DT UK 2409

One in four dental patients want to complain but don’t / News / News & Opinions / Touting your wares / Big business / A soft approach / The 10th Dimension… the power of 10 / Company Promotion / Life after training / Safeguard your accounts / Three years’ warrantee: parts and Labour / An alternative therapy? / Strategic marketing seminars announced / Apical microsurgery— Part I: Patient preparation / Global Ceram • X Case Contest 2008/2009 / Industry News / Considering the age factor

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DENTAL TRIBUNE
The World’s Dental Newspaper · United Kingdom Edition
PUBLISHED IN LONDON

OCTOBER 5–11, 2009

News in brief

News

VOL. 3 NO. 24
Practice Management

Clinical

£200m sale
Integrated Dental Holdings,
which has more than 250 practices in the UK, has been put up
for sale for £200m.
The company offers both private
and NHS dental services
David Hudaly, the former dentist
who started IDH in 1996, owns
about 29 per cent of the business
and will make about £58m from
any deal.
The Bolton-based business,
which employs 2,000 staff,
floated on the stock market in
2002 and was valued at £45m but
was taken private two years later.
Advisory firm Hawkpoint is auctioning the business.

Technician struck off

Commended guidelines

GDC to GPhC

Selling up

Microsurgery part I

BMA Medical Book awards has
highly commended radiographic
textbook written by two consultant orthodontists

Chief Exec and Registrar of the
GDC to move to General Pharmaceutical Council

Chris Hindle looks at ways to
maximise the selling potential of
your practice

Dr John Stropko offers practical
tips on using apical microsurgery for great results

page2

page6

page10–11

page21–23

One in four dental patients want to complain but don’t

A dental technician is to be struck
off the dental register after he
was arrested for having child
pornography on his computer.
John Stuart Martin was reported
to police by his wife after she
found child pornography on the
family computer at their home in
Shropshire.
Martin was called before the
General Dental Council after
magistrates in Shrewsbury convicted him on five counts of making indecent images of a child.
The GDC said its only option was
to strike Martin off the dental register to ‘protect patients and address the public interest’.
Martin was given 28 days to appeal.

5,000 complaints about private
dental care since its launch three
years ago.
In the last three years, the
DCS has received more than
20,000 calls to its local rate 08456
120540 complaints hotline. Two
thirds of complaints logged are
resolved within a fortnight.
The DCS was set up by, but is
independent of, the General
Dental Council, which regulates
dental professionals in the UK.
Complaints that raise issues
about patient safety and whether
a practitioner should be allowed
to continue practising continue
to be dealt with by the GDC.

Lib Dems
In his speech at the Liberal
Democrats’ conference, Shadow Health Secretary Norman
Lamb, claimed that the Lib Dems
‘will ensure there is an NHS dentist available to everyone who
needs one’.
They will do this by “making sure
that dentists who are trained by
the NHS - work in the NHS for a
minimum of five years. By reforming dentists’ contracts so
they’re paid to take on more NHS
patients, not just getting money
for the number of treatments
they provide.”
He added: “And we’ll prioritise
areas where dental services are
worst, by providing increased
payments to dentists who operate in the areas of greatest need.”

Amy Winehouse
Singer Amy Winehouse has had
dental reconstruction to improve
her teeth after her oral health deteriorated during her drug and alcohol binges. She has reportedly
undergone several procedures,
including fillings and extractions
but is in so much pain from the
work, she has been given medication to cope. She was forced to
stop a recent concert because of
the pain in her teeth.

www.dental-tribune.co.uk

‘Nine per cent of
those who failed
to complain
didn’t know
where to take
their complaint.’
To contact the Dental Complaints Service, call 08456 120540
(local rate), visit www.dentalcomplaints.org.uk, or email
info@dentalcomplaints.org.
uk DT

The Dental Complaints Service has received more than 20,000 calls
®

quarter of dental patients
want to complain about
their dental care but don’t
according to a survey by the Dental Complaints Service.
The survey by the Dental
Complaints Service (DCS) found
that a third had actually complained about some aspect of
their dental care.

‘Thirty-five per
cent of patients
didn’t complain
because they
thought it
wouldn’t be
‘worth it’
However half of those who did
complain to their dental practice
felt their complaint wasn’t resolved satisfactorily.
The most common cause of
complaints (13 per cent) was ineffective treatment, followed by the
cost of treatment (12 per cent).

But when it came to complaints that patients wanted to
make but didn’t, the most common reason was the cost of treatment (33 per cent), followed by
ineffective treatment (14 per
cent), inconvenient appointments (13 per cent) and unnecessary treatment (13 per cent).
Thirty-five per cent of patients didn’t complain because
they thought it wouldn’t be
‘worth it’, while 17 per cent didn’t
because they lacked confidence
and 15 per cent because they
feared ‘negative comeback’.

Plastic coated – no big shock!

Nine per cent of those who
failed to complain didn’t know
where to take their complaint.
‘If you have a complaint about
private dental care but don’t
know where to go, call us. We’ll
try to help resolve your complaint
quickly and fairly,’ said Hazel
Adams, head of the Dental Complaints Service.
The DCS can also advise on
where to go with complaints
about NHS dentistry.
The DCS is free to use and has
helped to resolve more than

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[2] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

News

BOS Radiology Guidelines
‘highly commended’

he British Orthodontic
Society’s
Radiology
Guidelines has been
highly commended’ by the
BMA Medical Book Awards.
The BMA (British Medication Association) Medical Book
Awards are presented annually
and this year there were more
than 600 entries in a variety of
categories.
Each section is judged and
awarded Winner, Highly Commended and Commended certificates.

Orthodontic authors, Keith Issacson (left), consultant orthodontist at North
Hampshire Hospital in Basingstoke and Allan Thom (right), consultant orthodontist at Queen Victoria Hospital, East Grinstead are pictured holding the
BOS book and the certificate.

In the radiology section the
BOS Radiology Guidelines was
one of only four Highly Commended books out of 27 entries.

The BMA called it an “excellent, well written and concise
write-up on the background of
clinical dental radiographs
and indication for radiographs
in clinical orthodontics. It is a
must read for all clinical dentists especially those treating
children”.
The guidelines were designed to assist the hospital
practitioner, orthodontic specialist and the general dental
practitioner on the choice and
timing of radiographs in clinical orthodontic practice and
reflect current best practice
and selection criteria to comply with the IRMER (Ionising
Radiations (Medical Exposures) Regulations) requirements.

To emphasise the importance of the legislative requirements and to strengthen the
sections of radiation safety, the
guidelines were co-authored
by experts in dental and maxillofacial radiology.
The guide contains invaluable step-by-step information to help with assessment
and treatment planning including four ‘at a glance’
charts which graphically illustrate the indications of
when patients should or should
not be subjected to radiographs.
Copies of the guide can be obtained for £15.00 (inc p&p) online
from the BOS – www.bos.org.uk
or by calling 020 7353 8680. DT

More and more
Wales gets it first state of
adults
opt
for
braces
the art dental training unit

new state of the art dental teaching unit has
been officially opened in
Wales.
First Minister Rhodri Morgan officially unveiled the
Dental Teaching Unit in Porth,
the first of its kind to open in
Wales.
Patients will be able to benefit from some of the best technology available in dentistry
with treatment provided by
foundation dentists based at
the multi-purpose unit.

The Dental Teaching Unit,
has been funded as a joint
initiative by the Welsh Assembly
Government, Rhondda Cynon
Taff Teaching Local Health
Board and the School of Postgraduate Medical and Dental
Education at Cardiff University.
It will be home to 10 recently qualified dentists while
they complete a two-year longitudinal Dental Foundation
Training Scheme.
A Central Decontamination
Unit has been installed in the
building to improve infection
control, while cutting edge
technology has been imported
from America and used to fully
equip eight dental surgeries.
The newly qualified dentists will work under the guidance of experienced dental
surgeons and will benefit from
versatile working stations,
which allows the dentist to
work ambidextrously with
their equipment.

Electronic charting and
digital imaging systems will
also save valuable time for both
dentists and patients, enabling
more patients to receive comprehensive care in all aspects
of NHS dentistry.

scope to provide specialist endodontic treatment for patients of the Dental Teaching
Unit along with referrals from
local practitioners under the
terms of the NHS Dental Services.

The Dental Teaching Unit
also features an air-conditioned conference centre with
120 seating capacity.

The Dental Postgraduate
Section within the School of
Postgraduate Medical and Dental Education has been instrumental in bringing these ambitious plans for dentistry in
Wales to fruition.

A large screen linked to
video-cameras located in one
of the surgeries will allow
members of the dental team to
watch live procedures.
After viewing the procedures they can enhance and
develop their own skills in a
specialised dental training
room fully equipped with 18 individual work stations.
First Minister Rhodri Morgan said: “This Dental Training
Unit will be the first of its kind
in Wales and it will make a significant difference to the quality of our dentistry.
Not only will it provide invaluable training for our future
and current dentists it will improve access to dentistry in the
area, so that every patient will
have access to a dentist.

Alan Griffiths, dental programme director, said: “This
Dental Teaching Unit will provide our newly qualified dentists with an invaluable opportunity to begin their careers
in dentistry. This is the start
of a promising career pathway in an environment where
they can gain practical experience and benefit from hightech operating and learning
tools.” DT

ore and more adults
are choosing braces to
fix their wonky teeth,
according to prosthodontist, Dr
Farid Monibi.

The growing popularity of
smile beauty procedures has seen
cosmetic dentistry sales rise by 76
per cent between 2006 and 2008.
Despite the economic downturn, the industry continues to grow
and Britons now spend around
£350m a year on treatments with
many parents seeking treatment at
the same time as their children.
The number of Britons who opted
for braces to fix their crooked teeth
was up by 345 per cent to 1,164 in
2007, according to the latest research figures.
Dr Monibi, principal specialist
at Central London dental practice
in Harley Street said he had seen an
increase in adults booking brace
fittings in the run up to Christmas.
He said: “Husbands are buying
their wives braces for Christmas

The surgery is also equipped
with a surgical operating microscope.
Jeremy Hayes, senior dental
surgeon, will use the micro-

He added: “Parents are seeing
the benefits braces are bringing
their children, and are asking
themselves why they aren’t doing it
as well. A beautiful smile is good for
everyone’s self confidence, young
or old.”
Research from the industry’s
governing body, the British Academy of Cosmetic Dentistry, found
that a third of the population were
concerned by the look of their teeth’
whilst only one in five would always
smile in photographs.
Over a quarter of the population believe that cosmetic dentistry could improve their quality
of life. DT

International Imprint
Executive Vice President
Marketing & Sales

Peter Witteczek
p.witteczek@dental-tribune.com

DENTAL TRIBUNE
The World’s Dental Newspaper · United Kingdom Edition

This is a real red letter day
for dental patients and trainee
dentists in Wales.”

and vice versa. We have even had
one teenager arrange for her
mother to be fitted with them as a
Christmas present. I think people
are increasingly recognising the
gift of the perfect smile. Our teeth
are central to the way we feel about
ourselves – they determine how
much we smile and how others see
us.”

Published by Dental Tribune UK Ltd
© 2009, Dental Tribune UK Ltd. All rights reserved.
Dental Tribune UK Ltd makes every effort to report clinical
information and manufacturer’s product news accurately, but
cannot assume responsibility for the validity of product claims,
or for typographical errors. The publishers also do not assume
responsibility for product names or claims, or statements made
by advertisers. Opinions expressed by authors are their own and
may not reflect those of Dental Tribune International.

Chairman
Torsten Oemus
t.oemus@dental-tribune.com
Managing Director
Mash Seriki
Mash@dentaltribuneuk.com
Editor
Lisa Townshend
Tel.: 020 7400 8979
Lisa@dentaltribuneuk.com
Director
Noam Tamir
Noam@dentaltribuneuk.com

Advertising Director
Joe Aspis
Tel.: 020 7400 8969
Joe@dentaltribuneuk.com
Marketing Manager
Laura McKenzie
Laura@dentaltribuneuk.com

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

[3] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

Editorial comment

A professional image
There seems to have
been a recent spate of
dental professionals behaving badly. From dealing Class A drugs (see
news pg8) to copping a feel of
pretty patients or nubile nurses
(pg4), it seems to be the season
for these stories to be getting the
public’s attention.

‘

Whilst we may have a secret
desire to read about a fellow professional colleagues’ misdeeds,
there is a concern that these types
of stories, especially when they
all seem to arrive at once, can
damage the image and integrity
of the profession. I would really
like to know Dental Tribune readers’ opinion on this – do you think
that cases such as those recently
seen in the news harm the reputation of the dental profession in
the eyes of patients, or does the
old adage of ‘Today’s news, tomorrow’s fish wrap’ apply? Email

me (lisa@dentaltribuneuk.com)
and give me your views.
On an unrelated note – whilst
walking to work today I glanced,
as I do, at a certain well known

corporate chain dental practice
situated in the grounds of an 18th
Century ruined church. Musing
on the fact that the ground is reputedly haunted, I wondered if
the team there had had any

News
strange experiences. This led me
to wondering if there were practices around the country who had
residents who simply refused to
leave, even in death? As a fan of
all things paranormal I would
love to hear your tales of ghostly
patients, strange noises or anything which would make the hair
stand up on the back of your neck!
The best ones will have a
chance to be printed in
the October 26th-November 1st issue of Dental Tribune... DT

’

NEW

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, EC1N 8BA.
Or email:
lisa@dentaltribuneuk.com

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growing number of dental
professionals are forming
companies to bid for contracts from PCTs and other bodies
and the Dental Defence Union is
urging them to ensure their company has adequate indemnity in
place.
Dental professionals’ individual indemnity will not cover their
company if they are sued because of
a failure in a company procedure or
the actions of a staff member for
whom the company has vicarious
liability.
For example, if there is inadequate provision of infection control
facilities by a dental corporate
which leads to a patient acquiring a
blood borne infection.
Consequently, the Medical Defence Union, the Dental Defence
Union’s (DDU’s) parent organisation, has introduced an insurance
policy for companies which dovetails with the policy that individual
members receive to ensure all their
clinical negligence claims are covered.
Rupert Hoppenbrouwers, head
of the DDU, said: “While an individual dental professional may be sued
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company’s system for following up
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[4] => DTUK2409_01_Title

News & Opinions

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

Gum disease linked to mouth cancer
M
cers where none of the traditional risk factors - tobacco, excessive alcohol and the human
papillomavirus (HPV) - were
present.

outh cancer campaigners are urging people to
get checked out by their
dentist for gum disease - after researchers linked periodontitis
with mouth cancer.

The British Dental Health
Foundation’s (BDHF) chief executive Dr Nigel Carter said: ‘This
fascinating study underlines the
importance of a good dental routine.

Research published in the
American Association for Cancer
Research journal ‘Cancer Epidemiology, Biomarkers and Prevention’ revealed that chronic
gum disease may present a high
risk for mouth cancer.

Preventing gum disease is as
simple as brushing twice a day
with fluoride toothpaste and
cleaning between the teeth with
an interdental brush or floss.

Chronic gum disease, or periodontitis – caused by a build-up
of plaque in the mouth and characterised by long-standing inflammation of the gums and
eventual tooth loss – was linked
to mouth cancers in both smokers and non-smokers.
The news could provide a
clue to the rise in mouth can-

Research shows gum disease is a high risk factor for mouth cancer

Dental visits are absolutely
vital. Check-ups look for potential problems, screen for mouth
cancer and professionally clean
to help control gum disease. As
our campaign tagline goes – ‘if in
doubt, get checked out.’’

November’s Mouth Cancer
Action Month run by the BDHF
aims to raise awareness of the
disease and risk factors.
Mouth cancer is diagnosed
in more than 5,000 people each
year – a 40 per cent rise in cases
in just 10 years.
Avoiding risk factors such as
tobacco, alcohol and HPV –
transmitted via oral sex – are
vital.
Early detection improves
survival chances from around
half of cases to more than 90 per
cent.
Self-examination can help
identify warning signs such as
ulcers which do not heal within
three weeks, red and white
patches and unusual changes in
the mouth. DT

Dentist struck off after Supermarket applies to open dental surgery
sexual ‘thongdoing’
A

married dentist took off his
trousers and paraded in
front of a dental nurse in
a leopard-print thong, a tribunal
at the General Dental Council
heard.
Dr Anthony Barton, who
worked at the Red Rose Dental
Group in Wigan in Greater Manchester, told the nurse to ‘get a
load of that’.
The 36-year-old had an affair
with the dental nurse between
2002 and 2007.
Dr Barton is was found guilty
of ‘inappropriate, unprofessional and indecent’ behaviour
with her and three other young
nurses - aged 19 and 22 - over a
period of eight years.
He resigned from the Red
Rose Dental Group last August
and denied misconduct.
Another young dental nurse
told the tribunal that the dentist
repeatedly groped her bottom
and on one occasion grabbed
her between the legs as she
tried to work.
She also said he would tell
her ‘vulgar’ details about his
sex life and ask her about hers.

wanting access to health care
professionals at convenient locations and at flexible times.’

The Sainsbury’s dental surgery in Trinity Street in Bolton
would be private.

Sainsbury’s
professional
services manager, David Gilder
said: ‘There is a shortage of dental practices in the UK and the
launch of this new service goes
some way to providing local people with greater access to dental
advice and a range of procedures.

She said: “I was highly embarrassed, it was high enough up my
leg to be very uncomfortable. I
didn’t say much, I just tried to pull
my leg away.”

The company has so far successfully set up dental surgeries
in stores in Heaton Park and Sale
in Manchester.

We have a long history of providing health care services in our
stores which have been enormously popular with customers

Another nurse claimed Dr
Barton would pull at her knickers
as she bent over and try to undo
her bra through her tunic.

‘Groping’ dentist faces retrial

On one occasion when she said
she had a sprained thigh, he
made her sit down, spread her
legs, put one thigh up on a table
and began massaging her.

Lydia Barnfather, for the
GDC, said: “These allegations
concern some inappropriate, unprofessional and indecent behaviour towards four dental
nurses and cover the period from
2000 to 2008.”
The conduct towards these
dental nurses, the council said,
shows a pattern of behaviour sexually motivated to transgress
both the verbal and physical
boundaries and standards to be
expected of an individual in his
professional position.
Dr Barton faces being struck
off if the GDC finds that his fitness
to practise is impaired by his
conduct. DT

Sainsbury’s supermarket
in Bolton has applied for
planning permission to
open a dental surgery in the
store.

dentist accused of groping
three female patients
faces a retrial, after the
jury hearing the case against him
were discharged.
Dr Adrian Heath, a former
Liberal Democrat parliamentary
candidate in Lincoln, has denied
three charges of sexual assault
which were alleged to have taken
place between June and August
last year.
The incidents were said to
have taken place at the Genesis
Dental Care practice in Gainsborough.
On the third day of his trial,
the jury in the case was discharged for legal reasons which
cannot be reported.

Judge Michael Stokes, QC, ordered a retrial on a date to be
fixed. Dr Heath has been granted
bail until then.
It is alleged that Dr Heath
touched the women in the examination chair at his surgery in
a way that had ‘no clinical justification’.

A decision is expected to be
made by Bolton Council next
month. DT

The court heard that he
touched one of the women’s
breasts. Another woman claimed
he stood behind her and touched
her jaw on both sides before sliding his hands under her arms and
down her top.

He allegedly told one of them
he was looking for swollen
glands and needed to compare
her breasts and even asked her to
remove her trousers after saying
‘this is serious’.

Both women came forward
and accused Dr Heath after an
alleged incident involving a
third patient emerged. The third
patient claimed he removed
both of her breasts from her bra
and invited her to compare them
‘to see if there was anything
wrong’.

Dr Heath has denied three
charges of sexual assault, which
are said to have taken place between June and August last
year.

When he was later arrested
Dr Heath of Roseberry Avenue,
Lincoln, told police he had
treated all three women ‘in an appropriate, clinical way’. DT

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[6] => DTUK2409_01_Title

6

News & Opinions

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

Dental nurses celebrate their success

A

presentation and luncheon to celebrate the success of the first dental
nurses to achieve the ‘Certificate
in Oral Health and Application of
Fluoride Varnish’ was recently
held in Rochdale.
This course is the result of an
innovative partnership between
North Western Deanery, The
University of Central Lancashire
(UCLan) and Colgate in producing a portable university accredited course for registered dental
nurses to deliver evidence-based
oral health advice and apply fluoride varnish. Heywood Middleton and Rochdale PCT commissioned this course as part of their
workforce development initiative within their local PCT.
Leslie Mort, executive director for Primary and Community
Care in Heywood Middleton and
Rochdale, opened the proceedings, stating how pleased she
was that this course, the first
of its kind in England, had
been delivered in partnership
with NHS Heywood Middleton
and Rochdale. She commented:
“Following the success of this

Dental nurses with Barry Cockcroft (centre, front), North Western Postgraduate Dental deanery, UCLan and Colgate.

programme, our nurses will be
able to positively contribute towards improving the oral health
of patients in the borough with
advice on oral health and the application of fluoride varnish.”
She acknowledged the hard
work and dedication that the
nurses had shown in being successful in achieving their certificate, adding: “It is a credit to them
and to their trainers and dentist

mentors that they are here to receive their certificate from Barry
Cockcroft, Chief Dental Officer,
England. The PCT is delighted to
have participated in this project
and looks forward to encouraging
skill mix in our dental practices,
and to further support around
innovative projects of this kind.”
Rebecca Craven, Consultant in
Dental Public Health for NHS Heywood, Middleton and Rochdale,

gave a presentation on the background to the scheme, highlighting the need for prevention within
the local population. Having been
involved in delivering the course
locally, she also outlined that this
approach was aligned with Delivering Better Oral Health – An evidence-based toolkit for prevention
launched by the DH 2007.
Dr Barry Cockcroft offered
his congratulations to NHS Hey-

wood, Middleton and Rochdale
and to the Dental Nurses, in being the first to complete this
course. The CDO went on to say
that “The two main forms of dental disease, periodontal disease
and caries, are almost 100 per
cent preventable by patient action; this programme, which includes evidence-based oral
health advice, delivered by dental nurses, will help patients
along that path. The application
of fluoride varnish is one of the
most effective, evidence based
measures of preventing decay;
this additional training is allowing the competencies of dental
nurses to grow into a much
greater role of preventing dental
disease.”
This course is open to registered dental nurses in current
employment with the support
of their employer and PCT.
For further information within
Cumbria and Lancashire contact
UCLan Course Enquires on
01772 892400. For all other
areas outside Cumbria and
Lancashire, please contact the
Portable Training Team on 0161
665 2882. DT

GDC Chief Exec moves to pharmaceutical regulator

T

he General Dental Council (GDC) has announced
the resignation of chief
executive and registrar, Duncan
Rudkin, who is moving to head up
the new General Pharmaceutical
Council.
Duncan Rudkin was appointed chief executive and registrar
in June 2006. Duncan’s tenure
has seen him lead the GDC staff
team through the opening of a
new Dental Care Professionals
Register, the implementation of
significant changes to the GDC’s
fitness to practise procedures
and the introduction of CPD for
the dental team.

Hew Mathewson. GDC president said: “Duncan was appointed as chief executive and
registrar back in June 2006. I am
very grateful for the strong staff
leadership he has provided in
this role through a period of significant change for the Council.
I would like to add my personal
thanks to him for his support during my presidency. I, on behalf of
GDC Council members and staff,
wish Duncan the very best in his
new role as chief executive of the
new General Pharmaceutical
Council.”
Speaking of his decision, Duncan Rudkin, said: “I would like to

roles at the GDC prior to his
appointment as chief executive,
including director of Professional Standards, deputy chief
executive and acting chief executive.

thank the members and staff of
the GDC for their encouragement
and support during my time at
the Council, particularly during
the last three years as chief executive. This new post with a new
regulatory body presents a new
and exciting opportunity for me
and I look forward to working to
develop a positive role for the new
regulator both as a champion for
quality and standards in the professions and an organisation that
puts patients and the public at
the centre of its work”.

Duncan Rudkin

Duncan Rudkin will leave the
GDC at the end of the year to take
up the post of chief executive of
the new General Pharmaceutical
Council, the new independent
regulator for pharmacists, pharmacy technicians and pharmacy
premises from 2010.

Duncan joined the GDC in
1998 as Director of Legal Services, and was tasked with set-

ting up the GDC’s first in-house
legal department. He has also
held other senior management

Arrangements are now in
hand to recruit Duncan’s successor. DT

"We don't worry about
our NHS compliance
anymore".
Dental Air has one of the best customer service reputations in the
dental industry, and with our fast call out times, it is no surprise that
we are the leading supplier of oil-free compressed air packages.

[7] => DTUK2409_01_Title

News & Opinions

Dental professionals vote
on research

D

ental professionals can
now vote online, on
what research they would
like commissioned, at the newly
redeveloped Shirley Glasstone
Hughes Trust Fund website.
The website www.dentistry
research.org puts research
commissioning into the
hands of the primary dental
care team and members of
the site can vote online for
the questions they need
answers to, to help their
practice.

This mechanism allows
members to ensure that the research funded by the Trust is
focused on issues which are
salient to practice.
Ultimately, it enables practice to be based on research

that dental practice is based on
evidence.”
“This exciting new feature of
the Shirley Glasstone Hughes
Trust Fund site enables dentists
and dental care professionals
at the frontline of patient care
to direct research activity
by voting for the questions
they’d like to see answered.”

Getting IT right for
the future

“We look forward to
seeing what really interests those in practice and
doing our best to answer
their questions, by either
revealing what is already
known or funding research which addresses
practitioners’ real issues.”

The new voting system
is designed so that dental
teams can choose a ‘question of the month’.

Each month, the quesThe Primary Care
tion with the most votes will
Dentistry Research Foform the subject of a critical
rum will provide guidance
appraisal of relevant literafor funding applications
ture and a short summary of
later this year when the
conclusions drawn from existing published evidence Online focus for frontline research – Photo: Yuri Arcurs first call for research tenders is anticipated.
will be posted on the website.
evidence, which the website will
For further information, please
present in an easy-to-access
If there is poor or little existcontact Beth Caines at
way.
ing evidence, the question will be
a priority for research funding
b.caines@bda.org, or by phone
from the Shirley Glasstone
at 02920 436 184, or log-on to
Professor Liz Kay, chair of
Hughes Trust Fund.
the trustees, said: “It’s important
www.dentistryresearch.org DT

Cornish town to join NHS
access void – temporarily

A

town in Cornwall is to lose
its last NHS practice after
the surgery decided to go
private.
Saltash Dental Surgery in
Saltash has told its patients it
can no longer carry on with its
NHS dental contract and is to go
private in November.
The surgery has been operating as an NHS practice for about
14 years.
The former town mayor Bob
Austin, who is still a Cornwall

councillor, called the situation
‘crazy’.

had other options in the meantime.

He said: ‘We're the sixth
largest town in Cornwall and
here we are, we haven't got one
NHS dentist left.

She said: “They have currently
have the option of a dental practice in Torpoint and also the option
of emergency NHS treatment at
the primary care dental service at
St Barnabas Hospital in Saltash.”

Ten years ago we had three or
four that were NHS-supported,
but they've gradually just dwindled to nothing.’
Julia Cory, associate director
of the PCT said that in a few
months the town will have a new
NHS practice and that patients

She added: “We have this
under control and we have plans
for a new dental practice for next
spring, so the actual time that
people would have to wait would
be from November until next
spring.” DT

Dental school gives free
books to children

T

he Peninsula Dental
School in Plymouth is
giving away more than
600 books to encourage children
to visit the dentist.
The Peninsula Dental School
has launched the ‘Happy Reading: Healthy Smile’ campaign
to encourage children aged between two and five years of age
to visit the dentist.

The school’s Dental Education
Facility has contacted nearby primary schools, children’s centres

and nurseries and will be giving
away the books in bags containing
leaflets on oral health and a voucher for a family oral health pack that
can be redeemed at the Devonport
Dental Education Facility.
The books have been bought
from funding granted by the
Devonport Regeneration Community Partnership (DRCP).
Wendy Smith, community development officer at the Peninsula
Dental School, said: “We aim to
encourage more people to read to

their children, feel more positive
about going to the dentist and help
them to access the wide range of
services available at our Devonport Dental Education Facility
– which is already a popular resource in the area and which has
seen a great number of patients
since it opened in April. We are
grateful to DRCP for its support
and the funding which has helped
us to achieve this initiative.”
The scheme was launched at
the Green Ark Children’s Centre
in Devonport. DT

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Facial Rejuvenation Technology
Audio Visual Equipment
Telephony

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UNITED KINGDOM &
THE REPUBLIC OF IRELAND

[8] => DTUK2409_01_Title

8

News & Opinions

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

Ex-dental nurse turns drug dealer

has otherwise led a useful life,
but it cannot be dealt with in
any other way.”

A

He added: “You lost your job
and got in debt.

woman who turned into a
cocaine drug dealer after
losing her job as a dental
nurse has been jailed.
Laura Davies, of Lincoln
Drive, Watford was jailed for
21 months after she was
stopped in her Vauxhall Tigra
and police found 29 wraps of
cocaine stuffed inside one of

her boots and £600 cash in her
bra.
The 23-year-old started dealing class A drugs after losing her
job as a dental nurse. St Albans
Crown Court heard that Davies,
who had worked as a dental
nurse for seven years, was
sacked after a row with her boss
over being late.

She pleaded guilty to possession of class A drugs with intent to
supply and possession of criminal property at the magistrates
court and was committed to the
crown court for sentence.

Judge John Plumstead said:
“I am afraid you are going to
prison for 21 months.”

Davies has no similar previous convictions, but has a conviction for common assault and a
warning for a similar matter.

“I have sympathy for your
family and some sympathy for
you. It is never a pleasure to
send someone to prison that

“Half of that will be served
in custody.”

“It is no coincidence that you
had been using cocaine as a
recreational drug and that is no
doubt why you stopped being the
reliable and helpful dental nurse
you were and turned up late for
work and had an argument and
lost your job.” DT

You will
go to
the ball!

D

ental professionals attending this year’s
British Dental Trade Association Showcase can dance
the night away at the Bridge2Aid
Charity Ball.
The Bridge2Aid Ball is on
13 November at the Hilton
Metropole Hotel
in Birmingham.

The
evening begins at 7pm
with the British
Dental Trade Association’s
(BDTA’s) traditional Exhibitors’
Drinks Reception.
This will be followed by
a three-course meal, a charity
auction, and music provided by
The Deloreans.
The evening will be compered by comedian Tim Vine.
A spokeswoman for the
BDTA said: “After being on your
feet all day, the Bridge2Aid
Charity Ball is a perfect opportunity to relax and have some well
earned fun whilst also raising
money for this extremely good
cause.”
“This event is sure to be a
night to remember and offers a
perfect substitute to organising
your own staff event and has the
added benefit of knowing that
you’re helping to build a sustainable future for one of the world’s
poorest communities.”
“The dress code for the
evening will be smart/glam,
and although it’s not a black tie
event, there will be a no jeans
policy.”
Tickets to the Bridge2Aid
Charity Ball cost £42 each.
Further information on
Bridge2Aid is available at
www.bridge2aid.org
All profits from ticket sales
and fundraising activities will be
donated to Bridge2Aid. DT

[9] => DTUK2409_01_Title

Events

Touting your wares

Excellent Quality
Excellent Value

It’s in your interest to advertise the cosmetic procedures
you offer at your practice, says Tracy Stuart

t is perhaps a testament to the
professionalism of UK dental
practitioners that they balk at
opportunities to ‘sell’ cosmetic
treatments to patients who might
benefit from them. In truth, it is a
mixture of a concern to preserve
the ethics of the profession and a
lack of confidence when it comes
to marketing their services.
These days, everyone in
the public eye has a nice smile.
Usually this is the result of very
expensive dental work that is
out of the reach of most people.
However, significant leaps in
technique and technology have
enabled dentists to offer
cosmetic treatments at an
affordable cost, to meet
the rising demand for improved aesthetics.

Quality of life

explain to the dentist exactly
what they want, because they
don’t speak the language.

Learning to communicate
Dentists do not want to be
pushy, and many are concerned
that any efforts to introduce a patient to further treatment options
may be misconstrued as ‘the hard
sell’, which is not suitable in
dentistry. So, what can they do to
confidently suggest other items
on the treatment list to patients
who might benefit from them? It is
all a question of developing new
skills in effective communication.

... Why compromise

the dentist will be able to introduce other items on the treatment list confidently and competently, without being pushy or
aggressive, retaining a strong
sense of professionalism.
There is more that dental professionals can do besides implementing proven communication
methods. A regular report on
patient flow can provide crucial
information that can be used to
market particular treatments
more effectively.

A-Silicone Fast Set Putty

Improving efficiency
In the current competitive climate, with the
credit crunch threatening everyone, it is strange
that many dentists do not
examine the statistics of
their practice more often.
How else will they know
how to improve the efficiency of their business?

Traditionally, dentists
were found in the same
club as undertakers and the
For instance, how
taxman – people you didn’t
many dentists know how
ever want to see. The carimany patients contact the
cature of the visit to the
practice per month? How
dentist, of dental pain being
many of those decide to
relieved by a cathartic dose
attend? How many still go
of surgical pain, no longer
on to accept treatment?
rings true. Now, many
Finally, how many come
people visit the dentist to
back in the future, and
improve their quality of life
by helping them achieve Improving patients’ quality of life. Photo: Monika Olszewska become loyal patients?
It is impossible to reap
a healthy, straight smile.
the full rewards of training and
Sometimes, even a straightforSolutions are available that
marketing without knowing this
ward cosmetic procedure can
include a patient care co-ordinainformation.
make the world of difference to
tor programme that helps the
a patient.
dentist and the dental team
achieve a gold standard in cusWouldn’t you like to know how
In order to meet this need,
tomer service. Improved lines of
that patient who just accepted an
dentists are investing a great deal
communication do not just run
expensive cosmetic treatment
of time and money in developing
between staff and patients, makfound out about it, and why they
the skills and installing the
ing patients more relaxed and
chose you and not your main comequipment to provide a range of
informed, and ensuring that
petitor? You can use this informarestorative and cosmetic dental
dentists know exactly what they
tion to reach out to more patients,
treatments. The most forward
want; the lines of communication
making the most of your skills,
thinking advertise these new
also run between staff members,
meeting their needs, and of
treatments on their websites and
enhancing efficiency of the workcourse boosting sales!
literature. However, there is
ing systems and reducing stress.
more that can be done.
Find out what your conversion rate of new inquiries is, and
The patient care co-ordinator
Dentists, who have invested
then look to improve it. If the rate
programme has a training plan
in a multidisciplinary approach
is lower than 80 per cent, you
that comprehensively covers the
and extended their treatment list
might need to think about inpatient’s journey through the
to cater for the many needs of the
vesting in training.
practice in its entirety, from telepatient base, may well treat paphone conversations with the
tients who could benefit greatly
front desk or receptionist, and
With first-rate communicafrom a particular procedure. The
what should be covered in that
tion, you can keep your patients
trick is, how to broach the subject
first appointment.
informed, and by examining data
with the patient without seeming
about your patients, you will be
pushy. There is a certain resistable to market your treatment
The treatment plan contains
ance against the blurring of
list more effectively, leading to
useful advice to help staff comboundaries between ‘healthgreater success. DT
municate more effectively and
care’ and ‘sales and marketing’,
with greater confidence. This is
but in the competitive modern
achieved by looking at greeting
dental industry, few dentists can
strategies, and phrases that are
About the author
afford to ignore the fact that maxuseful and ones that should be
imising opportunities increases
avoided. The role of body language
profits.
is also examined. By mastering
Tracy Stuart
verbal skills and tone of voice, usof Frank Taylor & Associates Consulting, with her experience of
Patients do not always know
ing methods including role-play to
practice development, helps denwhat treatments are being ofsharpen those skills and provide
tists achieve their full potential
fered, and there are many reaexperience, and repeated practice
and make the most of their skills
sons why it’s useful to advertise
using scripts, the dental team will
and resources. For more inforthem. For example, if you don’t,
be better equipped to deal with
mation, call Frank Taylor and
your patients might resort to
patient queries.
Associates Consulting on 08456
123434, fax 01707 643276 or email
travelling abroad for treatment
team@ft-associates.com.
– where they are especially vulOf course, armed with these
nerable and may not be able to
improved communication skills,

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[10] => DTUK2409_01_Title

Practice Management
One Source – One Solution

Big business
Chris Hindle discusses the benefits of selling
your practice to a large dental corporation
and answers a reader’s question on the subject

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ost dental solicitors
have seen the market
for practice acquisitions remain reasonably buoyant
this year despite the recession.
Undoubtedly prices, driven
higher by the interest of large
corporate buyers in recent years,
have now peaked.
We have noticed continued
acquisition activity involving
the purchase of NHS practices by
IDH, the owner of the Whitecross
chain of surgeries. James Hull,
the smaller, niche practice
provider have reportedly raised
funds and are now actively looking to purchase private practices.
We also understand that ADP is
expected to shortly re-enter the
market.

Reasons for selling

We are seeing dental clients
selling their practices for various
reasons; not just retirement but
also people who are still relatively youthful, in their late 30s
or early 40s, who wish to realise
their asset and either have a career break or simply work as an
associate free from the dayto-day pressures of running
a practice. Unfortunately, there
are also a good number of clients
selling for health reasons.

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So what issues should practitioners be both aware of and
thinking about if considering selling to one of the large corporate
bodies? Here are a few pointers,
although this is by no means intended to be a comprehensive list:
1. Liaise with your accountants
and one of the specialist dental
practice sales agents to establish how much your practice is
worth. You should also seek advice on apportioning the value
of the business between goodwill, equipment and the property. You should try and ensure
that the value of stock is not
lost in the goodwill price but
paid for, at cost price, on completion.
2. Seek the advice of specialist
“dentally aware” solicitors on
the mechanics of getting the
business transferred to the
buyer – this is especially true if
you have an NHS practice.
Be aware that if you are behind
with your UDAs then the value
of any shortfall on completion
will be deducted from the
purchase monies. You should
also expect retention on completion in respect of patient
charges that have been collected by you in advance –
somewhere in the region of
£5,000 per chair.
The buyer should take on any
PCT practice grant and/or
Quality Outcome Framework
(QOF) repayment liabilities.

There is continued acquisition activity amongst dental practices. Photo: Rudyanto Wijaya

3. Be aware that the buyer’s solicitors will have extensive
due diligence enquiries; all
elements of the practice will
be looked at with a fine toothcomb. For example it is a good
idea to ensure that the practice’s clinical governance is
up to date, i.e. equipment has
been tested when it should
have been and inspection certificates are available. Also ensure that Hepatitis B vaccinations are in date for those
working at the practice.
One of the factors that can
cause a delay in the sale of
a practice is where the client
underestimates the importance of these enquiries to the
Buyer and does not deal with
the due diligence both thoroughly and quickly.
4. Consider what you want to do
after the sale. Most corporate
buyers are happy for the former principals to stay on as
associates. If you want to move
on then be aware that the
buyer will want to bind you out
from practicing in the locality
for at least a two-year period;
the extent of the area is open to
negotiation.
5. Consider your staff and associates. You should ensure that all
have properly documented
contracts of employment or
self-employed agreements. Associates and self-employed

persons can be a concern – the
buyer will want them to sign
their own form of self-employed contract to be entered
into on completion. Sometimes
there is very little time in between exchange of contracts
and completion and if the selfemployed persons do not know
what is happening then the request to sign new paperwork
can come as something of a
shock. There may also be concerns that self-employed persons may decide to leave on
hearing of the sale – this could
adversely affect the nature,
running and value of the business.
6. If you own your premises then
consider whether you want to
sell the freehold or lease it to
the buyer. Some dentists like
to keep the premises as an
income-producing asset and
others prefer to make a clean
break. If you want to lease the
premises to the buyer then get
an idea of how much rent you
can charge from a qualified
chartered surveyor.
If you have a secured loan on
the property and intend to keep
the freehold then, unless you
intend to repay the loan from
the proceeds of sale, you will
need to get your Bank on board
at the relevant stage as the
lender will need to consent to
the transaction and approve
the form of the lease.

‘What issues should
practitioners be both aware of
and thinking about
if considering selling’

[11] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009
Consider whether local authority planning issues may be
relevant. Are there any planning decisions affecting the
premises? If so, it is a good idea
to have the planning permissions available and to check
that any conditions, which may
be attached, are being complied with. If you consider
the practice has scope for expansion by adding surgeries,
thereby making it more marketable, it may be sensible to
check that the local authority
will permit this.
If you have a lease then be
aware that the Buyer is likely
to want a term of up to 15 years
to satisfy it’s own Bank lending
requirements. If you only have
a short number of years left
to run then it may be sensible
to make tentative enquiries of
the landlord about agreeing an
extension.

‘If you consider the practice has scope
for expansion by adding surgeries [...]
it may be sensible to check that
the local authority will permit this.’
seller to you in the business sale
contract, which will allow you
to claim back the cost of any
remedial works from the seller.

Contracts sometimes provide,
particularly if there is a private
patient base, for there to be a
monetary retention from the

Practice Management 11
sale proceeds. This money is
held, for a fixed period, by one of
the parties’ solicitors and released to the buyer if required
to cover the cost of such works.

the purchaser’s solicitors, but it
is of course only fair to allow the
seller the opportunity of checking out any alleged problems –
if practicalities permit.

The contract should also be
checked to establish whether
provision was made for the seller
to be able to examine any patients and/or treat them. Any
contractual provision relating
to treatment by the seller after
completion is usually resisted by

A lot will depend on the relationship the former principal had
with the patient as to whether the
latter is happy for him to do any remedial works. The patient may
not want this and of course you
may not want the former principal
associating with your patients. DT

Have you got a query?
Each month, Cohen Cramer
will aim to answer your questions on any legal issues that
are bothering you. Here’s this
month’s question.

The Clearstep System

Question: I have recently acquired a dental practice and
discovered that a number of
patients have received very poor
treatment from my predecessor.
I am receiving complaints from
patients who are expecting me to
put right work that was not done
properly. They seem to think that
this is at my expense and while
my predecessor has offered to
come in and treat disgruntled
patients, I am not comfortable
with him going down this route.
Please advise.
Answer: Ask your solicitor to
check the business sale agreement to establish whether this
situation was considered and if
so how it was covered. Generally
speaking, you would not expect
to be liable for the shortcomings
of your predecessor and there
may be an indemnity from the

About the author

Comprehensive invisible orthodontics made easy
The Clearstep System is a fully comprehensive, invisible
orthodontic system, able to treat patients as young as 7.
It is based around 5 key elements, including
expansion,space closure/creation, alignment, final
detailing and extra treatment options such as functional
jaw correction.

Personal Accreditation
Receive a visit from a Clearstep Account Manager,
providing a personal accreditation in your practice at a
time convenient to you.

Further Courses
Once accredited, further your orthodontic expertise with

GDP friendly, with our with our Diagnostic Faculty
providing full specialist diagnostic input and treatment
planning, no orthodontic experience is necessary. As
your complete orthodontic toolbox, Clearstep empowers
the General Practitioner to step into the world of
orthodontics and benefit not only their patients, but
their practice too.

our hands on course, where you will learn sectional
fixed skills and other methods to reduce your costs and
treatment times.

Clearstep Advanced Techniques
Hands On Course dates for 2009
1st - 3rd December
London

Accreditation Seminar

Chris Hindle
is an experienced commercial solicitor who has for some time specialised in dental practice sales
and purchases including in particular, the sale and purchase of practices with NHS contracts and/or
capitation schemes. In addition to
his dental expertise, Chris also advises on planning issues relating to
the use of dental practice premises. To contact Cohen Cramer Solicitors, call 0113 2440597, email
dental.team@cohencramer.co.uk
or visit www.cohencramer.co.uk.

This accreditation seminar is aimed at General
Practitioners, providing you with all the knowledge and
skills required to begin using The Clearstep System
right away.

To find out what Clearstep can do for you,
contact us today.

01342 337910
info@clearstep.co.uk
www.clearstep.co.uk

[12] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

12 Practice Management

A soft approach

treatment schedules competently
administered and maintained.

Do your research

Neil Sanderson discusses how to release your
practice’s potential using management software

I

nvesting in innovative technology is considered a logical course
to improving a practice, but what
about your practice management
software? Often neglected, investing in a software system designed

to increase efficiency and productivity could transform the dental
team’s working environment.
Using software specifically
designed by experts in dental

care and reduces the risk of incompatibility with present systems, which could cause a delay
in installation.

practice management will assist
a practitioner in achieving
a sought after working environment, and enable practice staff
to perform at their optimum with
all finances, appointments and

Before deciding upon which
software to employ, it is advantageous to research which areas of
your practice can be improved
and ensure that any new equipment will be compatible with your
current system to maximise use.
Purchasing all solutions from the
same software provider ensures
a consistent level of customer

The leading practice management software providers offer
a product portfolio that includes
organisation of patient information, appointment scheduling,
online patient booking and customisable reports, devised to be
user friendly and easy to access.
Dentists also gain from providers
assisting with software integration for the practice and the supply of product demonstrations on
request for a beneficial insight.

Instant access

PracticeWorks

Software such as the Kodak R4
includes the ‘Patient Central’ feature enabling instant access to
patient details, including previous treatments and clinical notes
in one convenient place. Containing all relevant information necessary for every patient, time
spent searching for files and notes
can be greatly reduced, giving
staff the opportunity to confidently focus on other tasks. The
practice appointment calendar
can also be accessed, for cancelling, rescheduling or making
new appointments, all viewed on
one easy to navigate screen to
quickly see who is running late or
for noting schedule gaps.

Practice Management Software
and Digital Imaging Systems
Our team at PracticeWorks are recognised for their expertise in dental technology, from
installation through to support and maintenance, whether it’s the most advanced practice
management software or the most innovative digital imaging systems.
We have over 70,000 software installations worldwide to prove it. We also developed the ﬁrst
intraoral sensor, “RVG”, which started the digital radiography revolution.

Integrated with a surgery’s
current Kodak equipment, the
practice management software’s
launcher feature enables access
to any Kodak imaging device
without the need for a Kodak R4
licence. Any operator can use the
feature; by selecting the right
patient, the ‘Launcher’ will immediately take the image and
automatically provide all the required patient information to the
user. Employing such time saving
features will allow for improved
time management, enabling
more freedom to focus on patient
satisfaction and reducing the risk
of errors.

And when you buy a PracticeWorks product you also buy great support. Our trainers,
engineers and help desk staff are always on hand to ensure you get the most from our
products and services
So not only do you get the very best service at all times, you also get peace of mind from
knowing that your satisfaction is our top priority.

Improved environment
R4 Version III
Practice
Management
Software

Back Ofﬁce
Business
Management
Software

Managed
Service
Web Based
Practice
Management

Kodak 9000 3D
Extraoral Imaging

Dental
Photography

Kodak CR7400
Phosphor Plate
Digital X-Ray

Kodak STV
Digital Intraoral
Camera

Kodak
RVG6100 and
5100
Digital X-Ray

The very best products, expertise, support and service
brought to you on a plate
For more information or to place an order please call 0800 169 9692
or visit www.practiceworks.co.uk

An investment in cutting-edge
software that can be integrated
with other practice technology
such as digital imaging systems
creates a working environment to
be proud of, saving you time you
never thought you had. Intuitive
features work to enhance patient
and staff communication through
simple yet powerful tools created
by dental industry experts, meaning calm confident staff, well-informed patients and an organised
practitioner.
A fully integrated practice
ensures that staff has access to
reliable software, aiding them
to work with and not against
technology while providing patients with an outstanding level
of service. DT

About the author
Neil Sanderson

PracticeWorks

© PracticeWorks Limited 2009

is UK sales and marketing manager for PracticeWorks. For further information, call PracticeWorks on 0800 169 9692 or visit
www.practiceworks.co.uk.

[13] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

Education 13

The 10 Dimension… the power of 10
th

Ed Bonner and Adrianne Morris look at how best to reach your target market

What to do? The Internet, of
course! So, I built the new practice
with an innovative and beautiful
website, and that did very nicely
for me.
But it’s nearly 10 years later,
I've sold the practice and begun
expanding my already burgeoning
dental practice/healthcare consultancy as well as my alternate profession as an expert witness in
prosthodontics. My main marketing tool? Still the internet, but the
other guys are doing the same
thing. So I look around and come to
the conclusion that I need a new,
higher-tech more adaptable website. Plenty people out there willing
to do it for me, but they all tell me it’s
complex, time-consuming (at least
three weeks) and costly (at least
£3,000), and these days I count my
time and pesetas carefully.
And then, my life/success
coach and business associate
Adrianne Morris sends me an
email from someone she met at a
network meeting. Tony Sephton of
Hype London will do exactly what
I want and will do it in my presence
so I can see how he does it and learn
to do it all myself. He will take only
one day over it, and at the end of the
day, I will have a perfectly-formed
website from which I can blog,
YouTube, Twitter and what-all
else. As a special offer, he will do all
of this for £500 +VAT. The chap jests
– where are the attached strings?
Is he a cowboy, incompetent, or
what?

Delivering the goods
Anyway, I call him and he
seems a decent enough guy and
assures me he can deliver, and that
he will only stop when I am happy,

plex, bright/dark, modern/classic.
I make my selection and a font
I like. I select background pictures,
which he allows me to test first before purchasing my choice wholesale. He copies and pastes the text
which I have sent him by email, and
by 3pm I have a brilliant, function-

ing website. There is still time for
Tony to attend to the other requirement I have, for my dento-legal expert witness activities. We have already discussed issues of style, so
by 5.30pm I have not one, but two
functional websites. (www.bonner
dentalexpertwitness. com).

New research results from Aquafresh show that increasing brushing time:
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26% more plaque removal
was observed with brushing
for 120 seconds compared
with 45 seconds*2

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

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%

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+%

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&*%

&-%

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7gjh]^c\i^bZhZXdcYh

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?di_jk[dWc[b h[c_d[hWb_iWj_ed Yb_d_YWbijkZo

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

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((
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* p<0.05

Adrianne Morris
is a highly-trained success coach
whose aim is to get people from
where they are now to where they
want to be, in clear measured steps.

Ed Bonner
has owned many practices, and now
consults with and coaches dentists
and their staff to achieve their potential. Contact Ed at bonner.edwin@
gmail.com, call 07776 660 1338 or
email Adrianne at alplifecoach@
yahoo.com.

I am delighted to inform you that
Tony has extended the special offer
to readers of Dental Tribune UK, so if
you want to reach him directly, email
him on tony@hypelondon.co.uk and
see his site – www.hypelondon.co.uk
– you won’t be disappointed. DT

To motivate behavioural change, it helps if patients understand the beneﬁts
of brushing for at least 2 minutes twice a day with ﬂuoride toothpaste,
compared to an average brushing time of around 46 seconds.1

7gjh]^c\i^bZhZXdcYh

About the authors

Offer for DTUK readers

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D;>C8G:6H>C<7GJH=>C<I>B:

EaVfjZgZbdkZYIjgZh`n

When I started my next practice, I found advertorials a little less
successful, because by then every
dentist and his dog was doing the
same thing and the idea had run its
course. Truth is, if you can see the
bandwagon, no point in trying to
get on – you’ve missed it!

so we arrange to get together.
A few days later, I meet Tony at his
home, takes me to his home, and
the day begins. He gets me a
new website for the consultancy
(www.thepoweroften.co.uk).
Then he gives me a choice of design;
minimal/detailed, simple/com-

:cVbZaHB=gZXdkZgn

I

n the early nineties, I opened
a new practice. I placed an
advertorial in a local freebie
magazine telling residents what
my practice was about. It cost me
£1,000 but it brought me more
than 100 new patients, so as a marketing tool it was nothing short of
amazing.

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

[14] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 05–11, 2009

14 Company Promotion

From concept
to commission

The complete equipment solution from The Dental Directory.

T

he Dental
Directory is a
national, full
service dental dealer,
providing today’s dentists
with everything from a
paper cup to a full surgery
refit, all at the most
competitive price and with
the best service possible.
So whether your
equipment requirement
concerns a small
handpiece, a large
equipment unit or a
complete surgery
refurbishment, The Dental
Directory can help you.
You may need your
equipment repaired,
serviced or a new
alternative sourced,
whatever the issue – no
matter how large or small
– the equipment team are
here to assist you.
The equipment division
forms a major part of
The Dental Directory
operation, spanning across
the headquarters in
Witham and two office
facilities with showrooms
in Perth and Liverpool.
A national team of
experienced engineers,

equipment specialists,
surgery design consultants
and customer service
members ensure every
dentist receives the very
best service from start
to finish.
Mark Wheatstone,
Technical Sales Director at
The Dental Directory,
comments, “When
purchasing equipment,
Dentists are making a
considerable investment in
the practice, and they need
to know that the supplying
company supports this
commitment. We firmly
believe that it’s about a
long term partnership and
in turn we invest in our
people, products and
services to ensure that we
are always there when
needed and with the right
solution. We completely
tailor our equipment
service to the client and
their needs, providing a
professional product
that’s on time and
within budget”.
Quality Guaranteed
The Dental Directory
works with the worlds
leading equipment

suppliers and, although all
products meet todays
regulations and their own
strict quality programmes,
The Dental Directory still
performs its own quality
control checks. Every
piece of equipment
installed is tested and
demonstrated by our own
manufacturer-trained
engineers to ensure
correct performance.
Equipment new to the
market is reviewed by a
new product board and
selected for supply based
on suitability,
functionality, reliability,
quality and innovation.
Beginning to End
We support you through
the complete buying
process from guidance
on design, equipment
selection, supply and
installation, right through
to aftercare. The Dental
Directory offers you
complete piece-of-mind
that you are making the
right decisions for
your practice.
Our national team of
engineers provide an

The Dental Directory supplies bespoke dental cabinets from Modwood.

Oakmor Dental Centre, Braintree, Essex. A quality Surgery
refit by The Dental Directory.

excellent aftercare
service for repair
and maintenance.
Manufacturer acredited,
our engineers are on hand
so you can continue your
work confidently, knowing
that assistance is only ever
a phone call away.
Bespoke Surgery
Planning
Every Dentist has their
own way of working and
that’s why The Dental
Directory offers a
bespoke surgery planning
and design service.

Your surgery created just
the way you want it. Our
design experts will visit
your practice for a full,
free of charge,
consultation, where full
measurements are taken
and then a detailed
specification produced.
A schedule of work can
then be agreed, planning
works and contractors
around your timetable to
minimise distruption and
surgery downtime.
The Dental Directory
provides the full
turnkey solution to

[15] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 05–11, 2009
within 24 hours of your
approval of the quotation
then you will not be
charged.* Not only is
Handpiece Express fast,
but the quality of work is
exemplary. Only
experienced,
manufacturer-trained and
accredited engineers will
work on your equipment.
Regularly servicing
handpieces, motors,
couplings and scalers will

Company Promotion 15
Manufacturer Support
All of this great service
would be meaningless if we
did not have the support
of leading manufacturers.
The Dental Directory has
a range of products from
the most renowned and
respected manufacturers
within Dentistry. These
include Belmont, Anthos,
Kavo, Stern Webber,
Modwood, W&H, Satelec,
Tridac, Schick, E-woo,

The newest addition to our equipment portfolio, KaVo Dental.
ESTETICA E80T/C is the ultimate KaVo system.

surgery refurbishment.
We understand it is not
simply about the supply of
equipment products. We
have the expertise to help
you through the whole
process with informed
advice on current
regulations and guidelines,
including the recent
HTM 01-05
decontamination
memorandum, and project
management to develop a
long term partnership.
Digital Imaging
Our range of digital
imaging products includes
Panoramic, Cephalometric,
and CT digital imaging
systems. We supply
products from Soredex,
Dürr, Schick, Gendex and,
more recently, Vatech
(E-WOO), so ensuring that

1

. A dedicated team of
in-house specialists.
We have a team of
specialists in digital
imaging equipment and
surgery refit and design to
explain what is available
and which will suit your
needs best.

2

. The Widest possible
choice. We offer a
range of products
from leading
manufacturers ensuring
you can find the right
equipment for you.

3

. Unbiased, impartial
advice. As we are not
tied to any particular
manufacturer, we can give
you completely impartial
advice.

we can provide the most
up-to-date digital
diagnostic solution. The
Dental Directory is able to
provide expert advice in
all areas; from single user,
stand alone systems to
fully networked solutions,
from intra-oral cameras to
3D CT, and from direct
sensor systems (wired or
wireless) to phosphor
plate technology.

4

. A complete service.
We don’t just sell you
a box and walk away.
The Dental Directory will
plan, deliver and install
your new equipment with
the minimum disruption to
your surgery.

Handpiece Express
Handpiece Express is the
dedicated handpiece
servicing and repair
service from The Dental
Directory. Suggested in the
name, you can be assured
of a fast turnaround
repair of your handpieces
and motors. We are so
confident of this that if the
work is not completed

5

. Attractive finance
packages. In
partnership with
leading financial
institutions, we can offer
very competitive finance
packages, including lease,
lease purchase and
payment holiday options.

PaX-Reve 3D sets a new benchmark as the world’s most
advanced dental Cone Beam CT machine.

We have the expertise to help you choose the right equipment to
comply with the recent HTM 01-05 decontamination memorandum.

5 Reasons to choose,
The Dee ntal Directory

prolong the life of your
equipment. Inevitably
handpieces will always fail
at the most inconvenient
times, causing maximum
disruption. Planned
maintenance and
scheduled servicing can
prevent this. Servicing also
ensures reduced running
costs, smoother operation,
and efficiency which leads
ultimately to improved
treatment standards and
comfort for patients.

Dürr, Cattani and Murray
to name but a few.
Our equipment range is
vast, enabling us to
provide everything from a
replacement, bulb or
handpiece, through to a
complete surgery;
including treatment
centre, x-ray and
bespoke cabinetry.

Expert advice on your
equipment, needs is
only a phone call
away, call us on 0800
585 585 or visitt
www.dentaldirectory.co.uk

*Terms and conditions apply.

Why not visit
us at Dental
Showcase. Stands
P12, P13 & Q19

[16] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

16 Education

Life after training
In order to meet new challenges, it’s important
that you continue learning, says Dr Riz Syed

mplants are becoming an
increasingly popular option as a stable long-term
therapy for missing teeth with
both patients and dentists. In
the 1980s, implant therapy was

function driven, while in the
1990s the main focus was on
the prosthetic element. Today
implant therapy is driven by
oral health, function and aesthetics.

There are many factors to consider when seeing a patient, with
treatment planning the key to success of treatment. Bone and soft tissue considerations, respecting the
biology and translating the initial

treatment plan will ultimately decide whether the treatment is
deemed a success or failure.
It is therefore important to deliver not only a long-term stable option, but also a highly aesthetic result. After completing implant
training, the next hurdle is treating
patients in your own practice. It is
very important to treat patients either during or at the end of training
or straight afterwards to maintain
the confidence and knowledge
gained during the course. I have

surgical placement &
restoration of dental implants
13-15 & 20-22 November 2009
Hornchurch, Greater London

seen many surgeons on my refresher courses due to this very
reason and a majority of them have
not carried out any implant treatment following their training.

Using a mentor
The use of a mentor is a very popular way to translate the therapy of
implants into a real practical notion.
Mentors are highly experienced
surgeons in your local area and can
be found either through friends or
through implant companies who
produce mentor lists in the UK.
Following my own training in
implants I was supervised during
my initial cases and although I performed the treatment, having a
mentor to guide me increased my
knowledge and confidence.
As a listed mentor I have trained
many surgeons in the UK. The service I provide can range from simple
phone advice, radiographic evaluation, treatment planning or dealing with complications. Mentees
are then welcome to either bring
patients to my clinic or for me to
travel with my team to their clinics.
This allows the surgeon to perform
the operation with confidence under supervision, with one-to-one
practical training.

Dr. Michael McCracken DDS, PhD
Associate Professor in the Department of Prosthodontics
at the University of Alabama School of Dentistry. He
received his dental degree from the University of North
Carolina at Chapel Hill in 1993. After completing a
prosthodontic residency at UAB, he received a Ph.D. in
biomedical engineering for research related to growth
factors and healing of implants in compromised hosts.
Currently, Dr. McCracken serves as the Associate Dean
for Education and Curriculum Development at UAB. He
maintains an active private practice within the school.

Continuing professional
development
As the level of skill and knowledge increases, new challenges and
cases will present themselves early
on in implant therapy. In order to
meet these challenges, it is important to continue learning. Implant
therapy is continually evolving following some excellent research undertaken by some clinical teams
across the world. The knowledge
gained on specific courses will help
to offer different solutions to the patients and therefore give a more
comprehensive treatment plan.

Attendees of this 2-session, 6-day course will learn: how to diagnose and treatment plan for predictable results; the
rationale and scientiﬁc basis for surgical and prosthetic procedures; step-by-step placement and restorative techniques
via didactic lectures, hands-on workshops and live surgeries; and to develop case presentations and marketing skills
to integrate implants into their practice. All attendees will earn 48 hours Continuing Professional Development (CPD).

s diagnosis & treatment planning
s surgical and medical evaluation
s hands-on surgical workshops
s hands-on prosthetic workshops

s bone grafting & wound closure
s live surgeries
s patient surgeries (additional fee)
s practice marketing

For further information, call
01895 430 650, email info.uk@
nobelbiocare.com or visit www.
nobelbiocare.com. DT

About the author

For additional information about the course, including a complete
list of topics and registration information, please contact:

BioHorizons UK
+44 1344 752560
infouk@biohorizons.com
www.biohorizons.com
All attendees will earn 48 hours CPD.

SPMP08152 REV B JUL 2009

Dr Riz Syed
qualified at the Royal London Hospital in 1999 and runs a referral clinic
in Islington and Walton-on-Thames,
and was one of the first surgeons in
the country to use NobelGuide. He
is a mentor for Nobel Biocare, helping
to train UK implant surgeons. Regularly consulted for complex treatment planning cases, Dr Syed lectures on guided implant surgery. He is
a member of the Association of Dental Implantology, the International
Congress of Oral Implantologists and
Fellow of the Royal Society of Medicine. To contact Dr Syed, email
rizsyed@hotmail.co.uk, call 01923
223479 (Mulberry Dental Care) or
020 7226 9797 (AG Dentistry).

[17] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

Money Matters 17

Safeguard your accounts
Completing your tax returns online? You still need to think about protection.
Frank Pons of PFPoffers some practical advice

re you the kind of person
who, when a new opportunity arises, throws caution to
the wind and says ‘I’ll have a stab
at that,’ or are you more likely to
hang back, and check the lay of
the land first?

zealous approach, and have increased the tax yield accordingly;
if your name is picked out of the
hat for a random investigation,
you could be contributing to that
tax yield!

With policies from a leading
provider of Tax Investigation Cost
Protection, you can complete your
online forms with confidence. Insurance of up to £75,000 towards
accountant’s fees in the event of

a tax investigation means that, if
you do need to defend yourself,
you can afford the very best help.
With the internet there is always a certain naivety. Hopefully,

those of us using the internet to
complete our tax returns won’t do
so with a false sense of security;
you still need to be just as accurate
as before, and can still be subject
to random investigations. DT

The internet has affected the
way we all do business, and now
that the Self Assessment Tax Return
can be completed online, we have
seen many forward-thinking dental professionals enjoy the benefits of what is a more expedient
process.
If you do decide to complete the
forms online, you do need to make
sure that your entries are complete
and accurate. Your information will
still be subject to the same checks,
and you may still be selected at random for investigation. So, you could
benefit from insurance to protect
you from investigation by the tax
authorities, even if you are taking
the electronic route.
It goes without saying that the
challenges and enquiries made by
HM Revenue & Customs require
a great deal of time and expertise
to deal with. An accountant or
investigation specialist can offer
the right expertise and experience
to enable you to face the tax authorities on a more even field, but as
with all things, you get what you pay
for. You might very well find yourself avoiding any penalties as far as
the tax authorities are concerned,
but facing an enormous bill from
your expert.

Introducing A-dec 300
stylish functional innovative
A-dec are exhibiting at Dental Showcase
Visit us on Stand J02
NEC Birmingham
12-14 November 2009

Facing a full enquiry
You could end up facing a full
enquiry, considering all aspects of
the Self Assessment Tax Return,
a VAT Dispute as to the accuracy
or completeness of submitted
returns, a PAYE or NIC Dispute
or an Aspect Enquiry into one or
more facets of the return. The tax
authorities have adopted a more

About the author

A healthy new choice for dentistry
Find out why the A-dec 300 is a great choice for your practice.
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[18] => DTUK2409_01_Title

18 Money Matters

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

Three years’ warrantee:
parts and Labour
Could Jimmy Steele’s recommendations push dentists into
treatment planning around predictability for the dentist,
rather than the best solutions for their patients, asks Neel Kothari

A

fter years of turmoil we
have arrived once again at
a turning point in history
where the calls for change echo
in the halls of the DH. Professor
Steele and his team must surely
be commended for providing
the profession with a brave and

honest review into NHS dental
services, but as yet we still have
no notion of what currency
will replace the UDA. Professor
Steele’s review suggests a new
payment system where dentists
are paid in part based on how
many patients they have regis-

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tered on their books and in part
by the work they provide.
As with all reviews, very
few dentists will agree on all of
the recommendations. But often
good suggestions are let down by
poor implementation, leading
many to question: Are we better
off with the devil we know? While
I agree with many of the points
raised by the review, I do question
the review team’s recommendation on free replacements, which
states: ‘As dentists are paid as professionals to perform high-quality
services, neither the patient nor the
taxpayer should bear the cost of
unnecessary premature failure of
restorative care. We recommend
that the free replacement period
for restorations should be extended to three years and that
the provider should bear the full
cost of replacement rather than
the PCT or the patient.’

Theory v practice
Of course patients should
have the right to expect good
quality restorative work and, as
the review also points out, for
much of NHS dentistry patients
are getting this, but how will this
all play out in practice?
Thinking about this issue at
work today, with each patient
I found myself questioning
whether I could guarantee my
work for three years and whether
this would have an impact on my
treatment planning. By lunchtime, I had four cases where
I really could not be certain. One of
these cases was for adhesive
bridges on a young lady with missing upper laterals. Could you
guarantee this type of restoration
for three years? If dentists were to
bear the full cost of replacement,
my fear is that this may directly affect treatment planning and as
such push dentists too far within
their comfort zone, rather than
trying to provide the best solution
for their patients.
Another example was where a
patient could not afford £198 for a
NHS crown, so instead I provided
her with a very large filling to save
her money and give her the
chance to reconsider this in the
future if needed. Again I pose the
question: If you were in this situation could or would you guarantee
this restoration for three years?

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Now of course shoddy workmanship and poor-quality issues
need to be addressed and for this I
have no tangible solutions, but my
fear with this recommendation is
that it will push dentists into treatment planning around predictability for the dentist, rather than the
best solutions for their patients.

Cause for worry?
The reason this is such a
worry for me is because the most
predictable treatment tends to

the needs of the public, but at
present there are no systems in
place to encourage patients to
meet their end of the bargain. We
all know the NHS is a budgeted
system, so where is the financial
penalty for those patients who
frequently miss appointments or
cancel at short notice?
Missed appointments in the
NHS cost the taxpayer money
within secondary care and
directly affect dentists within
primary care, but more importantly have resulted in me putting in £5 (whenever I talk shop
with Anya) within the last month.
In Germany, a co-payment of

Predictability vs best solutions: a guaranteed trade-off? Photo: Khannanova Margarita

be extractions. From my own
practical experience I often find
myself in situations where I am
explaining to patients that there
are chances that their filling, root
treatment or crown may fail, but
I am happy to try and save the
tooth if the patient is willing to
accept it may have a reduced
chance of success. This may not
be a perfect solution, but it is one
which I am comfortable with and
I feel most of my patients benefit
from this approach, rather than
jumping straight to extraction.
At present it’s too early to
judge the general body of opinion
towards this recommendation,
but should it make its way into
the new new dental contract
one must wonder how robustly
a three-year guarantee can or
would be piloted. What I would
really like to know is how the DH
would judge ‘unnecessary premature failure of restorative
care’ and why anyone feels a filling robust enough to last over
a year (as per the current free
replacement period) but not up
to three has failed due to inadequacies of the dentist.
Of course I do not advocate or
support those who choose to put
profits above patients’ interests
and I fully support the review’s
recommendation to start looking
at measures to assess quality
within the health service rather
than focus on quantity. However,
if quality assessment measures
are finally put in place, let us hope
they raise standards from the bottom up, rather than unduly affecting those at the top of the pyramid
already providing sound ethical
treatments within the NHS.
Much of Professor Steele’s
future recommendations have
focused on how dentists and the
profession must change to meet

50 per cent applies to crowns,
bridges and dentures, but this
percentage can be lowered if
a patient has participated in
regular checkups. Currently our
system, as I see it, financially penalises those patients who attend
for regular checkups and require
a single filling or crown while
rewarding ill health by providing an unlimited mass of
restorative care all under the
auspices of one single band…
and on a completely unrelated
matter, dictionary.com defines
crazy as ‘senseless; impractical;
totally unsound, i.e. a crazy
scheme.’ 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 upto-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.

[19] => DTUK2409_01_Title

DCPs

An alternative therapy?
Have you ever heard of oil pulling? Neither had
Alison Lowe until one of her patients extolled its
virtues. She decided to find out more

o, what is oil pulling? Well,
in alternative medicine, oil
pulling is a traditional Indian folk remedy that involves
swishing oil in the mouth for
claimed systemic and oral health
benefits which include prevention of gingivitis and periodontal
disease, erosion caused by acid
reflux, dental caries, halitosis,
dryness of the throat and cracked
lips. There are even claims that
it can be used to straighten
teeth and align jaws – although I’m not sure that
many orthodontists would
agree!1

‘Oil pulling resulted in a significant
reduction in plaque and gingivitis
and although it can’t be considered
as a replacement for tooth brushing, there were no adverse reactions and it could definitely be used
to supplement a patient’s oral hygiene routine.’ 4

Oil pulling traces its roots
to oil gargling practiced in Ayuverdic medicine in India (mainly
the south) more than 2,000 years
ago, but it has recently come
back into the limelight in India
with widespread marketing aimed at both the public and the dental profession.

In another randomly controlled, triple blind study there
was found to be a statistically, significant reduction in the Strept.
mutans count in the plaque and
saliva samples of both the study
and control group using a Dentocult SM Strept mutans test. The
researchers concluded: ‘Our
study has shown that sesame oil
has an antibacterial effect. The reduction in bacterial count ranged
from 10 to 33.4 per cent and the average reduction in bacterial count
was 20 per cent after 40 days of oil
pulling. Therefore the sesame oil
is found to be effective in reducing
bacterial growth and adhesion.’3
The Journal of Oral Health and
Community Dentistry published a
research paper, which found that:

The main disadvantage of oil
pulling is that it is time consuming – how many of us can spare 15
to 20 minutes every morning?
However, there is a similar procedure known as ‘Dinacharya’
where you just swish for four
minutes6, but I’m guessing that’s
still three minutes too long for
many people. On the plus side it
is easy, inexpensive and relatively harmless.

Conclusion
I am a firm believer in evidence-based dentistry (EBD)
and therefore must confess that
I find myself slightly sceptical
about the practice of oil
pulling (I prefer to get my
essential oils from Listerine mouthwash). Still,
you shouldn’t knock it
until you’ve tried it and
although there is limited
scientific evidence or
proof of its efficacy, it is
possible that oil pulling
can be used as an effective, preventive adjunct
in both maintaining and improving oral health. DT

Literature review
An extensive literature review revealed
very little in British journals relating to the practice, but a few papers have
been published in Indian dental
journals. One such study compared the effect of oil pulling using sesame oil with chlorhexidine on plaque-induced gingivitis. Twenty aged-matched adolescent boys with plaqueinduced gingivitis were randomly divided into two groups.
Plaque index and modified gingival index scores were recorded
and baseline plaque samples
were collected which were used
to identify and measure total
colony count of aerobic microorganisms. The boys rinsed with either oil or chlorhexidine every
morning before eating or brushing. On completion of the trial
both groups showed a reduction
in plaque index, modified gingivitis scores and total colony
count of aerobic bacteria.

forms a sediment and then when
you drain it, the sediment is removed leaving the engine relatively clean.5

The oil-pulling procedure
Oil pulling is an easy (although somewhat time consuming) process that should be repeated every day. The patient
rinses their mouth with approximately one tablespoon of oil
(sesame and sunflower are the
most recommended) for 15 to 20
minutes on an empty stomach
then spits it out. The best time is
in the morning before breakfast,
but it can be done before any
meal. The aim is to thoroughly
mix the oil with saliva until it becomes thin in texture and white
in colour. The oil is put into the
mouth with the chin tilted up and
then slowly swished and pulled
through the teeth, from left to
right, back to front and vice
versa.
I’m told that it helps if you can
close your eyes, concentrate and
imagine the liquid moving in
your mouth. Throughout the
process the oil changes from a
thick, yellow and oily consistency. If the oil is still yellow after
twenty minutes then it hasn’t
been pulled for long enough. The
used oil is then discarded (spat
out) and the mouth rinsed with
water.
The theory is that the oil acts
like a cleanser. When you put it in
your mouth and work it around
your teeth and gums, it ‘pulls’ out
bacteria and plaque debris. It is
thought to act much like the oil
you put in your car engine, the oil
picks up dirt and grime which

References

1. Asokan, S.: Oil Pulling Therapy. Indian Journal of Dental Research.
(Jul. 2008).
2. Asokan, S,. Rathan, J, Muthu, MS,
Rathna, P.V., Emmadi, P., Raghuraman, C. Effect of Oil Pulling on
Streptococcus mutans count in
plaque and Saliva using Dentocult
SM Strept. Mutans test: a randomised controlled, triple blind
study. Journal of the Indian Society
of Pedodontics & Preventive Dentistry. 26 (1): 12-7, March 2008.
3. Amith, H.V., Antool, A.V., Nagesh,
L.; Effects of Oil Pulling on Plaque
and Gingivitis. Journal of Oral
Health and Community Dentistry
2007; 1 (1): 19-22.
4. Fife, B. Oil Pulling for a Brighter
Smile and Better Health. http://
www.coconutresearchcentre.org
5. Moritz, A. Timeless Secrets of
Health and Rejuvenation. P151,
ISBN 097657151X.

About the author
Alison Lowe
is a dental hygienist based in
Cardiff, at The Orthodontic Centre, a private practice (specialising
in implants, cosmetic work and perio) and Cardiff Dental School. She
has won several awards including
Hygienist of the Year 2008 and is a
columnist for the Western Mail.
She thoroughly enjoys what she
does and is delighted to be contributing to Dental Tribune UK.

[20] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

20 DCPs

Strategic marketing seminars announced
Improve your knowledge and skills at one of the BDPMA’s Autumn Management
Development seminars happening at various venues

bers and non-members, is entitled Strategic Marketing –
Closing the income gap.

he dates and locations of
the BDPMA Autumn
Management Development seminar have been released. This one-day seminar,
which is open to BDPMA mem-

Presenter, Andy McDougall,
will show participants how to

apply marketing principles
in their practices to close
the gap between current
incomes levels and where
they aspire to be. Andy says:
‘Whether you and your princi-

pal are trying to turn an underperforming business around,
take the business to the next
level or prepare the business for
exit, this seminar will prove invaluable.’

Amelia Bray, BDPMA Chairman, says: ‘This seminar follows the ‘Managing change and
projects successfully’ seminar
held in the summer which
proved popular and most beneficial. Our aim is to take practice managers and principals
through a journey of management development without taking a lot of their time or requiring a large financial outlay.’

Special early bird rates applying to bookings before 1 September: BDPMA member £75,
their team members £95, nonmembers £135. Bookings on
or after 1 September, add £20.
These costs include refreshments and lunch.

More than just a
dental plan provider?
Find out from the horse’s mouth. Talk to our customers.

There are three more venues for the seminar:
• Thursday 5 November 2009 –
The North
• Thursday 19 November 2009 –
The North West
• Friday 27 November 2009 –
The South East
The seminar entitles participants to five hours of verifiable
CPD.

Find them at:

Go to www.bdpma.org.uk
to download more information and a booking form. Alternatively, telephone Denise
Simpson at the BDPMA on
01452 886364. DT

Stand E06

BDTA Dental Showcase
12th – 14th November
NEC Birmingham

About the author

Andy McDougall

01691 684135 www.practiceplan.co.uk
marketing support

0% patient finance

consultancy days

team workshops

business support

has over 25 years experience of
business planning and brings
techniques and expertise from
a wide range of commercial and
competitive business sectors.
Andy now delivers business-planning services to help members of
the dental community to respond
to the dynamics of an increasingly
commercial and competitive environment. He helps businesses to
reach the next level and to turn
around poor performance. To find
out more about his business
planning services, contact info@
spoton-businessplanning.co.uk
or call 07710 382559.

[21] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

Clinical 21

Apical microsurgery—
Part I: Patient preparation
Dr John J. Stropko, USA

S

urgery can never replace
solid endodontic principles
and should always be a last
resort. Apical microsurgery consists of nine basic steps that must
be completely performed in their
proper order, so the desired result can be achieved:
1. Instruments, supplies and
equipment (including the operating microscope) ready;
2. Patient, doctor and assistants
positioned ergonomically;
3. Anaesthetic and haemostasis
staging completed;
4. Incision and atraumatic flap
elevation;
5. Atraumatic tissue retraction;
6. Access, root-end bevel (RER
and REB) and crypt management;
7. Root-end procedures: rootend preparation (REP);
8. Root-end fill (REF) techniques
and materials; and
9. Sutures, healing and post-operative care.

ner.” I have heard those very
words many times while per-

forming apical microsurgery; it
is truly a gentle technique when

Fig. 1: The sixhanded team
utilises all that current technology can
offer, to achieve results that are precise
and highly predictable.

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Fig. 2: All equipment, instruments,
monitors etc. are readily accessible
when required during the entire surgical procedure.

Fig. 3:These small but effective Tempur
pillows should be available for the
comfort of the patient wherever needed.

Predictable microsurgery requires the use of an operating microscope (OM) and a team committed to operating at the highest
level. The six-handed team approach optimises the instruments, equipment, techniques
and materials that today’s level of
technology presents for the benefit of all, especially the patient
(Fig. 1).
Dr Berman, an old retired
general surgeon, one of my senior-year dental school instructors, would begin each general
surgery lecture by tapping the
lectern with his pencil, and
when he got our attention, he
would say: “Treat the tissues
with tender loving kindness and
they will respond in a like man-

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DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

22 Clinical

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the steps are followed in the
proper order.

has been bent, the ergonomics
of the bend can be verified
quickly and easily because the
patient is in the proper position
and so is the doctor.

A thorough past medical history and dental examination,
using as many diagnostic aids
as possible, is a requirement for
a predictable microsurgical
event. Thoroughness can help
one avoid unfavourable experiences. For example, if the patient, or their physician, states
they are sensitive or allergic to
epinephrine to any degree apical
microsurgery should not be performed. One of my golden rules
of thumb is: No Epi, No Surgery
… Period! Should the doctor
choose to proceed with the microsurgical procedure, it will be
exceptionally more difficult for
both the doctor, and the patient.

Optimally, three Stropko Irrigators should be available for
any surgical procedure: one
three-way syringe fitted with a
larger tip (Ultradent/Vista), for
more general flushing of the
surgical area (we call it the Big
John); another three-way syringe fitted with a modified 25gauge needle, for more precise
cleaning and drying (Little
John); and one with an air-only
syringe also fitted with a modified 25-gauge needle, for precise and dependable drying of
the area without worry of moisture contamination (Fig. 4b;
Note, air pressure to the syringe
must be regulated.)

Today’s technology presents
us with much more pre-surgical
information than was available
even a few years ago; thus, recent advances should be included in the diagnostic process
whenever possible. A good example of current technology is
cone-beam computed tomography (CBCT). The radiological
images we used for many years
were the best we had but were
very limited. Now CBCT enables
the microsurgeon a view of all
angles of areas of concern in the
maxillofacial region and supplies much of what was missing
in the field of dentistry.1
The preparation of the patient takes not only the patient
into consideration, but also the
entire surgical team. The microsurgical protocol we teach involves four people: the doctor
(pilot), the ‘scope’ assistant with
the co-observer oculars (co-pilot), the surgical assistant using
the monitor as a visual reference
(flight director) and the patient
(first-class passenger; Fig. 2).
The medical history and all
necessary premedications are

Fig. 4a: The modified needles to be used in
the Stropko Irrigator are bent to the same
general shape as the tip to be used on the
ultrasonic during the root-end procedures.

reviewed with the patient to ensure they are taken at the appropriate times before the surgery appointment. The patient
is also instructed to rinse with
Peridex and take an anti-inflammatory (preferably 600 mg
of Motrin if no allergies are
present) the night before and on
the morning of the surgery. At
the time of the appointment and
before the patient is seated,
they are again asked to rinse
with Peridex.
The dental chair should allow the patient to recline comfortably and even allow the patient to turn to one side or another. Small Tempur pillows
placed beneath the patient’s
neck, small of the back or knees
make a big difference when used
(Fig. 3). After the patient is completely comfortable in the chair,
they are coached on making
slow and small movements of
their head, if necessary during
surgery. The patient is appropriately draped for the surgery. It is
especially important to wrap a
sterile surgical towel around the
head and over the patient’s eyes
for protection from the bright
light of the microscope and any
debris from the surgical procedure.
An important psychological
point is not to tell the patient that
they may not move. To an already
tense patient, telling them they

Fig. 5a: Owing to the ballooning and blanching
effect, the muco-gingival line becomes more pronounced during the haemostasis staging injections.

Fig. 4b: Set of three Stropko Irrigators with a variety of tips in
place ready for use during the surgical procedure.

may not move would probably
cause unnecessary apprehension, stress or panic. In more
than 500 surgeries, I’ve only had
one patient who didn’t hold still
during the procedure once they
were relaxed and had profound
anaesthesia.
The surgical team must now
become comfortable with the
position of the patient, the microscope, endoscope and associated equipment. The modern
OM has many features to enhance comfort and proficiency
during its use. Accessories such
as beam splitters, inclinable optics, extenders, power focus and
zoom, variable lighting and focal length all contribute to ease
of use, ergonomics and proficiency for the entire surgical
team. The mutual comfort of the
patient, the surgical assistants
and the doctor is of the utmost
importance. The microsurgical
procedure may take an hour or
more, so unnecessary movements or adjustments for comfort’s sake during the operation
may cause considerable inconvenience.
The doctor’s surgical stool
must have adjustable arms to allow the elbows to support the
back and serve as a reference
point, or fulcrum, if the doctor
has to reach for an instrument
during the procedure. Ideally,
neither the doctor nor the

Fig. 5b: When the buccal portion of the haemostasis staging is complete, the doctor can easily plan
the incision.

‘scope’ assistant are to remove
their eyes from the oculars of
the OM during the entire operation. The task of directing the
whole operation belongs to the
surgical assistant. The surgical
assistant is the choreographer
for the procedures viewed
through the OM. He or she is in
a position to observe, coach
and/or pass instruments to either the doctor or the ‘scope’ assistant. The surgical assistant
can see the entire surgical environment and is the only one on
the team that has an overview,
to keep track of everyone’s
needs. It is important that all
possible surgical instruments
be organised for ease of access
during the operation.
While the anaesthesia is becoming profound, the needles
that will be placed into the tips
of the Stropko Irrigators for use
during the surgery can be modified. The notched ends of 25gauge Monoject Endodontic irrigating needles (Ultradent/
Vista) are removed by bending
with Howe Pliers and placed
into the end of the Stropko Irrigators. One tip is used with an
air/water syringe, and the other
tip is used with the dedicated
air-only syringe (DCI). The endodontic irrigating needles are
then bent in the same configuration as the ultrasonic tip that
is used for the root-end preparation (Fig. 4a). After the needle

Fig. 6: Before the incision is made, the area is
rinsed again with Peridex.

Also, as the lumens of the
high-speed evacuator tips
(Young’s Surgical) are so small,
extra tips must be available if
one should become clogged. A
beaker of water should be available, so that the ‘scope’ assistant
can occasionally clear the evacuator system of blood and tissue
debris from the evacuator tip.
After topical anaesthetic has
been placed, local anaesthesia is
begun using less than one
carpule of warmed two per cent
lidocaine containing 1:50,000
epinephrine. This small amount
is used to anesthetise the injection sites that will be used next
for the blocks and infiltrations.
The 1:50,000 lidocaine is used
prior to the 0.5 per cent bupivacaine (Marcaine) because the
Marcaine tends to cause a burning sensation upon injection,
whereas the lidocaine is much
more comfortable to the patient.
This is then followed with one or
two 1.8cc carpules of warmed
Marcaine for nerve blocks
and/or infiltrations. All anaesthetic is warmed and injected
very slowly to avoid any unnecessary trauma to the tissue and
to create much less discomfort
for the patient.
After administering the local
anaesthetics, haemostasis staging is performed using two per
cent
lidocaine
containing
1:50,000 epinephrine. It has
been shown that two per cent lidocaine containing 1:50,000 epinephrine produces more than a
50 per cent improvement in
haemostasis compared with two
per cent lidocaine containing
1:100,000 epinephrine.2 While
keeping the bevel of the needle
towards the bone and directed
apically towards the root ends,
small amounts of two per cent lidocaine 1:50,000 are slowly injected into the free gingival tis-

[23] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009
sue in two or three sites to the
buccal of each tooth (MB, B, DB),
approximately three mm apical
to the muco-gingival line. Slow
injection of just a few drops of
the anaesthetic causes a slight
ballooning and blanching of the
tissue in the immediate area.
This is an important step as
it causes the mucogingival line
to become more pronounced,
allowing the doctor to have better vision, which results in more
accuracy with the following
haemostasis injections (Fig. 5a).
As the anatomy of the tissue
unfolds during the injections,
the doctor should continue visualising and planning the incision
(Fig. 5b). The amount and nature
of the attached gingiva is an important consideration whether a
full sulcular or a muco-gingival
(Leubke–Oschenbein) flap is
used. In general, a full thickness
sulcular flap is routinely used
unless aesthetics is a concern
and there is an adequate zone of
attached gingiva present.
In order to ensure haemostasis, the lingual tissues should
also be infiltrated to reduce blood
flow during the surgical procedure more completely. When
performing surgery on the posterior quadrant of the mandible,
special attention should be given
to the apical region of the
mandibular second molar. On
occasion, a small foramen, called

About the author

Dr John J. Stropko
received his DDS from Indiana
University in 1964 and for 24 years
practised restorative dentistry. In
1989, he received a certificate for
endodontics from Boston University. He recently retired from the
private practice of endodontics in
Scottsdale in Arizona. Dr Stropko is
an internationally recognised authority on micro-endodontics. He
has been a visiting clinical instructor at the Pacific Endodontic Research Foundation (PERF), an Adjunct Assistant Professor at Boston
University and an Assistant Professor of graduate Clinical Endodontics at Loma Linda University. His
research on in vivo root canal morphology has been published in the
Journal of Endodontics. He is the
inventor of the Stropko Irrigator,
has published in several journals
and textbooks, and is an internationally known speaker. Dr
Stropko has performed numerous
live micro-endodontic and microsurgical demonstrations. He is the
co-founder of Clinical Endodontic
Seminars and is currently an instructor of Microsurgery in the Endodontic Faculty at the Scottsdale
Center for Dentistry. He can be
contacted at topendo@aol.com.

the foramen coli, may be present.
The f. coli contains an ascending
branch of the mylohyoid nerve.
Lingual haemostasis staging can
contribute to more profound
anaesthesia, will enhance crypt
management and will contribute
to a more predictable event with
less stress for the entire team as a
result.
If the surgery is to be performed on the maxillary, the
patient is instructed to close on
approximately eight layers of

sterile gauze, (four 2 x 2s folded
over once) for stability of the
jaws and keeping any debris
from inadvertently entering
the oral cavity. A single piece of
a sterile 2 x 2 is also gently
placed distal of the tooth/teeth
to be operated on. If the surgical procedure is to be performed on the mandible, especially if a full sulcular flap is to
be used, the doctor may want to
make the incision with the
mouth slightly open before
placing the gauze.

Clinical 23
In either case, with the aid of
the OM and using a pre-filled 3 ml
syringe fitted with a 20-gauge
needle the entire surgical site is
rinsed with Peridex, to ensure
the area is free of debris and
plaque before the incision is
made (Fig. 6). The surgical site is
now ready for the next important
step in the procedure: Flap design, the incision and atraumatic
flap elevation. Stropko Irrigators
are available from SybronEndo
or Obtura Spartan in the United
States, from Clinicians Choice in

Canada, or directly from www.
stropko.com. DT

References
1. Thomas SL, Angelopoulos C. Contemporary Dental and Maxillofacial Imaging. Dent Clin North Am
2008; 52: xi.
2. Buckley JA, Ciancio SG, McMullen
JA. Efficacy of epinephrine concentration in local anesthesia during periodontal surgery. J Periodontol 1984; 55: 653–57.

[24] => DTUK2409_01_Title

N
E
A
ST
4 S M
AT
F0 CA HA
U
YO
& W ING
E
3 O BI R M
SE
F0 SH EC,
N
TA OV,
BD -14 N

Clinical

Global Ceram • X
Case Contest 2008/2009
Before

After

Photograph of the amalgam filling the patient was unhappy with. Some ditching was also present.

n the Dentsply Global Ceram• X
Case Contest three UK students
came out on top and were put
forward to the global final. In this
issue we take a look at University of
Birmingham, School of Dentistry
student Gregory Souster’s presentation.

Final image of the composite filling which replaced the unsightly amalgam filling.

smiled and laughed, making her
feel self concious.
Ceram• X™ Duo was the composite of choice. It was easy to
handle and sculpt thus resulting
in a restoration that the patient
was very happy with.

• Ceram·X™ Duo shades D1, DB
and E1

Discussion and conclusion

• Dentsply 34 per cent Phosphoric
acid etchant
• Dentsply Prime and Bond® NT

Patient was very happy with
the result. The material provided a restoration that was
contoured nicely to the shape of
the cusps and gave an excellent
aesthetic result. The use of a
translucent enamel shade resulted in a far more natural appearance. DT

Step 1
Occlusal image of the lower right
first molar.The filling was leaking at
the mesial aspect and there was also
some ditching around the margins.

Step 2
Rubber dam was placed to isolate
the tooth. The filling was removed
along with a small amount of
caries.

Step 3
Phosporic acid etchant was applied for 15 seconds to the enamel
and dentine. Prime and Bond® NT
was applied and cured.

Step 4
Ceram·X™ D1 and DB dentine
shades were placed in incremental
layers and cured. 1mm space was
left for the enamel shade.

Step 5
Ceram·X™ E1 enamel shade was
placed in the cavity, sculpted to the
contour of the cusps and cured.

Step 6
Composite finishing burs were
used to define the fissure pattern
and shape the restoration.

A 19-year-old female patient
attended complaining she was
unhappy with an amalgam filling
on her lower right first molar.
The filling was visible when she

Material and method

Trusted & loved by thousands, Sani-tip guarantees
dry air every time, ensuring the success of your
restorative procedures is not comprised.
Visit www.dentsply.co.uk to find out more
Miss Sani-Tip is clearly the better choice!
Be seen with her
or more information, please call
our freephone number or email us:
+44 (0)800 072 3313

UKP00207

enquiry.uk@dentsply.com

www.dentsply.
y co.uk
www.dentsply
y.com
w

Step 7
The rubber dam was removed and
the patient‘s occlusion was cheked.

[25] => DTUK2409_01_Title

[26] => DTUK2409_01_Title

26 Industry News
Colgate
Introduces
a New Solution
for Dentine
Hypersensitivity
Relief

and awarded Winner, Highly
Commended and Commended
certificates. In the radiology
section the BOS Radiology
Guidelines was one of only four
Highly Commended books out
of 27 entries and the other
three were published by major
publishing houses each costing
well over £100 a copy, compared
with the BOS publication which
sells for £15.
The BMA citation stated
“This is an excellent, well
written and concise write-up
on the background of clinical
dental radiographs and indication for radiographs in
clinical orthodontics. It is a
must read for all clinical dentists especially those treating
children.”

Colgate introduces Colgate
Sensitive Pro-Relief™ toothpaste, a major advance in the
treatment of dentine hypersensitivity. With its Pro-Argin™
technology, this global breakthrough offers relief to patients
who experience dentine hypersensitivity.

The Award certificate is to be
hung in the Museum at the Head
Office of the British Orthodontic
Society for all to see.

“Sensitivity is more than
just an inconvenience, it’s a
common condition that can
cause unwanted pain,” said
Dr. William Devizio, VP, Global
Technology, Colgate-Palmolive. “Colgate® Sensitive ProRelief™ can be directly applied to a sensitive tooth, using
your finger tip to gently massage for 1 minute, to deliver
instant relief from sensitivity.
And regular brushing with
Colgate® Sensitive Pro-Relief™
toothpaste builds a long-lasting protective barrier that
acts like a seal against sensitivity.”
Colgate ® Sensitive Pro-Relief™ with Pro-Argin™ technology is currently available
at your preferred dental
wholesaler, major retailers
and pharmacy. For more information about Colgate ®
Sensitive Pro-Relief™ toothpaste, please visit www.colgateprofessional.co.uk.

Radiating glory
– BOS publication acclaimed
in the BMA Medical
Book Awards
The BMA Medical Book
Awards are presented annually
and this year there were over
600 entries in a variety of categories. Each section is judged

model will next be on show at
the BSDHT and BDTA Exhibitions this autumn; however
before then its presence has
been requested at a top modelling exhibition.
For the unofficiated The
Brickish Association is a UKbased community of adult
fans of Lego. The Association
mounts an annual Lego show at
the Steam Museum in Swindon
and the model makers have
requested that the Sonicare For
Kids commissioned by Philips is
displayed during the event,
which runs between 3 and 4 October 2009.

The new brush aimed at
4–10 year olds features oodles
of innovative elements which
makes it particularly childfriendly, so much so that Sonicare for Kids removes more
plaque than a children’s manual toothbrush – up to 75% more
in hard-to-reach areas.

For more information about
Sonicare For Kids visit
www.sonicare.co.uk/dp or
call 0800 0567 222.

The guidelines were designed to assist the hospital
practitioner, orthodontic specialist and the general dental practitioner on the choice
and timing of radiographs in
clinical orthodontic practice
and reflect current best practice and selection criteria to
comply with the IRMER requirements.
As the award citation suggests the guide should be
required reading for every
practitioner undertaking
radiography. Copies can be
obtained for £15.00 (inc p&p)
online from the BOS –
www.bos.org.uk or by telephoning 020 7353 8680.

Top Model
Sonicare fans will know that
the launch of Sonicare For Kids
was marked with the creation
of a giant Lego model of the
new brush which was undertaken by two of the members
of the Brickish Association. The

For more information about
the Apex Locator or any
other Septodont products call
01622 695520 or log onto
w w w. s e p t o d o n t . c o . u k o r
come along and see us at the
BDTA showcase.

Treat Yourself
To The Perfect
Practice With
Genus

No kidding

For more information about
the Association and the event
visit www.brickish.org

New Colgate Sensitive ProRelief™ is the first toothpaste
clinically proven to deliver instant and lasting dentine hypersensitivity relief. While most
of the sensitive toothpastes
currently marketed primarily
numb dentine hypersensitivity
pain, Colgate® Sensitive ProRelief™ with Pro-Argin™ technology effectively plugs the
channels that lead to nerves of
dentine hypersensitive teeth,
thereby blocking the transmission of heat, cold, air and pressure that stimulate pain receptors within teeth.

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

The next
generation of
Apex Locators

Septodont is happy to introduce the next generation of
Apex Locators at the BDTA
showcase in November. The
new Apex Dal and Blue is a digital Apex locator built with
proven proprietary technology
designed to identify the exact
working length of the root
canal.
The Apex DAL advanced
digital technology decodes the
signals returning from the root
canal as a result of the electric
stimulus, while the NRG Blue
displays the reading via a PC
Screen graphic through a wireless Bluetooth® connection in
addition to the more traditional
on board light display.
Additional features include
higher sensitivity and complete control of the measuring
process, with a tolerance of
0.1 mm in the apical region. The
Apex Dal is more precise in use
and the display enables the user
to view results easily and conveniently from any angle.

Dr BK – Reading

The delivery of gold standard patient care is only possible with the right environment.
With its renowned Design and
Build service, Genus offers expert assistance in providing
dentists with bespoke practice
designs, using Computer Aided
Design and 3D images to satisfy
individual requirements and
meet the demands of the modern dental industry.
Dedicated experts then
oversee the construction of the
new practice, ensuring that this
stage of the project is completed
within the agreed time scale
and without exceeding the set
budget. Then, when the practice is built, the team will explore equipment solutions with
the dentist, always putting the
needs of the practice first.
With a state of the art practice fitted with the most suitable
high quality equipment the
dentist will be perfectly placed
to offer superior care. Wraparound services from Genus, including Site Location and Move
Management, will ensure that
the practice has pride of place
in the local area, with staff able
to hit the ground running from
the first moment.
For more information on
Design and Build please call
Genus on 01582 840484 or
email info@genusgroup.co.uk.
www.genusinteriors.co.uk

Don’t waste your
valuable time!
Your time is money. Don’t
waste it! Visit www.inventory
circle.com and join the thousands of other dental profes-

sionals who are saving money
on:
• Time sensitive (soon to expire)
supplies
• Returned equipment & supplies
• Used equipment
• Refurbished equipment
• End of line supplies
And, your practice can make
money out of equipment or
supplies that were just going
to be thrown away. Recycling
in its truest sense! And, unlike
advertising, you pay nothing
to list your equipment or supplies for sale on Inventory
Circle – you only pay a small
commission once the items are
sold.
It is absolutely free to register
on www.inventorycircle.com.
So, what have you got to
lose?

Can You
Benefit from
Incorporation?
The move from Sole
Trader/Partnership to a Limited Company can be an exciting, if somewhat apprehensive time. Incorporation can
be a far more sensible, durable
and long-term plan to reduce
tax than risky ventures such
as ‘tax-schemes’, which can
prove to be disastrous for many
dentists.

Lansdell & Rose can help you
with the complexities of Incorporation and offer you a personal, bespoke service that suits
you and your practice.
A Limited Company can hold
many benefits including:
• Limited Liability – shareholders are limited to the capital
they introduce
• Enhanced commercial and
patient credibility – Often seen
as more credible than sole
traders
• Taxation benefits –Taxation
can often be reduced by up to
50%, depending on personal
and business circumstances!
By offering you expert advice at every step and providing
you with a bespoke, reliable
service, you can be assured that
the team at Lansdell & Rose is
delivering correct, suitable advice that will help you and the
future of your business
For more information about
Incorporation and the services available from Lansdell &
Rose please call on 020 7376
9333.

DT page 27

[27] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009
DT page 26

Good for
Patients, Good
for Practices

The demand for dental work
is growing at an unprecedented
rate due to an ageing population
living longer; younger generations who continue to need
preventive services and maintenance of existing dental work.
In the meantime the UK faces
high unemployment and the
NHS is struggling to meet demands.
Munroe Sutton has developed a patient referral plan that
is affordable and effective. Unlike insurance, discount plans
have no annual limits and no
health restrictions. Referral
Plan members are granted access to a large network of participating dental care providers
that have agreed to offer their
services at a discounted fee.
Some of the many benefits
Dentists receive from the
Munroe Sutton plan are:
• Access to many potential new
patients
• Support with marketing their
practice through the scheme,
which encourages patients to
visit the dentist regularly and
helps them afford desirable
treatments such as aesthetic
dentistry.
• No long term commitment.
Dentists can cancel their participation with a simple 30-day
notice period.
• Patients pay each time they
visit the dentist
Simple, effective and tried
and tested by millions of Americans. Munroe Sutton offers
increased profitability for UK
dentists with no extra outlay.
For more information
call 020 7887 6084 or visit
www.munroesutton.co.uk/
dentist.

NobelProcera™
The New World of CADCAM
technology for General
Dental Practitioners!
NobelProcera™ offers professionals the most comprehensive technology, materials
and products within CAD/CAM
dentistry.

Mark Chapman further enthused about the products: “It’s
amazing to have the portable
dental equipment, the portable
x-ray equipment and our digital
system all available in the same
package and from the same
supplier – one call for service.
This range of products is also
available through our trade
partners and I’m excited about
forthcoming promotions.”.

Setting a new standard for
the development, design and
manufacturing of dental prosthetics, NobelProcera™ incorporates cutting edge 3D design
software and superior patented
conoscopic holograpic optical
scanning or “next generation”
technology.
Preparation is easy for GDP’s
and fully supported by readily
available guidelines offering
dentists the capability to deliver
the highest quality esthetics
simply, affordably and quickly.
Combining the industrialised
process with versatile and individualised esthetics, NobelProcera™ can enhance clinical
results and therefore, boost
your business.
NobelProcera™ offers:
• Precise impression scanning
capabilities, supported by delivery of the restoration on an
accurately milled model
• Full assortment of shaded zirconia products (from cement
to screw retained restorations)
• Launch of new materials for
cost effective solutions – such
as cobalt chrome and acrylics
for different indications
• Introduction of a wide range
of overdenture and screw retained bar solutions – on Nobel
Biocare and continuously
updated competitor implant
platforms
Significantly improving the
quality of restorations and
treatments, NobelProcera™
will help dentists benefit from
ensuring an excellent fit and
consistent reliable products,
every time.

You can see the chair for yourself at the Velopex stand, L22,
at the BDTA Dental Showcase
12–14 November at the NEC.

Being a true water based
product, Saniswiss biosanitizer
is in contact with the surface for
longer – it will not evaporate in
seconds like alcohol, meaning it
is even more effective at killing
germs.
Presented in either a spray
solution or biodegradable paper wipes that last 5 times
longer than conventional wipes,
eco-friendly Saniswiss biosanitizer is completely different
from any other surface disinfectant on the market.
To find out more please
call 0800 581108, e-mail
info@saniswiss.co.uk or visit
www.saniswiss.co.uk.

New Aseptico
Chair for
Children

Bambach are the suppliers
of a revolutionary new Swiss
surface disinfectant, Saniswiss
biosanitizer.
Without resorting to alcohol
or aldehydes which are proven
health hazards, Saniswiss
biosanitizer ‘digests’ viruses,
bacteria and fungi. To put it simply Saniswiss biosanitizer converts such germs to water utilising a unique and patented super
oxygenised solution.
When Saniswiss biosanitizer is applied to the germs the
electrically charged disinfectant enters the cells causing an
electrical exchange. Saniswiss
biosanitizer oxidizes the cells
causing instant death to the
virus, bacteria or fungi, ensuring complete disinfection without any of the inherent risks
associated with alcohol or aldehyde based products.

For more information or
to ask any questions, please
contact: Mark Chapman, Tel
07734 044877.

Vizilite Plus™
Screening Test
for Oral cancer
Vizilite Plus™ is a simple
technology to assist in the early
detection of oral abnormalities
including premalignant lesions
and oral cancer.
Vizilite Plus™ comprises of a
chemiluminescent light source
(Vizilite) to improve the idenfication of lesions and a blue phenothiazine dye (TBlue) to mark
those lesions identified by
Vizilite. Carried out as part of a
general check up, Vizilite Plus™
is a simple, low cost, pain free
and 100 % sensitive test that can
help save lives or give Patients
peace of mind.
Pack of 40 Vizilite Plus™
£622.78 plus VAT Pack of 20
Vizilite Plus™ £360.55 plus VAT

For further information on
any of the new Nobel Biocare
products please call: +44 01895
452 912, or visit www.nobelbiocare.com.

Germs =
Saniswiss
biosanitizer
= Water

Industry News 27

For more information,
please contact Panadent
01689 88 17 88 or visit
www.panadent.net.

The Velopex team are delighted to launch a brand new
paediatric portable dental chair
– from Aseptico. The chair, developed with extensive input
from the Childsmile project in
Fife, Scotland is now available.
Mark Chapman, Director of
Sales and Marketing commented: “We’re very excited
about the way that our Aseptico
range has taken off and this addition is superb. We worked
closely with both Aseptico and
Childsmile to get it right.”.
The Aseptico range provides
the ability to create a ‘dental
surgery’ in any room anywhere
– all you will need is power. The
equipment combines comfortable dental chairs (now both
Adult and Child) with operators
stools, convenient lights as well
as delivery systems. The delivery systems includes high and
low volume powerful suction
as well as a 3-in-1 syringe and
an electric motor (with 5:1 increaser this can achieve 150,00
rpm) or with high/low speed
turbines – as required.

mikrozid® AF
and mikrozid®
Sensitive
For All Surface
decontamination
mikrozid® AF and mikrozid®
Sensitive is the industry’s
biggest selling surface decontamination range from schülke
in the defence against contamination in clinical areas.
mikrozid® AF is an effective
disinfectant with proven rapid
activity, decontaminating any
work surface within 2 minutes
of application. Destroying a
wide range of micro-organisms
like MRSA and HIV, it’s the ideal
infection control product for
any practice.
mikrozid ® Sensitive has
been specially formulated for

materials susceptible to alcohol. Its quick drying time means
it’s the ideal solution for dental
chairs between seeing patients,
essential for preventing cross
contamination.
Both mikrozid ® AF and
mikrozid® Sensitive are available in liquid or wipes, making
cleaning and disinfecting your
clinical areas quick and simple.
With over 100 years of experience, schülke is proud to enjoy market leadership and a
well-deserved reputation for
developing product ranges designed to meet dental practices
needs today.
For more information
please call schulke on Tel.
0114 254 3500 or contact your
preferred dental dealer.

‘New’ Alkaspray-Ultra
(Alcohol Free)

’60 second’ High
Level Surface
Disinfectant/
Cleaner

• All Surface ready to use duel
purpose disinfectant/cleaner
• Microbiological Activity
• Bactericidal; (incl MRSA)
EN13727/EN13697. Tuberculocidal; EN14348/EN13697.
Virucidal (HBV/HCV/HIV,
SARS, Vaccinia, Herpes, Influenza H1N1/H5N1, DW/
RKI/EN 14476. Yeasticidal
& fungicidal; EN 13624/
EN13697: within 60 seconds
• 1 litre trigger with trigger
dispense
• 5 litre economy drum
Now available through your
usual dental wholesaler
www.alkapharm.co.uk

World-class
MSc in
Restorative
& Aesthetic
Dentistry
available online
Smile-on is the proud provider of the world’s first online
post-graduate MSc in Restorative & Aesthetic Dentistry.
Delivered in conjunction with
the renowned University of Manchester, this is an innovative,

DT page 28

[28] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

28 Industry News
DT page 27

technologydriven course specifically designed for professionals wishing
to further develop their knowledge and skills.
The latest media technology
allows students access to the
programme from anywhere in
the world, with input and support
from top lecturers and tutors
boasting a wealth of expertise in
their field.

• Foundations of 21st Century
Practice
• Aesthetic Considerations
• Anterior Aesthetics
• Posterior Aesthetics
• Complex Treatment
• Research Methodology
• Research Project/Dissertation

a self-directed learning approach, yet are also guaranteed
instant access to Course leaders
and the option to attend residential gatherings.

Complete
Protection
from Cardozo

Smile-on is the leading
provider of innovative, flexible
learning programmes to dental
professionals. Its complete approach utilises the latest learning
solutions, including Webinars.

With the majority of the
learning resources online, students are encouraged to take

For more information please
call 020 7400 8989 or email
info@smile-on.com

Vista Tec Orange from Cardozo is the newest version of
the popular eyeshield. Vista Tec
Orange protects eyes from harmful blue light frequencies emitted by curing lights. The high
quality of the orange shield allows an excellent optical view
and full-face protection. The
shield is easily fixed to the Vista

This 2 year parttime Course comprises
7 core units covering:

Tec frame to ensure a comfortable, lightweight and effective
barrier when curing.
Blade protective eyewear
features high specification,
lightweight metal frames with
optically correct wraparound
lenses. Blade are supplied with
clear or tinted anti-scratch,
anti-mist lenses in a titanium
coloured frame.
Polydentia Clean is the new
cleaner developed specifically
for cleaning protective eyewear
and shields in the dental surgery.
Polydentia Clean is gentle on
materials, but hard on dirt and
bacteria. It can be sprayed directly onto frames and lenses to
provide effective cleaning and
care. The liquid evaporates
quickly and leaves no residues
or streaks.
For further details on these
or any of our other products,
please contact Cardozo on 01494
773010, info@cardozo.co.uk

Review your practise infection
control policy? With the

Alkapharm
‘learning lunch’

The Alkapharm ‘learning
lunch’ focuses on professionally
recognised procedures for the
successful, day to day prevention
of cross contamination within
the dental surgery environment.
Learning Lunch is designed
as a refresher for the whole team
and covers the day to day aspects
of cross-infection control in the
dental surgery. This short training course designed for the whole
team takes just two hours and can
be scheduled either during the
practice lunch period or at the
begging/end of the clinical day.
‘Currently being offered to
practices free of charge’ Learning
Lunch helps meet the requirements of the GDC re-certification scheme by updating
knowledge and skills for the benefit of the practice its patients and
the whole clinical team for which
attendees can claim 2 hours of
verifiable CPD.
For further information or to
arrange a ‘learning lunch’ for
your practise telephone Alkapharm on 01785 714919 or e-mail:
enquiries@alkapharm.co.uk

[29] => DTUK2409_01_Title

When it’s time to invest...
Invest in the best !

[30] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

30 Clinical

Considering the age factor
A patient’s age can affect how you carry out endo treatment.
Dr Michael Sultan looks at some of the problem areas

he growing proportion
of adult patients living
longer is driving a
change within the profession.
Patients no longer expect or

desire dentures, they want
their own teeth and are more
inclined to keep up a good oral
healthcare regime to ensure
this happens.

The importance of retaining natural teeth cannot be
over emphasised. The improved science and techniques
within Root Canal Therapy/

Treatment (RCT) and the advancement in equipment can
normally avoid extraction and
help patients to keep their
teeth. There are however sev-

eral problems when treating
ageing patients, including:
• Reduction of space in the pulp
• Sclerosis of canals.
As the pulp and canals reduce
in dimensions, it is firstly difficult
to actually locate the canal and
sclerosis and difficult to actually
enlarge them. This means that
there may well be untreated proportions of the tooth harbouring
bacteria and this can lead to persistent problems.
Difficult Treatment areas
The endodontist may have to
work through crowns and
bridges, and this may make it difficult to see adequately what is
going on and in addition, many of
these teeth may have been root
treated before and the original
root filling may have to be removed and the canal renegotiated as part of the treatment.
Reduced saliva flow and dry
mouth
The lack of saliva encourages
caries and increases decay. This
may be due to either ageing or
even medication being taken.
A reduction in tooth sensitivity
and pain
As age increases, decay and
root caries incidence rise. There
can also be problems with the patient’s mobility and early diagnosis. This may mean that they postpone treatments until the complaint is quite advanced.

Check for medication
The patient’s age and health
status are of course considered
before dental treatment, but another factor that must be explored is the medications they
are taking.
Decay around previous
crowns and restorations is a familiar theme in ageing patients
who need RCT and these treatments can become more difficult
and may also be more time consuming. This poses a problem in
people who require shorter appointments for health reasons
and also comfort.
Often people are nervous
following a lifetime of poor experiences at the dentist and
the reputation that surrounds
treatments such as root canal
therapies. Understanding a patient’s reservations and helping
them work through their concerns will in turn help you complete treatment fast and efficiently. DT

About the author
Dr Michael Sultan
BDS MSc DFO
is a specialist in Endodontics and
the clinical director of EndoCare.
Michael qualified at Bristol University in 1986. He worked as a general
dental practitioner for five years
before commencing specialist
studies at Guy’s hospital, London.
To talk to a member of the Endocare team call 020 7224 0999 or
email reception@endocare.co.uk
or for more information please visit
www.endocare.co.uk.

[31] => DTUK2409_01_Title

DENTAL TRIBUNE United Kingdom Edition · October 5–11, 2009

Classified 31

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[32] => DTUK2409_01_Title

“People are often worried it is
something worse.”
Nick Rote, Dentist, East Finchley, UK.

1 in 3 people suffer from dentine hypersensitivity
and over 50% of sufferers don’t mention it to their
dental professional.1 This may be because they
fear it requires major dental work, the pain may be
variable so they don’t report it or because they may
be using techniques to try and avoid the pain.
These findings highlight the important role that
dental professionals play in actively diagnosing
dentine hypersensitivity.
Recommending daily brushing with Sensodyne
Total Care F is a simple, effective solution which is
specially formulated for people with sensitive teeth.
“When they come back to see me next time,
they’re very pleased that a solution was given
to them so easily.”

Potassium chloride, Sodium ﬂuoride, Triclosan

)5-(*ÅA,&A|4Å&>>3*(-&A*)

SPECIALLY FORMULATED FOR
PEOPLE WITH SENSITIVE TEETH
1. Addy M. Int Dental J 2002; 52: 367-75

Product Information. Sensodyne Total Care F. Presentation: Potassium
chloride 3.75% w/w, Sodium fluoride 0.32% w/w, Triclosan 0.3% w/w.
Uses: Relief from the pain of dentinal sensitivity, an aid for the prevention of
dental caries and contains an antimicrobial agent with proven anti-gingivitis
activity. Dosage and administration: To be used 2-4 times daily in place of
regular toothpaste. Contraindications: Sensitivity to any of the ingredients.
Precautions: Sensitive teeth may indicate an underlying problem which

needs prompt care by a dentist. See your dentist as soon as possible for
advice. Side Effects: None stated. Category: GSL. Product licence
number: PL 00036/0085. Product licence holder: GlaxoSmithKline
Consumer Healthcare, Brentford, TW8 9GS, U.K. Package quantity and
RSP: 45 ml tubes £2.40, 75 ml tubes £3.57, 100 ml tubes £4.20 and 100 ml
pumps £4.20. Date of last revision: January 2009. Sensodyne is a registered
trade mark of the GlaxoSmithKline group of companies.

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[cover] => DT UK 2409

[toc] => Array ( [0] => Array ( [title] => One in four dental patients want to complain but don’t [page] => 01 ) [1] => Array ( [title] => News [page] => 02 ) [2] => Array ( [title] => News & Opinions [page] => 06 ) [3] => Array ( [title] => Touting your wares [page] => 09 ) [4] => Array ( [title] => Big business [page] => 10 ) [5] => Array ( [title] => A soft approach [page] => 12 ) [6] => Array ( [title] => The 10th Dimension… the power of 10 [page] => 13 ) [7] => Array ( [title] => Company Promotion [page] => 14 ) [8] => Array ( [title] => Life after training [page] => 16 ) [9] => Array ( [title] => Safeguard your accounts [page] => 17 ) [10] => Array ( [title] => Three years’ warrantee: parts and Labour [page] => 18 ) [11] => Array ( [title] => An alternative therapy? [page] => 19 ) [12] => Array ( [title] => Strategic marketing seminars announced [page] => 20 ) [13] => Array ( [title] => Apical microsurgery— Part I: Patient preparation [page] => 21 ) [14] => Array ( [title] => Global Ceram • X Case Contest 2008/2009 [page] => 24 ) [15] => Array ( [title] => Industry News [page] => 26 ) [16] => Array ( [title] => Considering the age factor [page] => 30 ) ) [toc_html] =>

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