News / Clinical Innovations Conference 2012 / No longer a sensitive subject: Eric Peterson discusses sensitivity and whitening / Infection Control Tribune / Treatment of gingival hyperpigmentation / Why improving your practice is a mystery – part nine / The art of listening: Mhari Coxon discusses how using your ears can lead to success / Infection control / Industry News / Dental Tribune UK Editorial Board / Classified
News
01 - 10 viewClinical Innovations Conference 2012
02 - 05 viewNo longer a sensitive subject: Eric Peterson discusses sensitivity and whitening
11 - 12 viewInfection Control Tribune
13 - 21 viewTreatment of gingival hyperpigmentation
22 - 23 viewWhy improving your practice is a mystery – part nine
24 - 25 viewThe art of listening: Mhari Coxon discusses how using your ears can lead to success
26 - 27 viewInfection control
28 - 28 viewIndustry News
29 - 29 viewDental Tribune UK Editorial Board
30 - 30 viewClassified
31 - 31 viewArray
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[1] =>
June 4 -10, 2012
PUBLISHED IN LONDON
News in Brief
www.dental-tribune.co.uk
STOP PRESS
Clinical Innovations
Conference 2012
Ground-breaking
event in London
See pages 2-5 for
further details
Infection control
Drawing the line
Clean and safe
GP’s refuse CQC fees
Dr Zimmerman discusses
the meaning of sterile
page 6
pages 16-18
Clinical
DCPs
The art of listening
Hyperpigmentation
Mhari Coxon discusses
listening techniques
Using the diode laser
pages 22-23
pages 25-27
Satisfied, but not enough
Office of Fair Trading (OFT) report makes recommendations to free
patients from restriction of dentist referral
E
vidence gathered in the
recent Office of Fair
Trading report, has suggested “that dental patients are
largely satisfied with the services provided by their dentist.”
However, the report has also
highlighted some areas for improvement.
The OFT study found that
patients have insufficient information to make informed decisions about their choice of dentist and the dental treatments
they receive; it also stated the
complexity of the complaints
process for patients, instances
of potential pressure selling
by dentists of dental payment
plans and the need for accurate and timely information for
patients. The OFT is calling on
NHS commissioning bodies, the
General Dental Council and the
Care Quality Commission to be
proactive in enforcing existing
rules which require dentists
and dental practices to provide
timely, clear and accurate information to patients about prices
and available dental treatments.
The report also raised sufficient concerns about continued
restrictions preventing patients
from directly accessing dental
care professionals, such as hygienists, without a referral from
a dentist. The report considered
these restrictions to be highly
unjustified, and the OFT have
responded by urging the General Dental Council (GDC) to
remove restrictions preventing
patients from making appointments to see dental hygienists,
dental therapists and clinical
dental technicians directly, as
soon as possible.
The OFT report also high-
lighted concerns with the current NHS dental contracts in
England and stated how it is extremely difficult for new dental
practices to be established and
how successful dental practices, which offer a higher quality of service to NHS patients,
are prevented from expanding.
As a result, the OFT has urged
the Department of Health to redesign the NHS dental contract
to facilitate easier entry into the
market by new dental practices
and allow successful practices
to expand.
said: “Where patients do have
concerns about their care, it is
clearly important that they have
an effective complaints process.
This is helpful for dentists and
patients alike and dentists support the goal of making the process as simple as possible.
“Also crucial is the development of a new dental contract
which is already under way in
England. In piloting and designing those new arrangements
Government must ensure that it
provides clarity about what the
NHS offers and properly supports practitioners in providing
the kind of modern, preventive
care that our patients deserve.”
Dr Nigel Carter Chief Executive of the British Dental Health
Foundation (BDHF) said in
response to the OFT report:
“Whilst we welcome the report
and the fact it recognises the
need for change in certain areas, some of the findings are
DT page 6
John Fingleton, OFT Chief
Executive said: “Our study has
raised significant concerns
about the UK dentistry market
which need to be tackled quickly in the interest of patients. All
too often patients lack access
to the information they need,
for example when choosing a
dentist or when getting dental
treatment. We also unearthed
evidence that some patients
may be receiving deliberately
inaccurate information about
their entitlement to NHS dental treatment, and we expect to
see robust action taken against
such potential misconduct by
dentists.
“This study has also highlighted that the current NHS
dental contract in England may
well not be working in the best
interests of patients, and that
regulations unjustifiably restrict
patients from getting direct access to dental care professionals
like hygienists. Reform in both
these areas is needed without
delay.”
In response to the report,
Dr Susie Sanderson, Chair of
the BDA’s Executive Board,
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Patient swallows toothbrush
A recent report has told how
a 24-year-old was repeatedly
turned away by doctors as
she tried to convince them
that she had swallowed her
9 1/2-inch toothbrush. According to reports, it took
two visits to two separate
hospitals in northern Israel
before Bat-El Panker, 24, of
Kiryat Yam, was able to convince a doctor that she had in
fact accidentally swallowed
her green, white and orange
toothbrush while brushing her teeth. The report
said that the toothbrush had
slipped down her throat as
she bent over to drink some
water whilst the brush was
still in her mouth. According to reports, the plastic
toothbrush did not show up
on X-rays, which lead doctors at the first hospital to
send her home. “I begged
for another exam. I knew I’d
swallowed a big toothbrush,
but no one believed me,” she
was quoted in one report.
“They thought I was crazy.”
Eventually doctors at Carmel Hospital believed her,
however the toothbrush still
failed to show on an X-ray or
ultrasound. The toothbrush
was finally located it in her
stomach thanks to a sophisticated CT scan, and doctors were able to remove the
toothbrush without resorting
to surgery by coaxing it up
the oesophagus with a diagnostic endoscope.
News
VOL. 6 NO. 15
[2] =>
2 CIC 2012
United Kingdom Edition
June 4-10, 2012
From strength to strength –
Clinical Innovations Conference 2012
The ninth annual Clinical Innovations Conference has been hailed a ‘fantastic success’
from delegates and organisers alike. Dental Tribune was there...
tistry has a far smaller range
of tests to use when diagnosing a patient’s complaint. In
fact, the only truly objective
test is an X-Ray. This is not
however, a totally reliable
tool, as its limitations can affect the results shown. If an XRay does not show a specific
problem that does not necessarily mean there is nothing
wrong – if a lesion for example is limited to cancellous
bone, an X-Ray will not show
it at all.
Delegates and exhibitors mingle
T
he Clinical Innovations Conference 2012,
organised by Smile-on
and the AOG and in association with The Dental Directory, was a fantastic success,
boasting world-class speakers, cutting edge topics and
practical advice for the many
dental professionals in attendance.
Held last month at the Millennium Gloucester Hotel in
London, the event saw more
than 400 visitors from across
the country come together for
the two-day event.
As befits one of the leading aesthetic and restorative
conferences held in the UK,
delegates were able to expand
and develop their understanding of ideas and techniques
with help from some of the
top names in the field. For the
first time, the event included a
London Deanery DFT Conference, running alongside the
Clinical Innovations Conference, providing more variety
and attracting a number of additional practitioners.
The event began on the
Friday, with world-renowned
Dr Nasser Barghi speaking on
‘All-Ceramic and CAD/CAM
Restorations in 2012: Clinical
Steps’, to a highly attentive
audience. Always a popular
speaker, Dr Barghi’s look at
restorative materials and the
best indication for each was
both practical and entertaining.
After the coffee break
the conference split into two
streams; Dr Wyman Chan
and Dr Anthony Roberts. Dr
Chan gave a lecture on ‘Modern Bleaching Techniques’. As
a dedicated tooth-whitening
dentist, Dr Chan focussed on
bleaching techniques and the
science behind the products
he uses, as well as running a
live demonstration alongside
his lecture, with his dental
nurse.
Simultaneously,
Anthony
Roberts spoke about ‘The
Periodontal Jigsaw: Putting
it all Together’. Looking at
what a measure of success in
periodontal treatment might
mean for both clinicians and
patients, Dr Roberts discussed
BPE charting and the journey of diagnosis. He also explained the clinician’s role as
motivator, communicator and
educator in addition to their
clinical capacity for the best
treatment for patients.
In effect, an X-Ray gives
a ‘shadow’ of the tooth structure, so a 2nd and 3rd dimension is needed for an accurate
diagnosis. The Limited Volume Cone Beam Computed
Tomography (CBCT) gives
this, and allows for a reliable
and
immediate
diagnosis;
preventing the possibility of
working on the wrong tooth
and causing more problems
than existed originally.
Nasser Barghi, Mhari Coxon and Fraser McCord then
separated the conference into
three streams, speaking on
‘Bonded All Ceramic Restorations in 2012’, ‘Effective Biofilm Management’ and ‘Diagnosis of Complete Denture
Problems’ respectively.
Fraser McCord took over
the lectures to discuss the
best techniques for diagnosing problems with complete
dentures. He was quick to establish five main areas where
problems arise:
• Support (resistance to movement towards the tissues)
• Retention (resistance to
movement away from the tissues)
• Stability (resistance to movement by horizontal forces)
• Appearance
• Miscellaneous
‘Visitors were able
to expand and
develop their
understanding of
ideas and
techniques with
help from some of
the top names in
the field’
To diagnose each, Dr McCord recommended a handson approach, tracing the dentures while in the patients’
mouths to find where problems could be occurring.
Dr McCord concluded his
lecture with a few pointers
to aid success with complete
dentures. The first was that
practitioners should ensure
they use the suitable diagnostic treatment with confidence
and competency. Patients’
expectations should also be
kept realistic and the dentures
should be age appropriate,
helping them to look as natural as possible. Finally, good
communication with the tech-
The afternoon continued
the high standard of speakers,
with Richard Kahan giving an
enthusiastic talk on ‘New Horizons in Endodontic Diagnosis and Treatment Planning’.
Innovation in practice
Comparing the dental and
medical industries, Richard
highlighted the issue that den-
Visitors receive their passes and day programmes
[3] =>
United Kingdom Edition
of dentist-turned-magician Dr
Raj Rattan and fantastic company. As part of the evening,
the brand new Clinical Innovations Award was launched,
designed to showcase the
best, most innovative products
currently on the market (see
pages 4&5 about the award).
Dinner was then followed by
dancing and a fabulous party
into the night.
The morning after the
night before is always a tough
start, but with speakers such
as Basil Mizrahi and Ajay
Kakar to look forward to delegates were fired up for the
Saturday programme.
Dr Nasser Barghi presents his lecture
Dr Mizrahi discussed ‘Clinical Tips and Techniques to
improve the aesthetic and
biochemical precision of your
dentistry’. A very practicalbased lecture, Dr Mizrahi
looked at ways to make the
preparation of teeth easier;
from the use of loupes for better vision to the type of handpiece used for prepping teeth.
Various issues surrounding
restorations were discussed;
from dealing with microleakage to the problem of bonding
to dentine.
Dr Wyman Chan during his live demonstration
nician is of huge benefit, particularly when dentures need
manufacturing or adjusting.
Mhari Coxon followed on
from Dr Roberts’ presentation
of the morning with a look at
biofilm management. Giving
an update on recent research
into biofilm, Ms Coxon illustrated the four stages of biofilm development and showed
3-D images of biofilm in its
various stages of attachment,
growth, maturity and dispersal. She then went on to discuss the methods of removing
biofilm and the evidence to
support their use.
The first day concluded with Professor Gianluca
Gambarini lecturing on ‘3D
Endodontics: Concepts and
Techniques’. Discussing the
benefits of cone beam technology, he illustrated the importance of working with 3D
images to diagnose patients’
complaints.
Professor Gambarini then
looked at techniques to treat
a variety of complicated endodontic problems. As a great
believer that the ‘Anatomy
dictates instrumentation’, he
showed that success of endodontic treatment can only be
achieved if the most appropri-
ate tools and techniques are
adopted for each case.
The London Deanery DFT
Conference was for London
Deanery Foundation dentist
attendees only, and proved
to be a popular addition. The
exciting new programme featured captivating lectures
from Richard Kahan, Nasser
Barghi, Martyn Cobourne,
Stephen Henderson and Dr
Wyman Chan.
‘The London
Deanery DFT
Conference proved
to be a popular
edition’
In the evening, the event
hosted its third annual Charity Ball, where hundreds of
delegates dressed to impress.
Attendees were greeted by a
champagne reception, and
were able to relax and enjoy a
sumptuous three-course meal,
live entertainment in the form
CIC 2012 3
June 4-10, 2012
As the Conference split
into three sessions again, Professor Gambarini returned to
speak about ‘Improving Root
Canal Preparation and Obturation’. Simultaneously, Ajay
Kakar lectured on ‘Non Surgical Management of Periodontal Disease’, Sandeep Senghera discussed ‘Treating Your
Patients and Business to the
Latest in Technology’ and Dr
Nasser Barghi spoke about
‘CAD/CAM Zirconia’ to MSc
students.
Dr Senghera’s presentation was a practical look at
marketing your practice to
new and existing patients using the technology that many
use daily in their personal
lives – smartphones, social
media etc. Likening the patient base to a bath with water
running in and draining out,
he emphasised the need to
ensure patients are retained
with smart recall processes
and timesaving strategies for
patients such as online appointment booking.
popular lecture on Bonding
from the previous day, while
Dr McCord’s lecture was ‘An
Update on Impression Techniques for Complete Dentures’.
Dr Nilesh Parmar looked
at ‘Dentistry in the 3rd Dimension’. Discussing the clinical
applications for CBCT in various branches of dentistry, Dr
Parmar used many case examples using the technology to illustrate how, in his words, it
‘changed my working life’.
The Clinical Innovations
Conference 2012 came to a
close on the Saturday afternoon, with Dr Amit Patel
speaking on ‘Peri-implantitis
– a Future Timebomb’. With
the growing trend of placing
dental implants, cases of periimplantitis and peri-mucositis
will inevitably increase.
Dr Patel discussed the
process of the inflammation
and the reasons for it, looking at prosthesis design. He
discussed his preferences for
One of the many strengths
of the Clinical Innovations
Conference is that it combines lectures with live workshops, demonstrations and
a trade exhibition, to cater
to practitioners’ every need.
Between lectures, delegates
were able to browse the exhibition stands, accessing some
of the latest technologies in
the world of aesthetic and
restorative dentistry, and put
their questions directly to the
experts at each company.
Feedback from the event
has been fantastic, with many
delegates already penning the
2013 date in their diary. next
year’s event, the tenth anniversary of the Clinical Innovations Conference, will be held
17-18th May 2013. See you
there! DT
Noam Tamir and Ajay Kakar with guests at the AOG ball
Well done to the Smile-on team
John Moore then took
over the speaking to explore
‘Digital Dentistry and the Advantages for Cosmetic Treatments’. Primarily discussing
how his practice is using the
CEREC system to their advantage, Dr Moore showed how
clinicians can use CAD/CAM
in their practices to fulfil patients’ requirements.
Dr Barghi returned again
in the afternoon to repeat his
screw-retained
restorations
and looked at therapies for
managing the inflammation.
Guests party the night away at the AOG ball
[4] =>
4 CIC 2012
United Kingdom Edition
June 4-10, 2012
Rewarding innovation
Dental Tribune looks at the first Clinical Innovation Award finalists
T
he first ever Clinical
Innovations Award, a
fantastic new prize designed to showcase the best,
most innovative products on the
market today, was held this year
at the Clinical Innovations Con-
ference Charity Ball.
The Clinical Innovations
Conference, now in its ninth
year, has become one of the
leading conferences in aesthetic and restorative dentistry
in the UK. The conference itself brings together top international thinkers who present
the very latest developments
in dentistry.
In keeping with the theme
of the lectures, these conferences have become the backdrop for companies to expose
the genius of their innovative
products. Smile-on and the
AOG invited the dental industry
to nominate their most innova-
tive product to be judged by a
panel of experts.
There was a fantastic range
of entries, some of which were
described as “breathtakingly
brilliant”, others of which were
defined as “superbly practical”;
all were distinguished as having innovation at the heart of
their solutions.
The judging panel consisted
of a number of esteemed dental
professionals, as well as members of a number of key journal
editorial boards. As the award
ceremony got underway, the
judges were keen to comment
on the variety and excellence
of all the products short-listed, which had given the panel
“great admiration” for all the
companies involved. With such
a strong short-list, picking a
final three was tough, and the
judges were particularly interested to examine innovation for
dentistry as a profession – not
just in the product itself.
With such a strong line-up
of potential winners, the winner of the inaugural Clinical
Innovations Award really had
to stand out above the rest and
after much careful deliberation, Dean of the London Deanery Mrs Elizabeth Jones announced the winners.
The winner was the Morita
Veraviewepocs 3D R100 XRay machine and according
to the judges it was a cut above
the rest:
“This is an amazing development. No one thought anyone could achieve it. The field
of vision in the right trough
providing accurate information has been almost impossible
with rotational devices. This is
a technological breakthrough
of increasing an 80mm diameter cylindrical field of vision to
100mm triangulated field of vision – to simulate the shape of
the triangulated mandible, now
includes the missing anatomy
without exposing other tissue.
This improves accurate detailing and will enhance patient
safety when diagnosis and treatment planning is undertaken.”
Launched in March 2012
the Veraviewepocs 3D R100 is
the latest model in the Veraviewepocs 3D series of combination panoramic, ceph & cone
beam CT devices. It re-defines
the concept of 3D imaging with
a unique Reuleaux Triangular
FOV which more accurately
matches the shape of the patients’ jaw. The R100 FOV in-
[5] =>
United Kingdom Edition
This new innovation allows direct visual identification of the
caries-infected areas, thereby
enabling selective treatment
during caries excavation due to
the ease of detecting the caries.
Proface enables simple identification of the extent of a carious
lesion allowing the clinician to
ensure that subsequent excavation is minimally invasive and
leaves healthy tooth structure
intact. It also allows the clinician the confidence of knowing
that they have eradicated the
entire caries.
The commended award
went to NSK S-MAX PICO
HANDPIECE. In the modern
era of micro cutting and magnification, this handpiece reduces
the size of its head to allow wider visibility and better access
to the posterior regions of the
mouth where mouth opening
is restricted, or in children and
patients where mouth opening is limited. This handpiece
has the smallest neck and head
size yet developed in dentistry
and the NSK’s S-Max pico ultramini turbine has been specifically developed for minimally
invasive (MI) procedures. The
technical specification of this
handpiece’s cutting ability for
such a small head is impressive. This is minimalistic functional art in action.
Finalists for the award were:
- The Carestream CS7600, the
world’s first Intelligent Image
Plate System
- COMPONEER from Coltène/
Whaledent, Direct Composite
Shells that represent a completely new class of veneers
- Tri Plaque ID Gel from GC
UK, a gel that allows you and
your patient to identify areas of
plaque in three easy steps
- Propoints from Smart Seal,
nology.”
- A piezo scaler developed by Tigon+ W&H that provides the patient with temperature-controlled
irrigant spray thus avoiding irritation, even for sensitive teeth
Smile-on and the AOG would
like to congratulate all the winners of the Clinical Innovations
Award, and would like to thank
everyone who helped make
the Clinical Innovations Conference such a resounding
success. DT
Rob Pounds receives his award
Give your patients the freedom to book
their own appointments
Practice Management Software
The highly commended
award went to W&H with its
entry the Proface light probe.
Despite all the years of research
in the field, detecting caries remains difficult. Where previous
caries detection devices have
generally been chemical based
leaving stains, the Proface
light probe was commended
for its innovative approach that,
while not perfect, provides the
right approach to ‘evidence’ in
knowing when to stop treating.
the only obturation product to use
hydrophilic polymers which absorb water and expand laterally
within the root canal, creating a
3D mechanical seal
- TEPE Angle from TePe, designed to provide improved access and cleaning. A TePe Angle
clip strip also offers a novel way of
displaying the entire range in dental practices
- The Nano Water Flosser with
the Plaque from Waterpik, which
has been described as the “pinnacle of modern Water Flosser tech-
R4
cludes relevant anatomy that
would be imaged with a 100mm
circular diameter cross section
but excludes irrelevant tissues
outside the jawline. Not only
was it previously considered
impossible to achieve anything
other than a circular cross section, but by achieving this, the
X-ray dose to the patient is
comparatively lower by around
15 per cent. With such powerful
implications for enhanced patient safety, the R100 is the deserving winner of the first ever
Clinical Innovations Award.
CIC 2012 5
June 4-10, 2012
GIVES YOU MORE
Online Patient Appointment Booking allows patients to book appointments online, whenever they want to, or
need to, even out of normal surgery hours.
While this makes it very convenient for your patients, you still have complete control over who can make the
bookings, the types they can book, with who and when.
A quick glance will tell you when an appointment has been made so that you are
able to accept, refuse or adjust any request.
This gives your patients greater accessibility to you and your colleagues with
increased feelings of inclusivity and you’ll have fewer missed appointments.
• From a Laptop
• From an iPad
• From a Smartphone
For more information or to place an order
please call 0800 169 9692
email sales.uk.csd@carestream.com
or visit www.carestreamdental.co.uk
© Carestream Dental Ltd., 2012.
f eat ures o f r4
R4 Mobile
Direct link to PIN pad
Patient Check-in Kiosk
Care Pathways
Communicator
Steritrak
E-Forms
Patient Journey
on-line appointment Booking
Text Message and Email reminders
Clinical Notes
Appointment Book
Digital X-Ray
Managed Service
Practice Accounts
[6] =>
6 News
ß
DT continued from page
United Kingdom Edition
June 4-10, 2012
1
flawed and out of date. The
Steele Review, which was commissioned by the last government, has already addressed
the concerns raised around the
2006 NHS Contracts and a replacement proposal is already
being piloted. The results of
this will be used to help shape
the future of the way NHS dentistry is delivered.
“The recommendation for
the GDC to require that private practices display a pricing
structure is irrelevant. A dentist should provide a patient
with a treatment plan, and as
each patient’s plan is different,
fixed pricing will lead to confusion and the possibility of disappointed patient expectations.
“The report suggests that
patients should be given direct
access to dental hygienist and
therapists.
And whilst supporting this recommendation,
as we believe it may facilitate
better understanding of oral
health and encourage new patients and more referrals to the
dentist, it must be done under
caution.
“This report should not be
taken as cure-all for the future
of dentistry in the UK and if
taken in isolation it does not deliver a satisfactory solution for
the patients or the dental health
profession. The findings of the
OFT report need to be included
and reviewed as a part of the
education, research and change
which needs to happen to deliver the best quality dental care.”
David Worskett, Chair of the
Association of Dental Groups
(ADG) said: “The Association
of Dental Groups, which repre-
sents the larger corporate providers of dentistry and Dental
Groups, welcomes the OFT’s
market study of dentistry in the
UK and supports many of its key
conclusions.
“In particular, ADG members, who account for some 10
per cent of NHS dentistry, support provision of clearer pricing
information and are pleased to
have been able to reach agreement with the OFT on ways of
extending and improving this.
“The ADG supports the
OFT’s emphasis on choice and
competition in dentistry. Members welcome the emphasis in
the report on improving entry
to the market for new providers and the support the OFT
gives to increasing tendering.
Long–term contracts facilitate
investment and continuity of pa-
tient care but must not prevent
commissioners from tackling
poor quality. The OFT’s recommendations to the sector and to
the Department of Health have
the potential to improve quality for patients and help to drive
up standards, particularly when
taken in conjunction with the
new NHS dental contract, which
addresses many of the worst
problems identified by the OFT
in the current arrangements.
“Clinical opinion in the UK
remains divided over the issue
of direct access to some dental
services and the ADG believes
that it is clinical considerations
that should determine whether
to go down this route. The ADG
therefore awaits with interest
the work already being undertaken by the GDC on this.
proper practices are driven out
of UK dentistry and the OFT is
completely right to draw attention to the worst types of abuse.
ADG members already have
very high standards of clinical and corporate governance
designed to prevent abuse and
protect patients.
“However it is welcome
news that the level of abusive
practices is put into perspective by the very high levels of
patient satisfaction and in
practice there is already considerable choice and competition on the high street,
bringing real benefits to patients. The ADG agrees with
the OFT that the overall
assessment of the market
does not require or justify a
referral to the Competition
Commission.” DT
“It is of course vital that im-
GPs draw the line at CQC reg fee payment
A
ccording to a recent report, it has been agreed
by the local medical
committee’s conference that GP
practices should not have to pay
for CQC (Care Quality Commission) registration.
North Yorkshire GP Brian
McGregor said in the report that
GP practices were “already subjected to oversight from 28 organisations and the CQC would
become the twenty-ninth as of
next April.”
which GP practices to inspect
and reiterated its belief that registration was a bridge too far. DT
Dr McGregor won support
for his demand that registration
should not impose any expense
on practices.
practice to become a stark environment, “with plastic flooring
replacing carpet in a bid to meet
CQC standards.”
According to the report, the
conference called on the CQC to
use transparent and evidencebased criteria when deciding
He said: “It’s a bit like medieval times, giving a piece of silver to the axe-man to ensure the
sweep was sure. The ultimate
cost of registration should not
fall on GPs.”
GPC contracts and regulation subcommittee chair John
Canning reportedly said it was
‘claptrap’ that GP practices will
have to replace carpets and that
when CQC begins consulting
fees for CQC registration, GPs
and local medical committees
should respond by telling them
exactly what they think.
It has been agreed that GP’s should be spared the fee to register with CQC
The report also quoted
Gloucestershire GP Steve Alvis,
who said he did not want his GP
All smiles as professor scoops Dentist to clean
Lifetime Achievement Award shark’s teeth
T
he former dean of
Dundee Dental School
and chair of the Dental
Schools Council, Professor William Saunders has received the
first ever Scottish Dental Lifetime Achievement Award paying tribute to his commitment to
the dental industry in Scotland.
Professor Saunders has made
a substantial contribution to
dentistry in Scotland over many
years and has been pivotal in the
development of undergraduate
and postgraduate teaching. He
also sits as a council member of
the Royal College of Surgeons of
Edinburgh.
Four of Scotland’s top dental
professionals were nominated
for the award - Professor Saunders was up against Dr Graham
McKirdy from Glasgow, Edinburgh’s Dr Jim Rennie CBE and
Dr Hew Mathewson CBE. Fellow industry professionals voted
online making Professor Saunders the clear winner.
He received the accolade at
an evening drinks reception during the inaugural Scottish Dental Show at Glasgow’s Hampden
Park on Thursday 24 May. BBC
sports pundit Chick Young, who
entertained guests with dental
tales and football anecdotes, presented the trophy.
Bruce Oxley, editor of Scottish Dental magazine, organisers of the Scottish Dental Show
and Scottish Dental Lifetime
Achievement Award 2012, said:
“Professor Saunders fellow professionals admired his continued
commitment and his exceptional
academic work making him a
worthy winner of the first Scottish Dental Lifetime Achievement Award.
“Employing
more
than
10,000 professionals in Scotland,
R
dentistry is a significant industry
and Professor Saunders influential work can ensure that the
country continues to produce
the very finest graduates.”
ichard
Howarth,
a
45-year-old dentist from
Smile Style Dental, is taking up a fund-raising challenge
to dive in a shark-infested tank!
The award was one of the
highlights of the Scottish Dental
Show, where more than 100 exhibitors representing the cream
of the UK dental trade have been
showcasing the latest innovations, product developments,
services and launches.
Richard, who has been invited to do the charity event at the
Blue Planet Aquarium, Manchester, will be cleaning the teeth of
a shark named Storm, an 11.5ft
Sand Tiger Shark who weighs in
at a staggering 30 stone!
Created by the Connect Publications a subsidiary of Scotland’s largest contract publisher
Connect Communications and
the publishers of Scottish Dental magazine, the free event is
providing up to 12 hours of verifiable CPD through speaker sessions and hands-on workshops.
The Minister for Public Health,
Michael Matheson MSP officially
opened the show. DT
For the challenge Richard,
who is taking specialist training
before spending half an hour in
the chilly shark infested tank,
will be equipped with a toothbrush so he can clean Storm’s 46
razor-like teeth!
Richard hopes to raise £2,000
through this challenge for the
charity Dental Mavericks and
their work to end the daily dental pain for Moroccan kids. The
money will help buy a solar
powered dental chair so that
more conventional dental care
can be provided rather than just
extractions and fillings for the
charity Dental Mavericks and
their work to end the daily dental pain for Moroccan kids.
Richard Howarth, who is a
member of the Dental Mavericks
Charity, is travelling to Morocco
in September for eight days to
treat children in severe dental
pain with no access to dental
care. Richard said: “The idea for
this crazy dive came from a patient of mine. I think they find it
funny that I spend my life helping patients who are anxious
and fearful. And for me to immerse myself in the tank then
the tables would be turned.”
Richard has been invited to
do the charity event at the Blue
Planet Aquarium, Manchester
from 1:00pm to 1:30pm on 8
June 2012. DT
[7] =>
United Kingdom Edition
Editorial comment
The news today has
been dominated by the
Office of Fair Trading’s
report into dentistry
and the recommendations that they have made.
People from all areas of the
profession have been making
their cases in a variety of media
– radio, TV, newspapers etc –
aiming to downplay what many
have called the sensationalising
of the report.
Yet again the drum of evil
dentist misleading patients has
been banged, trying to drown
out the fact that the majority of
those who responded (and that
was 3450 people) are actually
satisfied with the dental care
they receive.
News 7
June 4-10, 2012
Statistics, as we all know,
can be twisted to prove anything. In my post-graduate days
as a green and grateful marketing assistant for a firm selling telephone systems, I had to
ring local businesses to find out
about their systems for a university-based project. Treated as a
loathsome cold calling salesperson, I had to take the figures
from the nine companies who
bothered to talk to me and make
a presentation out of them. With
the use of the times by five principal and some lovely pie charts,
I made a fantastic presentation
that bore no resemblance to the
true situation of the telephone
system usage of the city’s local
businesses.
Sound familiar?
Thought so.
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
Dental training
needs ‘urgent
consideration’
T
he recent Health Select
Committee report on
Education, Training and
Workforce Planning highlights
a failure to adequately consider
the dental issues that must be
tackled, the British Dental Association (BDA) has said. This
must be addressed urgently,
the BDA believes, by proper
consideration of how changes
might affect dentistry and what
must be done to support dental
training.
The report, which notes a
lack of vital detail in plans for
the reform of the training and
education of healthcare workers, has nonetheless failed to
pick up properly on warnings
in the BDA’s submission to the
Health Select Committee inquiry, meaning that the issue
of how the training of dentists
and their teams will be paid
for is still unclear. Detailed assurances that dental practices
will not be expected to pay for
training, a scenario that would
be completely unacceptable, are
urgently required, the BDA believes.
Dr Judith Husband, Chair of
the BDA’s Education and Standards Committee, said: “This
report reminds us that the Government’s plans are still lacking
in important detail and require
significant further development.
Disappointingly, differences between medical and dental training remain unacknowledged
and dental-specific issues have
not been addressed.
“The BDA has been pressing
for clarity on these issues. That
they continue to be unresolved
is a source of frustration and
anxiety for dental practice owners. Dentists need to see a bold,
unambiguous statement from
Government that confirms that
they are not to be landed with a
huge financial burden for training future generations of the
profession.” DT
DISPLACE
DISLODGE
DESTROY
The regime that
shows plaque bacteria
no mercy
Brushing and flossing/interdental cleaning are pivotal to oral hygiene. They displace
and dislodge dental plaque bacteria that can cause gingivitis and periodontal disease.
But bacteria from other areas of the mouth can recolonize on teeth quickly.1
Using LISTERINE® after mechanical cleaning destroys oral bacteria effectively, killing
up to 97% in vivo.2 This lowers the bacterial burden in the mouth and in plaque that
reforms.3 And when used for 6 months, LISTERINE® can reduce plaque levels by up
to 52% more than brushing and flossing alone.4 In addition, LISTERINE® Total Care
products offer various levels of fluoride and other benefits to suit patients’ needs.
So recommend LISTERINE® as the final step in your patient’s daily
regime, to finish the job started by mechanical cleaning.
References:
1. Barnett ML. JADA 2006; 137: 16S-21S.
2. Data on file FCLGBP0023+28, McNeil PPC.
3. Fine DH, et al. J Clin Periodontol 2005; 32: 335-40.
4. Sharma N, et al. JADA 2004; 135: 496-504.
Finish the job. Finish off with Listerine.
ID:UK/LI/12-0084
03930_ocdlis_DentalTribune_FullPage_ad_297x210_fa1.indd 1
1/31/12 5:50 PM
[8] =>
8 News
United Kingdom Edition
June 4-10, 2012
Buying smarter could save NHS £1.2bn
N
ew ways of buying supplies and medical equipment could save the
NHS £1.2 billion to reinvest in
patient care, Health Minister Simon Burns announced today.
The NHS has been asked
to ‘raise its game’ when purchasing goods and services,
such as gloves and sutures,
catering and energy, to save at
least £1.2 billion over the next
four years.
The Department of Health,
working with the NHS Supply
Chain, has also established a
£300 million cash fund to enable the NHS to bulk buy large
equipment such as:
• CT scanners
• MRI scanners
• ultrasound machines
•cancer treatment technology
Thanks to this fund, £11
million has already been saved
through orders that have been
placed in advance via NHS
Supply Chain with suppliers.
Traditionally, the NHS has
struggled to make the most of
its buying power as there was
very little knowledge between
local hospitals about their
equipment needs. This fund
allows the NHS to benefit from
the savings of bulk buying expensive medical equipment via
NHS Supply Chain.
Health
Minister
Simon
Burns said: “Waste is unacceptable when we know there are
simple solutions. That is why
the NHS needs to buy smarter
and get the best value for the
taxpayer for every penny spent.
“We know that at least £1.2
billion could be saved over the
next four years if the NHS innovatively changes the way it
buys goods and services.
“Already, over £11 million
has been saved through bulkbuy discounts on the cash fund.
“This is the first step to better, smarter procurement in
the NHS and we will be working closely with hospital trusts
over the next six months to
help them save even more
money that can be reinvested
in patient care.”
The recommended life of
the majority of equipment
such as CT and MRI scanners
is ten years, after which it either needs updating or replacing because of wear and tear.
There are over 200 of these
large scale items that will need
replacing over the next couple of years and the NHS will
be able to significantly benefit
from the discounts achieved
via these bulk buy deals when
replacing
this
important
equipment.
By having the cash fund
available, the NHS Supply
Chain are able to secure better bulk buys deals for the NHS
with suppliers. As equipment
is purchased by trusts, payment for it will go back into the
fund, effectively replenishing
it for future use.
Andy Brown Managing Director of Business Solutions
for NHS Supply Chain said:
“This important development
will allow NHS Supply Chain
to group together the purchasing power of the NHS for this
vital equipment, make large
commitments to suppliers and
bring improved planning to the
management and replacement
of this equipment across the
NHS and with suppliers.”
Procurement plays a valuable role in driving improvement in services. Better procurement means these savings
can be reinvested to benefit
patients. Our ambition is to put
in place a world-class procurement system in the NHS that is
responsive to modern suppliers. This will enable the NHS
to adopt existing innovations
and stimulate new ones that
will benefit patients and taxpayers.
In addition, hospitals are
now being asked to drive forward improvements through a
series of actions, being more
transparent and assessing how
they buy equipment and services, including:
• Publish the details of all contracts over £10,000
• Appoint a board executive to
be accountable for procurement performance
• Regularly audit procurement
These actions in Raising
our Game will be taken forward immediately, whilst the
strategy for developing worldclass procurement will be published later this year.
It is vital that we have procurement that is not only better, but is world class. As a first
step, Raising our Game sets out
the actions that the NHS must
take immediately. It should be
focused on outcomes, not just
cost, and must be responsive to
creative ideas from suppliers,
procurement specialists, clinicians and managers.
Transforming procurement
in the NHS could enhance
quality and value and the strategy for delivering this will be
published later this year. DT
Trade a smile for a ‘smiley’ “Grand Tour” to
benefit Dentaid
W
ant to take part in National Smile Month?
Struggling for ideas?
Budget too tight? Make the
BDHF smile and they can help.
Campaign organisers the
British Dental Health Foundation are offering five organisations the chance to win 300
‘Smileys’ to aid their event, simply by making them smile.
So how does it work? Well,
you can post your idea on their
website, Facebook fan page, on
Twitter or email them. They’ll
pick out their favourite and
voila – free ‘Smileys’. The contact details you will need can be
found below.
Dr Nigel Carter, Chief Executive of the Foundation, said:
“So far the campaign has generated an excellent response. It is
extremely pleasing to see such
a variety of organisations taking
part in this year’s campaign.
“We hope by making so
many ‘smileys’ available free of
charge that more organisations
will come forward and help us
spread the messages of National
Smile Month. All you need to do
is make us smile!”
on Friday 8 June at the following places to be in with a chance
of winning:
• www.smilemonth.org/page/
competition
• Facebook fan page – ‘National
Smile Month’
• Twitter – @smilemonth, @DavidW_BDHF or @DavidA_BDHF
• Email – pr@dentalhealth.org
For
further
information
please visit www.smilemonth.
org or call 01788 539792. DT
E
lizabeth May is a specialist in Special Care Dentistry currently working
for the Somerset Primary Care
Service. She plans to celebrate
her retirement in June with a
“Grand Tour”, in aid of Dentaid,
visiting each of the county’s ten
clinics in turn – about 200 miles
– backpacking with a lightweight tent.
Starting on June 28th, the
route will take her from her
home in the Mendips to Frome,
Yeovil, Chard, Taunton, Wellington, Minehead, Bridgewater, Burnham-on-Sea, Wells,
Glastonbury and home, cover-
Submit your attempts to
make the BDHF smile by 5pm
ing about 25 miles per day, using many of the long distance
footpaths in Somerset.
She writes: “Dentaid’s aims
sum up many of the areas of
dentistry in which I have been
involved – the wider aspects of
delivery of care to populations;
issues of access and reaching
out to the more vulnerable; prevention and education.”
Sponsorship donations to
benefit Dentaid will be much
appreciated and can be made at
www.justgiving.com/elizabethmay1. DT
Membership of Information Governance Review Panel announced
F
iona Caldicott, Chairman of the independent
Information Governance
Review, has selected the members of the panel who will conduct the review. The aim of
the Review is to advise on how
to achieve a better balance between protecting and sharing
confidential personal information.
The members of the Review,
entitled ‘Information: to share
or not to share?’ have been
drawn from patient and voluntary groups, clinical and local
government professionals. Further information is available at
www.Caldicott2.dh.gov.uk
Dame Fiona Caldicott, Chair
of the Review, said: “I am delighted that the individuals who
we invited to participate in this
work have accepted enthusiastically. They will play a crucial
role in ensuring we have effective connections with groups or
individuals whose support we
need if our recommendations
are to be realistic and likely to
lead to constructive and acceptable improvement. The breadth
of panel members’ experience
will guarantee us the necessary
insights to identify the appropriate balance between sharing
and protecting information.”
The full list of panel members is:
Dame Fiona Caldicott, Chair
John Carvel, former Social Affairs Editor at the Guardian
Professor Mike Catchpole,
Head of Epidemiology and Surveillance, Health Protection
Agency and Faculty of Public
Health
Terry Dafter, Director of Adult
Social Care, Stockport Council
and ADASS
Janet Davies, Director of Nursing, RCN
Professor David Haslam, President BMA
Dr Alan Hassey, GP, clinician
Academy of Medical Royal Colleges
Dawn Monaghan, Strategic Liaison Group Manager, Information Commissioner’s Office
Terry Parkin, Director Peoples
Services, Bright and Hove City
Council and ADCS
Sir Nick Partridge, Chief Ex-
ecutive Terence Higgins Trust
Professor Martin Servers, Geriatrician, University of Portsmouth
Caroline
Tapster,
Former
Chief Executive Hertfordshire
Country Council
Jeremy Taylor, Chief Executive National Voices
Sir Mark Walport, Director
Wellcome Trust
Dr David Wrigley, GP from
a
Clinical
Commissioning
Group. DT
[9] =>
United Kingdom Edition
News 9
June 4-10, 2012
The key to a healthy smile lies in the infant
and toddler years
L
Around a quarter of a million children starting primary school across the UK
will already have tooth decay
and the Infant & Toddler Forum (ITF) and British Dental
Health Foundation are working together to raise awareness about how to avoid this
eading experts in toddler feeding and dental
health have united to
highlight the importance of diet,
positive feeding habits and good
oral health routines in the early
years, as part of National Smile
Month (20 May-20 June).
wholly preventable problem.
Those who learn good
habits from an early age are
more likely to carry them into
adulthood, and the ITF – specialists in food and feeding in
the under threes – has produced a sheet of simple tips
to help families take positive
steps towards their toddlers’
good dental health. Endorsed
by the Foundation, the practical, evidence – based advice includes tips on how to
care for children’s teeth – including diet, bottle-feeding,
tooth
brushing,
fluoride
and medicines.
Advice around what and
what not to eat can also be
confusing; the UK Royal College of Surgeons Dental Faculty recently reported that half
of five year olds show signs
of enamel erosion caused by
fruit, particularly citrus fruits
and encouraged schools to
ban fruit juice and to offer
milk and water instead.
Judy More, paediatric dietician and member of the ITF,
says: “It is important to give
young children the opportunity to learn to like water as
a drink by offering it. Fruit
juice, like other sweet drinks,
causes tooth decay when
drunk frequently throughout
the day. If fruit juice is given
as a drink it should be well
diluted; for example one part
juice to about six to ten parts
water and served in a glass,
cup or beaker, not a bottle.
“Sweet food, sweet drinks
and fruit juices should only
be given at four occasions
throughout the day (eg three
meals and one snack) to
minimise the times teeth are
exposed to sugar and acid.
Water and milk are the only
drinks that should be offered
between meals and snacks.”
Dr Nigel Carter, Chief
Executive of the Foundation says, “Educating children from an early age can
reap huge benefits, as the
development of a good oral
healthcare routine begins at
a young age.”
For
more
information
on protecting toddlers from
tooth decay, download the
ITF’s free ‘Protecting Toddlers from Tooth Decay’ Guidance & Tips sheet for families
or Factsheet for professionals
working with parents.
honigum.
Overcoming opposites.
Often times, compromises have to be made when developing impression materials. Because normally the rheological
properties of stability and good flow characteristics would
stand in each other’s way. DMG’s Honigum overcomes these
contradictions. Thanks to its unique rheological active
For further information
about National Smile Month
and to view resources supporting the campaign visit:
www. smilemonth.org DT
matrix, Honigum yields highest ratings in both disciplines.
We are very pleased to see that even the noted test institute
»The Dental Advisor« values that fact: Among 50 VPS
Honigum received the best »clinical ratings«*
www.dmg-dental.com
2012
2010 Pr
e f e r r e d Pr o du
c ts
The key to a healthy smile lies in habits
formed during infant years
* The Dental Advisor, Vol. 23, No. 3, p 2-5
AZM_Honigum_DeEnItFr_1203.indd 1
02.04.12 09:47
[10] =>
10 News
United Kingdom Edition
June 4-10, 2012
A long career dedicated to the dental
nursing profession- Jean Smith
D
iana Wincott MBE, pays
tribute to M Jean Smith
MBE: Following the
Second World War there was
great difficulty in recruiting
suitable dental chairside staff.
There was no formal training
available, pay was poor and the
term `Attendant’ often deterred
suitable applicants from entering the work.
The Dental Nurses and
Assistants Society of Great
Britain and Northern Ireland,
established in 1940, sought to
influence and act to secure
proper training and pay for
their members and protect
the character and status of
dental nurses. It was in this
environment that the young
Jean Smith found herself.
Jean passed the National
Examination in 1945 at the
Leeds centre. At that time the
Panel of Examiners consisted
of six dentists.
In 1948 Jean replied to an
advertisement for a Secretary
to the Dental Nurses and Assistants Society who urgently
needed a new secretary; the
advertisement stated that, unless someone came forward at
once, the society would cease
to function. Fortunately Jean
Smith was appointed!
Jean made a huge commitment to her work and succeeded in increasing the number of courses, candidates and
examiners, ensuring that the
professional status of dental
nurses was promoted. She
became widely recognised as
the figurehead of the profession.
Then in January 1954 the
British Dental Association
and the British Dental Nurses
Association agreed to form a
Joint Committee.
Recommendations
on
pay and conditions for dental nurses in General Dental
Practice were issued in an
advice sheet and in 1964 a
National Voluntary Register
was established. Jean Smith
administered the register and
became the first registrar.
Succeeding years were
occupied with ever increas-
ing workloads and emerging
issues of fluoridation, dental health education and post
qualification courses. It became clear that there was a
need to look at creating an
improved career structure
for dental nurses within the
dental team; this was pursued
with the BDA and representatives from Area Health Authorities and the Department
of Health.
Jean’s style was always
calm and considered.
She
was able to read a situation
and make timely judgements
for the benefit of the profession and it is through Jean’s
considerable
contribution
that we now call ourselves
a profession. This service to
dentistry was recognised in
1975 when Jean was awarded
the MBE in the Queen’s Birthday Honours. (pictured)
In 1978 the Association
was officially entered on the
records as a Trade Union.
Pay negotiations continued
with the BDA and through
the Whitley Council. In 1983
a campaign was launched
and MPs approached to support a fair wages resolution.
Jean prepared the submission
made to the Nuffield Foundations research into the Training and Future Role of Dental
Nurses.
Jean was determined to get
proper recognition for Dental
Nurses and in 1980 approaches were made to the GDC to
set up a group of stakeholders to standardise their training and education. The Dental
Nurse Standards and Training
Advisory Board was set up in
1981 and the National Voluntary Register was taken under
the auspices of the GDC.
the Association on 31st December 1985 but continued to
work for the Examining Board
and in the development of Occupational Standards.
Jean Smiths’ impact on the
Dental Nursing Profession is
without equal. She leaves a
daughter Jennifer, grandchildren Diane and Joel and great
granddaughters Natalie, Hannah, Isobel and Alexandra. DT
A report was prepared and
published in 1984 outlining,
for the first time, the role and
training objectives for dental
nurses. It is widely acknowledged that much of the work
in developing this document
was undertaken by Jean and
three other dental nurse representatives.
Jean Smith retired from
BDA PEC member- BSDHT announce first
ship announced
accreditation awards
T
he results of the elections
for seats on the British Dental Association’s
Principal Executive Committee
(PEC) have been announced.
Voting for the elections finished
on Wednesday 23 May and has
been followed by the counting
of ballot papers.
The successful candidates
and the geographical constituencies they have been elected to represent are:
• Dr Martin Fallowfield (England, East)
• Dr Judith Husband (England, East Midlands)
• Dr Russ Ladwa (England,
London)
• Dr Paul Blaylock (England,
North)
• Dr Victor Chan (England,
South East)
• Dr Nigel Jones (England,
South West)
• Dr Eddie Crouch (England,
West Midlands)
• Dr Mick Armstrong (England, Yorkshire and Humber)
• Dr Philip Henderson
(Northern Ireland)
• Dr Robert Kinloch (Scotland)
• Dr Stuart Johnston (Wales)
A bye-election will take
place in the England, North
West constituency, with no
representative having been
elected to represent the seat
during these elections.
Members have also been
elected for three seats that
will represent dentists across
the whole of the UK. The successful candidates for the UKwide seats are:
• Dr Alison Lockyer
• Dr Susie Sanderson
• Dr Graham Stokes
The senior officers of the
PEC, including the Chair, will
be elected in June, ahead of
the body formally taking responsibility for the governance of the BDA on 1 July.
The results of those elections
will also be announced on the
BDA website. DT
The British Society of
Dental Hygiene and Therapy
(BSDHT) have announced
the first awards under their
new education Accreditation
Scheme, which was launched
at the Oral Health Conference
& Exhibition at Bournemouth
in November 2011.
The scheme aims to ensure a consistency of quality
and standard for Continuous
Professional Development educational material used by its
members.
half of GSK for their Talking
Points in Practice sessions on:
• Acid Erosion
BSDHT President, Sally
Simpson, and BSDHT Accreditation Lead, Michaela O’Neill,
presented the first three
Awards at the recent Dentistry
Show in Birmingham.
• Dentine Hypersensitivity
• Gingivitis and Periodontal
Disease. DT
The awards were received
by Caroline Thompson on be-
Exciting volunteering
opportunities with B2A
B
ridge2Aid are delighted
to offer a new and exciting opportunity for
volunteers in Dodoma, Tanzania. This is a new area for our
Dental Volunteer Programme
and after successfully piloting
in January, they are now filling
spaces for a second trip from
the 2nd-12th October 2012.
Dodoma, as illustrated on
the map, is located inland and
the geographical difference to
Mwanza will offer returning
volunteers the chance to experience something completely new.
Even as the capital city of Tanzania, Dodoma is under resourced
and under developed with great
dental needs within driving distance of the city centre.
Government officials in Dodoma requested our assistance,
and following the pilot, we are
confident that DVP will continue
to work well in this location.
At the moment Bridge2Aid
have a limited number of places left available for this trip so
if you are interested in joining
them, please contact the visits
team for more information visits@bridge2aid.org DT
[11] =>
United Kingdom Edition
Feature 11
June 4-10, 2012
No longer a sensitive subject
Eric Peterson discusses sensitivity and whitening
lion according to the Academy of
General Dentistry.
This growth has allowed
teeth whitening to become
more accessible for patients
and there’s a solution to suit all
budgets; in-office procedures,
dentist-prescribed
at-home
treatments, strips and gels. But
a common factor of this cosmetic procedure is that the patient
will almost certainly experience some level of discomfort
through sensitivity. This pain
can often be so excruciating
that the patient either stops
treatment halfway through or
dismisses this procedure altogether in search for a less painful option.
And it’s not just after teeth
whitening, dentine hypersensitivity affects one third of the
adult population at some point
in their lives. This can be any-
thing from a mild twinge to having severe discomfort that lasts
for several hours or even days.
Be it a result of teeth whitening
or if they are simply sensitive to
heat, cold, sweetness, acidity or
brushing, by educating patients
on how to deal with dentine
hypersensitivity you can help
them achieve a whiter, brighter,
“pain-free” smile.
Explaining the causes and
symptoms of sensitive teeth
Many people can be confused
about the causes of their sensitive teeth so it’s important
to make them aware of all the
common factors and put them at
ease. Generally, when the hard
enamel is worn down or gums
recede the dentine tubules become exposed; the causes and
symptoms will differ for every
patient, from eating or drinking
foods and hot or cold beverages
to touching teeth or exposing
them to cold air.
‘By educating
patients on how to
deal with dentine
hypersensitivity
you can help them
achieve a whiter,
brighter, “pain-free”
future’
Look
out fo
r
free s
ample our
within
this is
s
Denta ue of
l tribu
ne
The pain associated with
dentine hypersensitivity can
even affect the eating, drinking,
and breathing habits of patients,
so it’s ideal to start by informing them that sensitive teeth are
relatively common and not usually a health concern.
• Check which toothpaste they
use – Highly abrasive ingredients found in toothpastes
can add to the discomfort, as
they continue to wear away
the enamel.
Patients should
steer clear of highly abrasive
toothpastes, especially after insurgery treatment, as they can
damage the teeth and gums,
removing the lustre of the teeth
and dulling an otherwise beautiful smile.
Using tartar-control toothpastes can cause teeth to become sensitive and should be
avoided. There are many types
of toothpaste available on the
market specifically formulated
DT page 12
ß
T
he
popular
accessory
nowadays is not just the
handbag, the shoes, or the
Chihuahua; it’s the pearly white
smile to boost appearance and
self-esteem. In fact, tooth whitening is one of the fastest growing
in the dental market, boasting
an estimated value of £600 mil-
[12] =>
12 Feature
ß DT page 11
to minimise the effects of sensitivity, easing the pain and
protecting sensitive teeth by
sealing exposed, open dentine
tubules.
• Check the patient’s five senses – A study which appeared in
the General Dentistry journal
(2002) confirmed that people
who are sensitive to bright
lights, loud noises, pungent
United Kingdom Edition
perfumes and itchy clothing,
are most likely to avoid hot and
cold foods and drinks because
they have sensitive teeth. The
study found a direct relationship between sensitive teeth
and other sensitivities, finding that patients with sensitive
teeth expressed a need to wear
sunglasses when outdoors.
Helping patients overcome
sensitive teeth
As a dental professional your
expert advice and recommendation carries considerable
weight. Openly discussing sensitive teeth with patients will
enable you to identify how
much of a concern it is for
them and recommend a solution to help eliminate the discomfort. Put their mind at rest
by confirming that sensitive
teeth can be easily addressed
by following some simple oral
care procedures; avoid brushing teeth too hard or too much,
avoid grinding or clenching
teeth and avoid acidic foods
and drinks.
Patients should also be
advised to use a low abrasion, desensitising, whitening
toothpaste which contains the
ingredient Potassium Citrate.
This desensitising agent will
help relieve tooth sensitivity by effectively blocking the
transmission of pain sensation between the nerve cells
June 4-10, 2012
rapidly and effectively, so that
tooth whitening is no longer a
sensitive subject! Ultimately,
by switching to a low-abrasive
whitening toothpaste patients
can reduce the risk of suffering
from dentine hypersensitivity
from the outset.
In a study recently performed by Missouri Analytical Laboratories (July 2011), a
range of whitening toothpastes
were tested to compare and
evaluate their levels of abrasion. The results confirmed
that Beverly Hills Formula
whitening toothpaste is proven
to be less abrasive than other
leading brands of both whitening and regular toothpastes,
scoring as low as 93 on the
RDA table whilst some leading competitors have levels as
high as 147.
R4
Practice Management Software
Give your patients the freedom to book
their own appointments
‘By helping your
patient’s combat
sensitive teeth you
will be making
a dramatic
improvement to
their life.’
Raising awareness of sensitive teeth
By helping your patient’s combat sensitive teeth you will be
making a dramatic improvement to their life, enabling
them to enjoy hot and cold
foods and drinks again.
GIVES YOU MORE
Online Patient Appointment Booking allows patients to book appointments online, whenever they want to, or
need to, even out of normal surgery hours.
While this makes it very convenient for your patients, you still have complete control over who can make the
bookings, the types they can book, with who and when.
A quick glance will tell you when an appointment has been made so that you are
able to accept, refuse or adjust any request.
This gives your patients greater accessibility to you and your colleagues with
increased feelings of inclusivity and you’ll have fewer missed appointments.
• From a Laptop
• From an iPad
• From a Smartphone
For more information or to place an order
please call 0800 169 9692
email sales.uk.csd@carestream.com
or visit www.carestreamdental.co.uk
© Carestream Dental Ltd., 2012.
f eatures o f r4
R4 Mobile
Direct link to PIN pad
Patient Check-in Kiosk
Care Pathways
Communicator
Steritrak
E-Forms
Patient Journey
on-line appointment Booking
Text Message and Email reminders
Clinical Notes
Appointment Book
Digital X-Ray
Managed Service
Practice Accounts
Nominate
a
“sensitive
teeth” expert in the practice
or hold a “sensitive teeth” day/
week/month; you’ll be surprised at how many patients
will come forward to end
their fight against sensitive
teeth. Leave flyers/brochures
on sensitive teeth around the
practice, in reception or in the
waiting room, and patients will
feel more inclined to tackle the
subject. DT
About the author
Eric Peterson is founder of the whitening toothpaste Beverly Hills Formula. For more information on the
Beverly Hills Formula products please
call +353 1842 6611, email info@beverlyhillsformula.com or visit www.
beverlyhillsformula.com.
[13] =>
United Kingdom Edition
Infection Control Tribune 13
June 4-June 10, 2012
Infection Control Tribune
Infection control
Beyond HTM 01-05
Amanda Atkin explains
clinical governance
pages 14-15
Infection control
Clean and safe
Dr Zimmerman discusses
the meaning of sterile
Infection control
Dental education
Ben Adriaanse interviews
Dr Hans de Soet
pages 16-18
Infection control
Protein contamination
Peter Bacon discusses surface
cleaning
page 21
pages 19-20
How hand hygiene impacts
hospital infection rates
A
study published in BMJ,
which coincided with the
World Health Organization SAVE LIVES: Clean Your
Hands campaign on the 5 May
2012, reveals that the campaign
played a significant role in
reducing rates of some healthcare
associated
infections
in hospitals across England
and Wales.
The purpose of the study
was to evaluate the impact
of the Cleanyourhands campaign on rates of hospital
procurement of alcohol hand
rub and soap, report trends in selected healthcare associated in-
fections, and investigate the association between infections and
procurement.
Bedside alcohol hand rub,
materials promoting hand hygiene and institutional engagement, regular hand hygiene
audits, were installed from
1 December 2004 and rates
for each trust of hospital procurement of alcohol hand rub
and liquid soap and levels of
Staphylococcus aureus bacteraemia (meticillin resistant
(MRSA) and meticillin sensitive (MSSA)) and Clostridium
difficile infection for each trust
was obtained.
The results found that combined procurement of soap and
alcohol hand rub tripled from
21.8 to 59.8 mL per patient bed
day; procurement rose in association with each phase of the
campaign. Rates fell for MRSA
bacteraemia (1.88 to 0.91 cases
per 10,000 bed days) and C difficile infection (16.75 to 9.49
cases); however, MSSA bacteraemia rates did not fall.
Increased procurement of
alcohol hand rub was independently associated with reduced
MRSA bacteraemia, but only
in the last four quarters of the
study and the publication of the
Health Act 2006 was strongly
associated with reduced MRSA
bacteraemia.
The study can be found at
www.bmj.com/content/344/
bmj.e3005
The study concluded that
the Cleanyourhands campaign
was associated with sustained
increases in hospital procurement of alcohol rub and soap,
which the results suggest has an
important role in reducing rates
of some healthcare associated
infections. National interventions for infection control undertaken in the context of a
high profile political drive can
reduce selected healthcare associated infections.
The WHO’s SAVE LIVES:
Clean Your Hands campaign
is part of a worldwide effort to
improve hand hygiene amongst
healthcare workers, in order
to prevent infections, such as
Staphylococcus aureus infection, meticillin resistant (MRSA)
and meticillin sensitive (MSSA)
and Clostridium difficile that
are often life threatening. DT
Patients contacted over infection
concerns at dental practice
N
early 1,000 patients at
a dental practice in Aberdeen have been contacted by NHS Grampian due to
concerns regarding their infection control procedures.
According to a report, the patients at the Bridge of Don Dental Clinic and Research Centre
in Silverburn Crescent, Bridge
of Don have been sent advisory
letters after an inspection in
March found that infection control procedures at the practice,
including those for instrument
decontamination, did not meet
national standards.
A spokeswoman for NHS
Grampian said in a report: “The
letter reassures patients that the
risk of infection is low. However, any patient who remains
concerned can contact NHS 24
helpline 08000 28 28 16 between
8.00am and 10.00pm where they
can get further advice about
health concerns including for
blood borne viruses such as
hepatitis B, C and HIV.
“Letters have been sent to
patients registered at the independent practice between
January, when it opened, and
10 April, the date of a follow up
She added: “Dr Xenofon Gkouzis is the only dentist now
working in the practice. He is
registered in the UK with the
General Dental Council and is
authorised to treat NHS patients
in Grampian. This incident is
not related to him.”
and national experts and have
concluded there is a low risk
of infection to patients. As our
priority is always for the safety
and welfare of patients, we felt
it was important to write to inform them of this incident. The
letter emphasises that no action
is required by the patient, but
tests will be available if anyone
remains concerned having read
the letter and after calling the
helpline.”
Dr Maria Rossi, consultant in Public Health Medicine
at NHS Grampian, said: “We
are working closely with local
Ray Watkins is Consultant
in Dental Public Health at NHS
Grampian. He added: “While
this is an independent practice,
inspection which found infection control procedures were
satisfactory and now followed
national standards.”
it is expected to comply with
national infection control standards. We are unable to confirm
that these standards were adhered to prior to April 10 when
at a follow-up visit, procedures
were found to be satisfactory.
“The practice has co-operated with the investigation, and will continue to be
monitored.” DT
[14] =>
14 Infection Control Tribune
United Kingdom Edition
June 4-10, 2012
Beyond HTM 01-05
Amanda Atkin explains on-going clinical governance
B
y now, all dental practices must comply with the
essential requirements of
Health Technical Memorandum
01-05 Decontamination in Dental Practice (aka HTM 01-05). If
they do not, they are in breach
of CQC Regulation 12, Outcome
8. HTM 01-05 was produced
(in the words of the Department of Health) “in response
to emerging evidence around
the effectiveness of decontamination in primary care dental
practices and the possibility of
prion transmission through
protein contamination of dental
instruments.”
In brief, the essential requirements of HTM 01-05 are that:
• Regardless of the technology
used, the cleaned instruments,
prior to sterilisation, should
be free of visible contaminants
when inspected with a magnification device. Instruments
should be reprocessed using
a validated decontamination
cycle including: cleaning/
washing (in terms of manual
cleaning, this includes having
a written protocol, a validated
steam steriliser, and at the end
of the reprocessing cycle they
should be in a sterilised state).
• Reprocessed dental instruments should be stored in such
a way as to ensure restraint of
microbiological re-colonisation. These measures should
be backed by careful controls
on the storage times to which
instruments that are less frequently used are subject.
• Practices should audit their
decontamination
processes
quarterly using an audit tool
(the use of the Infection Prevention Society/DH audit tool
that accompanied the document was strongly recommended).
• Practices should have in
place a detailed action plan on
how the provision of decontamination services will move
towards best practice.
Continue raising clinical
governance awareness
Considering that last bullet point in more detail, it is
implicit in the guidance that
merely meeting the essential
requirements of HTM 01-05
is not an end in itself. Instead,
practices
should
continue
moving forward with decontamination and aim towards
best practice – effectively
shooting at ever narrowing
goalposts.
By definition, I cannot tell
you in detail what best practice
is. It will continue to evolve
over time as more effective
processes are discovered and
as better decontamination
equipment is produced. Also,
you may be close to achieving
best practice now or you could
be a long way off it.
In moving towards best
practice, you may wish to consider some or all of the following upgrades to your practice:
• The use of an automated (HTM 01-05) washerdisinfector
• Separate facilities for decontamination clearly separated
from the clinical treatment
area. This implies the use of a
separate room or rooms which
should be used for the purpose
of decontamination only and
to which access should be restricted to those staff perform-
[15] =>
Infection Control Tribune 15
Direct.com
United Kingdom Edition
ing decontamination duties
• Organisation of the reprocessing area into a dirty/clean
workflow system with best
practice being dirty and clean
areas as separate rooms, each
with a door and individual air
supply and extraction
• Provide suitable storage for
instruments, which reduces
exposure to air and a possible
risk of further contamination
• Minimise worktops – which
means less clutter and less to
clean – and replace them with
glass, so that patients can see
immediately that the surgery
is clean
To keep abreast of decontamination best practice, I suggest
you link up with your PCT, that
you always read Dental Tribune and Infection Control Tribune and that you keep an eye
on dentistry websites. Also,
check out the decontamination equipment manufacturers
for new products, liaise with
dentistry colleagues and visit
the appropriate trade and association stands at shows.
Direct
Direct.com
Direct.com
much this will cost. They may
well also need training in the
use of instrument rotation systems and working in a designated decontamination room.
will likely be a longer-term
aim.
For something a little easier to build into your action
plan, consider the purchase
of washer-disinfector. You will
need to investigate what models are available, which will
be most suitable, how much it
will cost and what the installation requirements area. You
will also need to consider how,
where and when your staff can
be trained to use it and how
Direct.com
June 4-10, 2012
Although you should check
whether your PCT has funds
available for the purchase of
washer-disinfectors, in England there was no central
funding for meeting HTM
01-05 essential requirements
and there is certainly none at
this time for moving towards
.com .com
Direct
Direct
In, for example, a listed
building or premises where
you are already short of space,
the only solutions may be to
move or rent/purchase additional premises. Clearly, this
Sample test processes and
procedures to evidence the
level of compliance
Finally, don’t forget to maintain the daily and weekly
checks of equipment and the
quarterly checks specified in
the Infection Prevention Society/DH audit tool. DT
Author info
Amanda Atkin runs Atkinspire Ltd
and offers practices support, training
and consultancy on information governance, CQC compliance, National
Minimum Standards and HTM 01-05.
Her bespoke service supports practices
as they embed the required standards
within their daily routines ñ to ensure
a high quality service and patient safety
at all times. Contact amanda@atkinspire.co.uk www.atkinspire.co.uk
.com.com
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An action plan for best
practice
Decontamination best practice cannot simply be a wish
list – you need to draw up an
action plan for achieving it.
At the moment, no timescales
have been set for practices
to achieve best practice. This
makes developing an action
plan with targets as to when
things will be achieved rather tricky. Bear in mind that
you will, at some stage, need
to show this action plan to a
member of your PCT and talk
them through it – so it needs
to be based on sound thinking,
not guess work.
Let’s take the example of
separating
decontamination
rooms. There are many dental practices that use the same
room for patient treatment
and decontamination and this
meets HTM 01-05 essential requirements at this time. The
principals or owners of these
practices need to decide how
they can work towards a separate and controlled decontamination room (or clean/dirty
rooms). If it’s merely a question of utilising an unused
room or erecting partitions,
the timescale for achieving it
could be relatively short and
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16 Infection Control Tribune
United Kingdom Edition
June 4-10, 2012
“Sterile” does not mean clean
and safe
Dr Mikael Zimmerman discusses disinfection
Fig 1 Endofile, sterilised but not properly cleaned and decontaminated before the sterilisation process. In this case sterilisation will fail
M
ost equipment-associated infection is due to
inadequate cleaning
and disinfection. The most effective stage of any decontamination procedure is thorough
cleaning.
Medical devices heavily
loaded with microbiological
material will be more difficult
to sterilise than one lightly
contaminated and must therefore be thoroughly cleaned
to reduce organic material
or bioburden before disinfection and sterilisation. Washerdisinfectors are the safest and
most reliable option.
Automated processors, eg
washer disinfectors and ultrasonic cleaners, improve
the quality of the decontamination process and offer the
safest, most reliable option,
providing they are suitably
monitored and maintained.
Decontamination is done
most simply in a disinfector which both cleans and
disinfects in one stage. In a
washer-disinfector the items
are first cleaned by rinsing in
cold water and then washed
Fig 6 Corrosion is a common problem
when mixing different materials in the
same fluid – as is the case with aluminium
and stainless steel. Corrosion pits increases
the possibilities for microorganisms to attach themselves to the surface
in water at less than +70oC.
The water temperature then
increases to between +85oC
and +93oC, for one to three
minutes, providing thermal
disinfection of the load. At the
temperature range of +85oC
- +93oC, pathogenic bacteria are inactivated or killed,
but bacterial spores survive.
In order to ensure inactivation of viruses, particularly
hepatitis virus which is relatively heat tolerant, it is now
recommended that the water
temperature during the disinfection phase should be just
over +90oC.
Disinfection is generally a
less lethal process than sterilisation. It eliminates virtually all recognised pathogenic
microorganisms but not necessarily all microbial forms
(eg bacterial endospores) on
inanimate objects. Disinfection does not ensure overkill,
and therefore disinfection
processes lack the margin of
safety achieved by sterilisation procedures.
Fig 2 Washer disinfectors offer the safest
and most reliable option for decontamination and disinfection. Tray systems must
allow water jets to reach every part of instruments to clean and inactivate efficiently
Fig 3 In the case of ultrasonic cleaning
instruments are best cleaned if instruments
are fastened but free and have no contact
with locking device
after use. Dried biological material is much more difficult
to remove than fresh deposits.
Blood, with its content of iron,
acid and sodium chloride, is
corrosive.
fluenced partly by the kind of
material the items are made
of, and partly by the shape of
the items. It is important to
note that packaging material
itself is a porous load (paper, textiles) and should be
handled as such. All packaged/wrapped goods require
sterilising in steam-autoclave
processes with pre- and postvacuum cycles.
The type B-cycle
Sterilisation is defined as the
use of a physical or chemical
procedure to destroy all microbial life, including large
numbers of highly resistant
bacterial endospores. The sterility requirement for medical
products means that the theoretical probability that a living
organism will be present on
an object after the sterilising
process is equal to or less than
one in a million, so-called
Sterility
Assurance
Level
(SAL) = 10-6. Sterility may be
achieved by various methods:
heat, chemical and ionising
radiation. The simplest method is heat sterilisation. There
are two methods: dry heat
sterilisation, ie use of dry heat
usually a hot air oven or autoclaving, in which moist heat
(steam) is used.
Cleaning and disinfection
of instruments should be carried out as soon as possible
Regardless of the method,
the result of sterilising procedures depends on the number
of microorganisms and other
biological material present
on the article before inactivation and the resistance of
microorganisms to the sterilisation process. The result of
steam sterilisation is also in-
Fig 7 Efficient trays should be made out of
non-heat absorbing, non-heavy and noncorrosion causing material
Fig 8 Stands for burs and endofiles are
often a problem – a simple solution is to use
standard kits and pre-prepared trays
Another factor which influences the result of the
sterilising procedure is the
way in which the chamber
is loaded as well as whether
the items are packaged and
the shape of the package. The
goods should not be tightly
packed: the steam must be allowed to penetrate all parts of
the goods. Residual moisture
in the packaging material after sterilisation will act as a
potential pathway for microorganisms to penetrate the
package.
Steam sterilisation
Saturated steam under pressure is by far the quickest,
safest and most efficient and
most reliable medium, known
for the destruction of all forms
of microbial life. The brief
exposure to steam destroys
the most resistant bacterial
species and heat is rapidly
achieved because of mass
heat transfer as the steam
condenses.
Fig 9 Good and safe handling of instruments with pre-prepared trays saves time
and money at the same time as quality will
be improved
Fig 4 A common problem in many clinics is
an overload of instruments
Fig 5 To organise the logistics and handling of instruments requires a lot of time
– tray systems offers a better solution
In order for the steam to
condensate within the whole
load to be sterilised, virtually
all air must be evacuated during pre-treatment. This can
only be achieved with several
(at least three (3)) pre-vacuum pulses. So called B-cycle
in accordance with EN 13060.
In steam sterilisers with
pre- and post-vacuum processes (ie B-cycle), the sterilisation process is composed
by three main phases: pretreatment,
sterilising
and
post-treatment. During pretreatment the air is expelled
by a number of pulses of
vacuum and the introduction
of steam. The temperature
increases successively, up to
the degree at which sterilising is to take place. The actual
sterilisation period, which
is called holding time, starts
when the temperature in all
parts of the autoclave chamber and its contents (the load)
have reached the sterilising
Fig 10 Tray systems should facilitate the
handling of instruments through the whole
hygienic circle
[17] =>
temperature. The temperature should then remain constant, within specified temperature band, throughout
the whole sterilisation phase
(plateau/holding time). In the
post-treatment phase, either
the steam or the re-vaporised
condensed water are removed
by vacuum to guarantee the
goods to be dried rapidly.
Virtually all air must be
evacuated during pre-treatment (pre-vacuum phase) so
that the saturated steam can
affect the goods during the
sterilising phase. If present,
trapped air pockets in the
goods prevent steam penetration during sterilisation of porous material such as textiles
and hollow items.
Steam sterilisation of hollow instruments (with long,
narrow lumina) and porous
objects always requires several (at least three (3)) prevacuum pulses to a defined,
pre-set, vacuum level.
Fewer instruments, better
control
The type of equipment and
the type of procedures in use
at the clinic will to a very high
extent determine the safety
margin of decontamination.
A very important issue, that
is often foreseen, is the logistics of instruments. A common problem in many dental
offices is an overload of instruments, which will contribute to a more difficult and
time demanding procedure to
keep track of all instruments
and to make sure that storage
and sterile as well as packaging/wrapping conditions are
maintained.
An item heavily loaded
with microbiological material will be more difficult to
sterilise than one lightly contaminated. The most effective
stage of any decontamination
procedure is thorough cleaning and this should accompany or precede all disinfection procedures. The effect
of cleaning, disinfection and
sterilisation is affected by
the design of the cassettes/
trays being used. Shadow effects may easily ensue from
the use of solid cassettes so
that instruments are not being properly cleaned, neither
in washer disinfectors nor in
ultrasonic bath.
An area of contact will not be
properly cleaned and disinfected.
Two different metals will
cause corrosion
Corrosion is a common problem. When in the same fluid,
instruments and other articles
made of different metals may
corrode, and corrosion destroys sharp and delicate instruments. Corrosion pits will
also make the surface rough,
which increases the possi-
Infection Control Tribune 17
June 4-10, 2012
bilities of microorganisms to
attach themselves to the instruments. Mixing different
types of metal in a liquid solution will result in an electrochemical cell and cause corrosion – this is often the case
during cleaning, ultrasonic
bath and washer disinfectors
when using aluminium trays
and instruments in stainless
steel or when cleaning carbon
burs and burs made of stainless steel in the same liquid
container. However, in daily
dentistry we call this rust
and blame the manufacturer
for poor material – the actual
problem is clinical routines!
Don’t make it too heavy
Metallic weight is another decisive in decontamination and
sterilisation. The heat energy
from the ultrasonic waves in
the ultrasonic bath and/or
the water in a dishwasher or
washer disinfector as well as
the saturated steam from the
steriliser shall be concentrat-
ed on the instruments that are
to be processed. A load that is
too heavy lessens the effect of
disinfection and sterilisation.
The steam sterilisers that are
most frequently used in dental clinics are adapted to loads
of 4.0–4.5 kilos. A stainless
steel tray with instruments
for endodontic procedures
has a weight of approximately
1.5–1.7 kilos! This will be an
important issue to consider
when using trays made out
DT page 18
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United Kingdom Edition
Luxator Extraction
Instruments
are now the preferred
method of
performing extractions
Often instruments made of
stainless steel are supposed to
be extremely strong and fit for
using for almost any amount
of time. But the truth is that
all kinds of instruments can
be harmed both by mechanical, thermal and chemical influences. Dental instruments
often consist of different parts
and of different kinds of metals and alloys, even in the
same instrument.
Fig 11 Evaluation of the handling of instruments with effective tray systems has shown
substantially reduced time
Fig 12 Rationalisation of the handling of instruments is a good way to improve practice
economy and quality
ß DT page 17
of stainless steel which are
heavier than trays made out of
aluminium.
The most efficient trays,
from disinfection and sterilisation standpoint will be
trays/cassettes made out of
a non-heat absorbing, nonheavy
and
non-corrosion
causing material.
Tray-prep increases efficiency and security
To organise the logistics and
handling of instruments requires a lot of time, and unfortunately few clinics take
that time to go through these
processes.
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as possible, the use of a system as complete as possible is
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For this reason our Luxator instruments are
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June 4-10, 2012
The first thing to do to
ameliorate the logistics of instruments and materials in
the clinic is to minimise the
number of instruments in the
treatment area. Tray systems
facilitate the flow of instruments and goods the whole
way between treatments, via
sterile area, to storing. With
a carefully planned tray system you can handle the tray,
the accessories and the instruments (products) as one unit
throughout the whole process
of work.
Tray systems and “trayprep-stations” facilitate the
handling of goods. A good
tray system with practical
tray accessories and carefully
planned hygiene routines facilitates the flow of materials. Unstructured handling of
instruments results in losing
valuable time and heightens
the risk of reducing security
and disregarding aseptics.
Secure handling of instruments also leads to minimising prick and puncture
wounds, at the same time as
simplifying the inspection of
instruments. It also means
that single use materials and
hazardous waste can be easily removed and thrown into
a lidded waste bin, if using
a tray-prep-station in the
surgery.
Stands for burs and endofiles
– a hidden problem
Stands for burs and endofiles
are very often a hidden problem in the clinic. A simple solution to the problem is to use
one standard kit that is in use
during the whole process of
work and the whole hygiene
circle.
Pre-prepared
trays
with all instruments in place
also minimises the process
time between patients.
Stainless steel is not forever
Dental
metal
instruments
are for the most made by
high quality stainless steel
with high elasticity and high
stretch. The material has
high resistance against wear
and corrosion. All of these
capacities can be negatively
influenced by erroneous handling of the instruments, particularly in connection with
cleaning, disinfection and
sterilisation.
It is important to maintain
the tenability of the instruments with careful handling.
They are not to be thrown in
the process of decontamination. The instruments should
be processed in trays, holders or stands so as not to
clash against each other. They
should also be in contact with
each other as little as possible
when washed, disinfected and
sterilised.
Reduce the number of articles and save time and money
To have fewer instruments in
use means that it will be easier
and safer to locate goods that
should be re-sterilised and redisinfected and that there will
always be current information
on which instruments that are
needed in the surgery.
Higher security will be a
result from always having the
right materials and instruments in the treatment area.
The time in need for handling sterile goods can be reduced, usually to half the time.
Good control of and minimising the number of instruments and materials result in
less costs and gives the conditions of safer handling, decontamination and disinfection.
A tray system should facilitate the handling of instruments through the whole
hygienic circle. Evaluations
of effective tray systems have
shown reduced time for handling the instruments at disinfection and sterilisation.
Rationalisation of the handling of instruments during all
parts of work - from preparation to sterile keeping – gives
the staff liberty to work with
quality improvement and to
take a greater part in the treatment of patients. Rationalisation of the handling of instruments is thereby a good way to
improve practice economy. DT
About the author
Dr Mikael Zimmerman is one of the
founding members of AESIC ñ Association in Europe for Safety and Infection Control in Dentistry. He is also
a member of the subgroup for dental professionals within Strama - the
Swedish strategic programme against
antibiotic resistance.
[19] =>
United Kingdom Edition
June 4-10, 2012
Infection Control Tribune 19
Infection control is continually
neglected in dental education
DTI’s Ben Adriaanse interviews Dr Hans de Soet, microbiologist and expert
in infection control
countries?
I did not observe any fundamental
differences. There are, of course,
some minor variations. For exam-
ple, in some countries gloves can
be used more than once. Generally though, the regulations are
quite similar.
STANDARD GRACEY
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guidelines in Europe. Dental
Tribune Netherlands spoke with
Dr Hans de Soet, microbiologist
and expert in infection control
at ACTA, and chairperson of
the event.
The conference offered lectures
on the current situation in the
Netherlands, Ireland, Scotland,
Germany and Sweden. What is
the most noteworthy regarding
the current situation in these
requires a separate record, such
as “equipment validation”. This
seems practical and logical, but is
DT page 20
PERIODONTAL
‘In Scandinavia,
dentists are
obligated to record
their activites
concerning infection control according to 10 stipulations. Each requires
a separate record,
such as “equipment
validation”’
Dental
Tribune
Netherlands:
Dr De Soet, what are your
thoughts on the conference in
Amsterdam?
Dr Hans de Soet: It was a successful conference. At last year’s
European Oral Microbiology
workshop, we sensed a need for
harmonisation in dental hygiene
and infection control. Apparently,
there are substantial regulation
differences among European
countries: in some, these regulations are set up as laws, while in
other countries they are merely
stipulations. The way in which
these guidelines are enforced
also varies.
In Scandinavia, dentists are
obligated to record their activities concerning infection control
according to 10 stipulations. Each
ß
I
n 2009, a group of microbiologists established the
Association for European
Safety & Infection Control in
Dentistry (AESIC), an organisation that promotes European collaboration for shared
knowledge and uniform legislation on infection control and
dental hygiene. This March,
AESIC and ACTA, an academic
centre for dental education in
the Netherlands, organised a
conference in Amsterdam with
the theme Harmonising dental
infection prevention guidelines
in Europe. During the conference, steps were taken towards
establishing a collaborative
working group to collect and
share dental infection control
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Gracey ad_GB_A4_2012.indd 1
16.02.12 14:38
[20] =>
20 Infection Control Tribune
ß DT page 19
not mandatory in other countries.
The situation in the UK is not
ideal either, in that all local authorities perform their own research and establish their own
regulations, owing to apparent
regional differences. In this case,
political considerations undermine efficiency, which stresses
the need for a European organisation like AESIC, which does not
serve political goals, but focuses
on science.
Infection control is currently
a hot topic in Dutch dentistry,
owing to the strict enforcement
of equally strict regulations.
How does this compare with the
rest of Europe?
By comparison, our regulations
are well developed: they are extensive, clear and realistic. Although some dentists regard them
as too strict, they are actually
more flexible than those of some
other countries. For instance,
Dutch dentists are not obligated to
publish an annual record of their
activities with reference to patient
safety. Dutch regulations are also
unique in that they are developed
by an independent party.
Regulations also require enforcement. How does foreign
regulation enforcement differ
from that in the Netherlands?
The Dutch situation is very good,
partly because of its well-functioning government-owned monitoring agency. The England monitor is of high standard as well,
especially compared with most
other European countries. Often,
patients need to file a personal
complaint before any action is taken against a dental practitioner.
The goal of the conference was
to establish a European working
group. What activities will this
group undertake?
The working group is not primarily concerned with formulating
European regulations. We are
mainly interested in sharing our
thoughts on patient safety. We
can all benefit from sharing our
knowledge at an academic level
and performing research using
data from all over Europe. The
ultimate goal is to give infection
control the place it deserves in
academic research programmes.
Once we have finished map-
‘Once we have
finished mapping
the current state of
infection control,
we can determine
whether it is possible to formulate
regulations at a
European level’
ping the current state of infection control, we can determine
whether it is possible to formulate
regulations at a European level.
As our situations do not differ significantly, it makes no sense that
our regulations do.
Does the subject of infection
United Kingdom Edition
control receive enough attention in dental education?
No, it is substandard in all European countries. Students learn
all about every possible dental
treatment, but the students’ and
teachers’ knowledge of infection
control is minimal. ACTA has a
small research department that
investigates and teaches dental
microbiology. However, this department was not spared in recent
budget cuts. In general, infection
control is continually neglected
in dental education, even though
poor oral hygiene leads to serious
health risks.
If all experts agree on this, why
doesn’t infection control take up
a more prominent place in dental education?
The problem is that the risks are
difficult to prove, and on a relative scale few cases can be linked
to poor oral hygiene. In our opinion, however, every case is one too
many.
The Lancet published a case
about an 82-year-old Italian patient who died of Legionella infection after seeing a dentist. The
Netherlands has never seen a
serious case like this, but if infection control is neglected, we just
might. As I indicated, the smaller
education budgets force universities to make certain choices. Unfortunately, microbiology is not a
priority for most dentists.
By the way, AESIC does not
confine itself to infection control
alone. We also discuss infection
treatment. Antibiotics are too
easily prescribed, even when not
necessary or desirable. Students
should also be taught the alternatives in infection treatment.
You indicated that infection
control in the Netherlands is of
a relatively high standard. Does
this mean that other countries
could benefit more from a European working group?
There is room for improvement
for us as well. The regulations for
Fig 2: Twenty-five experts attended the AESIC/ACTA conference in Amsterdam. (Photo courtesy of ACTA)
June 4-10, 2012
infection control in dentistry are
largely based on general medicine, which means that some
regulations may be too strict. We
lack empirical evidence of the risk
of infections like Legionella and
MRSA.
Therefore, it is difficult to determine whether and how the
regulations should be adjusted:
should they be stricter or more
flexible? There is some data about
MRSA in general medicine, but
not in dentistry. Now, we could
wait until something goes wrong,
or we could cooperate with other
dental professionals and experts
for whom MRSA is increasingly
problematic.
AESIC was set up in 2010. What
has the organisation accomplished so far?
Eighteen months is too short for
any tangible accomplishments,
but we have achieved a wonderful goal in bringing together so
many academics and commercial
representatives. The latter are of
crucial importance too: we can do
all this research, but it’s the manufacturers that have to produce the
desired devices and products.
AESIC
aims
to
anticipate
Fig 1: Dr Hans de Soet
split up into various reports, rules
and regulations. We have now decided to take one set of regulations
as starting point and compare it
with those of other countries. This
could be done by students.
Another important project is to
develop an educational curriculum that clearly states our minimal requirements for infection
control knowledge for all dental
professionals. We will also investigate how to get funding for collaborative research in our focus area,
‘The Dutch situation is very good, partly
because of its well-functioning governmentowned monitoring agency’
new developments, enabling it
to steer manufacturers in a certain direction. For instance, few
dental chairs are equipped with
an automatic drainage cleaning
system. Were such a system to be
made compulsory, manufacturers
should be able to anticipate this at
an early stage.
Dental
manufacturers
are
probably hoping for very strict
regulations on infection control,
thus forcing dental practitioners
to make large investments in
this field.
Some companies may think like
that, but those that join AESIC
adopt a responsible stance, demonstrating their passion for dentistry and their willingness to
achieve optimal infection control.
We sincerely value their contribution. Aside from that, conferences
like this one need funding and we
need commercial parties in that
respect as well.
How close are you to establishing a European working group?
We have now inventoried the
main similarities and differences between the regulations in
European countries. In doing
so, a practical problem immediately became apparent: The
Netherlands is the only country
that has translated its regulations
into English. Also, they are often
so that we can gather stronger
empirical evidence.
Will
the
Netherlands
be
represented
at
subsequent
AESIC meetings?
We have decided to meet once a
year. It could well be that the next
conference will again take place
in Amsterdam because of its central location. In that case, we will
definitely play a substantial role
again.
My colleague Wilma Morsen
and I were strongly involved in the
organisation of the conference,
but even if the next meeting takes
place abroad, the Netherlands will
certainly be represented. DT
Flags of the Europe
[21] =>
Infection Control Tribune 21
ONE wipe Protein contamination
does it all! in the dental surgery
Peter Bacon discusses surface cleaning and
disinfection
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HTM 01-05: 6.57
“Care should be taken in the use of alcohol wipes,
which – though effective against viruses on clean
surfaces – may fix protein and biofilm.”
To request your FREE sample,
view the Biocleanse Ultra video
at www.dentisan.co.uk
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Blood has the potential to carry
and transmit viruses such as HIV,
HBV and HCV. The risk of transmission of communicable bloodborne viruses might be considered
to come only from high risk areas
such as accidental sharps injuries,
but greater research and advances in the sphere of microbiology
now provides evidence that many
micro-organisms can survive
on a variety of surfaces, making
the danger of disease transmission from contaminated surgery
surfaces or equipment a genuine
threat to patients and staff. In addition, an increasingly mobile population including greatly increased
economic migration has resulted
in a resurgence of diseases such
as TB, which are associated with
overcrowding and poor standards
of general health.
In order to overcome the potential issue of surface decontamination and the prevention of
transmission of pathogens, dental practices must have rigorous
infection control policies which
establish clear protocols for cleaning and disinfection and document the practice’s adherence to
the procedures laid down.
Decontamination is defined as
a reduction in the risk of contamination to a level that is acceptable,
ie controlling the number of microbes in an environment. Within
a dental surgery, both cleaning
and disinfection are required
but although the terms are often
confused they are not the same
thing. Cleaning involves physical
removal of soiling matter from
surfaces while disinfection is inactivation of pathogens. Cleaning
must take place before disinfection to ensure that bacteria, proteins and other contaminants are
removed from surfaces before
disinfection takes place, unless a
suitable single stage process is in
use.
area is aided by the use of commercially available products and
many of these agents are based
on alcohol. In dentistry, alcohol
has been widely adopted as a disinfectant for many years and its
efficacy in this role is well documented.
The widespread use of alcohol as a disinfectant in dentistry
has been largely driven by its low
cost and quick drying properties,
where its rapid drying is perceived as beneficial in achieving
a short turn-round time between
patients. However, rapid evaporation of alcohol based products
also means that by the time the
treatment of a surface has been
completed, most of the alcohol
has evaporated from the wipe or
surface, so the areas wiped at the
end of the process will be neither
cleaned nor effectively disinfected.
As stated in HTM 01-05, alcohol does not clean effectively
but will disinfect clean surfaces,
therefore, a two-stage process is
required when using an alcohol
based disinfectant.
1. Clean to remove physical soiling
2. Disinfect with alcohol to inactivate pathogens
A fact frequently overlooked,
but one that is highlighted by the
HTM 01-05 guidelines, is that alcohol is not effective as a cleaner,
particularly where protein based
soils are present as is likely to be
the case in medical and dental environments.
This process however is less
than desirable from an operational point of view due to the additional time required to carry out
two procedures between each patient as well as the additional cost
of buying two products and the
additional inventory required.
Section 6.57 of HTM01-05
states: Evidence suggests that the
use of commercial bactericidal
cleaning agents and wipes is helpful in maintaining cleanliness and
may also reduce viral contamination of surfaces. Care should be
taken in the use of alcohol wipes,
which – though effective against
viruses on clean surfaces – may fix
protein and biofilm. However, the
careful use of water with suitable
detergents, including those CEmarked for clinical use, is satisfactory provided the surface is dried
after such cleaning.
Therefore we have seen in
recent years a growing demand
for water based combined cleaners and disinfectants. The ideal
solution is a carefully formulated
water based product that can both
remove soiling and disinfect in a
single process, greatly reducing
the time taken and providing an
effective solution.
NOTE: Alcohol has been shown
to bind blood and protein to stainless steel. The use of alcohol with
dental instruments should therefore be avoided.
Some of the limitations of alcohol are as follows:
• Protein fixation
• Materials incompatibility (particularly PMMA)
• Rapid evaporation
• Flammability
If we consider the ideal properties of a combined disinfectant
and cleaning agent, most “experts” would agree that the following would be a reasonable,
though not exhaustive list:
Use biocides safely. Always read the label and product information before use.
Decontamination of a specific
• Broad spectrum microbiocidal
action – some microbes present
bigger challenges than others, for
example TB
• Non-toxic – or at least selectively
toxic
• Short contact time – driven by
time pressure and the need for
short turnaround between patients
• Stability – some agents have a
very short shelf life
• Ease of use – no complicated
making-up requirements
• Competitively priced
• Excellent cleaning action
The properties required in
such a combined cleaner and disinfectant would be:
• Broad spectrum efficacy
• Wide surface compatibility
• Effective cleaning
• CE marked Class 2a (required if
a product is to be used to disinfect
medical devices)
• pH neutral
• Two-year shelf life
• Low residue
• Supplied in all formats (ready to
use, concentrate and wipes)
The ability to deliver all the
required features and their associated benefits in a single product
will answer the demands of the
market and provide a means of
ensuring complete compliance
with current guidelines. DT
About the author
Peter
Bacon
is
Technical Director at Dentisan.
www.dentisan.co.uk
[22] =>
22 Clinical
United Kingdom Edition
June 4-10, 2012
Treatment of gingival
hyperpigmentation
Drs Prabhuji, S Madhupreetha and V Archana discuss using the diode laser for
aesthetic purposes
Fig 1 Pre-op situation
T
he colour of the gingiva
is various among different individuals and it is
thought to be associated with
cutaneous pigmentation. It depends on the vascular supply
of the gingiva, epithelial thickness, degree of keratinisation
of the epithelium and the presence of pigmented cells.
Oral pigmentation is the
discolouration of the mucosa
or gingiva. It can be either
due to physiological or pathological conditions. Melanin,
a brown pigment, is the most
common pigment associated
with the etiology of oral pigmentation.
Gingiva is the most common site of pigmentation in
the oral cavity. This hyperpigmentation is seen as a genetic
variation in some populations
independent of their age and
Fig 2 Use of the FOX diode laser to treat gingival pigmentation
sex. Hence it is termed as
physiological or racial gingival
pigmentation. Melanosis of the
gingiva is frequently present
is dark skinned ethnic groups
as well as in different medical
conditions. Although pigmentation of the gingival is completely a benign condition, is
an aesthetic problem in many
individuals.
Gingival depigmentation is
a periodontal surgical procedure in which the gingival hyperpigmentation is eliminated
or reduced by different techniques.
Gingival depigmentation
Various depigmentation techniques have been employed
with similar results .Selection
of a technique should be based
on clinical experience and individual preferences.
The various methods includes gingivectomy, gingivectomy with free gingival auto
grafting, electrosurgery, cryosurgery, radiosurgery, chemical agents such as 90 per cent
phenol and 95 per cent alcohol,
abrasion with diamond bur,
Nd:YAG laser, semiconductor
diode laser and CO2 laser.
One of the most common
techniques for depigmentation is the surgical removal
of
undesirable
pigmentation using scalpels. In this
procedure, gingival epithelium is removed surgically
along with a layer of underlying connective tissue. The denuded connective tissue then
heals by secondary intention.
Laser ablation of gingival
depigmentation has been recognised as one of the effective
techniques. Different lasers
Fig 3 Immediate post-op situation
have been used for gingival
depigmentation
including
carbon dioxide (10.600nm),
diode (810nm), Neodymium:
‘One of the most
common techniques
for depigmentation is the surgical
removal of undesirable pigmentation
using scalpels’
Yttrium Aluminium garnet
(1.064nm) and Erbium: YAG
(2.940nm) lasers.
Fig 4 One week post-op
Fig 5 Three months post-op
Fig 6 Pre-op situation
Fig 7 Use of the FOX diode laser to treat gingival pigmentation
Fig 8 Immediate post-op situation
Fig 9 One week post-op
The diode laser was introduced in dentistry a few years
back. The diode laser is a solid-state semiconductor laser
that typically uses a combination of Gallium (Ga), Arsenide
(Ar), and other elements, such
as Aluminium (Al) and Indium
(In), to change electrical energy into light energy. It also can
be delivered through a flexible quartz fibre optic handpiece and has a wavelength
of 819nm.This energy level is
absorbed by pigmentation in
the soft tissues and makes the
diode laser an excellent hemostatic agent. It is used for soft
tissue removal in a contact
mode. The power output for
dental use is generally around
two to 10 watts. It can be either
pulsed or continuous mode.
The present case series describes simple and effective
depigmentation
techniques
[23] =>
United Kingdom Edition
Clinical 23
June 4-10, 2012
visited the department of
Periodontics,
Krishnadevaraya College of Dental sciences, Bangalore with the chief
complaint of “blackish gum”.
The medical history was noncontributory. Intra-oral examination revealed generalised blackish pigmentation of
the gingiva, however it was
healthy and completely free of
any inflammation.
Fig 10 Three months post-op
using A.R.C. Fox™ (semiconductor diode laser), which
have produced good results
with patient satisfaction.
Considering the patient’s
1200116_iChiro_UK-A4_Mise en page 1 29.03.12 15:26 Page1
concern, a laser depigmentation procedure was planned.
Procedure
The depigmentation was performed identically to the first
case. Analgesics and chlorhexidine 0.2 per cent mouthwash
were prescribed.
Results
No post-operative pain, haemorrhage, infection or scarring
occurred in first and subse-
quent visits. Healing was uneventful. Patient’s acceptance
of the procedure was good and
results were excellent as perceived by the patient. DT
About the author
Drs Prabhuji, S Madhupreetha and
V Archana Department of Periodontics, Krishnadevaraya College of Dental Sciences Hunasamaranhalli, Via
Yelahanka, Bangalore, 562157, India
prabhujimlv@gmail.com
Case report one
A 22 year old female patient
visited the department of Periodontics,
Krishnadevaraya
College of Dental sciences,
Bangalore with the chief complaint of “blackish gum”. The
medical history was non-contributory.
Intra-oral examination revealed generalised blackish
pigmentation of the gingiva,
however it was healthy and
completely free of any inflammation.
Considering the patient’s
concern, a laser depigmentation procedure was planned.
Procedure
Diode Laser (A.R.C. Fox™)
with wavelength of 810nm was
selected for the procedure. No
topical or local anaesthesia
was given to the patient. Melanin pigmented gingiva were
ablated by diode laser vaporization with a flexible ,hollowfibre delivery system with a
non-contact, air cooling handpiece, under standard protective measures. The procedure
was performed on all pigmented areas. Remnants of the
ablated tissue were removed
using sterile gauze damped
‘The diode laser is
a solid-state
semiconductor laser
that typically uses a
combination of Gallium, Arsenide and
other elements’
with saline. This procedure
was repeated until the desired
depth of tissue removal was
achieved. Analgesics and chlorhexidine 0.2 per cent mouthwash were prescribed.
Case report two
A 24 year old female patient
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[24] =>
United Kingdom Edition
24 Practice Management
Feature 11
June 4-10, 2012
United Kingdom Edition
June 4-10, 2012
No longer a sensitive subject
Why improving your practice is
Ta mystery – part nine
ble and memorable as you can.
Don’t worry, I won’t advocate
you donning fancy dress and
parading down the high street
a mild
twinge to havdismisses this procedure altotreatments, strips and gels. But
lion according to the Academy of
– whichthing
mustfrom
surely
be banned
severe
gether in search for a less paina common factor of this cosmetGeneral Dentistry.
by GDCing
rules.
And,discomfort
in any case,that lasts
for the
several
even days.
ful option.
ic procedure is that the patient
I’m using
‘royal’hours
you –or
your
Be it
a result
of teeth
whitening
will almost certainly experiThis growth has allowed
practice,
your
practice
team
and you.
or if they are simply sensitive to
And it’s not just after teeth
ence some level of discomfort
teeth whitening to become
heat, cold, sweetness, acidity or
whitening, dentine hypersenthrough sensitivity. This pain
more accessible for patients
Patient
journey by educating patients
album
released
a
month
later
bum
track
of
the
same
name
brushing,
sitivity affects one third of the
can often be so excruciating
and there’s a solution to suit all
I’ve written
before
about with
how dentine
point?
Well, hereatI some
want point
andthat
included
part of the
namestops My
and
reached
number procedures,
18 in the
on how
to deal
adult
population
the patient
either
budgets;
in-office
your team
should work you
to en-can help
to discuss
why
andThis
howcan
you
of the
band. That’s
correct;
it’s or
record
charts. The title of
the
hypersensitivity
in their
lives.
be anytreatment
halfway
through
dentist-prescribed
at-home
sure each
person aenjoys
should make yourself as visiWho Are You by The Who.
single was the same as the
them achieve
whiter,abrighter,
‘wow’ patient
journey.
But the
“pain-free”
smile.
benefits of that great experience in
terms of the
Explaining
theopporcauses and
tunity symptoms
for patientsoftosensitive
share it teeth
with friends
and family,
willconfused
Many people
can be
be lost about
if theythe
can’t
remember
causes
of their senwho you
are.
You
may
think
sitive teeth so it’s important
you’re to
memorable
butaware
believeof all the
make them
me you’re
eminently
common
factorsforgettaand put them at
ble! Don’t
take
it
personally.
As the hard
ease. Generally, when
soon asenamel
patientsishave
their
foot or gums
worn
down
out of the door they’ll probrecede the dentine tubules beably begin forgetting the name
come exposed; the causes and
of your practice, most likely
symptoms will differ for every
failing to recall the name of
patient, from eating or drinking
the dentist or hygienist they
foods and hot or cold beverages
saw and certainly putting
to touching teeth or exposing
out of their minds the names
them to cold air.
of nurses and front of house
(FoH) staff! I offer no science
to support this, only empirical
evidence based on making telephone calls to patients when
I’m commissioned to undertake satisfaction surveys.
Eric Peterson discusses sensitivity and whitening
he
popular
accessory
nowadays is not just the
handbag, the shoes, or the
Chihuahua; it’s the pearly white
smile to boost appearance and
self-esteem. In fact, tooth whitenkay,
pop fastest
quiz time!
In
ing is one
of the
growing
July 1978
a single
was
in the dental
market,
boasting
released
an estimated
value which
of £600 was
milan edited version of the al-
Jacqui Goss asks: Who are you?
‘By educating
patients
on how
So, how
do you counter
this to
collective and, presumably, sedeal with dentine
lective amnesia? Quite simply,
your namehypersensitivity
(by which I mean
the practice
approyouname
canand
help
them
priate team member names)
a whiter,
should goachieve
everywhere.
Logo
and nameplate
design“pain-free”
is not my
brighter,
department but I do know they
future’
should be distinctive,
memora-
Look out for our
free sample within
this issue of
Dental Tribune
ble and repeatedly visible. I’ve
quite often walked in to a dental practice (and other establishments) and seen nothing to
reinforce The
the knowledge
that
pain associated
with
I’m in dentine
the correcthypersensitivity
place. Look
can
aroundeven
your affect
practice
–
does
my
the eating, drinking,
comment
ring
true?
and breathingThere
habitsare,
of patients,
of course,
many
places
to
put
so it’s ideal to start by informyour practice
name
or logoteeth are
ing them
thatand
sensitive
– leaflets,
posters,
mugs, pens
relatively
common
and not usuand so ally
on. a health concern.
Name calling
• Check which toothpaste they
Turning
FoHabrasive
team, ingreuseto – the
Highly
which is
my department,
dients
found inthere
toothpastes
are several
ways
they
can
recan add to the discomfort, as
inforcethey
the name
of thetopraccontinue
wear away
tice, the
names
of
the
clinical
the enamel.
Patients should
staff and their own names. The
steer clear of highly abrasive
most obvious is for the infortoothpastes, especially after inmation to be on their clothing.
surgery treatment, as they can
However, this may not be obdamage the teeth and gums,
viously visible to the patient as
removing the lustre of the teeth
they approach the reception
and dulling an otherwise beauarea (they may not be wearing
tiful smile.
their reading glasses) so have
nice large nameplates on the
Using tartar-control toothdesk or counter as well. FoH
pastes can cause teeth to bestaff should get in the habit of
come sensitive and should be
introducing themselves. This
There are but
many types
is vitalavoided.
on the telephone
of toothpaste
available
also useful
in face-to-face
con- on the
formulated
tact. Asmarket
well asspecifically
the ‘who are
you?’ benefits I’m discussing
DT page 12
ß
O
[25] =>
temperature. The temperature should then remain conhere, itwithin
also prevents
patients
stant,
specified
temhaving
to
make
awkward
refperature band, throughout
erences
such
as: “The girl
on
the
whole
sterilisation
phase
reception said…” time).
or “Can
(plateau/holding
In you
the
lend
me
your
pen,
er,
miss?”
post-treatment phase, either
the steam or the re-vaporised
Now for water
some are
clinical
staff
condensed
removed
name
reinforcement.
FoH staff
by
vacuum
to guarantee
the
should
say
something
simigoods to be dried rapidly.
lar to: “Right Mrs Goss, your
appointment
is air
withmust
Doctor
Virtually all
be
XXXXX
in
five
minutes
and
her
evacuated during pre-treatnurse, (pre-vacuum
XXXXX, will collect
ment
phase)you
so
when
she
is
ready.”
that the saturated steam can
An area of contact will not be
properly cleaned and disinappointment
reminder card
fected.
system is still valid and should
be
used.
You may also
consider
Two
different
metals
will
acause
system
whereby
patients
get
corrosion
rewarded
a
Corrosionfor
is recommending
a common probfriend.
If so, you’ll
to fluid,
give
lem. When
in theneed
same
them
something
can
pass
instruments
andthey
other
articles
on
– similar
to a business
made
of different
metalscard,
may
perhaps.
corrode, and corrosion destroys sharp and delicate inThere is Corrosion
an almost pits
endless
struments.
will
choice
of
corporate
gifts
as
also make the surface rough,
potential
giveaways.the
I favour
which increases
possithings that are likely to be re-
June 4-10, 2012
June 4-10, 2012
Infection Control Tribune 17
Practice
Management 25
bilities of microorganisms to
attach themselves to the intained
and, Mixing
preferably,
kept
struments.
different
where
they
areineasily
visible.
types of
metal
a liquid
soluMy
noticeboard
in
the
kitchtion will result in an electroen
is so overcrowded
that corfor
chemical
cell and cause
this
reason
I suggest
rosion
– this
is oftenavoiding
the case
things
that
need
to
be
pinned
during cleaning, ultrasonic
up.
How
about
a fridge
magnetbath
and
washer
disinfectors
ic,
a branded
pen or a mouse
when
using aluminium
trays
mat
instead?
For
ideas
of
giveaand instruments in stainless
ways,
you look carbon
at the
steel Iorsuggest
when cleaning
British
Dental
burs and
bursHealth
made Foundaof staintion
shop
(http://www.dentalless steel in the same liquid
health.org/shop).
Anything
you
container. However,
in daily
do give to patients must contain
dentistry we call this rust
and blame the manufacturer
your
name and
contact
for practice
poor material
– the
actual
details.
problem is clinical routines!
And finally, a few words
about
If you set
Don’tsocial
makemedia.
it too heavy
up
a practice
Twitter,
FaceMetallic
weight
is another
debook
or
other
social
media
cisive in decontamination and
account,
do make
your energy
posts
sterilisation.
The heat
‘social’
(ie not
just oralwaves
healthin
from the
ultrasonic
orientated)
and dobath
keep it
gothe ultrasonic
and/or
ing.
dormant
givesor
the Awater
in a account
dishwasher
a washer
poor impression
disinfector –asshut
well itas
down
if you’re no
longer
going
the saturated
steam
from
the
tosteriliser
use it. On
LinkedIn,
which
shall be concentratis a showcase for your profes-
affect the goods during the
They can
actually
a bit
sterilising
phase.
If be
present,
more sophisticated.
If the
trapped
air pockets
in denthe
tist or hygienist in question is
goods prevent steam penetraa recent addition to the praction during sterilisation of porous material such as textiles
and hollow items.
‘There is an almost
Steam sterilisation of holendless choice of
low instruments (with long,
narrow
lumina) gifts
and porous
corporate
as
objects always requires sevpotential giveaeral (at least three (3)) preways.pulses
I favor
vacuum
to athings
defined,
pre-set,
vacuum
level.to be
that are
likely
retained and
Fewer instruments, better
preferably kept
control
The type of equipment and
where they are
the type of procedures in use
visible’
at the easily
clinic will
to a very high
extent determine the safety
margin of decontamination.
A
important
issue,
that
ticevery
team
how about:
“Okay,
is
often
foreseen,
is the logisMrs
Goss,
your appointment
is
tics
of
instruments.
A
comwith XXXXX our new hygienmon
problem
in many
ist, whom
I’m sure
you’lldental
like.”
offices is an overload of instruments,
which offers,
will conIf your practice
say,
tribute
to a treatments,
more difficultwhat
and
cosmetic
time
to
about:demanding
“Now Mrsprocedure
Goss, your
keep
track ofisallwith
instruments
appointment
our cosand
todentist,
make sure
that storage
metic
Mrs XXXXX,
and
and
sterile XXXXX,
as well as
packagher nurse,
will
come
ing/wrapping
are
for you in just aconditions
few minutes.”
maintained.
No harm in other patients
overhearing that you have a
An item
heavily loaded
cosmetic
dentist!
with microbiological materialOfwill
be more
difficult
to
course,
XXXXX
the nurse
sterilise
than one lightly
conshould subsequently
say sometaminated.
most
effective
thing like: The
“Hello
Mrs
Goss,
stage
of anyand
decontamination
I’m XXXXX
Mrs XXXXX is
procedure
is now.”
thorough cleanready for you
ing and this should accomReminders
pany
or precede all disinfecDon’t
let patients leave
withtion procedures.
The effect
outcleaning,
somethingdisinfection
reminding them
of
and
where
they’ve
been
and
who
sterilisation is affected by
they’ve
seen.ofEven
with SMS
the
design
the cassettes/
and email
the old
trays
beingreminders,
used. Shadow
effects may easily ensue from
the use of solid cassettes so
that instruments
are not beAbout the author
ing properly cleaned, neither
proven manager of change
inA washer
disinfectors nor in
and driver of dramatic business
ultrasonic
bath.
growth, Jacqui
Goss is the managing partner of Yes!RESULTS. By using Yes!RESULTS dental practices
Fastened
but free
see an increase
in treatment plan
take-up, improved
patient
Instruments
should
be satisfree
faction and more appointments
and
fastened
trays
so that
resulting
from on
general
enquiries.
Yes!RESULTSwaves,
turns good
practices
ultrasonic
water
jets
into great practices. Managing
and steam can reach every
Partner, Yes!RESULTS Honeydale
part
clean
inactivate
Barn,to
Wall
under and
Heywood,
Shropshire
SY6
7DU
Tel:
08456
efficiently during the 448066
whole
Mob: 07795 562617 Email: jacqui@
procedure
of disinfection
and
yesresults.co.uk
Website: www.
yesresults.co.uk
Twitter:
@Yesresterilisation. Even if fastened
sults www.facebook.com/Yesresults
the
instruments must be free
http://uk.linkedin.com/in/jacquigoss have no contact points/
and
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DT page 18
United Kingdom Edition
United Kingdom Edition
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Dental tribune_June12.indd 1
28/05/2012 12:00
[26] =>
26 DCPs
United Kingdom Edition
June 4-10, 2012
The art of listening
Mhari Coxon discusses how using your ears can lead to success
I
n general practice we can
often feel we don’t have
time to listen to our patients. And can we really be
bothered anyway? I mean, they
do go on a bit don’t they?
And yet, if we don’t listen
actively we run the risk of
missing out on treatment and
by default money. Yes, I said it,
listening can make you money!
Listening well can help you
to identify the patient’s wants
and needs and work these into
the treatment options you offer
them. And it can’t just be one
team member that does this.
For optimum results it needs
to be the whole team.
MediMatch dental laboratory
MHRA:CA009413 - DLA member - GDC registered staff - London Based - TUV - ISO 9002 - ISO 9001:2000
Milled Implant restoration
All inclusive pricing by MediMatch!
Porcela
i
n
Restora Bonded
tion (Co-C
r)
+
Cad/Ca
m
Abutme Milled
nt (Co-Cr)
For jus
t £ 28
0,Single u
nit on
im
plant
*Screws are not include *Analogues are not included
Our Cad/Cam abutments may vary in design from the original. Please call and find out if we have your brand and platform
available (in our database). MediMatch will only make abutments when part of a restoration. MediMatch will not supply the
screw for the final work; It is best to use a new screw from the original brand when the work is being fitted.
T: 08 444 993 888
MediMatch Dental Laboratory
Your -Private- Dental Lab
Terms and conditions apply. The alloy is charged per gram on the day of casting and is not included in the above prices. Price is
correct on day of going to press. MediMatch has the right to amend or terminate this promotion at any time. Protocols are for
guidance only. No clinical decision should be based on the above information. MediMatch cannot be held responsible for any
clinical decision whatever advice has been given in writing or verbally.
Orion Business Park, Northheld Avenue, West Ealing, London W13 9SJ
lab@medimatch.co.uk - www.medimatch.co.uk
Here are some simple tips
that can get you listening actively quickly and simply.
Shut up!
No really, ask a question and
then do not talk again until you
are absolutely sure the other
person is finished talking. It is
amazing the extra insight you
will gain by trying this. When
we interrupt two things may
happen. They will either persevere and talk for a long time
because of it, or they will clam
up altogether.
Ask permission
When you want to discuss something with a patient, stopping
smoking, changing diet, adding
a new oral hygiene product to
their routine; ask permission to
start the conversation. Rarely
the patient will say no. When
they do, respect that. It is so
hard to do but DON’T talk to
them anyway. They will see the
respect you gave their wishes
and be much more receptive to
you as a person, and in the long
run, your advice.
Take note
A great way to show you
are listening well is to write
down what the patient is saying. It doesn’t have to be word
for word but writing in their
choice of words then repeating these back to them can really show the patient has been
heard and understood. All of
us, regardless of background
or circumstances, value being
listened to and understood.
‘A great way to
show you are listening well is to write
down what the
patient is saying. It
doesn’t have to be
word for word’
Make a questionnaire with
open questions on it
To help the whole team get into
the swing of active listening
make your questionnaire have
open questions in it instead of
closed. An open question requires more than a yes or no
answer. For example: What
was it that made you decide to
book for your visit today? Open
questions can help lead the pa-
[27] =>
The art of listening
United Kingdom Edition
DCPs 27
June 4-10, 2012
Mhari
Coxon
discusses
your ears can lead to success
uring whichhow
listening using
sessions
That way
you can compare
went best.
how you communicate and listen now with the listening you
the treatment options you offer
on aare
bit don’t
they?
n will
general practice
canover do go We
all individuals
so by default money. Yes, I said it,
as a we
habit
‘To help the whole often develop
them. And it can’t just be one
don’tshould
have be learning a way of doing this listening can make you money!
time. feel
The we
results
team get into the time
team member that does this.
Listening well can help you
to conclusive
listen to our
Andworks
yet, if
listen
that
forwe
youdon’t
is important
pretty
that pathis is
For optimum results it needs
to identify the patient’s wants
really
be pa- actively
we run the risk of
too.
bestcan
way we
to work
with
swing of active tients.theAnd
tients
for theirI patient
centred missing out on treatment and
to be the whole team.
and needs and work these into
bothered
anyway?
mean, they
listening make your
Good luck and remember care pathway.
questionnaires have
we have two ears and only one
mouth for a reason. DT
Build it up one patient at a
open questions’
time per day over a week or so,
then look back and reflect on
You will gain extra insight by listening to your patients
MHRA:CA009413
- DLA member - GDC registered staff
- London Based - TUV - ISO 9002 - ISO 9001:2000
the benefits
as well as meas-
I
MediMatch dental laboratory
tient’s thoughts as well as providing the team with quality
information about the patient.
Re- read those notes
It is not easy to remember
each patient so always take a
minute to re-read your notes.
Remembering that their son
was doing his driving test, that
they hate the sound of the slow
speed, dread the 3in1; these
little touches mean so much
to your patients and will keep
them coming back.
Share – unless asked not to
Share the information received
with all the team so there can
be continuity in conversations
with the patients. Obviously, if
the patient tells you something
in confidence and asks you not
to share this again respect their
wishes. The only time this does
not stand is if the information
could pose a risk to others.
Try it out a bit at a time
Learning any new skill can be
tiring, and can make us run
late! So, try out listening in
this way to one patient in your
morning list, then on one patient from your afternoon list.
About the author
Mhari Coxon has 20 years experience in dentistry, working as a nurse,
receptionist, oral health advisor and
ultimately hygienist in a variety of
practice environments. She is passionate about her profession. At present, she works as Senior Professional
Relations Manager for Philips Oral
Healthcare and clinically as a hygienist in central London. From Chairing
the London BSDHT for 3 years, and
working as an MD; Mhari excels at
motivating and co-ordinating a team
and utilising skills, decentralising
leadership and developing self efficacy in members. Throughout her
career Mhari has developed hygiene
protocols and plans in practices which
have continued to be used with great
success. Mhari is Clinical Director for
CPDforDCP Ltd, a training company
offering motivational and interactive
development courses to the dental
team. A keen writer, Mhari is on the
Publications Committee of Dental
Health, the British Society of Hygienists and Therapists (BSDHT) Journal,
has a conversational column in Dental Tribune and writes articles for
many other publications and online
sites. As a speaker Mhari has presented regionally, nationally and internationally for many groups including
Talking Points in Dentistry, the British
Orthodontic Society Specialist group,
the BSDHT, the BDA, the International Symposium of Dental Hygiene,
the dentistry show and many others.
In 2006 she was the Probe Awards
hygienist of the year, and was highly
commended in 2010. 2011 saw her
placed 15 in the Dentistry Top 50 most
influential people in the UK.
Milled Implant restoration
All inclusive pricing by MediMatch!
Porcela
i
n
Restora Bonded
tion (Co-C
r)
+
Cad/Ca
m
Abutme Milled
nt (Co-Cr)
For jus
t £ 28
0,Single u
nit on
im
plant
tha
tiv
Sh
No
the
are
pe
am
wi
we
ha
sev
be
up
As
Wh
thi
sm
a n
the
sta
the
the
ha
the
res
an
you
run
Ta
A
are
do
ing
for
ch
ing
all
he
us,
or
list
sh
i
*Screws are not include *Analogues are not included
Our Cad/Cam abutments may vary in design from the original. Please call and find out if we have your brand and platform
available (in our database). MediMatch will only make abutments when part of a restoration. MediMatch will not supply the
screw for the final work; It is best to use a new screw from the original brand when the work is being fitted.
T: 08 444 993 888
MediMatch Dental Laboratory
Your -Private- Dental Lab
Terms and conditions apply. The alloy is charged per gram on the day of casting and is not included in the above prices. Price is
correct on day of going to press. MediMatch has the right to amend or terminate this promotion at any time. Protocols are for
guidance only. No clinical decision should be based on the above information. MediMatch cannot be held responsible for any
clinical decision whatever advice has been given in writing or verbally.
Orion Business Park, Northheld Avenue, West Ealing, London W13 9SJ
lab@medimatch.co.uk - www.medimatch.co.uk
p
d
Ma
op
To
the
ma
op
clo
qu
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[28] =>
28 Infection control
Clean water in minutes
ALKAZYME-W. Decontaminant for dental unit water
systems.
For the routine cleaning and disinfection of dental
chair-side water supply equipment Combined
enzyme based detergent/disinfectant; a simple
15 minute weekly routine service clean is all that
is required to ensure a continuous ‘bacteria free’
water supply. Available through all dental wholesale
suppliers, each 500gm pack allows for up to 100
service applications.
View or download comprehensive product
information visit www.alkapharm.com
United Kingdom Edition
Steritrak for instrument sterilisation
best practice
Steritrak is an inspired solution
from Carestream Dental that tracks
reusable instrument trays throughout
the cleaning process, helping you to
maintain HTM 01-05 standards and
adhere to requirements of the CQC.
Suitable for all dental practices,
Steritrak mirrors the processes of
individual surgery sterilisation or
centralised sterilisation to create
complete
traceability.
Recording
information about cycle parameters and the success or failure of a cycle, Steritrak
also reminds you when a tray is nearing the end of its usable life.
A comprehensive documentation system allows you to generate reports
demonstrating the cleaning and sterilisation history of each tray. These can be
used to support adherence to outcome 8 of the CQC regulations, which relates
to hygiene and infection control for the wellbeing of patients and staff.
Easy to use and with minimal set-up needed, Steritrak takes the strain out of
administering this vital area of practice, ensuring that your surgery is safe and
the relevant information is up-to-date and secure.
For more information, contact Carestream Dental on 0800 169 9692 or
visit www.carestreamdental.co.uk
Decontamination and debris
removal for your dental instruments
Dento-Viractis 55 is a versatile combined
pre-sterilisation
detergent
that
disinfects whilst cleaning instruments.
Dento-Viractis has been designed
specifically to remove debris from hand
instruments and surgical equipment
prior to sterilisation. It is particularly
useful in the removal of blood. It quickly dissolves proteins due to its enzymatic
action. This bacterial, fungicidal and virucidal product is available exclusively
from Dental Sky in either a 2kg or 5kg bucket or 50 unidoses of 15g each. DentoViractis 55 dissolves quickly and easily saving time and effort.
Dento-Viractis 59 is a competitively priced, highly efficient concentrate solution
for cleaning and pre-disinfecting dental instruments. Ideal for use in your
ultrasonic bath, this grapefruit fragranced product speeds up the process of
debris removal and is also bactericidal, fungicidal and virucidal.
Both products are available on buy two get one free offers throughout July and
August.
Dental Sky exclusively supply a complete range of Dento-Viractis disinfecting
products developed specifically to meet the demands of modern day practice.
For further information or to request your free catalogue please contact Dental
Sky on 0800 294 4700.
Prestige Medical Optima autoclave travels to
Mars!
The Prestige Medical Optima autoclave is to feature
in a new sci-fi movie currently being filmed at Elstree
Studios.
‘Last Days on Mars’ is set in 2036 where researchers
have set up a base and laboratory. They are studying
samples of material from the planet when they
discover fossilised remains of bacteria and proof that
life has existed, but the discovery has serious repercussions for the team.
Optima will feature on the main laboratory set that the lead actors, Liev
Schreiber and Elias Koteas, will be using in action as they study mineral and
biological samples.
The film company wanted to use equipment that had a sufficiently modern
appearance so as not to appear out of context in 2036 and Optima was the
ideal choice.
Optima is a considerable jump forward in performance compared with other
autoclaves because of the inclusion of Flash Steam® technology. Flash Steam®
is considerably quicker than current methods, cutting vacuum cycle times
considerable, in some cases by around 50 per cent.
‘Last Days on Mars’ will be released in 2013.
More information is available from Prestige Medical direct by calling 01254 844
103 or email to sales@prestigemedical.co.uk
For more information contact: Christine Bowness, Sales & Marketing Manager
01254 844 101 or email christine.bowness@prestigemedical.co.uk
Invest today for a safer tomorrow
W&H are the ECOnomical Solution for your
decontamination needs, working to comply
with all local guidelines to meet the needs
of a busy practice.
If you are looking to achieve ‘Best Practice’
and are currently asking your staff to
handwash soiled and contaminated
instruments with sharp protrusions, it
is time you looked at purchasing an automated washer disinfector dryer as
recommended by current guidance.
The ThermoKlenz offers guaranteed cleaning consistency and removal
of residual matter left on the instruments due to the regulation of water
temperature and detergent concentration. It also allows validation of a
professional, quality standard of cleaning, with the benefits of efficiency,
proven reliability, ease of use, cost effectiveness and time saving guaranteed
compliant performance.
Why purchase the ThermoKlenz? It is an accredited thermo-washer disinfector
manufactured for purpose with a high grade stainless steel casing and a
chamber of AISI 316 quality, to prevent corrosion by ensuring it can cope with
the strong detergents used and the heavy amount of use within a busy dental
practice.
The question,’ to have or not to have?’ becomes clearer if your aim is ‘Best
Practice’. For further details please contact W&H on office.uk@wh.com or +44
(0)1727 874990.
Melag MELAtherm® – decontamination made easy!
The Melag MELAtherm, available from Henry Schein
Minerva, sets a completely new benchmark in the world
of dental washer disinfectors.
This spacious and compact all-in-one washer can fit
almost anywhere in your practice. Some of the standard
features include a built-in water softener integrated
chemical storage and dosing unit, saving valuable LDU
cupboard and work surface space. Available in 13 Amp or three phase power the
system also boasts integrated process monitoring of the spray arm rotation and
spray pressure, RO water connection, five programmes whilst accommodating
handpiece adaptors for up to 11 hand pieces, as well as an active drying HEPA
air filter.
Within one compact system the Melag MELAtherm successfully combines a
large load capacity, small room space requirement and technical installation
and back-up from qualified Henry Schein Minerva engineers. Additionally, the
Melag MELAtherm’s integrated data logger makes documentation of the entire
treatment process simple, as this intuitive unit quickly and easily connects to
your computer and conveniently administers all required data.
Melag MELAtherm ticks all the right boxes in terms of quality, reliability and
safety standards, and for additional peace of mind is supported by Henry Schein
Minerva Care Plans and extended warranty options!
To make sterilisation easier with Melag MELAtherm from Henry Schein
Minerva call 08700 10 20 41, email sales@henryschein.co.uk or visit
www.henryschein.co.uk
June 4-10, 2012
Trust Clarke Dental for assured
infection control
Clark Dental offers a comprehensive
range of high-quality infection
control products to meet the
stringent regulatory requirements
for dental practices. This range
features alongside Clark Dental’s
specialised design services which
can be utilised to help practices
install a fully HTM 01-05 compliant
decontamination room.
Products include:
• The Medisafe Pico Table Top Washer Disinfector for automated cleaning,
disinfection and drying of dental instruments and hand pieces
• W&H Lisa 500 and the Prestige Advanced Autoclaves
• The revolutionary twelve minute cycle Sirona DAC Universal – the integrated
Handpiece and Turbine cleaner, oiler and autoclave with 27 adapters to suit
any handpiece.
Clark Dental enjoys a well-deserved reputation for superior service, and Clark
Dental’s experienced team will help you to choose for the best products
possible to suit your practice and your budget. You can trust Clark Dental to
provide the best in quality and value for your practice, with safety and infection
control a central part of the company’s approach.
For more information call Clark Dental on 01268 733 146, email
enquiries@clarkdental.co.uk or visit www.clarkdental.co.uk.
Less than £1.39 per 100 wipes
This is an excellent time to try ChairSafe Microfibre
or Economy wipes. Buy 2 x 250 Microfibre wipes
before the end of June for £8.30 each + VAT. Buy
2 x 600 ChairSafe Economy wipes before the end
of June for £8.30 each + VAT. ChairSafe Economy
wipes are available at less than £1.39 per 100
wipes.
ChairSafe disinfectants comply with the newly
reclassified EC regulations regarding the
disinfection of medical devices, and carry their CE mark with pride!
ChairSafe adsorbs and penetrates into the cell wall of bacteria, fungi and
the envelope of viruses. It attacks the phospholipid membrane, altering its
structure-causing disorganisation and faults. Essential molecules begin to leak
out from the cell rapidly reducing its action and destroying them.
HTM 01-05 a guidance published by the DOH, recommends that Dental Chairs
be cleaned between every patient to minimise the dispersal of microorganisms.
ChairSafe products should be used for daily disinfection of surfaces close to
the patient/frequently touched surfaces (eg dental chairs, door handles, work
surfaces).
For information on the full range of Kemdent disinfectants, ChairSafe,
PracticeSafe and InstrumentSafe visit the Kemdent website www.kemdent.
co.uk
For further information on special offers or to place orders call Jackie or Helen
on 01793 770256 or visit our website www.kemdent.co.uk.
Did you know…
… The average brand new dental unit
water line contains approximately 50
times as many bacteria as the standard
for safe drinking water?
Dental water lines provide the optimum
conditions for bacteria to thrive in,
providing a home for Legionella and
other dangerous organisms in biofilm
accumulation within the tubing.
Leading experts in infection control schülke have developed a system to combat
this. The Dental Water Line Solution clears the water line of 100% of biofilm and
bacteria, and with continuous use is clinically proven to prevent recolonisation
when used correctly*.
With one simple biofilm removal procedure followed by continuous application
of a 1% mix of Maintenance solution and water to the dental water line, the
Dental Water Line Solution is quick, simple and cost effective compared to other
treatments requiring repeated procedures.
Use schülke Dental Water Line Solution to ensure the safety of your patients and
staff.
For more information, call 0114 254 3500. Alternatively, visit www.
schulke.com
*When products are used exactly as stated in manufacturer’s guidelines.
Hygiene matters
There are many cross infection hazards within
a dental surgery which necessitate the need for
stringent legislation. Anything that reduces the risk
is therefore well received. The seamless upholstery
on the Cleo II treatment centre from Takara Belmont
is one such example; optimum hygiene is ensured
as there aren’t any crevices for bacteria to escape the
reach of suitable disinfectants and there are touchless sensor controls and easy clean membrane
switches.
The Cleo II is guaranteed to make your patient’s
experience a comfortable one. The ‘super soft’ upholstery range is comforting,
whilst the folding leg rest has benefits for both patient and practitioner. For
the patient, it looks a lot less intimidating when it’s inclined. The practitioner
has multiple benefits including a smaller foot print and a more logical working
area. The operators console can be positioned behind the chair out of the
patient’s view which also eases both DSA and operator access. The Cleo II is
available in either air or electric options the latter of which offers fibre optics,
micro-motor, endodontic features and digital displays as standard.
If you would like to see the Cleo II in situ, without any obligation, you can
make an appointment to visit either the company’s London or Manchester
showrooms. For more information contact Lucy Moscrop (lucy@takara.co.uk).
Handpiece care and maintenance products
from W&H
W&H have a range of handpiece care and
maintenance and decontamination products.
These include the Lisa, Lina and MS Sterilisers,
along with the ThermoKlenz and the W&H
Multidem.
The Assistina is the handpiece maintenance
unit for automatic internal cleaning of spray
channels and lubrication of all handpieces and
motors. W&H offers three sterilisers, the Lisa, the Lina and MS. The Lisa and Lina,
Type B Sterilisers are a reliable partner which can be adapted to your practice
requirements. They are user friendly and offer a great price performance ratio
with a choice of 17 or 22 litre capacity.
Multidem supplies top quality ultrapure demineralised water for generating
steam in all autoclaves, ensuring consistent and optimised performance.
The W&H Premium Care and Premium Careplus Service Plans for W&H
decontamination products have been developed to enhance your
decontamination facility in line with the Department of Health HTM 01-05
guidelines, ensuring peace of mind and the confidence that your sterilisers are
working at its peak performance. W&H also offer an exciting web based 24 hour
online support facility at wh247support.co.uk.
W&H are the ECOnomical Solution for your decontamination needs, working to
comply with all local guidelines.
For further details please contact W&H on office.uk@wh.com or +44 (0)1727
874990
W&H 24-seven support website
W&H are delighted to be offering the dental
team a new service, free of charge, which assists
them in adhering to current decontamination
guidelines. W&H 24seven is a new website which
provides immediate online access to expert
advice on maintenance and compliance testing
for the W&H decontamination product range.
The W&H 24seven website offers: Instructional
videos supported by downloadable Instructions
for Use, Troubleshooting Guides, FAQs, up to date National Decontamination
Guidance and an interactive Alarm Code lookup. In addition relevant information
on optional equipment and accessories is also included.
W&H works consistently to develop new and improve existing products and
services allowing them to continually increase the support that they offer the
Dental Team. W&H are a company who take professionalism seriously always
ensuring that they work to best practice.
W&H 24seven provides round the clock support allowing the dental team to
get advice whenever and wherever it is needed. To find out more about this
new website and to see for yourselves how W&H is working to assist Dental
Professionals by offering invaluable services hitherto not available go to www.
wh247support.co.uk. At W&H People Have Priority.
For further information on W&H products and services, please contact W&H (UK)
Ltd on +44 (0)1727 874990 or marketing.uk@wh.com .
[29] =>
United Kingdom Edition
June 4-10, 2012
Industry News 29
BKH prepares for the journey ahead with
new business development manager
Karl Taylor-Knight has joined the BKH
Group of Companies in the role of Business
Development Manager. He joined the dental
corporate on 26th May 2012 and is primarily
responsible for acquisitions and integrations
as the business continues to grow and evolve.
“My career in dentistry started as a
trainee nurse, which soon progressed into
management,” says Karl. “I have a been exposed
to most sectors in dentistry, from a single
handed NHS practice to first class dentistry in
Harley Street, and most recently working for
the largest dental corporate in Europe.”
Karl is delighted with his new appointment at BKH, saying, “My passion is
people… get the people right and the profit will follow! This is a core value of
BKH and I look forward to the journey!”
For more information about BKH please call 0161 820 5466 or
email Al Kwong Hing at al@bkh.co.uk, Chris Barrow at chris@bkh.co.uk or visit
www.bkh.co.uk Want to stay in touch with the Barrow Kwong Hing Group?
Connect with us here Facebook: www.facebook.com/bkhgroup; YouTube:
www.youtube.com/BarrowKwongHing:
LinkedIn:
www.linkedin.com/
company/barrow-kwong-hing-group: Twitter: Chris Barrow @ChrisBKH, Dr Al
Kwong Hingv@AlanBKH
Carestream Dental CS 7600
short-listed for major new award
Carestream Dental is pleased to
announce its pioneering CS 7600
Digital Imaging Plate System was
recently short-listed for the Clinical
Innovation Award. The award,
which was launched at this year’s
Clinical Innovations Conference,
is designed to showcase some of
the most innovative and effective
products on the market.
The judging panel included a number of well-respected dentists, as well as
members of journal editorial boards. Judges were keen to compliment the CS
7600 for its unique ability to store patient information directly on the plate,
which is of great benefit to busy practices. Judges also praised the CS 7600’s
innovative “Scan & Go” technology, exclusive to the CS 7600 system.
With experience providing industry-leading imaging systems and practice
management solutions across the globe, Carestream Dental’s products are used
by 7 out of 10 practitioners to deliver exceptional patient care. Recognition
by the CIC Innovation Award judging panel is yet further proof of Carestream
Dental’s continued commitment to innovation and success.
For more information, contact Carestream Dental on 0800 169 9692 or
visit www.carestreamdental.co.uk
The Dental Directory supports
the Clinical Innovations
Conference
Pronamel PR – prevalence – 199w
Acid wear appears to be on the
rise. Tooth wear is a multifactorial
condition in which Acid Wear plays
a major role.1 Dental health surveys
indicate that certain forms of tooth wear may be increasing in both adults2 and
children.3
Reflecting the importance of the condition, tooth surface loss has been
incorporated into the pilot NHS dental contract as a part of the Oral Health
Assessment.4
Patients may be unaware of the risks dietary acids can pose to their teeth.
Pronamel has produced a range of educational materials to help raise awareness
of acid wear, including a teaching aid and patient education leaflets.
Pronamel toothpaste, specifically designed to protect against the effects of acid
wear, has an optimised formulation proven to re-harden acid-softened enamel.5
To request trial sized packs visit www.gsk-dentalprofessionals.co.uk.
1. Bartlett D et al. Int Dent J 2005; 55: 277-284.
2. Executive summary: Adult Dental Health Survey 2009. The Health and Social
Care Information Centre, 2011 (Ed. I O’Sullivan).
3. Office for National Statistics. Children’s Dental Health in the United Kingdom,
2003. London: HMSO, 2005.
4. Dental Quality and Outcomes Framework, version 2. Department of Health
2011.
5. Hara AT et al. Caries Res 2009; 43: 57-63.
Talking Points 2012 – another year of success for dental education
Talking Points in Dentistry, GlaxoSmithKline Consumer Healthcare’s (GSK)
popular lecture programme, was a tremendous success this year, with over
5,000 dental healthcare professionals attending across 9 UK venues to listen to
this year’s speakers, Amanda Gallie and Mark Hill.
In his lecture, “Wear’s the problem in Oral Health Assessments?” Mark talked
about the new dental contract, Oral Health Assessments and the need for a
universally used and understood assessment for tooth wear.
Amanda Gallie’s lecture, “Make TALK your business”, discussed the importance
of effective patient communication in practice, and different ways in which
this can be achieved. The lecture focussed in particular on the technique of
motivational interviewing.
If you missed this year’s Talking Points, more information on the lectures will be
available online from the end of June at www.gsk-dentalprofessionals.co.uk,
along with videos of the talks.
Don’t forget to visit www.gsk-dentalprofessionals.co.uk for details of
next years’ event and to book your tickets in good time!
A saddle for everyone
Support Design have introduced a new stool to their
range, the Saddle Lite Advanced through Qudent, their
official distributors.
The Saddle Lite Advanced features a soft padded seat
with a V shape cut out at the front end along with a deeply
grooved centre. These features, in combination with a
supportive narrow seat, minimize uncomfortable pressure
when seated during long hours.
When seated, the stool recreates the natural S shape
alignment of the spine, maintains lumbar curve, improves circulation to lower
extremities and minimizes risk of muscular skeletal disorders.
In addition to the high quality craftsmanship a five-year warranty is offered with
the product. Custom colours are available if needing to match to an existing
patient’s chair.
With special offers available, details on this product and the full range
of support design stools is available for viewing on the Qudent website
www.qudent.co.uk or for full literature, please contact our sales office on
01903 211737
Introducing N’Durance Cristal
Septodont is delighted to announce
the launch of its newest product –
N’Durance Cristal.
Building upon Septodont’s innovative
nano-dimer technology, N’Durance Cristal
combines beauty and science to provide
clinicians with higher translucency for
optimal aesthetics.
N’Durance Cristal provides a unique
combination of low shrinkage and high conversion, as well as being easy and
fast to polish thanks to its nano-hybrid optimised filler system.
N’Durance Cristal also offers ‘soft on demand’ viscosity, compatibility with all
commonly used bonding agents and superior radiopacity for easy differentiation
from tooth structure.
N’Durance Cristal is available in seven of the most popular Vita shades plus
Incisal, which mimics natural enamel translucency, adding vitality to restorations.
Clinically tested with an overall satisfaction rate of 87 per cent (data on file), why
not experience the benefits of N’Durance Cristal for yourself?
For further details, please visit www.septodont.co.uk.
The Dental Directory was
pleased to be a sponsor of the
Clinical Innovations Conference
2012, which took place on 18th
and 19th May at the Millennium Gloucester Hotel & Conference Centre in
London’s Kensington.
Now in its ninth year, Clinical Innovations has become one of the leading events
in the aesthetic and restorative dentistry sector in the UK. The educational
nature of the event meant it represented 14 hours of verifiable CPD.
Hundreds of delegates attended to hear a panel of world class speakers
presenting lectures and workshops, keeping the audience informed about
global developments in dentistry. Speakers included Professor Nasser Barghi,
Dr Richard Kahan and Dr Nilesh Parmar.
The Clinical Innovations Conference also incorporated the AOG Charity Ball,
held for the third year and the first CIC Innovation Award. Delegates enjoyed
the very best in food and entertainment.
For more information, contact The Dental Directory on 0800 585 586, or
visit www.dental-directory.co.uk.
Listerine joins National Smile
Month campaign
Listerine is proud to be a platinum
sponsor of this year’s National Smile Month, which will take place between 20
May and 20 June.
Organised by the British Dental Health Foundation, the National Smile Month
campaign serves as the focal point for thousands of health professionals to
co-ordinate events and activities across the UK to improve oral health. These
events form the back-bone of the campaign and help to share the proven
messages and importance of good oral health.
Messages of National Smile Month include:
1. Brush teeth for two minutes twice a day with a fluoride toothpaste
2. Clean between teeth with interdental brushes or floss at least once a day
3. Use a mouthwash as part of a regular oral health routine.
The Listerine Total Care range contains Listerine’s four essential oils, as well
as offering various levels of fluoride and other benefits, ensuring there’s an
effective adjunct to help reduce plaque bacteria and manage the biofilm in a
wide range of patients.
For more information about the Listerine Total Care range contact Johnson &
Johnson on 0800 328 0750.
Sirona redesigns website and starts focusing on
social media
The Sirona corporate website has been given a new
look and provides quick, user-friendly access to
content, products and services. At the same time,
Sirona is focusing more on social media networks
and interactive dialogue with clients and interest
groups.
The corporate website of Sirona will feature a new
design and even more content. All the information
about the company, its products, services and
offerings can be found quickly.
As well as redesigning the website, Sirona has also extended its presence in
social media. Sirona will intensify its corporate activities on the social media
networks Facebook, Twitter, Youtube and Google+.
Dr Jürgen Serafin, Vice President Corporate Marketing at Sirona, explains:
“Digital social networks have facilitated something which those of us from
Marketing and Sales could only dream of just a few years ago: direct dialogue
with users, interested dentists, dental technicians, trade partners and
patients. A website which provides the users with genuine added value was
a precondition for ongoing and relevant communication in social networks.
We can now reach new customers in social media and intensify this dialogue
through our own website.”
Contact details for further information: Belfast: +44 (0) 28 9037 0702 Cork: +33
(0) 21 434 6392 Dublin: +353 (0) 1 456 5288
Further your education with Smile-on’s Key
Skills 3
Smile-on are delighted to announce the launch
of their new Key Skills 3. Smile-on’s Key Skills 3:
Record Keeping will be a vital part of the MFGDP
(UK) examination and is a must needed addition
to dental education.
The Key Skills 3 qualification will enable you to increase your understanding of
the importance of keeping full, precise and legible records. You will also be able
to demonstrate your understanding on the benefits of good record keeping and
the potential pitfalls and dangers of keeping poor records.
Smile-on’s Key Skills programme is a valuable and useful e-learning scheme
divided into seven sections covering topics beneficial to you and your entire
team. Medical emergencies, infection control, radiography, team training, risk
management, legislation and practice guidelines are all covered in a straightforward format, which will help you fit your continuing education seamlessly
around your daily practice.
Smile-on wish to help you on your educational journey and all the information
you need for developing skills is at your fingertips online. The Key-Skills 3 launch
will add to an existing successful scheme, continuing to help you provide better
treatment and care within practice.
For more information call 020 7400 8989, or email info@smile-on.com
Carestream Dental and CIC 2012:
Keeping clinicians at the forefront
of dentistry
Carestream Dental was a proud
sponsor of the ninth annual Clinical
Innovations Conference (CIC) on the
18th – 19th May 2012. Held at the
Millennium Gloucester Hotel and
Conference Centre in London’s Kensington, the dynamic event celebrated all that
is progressive and pioneering, and Carestream Dental was a fitting participant.
With a broad portfolio of products and services to deliver exceptional patient
care, the Carestream Dental stand was a popular destination for delegates.
Solutions on display included CS R4 Clinical+ practice management software,
which behaves as the hub of the practice, simplifying and speeding routine tasks
and communication throughout the practice.
For innovative imaging systems, delegates discovered the CS 9300 all-in-one
extraoral imaging system, which offers the widest range of clinical applications
on the market. Also on show was the CS 7600 intraoral imaging plate system
with its fully automated and secure x-ray workflow.
A leading conference attracts leading providers, and the cutting edge
technology from Carestream Dental brings practices to the forefront of dentistry.
From enhanced diagnostic capability to a streamlined workflow, these solutions
ensure that patients experience nothing less than the best possible care. For
more information, contact Carestream Dental on 0800 169 9692 or visit www.
carestreamdental.co.uk
Inman Aligner training for the team with Mhari
Coxon: Implementing change successfully
Straight Talk Seminars are thrilled to announce that
they have recently teamed up with Mhari Coxon RDH.
Mhari, who was voted 5th in the Dentistry Top 50,
and has 20 years’ experience in a variety of different
areas having worked as a dental nurse, receptionist,
oral health advisor and hygienist, and also as a
highly respected speaker. Mhari will be giving free
implementation lectures at all future Inman Aligner courses, motivating the
team to put their dentist’s new skills into practice successfully. Her workshop
will cover: • Communication with the team • Communication with patients •
Change management • Costing options • Marketing strategy
Straight Talk Seminars provide both hands-on and online training courses
for the Inman Aligner – an innovative appliance that uses opposing forces to
straighten anterior teeth quickly and safely.
In such a competitive market, it is important your practice offers the widest
possible range of quality treatments, but it is essential that you know how to
apply changes for the best results.
Gain the inspiration you and your dental team needs to effectively implement
the Inman Aligner into your practice today!
For more information on Straight Talk Seminars visit
www.straight-talks.com or phone 0854 366 5477
[30] =>
C-522-76-V0C-522-76-V0-10
C-522-76-V0-10
United Kingdom Edition
NEW
June 4-10, 2012
CEREC – PRECISION
AND
REDEFINED
CEREC
SW SIMPLICITY
4.0
Dental Tribune UK
Editorial Board
Seeing
CAD/CAM
CEREC.
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in a new
light.
CEREC.
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Made to inspire.
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The result of a study carried out by Professor Dr. Mehl (Zurich University, 2008): measuring depth accuracy of up to 19 μm.
State-of-the-art treatment during a single
appointment is a totally new experience for
patients. Word of this spreads fast and it soon
Dr Neel Kothari
becomes the flagship of the dental practice.
BDS Principal and General Dental Practitioner
For dentists the defining feature of CEREC
Dr Stephen Hudson
has always been greater job satisfaction.
BDS, MFGDP, MSc
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entirely new intuitive software 4.0. Discover
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imaging results in a quantum leap in CAD/CAMSpecialist
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reliability and efficiency. Capture a quadrant in less than one minute.
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Dentistry Dean of the Peninsula Dental School, Plymouth
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Ceramic Systems Ltd
Telephone: 0845 070 0137
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e-mail: sales@ceramicsystems.co.uk
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[1]
*26
[31] =>
United Kingdom Edition
Classified 31
June 4-10, 2012
STAND OUT FROM THE CROWD
Choose a first class dental specialist
accountant, with unrivalled expertise
and over 30 years’ experience
dealing with:
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FREE
CONSULTATION
Book your free
initial meeting at
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WWW.DBS.ORG.UK
01844 260111
210x148.indd 1
29/03/2012 15:21
Whatever your management role.....
S P E C I A L I S T D E N TA L A C C O U N TA N T S
Please contact:
Nick Ledingham BSc, FCA
Tel: 0151 348 8400
Email: mail@moco.co.uk
Website: www.moco.co.uk/dentists
- Assistance with Buying & Setting Up Practices
- Tax Saving Advice for Associates and Principals
- Incorporation Advice
- NHS Contract Advice
- Particular Help for New Associates
- Help for Dentists from Overseas
- National Coverage
- We act for more than 650 Dentists
N SDAL
National Association of
Specialist Dental Accountants & Lawyers
N SDAL
you can find a qualification to benefit you and your practice.
UMD Professional's range of qualification courses are
accredited by the Institute of Leadership and Management
and provide a practical management training pathway for
dentists, DCPs and practice managers.
ILM Level 3 Certificate in
Management
designed for senior nurses and
receptionists and new managers
taking their first steps in management
ILM Level 5 Diploma in
Management
for existing practice managers
and dentists
National Association of
Specialist Dental Accountants & Lawyers
N SDAL
National Association of
Specialist Dental Accountants & Lawyers
N SDAL
National Association of
Specialist Dental Accountants & Lawyers
ILM Level 7 Executive Diploma
in Management
for dentists and practice business
managers, and accredited by the
Faculty of General Dental Practice as
part of the FGDP Career Pathway
For full details, course dates and venues contact Penny Parry on:
020 8255 2070 penny@umdprofessional.co.uk
www.umdprofessional.co.uk
Contact
To
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call
Joe Ackah
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400 8964
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Table of contents
-
News
01 - 10
view
-
Clinical Innovations Conference 2012
02 - 05
view
-
No longer a sensitive subject: Eric Peterson discusses sensitivity and whitening
11 - 12
view
-
Infection Control Tribune
13 - 21
view
-
Treatment of gingival hyperpigmentation
22 - 23
view
-
Why improving your practice is a mystery – part nine
24 - 25
view
-
The art of listening: Mhari Coxon discusses how using your ears can lead to success
26 - 27
view
-
Infection control
28 - 28
view
-
Industry News
29 - 29
view
-
Dental Tribune UK Editorial Board
30 - 30
view
-
Classified
31 - 31
view
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/ Clinical Innovations Conference 2012
/ No longer a sensitive subject: Eric Peterson discusses sensitivity and whitening
/ Infection Control Tribune
/ Treatment of gingival hyperpigmentation
/ Why improving your practice is a mystery – part nine
/ The art of listening: Mhari Coxon discusses how using your ears can lead to success
/ Infection control
/ Industry News
/ Dental Tribune UK Editorial Board
/ Classified
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