pages 18-20

The wonders of teethwhitening treatment!

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Giving the people of Liverpool beautiful teeth behind
happy, confident, smiles says Dr Daz Singh BDS

I

n the heart of Liverpool city
centre sits a unique, award
winning cosmetic dental clinic.
Ollie & Darsh is the most exciting
new cosmetic dentist around and
has a simple ethos: to provide the
people of Liverpool with beautiful teeth behind happy, confident
smiles. With a range of treatments
available to help members achieve
and maintain the best possible
dental health, Ollie & Darsh prides
itself on its professionalism, skill
and relaxed, stress-free environment. This isn’t just an idle claim
either: last year Ollie & Darsh received the Most Attractive Practice
award at the Private Dentistry Awards
2009; a fantastic achievement for any
dental practice old or new.
Confidence to smile
Ollie & Darsh offers an extensive
range of treatments designed to

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plains why, ‘‘Whitening treatment
has become very popular and is
one of the most frequently requested forms of cosmetic treatment. In
today’s society, people are increasingly aware of not only the health
of their teeth, but also their aesthetic appeal. As a result of this, myself and doubtless many other practitioners have noticed a sharp increase in the demand for teethwhitening treatment. We offer clients three extremely effective teeth
whitening treatments, all of which
are approved by the British Dental

‘In today’s society, people are increasingly
aware of not only the health of their teeth, but
also their aesthetic appeal. As a result of this,
myself and doubtless many other practitioners
have noticed a sharp increase in the demand for
teeth-whitening treatment.’
give confidence to patients and peace
of mind with regards to dental hygiene and general oral health. Dr
Daz Singh BDS, is the Co-Clinical
Director at Ollie & Darsh, and is
passionate about furthering his
learning in the field of dentistry,
having learnt under the guidance of
internationally renowned dentists in
both the UK and the USA.
A highly popular and relatively new form of cosmetic dentistry is teeth-whitening.
Dr Singh decided to introduce this
treatment at Ollie & Darsh and ex-

Health Foundation. The latest “laser”
whitening technique is called Zoom
3D Advance as is without doubt the
quickest way to lighten your teeth by
up to ten shades.’’
Choice of suppliers
There are many whitening products available on the market today,
so the choice of suppliers is potentially enormous. How did Dr Singh
decide which supplier was right for
his practice?
‘‘When deciding on which supplier to use, it was an easy deci-

sion. I chose Discus Dental. Having
used and experienced the products
from Discus Dental for many years
now, I have always found them to be
easy to use, highly effective and
good value for money; I saw no reason to look elsewhere. I am currently using Zoom 3D Advance at Ollie
& Darsh, which is the most recent
addition to the Zoom range, and,
having used the previous versions,
I felt comfortable and confident that
both my clients and myself would
benefit from using it. Discus Dental
is well known for whitening products
and is, in fact, the world leader in
this category. The company seemed
like an obvious choice, and the fact
that I have had positive, first hand
experience of working with them
made my decision all the easier.’’
Whitening Wednesdays
As with the introduction of most
new concepts, intelligent marketing plays an integral role. Due to the
fact that many other dental practices
offer whitening treatment, it was
essential that Dr Singh thought
carefully about the best way to go
about promoting Ollie & Darsh’s
own unique teeth-whitening service.
He explains,‘‘I was aware of the need
to make our whitening treatment
stand out amongst the crowd of other clinics offering the same service,
and, as a result, the marketing was
given a lot of thought. After much
consideration, we decided on promoting our whitening treatment by
offering 50 per cent off Zoom 3D
Laser Whitening every Wednesday.
We called it Whitening Wednesà DT page 14

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[14] =>

14 Cosmetic Tribune
ß DT page 13

Dr Daz Singh of Ollie & Darsh

day and our aim was to attract
our
existing
(and
potential!)
members,
by
offering a very popular treatment
for outstanding value once
every week. The response
was immediate and very impressive! We have certainly
seen a significant increase in
our profits since the special
offer incentive was launched
and have experienced a noticeable growth in client requests
for whitening; we’ve even taken

United Kingdom Edition

the occasional referral from
other clinics.’’
Client Feedback
With teeth whitening treatment
in such high demand, how have
clients at Ollie & Darsh responded to the ‘Whitening Wednesday’
incentive?
‘‘The ‘Whitening Wednesday’ special offer has been a total success with clients. We’ve
received incredibly positive
feedback from all our clients

who have had Zoom 3D Laser
Whitening treatment and many
more have booked appointments. What many people don’t
know is that you only need a
single 90-minute appointment
to whiten and give sparkle to
your smile. It’s an extremely
efficient and efficient form of
treatment.’’
Having used Discus Dental as suppliers for the teethwhitening product Zoom 3D,
Dr Singh offers an insight into

July 12-18, 2010

working with Discus. ‘‘Having used Discus Dental as suppliers before, I was confident
that my experience this time
around would be just as
positive, and I wasn’t disappointed. They have a highly
efficient team and the direct
sales
models
means
that
Discus Dental can remain in
direct contact with you. There
is no one in the middle and
there are no marked up fees,
which is great. Discus Dental
also maintains direct access
with the manufacturer enabling
them to address your specific
queries and concerns.’

‘We have seen a increase in our profits
since the special
offer incentive was
launched and have
experienced growth
in client requests for
whitening.’
Having successfully launched, marketed and reaped the
financial rewards of a new treatment within the practice, what
advice would Dr Singh have for
other practitioners musing on
following suit?

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Dr Daz Singh BDS is
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• Special tips for precise application for all endo bleaching treatments

He is a great sports
enthusiast and enjoys
playing football and
cricket. He is also an
avid West Bromwich Albion Fan. Dr
Singh graduated from the University of
Liverpool and have settled and worked
in the city ever since.

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He has passionately sought further
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UK and the USA, has honed his clinical
ability to provide the best level of care
for patients at Ollie & Darsh.

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‘‘I would encourage any
dentist considering launching
a new treatment like whitening, to think carefully about
the way in which they plan to
market it. It’s such a crucial
aspect of any business, and
one, which, if done effectively,
will draw in new clients and
impress your existing ones!
In addition to this is making
sure that you have a reliable,
professional and expert supplier as this makes a massive
difference. Working with products that you have faith in and
know to be highly effective and
efficient is vital, it gives peace
of mind to both practitioner and
client. I’ve been delighted at the
success of ‘Whitening Wednesday’s’ at Ollie & Darsh. It’s clear
to me that by combining strong
marketing and excellent product suppliers, you are guaranteed success!’’

23.06.2010 11:19:45 Uhr

[15] =>

United Kingdom Edition July 12-18, 2010

Cosmetic Tribune 15

The new ‘old’ technology

Neil Photay and David Hands look at All-ceramic restorations

here is an old saying that
‘nothing is ever invented
and perfected at the same
time.’ Take a moment to consider
the advancements seen in the
dental industry and it’s clear that
many innovative techniques and
materials have required a great
deal of refinement in order to become successful treatments patients now benefit from today.
Consider restorations. In the
past the profession has seen great
leaps forward in the materials
and methods used to create and
fit restorative implants. One of the
central concerns of any restorative work is the balance between
strength and aesthetics of the implant. The progress made using
titanium helped address some of
the strength issues, but clinicians
have long known the aesthetic
limitations of metal. As a result,
maintaining the aesthetic integrity has always been a challenge.
In today’s image-conscious
society, providing restorations
that are aesthetically pleasing
is often now a priority for more
patients. Clinicians who address
this demand are the ones who
will ultimately benefit from a developed patient base: that is why
it is time to reconsider all-ceramic implants.
At the time of its introduction,
when dental professionals did
their research, they found that
while the all-ceramic could meet
the aesthetic needs, it was compromised by a lack of strength
and durability. Like so many new
innovations, it failed to live up to
the expectations.
But that was then. Now there
have been great advances in both
the materials themselves as well
as the technologies at the disposal of dental laboratories to create outstanding restorative work
that surpasses all expectations in
terms of both strength and aesthetics. All-ceramic has had time
to mature into an effective restorative solution, and this is supported by an abundance of research

About the authors
Neil Photay BSC (Hons) GDC Reg.
Technician. Neil proudly carries his
family tradition of working in the dental industry and creating and manufacturing dental innovations and technologies. Working at both the CosTech
Laboratory and family dental surgeries from the age of 16, Neil completed
a BSc(hons) in Computer Science,
before returning to the Costech Elite
laboratory in 2003.
David Hands MDT GDC Reg. Technician. David studied Dental Technology
at Lambeth college in 1999 achieving
BTech national diploma in science
and dental technology, and advance
HNC/ HND in dental technology. He
further trained with Master Technicians in the USA in ‘Advanced Aesthetics’ and ‘Smile Design’, gaining the
Master Technician status. David joined
CosTech in 2004.

and clinical evidence.
Cubic zirconia possesses several advantages over traditional
crown and bridgework materials
of metal and porcelain, but chiefly
it possesses the strength required
to maintain a durable restoration
whilst retaining the advantage of

being lighter and more natural
looking. One criticism leveled at
zirconia in the past is that it is not
biocompatible, but how compatible is metal? Many clinicians are
seeing less of an allergic reaction
between the all-ceramic restoration and the gum line, maintaining the aesthetically pleasing

nature of the work, to the overall
satisfaction of the patient.
As well as materials, the
technology has undergone rapid
transformations over the recent
years. At the scanning stage, the
model created from the impression taken is scanned by a ma-

chine capable of providing a phenomenal 100,000 points of data
per laser-triangulated scan. This
means an accuracy of 20 microns
is achieved and helping to create
a finished product engineered to
the highest degree of quality.
Those dentists already using
all-ceramic restorations are seeing the benefits of being able to
market the work as a more costeffective solution, and the opportunity it presents to grow patient
base and treatment acceptance. DT

[16] =>

16 Cosmetic Tribune

United Kingdom Edition

July 12-18, 2010

Dental Care or Beauty Treatment?
Denplan’s Roger Matthews speaks to Prof Richard Ibbetson on the subject of ethics

T

he aesthetics of dental restorations have always been
important and over the last
few years there has been a big increase in both the demand for, and
the supply of cosmetic dentistry.
There are ultimately three factors
responsible for this – the media,
patients and dentists themselves.

However, the fact of the matter is that some modern cosmetic
treatments may give little or no
thought to the future of the patient or what will happen to them
down the line. With treatments
such as veneers and implants on
the rise, dentists should be asking themselves, ‘what is best for

the patient?’ not ‘what does the
patient want right now?’

themselves to be influenced by
the desires of their patients.

Denplan’s Chief Dental Officer, Roger Matthews, interviews
Professor Richard Ibbetson to
discuss the ethical implications
of ‘selling’ cosmetic dentistry and
how much dentists should allow

In your opinion, what is the
dentist’s ethical obligation to
their patient when it comes
to cosmetic treatments?
“Dental care is about keeping
people pain-free and healthy,

while trying to satisfy their cosmetic concerns. However, with
magazines full of adverts for cosmetic dentistry and more people
aspiring to celebrity ideals, aggressive dental treatments for
aesthetic reasons alone are on
the rise to a worrying degree.
“In my view, any dental
treatment undertaken should
always be:
• Safe
• Conservative
• Predictable
• Patient directed
• Dentist monitored
“Many patients will come
into a surgery convinced of the
treatment they want. It is the
dentist’s job to ensure the decision is not rushed, that less invasive routes are explored and that
the risks are discussed in full.
We are taught as business owners that the customer is always
right, but when measuring the
aesthetic outcomes of various
treatments, what the customer
perceives can be subjective. In
fact, many patients will be open
to trying less aggressive procedures first, when they are fully
appraised of the potential downside of their initial preference.”
It has been a rising trend
for many years now that
amalgam fillings are being
replaced with the more aesthetically pleasing composite fillings. Is this a problem?
“In many cases dentists use
composite as a matter of course,
without ever giving patients the
choice. There are some situations where composite is the best
material for restoring a posterior tooth as it can be more conservative of tooth tissue. However, dentists know that direct
composite fillings, particularly
large ones, are more difficult to
perform and have a significantly
shorter life-span.
“As oral healthcare professionals, obliged by codes of practice, we should therefore always
talk through potential risks with
patients in order for them to
make an informed decision. In
the same way that dentists will
often choose amalgam fillings
for their own treatment, in practice I have found that patients
are far more open to amalgam,
when they understand that composite fillings are not without
their disadvantages.”
What impact has celebrity culture had on the profession?
“Celebrities such as Britney Spears and Simon Cowell have a lot to answer for
when it comes to dental treatment! Their “too-perfect” teeth
have all too often brought peo-

[17] =>

United Kingdom Edition July 12-18, 2010

ple into the dental surgery
with unrealistic goals, which
subsequently can pose a moral
issue for the treating dentist.

of repeat treatments and recurring problems. “

“As a profession we should be
ensuring that teeth outlast people,
not the other way round. The first
“The risks involved in porceprinciple is to preserve the palain veneers are significant, but
tient’s tooth structure wherever
this fact is often lost on people
possible. The life of the tooth is
who are continually bombarded
far more important than the life of
with images of ‘perfect’ teeth in
the crown or veneer. Treatments
the media. Although fracture or
such as A4
all SELECTED:Layout
ceramic crowns and1
loss of cementation of a veneer is Estetica
aggressive preparations for verare, deterioration in appearance
neers may mean the extensive reparticularly due to marginal dismoval of tooth tissue. In the event
colouration is more common
and constitutes a failure. Therefore, it is our responsibility to
inform patients of the risks and
benefits of veneers before they
willingly agree to the removal of
healthy tooth structure.

of a restoration failure or future
problems, there can be little tooth
structure left to work with.
“As healthcare professionals
we should be continually working under a system of compliance,
education and communication. All
dental treatments are temporary:
deterioration and failure are inevitable. Dentists should reflect on
modern trends
and Page
decide1wheth25/2/09
13:42
er the demands of their patients
out-weigh their moral obligations.
As such, it should be a matter of

Cosmetic Tribune 17
professional pride to decline treatments if they are felt to be unnecessary or unethical. If we fail to do
this it is only a matter of time before we are truly a lost profession.”
Final thoughts
I didn’t know it at the time, but
back in the Seventies I became
an enthusiast for minimally invasive dentistry. Back then, the
idea of keeping as much tooth
structure intact seemed much
more appealing than gambling
on the success of full dentures

and this is still true when looking at the costs of implants today.
It is clear that both Richard
and I are keen supporters of
prevention where possible and
high-quality preservation when
appropriate. To act otherwise is a
breach of our professional ethics:
and this should apply whether
the impetus for treatment originates with the dentist’s diagnosis
or the patient’s aspirations. Both
are legitimate, and both need the
same care in evaluating. DT

KaVo – Dental Excellence

“Interestingly, an increasing
number of people opt for veneers
simply to make their teeth whiter.
For a dentist to agree to this method of treatment solely for this
reason is unethical, as more
often than not, the results look
unnatural, over the top and simply odd. In many cases, bleaching teeth can achieve much of the
desired result without the loss of
healthy tooth structure. It is one
of the least harmful procedures
and many patients who were considering aggressive treatments
such as veneers are often completely happy with the results of
whitening alone.”
“This illustrates why dentists
should always explore a range of
options with the patient (including no treatment), before agreeing to a more complex approach.
Investigating other avenues allows the patient to make an informed decision and the dentist
to convey the benefits and risks
of each procedure, while protecting professional ethics. Remember, just because a patient says
they want something, does not
mean that a dentist must do it.”

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Another trend to appear in
recent years is that of ‘instant
orthodontics’. How do you
think this will affect
younger patients?
“More and more patients, young
adults in particular, are coming to dentists for treatments
such as implants and veneers
to avoid the traditional ‘traintrack’ orthodontic route. This,
however, is simply bad dentistry. To destroy good teeth for
a quick aesthetic result is not
only unethical but will subject
the young patient to a lifetime

Prof Richard Ibbetson
Richard Ibbetson – Director, Edinburgh Postgraduate Dental Institute
and Honorary Consultant in Restorative Dentistry, Lothian Primary
Care NHS Trust. Richard graduated
from Guy’s Hospital in 1974 and completed an MSc at the Eastman Dental
Institute in 1979. He worked at the
Eastman for 20 years before taking
up the post of Director of Postgraduate Dental Institute in Edinburgh. His
main clinical interests centre on the
postgraduate teaching and practice of
Fixed Prosthodontics.

*Finance is subject to status and for business purposes only.

Contact your local KaVo or

Gendex supplier for more details!
KaVo Dental Limited · Raans Road, Amersham, Bucks HP6 6JL Tel. 01494 733000 · Fax 01494 431168 · mail: sales@kavo.com · www.kavo.com

[18] =>

18 Cosmetic Tribune

United Kingdom Edition

July 12-18, 2010

ABB (Alignment,
Bleaching, Bonding)
The Treatment Sequence that should change
Cosmetic Dentistry says Tif Qureshi

T
The UK’s leading supplier of
dental anaesthetic, Septodont,
already bring you the high quality
Septoject and Septoject XL
needles and would now like to
introduce a new development
to Ultra Safety Plus.
Ultra Safety Plus syringe is
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Plus is now 100% disposable.

his article will outline how
the combined and simultaneous use of the Inman
Aligner, tooth whitening followed by
edge bonding can redefine the approach taken to smile design. It also
highlights how it will help dentists
respect a patient’s decision as their
treatment progresses rather than
shortcutting to an end result using
ceramics setup with classic smile
design principles.
Discussion.
“Changing cosmetic dentistry“ might
seem like a pretty big goal, but It’s
become very clear from lecturing
and writing about this particular discipline that it creates a huge amount
of excitement and positive reaction.
Dentists see the logic in it very quickly and can also see how, with some
education, they can employ a safe,
low risk technique that they know
their patients will want and will
massively change their approach
to cosmetic and aesthetic dentistry.
They also understand that there is
a massive market of patients who
will accept this kind of non-invasive
treatment happily.
Treatment with the Inman Aligner has been further developed in the
UK where techniques are used to
make it dramatically effective as a
solution for certain mild and moderate anterior orthodontic issues. Cases, which traditionally would take
six-10 months with clear aligner systems can, with education, be treated
in six-16 weeks.

We have all seen how bleaching can affect a smile. We know
how much bonding can improve
aesthetics and tooth anatomy. Now
that alignment is potentially so
simple, these three disciplines
have been brought together to create results that easily challenge traditional veneer based smile makeovers. And, if the three treatments
are combined with some thought,
it is possible to massively improve
a patient’s smile in around three
months.

For more information please
contact your dental retailer
www.septodont.co.uk
Anaesthetics • Endodontics
Restorative Dentistry • Dental Surgery
Prosthetic Dentistry • Disinfection & Hygiene

‘If the three treatments are combined with some
thought, it is possible to massively improve a patient’s smile in around three months.’
All of a sudden the six-10 unit veneer case used for a smile makeover
can look ridiculous and be seriously
in danger of becoming over treatment. There are always situations
where ceramics are highly appropriate, such as in wear cases or in major
reconstructions, but for anyone with
good quality intact enamel, I believe
this kind of treatment represents a
far more ethical, patient centric approach.
This is because I believe the way
smile design is approached, and
perhaps even taught, is wrong. The
final outcome, for what is aesthetic
is important. Golden proportion ideals, tooth width length ratio, gingival
zeniths etc all together create something we know to me almost mathematically correct. The problem is
that most dentists’ experience their
smile design education attached to
a lecture or course based on veneer
dentistry. As a result dentists will
naturally think this to be the only
and perhaps fastest way to achieve a
“perfect smile”.
If we assess a patient’s smile and
try to preview an end result at the
first consult, using imaging software, a wax up or even a preview
try in, we are not really letting the
patient see their teeth improve at
different stages to see if their expectations are being met along the way.
The smile design rules are there,
but how many patients if they see
their teeth improving with alignment then bleaching and then bonding, would actually then take another step with porcelain and some
tooth destruction to achieve total
perfection? In my experience, very
few.

Some still do go further,
but at least by then their
teeth are straight and we can use
truly minimal and almost no prep
veneers to improve the aesthetics
further.
Most of the time, once we are
¾ through alignment and start to
bleach it becomes very clear that
simple bonding is all that will be
needed to create a very aesthetic
smile that previously would only
have been achieved with aggressive
veneer preps.
The case outlined below is a typical case of a patient who once wanted and considered having porcelain
veneers. Instead she opted to align
her teeth then bleach and bond.
Case and Diagnosis
This 32-year-old patient complained
about the “crooked look” of her
smile. The patient was aware of what
a smile makeover could achieve, but
wanted to achieve something without damaging her teeth.
On examination several problems existed. Firstly her teeth were
moderately misaligned. This creates
aesthetic issues immediately. Large
unsightly embrasures were made
worse around the canines. The instanding laterals appeared darker
and in the shadow of the lips, the left
one being in slight cross-bite. With
the centrals splayed out and rotated
the line angles of the four incisors
were all different.
It was clear at the start by examining the incisal edges that there
had been differential degrees of wear
meaning that even if the teeth were
aligned, the incisal outline would

[19] =>

United Kingdom Edition July 12-18, 2010

still look uneven - this meant we
needed to have a conversation
about some potential edge build
ups after.

lapse and the midline can even
be unwound after the anteriors
have aligned. Each turn produces 0.25mm of space.

All options were discussed.
The patient ruled out fixed braces, even with more recent faster
techniques because she wanted,
something removable and we
had also discussed the possibility of simultaneous bleaching
during the alignment phase.

Treatment sequence
The Inman Aligner was fitted
at the next appointment. Instructions were given and only
a small degree of IPR was performed over the front teeth (0.1
mm per contact).

We assessed for an Inman
Aligner. At the consultation the
occlusion was examined and it
was clear that the laterals had
room to advance labially and the
centrals could also be derotated.
We then needed to assess the
actual amount of space needed.
Inman Aligner cases should be
planned carefully to ensure the
case is suitable and also to understand how much space needs
to be created. This can be done
with models using Hanchers
technique (1). The SpaceWize tm
crowding calculator was used to
assess the patient in the chair.
An occlusal photo was taken
with a mirror and the upper central tooth was measured with
digital calipers to help calibrate
the software.
The occlusal photo is uploaded and the calibration tooth
details entered. The mesial distal widths are simply drawn on
for the all the teeth to be moved
which in Inman Aligner treatment is always the front 6 teeth.
The software calculated the total
of the mesial distal widths and
this is described as the Required
space. An ideal curve is then
plotted with the software with
the proposed final position. This
is made with occlusion, aesthetics and function taken into consideration. The curve can be
manipulated easily with the software and this gives us the Available space. The difference between these two measurements
is calculated automatically and
this is the amount of space that
needs to be created to achieve
the final result.
As can be seen in the
Spacewize tracing, 3.1mm of
crowding was present. This may
seem less than expected when
considering the degree of crowding when looking at the occlusal
photo, but because the laterals
are advancing forward, this will
actually create space.
It was decided that an Inman Aligner with incorporated
expander would be used to treat
the case. Incorporated expanders are a useful tool to create
space supplementary to IPR or
as an alternative. They must not
be expanded beyond 2.5mm and
only supply a temporary degree
of space to allow the anteriors to
align. The small degree of posterior expansion will always re-

No IPR was performed initially around the centrals be-

cause with the degree of crowding it would be easy to miss the
contact point. Instead the teeth
are stripped strategically and
progressively meaning we release a little room to allow the
teeth to align then we re-perform
IPR over several visits again only
performing a little at a time.
Critically Inman Aligner
treatment uses progressive anatomically respectful IPR. Despite
calculating the amount of crowding present, the IPR is never car-

Cosmetic Tribune 19
ried out in one go. IPRs strips or
discs are only used. This gives
the opportunity to ensure the
stripping is far more anatomically respectful than using burs
or heavy discs.
This massively reduces the
risks of excess space formation,
gouging or poor contact anatomy.
The contacts are smoothed and
the fluoride gel is applied each
time.(2-9). Composite anchors
were also placed on the palatal
incisal edge of the instanding

lateral teeth to ensure the palatal
bow engaged correctly.
The patient was also shown
how to turn the midline screw.
She was instructed to do this
once a week and did this for seven weeks, but was seen every 2-3
weeks to check progress and reperform a little IPR if necessary.
The patient was instructed to
wear the Inman Aligner for 16à DT page 20

[20] =>

20 Cosmetic Tribune

ß DT page 19

18 hours a day. Studies (10,11) show
that this is far less likely to cause
root-resorption and the Inman
Aligner is highly effective even
with the Aligner out eight hours
a day. This allows better hygiene and patients can also function with day-to-day activities
more normally.
After nine weeks the laterals
were already getting close to the
proposed position and the centrals were de-rotating nicely.
At this point with Inman
Aligner treatment we often start
to bleach. Impressions are taken
even though the result is 25 per
cent from finished.
Sealed, rubber trays are made
and careful instructions are given to the patient.
While the patient is highly
concentrated on using the Inman Aligner, they are always
highly receptive to using bleaching trays. It adds greatly to mo-

United Kingdom Edition

ing ceramic veneers in this approximate time.

tivation and often means they
achieve a far better result. Discus
Dental Day White is used so that
the patient only needs to wear
the bleaching trays for 35-45
minutes a day. The patient was
happy with the degree of whitening achieved.

Venus from Hereaus Kulzer
was used in dentine and enamel
shades in B1 was used to build
the missing incisal outline. The
teeth were then polished with
discs, pogo sticks and flexibuff
discs. The patient initially was

It was becoming highly apparent to the patient at this stage
that she would only need some
final edge bonding to achieve a
very aesthetic result.

‘This patient achieved a result in just 13
weeks that she had only previously thought
possible using ceramic veneers in this approximate time.’

The patient whitened for two
weeks. At week 11, alignment
with the inman aligner was almost complete. A single clear
aligner was used to correct some
minor spacing and also to help
bring the right canine into line.
After using the Inman Aligner,
canines are far more receptive to
movement with clear aligners.
At week 13 the incisal edges
from canine to canine were only
slightly roughened. No local anaesthetic is required with this
simple additive bonding.

She also achieved it without
any damage done to the teeth
other than truly minimal and
anatomically respectful IPR.

not keen to have centrals that
were longer than the laterals so
a fairly flat smile line was created. One week later she returned
and asked for another 1.5mm of
central incisal length. This was
again provided by adding more
Venus. At the same visit a wire
retainer was bonded in place
from canine to canine. (12,15)

Her teeth are far better placed
for future ceramic restorations
if necessary.
She commented that she
was worried that with veneers,
she would have lost the natural
character of her teeth, but by a
using ABB, this was retained
and we just made her own teeth
more beautiful.

Results
This patient achieved a result in
just 13 weeks that she had only
previously thought possible us-

Discussion
Any dentist offering cosmetic
and restorative dentistry should
be aware of all developing tech-

References
1) Hancher P Orthodontics for Esthetic Dentistry Part1. Journal of Cosmetic Dentistry Winter 2005 (20) 4. 2) Sheridan, J.J.: Air-rotor stripping update. J. Clin. Orthod. 21:781-88, 1987.
3) Sheridan, J.J.; Ledoux P.M.: Air-rotor stripping and proximal sealants: an SEM evaluation. J. Clin. Orthod. 23:790-94, 1989. 4) Crain, G.; Sheridan, J.J.: Susceptibility to caries and
periodontal disease after posterior air-rotor stripping. J. Clin. Orthod.24:84-85, 1990. 5) Sheridan, J.J.: Hastings, J: Air-rotor stripping and lower incisor extraction treatment. J. Clin.
Orthod.26:18-22, 1992. 6) El-Mangoury N, et al. In vitro remineralization after air-rotor stripping. J Clin Ortho 25 (2):75-78,1991. 7)Radlanski R.(1991) Morphology of interdentally
stripped enamel one year after treatment. J Clin Ortho 23 (11)748-750, 1991. 8) Heins PJ. The relationship of interradicular width and bone loss. J Periodont 59 (2):73-79,1988. 9) Tal H.
relationship between the interproximal distance of roots and the prevalence on intrabony pockets. J Periodont 55 (10):604-607 1984 10) Inactivated periods of constant orthodontic movement forces related to desirable tooth movement in rats. T. Kameyama et al. Tokyo Medical and dental university, Japan. Kame.orts@tmd.ac.jp. 11) Apical root resorption in upper anterior teeth :Brita Ohm Linge and Leif Linge.The European Journal of Orthodontics 1983 5(3):173-183; doi:10.1093/ejo/5.3.173 © 1983 by European Orthodontic Society. 12) Reprinted:
Case CS. Principles of retention in orthodontia. Am J Orthod Dentofacial Orthop 2003;124(4):352-61. 13) Little RM, Reidel RA, Artun J. An evaluation of changes in mandibular
anterior alignment from 10 to 20 years post retention. Am J Orthod Dentofacial Orthop 1988. 14) (6) Blake M, Bibby K. Retention and relapse: A review of the literature. Am J Orthod
Dentofacial Orthop 1998;114:299-306. 15) Becker A, Goultschin J. The multistrand retainer and splint. Am J Orthod 1984; 85:470-4.

July 12-21, 2010

niques. Many patients in the UK
are choosing this approach and
are demanding it in their practices. This approach is becoming common with dentists who
offer orthodontic solutions, so
not offering it and only offering
ceramic solutions could result
in potential consent issues.
The simple fact is that once
a dentist is educated in the advanced use of an Inman Aligner, this kind of treatment is far
simpler and less risky than
treatments
where
large
amounts of tooth structure are
removed and where there is a
heavy reliance on porcelain for
the final result. Being able to
align and bleach simultaneously adds huge value and increases motivation tremendously.
Long-term predictability is
far better and the patient doesn’t
enter a restorative cycle that
can easily worsen the long-term
prognosis.
Patients are also far happier
because the treatment is more
affordable, and they understand
the benefits of reducing long
term risk by aligning, bleaching and bonding. Compared
to the traditional methods of
providing ideal smile design,
ABB represents a radical and
arguably revolutionary change
in the way cases like this
are approached.
A far more truly conservative result that actually respects
the opinion of the patient at different stages means that heavy
arch form preparations, with
aggressive tooth removal just to
line teeth up to allow space for
veneers, could soon become a
thing of the past.
Disclosure.
Dr. Qureshi runs hands on
courses with Dr. James Russell
and Dr. Tim Bradstock- Smith
and lectures on the Inman
Aligner worldwide.
Acknowledgements.
The author thanks Donal Inman C.D.T. Inman Orthodontic
Laboratory, Florida, Nimrodental Ortho Lab Paddington London (The only STS Certified Inman Aligner Laboratories.) DT

Course Information
Information about course dates and
training can be received from www.
straight-talks.com or www.inmanaligner.com. Alternatively contact Caroline Cross on +442072552559 email
info@straight-talks.com
Tif Qureshi will be speaking at the
BACD Conference “Esthetics Meets
Aesthetics” on 23 - 25 September 2010
at the Hilton London Metropole”. To
register, visit www.aacd.org

[21] =>

[22] =>

22 Education

United Kingdom Edition

July 12-18, 2010

Learning Curve
With more than 4,500 new cases opened every year, there is a wealth of experience
within Dental Protection from which all of us can learn

he confident approach
of the professional can
go a long way towards
influencing the eventual outcome of a treatment. If noth-

ing else, the dentist’s positive
attitude allows the patient to
accept a period during which
the tooth settles down after
treatment. But if treatment be-

comes a little more complicated
than expected, that same confident approach should extend to
sharing this information with
the patient.

Consider a case of endodontic treatment on a lower first molar. The dentist separated a file in
the early stages of the procedure
without the apical two thirds of

the mesio-buccal canal having
been instrumented in any way.
The dentist completed the endodontic treatment without any
comment to the patient about the
separated file or the possible future implications.
The tooth never settled down,
in spite of frequent prescriptions of antibiotics. The dentist
offered no explanation to the patient, when they asked why the
tooth was not responding. Eventually another dentist extracted
the tooth while the patient was
on holiday.
A better explanation
The second dentist explained
the need for an extraction and
also informed the patient about
the broken file. A settlement
was agreed with the patient, not
because the file had separated
during treatment, but because
the dentist failed to discuss and
document the presence of the file
in the records.
The implications that a
separated instrument has on
the prognosis for a tooth will
depend on its position, its effect
and whether or not the canals
can be effectively sealed. The
equipment and techniques for
resolving such a situation, where
the treatment of choice is the removal of the separated instrument, are often best achieved by
referral to a specialist endodontist if available.
It is imperative that patients
are fully informed about the
risks of any treatment that they
are about to undertake, and are
given the option of seeing a specialist if appropriate. This is particularly important if the treatment might exceed the dentist’s
skill and experience, and ability
to deliver an acceptable standard
of care.
In the absence of a local specialist, dentists should consider
making a referral to a more experienced colleague. Any discussions about a referral and the
patient’s decision should be carefully documented in the records.
Watch out for another Learning Curve from Dental Protection
in future editions of Dental Tribune UK. DT

DM Indesign.indd 1

29/10/09 13:35:27

[23] =>

United Kingdom Edition July 12-18, 2010

Clinical 23

Back to the Egg; Part I
Kenneth Serota continues his look at the Endodontic Implant Algorithm

F

our thousand years ago,
a number of Babylonian legal decisions were
compiled in what came to be
known as the Code of Hammurabi. The one referencing the construction of dwellings and the responsibility for their safety begins;
if a builder engineers a house for
a man and does not make it firm,
and the structure collapses and
causes the death of the owner, the
builder shall be put to death.
We are all builders or engineers of sorts; we calculate
the path of our arms and legs
with the computer of our brain
and we catch baseballs and
footballs with greater dependability than the most advanced
weapons system intercepts missiles. In our professional lives
however, in contradistinction
to the paradigm of evidence-based
dentistry, our efforts as builders
often rely solely upon personal
experience, intuitive cognition
and anecdotal accounts of successful strategies.
Vigilant interaction
The challenges posed by implantdriven treatment planning mandate vigilance of the interaction
between those involved in research and development, manufacturing and distribution and the
leaders of ideologically diverse
disciplines. Temporal shifts and
trends in the service mix are part
of the evolution of the art and science of dentistry; to some degree,
the implant-driven vector has
captured the heart and minds of
those who seek to nullify preservation of natural tooth structure
in the oral ecosystem and deify
orthobiologic replacement. The
corporate entities from which we
derive our tools too often fail to
distinguish the point where science ends and policy begins.
By positioning advocates and
acolytes at the vanguard of their
marketing campaigns, they effect change; however, their support for education is directed towards dissemination of product,

not the fundamentals and rudiments of biologic imperatives.
Prospective large cohort clinical
trials with clearly defined criteria for survival, with and without
intervention, quality of life information and economic outcomes
are essential to compare alternative foundational treatments.
These studies will require expertise, time, and financial support
from the various stakeholders,
professional and corporate alike
(1)
. According to Cicero, ‘The authority of those who teach is often
an obstacle to those who want to
learn.’
Sacrificing teeth
The prosthodontic pundits maintain that the spiraling costs of
saving endodontically retreated
teeth, where extraction may
well prove to be the common
endpoint, begs the question of
whether such teeth should be
sacrificed early. Ruskin et al
concluded that implants have
greater success than endodontic
therapy, are more predictable,
and cost less when you consider
the “inevitable” failure of initial
root canal treatment, retreatment, and periapical surgery (2).
Is it responsible therapeutics
or irresponsible expediency that
justifies the removal and restoration of such teeth from the outset
with an implant-supported restoration? Can one ethically argue
that extraction is warranted as
the financial cost of orthodontic
extrusion/soft tissue surgery, endodontic retreatment and post/
core/crown fabrication is greater
than extraction with an implantbuttressed restoration, and in all
likelihood, more predictable (3)?
Jokstad et al (4) identified over
220 implant brands in the dental
marketplace. With variability in
surface, shape, length, width and
form, there are potentially more
than 2000 implants for any given
treatment situation. A systematic
review by Berglundh et al (5) assessed the reporting of biologic
à DT page 26

Fig 2a. The use of dyes, colouring agents and micro-etching is invaluable in visualizing a suspected crack in tooth structure. Cohen et al
found that when premolars were used as bridge abutments, a surprising number of these abutments sustained a VRF. [J Am Dent Assoc
2003; 134(4)434-441].

à DT page 26

Fig 1: The term tipping point refers to the moment of critical mass, the threshold, the boiling point. The
colour sequence highlights the diagnostic steps to be followed in each tipping point algorithm for the listed
pathologic states.

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gingivitis; maintenance of oral hygiene; post periodontal surgery or treatment; aphthous ulceration; oral candida. Dosage & Administration: Adults and children 12 years and over: 10ml rinse for 1 minute twice
daily or pre-surgery. Soak dentures for 15 minutes twice daily. Treatment length: gingivitis 1 month; ulcers, oral candida 48 hours after clinical resolution. Children under 12 on healthcare professional advice only.
Contraindications: Hypersensitivity to chlorhexidine or excipients. Precautions: Keep out of eyes and ears, do not swallow, separate use from conventional dentifrices (e.g. rinse mouth between applications). In
case of soreness, swelling or irritation of the mouth cease use of the product. Side effects: Superficial discolouration of tongue, teeth and tooth-coloured restorations, usually reversible; transient taste disturbances
and burning sensation of tongue on initial use; oral desquamation; parotid swelling; irritative skin reactions; extremely rare, generalised allergic reactions, hypersensitivity and anaphylaxis. Legal category: GSL. PL
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References: 1. Veihelmann S, Mangold S, Beck P, Lemkamp V, Schmid F-G, Schlagenhauf U. Hemmung des Plaquewiederbewuchses auf Zähnen durch die Chlorhexamed alkoholfrei Mundspüllösung [Inhibition
of plaque-regrowth on teeth by Chlorhexamed alkoholfrei mouthrinse]. Parodontologie 2008; 19 (3): 326. 2. GlaxoSmithKline data on file, Bacteria Kill Test, In Vitro, SGS 2007. 3. GlaxoSmithKline data on file,
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Product Information: Corsodyl Mint Mouthwash (clear, chlorhexidine digluconate 0.2%), Corsodyl Original Mouthwash, (pink, chlorhexidine digluconate 0.2%) Corsodyl 0.2% Mouthwash (alcohol free) (clear,
chlorhexidine digluconate 0.2%) Indications: Plaque inhibition; gingivitis; maintenance of oral hygiene; post periodontal surgery or treatment; aphthous ulceration; oral candida. Dosage & Administration: Adults
and children 12 years and over: 10ml rinse for 1 minute twice daily or pre-surgery. Soak dentures for 15 minutes twice daily. Treatment length: Gingivitis 1 month; ulcers, oral candida 48 hours after clinical resolution.
Children under 12 on healthcare professional advice only. Contraindications: Hypersensitivity to chlorhexidine or excipients. Precautions: Keep out of eyes and ears, do not swallow, separate use from conventional
dentifrices (e.g. rinse mouth between applications). In case of soreness, swelling or irritation of the mouth cease use of the product. Side effects: Superficial discolouration of tongue, teeth and tooth-coloured
restorations, usually reversible; transient taste disturbances and burning sensation of tongue on initial use; oral desquamation; parotid swelling; irritative skin reactions; extremely rare, generalised allergic reactions,
hypersensitivity and anaphylaxis. Legal category: GSL. PL Numbers and RSP excl. VAT: Mint, Original: PL 00079/0312 & 0313 300ml £3.99, 600ml £7.82 (mint only) Alcohol-free PL 00079/0608 300ml £4.08.
Licence Holder: GlaxoSmithKline Consumer Healthcare, Brentford, TW8 9GS, U.K. Date of preparation: March 2010.
References: 1. A C Nielsen 52 w/e MAT 17.04.10 Corsodyl treatment mouthwashes unit share, medicated mouthwash market. 2. Jones CG. Chlorhexidine: is it still the gold standard? Periodontology 2000 1997;
15: 55-62.

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[26] =>

26 Clinical

United Kingdom Edition July 12-18, 2010

Fig 2b. The dental literature reports a statistically higher level of accuracy using cbCT (cone beam volumetric tomography) scans for
detecting vertical root fractures than with the use of periapical radiography alone.

ß DT page 23

Size

Success

and technical complications in
prospective implant studies.

0mm

87.6%

1-5mm

65.7%

+ 5mm

56.2%

Their findings indicated
that while implant survival
and loss were reported in all
studies, biologic difficulties such
as sensory disturbance, soft
tissue
complications,
periimplantitis/mucositis and crestal bone loss were considered
in only 40 to 60 per cent of
studies. Technical complications such as component/connection and superstructure
failure were addressed in only
60 to 80 per cent of the studies.
Are we as a profession standing
idly by and watching marketing pressures force treatment
decisions to be made empirically, with untested materials
and techniques? There is an unsettling similarity between these
events and the early days of implant development (6).
Favouring endodontics
The endodontic pundits argue
that major studies published

Table I. As reported by Chugal et al,
the most significant vector impacting
on post-operative healing is the presence
and magnitude of pre-operative
apical periodontitis.

to date suggest there is no difference in long-term prognosis
between single-tooth implants
and restored root-canal-treated
that in the comprehensive care
decision making process.
Salvaging teeth
Whenever possible, the treatment choice should be an attempt to salvage a tooth using a multidisciplinary team
approach, putting aside preconceived notions and biases.
Finances should not dictate
the advice proffered. Furthermore, it is advisable to forego
being clinically “conservative”.
Treatment should not be initi-

‘Whenever possible, the treatment
choice should be an attempt to salvage a
tooth using a multidisciplinary team
approach, putting aside preconceived
notions and biases.’

ated in the absence of a critical
evaluation of the potential for
all contributing factors to equate
with a positive outcome.
When needed, care must be
taken to carry out every diagnostic procedure available, even
those of a more invasive nature
(see Fig 1). Before arriving at a
definitive diagnosis and treatment plan, the clinician should
obtain consent from the patient
to remove any restoration in
order to analyse the residual
tooth structure and assess the
potential to carry out reliably
predictable treatment. The patient must understand in detail,
the feasibility of and margin for
success of each treatment option
presented (14).
There are few studies in
the endodontic literature analysing the reasons for extraction
of endodontically treated teeth.
Root-filled teeth are invariably
prone to extraction due to nonrestorable carious destruction
and fracture of unprotected
cusps. Tamse et al found that
mandibular first molars were
extracted with greater frequency than maxillary first molars;
the most significant causal difference was the incidence of
vertical root fracture (VRF – 1.8
per cent maxillary molar, 9.8
per cent mandibular molar) (15).

Fig 2c. The multivariate nature of the endodontic implant algorithm mandates the use of
cbCT to detect and evaluate the degree of periapical pathosis. Analysis of the size, extent,
nature and position of periapical and resorptive lesions in three dimensions is essential for
the optimal level of standard of care in diagnosis.

‘The endodontic pundits argue that major
studies published to date suggest there is no
difference in long-term prognosis
between single-tooth implants and restored
root-canal-treated that in the comprehensive care decision making process.’
Teeth not crowned after obturation are lost with six times the
frequency of those restored with
full coverage restorations (16).
Procedural failure, iatrogenic perforation or stripping,
idiopathic resorption, trauma,
and periodontal disease all
contribute to a lesser degree.
The major biologic factor influencing endodontic treatment
outcome failure with the pos-

sibility of extraction appears
to be the extent of microbiological insult to the pulp and
periapical tissue, as reflected by
the periapical diagnosis and the
magnitude of periapical pathosis (17). (See Table I and Fig 2a,
2b and 2c).
Parts 2 and 3 to be published
in further issues of Dental Tribune UK. DT

About the author
Kenneth S Serota, DDS, MMSc graduated from the University of
Toronto, Faculty of Dentistry in 1973 and was awarded the George
W Switzer Memorial Key for excellence in Prosthodontics. He received his Certificate in Endodontics and Master of Medical Sciences Degree from the Harvard-Forsyth Dental Center in Boston,
MA. A recipient of the recipient of the American Association of Endodontics Memorial Research Award for his work in nuclear medicine screening procedures related to dental pathology, his passion
is education and most recently e-learning and rich media. Ken provided an interactive endodontic program for the Ontario Dental Association from 1983
to 1997 and was awarded the ODA Award of Merit for his efforts in the provision of
continuing education. He was selected for Fellowship in the Pierre Fauchard Academy
and is a Fellow of the Academy of Dentistry International. The author of over sixty
publications, he has lectured on Endodontics internationally. He is on the editorial
board of Endodontic Practice, Endodontic Tribune and Implant Tribune. The founder
of ROOTS – an online educational forum for dentists from around the world who wish
to learn cutting edge endodontic therapy, he recently launched IMPLANTS (www.
rximplants.com) and www.tdsonline.org in order to provide a clear understanding of
the endodontic/implant algorithm in foundational dentistry. As well, he lectures on the
empowerment digital technologies provide to the sophistication of the dental team and
the propagation of comprehensive care.

References
1. Torabinejad M, Anderson P, Bader J et al. Outcomes of root canal treatment and restoration, implant-supported single crowns, fixed partial dentures, and extraction without replacement: A systematic review. J Prosth Dent
2007;98(4):285-311. 2. Ruskin JD, Morton D et al. Clinical controversies in Oral and Maxillofacial Surgery: Part One. Failed root canals: The case for extraction and immediate implant placement. J Oral Maxillofac Surg
2005;63:829-831 3. Moiseiwitsch J, Caplan D. A cost-benefit comparison between single tooth implants and endodontics. J Endod 2001;27:235. 4. Jokstad A, Braegger U, Brunski JB et al. Quality of dental implants. Int Dent J
2003;53:409-443. 5. Berglundh T, Persson L, Klinge B. A systematic review of the incidence of biological and technical complications in implant dentistry reported in prospective longitudinal studies of at least 5 years. J Clin Periodontol 2002;29 Suppl 3:197-212. 6. Brånemark PI. On looking back with Per-Ingvar Branemark. Interview. Int J Prosthodont 2004;17:395-396. 7. Christensen GJ. Implant therapy versus endodontic therapy. J Am Dent Assoc
2006;137:1440-3. 8. Morris FM, Kirkpatrick TC et al. Comparison of nonsurgical root canal treatment and single tooth implants. J Endo Oct 2009;35(10):1325-1330. 9. Torabinejad M, Kutsenko D et al. Levels of evidence for the outcome of nonsurgical endodontic treatment. J Endod 2005;31:637-46. 10. Torabinejad M, Bahjri K. Essential elements of evidenced-based endodontics: steps involved in conducting clinical research. J Endod 2005;31:563-9. 11. Ricucci
D, Grosso A. The compromised tooth: conservative treatment or extraction. Endo Topics 2006;13:108-122. 12. Friedman S, Mor C. The success of endodontic therapy: healing and functionality. J Calif Dent Assoc 2004;32:493-503. 13.
Friedman S. Considerations and concepts of case selection in the management of post-treatment endodontic disease (treatment failure). Endod Topics 2002;1:54-78. 14. Foster KH, Harrison E. Effect of presentation bias on selection of
treatment option for failed endodontic therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:36-9. 15. Tamse A, Fuss Z, Lustig J, Kaplavi J. An evaluation of endodontically treated vertically fractured teeth. J Endod
1999;25:506-8 16. Aquilinio SA, Caplan DJ. Relationship between crown placement and the survival of endodontically treated teeth. J Prosth Dent 2002;87(3):256-263. 17. Zadik Y, DMD, Sandler V, Bechor R. Analysis of factors
related to extraction of endodontically. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:31-35. 17. Chugal N, Clive J, Spångberg L. A prognostic model for assessment of the outcome of endodontic treatment: Effect of
biologic and diagnostic variables. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology & Endodontics 2001;91(3) 342-352.

[27] =>

United Kingdom Edition July 12-18, 2010

Effective treatment of periodontitis with
Dentomycin
Periodontitis is one of the most common causes
of tooth loss in UK adults. With preventative
dentistry at the heart of UK dentistry,
Dentomycin is an effective adjunct to scaling
and root planing (SPR).
In clinical studies, Dentomycin has been shown
to help produce significant improvements in
periodontal pathogen counts and plaque index scores, reducing pocket
depths by 42% in 12 weeks .
The specially designed applicator makes directing the gel into the affected
pockets simple, with no unpleasant aftertaste for the patient. The unique
formulation binds to the surface of the tooth, slowly releasing its active
ingredients over time.
When used in conjunction with SPR, Dentomycin has been shown to:
• Inhibit the periodontal destruction process • Significantly reduce key
periodontal pathogens • Actively help in the healing process
Indicated for the treatment of moderate to severe chronic adult periodontitis,
Dentomycin is a cost effective approach that achieves reliable results.
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

Nobel Biocare – Solutions Guaranteed
It is certainly true that patients are becoming
increasingly
knowledgeable
and
demanding
with regards the dental treatment they receive.
As a result of this, when a patient is faced with extraction,
dentures are often regarded as a less desirable option. Instead,
implants represent a more cost-effective and functional longterm solution.
In response to the perceived complexity and high treatment
costs that block the way of satisfying the patient’s expectations,
Nobel Biocare has developed an innovative range of products to provide patients with
the care they deserve.
NobelActive™ has a unique design that ensures excellent initial stability, a highly
desirable trait in both immediate placement and lesser bone quality situations. Dueto
the precise internal connection, TiUnite® surface technology, Platform Shifting ™ and
wide range of abutment options, this is an implant that every user should consider.
NobelReplace™ is the fastest growing product on the market for GDPs. Easy to use and
versatile, this implant has a unique root shape providing reliable initial root stability. Its
colour-coded parts allow fast identification of components. As a result of its step-bystep drilling protocol, surgical procedures become more predictable.
A world leader in innovative restorative dental solutions, Nobel Biocare also
offers a comprehensive range of dental prosthetics, scanners and CAD/CAM
software for premium aesthetics.

Enjoy successful marketing with
Munroe Sutton
Dentistry in the UK is becoming
more competitive, and as a
result dentists are required to be
considerably more business savvy. It’s not enough anymore to simply provide
treatment to patients; practitioners must also have the range of skills needed
to run a successful business
Frequently overlooked in the healthcare sector, but incredibly important
nonetheless, is marketing. As the leading dental care plan provider in the
US, Munroe Sutton can help market your practice in a number of ways. For
example:
• Online provider search with over 250,000 hits every month
• Multi-lingual assistance to aid patients in finding the most appropriate
treatment provide
• Daily database updates with groups and agents
• Printed directories
By enlisting the help of Munroe Sutton you can save yourself time and money
by no longer marketing to the wrong audiences,
Sue Waldron from Absolute Dental was delighted with the service she received,
‘Their contracting department is very efficient in processing new applications.
I have not had any problems and I always get quick resolutions to any issue
that may arise.’

Change of address at
Nobel Biocare
Nobel Biocare, leader in
restorative and aesthetic
dental solutions, would
like to inform its customers
and colleagues of its
recent change of address.
As of 14th June, the company’s UK office will be located at 3. Furzeguard Way,
Stockley Park, Uxbridge, UB11 1EZ. Nobel Biocare also has a new telephone
number: 0208 756 3300.
Stockley Park is one of Europe’s most successful business parks - a purposebuilt facility surrounded by acres of beautiful parkland, lakes and gardens.
Nobel Biocare hopes that the office’s change of location will provide its staff
with a much more pleasant and productive environment in which to work.
Should you have any queries, please do not hesitate to contact your Sales
Representative.
For more information, contact Nobel Biocare on 0208 756 3300 or
visit www.nobelbiocare.com

Genus – Making dreams a reality
By starting up you own squat practice,
you have an enviable ‘blank canvas’
opportunity: a chance to leave your own
unique stamp.
It’s vital that the practice you create clearly
reflects the exclusive services you provide,
the professional ethos that you work by
and ultimately, the type of patients that
you want to attract.
Genus has a team of specialists that
have enabled dentists far and wide to
achieve the practice of their dreams.
By transforming derelict premises and
dilapidated buildings into stylish, eyecatching ‘boutique’ style surgeries, Genus has helped many a dentist to create
practices that intrigue and attract passers-by.
With the ability to identify the potential in even the smallest of premises, Genus
can renovate a previously run-down building into a chic, fully functioning
practice. Intelligent design plays an integral role in Genus’s approach.
Genus also offers advice on creating a practical yet comfortable surgery by
choosing cleverly designed equipment and furniture within a small space.
For more information, please call Genus on 01582 840484 or
email chris.davies@genusgroup.co.uk
www.genusinteriors.co.uk

Out Now - The New Dental Directory
Catalogue!
The Dental Directory is delighted to announce
their new Pricewatch Eighteen Catalogue is out

SDR™ is the revolutionary flowable
composite base material that can
be used to bulk-fill cavities up to a
depth of 4mm.

For more information call +44 (0)800 072 3313 or visit www.dentsply.co.uk

Coltene Whaledent is proud to celebrate
the centenary of Roeko, a century of
experience. Started in Germany, originally
manufacturing

medical

dressings

then

to specialise in high range quality dental
products the

Roeko name stands for

expertise and innovation in endodontic,
cotton and infection control products.

Since 2002 Roeko has been part of the Coltene Whaledent Group and has had huge
successes with new trend-setting products such as Guttaflow the first two in one cold
flowable obturation system for root canals.
Dentists can be assured the all Roeko products are manufactured to the highest level and
that with continual technical advancement using the best raw materials and can expect the
best in reliable quality products.

To experience the wide range of Roeko products and to see the special anniversary offers
call Free Phone 0500 295454 exts 223/224 or visit www. Coltenewhaledent.com

www.monroesutton.co.uk

Excellent handling with SDR™
Dr David Payne of the Selly Park
Dental Centre has been using the
latest innovation from DENTSPLY.

“This is a very good new product. I’ve
used flowable composites before but SDR™ is much better at adapting and
filling into any vacuoles to ensure complete packing. Also, since SDR™ acts as
a base material that can be bulk-filledup to 4mm increments, there is no need
for conventional layering.
“The specially designed compula tip delivery system, makes placement much
easier, even with difficult to reach areas of the mouth. “It’s useful when there
is a time factor involved, such as issues with moisture in the oral cavity. SDR™
allows for quick and successful placement, especially as it can be cured to a
depth of 4mm.
DENTSPLY is committed to investing in better dentistry, and SDR is a
revolutionary new flowable composite that makes placement of posterior
restorations simple and efficient.

ROEKO celebrates 100th Anniversary,
1910 – 2010

For more information call 0808 234 3 558

Contact Nobel Biocare on 0208 756 3300, or
visit www.nobelbiocare.co.uk

S4S announces Bruxism Awareness
Week at WAC 2010
S4S was delighted to announce at this
year’s World Aesthetic Congress dates
for the first ever Bruxism Awareness
Week, to be held from the 25th to the
31st October 2010.
In its announcement to the dental
press, S4S gave details of the seven - day
event, which is being backed by clinicians nationwide, and explained the
importance of focusing national attention on this potentially debilitating
condition.. Bruxism Awareness Week will also aim to highlight where sufferers
can seek help.
As part of the awareness campaign, S4S will be making a donation of £1 to the
Help 4 Heroes charity for every SCI splint made from the start of the awareness
week until 31st December. Statistics indicate that a staggering one in two staff
members of the armed forces serving in the second Gulf War suffered from
PTSD, a symptom of which is bruxism.
S4S impressed delegates at this year’s event not only with its effective solutions
for bruxism such as Grindcare, NTI and comprehensive range of laboratory
made occlusal splints, but also with its popular snoring solution Sleepwell, and
orthodontic technologies.
For a free information/promotion pack call: 0114 250 0176, fax: 0114 258 6670,
e: info@s4sdental.com
www.s4sdental.co.uk

Industry News 27

now.
Inside you will find over 500 pages packed full
of the latest and most essential dental products
for your practice. The catalogue contains all of
our most popular professional products, ranging
from the Anaesthetic section which features
Citanest at a market beating £32.75 to Handpieces and small equipment all at
fantastically low prices, making this your must have dental catalogue with the
most up to date information.
The catalogue also includes a ‘what’s new’ section detailing all the most
recent dental innovations to enter the market. Plus inside you will find all
the products and equipment to comply with the latest decontamination
guidelines HTM 01-05.
To get your copy of Pricewatch Eighteen speak to your local Dental Directory
Representative or call 0800 585 586.

‘The Glitch’
It’s a natural reaction for
people to clench their teeth
when under stress or strain:
it’s part of the ‘fight or flight’
instinct. Under Armour
Performance Mouthwear ™
has found the solution.
‘The glitch’ is that clenching
triggers a reaction in the body.
Excess levels of performance-sapping hormones, such as cortisol (the stress
hormone) are released, levels of lactic acid increase whilst airflow through the
throat is diminished.
Developed and clinically tested for over fifteen years, and recently launched
in the UK, UA Performance Mouthwear is an innovative product that fixes the
glitch. It’s having a huge impact in sports and beyond.
Designed for both contact and non-contact sports, UA Performance
Mouthwear helps athletes at all levels reach their full potential with greater
endurance and strength, and less athletic stress.
UK dentists can now become authorised providers of the UA Performance
Mouthwear and develop a new and exciting client base for their practice.
For more information on how your patients can benefit from Under Armour
Performance Mouthwear, call The Dental Directory free on 0800 585 586
or visit www.dental-directory.co.uk. Or call Eric Solem on 07590 573 668

EndoCare congratulates Beverly Street on
award win
The team at EndoCare would like to congratulate
Operations Manager, Beverly Street, for being
awarded the Business and Professional Services
Award for the employed student who has made
the best use of studies from Kingston College in
London.
Beverly has been studying for a Certificate in
Business Management (Level 3) in her spare
time alongside her full time employment at the
Harley Street branch of the endodontic practice,
taking the skills she developed in the classroom and putting them into practice
at work.
Principal practitioner and owner Dr Michael Sultan is committed to ensuring
his staff are well trained and perform to the best of their abilities so that his
patients receive the very best dental experience.
Winners of the 2009 Private Dentistry award for Best Referral Practice,
EndoCare is renowned for its referral service in the endodontic world. The
surgeries are equipped with the latest technologies, ensuring your patient
receives the most effective treatment, and is returned to your surgery quickly,
ready for you to take over.
For more information about EndoCare please call 020 7224 0999 or
visit www.endocare.co.uk

UCL Eastman experts
contribute to recent
publication on

Intellectual Disability
Two senior clinicians from the UCL Eastman Dental Institute have contributed
to a book that provides a major review of the evidence relating to intellectual
disability and ill health.
Dr Stefano Fedele, Senior Clinical Lecturer in Oral Medicine, and Professor
Crispian Scully CBE, Professor of Oral Medicine, have written a chapter of the
new publication.
Entitled ‘Dentition and oral health diseases’, the chapter provides a
comprehensive review of the oral health aspects of care for people with
intellectual disability.
Edited by Jean O’Hara, Jane McCarthy and Nick Bouras and published by
Cambridge University Press , ‘Intellectual Disability and Ill Health: A Review of
the Evidence’ is intended to provide a better understanding and practice at an
individual clinical level: people with intellectually disability often have health
needs that go unrecognised and untreated.
The UCL Eastman Dental Institute is committed to education and research in
the oral health care sciences.
For more details about the UCL Eastman Dental Institute, please visit www.
eastman.ucl.ac.uk or telephone 020 7915 1038

[28] =>

28 Cosmetic

United Kingdom Edition July 12-18, 2010

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
• Gold Club for software upgrades, service and support • Courses by Ceramic
Systems’ exclusive Trainer Dr Simon Smyth – the UK’s Number 1 CEREC®
Trainer
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.
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

British Academy of Cosmetic
Dentistry membership
survey
A recent membership survey
undertaken by The British
Academy of Cosmetic Dentistry
(BACD) revealed that members
really valued the BACD as a source of continuing professional development and
forum to share knowledge and skills amongst peers.
The number one benefit of BACD membership, according to those surveyed,
was access to the annual conference, with opportunities for CPD training
second, and regional Study Clubs cited as the third most important membership
benefit to respondents.
The survey also established a membership profile, with the majority of members
(nearly 40%) based in the south of England and aged between 30 and 50 years.
Many members also expressed an interest in the creation of a BACD journal, as
well as increasing the opportunities to confer and network with peers.
This reflects a remarkable synergy between the overall aims and values of
the BACD and its membership base. Committed to excellence in cosmetic
dentistry, the BACD has strived to promote the sharing of knowledge and
best practice, especially with regard to the latest techniques available, since
its inception in 2003.

AACD and BACD brings the world’s best
to London
Don’t miss out on a unique opportunity, taking
place in London on the 23rd – 25th of September.
Leading international speakers from around
the world will be attending “Esthetics Meets
Aesthetics” Meeting of the American Academy
of Cosmetic Dentistry, to be held in association
with the Annual Conference of the BACD.
With world renowned speakers such as Frank
Spear, William ‘Bo’ Bruce, Thomas Schindler and
Wolfgang Richter, UK dentists have access to an
unprecedented resource to enable dental care of
the highest standard to be practised.
The BACD is committed to excellence in cosmetic dentistry and is proud to
welcome colleagues from across Europe who share its vision, including the:
• Dental University of Paris Study Group;
• European Society of Cosmetic Dentistry;
• German Society of Cosmetic Dentistry and
• Swedish Academy of Cosmetic Dentistry
Take advantage of this opportunity to learn from practitioners at the forefront
of cosmetic dentistry.
To register on-line, visit www.aacd.com and go to conferences. Be sure to click
BACD as your primary academy.
For more information, contact Suzy Rowlands on 0207 612 4166.
Or email info@bacd.com

Perfect Bleach Office – The new
complete set for office whitening
Perfect Bleach Office – The new
complete set for office whitening

Trust The Dental
Directory for a Great
range of
Whitening Products
Whitening treatments are
very popular and most
patients would love a
bright smile and at The
Dental Directory there is a
great range of products to
choose from.
Our whitening range includes the latest whitening products from Ivoclar
Vivadent, Dentsply, Voco and SDI. The Dental Directory is also the exclusive
distributor of WY10, the fast reacting whitening gel with a chairside contact
time of just 10 minutes!
We currently have some great offers on whitening kits and systems. To find out
more contact The Dental Directory on 0800 585 586 or
visit www.dental-directory.co.uk

For more information contact Suzy Rowlands on 0207 612 4166
Or email info@bacd.com
www.bacd.com

Perfect Bleach Office provides modern
tooth whitening in the surgery that
meets the highest aesthetic demands.
The new complete set permits office
whitening of up to five patients. With Perfect Bleach Office, whitening is
achieved in only one office visit.
Efficiency and safety with the QuickMix syringe and LC Dam
The practical QuickMix syringe prevents mixing errors and provides only the
amount needed of the highly concentrated, whitening gel for each use. In
contrast to other office whitening sys-tems, there is no remaining quantity of
material that must be discarded after the application of Perfect Bleach Office.
The reaction time for Perfect Bleach Office is only ca. 10 minutes. The gel does
not require additional activation once it has been applied to the teeth.
PERFECT BLEACH OFFICE – THE EFFECTIVE CHAIRSIDE WHITENING GEL
• QuickMix syringe for easy, automatic mixing without waste
• Visible whitening results after only approximately 10 minutes
• A genuine concentration of 27 % hydrogen peroxide even after mixing
• Special tips for precise application for all endo bleaching treatments
Voco - Sales Manager UK: Tim McCarthy, Mobile: 07500-769-613,
t.mccarthy@voco.com

The Direct Approach from GC UK
You are not unusual if you find that
you sometimes compromise your
composite aesthetic results by using
a single shade of composite for the
majority of patients.
Help is now at hand with GC Gradia
Direct. Due to the remarkable shade
adaptation of Gradia Direct to the
surrounding tooth structure, you will
be astounded by the brilliant aesthetics
of your restoration, even when you use
only one shade.
When dealing with more demanding
and complex cases a combination of different shades enables unlimited
aesthetic results. GC Gradia Direct offers you the complete assortment from
bleach white to dark translucent to outside special shades.
Radiopaque GC Gradia Direct Posterior combines aesthetics with excellent
mechanical properties by means of high fracture toughness to resist occlusal
stress, high wear resistance and low wear on opposing dentition.
Dentists across the globe have been delighted with the ‘one-shade simplicity
and aesthetic invisibility without compromise’.
For further information please contact GC UK on (0044) 1908 218999 or
visit gc.europe.com

Indent Systems
T-Scan
Take the guesswork out
of occlusion
Indent
Systems
are
exclusive UK Distributors for
T-Scan, the computerised
occlusal force analysis
device which takes the
guesswork out of occlusion.
T-Scan enables Dentists
to enhance the accuracy
of their diagnosis and treatment in a variety of clinical applications including
implantology, periodontology and cosmetic dentistry. The patient simply bites
on a thin sensor which relays changes in occlusal pressure as they move from
initial contact into maximum intercuspation and excursive movements. This
data is transmitted, in thousandths of a second increments, onto an easy to
understand visual display.
From single unit restorations to full mouth rehabilitation it is important for
patient comfort, as well as restoration longevity, to obtain a balanced occlusion
with mutual anterior/posterior support. Using articulating paper alone cannot
do this because it cannot measure force, balance or changes through time;
unlike T-Scan which allows clinicians to perfect occlusal balance with accuracy
and confidence. It can be the difference between success and failure.
For further information contact Indent Systems on 01932 582900,
email mike@indentsys.co.uk or visit www.indentsystems.com

The Cosmetic Dentistry Guide
Make your voice heard in
2010
With the new year well
underway, many patients are
looking to improve their smile
for 2010.
With more cosmetic dentistry options that ever before, it is vital that your
practice stands out above the rest, and is easily accessible to potential patients.
The UK’s leading website for cosmetic dentistry information the Cosmetic
Dentistry Guide is a must-visit for any patients considering treatment, and
contains hundreds of pages of information from some of the UK’s leading
cosmetic dentists.
Officially the worlds most visited dedicated cosmetic dentistry website,
the Cosmetic Dentistry Guide has been providing patients with invaluable
information about cosmetic dentistry procedures for over ten years. The site
is viewed by over 140,000 visitors a month, and as such is the perfect place to
market your surgery to a whole new sector of patients.
Coupled with the interactive forum, the perfect place to air any views,
concerns or advice on treatment plans, the Cosmetic Dentistry Guide really is
the marketing portal of choice for any savvy practitioner.

Miris 2
Miris 2 is a development
and improvement based on
existing Miris outstanding
technology. A radio-opaque,
highly filled nano-hybrid
composite
providing
excellent
restorations
that meet the highest
expectations with harmony
of light, material and colour; a new way to look at aesthetic dentistry from
Coltene Whaledent.
The Miris 2 natural layering concept, which differentiates between younger,
adult and older patients, is combined with a new adjusted unique shade guide
which shows a combination of enamel and dentin layer that allows an accurate
preview of the finished restoration and perfect natural mimicry, brightness
and vitality. With optimised handling properties and reduced shrinkage
Miris 2 has been kept as simple as possible to use whilst still providing
distinctive characteristic colours and opalescence. Call Coltene Whaledent
on Freephone 0500 295454 exts 223/224 for your information pack or to
organise a demonstration.
www.coltenewhaledent.com

BEAUTIFIL Composites from Shofu
New from Shofu is Beautifil II Gionomer. This
state of the art composite restorative material
based on Pre-Reacted Glass Ionomer
technology. This clever PRG technology
combines the benefits of glass ionomers
with those of composite resins to produce a
biocompatible, fluoride releasing, high
strength, beautifully aesthetic material.

Due to the on-going release and recharge of the fluoride particles within
Beautifil II, secondary caries are no longer a concern; with the added benefit
that plaque will not adhere to the surface of a Beautifil II restoration.
The chameleon effect makes Beautifil II the material of choice for all
restorations as the material takes on the colour of the surrounding tooth tissue.
With a highly translucent finish this radiopaque versatile, highly dependable
material exhibits excellent wear resistance combined with a high filler load to
ensure longevity of the final restoration.
Make your patients’ Beautifil today!
To claim your free Beautifil II sample (without obligation), which includes 3 x
single dose A2, 3 x single dose A3 and instructions for use please call 01732 783
580 or visit www.shofu.co.uk - hurry stocks are limited!

Implant and Aesthetic Dentistry
Working as an extension of your practice
Dr. Koray Feran, principle dentist and owner of the London Centre for Implant
and Aesthetic Dentistry, knows that when a patient is referred to him, the
practitioner needs to be confident that high standards of care and treatment
will be upheld.
For this reason, Dr. Feran and his team always ensure that each treatment is
carried out with the utmost care and attention, whether he is placing a single
crown or completing a full mouth restoration. Committed to achieving clinical
excellence, Dr Feran returns all patients to their practitioner ready for any
further treatment they may require.
Confident in his abilities, Dr. Feran invites all referring practitioners to attend
any stage of the treatment process and shows his appreciation of their custom
by providing dentists with a complimentary mentoring session.
Dr. Feran’s dedicated team ensures that practitioners are provided with regular
updates on the treatment and subsequent aftercare their patients receive,
and long-term support and maintenance is provided for all implants and
restorative work undertaken.
For more information on referring to Dr Feran, call 0207 224 1488 or visit www.
korayferan.co.uk.

“Dr. Feran is so experienced and very thorough
in his work.”
Dr Koray Feran, principal dentist and owner of
The London Centre for Implant and Aesthetic
Dentistry, welcomes referrals to his practice
for high quality, reliable implant and aesthetic
treatments.
Dr. Shernez Wadia of Longborough Dental
practice in Dorking often refers her patients
to Dr. Feran. “Having been taught by Dr. Feran
myself, I can completely trust him. Dr. Feran is so
experienced and very thorough in his work. What ’s
more, he never retains a patient and always sends
them back to me so I can finish off treatment that lies
within my own capability.”

“The centre’s online referral form is absolutely fantastic and the staff are very quick
to arrange appointments. Referring practitioners are welcome to attend their patient ’s
consultation or any stage of the treatment process, which is very helpful indeed.”

Dr. Feran and his team always ensure that each treatment is carried out with the utmost
care and attention, whether he is placing a single crown or completing a full mouth
restoration.

For more information, visitwww.cosmeticdentistryguide.com
For more information on referring to Dr Feran, call 0207 224 1488 or visit
www.korayferan.co.uk

[29] =>

United Kingdom Edition July 12-18, 2010

Don’t miss DENTSPLY’s Endodontic
Roadshow
Clinicians with an interest in endodontics
should not miss DENTSPLY’s 2010 Endodontic
Roadshow during September, where they can
gain the latest advice on how to use some of
the market’s leading endodontic products such
as ProTaper, along with recent innovations
including PathFiles and the Calamus Dual.
Hosted over one and a half days and at four
venues, internationally renowned speaker,
Dr. Arnaldo Castellucci (visiting Professor of
Endodontics at the University of Florence Dental
School, Italy) will be joined by a guest speaker at each event.
Dates and Venues
Guest Speaker
15 & 16 Sept Manchester – Mottram Hall - Dr Mike Horrocks
17 & 18 Sept Edinburgh – Norton House - Professor William Saunders
20 & 21 Sept Dublin – Radisson Blu, St Helens - Dr Hal Duncan
22 & 23 Sept Cardiff – Vale of Glamorgan - Professor Phil J. Lumley
Day 1Lecture - £100 + VAT (£117.50)
Day 1 and Day 2 - £175 + VAT (192.50)
Receive free DENTSPLY products up to £175RRP
Dentists are urged to reserve their place quickly as tickets are expected to sell
out fast.
For more information or to book your spot on the course call 0800 072 3313,
email enquiry-uk@dentsply.com or visit www.dentsply.co.uk

Reliable support from Ledermix
Dental Cement

treatment.

Ledermix Dental Cement represents a
medicament that dental practitioners
have come to rely upon as an effective
method for treating patients.
Where there is a deep cavity and the
dentine is hypersensitive, such as in
the instance of small pulp exposure, a
practitioner can use Ledermix dental
cement as a pulp capping agent
with confidence in the efficacy of the

For ease of use, Ledermix dental cement can be prepared with a choice of
hardeners. Simply by mixing one drop of the appropriate ‘fast set’ or ‘slow set’
hardener with the Ledermix powder, the practitioner can quickly create the
necessary cream for application.
For reliable, effective and practical solutions to the challenge of hypersensitive
dentition or pulp exposures, Ledermix dental cement is the ideal medicament.
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

Chairs need cleaning after every patient
ChairSafe disinfectant foam cleaner is available
in 200ml bottles and 1L and 5L refill containers
and with the new Kemdent range of durable and
economy wipes. These extra large ChairSafe wipes
mean that you can clean a chair for just a few
pence after each patient, protecting all the Dental
Professionals in your practice.
HTM 01-05 a guidance published by the DOH,
recommends that Dental Chairs be cleaned
between every patient to minimise the dispersal
of microorganisms. ChairSafe foam and ChairSafe
wipes are specially formulated to clean sensitive
surfaces and equipment, including the leather and
synthetic facings of dental chairs.
ChairSafe foam and wipes are alcohol free. They are effective against HBV/
HIV/HCV/BVDV/vaccinia, bactericidal and fungicidal microorganisms within
one minute of application. Kemdent ChairSafe foam and wipes used correctly,
guarantee a safe inactivation of influenza A (H1N1)- viruses (pathogens of
swine flu). These products should be used for daily disinfection of surfaces
close to the patient/frequently touched surfaces (eg. dental chairs, door
handles, work surfaces).

Easy to pack, with great
cavity adaptation
Dr Mary Brummitt of the
Stangrove Court Dental
Practice in Kent has been
trialing the latest innovation
from DENTSPLY – Smart
Dentin
Replacement™
(SDR™). SDR™ is the
revolutionary new flowable
posterior composite base
that offers bulk-filling of up
to 4mm without the need for layering, as Dr. Brummitt has discovered:“I found
Smart Dentin Replacement very user-friendly, thanks to the Compula® syringestyle tip which allows accurate placement. “The material is easy to pack and
adapts well to the cavity.”
A further advantage is that the shade of SDR™ matches that of dentine, making
for a better aesthetic finish - something which Dr Brummit has noticed.
“SDR™ is a simple and efficient product that I will continue to use when doing
posterior restorations.”
Investing in better dentistry is a key element of DENTSPLY’s vision to
revolutionize the profession. Developing innovative products, such as SDR™
helps dental professional to achieve that ideal.

Since Septodont was founded, we have
emerged as a company fully focused on a
single purpose: to provide dentists with
dental products of superior quality and
value.
We at Septodont believe that staying ahead
of the competition requires more than just
supplying dental products. Septodont is
actively involved and contributes to many
events, conferences, trade shows and CPD
courses around the world, using this valuable
time to pass on our technical expertise.
Septodont has also prided itself on being a highly creative business with
the example of improving on existing technology to bring the dental world
N’Durance, Septodont’s low shrinkage, long lasting, low toxicity composite for
use in anterior and posterior teeth that is compatible with all leading bonding
systems, plus the launch of a revolutionary product soon into the UK market,
so keep watching our website for more information.

To arrange for a free demonstration of SDR call +44 (0)800 072 3313 or visit
www.dentsply.co.uk

If you have yet to experience the benefits provided by all essential Septodont
products for yourself, please contact Septodont on 01622 695520 or call your
local Septodont product specialist.

Nuview – High Quality
Images Guaranteed
All dentists, at some point in
their career, have probably found
themselves wishing that they
could see the treatment site
more clearly.
Nuview offers an extensive
range
of
magnification
solutions
designed
by
the most reputable name in advanced visualisation technologies,
Carl Zeiss.
Renowned for their outstanding image quality and stylish, ergonomic design,
Nuview’s microscopes enhance the quality of both your diagnosis and your
treatment. The OPMI pico microscope is a true advancement in the prevention
of neck strain and back problems. The five-step magnification changer
delivers incredible images – from an overview of the working field, to the
finest of details.
Objective lenses with focal lengths of 200 mm, 250 mm 300 mm,350mm and
400mm are available to precisely match the microscope to your personal
working distance.
Many customers want to use the Carl Zeiss OPMI pico in general dentistry, and
although the microscope is excellent for specialist dentistry, its features give it
the versatility to meet the needs of every dentist.
Nuview offers its clients a wide array of magnification and illumination
products in addition to exemplary customer care that includes full installation
and training.
For more information call 01453 872266 or email info@nuview-ltd.co

Outstanding Vision With
EyeMag Pro Loupes
EyeMag Pro Loupes are an
invaluable asset to dental
professionals working in a
variety fields. Suitable for use
in endodontic treatment,
restoration procedures and
enabling quick and accurate
examinations, the EyeMag
Pro provides the optimum view of the treatment site.
Good posture is essential and the EyeMag Pro is expertly designed to promote
ergonomic comfort whilst supporting the very highest standard of treatment.
Users can select from several magnification options from 3.2x to 5x as well
as an array of working distances from 300mm to 500mm to find the very
best position for their individual requirements. The excellent view extends
into the peripheral areas, and makes the identification of structures very
straightforward.
Aftercare is vital with precision equipment and Nuview is proud to offer onsite equipment surveys, installation and in-depth training to help dental
professionals secure the very best EyeMag for their needs - and enjoy the
benefits immediately. The Nuview team is also able to assist with the practice’s
need for alcohol-free disinfectant products such as Continu.
For more information call Nuview on 01453 872 266
or email info@nuview-ltd.com
www.voroscopes.co.uk

The Dental Directory: Key
Distributor of Citanest® and
Xylocaine® - DENTSPLY’s leading
anaesthetics
The Dental Directory, the UK’s largest
full service dental dealer, is now the
UK’s key distributor for DENTSPLY’s
leading
anaesthetic
products:
Citanest® and Xylocaine®
Guaranteeing availability in addition
to next day delivery, The Dental
Directory offers the best knockout

Designed in the
laboratory for use in
the practice
NobelBiocare’s NobelProcera
has been designed with
ease of use in mind, helping
busy practitioners to achieve
excellent fit and consistently
impressive results each and
every time. Now dentists can
deliver the highest quality
aesthetics within their own
surgery, thanks to the system’s clear guidelines and intuitive set-up.
The system’s patented conoscopic holography optical scanning works in
harmony with the very latest in 3D design software to produce superior results
with detailed accuracy. GDPs are now able to:
• Manufacture a variety of overdenture and screw retained bar solutions on both
Nobel Biocare and updated competitor implant platforms.
• Scan impressions accurately, ending up with a restoration on an accurately
milled model.
• Utilise a wide range of shaded zirconia products (from cement to screw
retained restorations) as well as more cost effective solutions such as acrylic and
non-precious alloys for different indications.
• Benefit from 15 years of experience and research, and a dedicated aftercare
service.
For further information on any of the new Nobel Biocare products please call:
+44 0208 756 3300 or visit www.nobelbiocare.com

prices on the following anaesthetics:
• Citanest Standard: 2.2ml box of 100 best price £32.75
• Citanest Self-Aspirating: 2.2ml box of 100 best price £32.75
• Xylocaine: 2.2ml box of 100 –best price £30.75
• Xylocaine Self Aspirating: 2.2ml box of 100 best price £30.75
With The Dental Directory it couldn’t be easier, dispatching leading
anaesthetics and sundries all from under one roof, convenience and customer
satisfaction is guaranteed.

For further information on special offers or to place orders call Jackie or Helen
on 01793 770256 or visit our website www.kemdent.co.uk.

To order, simply contact your local Dental Directory Representative, call 0800
585 586, or alternatively visit: www.dental-directory.co.uk.

Kent Implant Studio welcomes
periodontist Dr Elena Sanz to his team
The Kent Implant Studio, located on
Northumberland road in Maidstone, is
pleased to welcome a new member of staff
to its team, Dr Elena Sanz, who is accepting
referrals for periodontal and prosthodontic
treatment.
Dr Sanz graduated in Dentistry from the
University of Barcelona and went on to
complete a Masters in Periodontology,
Prosthesis and Implants. After practising as
an Associate in Barcelona, Dr Sanz works
as a Periodontist and Prosthodontist in referral clinics in Harley Street and
Reading whilst lecturing on implants and prosthetics to GDPs at the Harley
Street clinic.
Dr Sanz is committed to improving her skills and has attended numerous
advanced courses and seminars to further her knowledge on subjects such as
occlusion, radiology and mandibular function. In May 2009 Dr Sanz received
a grant from the Spanish Society of Periodontics to develop a systematic
review and meta-analysis of periodontal maintenance, to be published by the
Cochrane Collaboration.

CORSODYL LAUNCH NEW
ALCOHOL FREE VARIANT
With more people losing teeth
to gum disease than tooth decay
and with over 90% of people
suffering from gum disease at
some point in their lives , the
importance of healthy gums and
teeth for everyone has never
been more relevant. And for
patients who prefer an alcohol
free mouthwash, GlaxoSmithKline
Consumer
Healthcare
(GSK)
has launched a new alcohol

For further information on the Kent Implant Studio or to
obtain a referral pack please call 01622 671 265, or visit
www.kentimplantstudio.com

Industry News 29

free Corsodyl Mouthwash variant.
The new mint flavoured variant has been demonstrated to have comparable
performance to Corsodyl Mint Mouthwash in inhibiting plaque regrowth . In
vitro studies also show comparable performance in reducing oral bacteria ,
as well as comparable substantivity . Where patient preference indicates an
alcohol free mouthwash for treating gum disease, dental professionals can
now recommend alcohol free Corsodyl Mouthwash with confidence.
To support your patient education Corsodyl have developed a range of patient
materials including a comprehensive patient guide and poster.
For further information contact your GSK representative.

With the Ultra Safety Plus system now available as as a completely disposable
syringe system with the introduction of the Ultra Safety Plus Single White
Handle and our established and well known anaesthetics range now being
latex free, Septodont continue to offer improvements on existing products.

Boost revenue and patient attendance
through education
Helping patients maintain their oral
health is a challenge for today’s
dental
care
professional
that
Curaprox understands.
As a company dedicated to the
investment in the most up-to-date
innovations to benefit both the dental
practice and its patients, Curaprox is
proud to offer the iTOP programme.
Individually Taught Oral Prophylaxis (iTOP) is the unique approach developed
by Dr Jiri Sedelmayer of Hamburg University and taught all over the world.
By using focused, one-to-one training sessions, dental care professionals can
help patients develop the skills, knowledge and confidence to develop an
effective oral healthcare routine.
As a result, the patient benefits from improved dental health, whilst the
practice can generate regular patient attendance for preventative treatment:
patients with better oral health are also more likely to consider other available
cosmetic treatments.
Help patients develop a suitable routine of prophylaxis for better oral
healthcare with iTOP and Curaprox.
For more information please call 01480 862084
www.curaprox.co.uk

[30] =>

30 Events

United Kingdom Edition July 12-18, 2010

Anniversary celebrations
This year, the Premier Awards announce their 10th anniversary, with more prizes
to give away and more subject areas available for submitting entries

ental Protection and
Schülke have been delighted with the success of the Premier Awards,
a major educational event in

the
dental
calendar.
This
year, the two sponsors are particularly pleased to announce
the 10th anniversary of the Premier Awards.

The Premier Awards were
originally created to reward
dental professionals who recognise the importance of patient
safety within the dental practice.

Throughout their 10-year history, dental professionals from
a variety of specialisms have
received one of the prestigious
awards as recognition for work

in their particular field.
Prize fund
With a total prize fund of £6,000,
the Premier Awards offer one of
the largest cash prizes for dental
risk management projects in the
UK. There are now six subject
areas available for submitting
entries. These are:
• Ethics and Professionalism
• Record Keeping
• Cross-infection Control
• Teamworking and Skillmix
• Consent and Communication
• Health and Safety

Come celebrate at the Premier awards

All members of the dental
team are eligible to enter, whatever stage of their career they
have reached.
• Dental care professionals
(undergraduate, postgraduate or
practising)
• Dental undergraduates
• Dentists (postgraduate or
practising)
Dental Protection, the world’s
leader in indemnity and risk
management support for the
dental team has renewed its
longstanding partnership with
Schülke, the European leader in
infection control, to present the
Premier Awards for 2010. Once
again the event will recognise individual achievements in developing awareness and the effective management of risk within
clinical dentistry.
This year’s Awards will be
presented during The Premier
Symposium to be held at Kings
College, London on Saturday 4
December 2010.

For More Information and to Register Contact:
Lito Christophilopoulou
(+30) 210.21.32.084 | (+30) 210.22.22.637,
Fax: (+30) 210.22.22.785
e-mail: lito@omnipress.gr
website: www.omnipress.gr
website: www.gidedental.com

Application forms and leaflets are now available from Dental Protection. Visit www.dentalprotection.org. DT

[31] =>

Classified 31

United Kingdom Edition July 12-18, 2010

Good ice-cream
Great lawyers
The Specialist Dental Team at
Cohen Cramer Solicitors would like
to thank everyone who visited us at our stand
at the Birmingham NEC Dentistry Show.

See you again next year with
more ice-cream…and legal advice!

Untitled-4 1

19/10/09 17:03:31

For a FIXED FEE quotation please call FREEPHONE 0800 542 9408
alternatively email dental.team@cohencramer.co.uk
or visit www.cohencramer.co.uk/services-to-dentists-services.html

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

MPMS 95x50 Dentists.indd 1

11/12/2006 21:56:19

for specialist knowledge,
find a knowledgeable specialist
National Association of Specialist Dental Accountants

visit www.nasda.org.uk

Lawyers’ Group

[32] =>

“Give me something that works fast
and I might be interested”
Patient, UK

Sensodyne Rapid Relief – rapid* and long-lasting**
relief from the pain of dentine hypersensitivity1,2
The strontium acetate formulation of Sensodyne
Rapid Relief forms a deep occlusive plug within
the dentinal tubules3,4 providing:
• Clinically proven relief.1,2
Works in 60 seconds*1

The robust occlusion formed by Sensodyne Rapid
Relief is still maintained after an acid challenge4
Unoccluded
dentine

After treatment
and a 30 second
acid challenge

After treatment
and a 10 minute
acid challenge

• Proven long-lasting relief
with twice daily brushing2
• A deep, acid-resistant occlusion3,4
• Fluoride to strengthen tooth enamel

In vitro study of dentinal tubule patency following an acid challenge
(immersion in grapefruit juice, pH 3.3) applied after dabbing and massaging
for one minute with Sensodyne Rapid Relief. Adapted from4.

Recommend Sensodyne Rapid Relief for rapid relief
from the pain of dentine hypersensitivity
* when directly applied with finger tip for one minute

** when used twice daily

SENSODYNE and THE RINGS DEVICE are registered trade marks of the GlaxoSmithKline group of companies.
References: 1. GlaxoSmithKline data on file, Study Z4010664, 2010. 2. GlaxoSmithKline data on file, Study
Z4010686, 2010. 3. Banfield N and Addy M. J Clin Periodontol 2004; 31: 325–335. 4. GlaxoSmithKline data on file,
Study SF/EU/02/10, 2010.

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[cover] => DT UK 1810

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