DT UK 3009

‘Tide is turning’ says CDO after latest NHS IC statistics / News / Sustainable service piloted for the homeless / News & Opinions / GDPUK round-up / Dealing with stress in the 21st century - a perspective for the dental profession / Access over quality? / Cross-infection collapse? / Streamlining operations / The 10th Dimension… the power of 10 / A good team is for life - not just Christmas / First-time sellers - seeking the right advice / Immediate single-tooth replacement and provisionalisation in the aesthetic zone / Learning Curve / Pride of dentistry in rural Devon / Industry News / Chemical disinfection – an integral part of endodontic treatment / A BADN do to remember

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Table of contents

December 7-13, 2009

PUBLISHED IN LONDON
News in Brief
Prison for dental thief
A woman who stole £15,000
from the dental surgery
where she worked as practice manager has been sentenced to six months in prison.
Victoria Moore, 28, pleaded
guilty to stealing the money
from the practice in Ebbw
Vale. The court heard she used
the cash to pay debts and to
fund her cocaine use. Newport Crown Court heard how
Moore, who was responsible
for banking the money at the
practice, took the cash between
2007 and 2009. The court
heard how Moore and her
husb-and took out a loan on
their home in 2005 to carry out
improvements but their debts
increased.
Clinic visit ahead of review
A £4.6m community clinic in
Lanarkshire has been visited
by the public health minister
before she chairs the local
NHS board’s annual review.
Public Health Minister Shona
Robison visited the Douglas
Street community health clinic in Hamilton, which brings
NHS services including dentistry, together under one roof.
Ms Robison said it was important that local people took part
in the review of healthcare
services. She added: “Our
NHS should always strive to
provide the best possible care,
so holding those who manage
our NHS boards to account in
public is the right thing to do.
NHS Lanarkshire chairman
Ken Corsar said: “Last year,
sound progress was achieved
across NHS Lanarkshire.” He
added: “The annual review
gives us the opportunity to
reflect on the extensive range
of activity which has been
undertaken, the delivery of
which could only have been
achieved through the dedication and commitment from
our staff.”
New Lerwick dental clinic
A new dental clinic is likely to
be set up in Lerwick, Shetland
within the next two years. The
new practice could house up
to four dentists and greatly improve access to NHS dentistry
in the region. The new clinic
aims to remedy the problem
of some non-urgent dental
patients being on waiting
lists for several years, as current NHS dental facilities are
over-stretched. The project,
the whereabouts of which has
not been decided upon, is part
of the Scottish government’s
new health targets. When the
clinic is fully functional, there
will be a total of 15 dentists
in Shetland.
www.dental-tribune.co.uk

News

Practice Management

News

DCP Advisory chair

FGDP(UK) has appointed Tony
Griffin as chair of its DCP Advisory Board

page 2

VOL. 3 NO. 30

Homeless initiative

CDO Barry Cockcroft launches
homeless dental services scheme
in London

page 6

Practice’s best friend

Jo Banks discusses one of the
greatest assets your practice has
- the appointment book

page 14

Clinical

High risk success

Dr Graham Magee gives an example of how high risk treatment leads to success

page 20-22

‘Tide is turning’ says CDO
after latest NHS IC statistics
Recent report indicates increase in both UDAs and patients during 2009

he latest NHS Dental
Statistics for England
have been published by
the NHS Information Centre for
health and social care.
The report, which evaluates
data under the new contract from
April 1, 2006, was published on
November 26. The latest information on ‘activity’ relates to
the first quarter of 2009/10, up
to June 30, 2009. ‘Patients seen’
data is reported to the end of the
second quarter, up to September
30, 2009.
Quarterly activity information for 2009/10 is provisional
and will be revised upwards to
include courses of treatment
(CoTs) reported too late. But if
there are similar patterns to last
year, any changes between provisional and final data by treatment band should be small, with
final figures published next summer.
In the first quarter of 2009/10
Band 1 CoTs accounted for 53.6
per cent of all those delivered.
Band 2 CoTs made up 29.9 per
cent and Band 3 CoTs, 5.0 per
cent. The remaining 11.4 per
cent of CoTs were for urgent and
charge-exempt treatments.
In the first quarter of 2009/10
units of dental activity (UDAs) in
England provisionally increased
by 3.2 per cent, compared to the
first quarter of 2008/09, from
19.8 million to 20.5 million.
In the first quarter of 2009/10,
9.5 million CoTs were provisionally delivered, an increase of 0.2
million - 1.6 per cent - on the

final figure for the equivalent
quarter last year.
This equates to 20.5 million
UDAs, a 3.2 per cent increase 0.6 million - on the final figures
for last year’s first quarter.
The number of patients seen
in the period ending Sept 30,
2009, was 27.9 million - 54.2
per cent of the population - a
decrease of 0.3 million - 1.0 per
cent - on the 28.1 million patients
seen in the two-year period ending March 31, 2006.
This is, however, an increase
of 0.2 million - 0.8 per cent - from
the previous 24-month period
ending June 30, 2009.
Chief dental officer for England, Dr Barry Cockcroft said:
“We have invested more than £2
billion in NHS dentistry, resulting in more NHS dental practices expanding and opening
all the time. The tide is turning
and access to NHS dentistry has
been increasing steadily for over
a year with more than 930,000
more people seeing an NHS dentist in the last five quarters.
“Dentists working in the NHS
treat around 250,000 patients
every working day and our aim
is to ensure that everyone who
wants to see an NHS dentist can
by March 2011.”
But Dental Practitioners Association chief executive, Derek
Watson, thinks differently.
Watson commented “The Department of Health said that the
very few dentists resigned in April

2006 represented very little capacity. They are missing the point.
The new contract was supposed
to correct supply problems and it
has had the opposite effect. Fewer
patients are now seeing NHS dentists as a result of the NHS contract, despite the fact the DH has
been spraying the money hose
around for two years in an attempt
to disguise their bungling antics.”
Dr Watson said that in April
2006, 55.8 per cent of the population was seen on the NHS in the
previous 24 months. Following

the introduction of new terms
of service on April 1, this fell to
52.7 per cent in June 2008, from
which point it was thought to be
recovering. However he said the
newly-released adjusted figures
to September 2009, demonstrated
that it was struggling to reach precontract levels.
The statistics are available to view at: www.ic.nhs.uk/
statistics-and-data-collections/
primary-care/dentistry/nhs-dental-statistics-for-england-quarter-1-30-june-2009 DT

[2] =>

2 News

United Kingdom Edition

Dental complaints concerns

healthcare barrister has
expressed his reservations about the, Dental
Complaints Service (DCS) and its
lack of independence.
Angus McCullough, whose
city of London practice deals with
public, regulatory and disciplinary law, was speaking at a meeting of the Dental Law and Ethics
Forum.(DLEF) on Topical Issues
in Dental Regulation.
At the recent meeting, which
had a live link-up with members and Cardiff and Leeds, Mr
McCullough acknowledged that
the DCS had successfully resolved minor complaints about
private dental treatment and reduced the load of the council’s
disciplinary department. He said
a survey, of both dentists and patients who had experienced the
service, reported that nine out of
ten gave feedback that it was good
or excellent.
But he added: “The DCS is a
creature of the General Dental
Council (GDC) and its procedures

are neither independent nor confidential. It used to describe itself
as ‘independent’ on its website,
but, correctly, no longer does so.”

GDC for a refusal to engage or cooperate, or if the DCS considered
the complaint to be indicative of a
broader problem.

He said the structure of the
DCS and its relationship with the
GDC made it possible for a dentist to be helpful and transparent
in responding to patient complaints, but in so doing, could provide the DCS with the grounds for
a referral to the GDC’s Fitness to
Practise, procedures.

A spokesman for the DCS said
The DCS is an impartial, expert,
free and fair service that can help
solve complaints about private
dental care. It is supported by more
than 160 trained volunteer panelists from across the UK. When
a panel is convened it is made up
of two members of the public and
one dental professional. The decision making process regarding
complaints is therefore completely
independent of the General Dental
Council (GDC).

He observed that it was also
questionable that the DCS now
claimed to be “run operationally
at arm’s length” but, has advisory
board that took half its membership from the GDC and whose
remit included advice on “day to
day operational performance”.
He added that while the DCS
had no powers to enforce its recommendations and dentists were
not “obliged” to co-operate in the
resolution of a complaint, a dentist could still find themselves
facing a misconduct charge if the
DCS decided to refer them to the

Complaints about the competence, conduct or behaviour of
clinical staff that raise questions
of patient safety come to the GDC
from a wide range of sources.
The DCS can recommend that
the complainant approaches the
GDC with this type of issue. DCS
staff may also sometimes refer
cases to the Fitness to Practise
team (FtP) if they feel it’s serious enough. Similarly, the FtP

Dental technician advisory board chair

he Faculty of General Dental Practice (UK) has appointed a leading dental
technician to become chairman of
its Dental Care Professional (DCP)
advisory board.

A former president of the
Dental
Technicians
Association and founder member of the
FGDP(UK) DCP advisory board,
Tony Griffin has been active more
than 30 years in supporting training courses for the dental team.
He takes over the post from Janet
Goodwin, who stepped down after
being appointed to the General
Dental Council. (GDC)
Mr Griffin’s achievements include playing a key role in developing a route to registration in
clinical dental technology. He was
also part of the team which developed the highly successful, Key
Skills in Primary Dental Care Assessment for DCPs.

The post of vice-chairman
of the DCP advisory board has
been given to John Stanfield, who
has represented dental hygienists on the board since 2006 and
is also an assessor for the DCP’s,
Key Skills Assessment. Both Mr
Griffin and Mr Stanfield are also
members of the editorial board
for the FGDP (UK)’s DCP journal,
Team in Practice.
Mr Griffin commented: “Along
with John as vice-chairman
and the DCP advisory board
as a whole, I am looking forward to building upon the FGDP
(UK)’s initiatives to support the
career development and training of DCPs.
“I am keen to explore opportunities for demand-led educational programmes enabling
individual DCPs to choose specific training areas for their own
personal development and also

to meet the requirements for
eventual GDC revalidation.”
The GDC has recently consulted on revalidation for dentists,
which it is anticipated will be introduced for DCPs at some point in
the future. The FGDP (UK) plans
to provide a professional development framework to allow DCPs to
transfer educational credits from
their learning. It is intended that
such a framework will not only
support DCPs in meeting their revalidation requirements, but will also
lead to an award by the faculty.
FGDP (UK) Dean, Russ Ladwa,
said: “I am very much looking forward to working with Tony, John
and members of the board to expand the FGDP (UK)’s educational and training opportunities for
DCPs. I also hope to see the board
develop beyond its ‘advisory’ status to become a more integral part
of the faculty.” DT

International Imprint
Executive Vice President
Marketing & Sales

Peter Witteczek
Dental Tribune UK Ltd
p.witteczek@dental-tribune.com 4th Floor, Treasure House, 19–21 Hatton Garden, London, EC1N 8BA
Chairman
Torsten Oemus
t.oemus@dental-tribune.com

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.

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
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Sam Volk
Tel.: 020 7400 8964
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Marketing Manager
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Design & Production
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team may refer complainants to
the DCS if they feel the service
would be better placed to handle
the issue.
Before 2006 if a private dental patient had a complaint and
their dentist showed them the
door, they had virtually nowhere
to go. A critical report from the
Office of Fair Trading provided
the catalyst, and the Government
called for action. The General
Dental Council stepped in to set
up and fund the DCS to operate
at arms length.

December 7-13, 2009

120 540. It gets its funding from
the GDC which means all registered dental professionals pay for
the service through their Annual
Retention Fee.
The service can look into complaints about private dental services provided by dental practices
in the UK. It can’t look at complaints about NHS treatment. It
also can’t look at staff matters
- such as recruitment, pay and
discipline - or at commercial or
contractual issues.

The aim of the DCS is to resolve complaints fairly, efficiently, transparently and quickly by
working with the patient and
dental professional involved. It is
completely impartial and this is
considered an important part of
the service – which the staff takes
seriously.

Until recently the service had
been supported by an Advisory
Board made up of GDC Council
members - both registrant and lay
members - as well as a number
of independent individuals. However since the restructuring of the
Council of the GDC this year, the
role of the Advisory Board is under review.

The service is open to the public and registrants and doesn’t
charge for its services. It has a local rate helpline, which is 08456

Full details of the DCS and
what it can offer can be found
on its website www.dentalcomplaints.org.uk. DT

bda dentistry honours

he Peterborough Dental Access Centre was
named as the third
winner of the British Dental
Association (BDA) Good Practice Scheme Practice-of-the-Year
Award.
The 20-strong team received
the award at the fourth annual
BDA Honours and Awards Dinner
in London, which is supported
by the British Dental Trade Association (BDTA). The evening also
featured presentations to individuals by the BDA in recognition of
service to dentistry and the BDA,
along with a range of awards presented by the BDTA and dental
care professional associations.
The President of the British
Dental Association John Drummond said: “This event has become a true celebration of the
dental team, giving recognition
to the commitment and talent of
some very special individuals.
We were delighted to be joined by
so many friends and colleagues
from across dentistry to mark
these achievements.
“The Good Practice Scheme
is recognised as a benchmark for
excellence with 1,250 members
who have successfully completed
the programme, with a further
2,000 practices working towards
membership.”
The honours and awards presented were as follows:
■ BDA life membership to Richard Beardon, David Evans,
Tony Glenn, Robin Graham, Richard Kendrick, Philip Lang,
John Muir, James Robertson and
Jim Watson.

■ The 2009 British Association
of Dental Nurses’ award for outstanding contribution to dental
nursing: Janet Goodwin
■ John Tomes Medal for scientific
eminence and outstanding service
to the dental profession: Richard
van Noort and Geoff Craig
■ The Orthodontic National Group award (ONG) for
outstanding
contribution
to
orthodontic nursing and distinguished service to the ONG:
Fiona Grist
■ BDA Fellowship for outstanding
service to the Association and the
dental profession: David Lester
■ The Dental Technologists Association Fellowship award for
outstanding contribution to dental
technology: Brian Gordon
■ The BDA Certificate of Merit
for Services to the Association:
Mike Hill
■ The BDTA Award for outstanding contribution to the dental industry: Martin Mills
■ The BDA Certificate of Merit
for Services to the Profession:
Jane Armitage, Bridget Ashton,
Glenys Bridges, Jo Eisenberg,
Ashiq Ghauri, Eric Nash, Malcolm Prideaux and Kenneth
Stark(posthumously awarded and
received by his wife)
■ The Clinical Dental Technicians
Award for outstanding achievement: Kevin Manners
■ The British Association of Dental Therapists Roll of Distinction
Award: Irene Ellis. DT

[3] =>

News 3

United Kingdom Edition December 7-13, 2009

Farewell from 2009

‘

Well, doesn’t time fly
when you’re having
fun! It doesn’t seem
five minutes ago since
I was penning my first
comment back in August, and
here we are at the end of the
year! Dental Tribune will be
taking a break now until January 2010, but don’t think it will
all be mulled wine and Christmas shopping (that should only
take up four days of the week!);

the team here will be looking
forward to 2010 and planning
to make DT even better for the
New Year!
With that in mind, here is a call
to readers to get involved. For
2010 we are looking for case
presentations from dental pro-

Within the meaning of the
Safeguarding Vulnerable Groups
Act 2006, the delivery of dental care is a ‘regulated activity’;
therefore all those delivering
care must be registered with
the ISA in the long term. Registrants already employed and not
changing jobs will be included
in the scheme over time, with
everyone needing to be included
by 2015.
As of 12 October 2009, it became a criminal offence for people barred by the ISA to work
or apply to work with children
or vulnerable adults in a wide
range of posts. It is also now a
criminal offence for an employer
to knowingly employ a barred
person in a regulated activity.
The Council now has a legal
obligation to share information
about GDC registrants with the
ISA. It is waiting to be advised
as to exactly what information it
will have to share, but it is likely
to be anything which could indicate that a registrant poses a risk
to children or vulnerable adults.
The GDC may also receive information about its registrants
from the ISA. It has already been
decided by Council that such
information should not result
in automatic erasure from the
Register, but should be considered as an allegation of impaired
fitness to practise through the
usual channels.
The GDC is looking carefully
at how the Vetting and Barring
Scheme will affect registrants
and what role the Council will
play. It is liaising with other
regulators and working out how
best to share relevant information alongside existing guidance
on protecting patients. DT

Just one thing remains for me
to say – thanks to all our readers, contributors and corporate

partners for all of your support
over 2009 and in particular since
I’ve been editing DT – you have
made it a very easy transition for
me. Hope you all have
a peaceful Christmas,
a prosperous New Year
and see you on January
18 for Issue 1, 2010. DT

Do you have an opinion or something to say on any Dental Tribune
UK article? Or would you like to
write your own opinion for our
guest comment page?

If so don’t hesitate to write to:
The Editor,
Dental Tribune UK Ltd,
4th Floor, Treasure House,
19-21 Hatton Garden,
London, EC1 8BA
Or email:
lisa@dentaltribuneuk.com

Dentists drop the price
of dental implants

GDC on Vetting
and Barring
ollowing the introduction of the Government’s
new Vetting and Barring
Scheme, the General Dental
Council (GDC) would like to
clarify its current stance and
obligations in relation to the
change in the law.

fessionals covering all aspects of
dental treatment. E-mail Lisa@
dentaltribuneuk.com if you’re
interested in seeing one of your
cases in print!

‘

Editorial comment

Dr. David Fairclough explains how DIO make implants more accessible for UK patients

company selling dental implants for
almost half the price of other suppliers
are giving dentists the opportunity to
pass this saving on to their patients, potentially
dropping the price of dental implants in Britain.
DIO Implant of South Korea is now operating in the UK after recently identifying a gap
in the UK market. DIO UK is offering dental
implants at prices less than half that of the most
established of UK brands (e.g. DIO titanium
RBM fixtures for under £98.00). The company
has been around for over 25 years and is one of
the largest implant manufacturers in Asia.
One dentist who has been able to drop his
prices by 30% after switching to DIO implants
is Dr. David Fairclough, who’s prime interests
are dental implants and cosmetic dentistry. He
believes that using implants of this kind could
lead to them becoming cheaper for patients
across Britain, currently one of the most expensive places in Europe for dental implants.

“One of my big criticisms
of implant companies
is that they sell you the
implants and then you
get very little from them
again. There’s poor backup. This hasn’t been the
case with DIO.”
In a recent interview Dr. Fairclough said,
“There is no reason why it can’t be as cheap
here as it is abroad, when you factor in travel
and accommodation expenses. The savings I
am making have meant that I’ve been able to
reduce my prices by 30%, so it has made a huge
difference. It means that those people who are
thinking about going abroad for implants may
consider staying in Britain and those who
thought they couldn’t afford implants can now
consider it an option.”
Dr. Fairclough was initially drawn to DIO
by their lower prices, however he changed suppliers when he found that their implants were
easier to place as well as more aesthetically

pleasing results than implants he had used previously.
Dr Fairclough said, “I’ve been doing dental
implants for over 20 years now and I’ve tried
most systems. When I came across DIO’s system it seemed to be the easiest to use at an affordable price. The implants are very easy to
place and they have very good primary stability
which is important.”
This increased primary stability comes
from the multi-platform design and the doublethreaded base which offers high stability in
low bone density. Alongside this, the stability
offered by the root form design reduces the possibility of interference with other teeth.
DIO UK aims to assist all of its dentists
during the integration stages in understanding
the implant system. Rather than hosting clinical days attended by large numbers of dentists,
DIO involves new clients in live implant placements alongside an existing user, without a
DIO representative being present. This allows
the session to be very open between the two
dentists meaning they are free to discuss the
implants candidly. It also means that the dentist new to the system benefits from one-on-one
tutoring.
“The back-up service I have been given has
been invaluable.” said Dr Faiclough, “One of my
big criticisms of implant companies is that they
sell you the implants and then you get very little from them again. There’s poor back-up. This
hasn’t been the case with DIO.”
Dr David Fairclough BDS(Lond.) LDS RCS
(Eng.) qualified at University College Hospital,
London in 1973 and has since received post
graduate training in the UK, France, USA, and
the Arabian Gulf. He has been involved in implants since 1977 and is a founder member of
the Association of Dental Implantology. He has
also lectured and run courses both in England
and abroad on implant procedures.
Dr David Fairclough
Circus House
Bennett Street
BathBA1 2EX
Tel: 01225 447600
Visit: www.davidfairclough.co.uk

[4] =>

4 News

United Kingdom Edition

Cosmetic Dentist Gives Parisian Lecture

dentist, who lectures at
Smile-On’s annual Clinical Innovations conference, addressed delegates at the
sixth annual meeting of the, European Society of Cosmetic Dentistry, (ESCD) held in Paris.
At ESCD’s Autumn meeting,
Professor Edward Lynch talked
about minimal intervention in
cosmetic surgery, placing em-

phasis on the use of ozone and
ozonated water.
He told the audience that the
powerful disinfectant properties
of ozone are useful for a range of
dental procedures and ozonated
water can be used in hand washing, root canal disinfection, full
mouth disinfection, in ultrasonic
scalers, for dental water line disinfection, during the placement

of implants, for cavity disinfection and the disinfection of deep
lesions to reduce the need for
root canal therapy.
Earlier that same day, Dr Irfan
Ahmad presented an overview of
caries pathogenesis and the role of
biofilm. He went on to challenge
existing paradigms and suggested
that treatment should be based on
risk assessment.

The session also included
input from Dr Michael Karlstén
on predictable bite registration
with implant-supported bridges,
while Dr Ajay Kakar demonstrated aesthetic splinting techniques
for compromised teeth using
quartz glass materials, which are
easy to place and adapt.
During the day, ESCD members were invited to present clinical cosmetic dentistry cases and
other evidence for scrutiny by a
panel of experts, with success-

December 7-13, 2009

New Practice

new dental surgery is set
to open at Malmesbury
primary care centre in
Wiltshire in the new year.
The opening of the practice,
which will serve 3,000 new patients from about the middle of
January, follows an investment
programme of £3.1 million to set
up new dentistry contracts in five
Wiltshire towns.
The scheme’s overall aim is
to increase the amount of people
who have NHS dental treatment
in Wiltshire.
Other new dental practices
are being set up in Amesbury,
Tidworth,
Warminster
and
Westbury. In addition, existing
dentists in Calne, Chippenham,
Devizes, Marlborough, Melksham, Pewsey, Trowbridge and
Wootton Bassett will be extending their NHS provision. DT

Irish Tooth
Decay Trial

new dental trial in Northern Ireland aimed at reducing tooth decay in the
under fives has been launched.
Health Minister Michael
McGimpsey, who launched,
The Northern Ireland Caries
Prevention in Practice, trial in
November, said the trial would
investigate the effectiveness of
preventing tooth decay in youngsters by applying fluoride varnish to their teeth, as well as using fluoride toothpaste.
Nearly 2,500 children will be
involved in the trial, with each
child monitored over a period of
three years.
Mr McGimpsey said: “It is
vitally important that we look at
new approaches to tackling tooth
decay as, unfortunately, young
people in Northern Ireland have
some of the worst oral health in
western Europe.
“Last year, for example,
26,500 teeth were extracted from
children who underwent a general anaesthetic in hospital for
dental extraction. While this figure is a marked improvement
over previous years, it is still way
too high and unacceptable.
“Investing in preventive care
now will provide dividends for
the next generation.”
The trial has been developed
through a partnership with
bodies including Manchester
University, the Department of
Health and the British Dental
Association. DT

[5] =>

[6] =>

6 News & Opinions

United Kingdom Edition

December 7-13, 2009

Sustainable service piloted for the homeless

he recent Steele review acknowledged that although
NHS dental services were
generally available, communication and publicity about these
services could be much improved.
Last month chief dental officer
for England, Dr Barry Cockcroft,
launched an initiative at East
London homeless charity the
Whitechapel Mission to enable
London’s homeless to better access dental services.

“This pilot is a microcosm of
improvements needed across the
UK. It is not enough just to commission services for homeless
people if they cannot find them.
So taking services to them is the
key to reducing inequalities.

A mobile dental unit serving the homeless has been set up
as a pilot project in Tower Hamlets, which runs until May 2010.
Homeless people can access it at
the Whitechapel Mission, as well
as nearby residential homeless
unit, Booth House and Dellow
House day centre.

Pro-active
“Tackling inequality means encouraging people to access services which are already there, which
is a more pro-active way for them
to get dental care.”

Leaflet
As part of the pilot, Dr Cockcroft
launched a newly-published leaflet - Free NHS Dental Services for
homeless people in London - which
gives information on dental services for homeless people, as well
as details about emergency dental
services and tips on oral health.
The leaflets are being distributed at homeless organisations
and through the Department of
Health-funded existing mobile
tuberculosis
screening
service, which reaches thousands of
homeless people annually. The
TB service has been on the road
for three years, after a successful
pilot.
The mobile dental service
for homeless people is modelled
on the TB unit. Its director, Stephen
Trilvas said homeless people were
more comfortable if services were
taken to them, which could act like
a bridge. He said: “NHS services
are not geared up for people with
challenging health needs. As
we got better at working with
outreach workers in the TB
project, we started to discover
that there were parallels for other
health interventions.
Mainstream services
“The oral health project is being piloted along the same
pattern, of plugging people
into mainstream services who
hadn’t previously accessed them
successfully.”
Dr Cockcroft commented:
“The Steele review said dental
services were available overall,
but that communication about
this was not good enough.
“We are trying to communicate the fact that there are dental services available for homeless
people.
“Oral health is generally good
in England, but there is a need to
reduce inequality.”

“That’s why we are working
with existing services for homeless people to give them information on where they can go for
treatment.

Whitechapel Mission’s director,
Tony Miller said: “We work with
chaotic people who are hard to
pin down and are excluded. The
TB mobile service saw 1,603
homeless people last year. The
next chapter is the dental service,
from which we are hoping for
big things.”

of only £3.65 a year.
Dentist Dr Cyril Brazil
treats homeless people two
days a week at the community
dental services for homeless
people at Great Chapel Street
medical centre, in central
London.
Make a difference
He said: “It is very rewarding
work. If I can go home and feel
I have made some difference to
help homeless people survive
the day and not suffer from
dental pain, then it has been
worthwhile.
“The
treatment
won’t
change their world, it just
means that at least they will
not have to suffer dental pain.”
Project development officer
for the homeless, Rellet Bailey,
who designed the oral health
leaflet for the homeless, said:
“Although most people have
access to NHS dental services
the DH has identified a need for

The Mission has set up an
innovative
programme of its
own, by donating
300,000 fluoridepreloaded toothbrushes annually
to homeless people, at a cost to
the mission of 1p
each. This means
homeless people
who attend the
centre can have a
CDO Dr Barry Cockcroft holding a fluonew
toothbrush
ride toothpaste pre-loaded brush with
every day, for a
Whitechapel Mission director, Tony Miller
cost to the mission

helping hard-to-reach client
groups including the homeless
and those living in hostels.
“The aim for this project is
to put a system in place to manage a clear pathway for homeless
and vulnerable people to access
dental care.
“The leaflet on oral health is
specifically targeted at the hardto-reach. It stresses the importance of oral health and signposts individuals to community
dental services in London.”
Ursula Bennett, head of dentistry at Tower Hamlets PCT, said
people were now being reached
who never had access to dental
care before.
Extending relationships
She said: “The key to improving access is building networks
of relationships. This pilot
is an example of extending relationships with other services.
We will all learn from working
together.”

a homeless dental patient being treated at
the mobile dental unit in Whitechapel

She said experience showed
that what worked was to offer
dental check-ups to the homeless
attending breakfast at the mission, which could be followed up
by treatment in the afternoon.
In 1876, the forerunner of
Whitechapel Mission opened,
serving more than 11,000 breakfasts to the homeless in its first
year. The mission took over in
1896 and now serves breakfast
for up to 150 daily.
Mr Miller said: “We have kept
to the promise not to preach, but
to demonstrate through action.”
The pilot mobile oral health
programme is a step towards
the Mission’s goal to empower
excluded people.
The pilot’s impact will be
evaluated by analysing the data
of people receiving dental treatment at the community dental
services, which it is anticipated
will provide information on the
scale of oral health problems
among London’s homeless. DT

the mobile dental unit for homeless
people outside the Whitechapel Mission

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[7] =>

News & Opinions

United Kingdom Edition December 7-13, 2009

BADN president thanks sponsors

pens from Colgate and the British Cheese Board provided the
luncheon cheeseboard.

ADN
president
Sue
Bruckel has thanked all
the sponsors of the 2009
National Dental Nursing Conference for helping to make it
such a resounding success.

Ms Bruckel said: “Our chief
executive, Pam Swain, has calculated that without the direct
financial contributions from the
BDTA, NHS Direct and Philips
Sonicare; the provision of speakers by the British Chiropractic
Association,
Colgate,
the General Dental Council,
Nobel Biocare, Philips Sonicare,
Schuelke, the University of Kent,
WR Berkley Insurance (Europe) Ltd, 2gether NHS Foundation Trust and NHS Gloucestershire; and the generous donation of their time and expertise
by the remaining speakers, con-

Ms Bruckel said that delegates would have had to pay
up to three times the current
conference fee without sponsorship, which paid for speakers’
fees and travel costs for the majority of the presentations, while
the remaining speakers were local experts who gave their time
for free.
The actual conference delegate rate charged by the venue was sponsored by the British Dental Trade Association,
(BDTA) with conference handbooks sponsored by Philips
Sonicare, which also sponsored

New BADN president Sue Bruckel

additional costs along with NHS
Direct. In addition, the BDTA

provided delegate bags, supplemented by washbags and USB

Premier Award Winners 2009
An audit to assess the cleanliness
and storage of decontaminated
dental instruments.
2nd Richard Holliday
Dental record keeping and the
role of oral cancer screening in
the dental access centre.
DCP prize
1st Michelle Mitchell
Ethical considerations in 21st century dental hygiene.
2nd Amy Wilkins
Extending the role of the dental
nurse in the orthodontic practice:
the patients’ perspective.

his year’s Premier Symposium, organised by Dental
Protection and Schülke,
saw the winners of the Premier
Awards 2009 announced. The
annual risk management competition has a total prize fund of
£6,000 and accepts entries from
projects which recognise the importance of patient safety.

Undergraduate prize
1st Richard Beckwith
Difficulties in obtaining valid consent in clinical dentistry.
2nd Rachel Ingle
A comparison of HTM01-05 guidance with the sterilisation of reusable instruments in the Dental
Practice Unit, University of Sheffield.

Congratulations to this year’s
winners:

Postgraduate prize
1st James Roberts

New GDC chair

entist Alison Lockyer
(picture left) has been
elected as chair of the
new-look General Dental Council.
Alison was born in Leeds and is
now based in Leicestershire, but
also works in Oxfordshire.
Alison was a returning Reg-

This year’s winners were of
a very high calibre, and even
though Sheffield Dental School
was predominant amongst the
winning entries, Kathy Harley,
Chair of Dental Protection, who
presented the awards took time
to encourage dentists and DCPs
from all regions of the UK to participate again next year.
Thank you also to the sponsors of the Premier Symposium,
Smile-on and Henry Schein, who
helped to make the day possible.
If you would like to receive
details of next year’s Awards
you can register your interest
by emailing sarah.garry@mps.
org.uk. DT

istrant member to the Council of
the GDC which she has been involved with for more than eight
years.
She qualified in Edinburgh
in 1980 and works full-time as
a primary care dentist with five
private and NHS practices in
Oxfordshire and Leicestershire.
She’s also provided dentistry

ference registration fees would
have had to start at over £200

each for BADN members and
consequently £270 for nonmembers to cover the cost of staging the conference. And this
doesn’t even take into account the administrative costs or
the many hundreds of hours
which the chief executive and
staff put into the organization of
the event.
“On behalf of the BADN council, members and the delegates to
the 2009 National Dental Nursing
Conference, I should therefore
like to thank all the sponsors, and
speakers, for their generous support of dental nurses in the UK.”
The registration fee for the
2009 National Dental Nursing
Conference was £120 for BADN
members and £190 for non members. The current annual BADN
full membership fee is £70. DT

Designed to Smile

n oral health improvement programme for
young children in Wales
is to be extended.
Designed to Smile is being
expanded, following two successful pilot schemes in north
and south Wales.
In the scheme, which is
delivered by the community dental service, dental health support
workers deliver a supervised
tooth-brushing programme in
schools and provide toothbrushes and toothpaste to schoolchildren along with oral health
advice. Part of the service is
carried out via mobile dental
health units, which provide specialist preventive care and treatment to schools.
Funding for the scheme is
doubling to £3.1 million for
2009/10 and rising to more than
£3.8 million for 2010/11. As well
as rolling out the scheme beyond
the existing pilot areas to specifically targeted, ‘communities first’
schools in the rest of Wales, the
additional funding will allow the
scheme to be extended within the
existing pilot areas. This means
that six and seven year olds as
well as three to five-year-olds will
be included, as well as a nursery-

within prisons and in an industrial setting (BMW factory).
The current Chair Hew Mathewson and the Chair Elect Alison
Lockyer will discuss and agree
the detailed handover timetable.
The Chair Elect will take office
as Chair on either 1 January
2010 or on the date on which the
current Chair resigns, by agree-

based programme for very young
children under the age of three.
Compared to the rest of the
UK, the dental health of children
in Wales is poor, with a direct
correlation between poor oral
health and social/economic deprivation.
Health Minister, Edwina Hart
said: “The rates of tooth decay in
parts of Wales are too high and
are something which needs to
be tackled. This additional funding for the, Designed to Smile,
scheme will carry on and enhance the good work done in the
pilot areas to extend it across the
whole of Wales. There is a significant role for parents to play, but
we know that for many children
at the greatest risk of dental decay, cleaning their teeth or having their teeth cleaned does not
form part of their daily routine.
“It is clear that more direct
and also more innovative methods of delivering preventive care
are necessary if advances in child
oral health are to be made.
“By teaching children the importance of good oral health at an
early age, they will develop good
habits which they can carry on
into adulthood.” DT

ment, whichever is earlier.
Alison commented: “I would
like to thank Hew for his excellent Presidency, he will be a
hard act to follow, but has been
an excellent example of how to
Chair. I am really looking forward to leading this multi-skilled
and talented Council in public
protection.” DT

[8] =>

8 News & Opinions

GDPUK round-up
Tony Jacobs shares the most
recent snippets of conversation
from his ever-growing GDPUK
online community

he diversity of topics on
GDPUK can be mindboggling. What’s more,
the site has been at its busiest

ever during October and November with contributions from
many new members as well
as older ones. GDPUK read-

United Kingdom Edition

ership is now at a staggering
10,000 hours per month, which
equates to 40,000 15-minute visits a month.
Recent discussions have
raged about the various communications regarding HTM
01-05, including letters in the
British Dental Journal and Parliamentary answers. The Chief
Dental Officer wrote that the
Department of Health (DH) will
produce scientific references
to support the decontamina-

tion document “if required”,
which Ann Keen told the House
of Commons would be arriving
soon. Colleagues on GDPUK
cannot believe the situation
surrounding the scientific references; surely they would be
ready at the touch of a button
or the click of a mouse if they
were the true basis of this derided document? In the meantime,
a further letter was drafted by
Tony Kilcoyne with 15 references all countering the edicts
of HTM 01-05.

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December 7-13, 2009

When the PDS Plus contract
was published soon after BDTA
Showcase (where GDPUK members met up on all three days) in
many ways there was only a minor response on the site as the
access contract with all its pitfalls
had been dissected previously
when the draft document and
spreadsheet were leaked.
Among other topics discussed
were clinical ones, as well as more
general and non-dental ones –
how to repair a wrecked dentition;
advice sought on cementing all
porcelain restorations; should the
profession take up the flu vaccine;
abfraction; strategies against key
performance indicators; weight
training as well as James Hull
news coverage to name a few.
It was suggested that practices should carry out a risk assessment for latex allergies. Someone
pointed out this was called a medical history. Others report they
have tried to remove latex products completely, gloves, LA cartridges and dam, to name a few.

‘Recent discussions
have raged about
the various communications regarding
HTM 01-05’
During the month, there were
some polls of GDPUK membership; about 80 per cent responding were male, and 73 per cent
practice owners. When asked
about source of income, practitioners are polarised – very few
earn 50 per cent of their income
from NHS, the large majority of
respondents earn either mostly
from NHS, or mostly private fees.
The polls on the GDPUK forum
software only allow one vote per
member per poll, so they cannot
be manipulated.

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A kind soul had posted some
video footage on YouTube immediately after the recent Manchester United v Chelsea football
match, a young man could be
clearly seen in the crowd, chewing on a toothbrush during the
match. This was linked from the
forum, and there was much surprise, even from a group of dentists, at this behaviour. DT

About the author
Tony Jacobs, 52 is
a GDP in the suburbs of Manchester, in practice with
partner Steve Lazarus at 406Dental
(www.4 0 6dental.
com). He has had
roles in his LDC,
local BDA and with
the annual conference of LDCs, and is
a local dental adviser for Dental Protection. Nowadays, he concentrates on
GDPUK, the web group for UK dentists
to discuss their profession online, www.
gdpuk.com. Tony founded this group
in 1997 which now has around 7,000
unique visitors per month, who make
35,000 visits and generate more than
a million pages on the site per month.
Tony is sure GDPUK.com is the liveliest and most topical UK dental website.

[9] =>

Feature

United Kingdom Edition December 7-13, 2009

Dealing with stress in the 21st century a perspective for the dental profession
Ros Edlin looks at the issue of stress in the lives and careers of busy dental
professionals and how you can help to minimise stress in your day

sk the average man in
the street for his opinion
as to whether or not dentists experience stress, and your
query will, in all probability,
be met with a look of incredulity and a snort of derision. After
all, isn’t stress in the domain of
the poor patient rather than the
high- earning, fast-living, , Porsche- driving dentist?!
A media-fuelled opinion such
as this may be true for a minority
of dentists, but for the majority
this is an entirely inaccurate assessment of dentistry today.
What is true, however, is that
dentistry has been identified as
one of the most stressful of the
health professions.

A recent study by HL Myers
and LB Myers conducted using
an anonymous cross-section of
2,441 UK GDPs, found that 60
per cent of GDPs reported being
nervy, tense or depressed, 58.3
per cent reported headaches, 60
per cent reported difficulty sleeping and 48.2 per cent reported
feeling tired for no apparent reason1 – all signs possibly related
to work related stress.
So why are dentists so susceptible to stress? Not only are

they required to work in an intricate manner in a sensitive and
intimate part of the body, sitting
in the same position for long periods of time, but they also have
to be responsible for the smooth
running of the practice with regard to both staff and patients,
as well as managing the financial aspect. Added to this are the
ever-increasing demands and
expectations of patients and the
constant awareness of running
behind schedule. As if this wasn’t
enough, they have to ensure that
they maintain clinical excellence
in the eyes of a Regulatory Body.
Faced with all these factors,
and for the most part, not having
received any particular training
in, for example, people skills or
financial management, it is little wonder that many dentists
fall victim to stress - related illnesses, either mental, physical
or both.
Stress itself is not an illness
but is, according to the Health
and Safety Executive [HSE]
definition, ‘the adverse reaction
people have to excessive pressure or other types of demand
placed upon them’. The HSE also
“makes an important distinction
between the beneficial effects of
reasonable pressure and chal-

lenge (which can be stimulating, motivating and can give a
‘buzz’) and work- related stress,
which is the natural but distressing reaction to demands or ‘pressures’ that the person perceives
they cannot cope with at a given
time”. The concept of perception
is particularly relevant in that,
faced with the same situation, a
difficult procedure or a demanding patient, one dentist may relish the challenge and yet the other be trembling in their shoes!
Also pertaining to the definition of stress are the notions of
control and change.
It is clear that we function
best when we are in control of

price of chronic stress.’2
There is no doubt that we all
need pressures and challenges
in our lives to get us up in the
morning and to keep us going.
These can galvanise us into
achieving great things; to work
at our most productive level, but
we have to be aware that having
unrealistic goals or expectations
can possibly result in the ‘law of
diminishing returns’ ie the more
we push ourselves to reach that
elusive goal, the less well we
can sometimes perform. This is
not to underestimate the thrill of
achievement, but it is worth paying heed to the warning signs.
These warning signs are like

‘Stress itself is not an illness but is ‘the
adverse reaction people have to excessive
pressure or other types of demand
placed upon them’.’
our circumstances; when we feel
we are responsible for our successes or failures due to our own
personal attributes. This could
also include the responsibility of
the welfare of both patients and
staff. As is often the case however, the bureaucracy of the NHS
mitigates against this feeling of
control which could result in
work-related stress.
The recent NHS Dental Contract is a prime example where
it can be argued that dentists
have a loss of control of their
own destinies. It also illustrates
the importance of involvement
in the process of change for the
best results to be achieved. ‘Today’s dental environment is not
going to change to accommodate
the individual. It’s the individual
who needs to learn to accommodate to the environment if he
or she does not want to pay the

traffic lights in our lives. Green
means that everything (or nearly
everything) is going well with us.
We are enjoying our work; the
practice is flourishing; we have
a great team and the patients
are appreciative. Home and social life is good; the children
are behaving themselves and
the sun is shining. Then perhaps
things start to go slightly awry
- your valued nurse leaves, creating extra work for the rest of
the staff, and leaving you feeling
is if you’ve lost your right arm.
You find yourself staying later
at the surgery to catch up and
you are aware that you are feeling more tired than usual. At the
surgery you feel your concentration slipping slightly and you are
becoming tense and irritable.
This situation may carry on for a
while with perhaps other events
occurring to add to the mix – a
complaint or family illness for

example. At home, your evening
glass of wine is turning into two
or three. You are sleeping badly,
relationships are suffering and
you are starting to feel that you
can’t cope. The red light is beckoning! If the symptoms continue
to intensify to the extent of absolute exhaustion, ill health and
the inability to cope, it could be
advisable to seek help.
Personality can also have a
bearing on the dentist’s ability
to cope with stressful situations.
A study carried out by Professor
Cary Cooper et al3 suggested that
dentists had a tendency to exhibit ‘Type A’ behaviour. People
with ‘Type A’ personalities tend
to be driven, highly ambitious,
impatient, aggressive and intolerant. They have high expectations of themselves and those
around them. ‘Type B’ personalities although they may be equally ambitious and successful, are
able to perform in a calmer and
more relaxed manner. People
can fluctuate between these two
behaviours which are said to be
on a continuum.
A successful practice is one
where effective stress management strategies are firmly in
place. This contributes to the atmosphere of well-being and competence within the practice. Its
positive effect emanates throughout - the staff feel valued and motivated and the patients feel more
relaxed and welcome. A ‘winwin’ situation for all concerned.
Achieving this ideal situation
does not come naturally to many
practitioners who may require
guidance. It may be necessary
to consider what your goals and
aspirations are in relation to both
yourself and your practice. Hopefully some of the coping strategies
that follow will be of assistance.
à DT page 10

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[10] =>

10 Feature

United Kingdom Edition

ß DT page 9

the way of getting the help you
need.

In terms of individual stress,
try take a step back and assess
where the stress is coming from.
Writing a list of causes from the
most stressful down to the least
will help you gain some perspective on the problem and may inspire you to tackle some of the
issues raised. It is even possible
that you could be the cause of
the stress! You may need help
in dealing with some of these issues. Try not to let pride stand in

It could also be useful to employ this technique with your
staff by asking them to identify
the sources of stress. ‘By airing
and discussing grievances, concerns and new strategies, the various members will feel part of the
dental team and provide mutual
support in time of stress.’4
For the individual, relaxation
techniques are also recommend-

ed. Although it is often thought
that relaxation is not compatible
with working in a dental surgery,
with organisation and planning it
is feasible. (Some European countries manage successfully to incorporate this into their working
day.) A prerequisite would have to
be a competent receptionist who
would not fill your appointment
book so full that you do not have
time to breathe, let alone try some
deep breathing (which is excellent
for calming you down.) Take in
a deep breath (don’t hold it) and

count one, two three as you exhale
slowly.
In your every day life having a period of relaxation is vital. It could be as basic as taking
breaks in the day or going out at
lunchtime to listening to music
or having a relaxing bath. The
importance of relaxation is that
it enables you to switch off and
recharge your batteries!
Equally important is physical
exercise. Exercise burns up the

December 7-13, 2009

excess adrenaline resulting from
stress, allowing the body to return to a steady state. It can also
increase energy and efficiency.
Do find an exercise which you
enjoy that will motivate you to
continue doing it.
Balance your diet. Eat breakfast, drink sensibly and include
lots of water to rehydrate the system. Include complex carbohydrates (wholemeal bread, jacket
potatoes) in your diet, to counteract mood swings, and fruit and
vegetables to provide vitamin C to
support the immune system.
Manage your time ( and yourself) efficiently. Again, taking a step
back and reviewing your working
practice is essential. Do you have
an allotted time for dealing with
emergencies and administration?
Are you constantly running behind
schedule causing your stress levels
to escalate? Developing leadership
and organisational skills will enable you to feel more in control of
your working environment.

More than just a
dental plan provider...

Ensure that your staff are properly trained and aware of their individual roles and responsibilities.
Encourage a culture of mutual
support, whereby asking for help
is not viewed as weakness. Talking
over your problems with someone
you trust can be such a help!

“Practice Plan provide me
with the support I need to run
my practice the way I want.”

As mentioned previously, some
dentists may be excellent practitioners but sadly lacking in interpersonal skills. An ability to listen
is a gift. If you feel you need some
training in communication, there
are plenty of courses available.

Dr Simon Thackeray, Thackeray Dental Care, Nottinghamshire

By incorporating at least some
of these strategies into your everyday life and your working life,
you could create an environment
which is stress-free and an environment in which it is a pleasure
to work. It could make the difference between a good practice
and an outstanding one. Who
wouldn’t want that? DT

There is only one person to decide on the future of your
practice. That’s why our dental plans are tailored to help
you develop your own unique brand and identity.
Run your practice the way you want.

About the author
Ros Edlin is a freelance stress consultant. Her background is in social work
and counselling. She lives in the North
West and travels throughout the UK
giving presentations and facilitating
workshops on stress awareness and
management to the dental team.
Ros tries to practise what she preaches
and relaxes by walking the dog ,yoga
and playing the piano (badly!)
Email: ros@stresswatch.co.uk

H.L Myers And L.B Myers, ‘It’s difficult
being a dentist’: stress and health in the
general dental practitioner, (BDJ, 2004
197:89-93)
1

Mark Hillman, Ph.D, Article. Stress and
Dentistry: Better Practice Through Control
2

01691 684135 www.practiceplan.co.uk
bespoke dental plans
G10525 PP Post BDTA Ad 5.indd 1

financial analysis

patient communication

in-practice support

team training
17/11/09 17:10:39

Sutherland V J, Cooper C L, Understanding stress: A psychological perspective for
health professionals. London: Chapman &
Hall , 1990
3

R. Freeman et al, Occupational stress and
dentistry: theory and practice Part II Assessment and control, BDJ, 1995; 178:218-222.
4

[11] =>

Feature 11

United Kingdom Edition December 7-13, 2009

Access over quality?
Although high-need patients can be seen for dental treatment,
Neel Kothari thinks the jury is out as to whether they are getting
the treatment that best meets their needs

O

ver the last few days,
I witnessed a miraculous cure to my writer’s
block when a patient I recently
treated brought to my attention
some of the issues that can still
be seen within NHS dentistry.
This patient is a young lady
of around 25 who presented in
a great deal of pain from a lower
abscessed molar tooth, as well
as rampant caries elsewhere.
I asked her when she had last
seen a dentist and she replied:
‘Only last week, I booked in to
see a dentist under the NHS, but
at the end of my session I was
told that this was only an emergency visit and they did not have
the time to see me for treatment’.
She was told to find another dentist and was given a prescription
for antibiotics, but still could not
sleep or eat.
Funnily enough, this is not
the first time this has happened
and I am sure that many of
you may have encountered
something similar. The problem here in my opinion cannot
purely be put down to the new
contract, but when any system is
based solely on ‘improving NHS
patient numbers’ rather than
‘improving quality’, surely the
architects of the new contract
must accept some culpability
for introducing a system that,
through a lack of proper piloting, has effectively prescribed
neglect across the nation.
The good news for the Department of Health (DH) is that
this patient will now probably
count twice in the access figures! Leading me to question,
just how exactly does the Government collate access figures?
Meeting bottom line
While I have some sympathy for
dentists having to provide an
unlimited mass of dental treatment for a fixed level of remuneration, surely there can be no
excuse for kicking out patients
in pain and agony while cherry
picking those patients who help
to better meet the bottom line?
Cases like these do raise important questions as to how the profession deals with those patients
needing much restorative intervention. When trying to find out
what the ‘powers that be’ (various PCTs and dental unions)
seem to think, I was not surprisingly bombarded with a myriad
of different options ranging
from treating all dental disease
within one course of treatment,

to treating some of the major
problems, stabilising the patient
and spreading the treatment
over multiple courses.

later the drive to (still) try and
achieve this has clearly had disastrous consequences. Rather
than improve quality, access

‘While I have some sympathy for dentists
...surely there can be no excuse for kicking
out patients in pain and agony while cherry
picking those patients who help to better
meet the bottom line’
While they all agreed that it
was unacceptable to leave a patient in pain, I’m afraid across
the nation, many dentists are
apparently still working in different ways and it is clear that
we still all have different interpretations of exactly how the
new dental contract should be
implemented. One problem
still remains: when one dentist
chooses to cherry pick patients,
this leaves others to unfairly
pick up the pieces.
Disastrous consequences
Ten years ago, in September
1999, Tony Blair told the Labour
Party Conference: ‘Everyone
will have access to an NHS dentist within two years.’ Ten years

and patient satisfaction with the
service, the reality of the situation is that in real terms we have
gone backwards.
The promises made at the
recent Labour Party Conference
should really be measured up
against Labour’s own record.
This in fact shows loss of access.
After the introduction of the new
contract, the number of people
accessing NHS dentistry fell by
one million. Some 7.5 million
people are not going to an NHS
dentist, because it is hard to find
one. Fewer children are accessing NHS dentistry – more than
100,000 fewer than before the
new dental contract and dental caries is now the third most

common reason for children’s
admission to hospital.
A key driver?
Regardless of how the Government dresses up various new
schemes and initiatives to improve NHS dentistry, it does not
take long to realise that ‘improving access’ tends to be the key
driver. But how sensible is this
aim? Of course everyone who
needs a dentist should be able to
get one, especially as it’s called a
National Health Service, but exactly what are they getting?
In Hampshire and the Isle
of Wight, access figures are
clearly well below average. Regardless of how much investment into dentistry has been
made here in recent years, according to prospective Parliamentary candidate Terry Scriven, thousands of people across
the New Forest still have no access to an NHS dentist.
One of the problems here
is that any new practice commissioned by the PCT would be
subjected to a massive number
of patients, many of whom may
require treatment for years of
dental neglect. That’s great,
you may say? Surely that’s ex-

actly what a new dental practice
needs, isn’t it? Well, yes and no;
we hear a lot about NHS efficiency savings and getting more
for less, but there comes a point
where less is definitely less and
if PCTs choose to fund new services based around improving access rather than quality, just exactly who are they accountable
to? And at what point does this
transgress from governing to influencing clinical decisions?
Of course since the inception of the NHS, dentistry has
always been used as a political football where successive
governments have incentivised
clinical choices they deem favourable. However in incentivising access over quality, while
high-need patients are able to
be seen for dental treatment (according the DH), for me the jury
is out as to whether they are
getting the treatment that best
meets their needs. DT

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

[12] =>

12 Practice Management

United Kingdom Edition

Cross-infection collapse?
Bruce Nell looks at the HTM01-05 guidance, its implications for
those in dental practice and how the Department of Health intends to enforce it

W

to ‘deliver the standard of dethis year, the Government has
ith the publication
contamination that our patients
signalled its determination to afof the Department of
have a right to expect’ through
fect a change in practice within
Health’s Decontami‘a programme of continuously
the dental profession. Within its
nation
Health Technical MemoDH19351 DS Cherokee-Toffeln Ad-A4:Layout 1 10/8/09 15:19 Page 1
improving decontamination perintroduction, it states the desire
randum (HTM 01-05) earlier

formance at a local level’.
The way in which the authorities will ensure dental
practices are adhering to the

December 7-13, 2009

guidelines is through the Care
Quality Commission (CQC).
Over the next two years all
healthcare providers (including NHS and private dentists)
will have to be registered with
the CQC and the “provision of
a safe, clean environment and
appropriate decontamination of
dental equipment’ will be a requirement. Demonstrating compliance will involve a self-audit
of a practice’s procedures, with
supporting evidence to show
decontamination management
is in effect.
The focus of the guidance
is to impel a progression from
the current ‘essential’ quality
requirements for every practice
to have instruments which are
sterilised after the decontamination (reprocessing) cycle,
to a state of ‘best practice’ comprising of three areas, summarised as:
■ Separate decontamination
facilities
■ Use of a validated automated
washer-disinfector
■ Controlled storage of reprocessed instruments.

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standard or, at worst, hazardous
to the health of patients and staff.
However, the ‘we’ve had no problems’ retort, coupled with the
side effects of a repetitive process could lead to problems, as its
not just contempt that is bred by
familiarity when dealing with infection control.

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The HTM 01-05 makes reference to a survey conducted in
2004 of the decontamination in
general practices in Scotland,
and it makes for some interesting reading. For instance, 42 per
cent of surgeries did not have a
dedicated area for decontamination, with the space also being
used for activities such as food
and beverage preparation or
housing the compression unit;
52 per cent did not have a dedicated sink for cleaning contaminated instruments.
Consider for a moment the
potential ramifications to the
health of staff and patients of
having a compression unit in
with contaminated instruments.
At least the Department of
Health recognises that there
needs to be time to institute the
shift towards best practice of
the separation of instrument reprocessing from other (clinical
or otherwise) practices. It’s understood that sterilisation may
well be taking place within surgical areas. At least if it’s using a
bench-top machine, transplanting it to the separate facilities
(once the necessary refurbishments have taken place) won’t
be a difficult task.

[13] =>

Practice Management 13

United Kingdom Edition December 7-13, 2009

The second aspect of achieving the state of compliance
is the use of a validated automated washer-disinfector. In
the 2004 survey, 96 per cent of
surgeries used manual washing as either the sole method,
or part of the cleaning process.
43 per cent of surgeries had a
designated sink purely for reprocessing instruments, which
means that more than half of
the surgeries were using the
same sink for other purposes,
such as hand washing. Can anyone confidently say they can
guarantee the same is not happening in their practice?
HTM 01-05 states that ‘practices should plan for the introduction of a washer-disinfector’
primarily because hand washing
cannot be guaranteed of maintaining controlled conditions
(only two per cent of surgeries
in the 2004 survey were using
a detergent specifically formulated for the manual washing of
surgical instruments; some were
using kitchen cleaning agents).
Using a washer-disinfector is the
preferred method for cleaning
dental instruments because it
provides the best option for control and reproducibility of cleaning; the process can be validated
which is an important aspect of
establishing compliance.
In response to the HTM 0105 companies are manufacturing washer-disinfectors specifically designed to meet the
requirement for maintaining
records of correct functioning
of the machine. By incorporating an in-built microprocessor,
which controls and records the
pressure and temperature used
during the cycle, an independent monitor with printer then
creates a printed copy as evidence so that a record showing
compliance is created;. Since
this needs to be completed every day, having an automated
system really is a time-efficient
solution. Practices will have to
maintain such records for at
least two years.
The washer-disinfector also
has to be easily dismantled to allow each part to be adequately
cleaned. By having a water reservoir that is completely detachable from the machine means a
practice can easily ensure they
remain confident in minimising
cross contamination from bacterial or chemical agents within
water supplies.
The third element of achieving best practice is the storage
of instruments. The HTM 01-05
recommends that: “the storage
of instruments does not exceed 21
days for instruments sterilised in
a non-vacuum (type N) steriliser
or 30 days if sterilised in a vacuum (type B or S).”
The 2004 survey found there
were flaws in the methods used

to clean, sterilise and store reprocessed instruments, with the
necessary record keeping frequently incomplete.

take a critical role in ensuring the CQC’s requirements are
met. Being able to demonstrate
records are being kept in regards
to decontamination equipment
will be a significant element
within that so any system that
has been designed to facilitate
will be of valuable service.

An important element of
achieving compliance will be
to have an assessment of the
changes needed within the practice to meet ‘best practice’ reTo demonstrate best pracquirements. It’s an opportunity
tice; ‘a cleaning process should
for managers to re-evaluate curbe carried out using a validated
rent procedures and to establish
EMS DIN
A4 29.10.2009
11:18 automatic
Uhr Seitewasher-disinfector.
1
’ A
a clear
framework
within which
dental practice needs a machine
the Infection Control Policy will

that can reliably and consistently
produce the same high standard in cleaning and disinfection
which is required to minimise
the risk of cross contamination.
Undoubtedly a great deal has
been done to raise the standards of decontamination in dental practices since 2004. A similar survey of practices in England conducted in 2008/9 will
return its findings in the near
future and its results will be of
great interest. DT

About the author
Bruce Nell worked
on Equipment and
Surgery Design for
Wrights Millners
in South Africa.
Trained in Dental Ergonomics at
ADEC in the USA
before going on
to lecture extensively in South African Universities on Sterilisation and
Advancements in Dental Equipment.
Bruce is now the Sales Director of Yoyo
Dental Supplies. He also lectures at local PCT Dental Forums on HTM 01-05
LDU Design and Considerations

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[14] =>

14 Practice Management

United Kingdom Edition

December 7-13, 2009

Streamlining operations
Jo Banks discusses how to simplify the day-to-day running of your practice and
ensure your appointment systems are working smoothly

likely to run more effectively.
Another effective management tool is to see nervous patients first thing in the morning
before the practice gets too busy,
in order to reduce their anxiety
and reduce the risk of them having to wait. You could also aim to
see children at the end of the day
so they do not have to have time
out of school. And, mixing them
with your more nervous patients
could release the potential for
anxiety in both parties.

sed correctly, the appointment book can be
the practice team’s greatest ally. Not only can it that the
reception room does not become
a waiting room, but it is also the
cornerstone of a smooth-running
practice.
However, the appointment
book is also one of the tools we
use day-to-day without really
utilising it effectively and it is
easy to take it for granted. By following the top tips below you,
can get your appointment system
working seamlessly and ensure
that you are taking full advantage of this valuable tool.
Manage new patients
It is important to make sure
every new patient feels valued,
as choosing a dentist is a significant decision and requires a
feeling of trust in both the dentist and the practice. Therefore,
when a new patient contacts the
practice by telephone to make
an appointment - why not send
them a practice information leaflet, directions to the practice and
a medical history questionnaire,
together with their appointment
card? By doing this you are not
only reminding the patient of
their appointment, but you are
also reducing the time they
have to wait in reception by saving them completing any forms
when they arrive.
Book at short notice
If a patient calls for an appointment time which is not available,
or they have to wait for a number
of weeks for their appointment,
you could ask them if they would
like to be notified of any cancellations. By retaining and using an up-to-date list of patients
who are willing to attend at short
notice you can help ensure that
cancelled appointments are
filled and the appointment list is
used efficiently.
It is also a great idea to give
patients a courtesy call around
one to two days before their appointment. This cuts down on
missed appointments from patients that have forgotten or accidentally double booked, and
also gives you time to book last
- minute appointments. Many
practices have found that text reminders for those patients who
have mobile phones are really
effective or e-mail reminders for
those who have provided email
addresses. This is also is a great
time-saving method for the practice team.
Name names
Another way of making patients

Children’s days
Many practices have found it really useful to clear a day in the
appointment book in the school
holidays and have a children’s
day. You can provide fun activities such as face painting and
use the opportunity to educate
children on how to brush their
teeth and what foods they should
avoid. It also works well if the
dentist spends the whole day
doing examinations only, booking future appointments should
a child require further treatment. This is an excellent way
of seeing your children in one
block, encouraging more regular
check-ups and reducing the fear
factor for children who may see
the dentist as a scary place!
feel relaxed and appreciated is
to ensure that they know which
member of the team they will
be seeing at each appointment.
If your patient visits a particular
dentist regularly, be sure to let
them know, before their appointment, if their dentist is unable to
see them, and the name of the
replacement dentist who is seeing them.
This is particularly important
for nervous patients, as they may
have built up a level of trust with
their regular dentist and may not
feel comfortable seeing anyone
else. If you leave it until they ar-

time to record the relevant details, such as the date, time and
who they will be seeing at their
appointment, in their diaries.
This not only reduces the risk
of missed appointments but also
provides them the opportunity
to explain any problems or concerns, which will put them at
their ease and also help the dentist.
Be clear on charges
Appointment time is precious
in any practice, so it is essential to make sure patients, especially new ones, understand
the practice’s policy on failed

‘the appointment book is also one of
the tools we use day-to-day without really
utilising it effectively and it is easy to
take it for granted.’
rive for their appointment to inform them of this, they may not
feel comfortable enough to go
ahead with it and therefore it is
wasted appointment time.
Give patients time
Be sure to allow sufficient time
for patients to make their appointments, either in person or
on the phone, and not to rush
them. This is an effective and
easy way of making patients feel
valued; it and also gives them

appointment charges. This will
discourage last minute cancellations and no-shows, while also
helping to keep the appointment
book up-to-date, with more opportunity to fill cancellations
with last minute appointments.
You could also put this in
your patient information leaflet
or welcome packs to new patients. This may create an initial
cost, but this expenditure can often pay dividends when it comes

to cancelled appointments. Other
options include a patient newsletter or adding this information
to your practice website.
Keep it legible
As the appointment book will be
read by most of the practice staff,
ensure that your writing is neat
and legible. This may sound obvious, but some of the most common mistakes in practice are
often down to poor written communication. It is also important
to use only recognised abbreviations, not your own version of
shorthand, to ensure that entries
can be understood by everyone.
A lot of practices are now
computerised, so why not promote the benefits of computerised appointment books? This
will be an effective solution if
you have trouble reading other
team members’ handwriting, or
even if you just want to make
your appointment book more
secure. Though this may reduce
illegibility issues, you will still
need to be clear about abbreviations and shorthanded notes.
Zoning the appointment book
It is a really good idea to have allocated slots every day for emergency patients. This means that
your scheduled patients do not
have to wait for their appointment in the event of an emergency and your practice is far more

These tips are designed to
give you a starting point, but if
you wish to learn more about
how you can streamline the running of your practice there are
a number of handbooks and
guides available, which can even
be personalised to suit your particular practice’s needs.
Alternatively, why not look
into attending a training course
to target any areas of improvement? Some dental payment plan
specialists not only offer a range
of structured training courses,
but can also provide bespoke
training for your practice to take
place at a venue that suits you. DT

About the author
Jo Banks is
Sales Trainer
Manager.
Jo
joined
Denplan in 1995,
providing
training
to
dentists
and
their practice
teams on a
wide
range
of subject areas. She has
an
in-depth
understanding of modern
practice.
As
well as providing bespoke training, she has been instrumental in developing the Denplan
Excel Accreditation Training Programme and the Introductory Training Course for dentists converting
to Denplan.

[15] =>

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[16] =>

16 Practice Management

United Kingdom Edition

December 7-13, 2009

The 10th Dimension…
the power of 10

In part two of this two-part series, Ed Bonner and
Adrianne Morris discuss the art of problem solving
Dealing with problems
t’s not the problem that’s the
problem, it’s how you deal
with it. Unfortunately, given
the underlying issues of relationships and prior personal history
that invariably accompany any
difficult situation, dealing appropriately with problems is
never easy. It therefore seems to
make sense to set out some basic
ground rules on how to be an effective problem solver.

Bite-sized chunks: A few
years ago, there was a bestselling book by Kristine and Richard Carlson called Don’t sweat
the small stuff… and it’s all small
stuff. All too often, individuals
refer to a series of inter-related
problems instead of tackling the
specific problem at hand. If you
can take what appears to be a
large problem and break it down
into several sub-components,
and then deal with each component part individually, you are
much more likely to find a solution than trying to sort out the
problem in its entirety.

Control: Define and clarify
the issue – does it warrant
action? If so, now? Is the matter urgent, important, or both?
Are you able, in a clear and rational manner, to identify the
problem and the obstacles that
the problem presents? Clearly
state the problem and what obstacles the problem presents to
you. Once you have done this,
you need to understand what
you have control over and what
you don’t. Your efforts to resolve
the problem must focus on, and
be within, the areas over which
you have control.

Reality and perception:
Which components of the
problem are real, which are perceived? You may contribute to
the problem by magnifying it out
of proportion, thereby turning
a small issue into a very large
one. Check the realities! Take the
example of a patient who promised to send a cheque, which has
not yet been received. You might
think the patient had simply forgotten, and send a gentle postal
reminder, or you could become
incensed that you had done so
much for the patient which had
gone unappreciated, pick up the
phone, ask the patient how they
expect you to run a business if
people don’t pay on time and
demand immediate payment.
Guess which is the reality and
which is the perception. Guess
which way will get you payment
quicker. Guess which way will
lose a patient to the practice.

Information: Do you have
all the information you need?
Solving problems is often like
becoming involved in investigations. Have you thoroughly
researched why the problem
exists? Do you have all the information you need? If not, be persistent and seek out all information before tackling the problem.
Gather all the facts and understand their causes.

Non-emotion: Are you able to
see issues clearly, objectively
and with emotional detachment?
Are you able to discuss points
of contention without becoming
angry or emotional? We all have
‘buttons’ which, when pushed,
cause us to react in a predictable
but unfortunately irrational way.
For example, when a partner
says: ‘You always do this’, chances are you will respond with a
retort that is as unreasonable as
the very statement itself.

Negative energy: Working
toward your goal without the
interference of negative mental energy makes any job more
manageable – you should not allow another person who is critical of you, rather than having
your best interests at heart, to
be part of the solution – they are
more likely part of the problem.

Options: How many options
for solutions do you have?
Generate a list of different options for solving the problem.
Are some better than others?
Why? Which options seem reasonable? Some are practical,
others rooted in fantasy. Have
you weighed the pros and cons,
advantages and disadvantages
of your options? Are there any
limitations to your options? Are
they affordable? Avoid vagueness
or ‘foot in both camps’ compromise. As Aneurin Bevan once
said, ‘We know what happens to
people who stay in the middle
of the road. They get run down.’
Think about, or brainstorm with
others, possible options and solutions. Select the best option.
Explain your decision to those
involved and affected, and follow
up to ensure proper and effective
implementation.

Is it you? Could it be that you
are the problem? Your personal belief and value systems
may be contributing to the problem, and may equally be getting
in the way of a solution – ‘I’m not
going to let a nurse tell me what
to to do!’ Don’t jump to conclusions. Once you have all of your
information, analyse it carefully
and look at it from various view-

points. Be as objective as possible and don’t be quick to judge.
Remain judgment-free as much
as possible. This is a time for
you to use your critical thinking
skills.

Take a break: When you
are beset by what appears to
be an insoluble problem, take
a break. Failure to take regular
breaks not only wears you down,
but also makes you less productive. While you may not feel it
at the time, slowly but surely,
frustration will sneak up on
you. You’ll become less patient
and less attentive. Over time,
you’ll burn out more quickly and
your creativity and insights will
slowly fade away. Breaks don’t
have to be disruptive or last very
long. Usually all we need is a few
minutes every hour or so to clear
our heads, stretch our arms and
get some air. It’s like pressing
the reset button and providing
ourselves with a fresh start. Furthermore, a week or two away
doesn’t harm either.

Buying a solution: Some
decisions and challenges
are difficult because you don’t
have the necessary knowledge or
experience. Could it be beneficial
to buy a solution, for example, by
calling in a coach, consultant or
an accountant? How often does a
pair of eyes that is not emotionally involved in a tricky situation
see the reality of the situation
with absolute clarity!
Problem-solving and decision-making are closely linked,
and each requires creativity in
identifying and developing options, for which the brainstorming technique is particularly
useful. Good decision-making
requires a mixture of skills: identification and creative development of options, clarity of judgment, firmness of decision, and
effective implementation. Once
your solution is in place, it is important to monitor and evaluate
the outcome regularly.
www.thepoweroften.co.uk

About the authors
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. For a free consultation, or a
complementary copy of The Power of
Ten e-zine, email Adrianne at alplifecoach@yahoo.com or Ed on bonner.
edwin@gmail.com.

[17] =>

DCPs 17

United Kingdom Edition December 7-13, 2009

A good team is for life, not just Christmas
it’s a good idea to treat staff little and often throughout the year,
says Sharon Holmes, as a way of showing appreciation

m

oving into a new year
is like starting afresh.
It gives you a chance
to forget how busy you’ve been
and move on to new things.
When I joined our first practice as manager, we used to celebrate at the end of the year by
going out for to a swanky restaurant with practice owners,
Dr Malhan and Dr Solanki. Once
we moved into the corporate environment, arranging this became a bit more complex, and
celebrations too many. None of
us in upper management wanted to eat four expensive meals in
a space of one week – this would
surely increase our waistlines
before Christmas Day even arrived – so on our first year, I
decided to ask individual staff
members how they best liked to
celebrate the Christmas period.
As it turned out, most staff
chose to have individual dinners
with their own staff and associates and to receive gift vouchers
from the Dental Arts Studio. So
out I went to buy M&S vouchers,
which I sent to all the staff with a
Christmas card, thanking them
for their contribution throughout the year. We did this for two
years running.
Now we have been established
for nearly six years to become
a mini corporate group of four
practices and a low level of staff
and associate turnover, we all
know each other very well, so
have chosen to have one huge
Christmas bash at the end of
the year with staff and their
partners from all the practices
combined. we’ve successfully
done this for three years now
with staff talking about it for
weeks afterwards.
Our first joint Christmas Party – the “Pink Party” – was affiliated to a charity event where the
Dental Arts Studio raised £3,000
from ticket sales and a further
£900 from raffles and prize
draws on the night, for Breast
Cancer Awareness. Not only did
we have a lot of fun on a Thames
River Boat, we were also able to
contribute to a worthy cause.
Last year, we hosted a party
at the Hilton Hotel in London’s
Docklands, which was also a
success, and once again this
year we will return to the Hilton
Hotel, but this time in Mayfair.
I am starting to feel the buzz
in the surgery and the ladies
are already talking about finding the perfect outfit for the occasion. These are the moments
we all look forward to, and for

a short while we can all forget
about root canals and pain and
realise that life does not have to
always be fast and furious.

Studio. Recently, we’ve started
having regular social get-togethers
on Saturday evenings at either one
of our principal dentists’ homes.

We don’t only celebrate at Christmas time here at the Dental Arts

We also have staff member of
the month award where the high-

est performer is rewarded for doing more than is required of them,
a lot of the time in difficult situations that may arise in the practice. Let’s not forget “Fatty Friday”,
which involves buying sweet treats
every Friday.

Each practice has its own
Secret Santa event at Christmas,
and we always make sure we
carry out collections for birthday
presents.
As Albert Einstein once said:
‘A hundred times every day I
remind myself that my inner
and outer life depend on the labours of other men, living and
dead, and that I must exert myself
in order to give in the same measure as I have received and am
still receiving.’ DT

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[19] =>

Money Matters

United Kingdom Edition December 7-13, 2009

19

First-time sellers - seeking the right advice
If you’re about to embark on selling your dental practice for the first time,
careful consideration should be taken when seeking legal advice. Andy Acton offers
some useful advice to those looking to make that first sale

S

elling your practice is certainly not a task you want
to put in the hands of
someone who has little experience. It’s also something you
don’t want to enter into lightly,
because it could well represent
your life’s work or create a lump
sum for retirement or investment
in a new project. You deserve the
very best advice available from
someone with good pedigree and
a proven track record.
In the current climate, there
is a lot of scurrying about for
business and many firms are
extending their range of services beyond their core in an
attempt to generate new income
streams. I am a great advocate
of innovation and we should all
be looking to evolve and develop
– it’s what makes business fun.
That said, would you buy a car
from a company that specialises in selling trucks? However,
from the service recipient’s
viewpoint this requires some
consideration.
Pay special attention
Selling dental practices is a complex business and while there is
a core underlying transaction,
even through the thousands that
we have had an involvement in,
there is always a unique element
that requires some special attention. Take your pick – the list
goes on:

‘would you buy a
car from a company
that specialises in
selling trucks?’
■ My property value has
dropped and I don’t want to
sell it with my practice, what are
my options?
■ I have someone who is interested but they won’t make a
commitment.
As well as an experienced
sales agent, the need for a specialist should be considered
when seeking legal advice.
You could use a local firm who
have quoted a relatively low fee,
compared to a specialist firm.
However, I would want a firm
that understands the need for
dental-specific covenants and
warranties to ensure I was protected and the contract was fit for
purpose.
I had a client many years
ago that bought a practice and
(against my advice) chose to use
a local law firm. This firm failed
to ensure that all the leases outstanding on the equipment in
each surgery were repaid from
the sale proceeds at completion.
This error resulted in the finance company repossessing the

equipment from each surgery
because lease payments were
not being made (the seller was
enjoying retirement in another
country!). The practice survived
– just – but it had to be fully reequipped by the new owner and
the impact on business was cata-

strophic. The client saved a couple of thousand pounds on their
legal bill and nearly went bust in
the process.
Choose wisely
There is no guarantee that working with those of good pedi-

gree and a wealth of experience
means that everything will go
smoothly. However, carefully
selecting firms that know what
they are doing, and are backedup by real and current-market
experience should make for a
safer transaction. DT

■ How do I protect my UDA
value?
■ Is it a problem that I don’t
have contracts with my
associates?
■ I am planning to incorporate,
how does this affect my sale?

About the author

• Valuations purchase, sale, buying in, retirement
• Purchases practices available countrywide
• Sales
totally confidential service for vendors
• Consultancy communication, systems, people=profit
Andy Acton is director of Frank Taylor
& Associates, independent valuers and
consultants to the dental profession.
Andy has helped a number of dental
specialist banks develop their services
to the dental profession, including NatWest and Bank of Ireland. For more
information, call 08456 123434, email
team@ft-associates.com or visit www.
ft-associates.com.

Practice loans
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purpose – highly
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team@ft-associates.com
www.ft-associates.com

T 08456 123 434
F 01707 643 276

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service

[20] =>

20 Clinical

United Kingdom Edition

December 7-13, 2009

Immediate single-tooth replacement and
provisionalisation in the aesthetic zone
As immediate implant placement gains momentum, Dr Graham Magee gives an
example of how this high-risk treatment leads to success

ith more than 40 years
of clinical evidence,
Titanium Endosseous

Implants have become an acceptable (evidence based) form
of treatment to replace natural

teeth and should be considered
as an alternative to either a partial denture or bridge.

Immediate implant placement with simultaneous immediate function or immediate

t
N EchW
ed a

PracticeWorks

Oralinsights

Laun Dental
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i ntel l i gent or a l cl eani ng
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Oralinsights is an interactive, personalised education system exclusive to PracticeWorks.
It is proven to motivate long lasting improvements in brushing behaviour and technique.
There are also equivalent improvements in plaque removal.
A modern and motivating system which really helps to correct and educate resulting in:
• higher patient satisfaction levels
• increased practice proﬁle
• a new revenue stream

loading has been gaining momentum over recent years and
can be a very predictable method
in providing implant treatment
for our patients. There have been
various timeframes used for
the definition of immediate implant placement. Hammerle et al
(2004) suggested that immediate
implant placement was when an
implant was placed following
tooth extraction and as part of
the same surgical procedure.
In the same paper, the consensus statements say “implants
should not be placed at the time
of tooth extraction if the residual
tooth morphology precludes attainment of primary stability.” It
also states that, “If buccal plate
integrity is lost, implant placement is not recommended at the
time of tooth removal. Rather
augmentation therapy is performed.” The implant is then
placed after healing, that being 12-16 weeks or even longer
than 16 weeks. It has also been
reported that infection adversely
affects immediate implant placement (Rosenquist & Grenthe
1996; Grunder et al. 1999). and is
a contraindication for immediate
placement of an implant into an
extraction socket.
predicatable treatment
concept
Immediate implant placement
and provisionalisation is a predictable treatment concept (De
Rouck et al 2008). The success
rate is at least comparable to
data published for single-tooth
implant placement using standard protocols in healed sites.
This happens providing careful
appropriate patient selection is
used and the surgeon is familiar
with the techniques that differ
from the standard two-stage protocol for implant placement.

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For the patient, the main advantage for immediate replacement and provisionalisation is
fewer surgical visits as well as
providing immediate aesthetics
that are virtually indistinguishable to the original tooth. Sometimes if the tooth being replaced
is discoloured due to non-vitality, the aesthetics will provide an
immediate improvement.
For the clinician, immediate
replacement allows for minimal
disruption of the soft tissue providing immediate peri-implant
support through careful manufacture and design of the provisional restoration. This helps to
maintain the stability of the gin-

[21] =>

Clinical 21

United Kingdom Edition December 7-13, 2009

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gle produced by the buccal plate.
In the anterior maxilla, implant
placement is typically toward the
palatal aspect of the socket. Ideally there should be a space of
0.5mm-1mm between the buccal
plate and the anterior surface of
the fixture.

gival marginal tissues, which is
necessary for a successful aesthetic outcome.
Root-filling failure
The following is a case study of a
50-year-old female with a history
of a failing root-filled, upper-left
central incisor. The root filling
had been present for approximately 25 years and this had
been apicected approximately
13 months before the tooth became problematic (Figure 1).
The patient did not want another
apicectomy and requested that
the tooth should be extracted.
The various options for restorations were discussed and as the
neighbouring central incisor
was root filled and restored with
a post crown, the lateral incisor
was restored with a veneer due
to microdontia, a bridge was not
a viable option. The patient was
adamant that she did not want a
partial denture.

Figure 1: Radiograph of failing upper left
central incisor

The site was further prepared using the standard drill sequence. A Nobel Speedy Replace
regular platform fixture (ø4mm
x 15mm) was then placed which
stopped at a torque value of
35Ncm. It is recommended that
if a torque value of 35Ncm cannot be achieved the implant
should not be brought into immediate function. A cover screw
should be used and the implant
submerged;
therefore
some
other temporary measure such
as a Maryland Bridge should be
used. In these conditions the root
could even be sectioned from the
extracted tooth and the crown
bonded to the adjacent tooth.

Figure 2: Pre-operative view of UL1

As the tooth was not infected
and investigation had shown that
the buccal plate was still intact, it
was decided that the tooth could
be extracted and immediately replaced with an implant fixture.
This was to be utilised to support a Nobel Biocare immediate
temporary abutment and a provisional crown.
What the treatment involved
Under local anaesthesia, a crevicular incision was used and
no flap reflection. The upper left
central incisor was extracted using a very careful (atraumatic)
technique with a periotome to
preserve the buccal plate of bone
and careful manipulation of the
gingival tissues.
Once the tooth was removed,
the socket walls were curetted
to remove any remnants of periodontal fibres or granulation tissue. The socket was inspected to
ensure that the buccal plate was
still intact (Figure 3). Using the
standard protocol, the bone was
first prepared by penetrating the
palatal wall at the apical third.
Great care needs to be taken in
the osteotomy preparation as
the palatal wall of the extraction
socket is commonly very dense
and difficult to prepare which
can cause “run-off” of the drill
tip.
To achieve the initial perforation, the drill is held at an
angle of approximately 45-° to
the palatal wall. Once the drill
has penetrated the palatal wall,
the angle is changed to then run
more-or-less parallel to the an-

DVD availab

Primary stability is very important in this procedure as the
bone support needs to be strong
enough to support the fixture
and prevent micromotion from
exceeding the threshold above
which fibrous encapsulation
prevails over osseointegration
(Szmukler-Moncler et al. 1998).
An Immediate Provisional
Abutment (IPA) (Figure 4) was
fitted to the implant and fastened
down to 20Ncm. The abutment
is non-engaging, screw-retained
and inserted using a multi-unit
abutment driver. The abutment
has a 1.5mm depth of shoulder
and comes with a plastic coating,
which can be used with acrylic
provisional materials. I find
however, that when using composite materials it is better to discard the coping and cement the
composite to the IPA.

Figure 3: Extraction of UL1

Figure 4: Immediate Provisional Abutment (IPA)

Figure 5: Provisional crown being
manufactured on IPA

Figure 6: Internal hex which has been
created by curing flowable composite
over the IPA.

Figure 7: Immediate Provisional Abutment (IPA)

Figure 8: Provisional crown being
manufactured on IPA

Figure 9: Internal hex which has been
created by curing flowable composite
over the IPA.

A provisional composite
crown was pre-manufactured by
the laboratory. A small amount
of Tetric Flow composite (any
flowable composite would also
work) was placed in the provisional crown. A sufficient
amount was used to engage with
the metal of the IPA but not spill
out and touch the tissues. This
was then light cured whilst the
provisional was supported in the
correct position. The provisional
was than removed and placed on
another IPA connected to a protection analogue. The voids were
then filled with more Tetric Flow.
The margins were then shaped
à DT page 22

[22] =>

22 Clinical

United Kingdom Edition

ß DT page 21

and polished to ensure a smooth
shoulder with no ledges or deficiencies against the IPA. (Figures 5 and 6). The provisional
crown was then cemented to the
IPA with a very small amount of
Tempbond, ensuring that no cement extrudes into the tissues.
Adjusting the provisional
crown
It is important at this stage to ensure that the provisional crown

or excursive movements (for example, not immediate loading).
The patient was advised to try
and avoid the provisional crown
and not to apply any forces with
eating for the first four weeks.

Figure 10: Final restorations 18 months
after fitting.

is adjusted to ensure that there
is no contact with the lower teeth
in centric occlusion (Figure 7)
and no contact in any protrusive

The provisional crown was
left in situ for six months (it is
recommended that an absolute minimum of three months
should be allowed for osseointegration before disturbing the immediately placed implant). The
provisional crown was removed

and a fixturehead impression
taken of the implant. The adjacent post crown (upper right
central incisor) was also prepared for a new crown to ensure
a good match for both central
incisors.
A Procera Zirconium abutment was connected to the fixture (Figure 8). The abutment
screw was fastened down at the
recommended torque of 35Ncm.
Procera porcelain crowns were
fitted to both central incisors

December 7-13, 2009

(Figure 9). The implant-retained
crown was cemented with
Tempbond. It is recommended
that the definitive restorations
on implants should be cemented
with a temporary cement as this
allows access to the implant if
necessary.
Immediate implant placement is gaining momentum.
Clinicians should be aware however that this is a higher-risk
procedure and should only be attempted by those surgeons with
experience in dental implant
surgery particularly when dealing with the aesthetic zone. DT

References
De Rouck T, Collys K, Cosyn J. 2008,
“Single-Tooth Replacement in the Anterior Maxilla by Means of Immediate Implantation and Provisionalization: A Review.” Int.J.Oral Maxillofac.
Impl., vol 23, no. 5, pp. 897-904.
Grunder U, Polizzi G, Goene
R, et al. 1999, “A 3-Year Prospective
Multicentre Follow-up Report on the
Immediate and Delayed-Immediate
Placement of Implants.” Int.J.Oral
Maxillofac.Impl., vol 14, no. 2, pp.
210-216.
Hammerle, C. H. F., Chen, S. T.,
Wilson, T. G. 2004, “Consensus Statements and Recommended Clinical
Procedures Regarding the Placement
of Implants in Extraction Sockets.”
Int.J.Oral Maxillofac.Impl., vol 19,
Suppl:26-28.
Rosenquist B, Grenthe B. 1996,
“Immediate Placement of Implants
into Extraction Sockets: Implant Survival.” Int.J.Oral Maxillofac.Impl., vol
11, no. 2, pp. 205-209.
Szmukler-Moncler S, Salama H,
Reingewirtz Y, & Dubruille J.H. 1998,
“Timing of Loading and Effect of Micromotion on Bone-Dental Implant
Interface: Review of Experimental Literature.” J.Biomed.Mater.Res., vol. 43,
no. 2, pp. 192-203.

About the author
Dr Graham Magee qualified at
Liverpool University in 1978
and in 1993 Graham created the
Chester Dental
Implant
Centre within the
general practice
where he was a
partner. Finally
in 1998 needing more space
for the Implant
Centre he relocated the Clinic
to the present building. Graham has
undergone extensive postgraduate
training to develop his skills in Dental
Implant Surgery and Cosmetic Dentistry including a Masters Degree in
Dental Implantology from Sheffield
University. He continues with his postgraduate education regularly attending courses in Britain, Sweden, France
and America and also gives lectures
on the aspects of Dental Implantology
and CT Scanning and 3D Planning in
Advanced Dental Implant Therapy.
Graham also runs postgraduate training courses in implant dentistry for
dental practitioners in his practice and
is a member of the Association of Dental Implantology and of the American
Academy of Osseointegration. To refer
to Graham or for further information
on Chester Dental Implant Centre, call
01244 340 177.
DM Indesign.indd 1

29/10/09 13:35:27

[23] =>

United Kingdom Edition December 7-13, 2009

Education 23

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

n a world where most things
we purchase are ready-made
rather than bespoke, we are
protected by a money-back returns policy in case we don’t like
something after we’ve paid for it.
However, dentists spend the majority of their time creating custom-made items which makes
such an approach expensive and
best avoided if possible.

dentist by now and instead went
to another dentist who replaced
the veneers for a considerably
higher fee, which the patient
now demanded from the original
dentist.

Whenever aesthetics are involved in dentistry, it is wise to
obtain the patient’s consent on
the complete final appearance
before finishing the case, particularly if it will be difficult or

Consider the case of a young
male patient in his early twenties who requested his dentist
to close his midline diastema.
The patient was soon to be married and wanted the work done
before the wedding day. It was
quite a large gap of some 4mm
between the upper central incisors, but the dentist confidently
assured the young man that he
could close the gap and produce
‘a perfect smile’ ready for the
wedding photos.
When the patient returned
for the preparation to be done,
he asked the dentist to prepare
the two lateral incisors as well as
the centrals. This was duly done
and an impression was taken before the patient rebooked to return a week later
At the fitting appointment,
the two central veneers were
tried in. The patient agreed they
looked fine and he was pleased
with the way they closed the diastema. To save time, the dentist
did not try in the two other veneers and went ahead and cemented all four of them. When
he now looked in the mirror, the
patient was surprised at the result and not at all happy with the
size of the central incisors. He
also felt the veneers were quite
bulky under his lip. The dentist
reassured him and asked him to
try them for a couple of weeks.
A tricky situation
The patient phoned the next day
saying that both he and his fiancée were very upset with the result and that the teeth were now
far too prominent. With the wedding taking place in less than a
fortnight the dentist agreed to replace them at his own cost. The
patient had lost confidence in the

‘The patient had
lost confidence in
the dentist by now
and instead went to
another dentist who
replaced the veneers
for a higher fee’

For Registration & More Info:
Contact Person in Athens:
Lito Christophilopoulou
¨HO +30 210 213 2084, +30 210 222 2637
E-mail: mp-mediterranean@gidedental.com
Nena Puga
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E-mail: nena@gidedental.com
website: www.gidedental.com

expensive to redo the treatment
once it has been cemented or
bonded in place.
Look out for another Learning Curve feature from Dental

Protection in future editions of
Dental Tribune UK. DT

[24] =>

24 Feature

United Kingdom Edition

Pride of dentistry in rural Devon
The Devon Centre of Dental Excellence is achieving outstanding
business success and going from strength to strength. So what is
the secret to his success? Centre owner Dr Badiani reveals all

Today, the Devon Centre of
in the West Country, but you’d be
he ancient stannary town
Dental Excellence is the flagwrong. And Dr Mitesh Badiani,
of Ashburton, on the slopes
ship practice for a group of
who bought the place in 1995, has
of Dartmoorm, is hardly
practices
more than demonstrated
what20:33
a
the
place you’d think you’d find
OPT_DentalTribune_210x297_NOV_PressAd:Layout
1 24/9/09
Page 1 including Plymouth,
Bovey Tracey and Portland. More
wise decision it was.
the leading referral dental centre

are in the pipeline and dentists
are queuing up to join. So what
is Dr Badiani doing that is
having such an impact and
how is he achieving it in what,

The Clearstep System

December 7-13, 2009

at face value, is a sleepy rural
community?
The answer is deceptively
simple. Dr Badiani makes no
decisions without carefully considering them. When he does,
his commitment is total and his
business acumen sure-footed.
And above all, he ensures that
the patient experience exceeds
expectations. It’s worth taking a
closer look at how these values
translate themselves into action.
Developing your product
The ‘marketing’ advice given
generally to dentists by any
number of ‘experts’ is seemingly
endless with the majority of it
simply being statements of the
obvious. It does not take a genius
to work out that there are established ways of communicating
with patients, all of which are
relevant and applicable to almost every practice. The genius
comes, not describing and defining your market, but in developing a product that satisfies its
needs.
In this respect, Dr Badiani’s
philosophy and skill are clear. It
is not about creating a practice
that simply flaunts its capability. It is about creating a practice
that shows that it listens to and
cares about what patients want.
A few examples highlights
this point:

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.
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.

Accreditation Seminar
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.

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

First Accreditation Seminar for 2010
28th January
Leeds
Further Courses
Once accredited, further your orthodontic expertise with
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
To find out what Clearstep can do for you,
contact us today.

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

■ The reception team greet everyone with a welcome that says
‘we’re glad you’re here’. The
smile endorses this greeting and
is genuine. It isn’t just a ‘skindeep’ gesture. This can only happen in a practice where the staff
are happy and is aware that patients recognise and take notice
of body language.
■ There are a variety of places
(other than reception) throughout the practice in which patients may wait and relax. This
provides personal ‘space’, encourages a greater affinity with
the practice and builds the patient/dental team relationship.
■ There is a delightful, spacious
and calming garden, which, on a
summer day, is a haven of calm
and tranquillity. Patients are free
to sit and relax there before and/
or after treatment. Again it enhances the relationship.
■ the toilets are spotless and
stocked with supplies of toiletries for patients to use. These
make a nicer touch than a bottle
of disinfectant.
Dealing with anxiety
It is a sad fact that many people
fear dental treatment. Dr Badiani, who mentors and trains
dentists all over the country,
says: ‘We have for many years
treated a great number of patients who are extremely nervous of dental treatment and

[25] =>

Feature 25

United Kingdom Edition December 7-13, 2009

where a local anaesthetic is required, there are various methods we will consider. One of
my favoured techniques is the
WAND system, which is amazingly effective when used by a
skilled, well-trained dentist. It
reduces anxiety and is literally
pain free. It is particularly helpful when treating children or
those with needle phobia who
we find often don’t even realise
they’ve had an injection!’
Another concern of some patients is radiation dosage. In reality, the risk to the patient may be
minimal, but this does not necessarily allay fears and anxiety.

Centre of Excellence can provide
to referring dentists.
Dr Badiani is very conscious
of the trust that other dentists
place in him. He recognises the
concerns that any dentist has
when he or she refers a patient:
“When you build a referral practice, you have to do so clearly
understanding that your role
is to support and advise, never
compete, be it consciously or unconsciously. You must strive to
exceed the expectations of your

colleagues in the same way as
you do with your patients, always
keeping in mind that they are
all clients.”
In this way, referring dentists are seen as almost part of
the team. They have access to
the technology and share in
the knowledge, facilities and
skills available in Ashburton.
Specialist training facilities are
available and procedures can
be watched at the viewing theatre as they take place and then

discussed in a comfortable and
relaxed atmosphere.
For more information, contact Devon Dental Centre of Excellence at Croydon House, 78
East Street, Ashburton, Devon
TQ13 7AX; call 01364 652 253 or
email info@devondental.co.uk or
visit www.devondental.co.uk
For more information on EWoo Technology, call 020 8831
1660, email info@e-wootech.co.uk
or visit www.e-wootech.co.uk. DT

About the author
Dr Mitesh Badiani is a practitioner of high
standing and expertise. Qualified
from Newcastle
Dental Hospital
in 1991, and has
been a Clinical Director of a
number of successful primary
care practices since 1995. He aims
to provide a comprehensive range of
pain-free dentistry for patients as well
as mentoring and training dentists
from all over the world.

‘Low radiation dosage was
one of the criteria I had in mind
when seeking to upgrade to 3D
digital imaging. I was worried
that, by referring to the hospital,
I was increasing patient concern
and in many instances the diagnosis did not warrant the radiation dosage’, says Dr Badiani, “so
I decided to see what the market
had to offer.’
An exhaustive look at CT
scanners ended with Dr Badiani
choosing the Picasso Trio from
Vatech and E-Woo. ‘Quite simply the quality, the software, the
service and product knowledge
are the best,’ he says, ‘and the
Picasso is already enhancing our
diagnostic capabilities across
the range of specialist treatments
we offer.’

ESTETICA E80
Rise above the rest with
outstanding ergonomics
and an attractive, highly
functional design

Working as a team
Dr Badiani’s choice of the Picasso Trio exemplifies the policies
of the Devon Dental Centre of
Excellence to put quality above
cost. He has surrounded himself with something of a “dream
team” in the way of specialist clinicians and knows that they, too,
want the best.

• Innovative suspended chair gives
improved ergonomic working
• Unit includes the option of
an integrated Endo function
• Future-proof
• Unit allows for the integration of additional
instruments
• More comfortable
positioning for patient
• Integrated technology
offers a perfectly
harmonised system
• Includes free
COMFORTdrive speed
increasing handpiece

Dr Badiani himself concentrates on dental implants, IV sedation and cosmetic dentistry.
He also mentors for Osteo-Ti and
Ankylos. Andrew Pickering, Linda Blakely, Carol Robinson and
Anna-Marie Smith offer general
dental treatment and specialists
include Professor Nico Louw
(Endo), St John Crean (Oral and
Maxillo facial), Amelia Jerreat
(Ortho) and Matthew Jerreat
(Perio and Restorative dentistry).
It is Dr Badiani’s view that
individually and collectively
we will benefit from 3D imaging. ‘While most treatments are
straightforward, careful planning is always required and the
exceptional quality of the Picasso
images is second-to-none. I also
value the information it provides
for more complex cases where
we need to work and assess as
a team.’

CALL US ON FREEPHONE 0800 281 020

Building referral business
A further benefit of investing in
3D imaging is that it adds to the
service that the Devon Dental
Untitled-1.indd 1

01/12/2009 18:48:00

[26] =>

26 Industry News
BACD Study Club:
Impression Free Dentistry
The British Academy of
Cosmetic Dentistry presents
the latest in its series of Study
Club Lectures, to be held at
the British Dental Association, London on Tuesday 26th January 2010. Entitled
‘Impression Free Dentistry: Are We There Yet?’ Dr Ilan Preiss will explore how
digital impressions can have a significant impact on the way dentists practise.
The focus is the new 3M Lava Chairside Oral Scanner and the lecture will cover:
• An overview of the technology involved
• Clinical tips for capturing data
• Interpretation of data and communication between dentist and lab
• Clinical cases and photos for onlays, veneers and all ceramic crowns
The lecture will also feature a practical element, allowing attendees to use the
equipment. Dr Ilan Preiss is a member of the BACD, AACD and ADI. Part of the
Bow Lane Dental Practice since 2002, Ilan won the 2009 Restorative Smile of
the Year Award at the prestigious Smile Awards.
Places are limited for this event and so booking early is recommended.
For more information or a booking form please contact Suzy Rowlands on
0208 241 8526 or email suzy@bacd.com.

Chlorhexidine Without The Drawbacks!
Curasept, from Curaprox, is a chlorhexidine
mouthwash whose unique formulation helps
prevent changes in patients’ taste perception as well
as reducing the occurrence of discolouration of the
teeth.
Chlorhexidine-based mouthwashes are considered
the gold standard for plaque control and inhibition.
With Curasept ADS (Anti Discolouration System) range dental professionals
can provide a chlorhexidine-based mouthwash without any of the side effects.
There will be: • No staining • No alcohol • No aftertaste
Studies have shown that alcohol provides no extra benefit to the antiplaque
effect of chlorhexidine, and may be linked with oral cancer. Both alcohol and
sugar free, Curasept protects gums and teeth against attack from harmful
bacteria and the build up of plaque.
Now all the benefits of Curasept mouthwash are available in a handy gel,
allowing for specific application to the gums or even the periodontal pockets
between teeth.
Curaprox is committed to developing oral hygiene products of the highest
standard for today’s dental profession. For further information or to order
please contact Curaprox UK on 01480 862084

United Kingdom Edition

Predictable Diagnosis and Treatment Planning
The most recent Study Club event organised by The
British Academy of Cosmetic Dentistry took place at the
Cresta Court Hotel on Friday 11th September, and saw
one of the leading authorities in cosmetic dentistry give
a presentation on ‘Records for Predictable Diagnosis and
Treatment Planning’.

BioHorizons 2009 - 2010
BioHorizons have had an exciting
year with the expansion of their
biologics range, new Virtual Implant
Planning (VIP) software and the
introduction of some brand new implant courses which delivered a record
number of delegates.

With over 20 years’ experience in both private and public
health sectors, Dr. Buckle is an accomplished practitioner,
recognised through his membership to both the British
and American Cosmetic Dentistry Academies.

These new product developments in 2009 have confirmed BioHorizons’ place
as one of the fastest growing oral reconstructive device companies in the
world; they also further demonstrate their commitment to providing the most
comprehensive line of evidence-based, scientifically-proven dental implants
and tissue regeneration solutions.

Attendees were also taken through issues concerning the
use of articulators and the way to decide which type to use
as well as the arguments in favour of utilising a facebow as
an aid to planning treatment. His elucidation on the most
opportune times to use Centric Relation instead of MIP
was also extremely helpful.
The British Academy of Cosmetic Dentistry would like to
extend its thanks to Dr. Buckle for a most informative evening.
For information on future Study Events, please contact:
Suzy Rowlands on 0208 241 8526 or email suzy@bacd.com.

Also on display was the Swiss-designed Everclear, the first dental mirror that
self-cleans for continuous clear vision, together with Nuview’s Continu Alcohol
Free disinfectants. The latest Continu products include HTM 01-05 compliant
solutions such as sealed disposable cartridges, a 2 in 1 surface cleaner/
disinfectant that incorporates a mild detergent and an alginate mix to disinfect
impressions at source. Proud to sponsor the 2009 BACD, Nuview is delighted
with the success of the Sixth Annual Conference.
For more information please call Nuview on 01453 759659, email info@
nuview-ltd.com or visit www.voroscopes.co.uk

New Owandy Visteao Intra-oral Digital X-Ray System
Velopex are proud to announce a new Digital Intra-Oral
System featuring unique USB connectivity and both size
1 and size 2 CMOS sensors. Both sensors have either a hard
wearing cable connection: the removable cable is clipped
on to the back of the sensor for easy ergonomic positioning
in the mouth or the system comes with a unique integral
positioning device which the sensor can be clipped into.
The package includes:
• Owandy “Quickvision” Software • Interface Modem • Storage box
• Integral Positioning device/cable • Cable with connection for sensor
• Sensor • Full instructions • 24 Months Warranty
• USB connection between modem box and computer
This USB connected system comes with a 3M cable length between sensor and
modem interface, The USB system draws power through the USB cable.
The cable and sensor housing can be replaced on a ‘service exchange’ basis as
long as the CMOS sensor chip is NOT damaged.
For a limited period, but an Owandy Visteo system and get an Owandy Cam
Intra-Oral camera FREE. Owandy, supported by Velopex
For more information, please contact:
Mark Chapman, Director Sales & Marketing
Mobile: 07734 044877 E-mail: mark@velopex.com

From the launch of the flagship External Implant System (Maestro) in 1997,
to the introduction of the Tapered Internal Implants incorporating Laser-Lok®
technology, BioHorizons has continued to provide clinicians unique products
supported by university-based research.
2010 is set to be even bigger for BioHorizons and will see a number of new
product developments and launches on which information will soon be
released in the UK. For further information on up and coming courses and
BioHorizons’ comprehensive range of implants and regeneration products
please contact the UK office directly on 01344 752560, email: infouk@
biohorizons.com or visit our website at www.biohorizons.com.

Hogies Plus Eyeguards
See the difference
Award-winning protective eyewear from the Hogies range
has always given dental practitioners uncompromised
safety and integrity whilst remaining lightweight and stylish.
Now the Hogies Plus Eyeguard range has been improved with additional
features including:
• Adjustable nosepiece for maximum comfort
• Resilient water repellent coating to protect the lens
• Enhanced scratch, fog and solvent resistance on both sides of the lens.
• Additional Minus Projection for various nasal features
With the ophthalmic-quality polycarbonate lens providing the clear vision
essential for successful treatment, the Hogies Plus range ensures eyes are
protected from harmful flying debris or liquids.
The Hogies Plus nose bridge is made of medical grade silicone, reinforced with
stainless steel, giving it maximum adjustment for comfort and suitability for all
facial characteristics. The Hogies plus Eyeguard gives unrivalled comfort and
optimal airflow to prevent lens fogging. Combined with the range of colours
available to suit all tastes, Hogies Eyeguards remain the ultimate in clinical eye
protection. For more information please call John Jesshop on 07971 128077
or email john.jesshop@blackwellsupplies.co.uk

Nuview at the Sixth Annual BACD
Conference!
Delegates at the 2009 BACD Conference were
delighted with the remarkable technology
available from Nuview, including the OPMI Pico
dental microscope, designed by world leader
Carl Zeiss, and the EyeMag loupes range such as
the EyeMag Smart, with 2.5x magnification and
a choice of working distances.
Nuview delivers an extensive range of equipment solutions, offering a
comprehensive service including:
• In-depth equipment surveys to ascertain the client’s specific needs • Helping
clients find the ideal solution • Installation • Training • Aftercare

December 7-13, 2009

New Year, New Job
As 2010 starts will you be looking for a
change of job? A New Year is a chance to
change many aspects of our lives, and
employment is no different.
Maybe you want to see what jobs are out
there, and don’t want to spend any money!
Wouldn’t it be good if you could post your
CV and details to a website for FREE?
Receive email alerts when a relevant vacancy is listed?
Visit www.practicecity.com and you can post your CV, details and even a video,
absolutely FREE.

List your second-hand equipment for FREE!
If you have second-hand equipment that you no longer need, what is your best
course of action? Advertise? Tell your colleagues?
Why not list it for FREE on www.inventorycircle.com ? You can reach a huge
potential audience in just a few clicks and you only pay anything when you
sell it.
Hundreds of dentists have already registered (for FREE) on the site since it
launched so why not join them?

SIROLaser Advance sets new standards
of user-friendliness and flexibility
Today the SIROLaser Advance offers a fast
and effective way of treating your patients.
With a wide variety of treatments such
as Periodontics, Endodontics as well as
Surgery applications the new diode laser,
due to its precise power setting offers
even greater flexibility than ever before.
The SIROLaser Advance also allows you to
store information about individual users
as well as individual treatment sessions.
Patient data can be easily transferred to
patient records via a convenient USB flash
drive.

And, there are a number of other FREE services including:
The SIROLaser Advance comes ready-to-use, with several preset programs
for common laser applications and an intuitive user interface that allows you
to start taking advantage of its convenient features and small footprint right
away.

• Practice for Sale Listings
• Classified Listings
• Education Listings
• Email Alerts
Visit www.practicecity.com and register your details for FREE today.

DÜRR DENTAL (PRODUCTS) UK
LTD
Dürr Dental really does believe
that ‘good things come in small
packages’ with the launch of
their VistaScan Mini image plate
scanner last month at the NEC. This
miniature unit is simple to use, does
not compromise on image quality
and is extremely compact so that it can be easily sited in even the smallest
surgery. X-Ray and scanning can literally be at arms reach.
VistaScan Mini is priced similarly to a traditional two sensor CCD system (but
offers considerable advantages over this older technology). It is ideal for
smaller or individual practices without an OPG. Ironically, it is also suitable for
large surgeries too, as it obviates the need for the nurse to go out of the room
to process plates.
Ian Pope, Managing Director for Dürr Dental, commented, “The evolution of
VistaScan technology is not dissimilar to that of the mobile phone for those of
us old enough to remember the brick-like Motorola prototypes of the 1990’s.
and proves that big isn’t always beautiful!”
For more information please call without obligation on 01536-526740.

For further information please contact:
Sirona Dental Systems 0845 071 5040
Info@sironadental.co.uk

Takara Belmont
Takara Belmont launched their latest treatment
centre, the Cleo II, at Dental Showcase last month.
This remarkable treatment centre combines
good looks with incredible functionality, not
an easy task when you arguably already have
the most ergonomic treatment centre on the
market. However, even with great beauty there is room for enhancement.
Like all good makeovers, there are many subtle improvements, which
collectively result in an exquisite transformation. The Cleo already boasts
a design of distinction; its’ folding leg rest making it as easy as sitting in an
armchair.
As a society we are obsessed with aesthetics, and Takara Belmont has taken
the opportunity to add a few more ‘finishing touches’ to the latest Cleo model.
A treatment centre is the first thing a patient will see in your surgery and they
are quite likely to judge the practice on what it looks and feels like. Their first
impression of Cleo II will not disappoint.
Enhanced aesthetics can often be at the expense of functionality, reliability
and cost. Takara Belmont is confident that the Cleo II will not disappoint on
any of these accounts.

[27] =>

United Kingdom Edition December 7-13, 2009

Kemdent value the expertise of their customers
Kemdent are currently funding a project to carry
out extensive research into Diamond GIC Dental
materials, with the support of Exeter University
and Bristol Dental School. Kemdent have always
valued the contribution of experienced dentists to
help them research their products.

Christmas Bonanza
In response to popular demand from
Dentists, Kemdent will be repeating their
Christmas Hamper Promotion.

Panadent Minamint ZINC – The Next Generation of Mouth
Rinse arrives
Panadent is pleased to announce the next generation of dental
mouth rinse is launched with the introduction of Minamint Zinc

To enable their customers to receive
a Christmas Hamper, Kemdent are
providing some excellent offers on
their range of Glass Ionomer and Cross
infection control products.

Now all that has changed.
Panadent has managed to engineer a small amount of Zinc into
the formulation for Minamint Zinc Concentrated Mouth Rinse. Zinc in low
concentrations is known to reduce levels of Volatile Sulphur Compounds in
the mouth.

Buy one pack of Diamond 90 or Carve
and receive one pack at half price! Buy 60 Diamond Capsules and receive 20
capsules free! Buy a 5L PracticeSafe refill and receive 1L of InstrumentSafe free!
These are just some of the offers available to Kemdent customers before the
31st December 2009.

By rinsing with Minamint Zinc, patients not only benefit from the fresh clinical
bouquet and freshness provided from original Minamint’s unique high
quality formulation but also will assist to reduce unpleasant odours and taste
associated with dental procedures and poor oral hygiene pre, during and post
procedure

Three sizes of Christmas hampers are available from Kemdent. The more you
spend on Kemdent products in November, the larger the hamper you will
receive:- so take full advantage of the Kemdent special offers by contacting
Helen or Jackie on 01793 770256.

Minamint Zinc is recommended for all dental surgeries as a effective mouth
rinse with additional benefits. Panadent is offering a special introductory trial
offer to let you see the advantages for yourself of buy 2 get 1 free, which brings
the unit price per 100ml bottle to £8.33 + vat each. Call Panadent today at
01689 88 17 88 for details.

For this reason Kemdent are encouraging new customers to evaluate their
Glass Ionomer Capsules by providing them with 5 x A3 Diamond Rapid Set
Capsules and an evaluation form.
The completed evaluation forms will provide a valuable contribution to the
project so Kemdent is offering an added incentive. Completed evaluation
forms will be entered into a monthly prize draw with a chance to win £100.00
of M & S vouchers.
Diamond Rapid Set Capsules are packed in individual, easy to access foils.
Diamond Capsules can be used for class 1, 2 and 5 abrasion cavities- for
additional strength. Diamond’s early snap set creates a waterproof resistance
to moisture and saliva which prevents any expansion of the restoration,
providing a more reliable seal to the cavity wall.
For further information or to place orders call Jackie or Helen on 01793 770256
or visit our website www.kemdent.co.uk.

BACD Study Club: Impression Free Dentistry
The British Academy of Cosmetic Dentistry presents the latest in its series of
Study Club Lectures, to be held at the British Dental Association, London on
Tuesday 26th January 2010.
Entitled ‘Impression Free Dentistry: Are We There Yet?’ Dr Ilan Preiss will explore
how digital impressions can have a significant impact on the way dentists
practise.
The focus is the new 3M Lava Chairside Oral Scanner and the lecture will cover:
• An overview of the technology involved
• Clinical tips for capturing data
• Interpretation of data and communication between dentist and lab
• Clinical cases and photos for onlays, veneers and all ceramic crowns
The lecture will also feature a practical element, allowing attendees to use the
equipment.

For further information on the Christmas hamper promotion or to place orders
call Helen or Jackie on 01793 770256 or visit our website
www.kemdent.co.uk.

PracticeWorks Launches New Way to Improve Oral
Health

Braemar Finance an established direct lender to the profession wish to remind
you that HMRC propose to increase the VAT rate from 01 January 2010, adding
further cost to any purchase. You can save £500 on a £20,000 order provided
the paperwork is processed by then.
There is still time to order your equipment and save some money.
Secondly your HMRC tax bill is due on 31st January 2010. Braemar offer a tax
funding facility to ease the impact on your practice cash flow allowing you
to have your finances in place when your tax bill arrives and avoid HMRC late
payment surcharges.
Whatever your finance requirements Braemar can assist, call us on 01563
852100 where we are available to discuss your finance options.

A company with over 115 years of experience
in infection control, schülke were a source of great interest from dental
professionals keen to learn more about the new range of ‘s4dental’ training
programmes available.
The s4dental in-practice sessions (developed with the BDA, DOH and
COPDEND) and the DVD and on-line training packages all ensure compliance
with the latest regulations HTM 105, and provide a wealth of knowledge and
ideas.
As well as the ongoing work in the European dental industry, schülke are also
doing all they can for the developing world. schülke has been working with
dental and community development charity Bridge2Aid for three years, and
has already helped train two medical staff.
For more information on the training visit www.s4dental.com or contact
Schülke on 0114 2543 500 or visit www.schulke-mayr.co.uk

Improved aesthetics in cases with
compromised bone
A one-day course for implant dentists who
wish to improve the aesthetic outcomes in
cases with compromised bone takes place in
early 2010. Presented jointly by Mark Diamond
and Dan McKenna, the course covers the
latest techniques in oral hard and soft tissue grafting. Full details can be
found on the dental implantology education website www.courses4implants.
com, the new online version of the DENTSPLY Friadent’s Skills Development
Programme for 2010.
The content of the one-day grafting course includes live surgery and problem
solving. According to Dr Dan McKenna, ‘Participants experience handson training in suturing, grafting and vestibuloplasty using pigs’ heads. On
completion, they are able to treat their own patients under expert guidance.’
Booking and further information:
Robert Graham
Tel: 02890 371517
Email: robertgraham@fortwilliamclinic.co.uk
Dates: 22 January 2010
Fortwilliam Clinic, Belfast
26 February 2010
Whiterose Clinic, Londonderry
Fees: £400 per delegate, lunch and refreshments provided
Other Courses: Implantology year programme commencing 15 May 2010

PracticeWorks have always been at the forefront
of innovation, and this year’s display BDTA Dental
Showcase proved no exception. Amongst the range of
impressive devices launched on Stand J05 at the Birmingham NEC between
the 12th and 14th of November was the Oralinsights system.
With improving oral health clearly on the national agenda, the newly launched
Oralinsights was a popular model for delegates visiting the PracticeWorks
team. Its 3D computer-generated imaging will give all dental professionals
access to a useful tool in helping children to develop effective brushing
techniques.
Visitors to the stand were impressed with how easy the system is to use and
the potential it has to help form the brushing habits that will ensure better oral
healthcare in the long term.
With other innovative solutions for today’s dental professionals on display,
PracticeWorks continues to demonstrate its dedication to supporting firstclass oral healthcare.

Places are limited for this event and so booking early is recommended. For
more information or a booking form please contact Suzy Rowlands on 0208
241 8526 or email suzy@bacd.com.

schülke enjoyed a busy event, experiencing a huge
amount of interest in both their brand new training
programmes and infection control methods at this
year’s BDTA Dental Showcase.

For further information on the Christmas hamper promotion or to place orders
call Helen or Jackie on 01793 770256 or visit our website www.kemdent.co.uk.

Practice Finance - OTHERS

Dr Ilan Preiss is a member of the BACD, AACD and ADI. Part of the Bow Lane
Dental Practice since 2002, Ilan won the 2009 Restorative Smile of the Year
Award at the prestigious Smile Awards.

A clean sweep for schülke at BDA Dental
Showcase 2009

Industry News 27

For more information please call PracticeWorks on 0800 169 9692 or visit www.
practiceworks.co.uk

PracticeWorks presents Groundbreaking
Technology at BDTA 2009
PracticeWorks have always been at the
forefront of innovation, and this year
proved no exception. Amongst the range of
impressive devices on display were:

Access to More Patients with Munroe Sutton at
the Sixth Annual BACD Conference
Delegates of the sixth annual BACD at the EICC
in Edinburgh were introduced by Munroe Sutton
to a truly world class Patient Referral Plan to
successfully grow their patient base and encourage
returning clients.

• The newly unveiled Kodak 6500 wireless RVG
sensor is a robust, waterproof device providing the highest image resolution in
the industry. Using wi-fi technology the information can be reviewed on iPod
devices, offering a whole new level of convenience and accessibility.
• Alongside this comes the PEARL Access system, a simple yet powerful mobile
link to the practice, offering real time data handling of patient information and
financial records. Dental professionals liked how it provided access to essential
data whilst away from the practice.
• With oral health on the agenda, OralInsights was a popular model on display,
with its fully interactive, 3D computer-generated imaging allowing children to
develop effective brushing techniques.

The Patient Referral Plan has been developed by
dentists, for dentists, and proven successful in the US for three decades. Now
tailored to the UK market, Munroe Sutton’s outstanding solution lets practices:

With other innovative solutions for today’s dental professionals on display,
PracticeWorks continues to demonstrate its dedication to supporting firstclass oral healthcare. For more information please call PracticeWorks on 0800
169 9692 or visit www.practiceworks.co.uk

• Increase cashflow with payment at time of service
• Reach out to more patients with FREE marketing solutions
• Offer a seamless service with an automated patient verification system
• …and treat MORE patients!
Munroe Sutton was proud to sponsor the 2009 BACD and delighted with
the success of the conference. Delegates to the Munroe Sutton stand
were introduced to the first step towards growing their practice with full
appointment books, cost-effective treatment plans, happy patients and the
support of a world leader in highly effective patient referral plans.
For more information please call 0808 234 3558
or visit www.munroesutton.co.uk

The Complete Smile Academy
Introduction to Implants Day Course Newcastle

The Wand
A significant advancement in pain-free dentistry
Clinically Proven in Practice
• TheWand consistently proves to be more comfortable in providing profound
anaesthesia.
• Fear and anxiety is reduced by up to 80%.
• Out of 50 dentists given a traditional injection and aWand injection, 82%
reported no
pain or minimal pain from TheWand injection.
• Over 90% reduction of topical anaesthetic and NO₂.
• 95% of patients reported no pain.
Many patients believe that the needle insertion is what causes discomfort,
when in fact most of the pain is caused by the flow of the anaesthetic. When
injected too quickly, traditional anaesthetics create a burning sensation.
Experts in anaesthesia agree that a controlled slow rate of injection is ideal.
The patented Wand flow rates are automatically delivered regardless of
tissue density, resulting in an injection experience that is typically below the
threshold of pain.
For more information visit: www.d-p-s.uk.com
Or contact us on: 01438 820550, email: info@d-p-s.uk.com

On the 25th of February and the 21st of July 2010,
the Complete Smile Academy will be offering an
excellent opportunity for dental professionals to
grow their practice by placing implants. The day
course will cover everything you need to know
about giving you
h optimal personalised
aesthetics for all indications and enhanced patient
satisfaction.
The Implant Day Course will incorporate:
• A number of Limited delegates in a fabulous venue • Surgical techniques
• Implant occlusion – getting it right! • Aspects of smile design • Prosthetic
treatment • Predictable restorations • Planning your own cases - a template
for success • Lectures, video, hands-on-training and live cases • 6 hours CPD
Learning the techniques of reducing chair time with one-stage and minimally
invasive surgery, the Implant Day Course will also include hands-on activities
to give you confidence and competence when offering implant treatment
within your practice. Learn, practice, discuss and embrace the world of dental
implants!
For more information call 0191 427 1029 or visit

[28] =>

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[29] =>

United Kingdom Edition December 7-13, 2009

Advertorial 29

Chemical disinfection – an integral part
of endodontic treatment
Endodontic treatment aims to resolve
periapical and radicular periodontitis as
well as intracanal infection caused by microorganisms. This
can be considered
a three part process involving shaping and cleaning the
canal, chemical disinfection and finally
root canal obturation
followed by coronal
restoration of the
tooth.

haping and cleaning involves enlarging the canal in
order to allow for chemical
disinfection. This is an important
next step for ensuring complete
eradication of remaining bacteria,
which will facilitate healing and
help prevent recontamination.
Chemical disinfection involves the use of irrigants to eliminate any remaining pathogens.
It is important to use the correct
irrigant sequence and concentration. A lack of awareness of any
limitations could still result in
endodontic failure and periapical
disease.
For example, the golden
standard irrigant is sodium hypochlorite, often used in conjunction with ETDA. Recently, new
irrigation sequences involving
the addition of other solutions
have proven to raise predictability rates.
Canals can have complex
internal anatomy with various
fins and cul-de-sacs so it is also
important to use energising techniques. These techniques will
help loosen adhesion of biofilm to
the dentinal substrate.
It is also important to remember that killing endodontic pathogens present in teeth is more difficult than in laboratory exercises.
A new MSc in Endodontics
The University of Warwick will
launch a new MSc in Endodontics in January 2010. The programme will be delivered by
leading professionals, academics
and researchers in the field of endodontic dentistry, and supported
by respected academics from the
field of continuing professional
development.
As a part-time course, it has
been designed to offer a flexible

training pathway tailored to individual requirements and circumstances. The programme will
allow students to improve and
increase the scope of endodontic treatment in their practices
through the study of a wide range

of topics, such as tooth morphology, mechanical shaping, chemical disinfection and pain management in endodontics.
Learning will take place
through traditional seminars and

practical work, performed in labs
and at regional training centres.
Students will gain a thorough
understanding of modern technologies, using materials and
instruments such as surgical microscopes and cone beam CT.

Applications are being accepted now and further information
about the course can be found at
www.warwick.ac.uk/go/dentistry.

[30] =>

30 Events

United Kingdom Edition

December 7-13, 2009

A BADN do to remember
The 2009 National Dental Nursing Conference, held at the Cheltenham Chase Hotel
in October was the biggest and most successful to date

T

and Philips Sonicare. As well
his
year’s
BADN
as the opportunity to network,
conference saw a record
delegates watched as outnumber of delegates in
going President Angie McBain
attendance at the event sponhanded over the Chain of
sored by the British Dental
a4_ad_doormat_uk_20oct.pdf
20/10/09
Office 13:36:59
to Sue Bruckel who beTrade Association, NHS Direct

came BADN’s 2009 to 2011
President at the Opening
Ceremony, and listened to a
presentation from keynote
speaker GDC President Hew
Mathewson.

The lecture programme,
which offered up to seven hours
of verifiable CPD, covered crossinfection control, introducing
preventive practice, law and ethics, back care for dental nurses,

risk assessment, prosthetics,
oral and maxillofacial surgery,
implants, medical emergencies
and resuscitation, the new BSC
for DCPs, forensic dentistry and
accessibility for people with

‘delegates watched
as outgoing President Angie McBain
handed over the
Chain of Office to
Sue Bruckel’

learning disabilities. Delegates
were able to choose which presentations they wished to attend
in advance, through BADN’s
new CVENT online registration
facility. Schuelke, Colgate, WR
Berkley, the British Chiropractic Association, Nobel Biocare,
Philips Sonicare, the University
of Kent, Gloucestershire PCT
and the 2gether NHS Foundation
Trust provided speakers.
Extra curricular activities
Outside the lecture theatre,
delegates were able to talk to
representatives of NHS Direct,
the General Dental Council
and Parliament Hill, providers
of the BADN Benefits Scheme.
At lunch, delegates were
treated to a selection of specially chosen British cheeses,
courtesy of the British Cheese
Board.
Master of Ceremonies at
the black tie Presidential Dinner was Peterborough GDP
Martin Fallowfield. Entertainment was provided by swing
tribute act Swing Thru a Lens,
whose repertoire of rat pack
classics and modern swing
favourites proved a big hit
with delegates.
At the Closing Ceremony,
sponsored by Philips Sonicare,
President Sue Bruckel presented four new BADN Fellows with
their certificates, introduced
new members and first-time
delegates and congratulated
delegates on recent qualifications and achievements.
Photos, taken by local photographer Sally Burford, will be
available shortly on the BADN
website and the BADN Facebook Group.
Next year’s National Dental Nursing Conference will be
held at the Blackpool Hilton on
26 and 27 November 2010. DT

[31] =>

Classified 31

United Kingdom Edition December 7-13, 2009

STAND K02

Look after your body,
you’ve nowhere else to live

Geoff Long
2010

Poor posture is a major cause of pain and tiredness
for many professionals. It needn’t be...
Research has shown that the Bambach Saddle Seat
makes a real difference to posture, resulting in more
comfort and fewer aches and pains. Try it for yourself.
After all, prevention is better than cure.

Tax Planning Slate
Now Available!

Freephone 0800 581108. www.bambach.co.uk
The Bambach Saddle Seat, Prospect Business Park, Langston Road, Loughton, Essex. IG10 3TQ

Dental Tribune.indd 1

office@dentax.biz

15/10/2009 17:55

Something to
Smile about!...

SmileGuard is part of the OPRO Group, internationally renowned for revolutionising the
world of custom-fitting mouthguards. Our task is to support the dental professional with
the very latest and best oral protection and thermoformed products available today.

Custom-fitting Mouthguards* – the best protection for teeth
against sporting oro-facial injuries and concussion.
OPROshield – a self-fit guard enabling patients
to play sport whilst awaiting their custom–fit guard.
NightGuards – the most comfortable and effective way
to protect teeth from bruxism.

Untitled-4 1

Bleaching Trays – the simplest and best method for
whitening teeth.
Snoreguards – snugly fitting appliances to
reduce or eradicate snoring.
OPROrefresh – mouthguard and tray
cleaning tablets.

In 2007, OPRO was granted the UK's most prestigious business award,
the Queen's Award in recognition of outstanding innovation.

CONTACT US NOW!
OPRO Ltd, A1(M) Business Centre, 151 Dixons Hill Road,
Welham Green, Hatfield, Herts. AL9 7JE

www.smileguard.co.uk
email info@smileguard.co.uk or call 01707 251252

part of the oprogroup

* SmileGuard - the first to provide independent certification relating to
EC Directive 89/686/EEC and CE marking for mouthguards.

7320_09_3

mouthguard and tray
cleaning tablets

FCA

19/10/09 17:03:31

Call 01438 7222242

[32] =>

36

1.1
Enamel SMH recovery (%)

Plaque removed (Turesky)

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

35
34
33
32
31
30

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

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

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

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

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

0

30

60

90

120

150

200

180

210

Brushing time (seconds)

Enamel SMH recovery (%)

Plaque removed Enamel
(Turesky)SMH recovery (%)

35 cantly increases plaque removal
Signiﬁ

35
34
33
32
31
30
29

0

50

100

150

200

Brushing time (seconds)

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

3

Enamel SMH recovery (%)

36
35

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

34
33
32
31
30
29

0

50

100

150

200

Brushing time (seconds)

* p<0.05

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

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[cover] => DT UK 3009

[toc] => Array ( [0] => Array ( [title] => ‘Tide is turning’ says CDO after latest NHS IC statistics [page] => 01 ) [1] => Array ( [title] => News [page] => 02 ) [2] => Array ( [title] => Sustainable service piloted for the homeless [page] => 06 ) [3] => Array ( [title] => News & Opinions [page] => 07 ) [4] => Array ( [title] => GDPUK round-up [page] => 08 ) [5] => Array ( [title] => Dealing with stress in the 21st century - a perspective for the dental profession [page] => 09 ) [6] => Array ( [title] => Access over quality? [page] => 11 ) [7] => Array ( [title] => Cross-infection collapse? [page] => 12 ) [8] => Array ( [title] => Streamlining operations [page] => 14 ) [9] => Array ( [title] => The 10th Dimension… the power of 10 [page] => 16 ) [10] => Array ( [title] => A good team is for life - not just Christmas [page] => 17 ) [11] => Array ( [title] => First-time sellers - seeking the right advice [page] => 19 ) [12] => Array ( [title] => Immediate single-tooth replacement and provisionalisation in the aesthetic zone [page] => 20 ) [13] => Array ( [title] => Learning Curve [page] => 23 ) [14] => Array ( [title] => Pride of dentistry in rural Devon [page] => 24 ) [15] => Array ( [title] => Industry News [page] => 26 ) [16] => Array ( [title] => Chemical disinfection – an integral part of endodontic treatment [page] => 29 ) [17] => Array ( [title] => A BADN do to remember [page] => 30 ) ) [toc_html] =>

Table of contents

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