DT UK No. 22, 2012

News / Does your continuity plan hold water or will it be powerless to help when the rains come? / Training day: Jane Armitage looks at staff training / Perio Tribune / Dental patient bib holders source of bacteria / In search of the confidence element / Complications in the leasehold system / Industry News / Dental Tribune UK Editorial Board / Classified

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September 10-16, 2012

PUBLISHED IN LONDON
News in Brief

Fake dentist charged for
practicing illegally
Alberto Nunez practised dentistry for two years without a
license in Chicago according
to the Cook County Sheriff’s
Office. According to police,
the 32 year old performed a
wide variety of treatments for
hundreds of patients, from
teeth cleaning to root canals
and even major surgeries.
Nunez has been charged with
felonies including practising
dentistry without a licence
and unlawful possession of
hypodermic syringes. ‘This
wasn’t something where the
person was cleaning teeth
out of his garage,’ Cook
County Sheriff Tom Dart told
NBC5, adding that Nunez’s
makeshift dental office had
all the necessary equipment.
The ‘dentist’ claimed to have
attended dental school in
Mexico City, however he was
not able to prove this. Police
are understood to have received a tip-off about Nunez
and arranged a sting operation, where the officer found
a dental chair, syringes, an Xray machine and other tools
of the trade. ‘The fire department was just blown away
because there wasn’t a major
fire there because there were
so many wires that were running everywhere, in and out
of garages and under sidewalks that clearly were done
by probably someone with
fifth-grade electrician background,’ said Dart. Investigators told CBS2 they suspect
that Nunez’s practice catered
toward undocumented immigrants and may have been a
cash operation. However it is
unclear whether the patients
knew Nunez was unlicensed.
Nunez was issued a $10,000
bond and is expected back in
court on 6 September.

www.dental-tribune.co.uk

Practice Management

Coconut to destroy dental decay?
Latest research findings

Contingency plans

Linda Young gives her thoughts
on disaster planning

Perio Tribune

Perio blaster

Perio Tribune looks at a new
system for reducing perio

pages 8-9

page 4

Perio Tribune

LANAP

Dr Kimmel presents a case

pages 20-22

page 19

Government launches consultation
on local fluoride consultations
Consultation to focus solely on process; not pros and cons
adopt, change or end fluoridation programmes.
Public
Health
Minister
Anne Milton said: “Decisionmaking on public health issues should be made at the

ater fluoridation hits
the headlines again
as the government
launches a consultation on the
consultation process for fluoridation schemes in the UK.
Public
Health
Minister
Anne Milton launched the consultation, which is exclusively
on the process by which local
authorities carry out consultations and decision-making on
new and existing fluoridation
proposals – not on the pros or

cons of fluoridation itself.
These changes are prompted by the abolition of Strategic
Health Authorities, which currently carry out this role, and
means local authorities will be
given new responsibilities and
powers to improve the health
of their communities.
This will mean ensuring
local people’s opinions on
fluoridation are considered
before decisions are made to

‘We want to hear
as many views as
possible about how
this process should
work when local
authorities get their
powers - I encourage everyone to
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It will seek views on a
range of processes related to
making local decisions including how public views are considered and how joint decisions are made in areas where
water supply covers more
than on local authority.

local level where they understand what is needed and
where the community’s voice
can best be heard.
“We want to hear as many
views as possible about how
this process should work when

Link to consultation http://consultations.dh.gov.
uk# link with bold text

Quote GRAZE2 when contacting us

Strategic Health Authorities currently have the responsibility for considering
changes to fluoridation in local areas, but this consultation
is about how this power is taken over by local authorities.

The consultation will be
open for responses from 4
September to 27 November.
Any person, business or organisation with an interest is
encouraged to respond. DT

We would like to
feed your practice
for 1 month with
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We hope you enjoy this offer! Offer ends 28th September 2012

Dog gets reconstructive
surgery on jawbone and
beats oral cancer
Whisky, a 10 year old dog
was discovered to have a
large malignant tumour in
his mouth, leading to his
owners obtaining a cutting
edge surgical procedure for
him that saw part of Whisky’s
jaw amputated and replaced
by a bone-growing sponge,
only the eighth dog to receive
such treatment. A team of
oral surgeons and biomedical engineers at University
California Davis’ Veterinary
Medical Teaching Hospital
removed the six centimetrewide growth in a $8000 procedure that may hopefully
pave the way for similar advances in the treatment of
human jaw injuries.

News

VOL. 6 NO. 22

sales@topdental.co.uk
06/09/2012 14:44

[2] =>

2 News

United Kingdom Edition

September 10-16, 2012

Lansley out in radical cabinet reshuffle

n an unsurprising move,
Health Secretary Andrew
Lansley has been relegated
to Leader of the Commons in
today’s Cabinet reshuffle. Lansley, who was the thinker behind the contentious reforms to
the NHS has been replaced by
former Culture Secretary Jeremy Hunt, who was described
as a “strong reformer” by the
Prime Minister.

contemporary of Cameron’s and
Boris Johnson’s at Oxford University, has had a difficult year.
Following a near-scandal over
his management of Rupert Murdoch’s bid for control of BskyB,
it was revealed that his aide was
in close contact with the news
corporation. Indeed, he was one
of the few people allowed to be
called a ‘liar’ in parliament by
the Speaker.

Speaking outside No 10,
Mr Hunt said he was “incredibly honoured” to take over as
Health Secretary. “It is a huge
task and the biggest privilege of
my life,” he told the BBC. Hunt, a

However, it seems Hunt is
back in favour with the Prime
Minister after Lansley was
dropped by Cameron, supposedly over his failure to communicate his NHS reforms. A year

after his ‘sack me or back me’
ultimatum to the Prime Minister, where he warned Cameron
he would rather quit the Cabinet than abandon the controversial health reforms, Lansley has
been radically demoted.
In March this year, Lansley had said about the reforms
“Some people say we should
not have embarked on this
programme of NHS reform. To
those people who doubt what we
are doing I would say, because
of the pressures we are facing,
we cannot afford not to reform
the NHS. To take the approach
advocated by Labour of simply

sitting on our hands would be
storing up a crisis for the future. Not reforming the NHS
would have been a much easier
decision for me as secretary of
state to have taken. We could
have just protected the NHS
from cuts, put in an extra
£12.5bn and left it there. But
sooner or later the cracks would
have started to show. New
treatments would have been
held back. Queues would have
grown. Patients would have
been let down,” he adds.
However, the Shadow Health
Secretary Andy Burnham had
countered this, arguing, “The

health secretary has demonstrated once again why we
are in this problem; his dismissive attitude and inability
to listen. His siege mentality is
preventing him from seeing the
bigger picture.”
And it seems that it is this
‘siege mentality’ that has caused
Lansley to lose his job as Health
Secretary, despite having an
enduring relationship with the
Prime Minister, when he was
Cameron’s boss when the he
took his first political job in the
Conservative research department. DT

Just over half of people registered
with dentist as revealed in new survey

n a new survey carried out
by the Blackburn with Darwen Local Involvement Network, it has been revealed that
only 56 per cent of respondents
in Darwen are registered with a
dentist. This shocking statistic is
teamed with the fact that on average, children in this area have
more than two rotten teeth by
the age of five.

A new Stop the Rot campaign
has since been set up to hinder
this worrying trend. The Primary Care Trust for the region
is encouraging people to go to
the dentist by working hard to
ensure that there are no waiting
lists for dental patients wanting
to go to an NHS dentist- a new
health and wellbeing centre in
the area has created a further

2,500 places.
However, Darwen councillor
Roy Davis, who is also the vicechairman of the health scrutiny
committee said it is the high
prices of dental treatment, and
the lack of information available about NHS treatments
that is scaring people away. He
said: “We have NHS dentists

Government response to OFT

here has been report published as a response by the
government to the recent
study by the Office of Fair Trading’s market study of the private
and NHS dental markets in May
2012. The study was prompted by
complaints to Consumer Direct
and the OFT’s concerns patients’
ability to directly access dental
care professionals. The purpose
of this study was to examine
whether the UK dentistry market
is working well for patients. The
issues were considered within the
context of both NHS and private
dentistry.
The OFT gave five recommendations to address its concerns:
• Provision of clear, accurate and
timely information for patients
• Direct patient access to dental
care professionals
• Reform of the NHS dental contract in England
• Simplification of the complaints
process
• Development of a code of practice for sale of private dental plans
The government response
began by stating they welcomed
the recent report, and were particularly pleased that ‘this market
study shows that dental patients
have a high level of satisfaction
with the services provided by

their dentist’. The government
agreed with the OFT report with
regards to patient care, claiming
that there needs to be ‘Provision
of clear, accurate and timely information for patients’, particularly
with regards to prices and dental
treatments. The report goes on
to share the concerns of the OFT
that some dentists have been denying their patients treatment on
the NHS by not providing enough
information. The government
warned such dentists that not permissible and any dentist ‘doing so
deliberately is in breach of their
NHS contract.’ As a result of the
report the Department of Health
are attempting to improve their
transparency, particularly on their
website, including adding ‘new
pages which clearly explain NHS
dental charges and exemptions,
and inform patients how to get
help with NHS dental costs.’
The government agreed that
patients should be able to see the
‘right dental professional when
they need to’, although they admit
that ‘this needs to be in a managed
and clinically appropriate environment’.
The government went on to
agree with the OFT’s beliefs that
patients’ capacities to make a
complaint about their treatment

should be as simple as possible.
With this in mind the government
are changing their patient leaflet
by updating any information about
the complaints procedure and ‘the
opportunity to give feedback on
practices on NHS Choices.’ The
government also want to consider
whether there can be any synergy
created between the current private and NHS complaints systems.
The OFT recommended that
the government developed a new
system for the sale of private dental plans. As a result of the report,
the government are looking into
setting up a code of practise to
avoid the miss- selling, or pressurised sale of a private dental plan;
in particular the response has
highlighted that there should be
clear penalties for dentists who do
mislead patients.
The government surmises
that although there is some action
needed to be taken, particularly
with regards to direct access. The
government will look into designing new dental contracts, and increasing transparency for dental
patients, however, on the whole,
the government concluded that
‘the vast majority of patients are
happy with their dental treatment
and that the majority of dentists
behave ethically.’ DT

available, but in a lot of cases
the charges are ridiculous. It’s
£17.50 for a check-up, £48 for
a filling and £206 for root canal
treatment, so it’s no wonder that
people are going up and down
with no teeth. It’s a choice between putting food on the table
or going to the dentists.

over the past 10 years or so, that
people don’t want to go, even
though sometimes these specialists can spot something that
might save your life.
“We need to get advertisements out showing the
places that are available at surgeries.” DT

“It has become endemic

Foundation Trio Give Miles of
Smiles for Mouth Cancer Walk

hree employees of the
British Dental Health
Foundation are planning
on embarking on a 10km Awareness Walk for a mouth cancer
charity.
David Arnold, 29, David
Westgarth, 27 from Rugby and
Doychin Satutov, 22, who lives in
Coventry are taking part in the
walk on 22nd September in Hyde
Park in London to raise hundreds of pounds for research into
mouth cancer.
David Arnold, Senior PR and
Press Officer at the Foundation
is hoping that the walk will get
more people talking about the
disease and also help to raise
awareness about the risks and
different symptoms of mouth
cancer.

and testicular cancer campaigns,
we can put mouth cancer firmly
in the news agenda. In highlighting key risk factors and symptoms, along with information
about self-examination and oral
screenings we can potentially
save thousands of lives.
“The five-year survival rate
of mouth cancer patients is just
50 per cent. But early diagnosis gives patients a 90 per cent
chance of survival.”
If you would like to sponsor
any members of the British Dental Health Foundation on their
Mouth Cancer 10km Awareness
Walk, please contact them by telephone on 01788 539 792 or by
email at pr@dentalhealth.org. DT

David said: “Events such
as the Mouth Cancer Awareness Walk, along with annual
campaigns such as November’s
Mouth Cancer Action Month, really do help to take this hidden
problem and place it in the spotlight.
“By taking positive action in
similar fashion to recent breast

L-R: David Westgarth, David Arnold and
Doychin Satutov

[3] =>

United Kingdom Edition

Editorial comment

I

t has been a very
tumultuous time in
the political sphere
for dentistry. As the
Cabinet waves goodbye
to Andrew Lansley as Health
Minister, it says hello to Jeremy Hunt.
In addition, there are the
various consultations around

Fact sheet

T

he
General
Dental
Council (GDC) has produced a new fact sheet
for patients across the UK to
help them understand what
responsibility
their
dental
professional has to make sure
their indemnity or insurance
is up to date, ensuring that patients’ rights are upheld.
Indemnity and insurance
is a way for dental professionals to ensure patients have a
way to claim compensation if
something goes wrong with
the treatment they’re having.
The new fact sheet guides
patients through what is expected of their dental professional as well as what to do if
something does go wrong. The
guideline asks questions such
as what should I ask my dental
professional and what happens
if something goes wrong?
Chief Executive of the GDC,
Evlynne Gilvarry said: “We are
working to increase the current, substantial protections
for patients, by seeking powers
to require proof of insurance
or indemnity as a condition of
being registered to practise as
a dentist or dental care professional. We expect to have these
powers by October 2013.”
The GDC can stop dental
professionals working in the
UK if they are found not to have
indemnity or insurance and
the new powers being sought
will mean dental professionals
not only have to have insurance before they can practise
but declare they have it every
year after that. DT

Evlynne Gilvarry

dentistry including looking
at the process of fluoridation scheme planning, views
on the CQC (that should be a
good one!) and the continuing
piloting process.
Traditionally the last quarter of the year is busy not
just politically but in terms

September 10-16, 2012

of conferences and other
events. I’m sure that many a
glass of enamel-friendly wine
will be consumed as the issues around the profession
are debated. Please join in
the process – not only by adding your voice to the consultations but by letting
Dental Tribune know
what you think! Email
me at lisa@dentaltribuneuk.com DT

News 3
Do you have an opinion or something to say on any Dental Tribune
UK article? Or would you like to
write your own opinion for our
guest comment page?
If so don’t hesitate to write to:
The Editor,
Dental Tribune UK Ltd,
4th Floor, Treasure House,
19-21 Hatton Garden,
London, EC1 8BA
Or email:
lisa@dentaltribuneuk.com

[4] =>

4 News

United Kingdom Edition

September 10-16, 2012

Coconut oil could help the fight
against tooth decay
T

he natural antibiotics in
digested coconut oil have
been found to attack the
Streptococcus mutans bacteria
which cause dental caries. Scientists at the Dublin based Athlone
Institute of Technology (AIT) say
that coconut oil could be added
to commercial dental products as
a marketable antimicrobial. The
AIT team tested the antibacterial abilities of the oil in both its
natural state and once it had been
treated with enzymes, to help
replicate the process of digestion;
the coconut oil was then tested
against Streptococcus mutans, the
most common bacteria found in
the mouth. Researchers discovered that the coconut oil which
had been treated with enzymes
hampered the growth of the common bacteria vastly.
Previous research had shown
that other enzyme- treated foodstuffs, including milk, had inhib-

ited the growth of the Streptococcus bacteria, leading to scientists
investigating what other foods
might be similarly affected. Further research is now planned into
looking at how coconut oil reacts
with the Streptococcus bacteria at
a molecular level. Scientists aim
to discover what other types of
bacteria and yeasts the oil affectsthe testing group at AIT found that
enzyme- modified coconut oil was
detrimental to Candida albicans, a
yeast known to cause thrush.
This ground-breaking discovery could greatly aid the dental
hygiene world. Dr Damien Brady,
who led researchers in AIT’s Bioscience Research Institute said
“Dental caries is a commonly
overlooked health problem affecting 60-90% of children and
the majority of adults in industrialised countries. Incorporating enzyme-modified coconut
oil into dental hygiene products

would be an attractive alternative to chemical additives, particularly as it works at relatively
low concentrations. Also, with increasing antibiotic resistance, it is
important that we turn our attention to new ways to combat microbial infection.”

ing coconut oil and other enzymemodified foodstuffs to identify
how they interfere with the way
bacteria cause illness and disease,” he said.

The researchers in AIT’s
Bioscience
Research
Institute are presenting their work
at the Society for General Microbiology’s autumn conference at the
University of Warwick. DT

The work also adds to
our knowledge of antibacterial activity in the gut. “Our
data suggests that products of
human digestion show antimicrobial activity. This could have implications for how bacteria colonize the cells lining the digestive
tract and for overall gut health,”
explained Dr Brady.
“Our research has shown that
digested milk protein not only reduced the adherence of harmful
bacteria to human intestinal cells
but also prevented some of them
from gaining entrance into the
cell. We are currently research-

Coconut oil could help fight tooth decay

Dental workers’ charity trek

Durham based dental
practice team completed
a 26km walk along the
historic Hadrian’s Wall to raise
thousands of pounds for Help for
Heroes.
The team at Durham City
Smiles finished the achievement, and managed to raise an
impressive £1,500 for the military charity. Help for Heroes provides direct, practical support
to wounded, injured and sick
service personnel, veterans, and
their families. The charity is Important to dentists Graeme Dentith and Stuart Cox, who both
come from Royal Navy families.

The team at Durham City smiles

The extra pains of
mouth cancer

eing diagnosed with
mouth cancer is a harrowing experience. Not
only will the sufferer have to
endure aggressive surgery,
which often results in the loss
of teeth and supporting structures, additional treatments
such as radiotherapy and
chemotherapy are common,
and also have an unfortunate effect on a patient’s oral
health.
People who have had
treatment for mouth cancer

unfortunately need further
expensive dental treatment
to restore their teeth which
are damaged by the harsh
cures
for
the
disease,
unlike sufferers of other types
of cancers, who do not always
have the same financial issues
for follow up treatments.
A petition has been created by Dr Chetan Trivedy
urging ‘the government to review the current NHS dental
charges by including an exemption category for patients

who have had treatment for
mouth cancer.’ As it stands,
patients are able to claim their
dental treatments on the NHS,
a disparity Dr Trivedy wishes
to highlight, stating ‘There is
clearly a financial inequality
for patients with mouth cancer to pay for the postoperative and reconstructive phase
following their cancer treatment.’ DT

Graeme Dentith, principal
dentist at the practice, said: “The
trek along Hadrian’s Wall was
really tough, but completing it
and raising over £1,500 for Help
for Heroes in the process is a
fantastic achievement.
“We’re very grateful to everyone who has supported and
sponsored us – it really has made
a huge difference.”
Graeme said the camaraderie of the team kept them going
through the punishing condition.
“We set off at 10am from
Walltown Quarry with a little

apprehension of what was to follow, but we kept our spirits up as
a team, even when our energy
levels were flagging,” he said.
“It was a real test of endurance for all of us, but there
were lots of smiles and camaraderie, not to mention
the stunning scenery which
took us through the sweeping
countryside along the Roman
wall.
“We paused briefly at the
Roman Fort of Housteads for
lunch before our final descent to
Chollerford where we enjoyed
dinner and well-earned pint!” DT

Patient fraud costs NHS
£110m in Scotland

housands of patients
have been found to be
conning the NHS in
Scotland. New information
has shown that over 15,000
cases where dental patients
have received free treatments
they were not eligible for.
Counter Fraud Services (CFS)
investigators have obtained
£538,000
back,
however
the problem has been found to
be far greater than first realised.
It has been estimated
that the Scottish NHS loses
up to £110 million every year

through fraud, including false
claims for free treatments and
staff dishonesties. The number
of people who received free
treatments they were not entitled to has vastly grown over
the last three years.
In 2009-10, there were
4994
incidents
detected
and £152,000 recovered. In
2010-11, there were 5238 incidents detected and £175,000
recovered, and, in 2011-12
there were 5398 incidents
detected and £211,000 recovered. DT

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[6] =>

6 News

United Kingdom Edition

September 10-16, 2012

Link between alcohol and cancer
and hard liquor into several substances, including acetaldehyde,
a substance with a chemical
backbone that resembles formaldehyde -- a known human
carcinogen, according to lead
author Silvia Balbo, PhD, a research associate at the University of Minnesota.

Scientists have known for 30 years about alochol and cancer

S

cientists
have
known
for 30 years about the
links between drinking
alcohol and certain types of
cancer, however there is new
research explaining the effect
the beverage has on people.

The report was first recounted
during the American Chemical
Society annual meeting in Philadelphia.
The human body metabolizes the alcohol in beer, wine,

“We now have the first evidence from living human volunteers that acetaldehyde formed
after alcohol consumption damages DNA dramatically,” Balbo
stated in a press release. “Acetaldehyde attaches to DNA in humans in a way that results in the
formation of a ‘DNA adduct.’ It’s
acetaldehyde that latches onto
DNA and interferes with DNA
activity in a way linked to an increased risk of cancer.”

To test the hypothesis that
acetaldehyde causes DNA adducts to form in humans, Balbo
and colleagues gave 10 volunteers increasing doses of vodka (comparable to one, two,
and three drinks) once a week
for three weeks. They found
that levels of a key DNA adduct increased up to 100-fold in
the subjects’ oral cells within
hours after each dose, then declined about 24 hours later. Adduct levels in blood cells also
rose.
“These findings tell us that
alcohol, a lifestyle carcinogen,
is metabolized into acetaldehyde
in the mouth, and acetaldehyde
is forming DNA adducts, which
are known major players in carcinogenesis,” Balbo said.

People have a highly effective natural repair mechanism
for correcting the damage from
DNA adducts, so most are unlikely to develop cancer from
social drinking, she added. In
addition, most people have an
enzyme called alcohol dehydrogenase that quickly converts
acetaldehyde to acetate, a relatively harmless substance.
However, about 30% of people of Asian descent have a variant of the alcohol dehydrogenase
gene and are unable to metabolize alcohol to acetate, resulting
in an elevated risk of esophageal
cancer from alcohol drinking,
the researchers noted. Native
Americans and native Alaskans
have a deficiency in the production of that same enzyme. DT

Dental information website Damage caused by
launched for Indian market electronic cigarettes

U

K dentist Dr Priya Patel
is launching a website
in India called ‘dentistmum’ to provide information
and raise awareness of dental
issues and oral cancer amongst
the Indian population. Although
Dr Patel was born and raised
in the UK, she says ‘I am an Indian at heart’. The dentist, who
owns the Village Dental Practice
in Stevenage and also teaches
postgraduate dental students at
the Royal College of Surgeons
in London and overseas dentists
studying for their equivalency
exams, decided to launch dentistmum.in after learning of the
alarming statistics surrounding
oral health in India: for exam-

ple, 40-50% have never visited a
dentist; nearly 70% suffer from
dental diseases; only 55% of the
population uses toothpaste; and
90% of oral cancer cases in India are attributed to the habit of
chewing tobacco and gutka. In
addition, the dentist to population ratio in rural areas is just
1:250,000.
Dr Patel is working hard to
develop the dentistmum website and the launch is set for
early September. ‘I am loading it
with content on a regular basis
and fixing minor bugs as well
as marketing the website by
raising awareness on social media channels and by contacting

bloggers in India to help spread
the word,’ said Dr Patel, who admits that she is not internet savvy and is learning as she goes.
She intends to travel to India
once the website has launched
to raise further awareness.
‘Ultimately even if only one
person is successfully diagnosed and treated for oral cancer because of my website I will
be very happy.’
If you are interested in contributing to Dr Patel’s website
she can be contacted on e-mail:
priya.patel@dentistmum.co.uk
and you can also follow her on
Twitter: @dentistmum. DT

A

recent study conducted by
the University of Athens
has found that electronic
cigarettes can still cause irreparable damage to the lungs, despite
being promoted as a safer alternative to cigarettes. Researchers at
the university conducted a study
involving eight non-smokers and
24 smokers, 11 of whom had normal lung function, while 13 had
asthma or chronic obstructive
pulmonary disease. (COPD).
Applicants used an electronic
cigarette for ten minutes, after
which their airway resistance was
tested. The researchers found that
the devices caused an increase in
airway resistance for around ten
minutes in both non-smokers

and smokers with normal lung
function, but not in smokers with
COPD or asthma, suggesting that
electronic cigarettes, which work
by delivering nicotine through a
vapour, might still be damaging.
The findings were presented
at the annual congress of the European Respiratory Society (ERS).
‘We found an immediate rise in
airway resistance in our group
of participants, which suggests ecigarettes can cause immediate
harm after smoking the device,’
said author Prof Christina Gratziou, who chairs the ERS Tobacco
Control Committee. She added:
‘More research is needed to
understand whether this harm has
lasting effects in the long term.’ DT

Dentist sues patient
over internet blogging
experiencing pain subsequent
to the procedure, Bailey sought
another dentist’s opinion. The
second dentist told Bailey that
some of the fillings had not
been necessary, and they were
also badly fitted. It was then
that Bailey took to the internet
to warn others of the “improper
and insufficient dental services
by Dr Saleh.”
xx

A

dentist is suing a former
patient after he blogged
online what the dentist
felt were unfair and defamatory comments. Dr Mo Salah,
of Dental Dynamics in Portland
filed the lawsuit for $300,000
after Spencer Bailey wrote a

series of blogs on Yelp, DoctorOogle.com and Google, in one
instance stating “if Dr Saleh
tells you that you have a cavity
— GET A SECOND OPINION.”
Bailey has said that he had never had a cavity before, however,
Dr Salah found several. After

Salah
has
complained
that the blogs caused ‘damage
to his reputation, loss of profits
and emotional distress.’ Bailey
has since removed the posts,
out of fear for the safely of himself and his family, however
Salah is continuing with the
lawsuit. DT

Spray-on teeth

S

pray-on teeth are being
developed by scientists at
King’s College London and
Imperial College London.
The spray contains a type of
calcium and helps repair damage
to the teeth enamel and may help
repair any exposed dentin.
The developers say the product blocks tiny tubes in the dentin,
which can reduce sensitivity.
The spray is held a few mil-

limetres from the teeth and projects a dry powder — the action of
the powder hitting the teeth also
acts as a mild abrasive, helping to
remove stains.
“Sprays allow more accurate
and consistent delivery of the
drug or treatment, and allow it to
be held in the controlled sterile
environment of a spray can,” Sam
Shuster from the Newcastle University said. DT
http://www.kcl.ac.uk

[7] =>

United Kingdom Edition

September 10-16, 2012

New appointment at IndepenDent Care Plans
At a time of financial pressure on
both dental practices and their
patients, IndepenDent Care Plans
are pleased to experience continued success in providing a service
to dentists that helps increase additional regular income whilst
providing their patients with a
dental plan they can budget for.

Wayne Mayhew

I

ndepenDent Care Plans (ICP)
are experiencing a sustained
period of growth in their business, working with more and
more dental practices who want
to introduce new dental plans to
their patients or indeed switch
from other providers where current service levels are not met.

As a result of the current
growth, the company are also
bucking the trend of staff support levels by increasing their
Business Development team to
support practices introducing,
converting and developing
their patient dental plans.
Therefore ICP are delighted to announce that
Wayne Mayhew has joined the
IndepenDent team as our new
Business Development Consultant, bringing with him a
wealth of experience in both
the Dental & Healthcare sectors.

Mayhew is very experienced
working with Dental practices
and in particular with Dental
Plans, having previously worked
for Isoplan where he enjoyed developing fantastic and successful
relationships with many Dental
Practice teams.
Mayhew will provide business development support and
advice, including guidance on
marketing, conversion management, banding rate assessment
and team training needs, helping
practices to implement and grow
their patient plans.
Gary Moore, Business Development Manager for ICP
said “We feel Wayne is a great
acquisition to the team and
furthermore
cements
IndepenDent Care Plans growth in
the market whilst providing Principal Dentists with a further option as their preferred Plan Provider”. DT

SUPPORTING
DENTISTRY
SINCE 1993

Care Quality Commission survey

T

he Care Quality Commission is seeking feedback from health and
social care staff.
The CQC
claim that ‘our job is to check
whether hospitals, care homes
and care services are meeting
government standards’.
The website shows the
latest reports on whether
government standards are being met, which includes encouraging both patients and
health workers to share their
experiences or report a specific
concern.

standards of quality and safety?’
• ‘Overall, how well do you
think CQC is ensuring that all
providers are supporting quality improvement in health and
social care?’
• ‘How clear are you about what
you need to do in your role to
ensure that your organisation
is meeting the essential standards?’

• And ‘Are you aware of CQC’s
process for raising a concern
about quality of care (whistleblowing)?’
These questions are worthy
of dentists and dental health
workers time since the Care
Quality Commission have just
started regulating primary dental care for both private and
NHS services, publishing up-todate information assessments
received on their websites. DT

Enjoy 0%
Admin Fees
when you join
IndenpenDent

The questions included in
the recent survey include:
• ‘Overall, how well do you
think CQC is ensuring that all
providers meet the essential

Australia promises $4B for
dental care in rural areas

T

he Australian Department of Health and
Ageing has announced
a six year dental package for
low-income citizens in rural
areas. Three million children
are now eligible for the government- subsidised dental
care, as well as one million
low-income adults and pensioners, according to Tanya
Plibersek, Minister for Health.
The package includes the

following:
• $2.7 billion for 3.4 million
Australian children who will
be eligible for subsidised dental care
• $1.3 billion for 1.4 million
additional services for adults
on low incomes, including
pensioners and concession
card holders, and those with
special needs

• $225 million for dental capital and workforce to support
expanded services for people
living in outer metropolitan,
regional, rural, and remote
areas
The $4 billion package is
in addition to the $515 million
announced in the 2012-2013
federal budget. It will replace
the Medicare Teen Dental
Plan and the Chronic Disease
Dental Scheme (CDDS). DT

Tel: (01463) 223399
Email: icpltd@ident.co.uk
Web: www.ident.co.uk

[8] =>

8 Practice Management

United Kingdom Edition

September 10-16, 2012

Does your continuity plan hold water or will
it be powerless to help when the rains come?
Linda Young discusses contingency plans for dental practices
recorded here? Make no assumptions that the person following the procedure in the
event of a disaster has any
prior knowledge of the process. If directing the reader to
‘switch on the surgery’ state
exactly how to do this and
where the switch is located.
Think about where these
procedure papers are kept. If
storing documents electronically and off site, perhaps on
a portable hard drive, or using virtual storage, make sure
the location of these files is
detailed in the plan, together
with any logon, password and
file path information. Perhaps
the documents need to be protected from editing, so store
them so that they can only be
accessed as ‘read only’.

Have you planned for a ‘rainy day’?

he last two British summers have been memorable for many businesses in the UK for a number
of reasons: London 2012, Her
Majesty The Queen’s Diamond
Jubilee celebrations, floods,
riots, fuel shortages, storms
and power blackouts were
just a few of the events that
disrupted businesses across
the length and breadth of the
country.
Whilst it is possible to
predict when and how some
man made events are likely to
cause disruption to your practice, a natural disaster cannot
be predicted and so poses a
real challenge to businesses.
What can a business do to plan
for the unknown; the ‘What if’
scenario?
No Plan
Over the years I have worked
in businesses that have had
to temporarily cease trading
for a variety of reasons, all of
which were beyond their control. A very cold winter froze
the locks of one business’ only
access door, which meant
that nobody could get into the
premises. There was no continuity plan and no one knew
what to do! The staff, including me, arrived for work totally unaware of the problem; we
were left standing outside in
the bitter cold. The locksmith
didn’t arrive until midday. We
had no other option but to direct our customers to the com-

petitor’s business next door!
Gale force winds blew part
of the roof off a relatively
new building in which I was
working. People working beneath the damaged roof were
moved. The engineers could
not access the roof area until
the high winds subsided. The
staff affected continued their
shifts ‘working from home’.
The ability for these people to
remotely connect to the main
servers had been part of that
business’ continuity plan, resulting in negligible disruption to service levels.
Computer hardware and
software failures, theft and
server down times regularly
can cause disruption to services for both staff and customers alike. Even the biggest
company can get this wrong,
look at NatWest’s recent experience! Having good backup
systems in place will pay dividends.
Personnel
Losing personnel through illness poses a serious risk to
the smooth running of a practice. Episodes of contagious
viral illnesses unfortunately
cannot be avoided, but can
reduce staffing levels to the
point where only a basic service can be delivered. It is not
only your own staff who might
be affected by a ‘flu epidemic’;
remember that the availability
of agency staff will also be re-

duced. Keep details of all staff,
their skills and past experience in the plan; these skills
could be called upon to help
out in an emergency.
Many practices have a lottery syndicate of which the
nurses and receptionist are all
members. What would happen on a Monday morning if
the syndicate had won on the
Saturday night? If the win was
substantial then I doubt they
would report for work!
Virtual
If using a ‘virtual receptionist’
service appeals to a practice,

and both premises could be affected by the same event; too
far apart may cause a logistical problem for staff, patients
and suppliers alike. A practice
can’t set up shop in the spare
room in someone’s home even
in the short term, so consider
a reciprocal arrangement with
another practice. The short
notice change in location can
be overcome by ensuring good
communication with patients
and suppliers, and perhaps
the provision of a bus shuttle
service for the patients, which
would have to be agreed with
the transport provider and, of
course, noted in the continu-

‘Making continuity planning part of
the way a practice operates helps prepare
for ‘business as usual’ in the quickest
possible time’

make sure that details of this
facility and its provider are
fully documented in the continuity plan. Test the service
regularly to ensure connectivity to the appointment book
and that it meets the practice
and the patients’ needs.

ity plan. Include a map of the
contingency location and the
premises layout in the plan.
As part of the continuity plan
process and review the practice personnel should visit the
temporary site so that they are
familiar with it.

Finding suitable contingency premises is essential,
but can be a dilemma! Choose
the contingency premises with
care: too close to the practice

Check all the practice
procedure documents. Are
all, even the simplest, stages
of every activity or process
undertaken in the practice

Critical documents and information held on computer
may already have been copied and backed up, but where
are the copies and back-ups
kept? Store them locally and
they may also be affected or
destroyed by the disaster, or
may be inaccessible because
the area is cordoned off. Installing a fire proof safe in the
practice to safeguard documents that are in the short to
medium term irreplaceable
is a good idea. This will safeguard them against theft and
fire, but will not protect them
against a flood. Perhaps a set
of certified copies should be
stored off site.
Back up
A practice’s ability to react
quickly to any incident that
affects their ability to trade is
critical. The secret to achieving this is in continuity planning, and regularly reviewing
the continuity plan to ensure
it is still accurate and relevant. A good continuity plan
should take into account all
the practices’ resources ie its
premises, services, technology and people.
Making continuity planning part of the way a practice operates helps prepare
for ‘business as usual’ in the
quickest possible time. This is
preferable to taking the attitude of dealing with the disaster should if it ever happens.
Having a tried and tested plan
helps protect the practice
against the impact of a man
made or natural event, or disaster.
There are plenty of online
sites eager to share their ideas

[9] =>

United Kingdom Edition

on how to draw up a plan. The
time invested in collating all
the information required for
the plan at this stage could be
one of the best investments a
practice has ever made. The
things that seem to be very
simple now, when the practice
is operating without any problems, could be insurmountable in the event of a crisis.
Level of detail
There are no hard and fast
rules as to how long or short
a continuity plan has to be.
The level of detail in the plan
is down to the continuity plan
manager, who should never
assume that everyone will
still be around or be able to
remember the essential processes, telephone numbers
etc. So that your practice can
continue to function without
its premises and / or key personnel ensure that all the day
to day activities and processes
are all documented, and that
that they are all reviewed regularly.

ten it cannot be changed. To
assume this is to take a big
risk. Even the simplest and
smallest of plans will have
some amendments. Make sure
the plan is kept up to date by
reviewing it, even down to the
smallest detail. Test the plan
on a regular basis, combining
this with a team building exercise. Make the testing scenario as realistic as possible,
change the theme each time
it’s tested from loss of prem-

September 10-16, 2012

Practice Management 9

ises, to people, to services
and technology. Look at the
impact of short-term losses to
the medium and longer term.
Keep a diary of the outcomes
of each test so that key information that arises during each
test isn’t forgotten about and
can be built into the plan to
improve the process.
Success
This article is not meant to
be about how to write a prac-

tice continuity plan: it’s about
thinking outside the box;
thinking around all those decisions that will have to be
made and which will make
the difference to a plan, and
your business’ ability to carry
on trading.

planning, organising, implementing, control and finally
reviewing. DT

Success
in
a
crisis
isn’t about good luck: it’s
about good management continuity planning. Good management of anything involves

Give your patients the freedom to book
their own appointments

‘At the same time
think about processes that would
only come into
force if the continuity plan were activated’

Practice Management Software

At the same time think

about processes that would
only come into force if the
continuity plan were activated. Why not create a set
of procedures specifically for
when the plan is activated?
Include details in the plan of
where these procedures are
stored! Don’t forget to make
sure everyone in the practice is familiar with the plan,
and regularly test it together
to see what might need to be
changed, and if indeed the
plan really works!!
Testing
Once the plan has been written and carefully checked
think about testing it. Don’t
be complacent and think that
once the plan has been writ-

About the author
Linda Young was the Information
Security Manager and continuity plan
holder for an international company
for over 20 years. She is currently
writing a practical resource manual
to be published in 2013, which is
designed for dental practices looking
to improve their team’s management
skills.

GIVES YOU MORE

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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.

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Patient Check-in Kiosk
Care Pathways
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Text Message and Email reminders
Clinical Notes
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Managed Service
Practice Accounts

[10] =>

10Practice Management

United Kingdom Edition September 10-16, 2012

Training day

can continue to see any emergency patient that may contact
on the training day.

Jane Armitage looks at staff training

E

ach year we close the
Practice and have a full
days training session.
This might seem a bit harsh but
during this day I will ensure that
we have a full day of learning, set
with aims and objectives.
This year our Investors in

People review was due so we
had our review on the same day
as this saved disruption at a later
date.
Staff meetings are held on a
regular occasion but quite often
you don’t have everyone’s undi-

vided attention as they are usually held around lunchtime so can
quite often become shortened.

I will then contact the mandatory training companies (ie Cross
Infection Control, CPR) and allocate a time for the training to be
carried out.

At the start of the year I will
choose a suitable date and close
the appointment book with the
exception of one surgery so we

Appraisal forms are given out
and a time set for the appraisal
during the training day. Peer reviews are scheduled for the den-

...

tists during the training day.
Contracts are reviewed and
updated with any pay increase
and given out on the same day.
BDA Good Practice is discussed.
The Partners and I will meet
and discuss the business plan for
the coming year and see what
we require to ensure we reach
our goal. This can then become
a working tool in our days training. Identifying the needs of the
business and ensuring you meet
them usually includes the involvement of team members. It’s
of little use you having a goal and
not sharing what you need to do
to achieve it.
The day will start with an indepth staff meeting, in the past
we have also asked speakers to
attend to cover various subjects,
ie Health & Safety, Significant
Events anything that I feel will
be of benefit to the staff. We will
also look at everyone’s roles and
ensure we have current first aiders, fire marshalls etc, quite often
these roles get overlooked especially if a person leaves and held
these extra duties.
CPD logs are hours are
checked and new CPD folders
are given out for the coming year.
I purchase a CPD folder from
a Company that can be used by
all members of the team. This I
find such an easy tool to use. The
staff are provided with individual folders containing sufficient
verifiable CPD, I understand that
mandatory CPD is the individuals
responsibility however I feel this
is an investment in your staff.
During the lunch break I
book a lunch & learn from a rep.
It’s surprising how quickly the
day goes and how much groundwork you have covered.
To take a day out needs to benefit the Practice, I believe quality is
something that should be expected and delivered at the highest
level. Training days may sound
expensive but what you gain
from a whole days experience
outweighs the negative side. DT

About the author

Special Launch Offer inc accessories, delivery, online training ex vat

Jane Armitage, Practice Manager of
the Year 05,06,07,09
Jane Armitage is an
award-winning practice
manager and
has almost 40 years
industry experience.
She is currently a
practice manager for
Thompson & Thomas,
and holds a Vocational Assessors
award. She is also a BDA Good Practice
Assessor, BDA Good Practice Regional
Consultant, and has a BDA Certificate
of Merit for services to the profession.
PM of the year 2005,06,07,09
BDA Certificate of Merit fir services to
the profession.
UK Outstanding achievement award
2011.
Readers can contact janearm@btinternet.com

[11] =>

Perio Tribune
Perio Tribune

Perio Tribune

Evidence evening

Perio Protocol

Colgate reviews the evidence

Mhari Coxon looks at protocols

page 12

Perio Tribune

Perio Tribune

Perio Insights

Two symposia from EuroPerio7

LANAP

Dr Kimmel presents a case

pages 20-22

pages 16-18

pages 13-15

Evidence that new biomimetic controlledrelease capsules may help in gum disease

S

Little
and
colleagues,
who are with the University
of Pittsburgh, have evidence
from laboratory experiments
with mice stand-ins for humans in early research of
this kind that cannot be done
with actual patients that the
approach does foster healing
and regrowth of gum tissue
damaged by periodontal disease.

cientists are trying to
open a new front in the
battle against gum disease, the leading cause of
tooth loss in adults and sometimes termed the most serious oral health problem of the

21st century. They described
another treatment approach
for the condition in a report
here today at the 244th National Meeting & Exposition of
the American Chemical Society, the world’s largest scien-

Proud of our 50 Years
in Quality Imaging,
For 3D Imaging, please read on...

tific society.
“Our technology uses controlled-release capsules filled
with a protein that would
be injected in the pockets
between the gums and the

A bacterial infection causes periodontal disease. It first
appears as mild tenderness
and bleeding of the gums. It
leads to inflammation and,
if left untreated, can damage

the gums so that they recede
and lose their attachment
to the teeth. It may progress
even further and damage bone

‘That’s ground-zero
for periodontal disease ‘gum disease’
the place where
bacteria breed
and inflammation
occurs’

and other tissues that hold
teeth firmly in place. Surprisingly, gum disease has a
number of deleterious effects
outside the mouth, with some
studies linking inflammation
in the gums to an increased
risk of heart disease, stroke
and preterm delivery in pregnant women.
Treatment includes scalà DT page 12

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teeth,” said Steven Little,
Ph.D., who reported on the
research. “That’s ground-zero
for periodontal disease ‘gum
disease’ the place where bacteria breed and inflammation
occurs. The capsules dissolve
over time, releasing a protein
that acts as a homing beacon.
It guides immune cells to the
diseased area, reducing inflammation, creating an environment that fights the disease process and even could
create conditions favorable
for gum tissue to regrow.”

[12] =>

12 Perio Tribune

United Kingdom Edition

ß DT page 11

ing, root planing and other
procedures to remove the
plaque and bacteria that have
accumulated in pockets between the teeth and gums.
Dentists may combine this
with antibiotics to fight the
bacteria involved in gum disease.
Many scientists are seeking alternative treatments that
kill the bacteria. Little’s group
is taking an entirely different
approach. They are targeting the inflammation process.
“Although bacteria start the
disease, inflammation is what
keeps it going and causes progressive damage,” Little explained.

‘Inflammation is inherently a good thing,
but too much of it is a bad thing. That’s
why we aim to restore the immune balance, or homeostasis’

To reduce inflammation
at the gums, Little and colleagues designed injectable
controlled-release
capsules
containing a protein encased
inside a plastic-like polymer material. The polymer
is already used in medicine
in dissolvable sutures. After
the capsules are injected, the
polymer slowly breaks down,
releasing the protein encapsulated inside. The protein,

termed a chemokine, is already produced by the body’s
existing cells in order to summon specialised white blood
cells to a specific site. Scientists previously tried to keep
those cells, termed lymphocytes, away from the gums so
as to block inflammation from
occurring in the first place.
“It seems counterintuitive to lure in a lymphocyte,

September 10-16, 2012

which is traditionally thought
of as an inflammatory cell, if
there’s inflammation,” Little
pointed out. “But remember
that a certain level of natural
inflammation is required to
fight off an infection. Inflammation is inherently a good
thing, but too much of it is a
bad thing. That’s why we aim
to restore the immune balance, or homeostasis.”

system, but also prompt regrowth of lost gum and bone
tissue in the mouth.

Little’s team injected the
capsules into mice and discovered evidence that disease
symptoms are dramatically
reduced and that proteins and
other substances involved in
regrowth of gum tissue had
appeared. Little said that this
finding offers encouragement
that the treatment could not
only rebalance the immune

This research was presented at a meeting of the American Chemical Society.

The researchers acknowledged funding from the Arnold
and Mabel Beckman Foundation, the Wallace H Coulter
Foundation and the National
Institute of Dental and Craniofacial Regeneration of the NIH
(1R01DE021058-01). DT

Source: American Chemical Society http://portal.acs.
org/portal/acs/corg/content

Improving periodontal health in style
lington Arch in central London.

Dr Fotinos Panagakis, Colgate Director of Clincial Research

number of key decision
makers and specialists
in periodontology, dental
public health & restorative dentistry came together recently to

review the latest additions to
the wealth of clinical evidence
on Triclosan & Copolymer at an
event held within the superb
English Heritage site of Wel-

Dr Anousheh Alavi, Scientific Affairs Manager, Colgate
UK & Ireland, opened the proceedings by reviewing the status of periodontal health and
preventive behaviour data from
the recent Adult Dental Health
Survey.1 Dr Alavi also shared
the
hierarchy of evidence
base, from systematic reviews
to consensus of experts, in line
with the ranking of evidence
in the Department of Health
publication: Delivering Better
Oral Health2 and shared some
insight into the difference between therapeutic and cosmetic claims made by toothpaste
manufacturers, depending on
whether the products had medicinal licence status.

Dr Fotinos Panagakos, Colgate Director of Clinical Research based in Piscataway, NJ,
USA, reviewed the latest clinical studies on Triclosan & Copolymer. Bringing the clinical
evidence to life, Dr Panagakos
gave an overview of Triclosan
and Copolymer Technology,
used exclusively in Colgate Total, before sharing a compelling
wealth of clinical evidence on
the effects of Triclosan & Copolymer on plaque, gingivitis, periodontitis, and peri-mucositis
around dental implants.
New Colgate® Total® Pro
Gum Health toothpaste is medically licensed to ‘improve gingival health and reduce the
progression of periodontitis’. It
contains clinically proven Triclosan & Copolymer Technology

to improve gingival health for
everyday use, as part of treatment and maintenance of periodontal health.
Recommend an evidencebased toothpaste to treat and
maintain your patients’ periodontal health. DT
For further information on
New Colgate® Total® Pro Gum
Health toothpaste and details of
its medicinal licence status, visit
www.colgateprofessional.co.uk
1. Adult Dental Health Survey
2009, NHS Information Centre
for Health and Social Care
2. Delivering Better Oral HealthAn evidence-based toolkit for prevention, Department of Health,
2nd edition, July 2009

Perio prevalence in Global Oral Care
partnership
US reported in study
C
A
study looking into the
“Prevalence of Periodontis in Adults in the United
States: 2009 and 2010,” evaluates the prevalence, severity
and extent of periodontitis in the
adult US population using information from the Health and Nutrition Examination survey.

Lead author Paul Eke used
information from a sample of
3,742 adults 30 years and older
with one or more natural teeth
of the civilian non-institutionalized population. Attachment
loss and probing depth were
measured at six sites per tooth
on all teeth (except the third
molars). The study is important because it is the first na-

tional probability sample that
has employed a full-mouth
periodontal examination protocol versus previous partial
mouth examinations.

Of the sample presented,
47.2 per cent, representing
64.7 million adults, had periodontitis distributed as 8.7 per
cent, 30.0 per cent and 8.5 per
cent with mild, moderate and
severe periodontitis respectively. For adults 65 years and
older, 64 per cent had either
moderate or severe periodontitis. These estimates are far
higher than previous national
estimates.
Periodontitis was highest

in males, Mexican Americans,
adults with less than high
school education, adults below
100% Federal Poverty Levels,
and current smokers. This
survey has provided direct
evidence for a high burden of
periodontitis in the adult U.S.
population, especially among
adults 65 and older.

This
information
implies that despite America
having almost twice the
number of dentists per person than any other country,
still more needs to be done
to increase oral care and
dental education, partially
within the less affluent areas
of the country. DT

olgate is pleased to announce a global partnership with OMRON,
a worldwide leader in innovative sensing and control technology for the manufacture of
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This unique partnership
combines OMRON technology,
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To have a chance of being
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Full terms and conditions are
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[13] =>

United Kingdom Edition

Perio Tribune 13

September 10-16, 2012

Protocol building for effective periodontal
case management in general practice
Mhari Coxon discusses why having a protocol is vital

O

ne way to ensure that
the advice, assessment, diagnosis and
treatment path remains at a
consistently high standard in
practice is to build a protocol
which the whole practice will
work to. This also makes induction training for new staff
members robust and in keeping with CQC guidelines. The
protocol is a map for anyone
to refer to which will add reassurance and weight to their
own conclusions. The secret
to success within general
practice is to be consistent in
your delivery. Protocols really
help this to happen.
What should go in your
protocol?
Well, if I am honest, as much
or as little as you feel appropriate. If you have several
dental professionals working
on periodontal cases in your

lines and the plan for each
• When to refer
Risk assessment guidelines
Mathew Perkins, a specialist

Tobacco Use:

(pictured). You may want to
combine your risk assessment
to incorporate caries and
tooth surface loss but this example is purely assessing for

periodontist in general practice in Coventry www.modusdental.com , kindly shared
his risk assessment questionnaire with me for this section,

risk in relation to periodontal
treatment.

à DT page 14

This is THE most significant risk factor for gum disease

Please circle if you now or have ever used
Cigarettes

Cigars

Pipe

Chewing Tobacco/Paan

Amount Per day

Used for How many Years

_____________

_____________________

Heart Attack/Stroke:
or stroke

Snuff

If you quit, when did you quit?
________________________

Untreated gum disease can increase your risk of heart attack

Do you have any other risk factors for heart disease or stroke? (please circle)
None Family history of heart disease Tobacco Use High Cholesterol High Blood Pressure
Medications:

A side effect of some medications causes changes in gums

Have you ever taken the following medications?
None

Anti-Epileptic Medications

Calcium Channel Inhibitors

Cyclosporin

Genetic: The tendency for gum disease to develop can be inherited
Has anyone on your side of the family had gum problems (eg mother, father or siblings)?

‘The protocol is a
map for anyone to
refer to which will
add reassurance
and weight to their
own conclusions’

Yes

No

Diabetes: Diabetics are more prone to gum disease. If left untreated, gum disease
makes it harder to control their blood sugar. When gum disease is eliminated, diabetics may improve their blood sugar control and make diabetic complications less likely.
Any family history of diabetes?

Yes

No

Have you had any of these warning signs of diabetes?
None

Frequent urination

Weakness and fatigue
practice, for example three
part time hygienists and a
specialist periodontist who
comes in once a month, then
you would need a detailed protocol as they will undoubtedly
have different opinions on
what is right and not and what
should be advised or used and
not. The initial mapping of the
protocol can take longer the
more dental professionals are
involved but is never the less
worthwhile compiling. From a
patient’s perspective, there is
little more de-motivating than
visiting another dental professional within the practice and
receiving different advice and
comment for the normal. It offers confusion and a feeling
of mistrust in some cases and
annoyance in others.
A basic protocol would
contain:
• Risk assessment guidelines
• BPE measurement guide-

Excessive thirst

Slow healing of cuts

Excessive hunger
Unexplained weight loss

Rheumatoid Arthiritis: The causes of gum disease and RA may be related. One doesn’t
cause the other, but when one is present the other is more likely to be going on. If your
gums are inflamed you may be at increased risk for developing RA.
Have you ever been diagnosed with Rheumatoid Arthritis?
Yes No
If you have rheumatoid arthritis, emerging research suggests that eliminating any gum
disease and then keeping it at bay can lessen the crippling effects of arthritis
Special Concerns for Females:
Pregnancy: Tell us if you are planning to become pregnant. Gum disease can make it
up to eight times more likely that you will have a pre-term low birth weight baby. You
can greatly reduce the likelihood of having an adverse pregnancy outcome by finding
out if you have any gum disease and then doing whatever is necessary to eliminate it
before you get pregnant. It is also important to make sure your gums are inflammation
free while you are pregnant.
Osteoporosis:
Do you have osteoporosis?
Yes No
The following are risk factors for osteoporosis: Post-menopausal, Family history of osteoporosis, Early menopause, Rheumatoid Arthritis, Inadequate exercise, Smoking
Do you have any risk factors for osteoporosis?
Yes No
Have you ever been tested?

Yes

No

[14] =>

14 Perio Tribune
ß DT page 15

Please note that the wording of these questions is to
ensure they are easy to understand for the patient and easy
to answer. The risk assessment questionnaire is useful
in more than one way. It is
extremely useful for gathering information to aid diagnosis and categorisation of a
patient. It is also a subtle tool
for moving thepatient from
pre-contemplation to contem-

plation regarding their gum
health. This, combined with
a little open question session,
can create a non-confrontational opeining to discussion
and advice and education sessions.
BPE guidelines and a guide
to care – see www.bsperio.org.
uk for full details
Careful assessment of the
periodontal tissues is an essential component of patient

United Kingdom Edition

management. The BPE is a
simple and rapid screening
tool that is used to indicate the
level of examination needed
and to provide basic guidance
on treatment need. Please
note; the BPE does not provide
a diagnosis.
How to record the BPE

The dentition is divided
into six sextants:
upper right (17 to 14), upper

anterior (13 to 23), upper left
(24 to 27) lower right (47 to
44), lower anterior (43 to 33),
lower left (34 to 37)

All teeth in each sextant
are examined (with the exception of 3rd molars).

For a sextant to qualify
for recording, it must contain
at least two teeth. (If only 1
tooth is present in a sextant,

Treat small
spaces with

confidence

September 10-16, 2012

the score for that tooth is included in the recording for the
adjoining sextant).

A WHO BPE probe is used
(World Health Organisation
probe). This has a “ball end”
0.5 mm in diameter, and a
black band from 3.5 to 5.5 mm.
Light probing force should be
used (20-25 grams). – you can
calibrate your probing using
an electric scale to measure
10 probe movements and take
the mean number. You can

‘It is also a subtle
tool for moving
thepatient from precontemplation to
contemplation regarding their gum
health

Human histology shows the apical
extent of the junctional epithelium
below which there is a supracrestal
connective tissue attachment to the
laser microchannel surface2.

also invest in a set of pressure
sensitive probes if you want ot
be gold standard.

Laser-Lok 3.0 placed in
aesthetic zone.

Radiograph shows proper
implant spacing in limited site.

Image courtesy of Michael Reddy, DDS

Image courtesy of Cary Shapoff, DDS

Introducing the Laser-Lok® 3.0 implant
Laser-Lok 3.0 is the first 3mm implant that incorporates Laser-Lok technology to create a biologic seal and maintain crestal bone
on the implant collar1. Designed specifically for limited spaces in the aesthetic zone, the Laser-Lok 3.0 comes with a broad array
of prosthetic options making it the perfect choice for high profile cases.

• Two-piece 3mm design offers restorative flexibility in narrow spaces
• Implant design is more than 20% stronger than competitor implant2
• 3mm threadform shown to be effective when immediately loaded3
• Laser-Lok microchannels create a physical connective tissue attachment (unlike Sharpey fibers) 4

Probing
The probe should be “walked
around” the sulcus/pockets in
each sextant, and the highest
score recorded. As soon as a
code 4 is identified in a sextant, the clinician may then
move directly on to the next
sextant, though it is better to
continue to examine all sites
in the sextant. This will help
to gain a fuller understanding
of the periodontal condition,
and will make sure that furcation involvements are not
missed. If a code 4 is not detected, then all sites should be
examined to ensure that the
highest score in the sextant is
recorded before moving on to
the next sextant.
BPE Scores

For more information, contact BioHorizons
Customer Care: +44 (0)1344 752560 or
visit us online at www.biohorizons.com

1. Radiographic Analysis of Crestal Bone Levels on Laser-Lok Collar Dental Implants. CA Shapoff, B Lahey, PA Wasserlauf, DM Kim, IJPRD, Vol 30, No 2, 2010.
2. Implant strength & fatigue testing done in accordance with ISO standard 14801.
3. Initial clinical efficacy of 3-mm implants immediately placed into function in conditions of limited spacing. Reddy MS, O’Neal SJ, Haigh S, Aponte-Wesson R, Geurs NC.
Int J Oral Maxillofac Implants. 2008 Mar-Apr;23(2):281-288.
4. Human Histologic Evidence of a Connective Tissue Attachment to a Dental Implant. M Nevins, ML Nevins, M Camelo, JL Boyesen, DM Kim.
SPMP10109 REV D SEP 2010
International Journal of Periodontics & Restorative Dentistry. Vol. 28, No. 2, 2008.

Bio Horizons_treat small.indd 1

01/03/2011 16:33

0 No pockets >3.5 mm, no calculus/overhangs, no bleeding after probing (black band
completely visible)
1 No pockets >3.5 mm, no calculus/overhangs, but bleeding after probing (black band
completely visible)
2 No pockets >3.5 mm, but supra- or subgingival calculus/
overhangs (black band completely visible)
3 Probing depth 3.5-5.5 mm
(black band partially visible,
indicating pocket of 4-5 mm)
4 Probing depth >5.5 mm
(black band entirely within
the pocket, indicating pocket
of 6 mm or more)
*
Furcation
involvement

[15] =>

United Kingdom Edition

BPE Inertpretation
0 No need for periodontal
treatment - but lots of praise
is good!
1 Oral hygiene instruction
(OHI)
2 OHI, removal of plaque retentive factors, including all
supra- and subgingival calculus
3 OHI, root surface debridement (RSD)
4 OHI, RSD. Assess the need
for more complex treatment;
referral to a specialist may be
indicated.
* OHI, RSD. Assess the need
for more complex treatment;

In others it can send a mixed
message to the patient about
the work they have had with
either the GDP or hygienist/
hygienist therapist. It is important that the patient is aware
of the importance of their role
in stabilising any disease and
has ownership of their condition before referring on. They
should also value the clinician
who will be carrying out their
maintenance regime as that is
the person who will support
them in ensuring they keep

Perio Tribune 15

September 10-16, 2012

themselves at a high level of
oral health.
My lovely Professor Barry
Ely, sadly no longer with us,
used to say three strikes then
refer. So, have three goes at
RSD with OHE and if there
is still no improvement then
refer on. This would be done
within a three - four month
period and will not be detrimental to the patient in almost
all cases. Of course, if you see
rapid deterioration, then you

would refer on and seek advice at the soonest possible
opportunity.
Other things that could be
put in your protocol:

the template for debate within your team and provide the
bones for your final structure
to ensure quality, consistency
and best practice. DT

• A guide to an oral health education session
• Recall interval guide
The list I have developed
here is just a general example for you and could form

Periodontal Disease

How do you measure success?
‘It is important
that the patient is
aware of the importance of their role
in stabilising
any disease and has
ownership of their
condition before
referring on’

Dentomycin offers:
• 42% reduction in pocket depth after 12 weeks1
• broader spectrum of antibacterial action2 with greater all round
activity than metronidazole or tetracycline

• conditioning of the root surface3 and enhanced connective
tissue attachment4

• improved healing through inhibition of degradative collagenases5
referral to a specialist may be
indicated.
When to refer
If a specialist is at hand, there
can be a temptation to refer on
to them quickly. In some cases this is entirely appropriate.

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.

• effective treatment of chronic periodontitis which has been
associated with cardiovascular diseases6-9
1. van Steenberghe D, Bercy P, Kohl J, et al. Subgingival minocycline hydrochloride
ointment in moderate to severe chronic adult periodontitis: a randomized, double-blind,
vehicle-controlled, multicenter study. J Periodontol 1993;64:637-44
2. Slots J and Rams TE. Antibiotics in periodontal therapy: advantages and
disadvantages. J Clin Periodontol 1990;17:479-93
3. Rompen EH, Kohl J, Nusgens B, Lapiere CM, Kinetic aspects of gingival and
periodontal ligament fibroblast attachment to surface-conditioned dentin. J Dent Res
1993;72:607-12
4. Rifkin BR, Vernillo AT, Golub LM. Blocking periodontal disease progression by inhibiting
tissue-destructive enzymes: a potential therapeutic role for tetracyclines and their
chemically-modified analogs. J Periodontol 1993;64:819-27
5. Somerman MJ, Foster RA, Vorsteg GM, et al. Effects of minocycline on fibroblast
attachment and spreading. J Periodontal Res 1988;23:154-9
6. DeStefano F, Anda RF, Kahn HS, et al. Dental disease and risk of coronary heart
disease and mortality. BMJ 1993;306:688-91
7. Joshipura KJ, Rimm EB, Douglass CW, et al. Poor oral health and coronary heart
disease. J Dent Res 1996;75:1631-6
8. Mattila KJ. Dental infections as a risk factor for acute myocardial infarction. Eur Heart J
1993;14 Suppl K:51-3
9. Morrison HI, Ellison LF, Taylor GW. Periodontal disease and risk of fatal coronary heart
and cerebrovascular diseases. J Cardiovasc Risk 1999;6:7-11

Information about adverse event reporting can be found at www.yellowcard.gov.uk Adverse events should also be reported to
Blackwell Supplies,Medcare House, Gillingham, Kent ME8 0SB or by telephone: 01634 877525
Dentomycin abridged prescribing information. Please refer to the Summary
of Product Characteristics before using Dentomycin 2% w/w Periodontal Gel
(minocycline as hydrochloride dihydrate). Presentation: a light yellow coloured gel
containing minocycline as hydrochloride dihydrate equivalent to minocycline 2%
w/w. Each disposable application contains minocycline HCI equivalent to 10mg
minocycline in each 0.5g of gel. Uses: Moderate to severe chronic adult periodontitis
as an adjunct to scaling and root planing in pockets of 5mm depth or greater.
Dosage: Adults – Following scaling and root planing to pockets of at least 5mm
depth. Gel should fill each pocket to overflow. Applications should be every 14 days
for 3-4 applications (e.g. 0,2,4 and 6 weeks). This should not normally be repeated
within 6 months of initial therapy. Use only one applicator per patient per visit which
should be wiped with 70% ethanol between applications to each tooth. Avoid tooth
brushing, flossing, mouth washing, eating or drinking for 2 hours after treatment.
Elderly – As adults, caution in hepatic dysfunction or severe renal impairment. Children
– contraindicated in children < 12 years.

Not recommended in children > 12 years. Contraindications: Hypersensitivity to
tetracyclines, complete renal failure, children under 12 years. Precautions: Closely
observe treatment area. If swelling, papules, rubefaction etc. occur, discontinue
therapy. Safety in pregnancy and lactation not established. Side-effects: Incidences
are low and include local irritation and very rarely diarrhoea, upset stomach, mild
dysphoria and hypersensitivity reactions. Storage: 2°-8°C. Legal category: POM.
Presentation and cost: Disposable applicator in an aluminium foil pouch. Each
carton contains 5 pouches. Carton £103.02+VAT. Licence No: PL 27880/0001
PA1321/1/1. Product Licence Holder: Henry Schein UK Holdings Limited, Medcare
House, Centurion Close, Gillingham Business Park, Gillingham, Kent, ME8 0SB.
Telephone 020 7224 1457 Fax 020 7224 1694 Distributed by: Blackwell Supplies
a division of Henry Schein UK Holdings Ltd, Medcare House, Gillingham Business
Park, Gillingham, Kent ME8 0SB Tel 020 7224 1457 Fax 020 7224 1694 Date of
preparation: February 2011 *Registered Trademark BLA/DEN 18

[16] =>

16 Perio Tribune

United Kingdom Edition

September 10-16, 2012

Insights into the latest therapy
options for periodontitis
A look at Europerio7 in Vienna

Delegates at the event

Heraeus’ stand at Europerio

(Nackaerts et al., 2008). Another treatment approach looks at
the effect of micronutrients as
a food supplement. Here, daily
intake indicates a reduction in
probing pocket depths (Chapple ILC et al., 2012). Further
clinical studies are required in
order to verify the clinical significance.
Prof Peter Eickholz

s part of this year’s Europerio in Vienna, Heraeus
held two symposia on
the latest developments in the
treatment of periodontitis. The
question investigated by the
first session on Friday morning
was how local antibiotics can
assist in the treatment of periodontitis. Following a brief
introduction from Professor
Niklaus P. Lang from the University of Hong Kong, China,
Professor Maurizio S. Tonetti,
Executive Director of the European Research Group on
Periodontology (ERGOPerio),
Italy, opened the first Heraeus
symposium with his presentation on current understanding of periodontitis and how it
changes treatment. He began
by immediately emphasising
that periodontitis has become
a serious health problem in
Europe.
In addition to the role
played by biofilm in triggering development, individual
susceptibility to periodontal
disease is also an increasingly
important factor. This is influenced by genetic predisposition and environmental risk

factors, and determines the
intensity and clinical presentation of the periodontal inflammatory process.
Periodontitis is also proven
to have various effects on the
body as a whole. In addition
to providing systematic periodontal therapy with regular
follow-up for the rest of the patient’s life, it is therefore also
important to limit additional
risk factors. With professional
preventative measures geared
towards the patient’s individual symptoms, further progression of the condition can be
prevented in the long-term.
Professor Tonetti concluded with an outlook on possible future therapies. In a dog
(beagle) model of replacement therapy, “friendly” bacteria such as streptococcus
sanguinis, streptococcus salivarius and streptococcus mitis
appear to have a positive impact on inflammatory response
when applied sub-gingivally in
addition to scaling & root planing (SRP). This is demonstrated
in X-ray images by increased
bone density and bone level

Professor Lang concentrated his presentation on the
management of deep pockets.
Currently considered equivalent to a probing pocket depth
of ≥ 6 mm, this correlates with

Prof Niklaus Lang

once-off, topical, adjunctive administration of a slow-release
doxycycline gel (SRD) in patients with persistent/recurring
periodontitis during supportive
periodontal therapy (SPT). Following supra-gingival debridement and sub-gingival treatment using ultrasonic/sonic
instrumentation, the SRD was
applied in all the residual pockets ≥ 4 mm in the test group. The
result of this study supports the
concept of additional local antibiotic administration, particularly SRD. In the treatment of
persistent/recurring periodon-

‘In addition to the role played by biofilm
in triggering development, individual susceptibility to periodontal disease is also an
increasingly important factor’
a significantly increased risk
of tooth loss. This is also the
level at which the composition
of biofilm and its pathogenicity
changes. The local administration of adjunctive antibiotics
requires the application of a
significantly higher concentration of active ingredients in order to kill the periodontal pathogenic bacteria. In addition,
the delivered substance must
remain at the active site for a
sufficient length of time in order to ensure continued release
of the active ingredient.
A recently completed study
by the ERGOPerio group
(Tonetti et al., 2012) investigated the therapeutic effect of

titis during SPT, this has been
shown to have a positive therapeutic effect on inflammatory
response as well as in the case
of deep pockets (≥ 5 mm). Local antibiosis also seems to be
the most effective approach for
treating peri-implantitis due
to the high concentration of
active ingredients. The microbiological flora is for the most
part comparable with periodontitis, although peri-implant
lesions may also be affected by
staphylococcus aureus (typical
pyogenic organism). The discharge of pus when probing a
pocket is a clinical indication
of infection in the diagnosis of
peri-implantitis. The greatest
challenge here is the removal

of biofilm, a procedure that
is considerably more difficult
in the case of implant surfaces than in the case of natural
dentition. Currently there is no
standard, evidence-based approach to therapy: local antibiotics may provide an answer
for the future, however, this
must first be borne out by a
study. Nevertheless, Professor
Lang summarises as follows:
“Nothing excuses the patient
from cleaning his teeth every
day”.
Dr. Waleed S.W. Shalaby,
Chief Science Officer at PolyMed Inc., USA, continued in
the same vein as Professor
Lang, and presented the latest
biomaterials for oral and periodontal applications. He provided detailed information on
the critical aspect of the slow
release of active ingredients in
local antibiosis.
According to Dr. Shalaby,
“The development of Ligosan
Slow Release for non-surgical
therapy of periodontitis is a
good example of functional
technological innovation”. Its
main feature is its biodegradable carrier substance comprised of hydrophobic and hydrophilic parts, which ensure
that the initially fluid consistency enables penetration into
the deep areas of the periodontal pocket that are difficult to
reach. Liquid environments
increase the viscosity, creating
a gel consistency that ensures
that the carrier substance remains at the active site. This ef-

[17] =>

United Kingdom Edition

September 10-16, 2012

odontal disease reduces the
presence of certain periodontal
pathogenic bacteria in the subgingival plaque.

fect results in slow, continued
release of the active ingredient in sufficient concentrations
over a period of at least 12 days.
Thanks to the bioresorbable
nature of the product, the patient does not require a further
appointment and also benefits
from relatively low systemic
doxycycline exposure.
Following Dr. Shalaby’s detailed look at the advantages
of the innovative slow release
gel formula, Professor Peter
Eickholz, from the University
of Frankfurt, Germany, continued with the question of the
effect to be expected following
adjunctive administration of
the new doxycycline gel. He
began by listing the indications
for local antibiotic therapy and
continued with the results of
clinical studies, which he used
to present scientific evidence
for the additional benefits of
14% SRD gel. In combination
with SRP in the case of previously untreated periodontitis,

The press breakfast

Perio Tribune 17

Risk-based follow-up ensures
long-term therapy success
The second event on Friday
evening focussed on current
therapy options in periodontal
treatment. In the first presentation, Professor Petra RatkaKrüger from the University of
Freiburg, Germany, looked at
supportive periodontal therapy

Briefing the assembled press

in daily practice, underlining
the importance of SPT in longterm therapeutic success. She
based her conclusions on a
variety of studies, all of which
provide scientific evidence of
the positive impact when patients with periodontal disease
are treated regularly and consistently using SPT techniques.
Based on a risk assessment at
various levels (Lang & Tonetti,
2003), an individual risk analyà DT page 18

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Prof Ratka-Kruger

this has been proven to lead to
improved attachment as well
as greater pocket reduction
that is clinically more relevant
than achieved by SRP alone
(Eickholz et al., 2002). A comparison of sub-gingival, topical
administration of antibiotics
and mechanical debridement
has shown comparable clinical efficiency (Eickholz et al.,
2005). The primary benefits in
the case of any residual deep
pockets during SPT (Tonetti
et al., 2012) had already been
discussed in Professor Lang’s
presentation. In his conclusion,
Professor Eickholz emphasised
a further feature of doxycycline: not only does it have an
antibacterial effect, it is also
anti-inflammatory.
Clinical
studies have also shown that
once-off application of a 14%
SRD gel in patients with peri-

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[18] =>

18 Perio Tribune

United Kingdom Edition

ß DT page 17

sis can be performed, helping
to prevent insufficient or excessive treatment. Professor
Ratka-Krüger continued with
a description of the timeframe
for a follow-up check-up, providing detailed information on
the individual steps and what
they entail. She referred back
to the positive effect discussed
in the first Heraeus symposium, specifically that of additional topical administration

Juliette Reeves

Prof Maurizio Tonetti

of SRD gel in the case of previously untreated cases of periodontitis (Eickholz et al., 2002),
and once again emphasised the
advantages of local antibiotics:
reliable, simple and fast application. The additional benefits
of this approach combined with
SRP during SPT are also scientifically proven (Tonetti et al.,
2012). In this regard, she also
referred to a study (Dannewitz
et al., 2009) in which the effect
of topical SRD administration in
addition to SRP during SPT was

September 10-16, 2012

investigated in teeth with furcation defects. Once again, improvement was observed at furcation sites compared with SRP
alone. In her conclusion, Professor Ratka-Krüger described
supportive periodontal therapy
as the key to long-term therapy
success. Regular participation
in risk-based follow-up allows
recurrences to be recognised
and treated at an early stage,
thus preventing tooth loss. Local antibiotics can boost the
effect of mechanical therapy,
contributing to the success of
treatment.
In the second presentation
“Telomere Length, Oxidative
Stress and Chronic Periodontal Inflammation: Implications
for Supportive Therapy”, Juli-

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ette Reeves, Clinical Director
at Perio-Nutrition, Great Britain, looked at previously littleknown links with periodontitis. Telomeres are regions at
each end of a chromosome
that shorten each time cells
divide. This process is accelerated by oxidative stress. The
length of telomeres is related
to aging, chronic infection,
oxidative stress and systemic
illness (Zglinicki et al., 2005).
Over the last ten years, the effects of periodontitis on general health have been clearly
established. Masi et al. (2011)
found that shorter telomeres
are linked to periodontitis
and that their size correlates
with oxidative stress and the
gravity of the condition. Gilley
et al. (2008) proved that telomere degradation, the extent
of chronic infection and oxidative stress can be reduced
through changes in lifestyle
(smoking, nutrition, obesity,
stress). In her presentation,
Ms. Reeves once again demonstrated the evidence-based
links between living a healthier life and periodontal and
general health, and defined
the control of inflammatory
response as a primary goal of
treatment. DT

[19] =>

United Kingdom Edition

Perio Tribune 19

September 10-16, 2012

Gumsaver® unveils a brand new oral health
system designed to treat and prevent gum disease

he gumsaver® team
is thrilled to unveil its
brand new oral health
system designed to treat and
prevent gum disease.
The gumsaver® system includes a soft bristled tool specifically designed to remove
the bacteria from beneath
the gum line and between the
teeth, and a simple three step
cleaning technique.
We have designed Gumsaver® to make the task of
looking after gums and teeth
simple for dentists, therapists,
hygienists and the patient:
• The ergonomic design of the
brush along with the simple 3
step technique means patients
can be taught how to treat and
prevent gum disease at home.
• The bristle heads are angled towards each other and
are spaced apart, providing a
small clearance in which the
inter-dental spaces are lined
up during use.
• An up and down motion will
guide a head under the gumline and into the pocket to
remove bacteria rooted deep

team have just returned from
presenting this data at the
International Association for
Dental Research (IADR) General Session in Brazil and
received wide acclaim from
their global colleagues.
Invented by Leamington-

Spa based dentist Dr Hani Mostafa, Gumsaver® has been
designed to tackle one of the
UK’s most significant public
health challenges today.
Inevitability
“As a practicing dentist for
14 years, I have always been

frustrated by the inevitability
of tooth loss amongst patients
with
periodontal
disease.
Since 2006, I have been advocating the use of a narrow
headed inter-dental brush
and sub-gingival oral hygiene
techniques, as taught by Philip Ower and the late Graham

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tooth, inside and out.
• The unique angle of the
heads make it easy for the
patient to use and the soft
bristles will reduce any discomfort, thereby improving
patient compliance.
Audit
In an audit of 93 patients with
pocket depths of 3.5 – 10mm
(BPE 3 or 4), Warwick Dentistry found that 98 per cent
of subjects using the Gumsaver® system experienced
a significant improvement.
After just six months of using the Gumsaver® system, a
staggering 63 per cent of subjects presented BPE scores of
0. In other words, their gum
disease had been completely
eradicated. The Gumsaver

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Smart. I have designed Gumsaver® to enable the dentist,
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thereby removing sub-gingival pathogenic bacteria from
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31/08/2012 17:35

[20] =>

20 Perio Tribune

United Kingdom Edition

September 10-16, 2012

LANAP - Laser-assisted new attachment procedure
Dr David Kimmel discusses the LANAP protocol

Fig. 2_Formation of the stable fibrin clot.

Fig. 1_Selective thermal ablation of epithelium.

historical perspective of
the development of the
Laser-Assisted New Attachment Procedure is presented in this article. The simplicity
of the protocol is discussed, as
well as its nuances. The concept of the Laser-Assisted New
Attachment Procedure (LANAP)
was born back in 1989 with Drs
Robert Gregg ll and Del McCarthy. As with most general
dentists battling with the dayto-day realities of periodontal
disease, they were looking for
an answer on how to better
care for their patients. The reality at the time was that periodontal disease was difficult
to treat and maintain. It was
primarily based on older concepts of wound debridement
and amputation. Once treated,
relapse was common. We know
periodontal disease is a multifactorial disease process and
patient behavioural routines
can play a significant role. It is
a wonder that the conventional
treatments worked as well as
they did. Even when they did
work, there often were significant secondary repercussions
clinically as well as psychologically. Clinically, many of these
traditionally treated cases were
difficult to restore whenever
dental prosthetic treatment was
needed and patients were often
left with the compromised aesthetic result of a long tooth appearance. Post-surgically, there
was significant root surface
exposure and with patients’ increased life span and the incidence of dry mouth, root caries
can become a very difficult en-

tity to control.
More problematic, is that
psychologically many of these
patients felt that the discomfort from the procedure and/
or the residual tooth sensitivity after treatment was so great
that they would not complete
remaining areas that needed
treatment or declined retreatment when they relapsed. Further complicating matters, the
patients would recant their experiences to friends and family, making case acceptance
for periodontal treatment often
a challenge. During this same
time, Drs Gregg and McCarthy
were involved in the early use
of Nd:YAG lasers in dentistry.
Confronted with patients not

Fig. 3_Periodontal charting.

wishing to lose teeth and declining traditional surgery or extraction, they developed the LANAP
protocol, which eventually led
to its US FDA clearance in 2004.
In concept, the LANAP protocol
is rather simplistic. The ultimate goal is to set up the periodontal environment to promote
self-regeneration of the lost attachment and osseous structure
that result from
LANAP—Laser-Assisted New
Attachment Procedure
Reinforced when new attachment was found on all the LANAP-treated teeth in the initial
histology studies done by Dr
Ray Yukna. LANAP is also a very
safe protocol. The use of the
Nd:YAG laser has often been of
concern by some owing to possible damage to root surfaces
and the tissue attachment but,
with a basic understanding of
laser physics, laser–tissue interaction parameters were developed that enabled the use
of an Nd:YAG in a very safe and
effective manner. LANAP is also
standardised. That is, before

a doctor can obtain his laser
he goes through three days of
training: one day of laser physics and laser–tissue interaction
and then two days of hands-on
training with patients. This is

Patients undergo a full dental examination and treatment
plan—as with all dentistry. If
they have an appropriate diagnosis of Type III or greater periodontal disease, all treatment

‘We know periodontal disease is a multifactorial disease process and patient
behavioural routines can play a
significant role’

then followed up by two more
separate days of treating patients to refine techniques and
add other treatment modalities
utilising the Nd:YAG. Because
of the simplicity, predictability
and standardisation of LANAP,
it has become a very safe and
effective way to treat periodontal disease. The simplicity of the
LANAP protocol can be seen in
Table I.
The LANAP protocol
Step A

options are presented to the
patient. The initial step of the
LANAP protocol, after anaesthesia has been administered,
ism bone sounding around each
tooth. The objective is to determine areas of osseous defects
that cannot be seen radiographically.
Step B
This is the first time the laser is
used. The objective of this step is
to remove only diseased epithelium, to affect selectively bacte-

[21] =>

Perio Tribune 21

United Kingdom Edition September 10-16, 2012

ria associated with periodontal
disease, to affect the calculus
present, and to affect thermolabile toxins. The bacteria that
are associated with periodontal diseases are pigmented and
are found in the sulcus, within
the root surface and within the
epithelial cells. One of the reasons for the predictability of this
step is in the selection of a freerunning pulsed Nd:YAG laser
with a wavelength of 1,064 nm
and pulsed in a range of seven
different microseconds. The
shorter 1,064 nm wavelength
was selected for its affinity for

to the calculus.
Step D
The next step again utilises the
laser. This time the parameters
are varied to enhance the ability to form a fibrin clot to close
the mini-flap and to disinfect
the site again. The formation
of the stable fibrin clot is significant, as it is stable for approximately 14 days. The role
of the fibrin clot is to keep the

Fig. 5_Post-op periodontal probing at 15 months.

the calculus. The first interaction of the laser results in the

initial formation of a mini-flap,
thereby further assisting in the

removal of calculus because of
increased visibility and access

à DT page 22

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Fig. 4_ Pre-op CBT scan.

melanin or dark pigmentation,
unlike the longer wavelengths
that are highly absorbed in
water and would have a shallow depth of penetration. This
ability to increase the depth of

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penetration of the laser energy
with minimal collateral damage
is the reason that the diseased
epithelium can be selectively
removed without damage to the
underlying tissue, leaving intact rete pegs. The diode lasers
are also known for this selective absorption in pigmented
tissues, but the free-running,
pulsed Nd:YAG lasers differ in
their ability to operate at very
high peak powers in very short
timeframes, which allows the
Nd:YAG to have the greater
depth of penetration and the
lack of collateral damage
Step C
This step in the LANAP protocol
is straightforward; it is just a
matter of using the piezo-scalers to remove the calculus present on the root surfaces. The
removal of calculus is believed
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[22] =>

22 Perio Tribune

United Kingdom Edition

September 10-16, 2012

ß DT page 21

sulcus sealed against bacterial
infiltration and to prevent the
growth of epithelium down into
the sulcus. Other laser wavelengths not only lack the ability
to form this stable fibrin clot,
but also require repeated treatments to prevent epithelium
growth down into the sulcus.
The ability to select the laser
tissue interaction specifically is
unique to the PerioLase MVP-7
(Millennium Dental Technologies). Through the use of specific fibre sizes, energy, repetition rates, pulse durations and
standardisation of the energy at
the fibre tip, this protocol can
be followed in a predictable
and reproducible manner. The
high standard of training that
each LANAP doctor receives
also contributes to the predictability of this protocol and to
its safety. Patients often present
with different tissue types along
with different degrees of disease. One of the purposes of the
handson training is learning to
recognise these differences and
how to change the laser parameters accordingly so that the desired laser–tissue interactions
are achieved.
Step E
The fifth step in LANAP is the
compression of the fibrin clot
to enhance the healing process.
Because laser wounds heal by
secondary intention, closer approximation enhances the heal-

Table 1

Fig. 6_CBT scan 15 months post-op LANAP.

Fig. 7_Pre-op photograph.

Fig. 8_Post-op photograph.

ing time.
Step F
Following the compression and
stabilisation of the clot, the last
step of LANAP is refining the
occlusion. Occlusion has been
considered a greater cofactor in
the progression of periodontal
disease than smoking. In order
to minimise this role, extensive
adjustments are made to the
dentition. The patients are then
followed for nine to 12 months
with routine supra-gingival
cleanings and occlusal refinements. No sub-gingival restorative or periodontal probing is
done during this time. Only
during the final post-operative
visit is a periodontal probing
done. The results that are seen
from LANAP treatment are very
similar to the following cases,
where new bone fill can be seen

in vertical osseous defects. The
bone fill ranges from simple
proximal defects to the more
complex furcation defects. The
hallmark of LANAP is pocket reduction, new tissue attachment
and a lack of tissue recession.
_LANAP case 1
The patient in this case was
a 40-year-old female patient
with a history of lupus, rheumatoid arthritis and Sjögren’s
syndrome. She was also a
smoker. There was generalised deep pocketing as seen in
her periodontal charting. The
extent of the osseous defect is
shown on the lingual view of
the right quadrant preoperative
CBT scan. The initial post- LANAP evaluation was done at 15
months. Post-operative probing is shown in Figure 5. The
CBT from the lingual view of
the right quadrant at 15 months

Fig. 9_Pre-op X-ray.

postoperatively is shown in Figure 6. The change in the osseous defects is apparent. Minimal to no recession is shown in
the preoperative clinical photograph in Figure 7 and the postoperative in Figure 8.
_LANAP case 2
The patient in this case was a
59-year-old male patient, with
Type 1 diabetes and a smoker.
His periodontal pocketing was 7
mm on the mesial second premolar. The preoperative X-ray
is shown in Figure 9 and the
36-month post-LANAP X-ray
in Figure 10. The 7 mm pocket
had been stable and maintained

Fig. 10_Post-LANAP X-ray at 36
months.

at 3 mm for the last 36 months.
The LANAP protocol will be 21
years old this year. It is coming of age. It has stood the test
of time. There are over 1,000
trained clinicians applying LANAP. They have all been standardised. The uniqueness of the
protocol is that whether the
doctor is new to LANAP or a veteran “LANAP’er”, his results are
similar. During its early stages,
early adopters accepted LANAP
with anecdotal evidence alone,
which was reinforced by the
individual successes seen clinically. It was further validated
by Dr Ray Yukna’s histological
studies in 2003. As the LANAP

multicentre clinical studies
move to completion, it would
be reasonable to expect to see
LANAP become the conventional manner or the standard
for the treatment of periodontal
disease. It is a very simple but
eloquent protocol, one in which
the patient has no to minimal
discomfort and treatment acceptance is high. DT

About the author
Dr David Kimmel
12124 Cobble Stone Dr
Bayonet Point, Florida 34667
USA
E-Mail: dskimmel@mac.com
Tel.: +1 727 862 8513

[23] =>

20 LIM
DE IT
LE ED
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Tim Earl East Sussex

One of the best courses I’ve been to, very
focused on implementing learnt skills into
practice. Great friendly atmosphere!

Occlusion & Aesthetics

Przemek Popielarek Ireland

Treatment Planning
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September 27 – 29 2012

“The glue that sticks dentistry together.”

This course provides the participant
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Special emphasis will be placed on the four options of treatment
(reshaping, repositioning, restoring and surgical correction), so
that the correct option(s) are chosen for each patient. Additionally,
each student will learn how to segment large treatment plans, so
that patients with financial issues can receive optimum care over
time. The focus of the programme is to integrate a comprehensive
treatment planning process into their practice. Suggestions will
also be made on creating time and a place for optimum treatment
planning. Finally, a consultation process will be discussed in detail,
ensuring each participant will enjoy a healthy case acceptance rate.

Greg Finnegan Belfast
Sean Corry Magherafelt

LEARNING OBJECTIVES
Establish a step-by-step process for treatment planning
any restorative case, from the simplest to the most complex.
Special emphasis will be placed on the four options of
treatment (reshaping, repositioning, restoring and surgical
correction).
Explore why 90% of mistakes occur not during the restorative
phase, but rather during the treatment planning process.
Plan and visualise ideal aesthetics and ideal function.
Design programmed treatment planning processes and
integrate into your practice.
Discover the need for/value of quality records.
Master the 16 functional and esthetic components of
healthy, functionally correct dentition.
Investigate how the teeth should be positioned in space for
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Identify specifically how to utilise the diagnostic photographs
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Create a segmented treatment plan so that optimum care
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Creating time and a place for treatment planning.

For further information on this introductory course, basic Core Curriculum of learning and team events, please contact:
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[24] =>

24 Product Spotlight

United Kingdom Edition

September 10-16, 2012

Dental patient bib holders source of bacteria

ygiene in the dental office is a matter of course
and a must for patient
safety. Instruments are sterilized daily and work surfaces
disinfected. Moreover, dentists
and assistants wear gloves and
face masks. Nonetheless, a
seemingly harmless object is

found wanting in terms of hygiene in many dental offices:
the patient bib holder. These
are often contaminated with
bacteria, a recent study by Witten/Herdecke University (Germany)1 has shown.
Bacteria were found on 70 per

cent of the bib holders.
Witten/Herdecke
University
examined the number and
type of germs found on patient
napkin holders more closely.
A total of 30 metal and plastic
patient napkin holders were
subjected to microbiological
tests. The results are alarming.

Bacteria were found on 70 per
cent of the bib holders, despite
the fact that some of the holders were regularly cleaned and
even disinfected.
The most frequently found
microorganisms were staphylococci and streptococci. Also,

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different types of rods, pseudomonads - both types of bacteria -, fungi as well as other
types of cocci were found on
individual chains. Although all
were non-pathogenic bacteria, it is clear that, in principle,
bacteria transfer can occur via
bib chains. During a comparable study conducted by the
University of North Carolina2
the E.coli bacterium, which
can cause serious diseases, was
found on napkin holders.
Risk of cross-contamination
Previous studies published in
2010 2,3,4 already noted the potential risk of cross- contamination. The staphylococci and
streptococci mainly found in the
current study occur all around
us and are non-hazardous for
healthy people when found in
low concentrations. However,
it should be noted that both
types of cocci can also cause
infection: staphylococci are responsible for wound infections,
boils and food poisoning, while
streptococci can lead to scarlet
fever, endocardium inflammation and pneumonia. The detected fungal species can also
trigger physical reactions such
as allergies, fever or irritation
of the respiratory tract if they
occur in higher concentrations.
In view of the possible hazards posed by germs on patient
napkin holders, the conventional practice of cleaning such
utensils is unacceptable. Even
if no known evidence for serious infections exists to date, a
change of thinking is needed
here so that no potentially contaminated napkin holders are
used on patients during dental
treatment.
Disposable napkin holders
such as Bib-Eze™ from DUX
Dental (www.duxdental.com)
offer the solution: they are easy
to handle and provide a safe alternative to traditional metal or
plastic reusable holders while
eliminating the contamination
risk. Hygienic, disposable napkin holders are the right choice
for you and your patient. DT

1 Study Report Witten/Herdecke University, Faculty of Health, Germany: Microbial contamination of patient bib holders,
February 2012.
2 UNC School of Dentistry, Chapel Hill,

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Contamination of Patient Napkin Hold-

tion Study.
3 John A. Molinari, Ph.D. - Microbial
ers THE DENTAL ADVISOR Biomaterials Research Center Dental Consultants,
Inc., Ann Arbor, Michigan; June 2010.
4 Noel Kelsh RDH. Don’t Clip That Crud
On Me. RDH. January, 2010.

[25] =>

United Kingdom Edition

In search of the
confidence element

Self-adhesive sterilisation pouches

by Glenys Bridges

any things have changed
in the profession over
recent years. One thing
that has not changed is the most
frequently given answer by students enrolling onto non-clinical
skills programmes, when asked
“What do you want to achieve
from this course?” The majority of
new learners say: “I want to feel
more confident in my work.”

In my opinion some of the
main reason for the lack of respect and recognition extended to
dental colleagues are due to:

The good news is that when
asked in end of course evaluations, “What did you gain from
the course?” in the response is
always, “confidence”. From the
trainers point of view this raises
a few questions, beginning with:
“What is the elusive ‘confidence
element’ and how does training
increase feelings of confidence
and competence?”

Each of these lead to feelings that colleagues are secretly
pleased to see you fail, rather
knowing that your colleagues are
watch , rather than getting ready
to stab you in the back. It is much
more complex to decide how
training can help with this it aspect of self-confidence.

The starting point to answer
these questions is a dictionary
definition for self-confidence Macmillan Dictionary defines
self-confidence as ‘a feeling that
you can do things well and that
people respect you’ - Let’s look at
these two elements individually.
Feeling you can do things well:
They say that “practice makes
perfect”. There is no doubt that we
feel much more comfortable when
doing familiar work task, than we
do when trying something new.
But if the technique used is poor,
or the task unfocused and not fit
for purpose repetition will not improve results. To do things well
we must be able to identify the required end results, so that we can
plan ways to achieve those results
using methods that recognise the
needs of the patients, the dental
team and the dental business. The
skills for this are what the training
must provide. Namely skills of audit and evaluation can be taught
and applied to individual tasks,
so that these are no longer empty
tasks performed for compliance,
but meaningful activities leading
to tangible benefits, continuous
improvement and increased selfconfidence.
Feeling that people respect you:
Something very few dental teams
have truly understood is the immense power for the good that
can be accessed by offering support and positive regard to your
team colleagues. We have got the
idea that teamwork involves trust
and cooperation, yet no idea of
how to support each other’s skills
and confidence by showing them
respect. Too many of the dental
teams I work with have not got a
working knowledge about what
respecting colleagues’ means, or
how to do it.

• The tendency to be task-focused,
rather than person-focused
• A failure to thank colleagues
when thanks are due
• Problem- focused blame, rather
than solution–focused cultures

There are many formats training can take; each format has its
part to play in developing quality
dental services when woven into
an overall training and development plan. Micro aspects of training look at on the job instructions,
how to do... Without doubt the
confidence of workers is higher
when they know what is expected
of them and how to deliver this.
Macro aspects of training are
the route to lasting confidence.
This is because it provides ‘tools
to think with’. This provides is
a working knowledge of proven
theories and techniques so that
people can master their responsibilities, not only when things
are going well, but they have
the resources to put things right
when things are not going to plan.
Training to secure this level of
competence for clinical for dental
professionals is generally available, whereas this sort of quality of
training for the non-clinical dental team lags behind. As a result
the self-confidence of non-clinical
dental professionals is lower than
that of their clinical colleagues.
In June a meeting of nonclinical dental professional, practice manager, trainer and dental
media representatives met at Aston University Business School
to form CASPER, Coordinators of
Administrative Standards and Professional Education for Receptionist, practice managers and care
coordinators. One of CASPER’s
objective is to increase the profile
and provision of quality non-clinical dental training and secure the
confidence element in practices
throughout the UK. Watch this
space. DT

About the author
Glenys Bridges is an independent
dental team trainer. She can be contacted at glenys.bridges@gmail.com

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www.duxdental.com

DUX_ad_PV_1-2p_DT_EN_sep12.indd 1

31-08-2012 14:53:06

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26 Business Management

United Kingdom Edition September 10-16, 2012

Complications in the leasehold system
Ray Goodman discusses disagreements over property conditions

t is common in the UK
for commercial premises
to be held by tenants on
a leasehold basis, and many
dental practitioners will be fa-

miliar with some of the practical aspects of that through
their own experience.
Most leases contain pro-

vision that the tenant should
keep the property in a good
state of repair, maintaining
the building to an acceptable
standard and generally look-

ing after it, on behalf of the
landlord or owner of the freehold.
Unless a schedule of con-

dition is agreed with the
landlord at the outset, the
covenant to repair usually applies regardless of whether
the property was in a poor
state of repair when the leaseholder takes over. This means
those who are unprepared
could be faced with immediate repair bills for a property
they have just taken over. It is
no defence for a tenant to
plead that “the property
was like that when I took
over, so why should I improve
it”. This is why it is crucial to
take proper advice before entering into a new lease so that
such issues can be negotiated
and, where possible, onerous repair obligations can be
avoided.
Naturally, disagreements
can occur when freeholders believe that their tenants

‘Most leases contain
provision that the
tenant should keep
the property in a
good state of repair,
maintaining the
building to an acceptable standard
and generally looking after it’

are not keeping the property in the condition agreed
upon. Leases often feature
provision for the landlord to
inspect the property on request to ensure they can keep
an eye on the condition of
their investment.

honigum.
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Timetable
Landlords who feel the repair
covenant has been breached
can, depending on the terms
of the lease, be entitled to
serve a schedule of dilapidations, which obliges tenants
to rectify the breach of the
covenant by carrying out the
necessary repairs. A timetable
for the repairs will be drawn
up as part of this process, and
if it is breached the landlord
may carry out the repairs on
the tenant’s behalf and charge
them for it.

2012
2010 Pr

e f e r r e d Pr o du
c ts

Depending on the lease in
question the landlord would
usually have a right to serve

* The Dental Advisor, Vol. 23, No. 3, p 2-5

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[27] =>

United Kingdom Edition September 10-16, 2012

It is not uncommon for a
lease to contain provisions
stating that it cannot be assigned to a new leaseholder if
there are any existing breaches of the lease. Landlords
sometimes choose to serve
a schedule of dilapidations
when there is the opportunity
of an assignment, in a bid to
force the existing leaseholder
to carry out repairs before
they are able to sell their interest in the property.
Impact
The impact can be dramatic
for the leaseholder. They will
be unable to sell their property until the repairs have
been completed and they
may well put off the potential
new tenant, who will be aware
that the property features
items of disrepair. This can
be the case even if the issues
with the property are relatively minor ones.
Even if a lease does not feature a covenant that allows refusal of an assignment before
dilapidations are addressed,
landlords may still try to exercise that power. I recently
came across a case where the
landlord still refused to allow
an assignment until repairs
were made, despite having no
right within the lease to place
such a condition on his consent. He did this, in effect, by
moving extremely slowly until
the issues with the building
were resolved.

a possibly lengthy battle, or
simply settling the dilapidations claim.
Recession can make landlords very keen to maintain
their properties in a good condition, in case tenants go out
of business and they end up
with a vacant property that
needs to appeal to a new user.
As a result, a difficult economy
can mean landlords are more
likely to serve a schedule of

dilapidations. More unscrupulous freeholders can also
over-value repair works with
the view to making a profit,
thought whether this is possible will depend on the drafting of the lease.
Solution
The complexities of the UK
leasehold system, and the
differences in the drafting of leasehold documents,
mean there is no ‘one size

fits all’ solution to these issues. The common terms involved are by no means universal. This makes it all the
more important that your
lease is well-drafted and that
you are fully aware of any obligations and conditions it entails. As always, expert advice
from a dental lawyer is an essential safeguard. DT

About the author
Goodman
Legal,
Lawyers for Dentists, has many
years’ experience
in providing legal
services to dentists
setting up their
own practices.
For more information call Ray Goodman on 0151 707
0090 or email rng@goodmanlegal.
co.uk
www.goodmanlegal.co.uk

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a schedule of dilapidations at
any time. However, in practice
the issues usually arise when
the tenant is seeking to make
alterations or sell the property
on. At this point, a disagreement over the condition of the
property can be time consuming and costly for the existing
leaseholder.

Business Management 27

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The enormous pressure
on the selling leaseholder
also served to discourage

‘Recession can
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very keen to maintain their properties
in a good condition’

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[28] =>

28 Industry News
BKH Healthcare: The
Dragon’s Den of Dentistry
Looking for a partner to help
make your dental practice
dreams come true? Make a
pitch to BKH Healthcare, the
‘Dragon’s Den of dentistry’,
and find out how the dental
corporate can help you to
open up a brand new practice or really transform an existing one.
If you have the ambition, drive and enthusiasm to make your plans a reality,
BKH Healthcare is there for you every step of the way.
With BKH Healthcare, you can focus on what you do best – clinical dentistry
– and the BKH team will do the rest, to the highest possible standard. From
marketing to management to training and beyond, you have a range of
expertise at your fingertips to create the practice of your dreams.
BKH Healthcare: getting practices off the ground.
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

United Kingdom Edition

Become a dbg member today for
only £330 per year, and enjoy a
huge range of benefits!
These include:

Create your own beautiful
practice website with Dental
Focus ® Web Design
With over 10 years’ experience
building beautiful yet effective
practice websites the Dental Focus
team know how to build websites
that work. That’s why Dental Focus
is one of the most respected
names in dentistry – a company
with a proven track record of
success – with over 500 dental
websites already accredited to the

• Free access to dbgVCO, the
industry’s leading cloud-based compliance system.
• Access to a dedicated Practice Manager who can advise you on training courses,
compliance packages, employment law and ways to save money!
• A complete like-for-like guarantee. If you find any comparable dbg service
cheaper, we will refund the difference!
• Free employment law templates.
• Have a compliance question? Ask the experts for free with unlimited access to
dbg’s dedicated compliance team.
• Price freeze on all training, audit or engineering when booked now for 2013!
Fantastic Member Benefits For Only £330!
To learn more about how we can become an invaluable extra member of your
practice team, contact us today!

For more information call 01606 861950, or visit www.thedbg.co.uk

September 10-16, 2012

award winning team.
All Dental Focus websites are compatible with mobile technology including
iPhones, iPads, and other smart technology devices. The Dental Focus team
can also help you set up your own practice blog, and can optimise your
website to achieve Page 1 Google Ranking.
Krishan Joshi aka the Master is the Internet Marketing Director supported by
his trusted group of experts: Dan aka the Genie, Adrian aka the Wizard and
Gavin aka the Surfer. To learn more about how an exclusive website can benefit
your practice, contact the Dental Focus superheroes today!
For more information call 020 7183 8388, or visit www.dentalfocus.com

Wireless Freedom With The RVG
6500 Sensor
Enjoy high quality intraoral images on
the move with the RVG 6500 Wireless
Sensor from Carestream Dental,
the leading provider of premium
quality imaging systems and practice
management solutions.
The sensor delivers best-in-class
images and is practical, comfortable
and easy to use. Available in several
different sizes, the RVG 6500 Wireless
Sensor supports the examination and
diagnostic needs of any practice. Proven Wi-Fi technology, along with compact
design and complete set of holders, allow the sensor to be used quickly and
conveniently throughout a multi-chair practice. Suitable for practices using
Windows or OSX operating systems, the sensor is also compatible with the
iPhone and iPod Touch platforms, transforming them into fully functional
communication and review tools. The RVG 6500 Wireless Sensor takes image
portability to the next level, for easy access to premium quality images
anytime, anywhere. Simple to integrate into any practice, the sensor allows
clinicians to acquire, store, view and share images effortlessly.

Refresh your Practice with Tavom
When the time comes to refresh
the look of your dental practice, it
is important to use a company with
experience and specialist expertise.
Whether you are completely
reinventing the appearance of your
practice, or simply updating it, Tavom
provide customised furniture and
cabinetry of the highest quality.
Tavom’s personalised cabinetry is
supplied by RPA Dental, the equipment specialists with over 40 years experience
in delivering an unrivalled service and after-sales support. Their experienced
team will guide you through the entire process from design to installation, and
you can be sure your new practice will be created with minimal disruption to
your daily routine.

Castellini Dental Units –
Superior Ergonomics as
Standard
Castellini understands that
ergonomics are fundamental
to the design of any dental unit,
and play a vital role both in terms of treatment procedures and interactions
between medical staff.
For this reason all of Castellini’s unit designs are created with ergonomics
at their heart in order to give practitioners the freedom to define their own
working area, unencumbered by the restrictions their dental unit may impose
upon them.
Conceived not just with the patient in mind, all models in the Castellini range
are designed to take into account the whole medical team as they move
around the patient during treatment.

Make sure you work with names you can trust, and create your ideal practice.

In addition to the quality and accessibility of Castellini products, Castellini’s
chief UK distributor RPA Dental is renowned for providing an exceptional
support service. With dedicated technical support teams just a phone call
away, RPA Dental provide a quick and effective after-care service to practices
across the North of England.

For more information, contact Carestream Dental on 0800 169 9692 or visit
www.carestreamdental.co.uk

For more information call Tavom UK on 0870 752 1121 or visit the Tavom website
www.tavom.com. For RPA Dental on 08000 933975, or visit www.rpadental.net

For more information, phone RPA Dental on 08000 933975, or visit
www.castellini.com

Local rules for local PCTs mean
care is needed when designing
Local Decontamination Units

Drill-free dentistry introduced in Colchester
National firm Dentist Direct has launched its first new spa-style practice which
aims to stamp out fear of drilling and injections among dental patients.

Regional differences in the
implementation
of
HTM0105 guidelines make it vital for
dentists to seek expert advice
when redesigning their practices,
says Roger Gullidge of Roger

Dentist Direct’s first practice has now officially opened in Colchester, with
Principal Dr Neel Sanghavi, allowing patients to be treated with revolutionary
laser technology which can be used instead of drills and needles for almost any
dental procedure and which – in most cases – is completely painless.

CS Back Office Software: It’s The
Business
CS Back Office software from
Carestream Dental is a must-have
suite of business tools for intelligent
practice management to maximise
income potential. Delivering all
business-related information to your
fingertips, CS Back Office puts you in
the driving seat.
The software comprises all the
key business and administrative
support that practices are likely
to need, including: • Accounting: for purchase orders, invoices, credit notes,
transactions and payments. • Reporting: documentation is automatically
generated to keep track of business performance. • Inventory: for petty cash
and stock control. • Employment Records: for personal records, absence,
payroll, training, development reviews and more.
A sophisticated module for the CS R4 Clinical+ practice management software,
CS Back Office gathers data from all areas of the practice and presents the
information to provide a clear picture of practice performance.
With a complete understanding of the practice finances, principals can
monitor the business, target areas for improvement and make sound decisions
to safeguard the future of the practice.
For more information, contact Carestream Dental on 0800 169 9692 or visit
www.carestreamdental.co.uk

Gullidge Design.
“At the heart of the issue is the way that HTM01-05 is written. Like many
official and bureaucratic documents, it is at times ambiguous. Different PCTs
have interpreted passages of the document in different ways and enforce it
accordingly,” says Roger.
Factors such as ventilation within decontamination units can be especially
complicated. Taking advice from local PCTs and expert equipment suppliers is
essential when designing the layout of the units, he adds.

Dr Pete Equizi describes the company as “fundamental in the modernisation of
every aspect of our practice, from design to service.”

This technology, known as the Waterlase iPlus works by fusing laser energy with
a gentle stream of water, reducing pain, anxiety and trauma for patients and
instead creating a much more comfortable experience for them.
Principal dentist Dr Neel Sanghavi said: “I think it’s a brilliant concept for dentists
like myself who want to grow their clinical skills and concentrate on caring
after their patients rather than spending time worrying about the business and
compliance side of things.”
For more information please call Robyn Wright or Emily Packer at Harvey & Hugo
on 01325 486666 or email pr@harveyandhugo.com /
emily@harveyandhugo.com

“All guidelines are put in place to protect patients,” says Roger Gullidge. “The
process of achieving that protection can be far smoother if you take expert
advice at the right time.” Roger Gullidge Design is a specialist design and
project management consultancy specialising in the dental sector. Call 01278
784442 for more details or visit: www.rogergullidgedesign.com

Totally Unique Dental
Nursing Education from
Smile-on
As one of the worldwide
leading providers of online
dental education, Smileon have collaborated with
Tempdent to bring you
the
innovative
Dental
Nursing Education Zone – an online community that provides everything
you need throughout your dental nursing career. It provides access to a
variety of services from job vacancies to CPD opportunities and discussion
forums, and qualifications available include the only UK online course for a
Diploma in Dental Nursing (NEBDN), and the Dental Nursing NVQ & Advanced
Apprenticeship. Using the latest technology, the courses utilise a combination
of webinars, eLearning modules and both face-to-face and online support and
assessment from tutors, and allows you to follow your progress throughout.
The NEBDN course culminates in a formal examination, whereby upon
successful completion the full qualification will be awarded to you.
For everything you may need to develop your skills and enjoy a successful
career in dental nursing, contact Smile-on today.

A second contract can cause complications
when it is time to sell a practice
Dental practices with a second GDS contract in the name of an associate can face
problems if they try to sell, warns legal expert Ray Goodman.
Many practices have a second contract. With no obligation for this to be held by
the principal dentist it may be held by an associate. But a third party buying the
practice would want both contracts transferred to them.
Questions as to who has the benefit of the second contract inevitably arise. The
ideal solution is to address the issue before it becomes a problem, transferring
the contract either into joint names, or preferably to the principal, by utilising
partnership provisions in the GDS regulations.
Ray Goodman is Chairman of the NASDAL Lawyers Group and a member of
ASPD. Goodman Legal, Lawyers for Dentists, has many years’ experience in
providing legal services to dentists setting up their own practices.

New Recession-Free Laser &
Whitening products from Quicklase
Quickwhite
Wow, it’s here! Quicklase have launched
their new affordable recession free laser.
It is British made, calibrated and serviced
here in the UK and is designed to appeal
and be obtainable by all Dental Practices
without fear of paying over the top. It
comes fully loaded with full features
and 8 programmable pre-sets, including
troughing, gum recontourring, perio,
endo and teeth whitening. There is a
colour coded screen for ease of use and built in fibre caddy to protect the fibre.
In addition there is a wall mount bracket option for those who prefer. The new
dentaLase Laser is half the price of its competitors.
In addition, QuickWhite have launched their new offers for their Carbamide
and in-surgery kits, the kits are new in a special cosmetic looking package. The
brand is known for effectiveness and excellent fast results.
Why not look at the NEW Dual IntroOralCamera, the TeleCam?

For more information about Smile-on’s Dental Nursing Education Zone, please
call 020 7400 8989 or email info@smile-on.com

For more information call Ray Goodman on 0151 707 0090
or email rng@goodmanlegal.co.uk
www.goodmanlegal.co.uk

Call us on 01227 780009 or visit our website www.Quicklase.com

[29] =>

United Kingdom Edition

UCL Eastman Training in Restorative Dental
Practice:
“fundamentally changed my ability”
Dr Alistair Bunting is an associate dentist at
Balmoral Lodge in Dorset. He completed his MSc
in Restorative Dental Practice at the UCL Eastman
Dental Institute in December 2011.
“I decided to undertake the Restorative Dental
Practice programme at the Eastman to improve
my clinical practice, theory and learn the latest
techniques,” says Dr Bunting. The superb facilities
at the Eastman gave us everything we needed.
“The first year was comprehensive, giving a good
broad base of knowledge, both practical and theoretical. The second and
third years were reassuringly more in-depth. The final year required writing
a dissertation, which fundamentally changed my ability to critically appraise
published material. As a result, my patients receive a better service. The quality
of my work is of a much higher standard and I have greater confidence in
providing predictable, comprehensive treatment plans.”
For further information, please contact Victoria Banks, Programme
Administrator, on 020 7905 1251, email v.banks@ucl.ac.uk
or visit www.ucl.ac.uk/eastman/cpd

Spry Toothpaste with
xylitol – for excellent
caries prevention
Help keep dental caries at
bay with Spry Toothpaste –
a highly effective dentifrice
rich in all-natural xylitol.
Xylitol is a naturally
occurring sweetener that is proven to be a powerful tool in the fight against
tooth decay. Thanks to its unique chemical composition, xylitol is unfavourable
to the metabolism of plaque bacteria, reducing their ability to proliferate and
adhere. This makes xylitol an excellent tool in the fight against dental caries
Available in a range of flavours including coolmint, peppermint and cinnamon,
Spry Toothpastes (with xylitol) are a great addition to any oral hygiene regime,
and will help your patients enjoy a healthier smile, fresher breath, and a cleaner
mouth. For best results patients are recommended to follow bushing with Spry
Oral Rinse, also with all-natural xylitol for optimum effect.
For further information contact Anyone 4 Tea Ltd on 01428 652131,
Or visit www.anyone4tea.com

September 10-16, 2012

Industry News 29

Minimally Invasive Tooth Straightening
Treatment: The Inman Aligner
The Inman Aligner is a minimally invasive appliance
that straightens anterior teeth safely and in as little as
6-16 weeks. Many professionals are undergoing the
training courses from Straight Talk Seminars in order
to expand their treatment range, and offer the service
their patients expect.

Advanced Digital Sensor
Technology from Schick
Schick CDR Elite, from Clark Dental,
is one of the world’s leading digital
radiograph systems, producing
incredibly high-quality images to
meet the diagnostic needs of every
clinician.

Dr Amitis Rajabzadeh is the principal dentist of Image
Dental Clinic, and has been using the Inman Aligner
for about a year. “I am always very keen on learning
new skills and developing my knowledge of the
profession. In the current market, all dentists are trying to provide services that
distinguish them from others.

The modular system is designed so
that it can be upgraded to include future improvements in technology, futureproofing your investment and making sure you will never be left behind in
terms of the patient care you can provide. To expand upon the market-leading
Schick platform, Clark Dental now offers Schick WiFi – a new communications
platform designed to add portable functionality to the highly versatile Schick
system. Schick WiFi brings a new level of freedom and flexibility to dental
digital radiography. With no cumbersome sensor-to-computer cable to get in
the way, Schick WiFi gives clinicians complete 360-degree chair-side mobility,
unhindered by trailing wires and other unnecessary complications.

“I heard about the course from Straight Talk Seminars from a colleague of mine,
and decided to attend as tooth straightening is a very popular treatment for
patients. The Inman Aligner is a good treatment option for straightening anterior
teeth, and more affordable than other similar appliances.”

As one of the UK’s leading dental equipment suppliers Clark Dental is a name
that has long been associated with excellence in all its operations.
For more information on Inman Aligner training please visit
www.inmanaligner.com or phone 0845 366 5477

NobelActiveTM from Nobel Biocare:
“versatility in all types of bone”
Dr Alistair S Imam BDS, FDS (RCS) is an
Associate Dentist at Pendragon Health, a
highly respected dental and medical practice
in Central London.
“After placing implants for 12 years, I have
recently started placing NobelActiveTM
implants,” says Dr Imam. “It is a unique implant
that performs like no other major implant
system, and the versatility that it has in all
types of bone is unparalleled.
“NobelActiveTM has a different feel and
technique from any other implant, and the way it can change the direction of
the osteotomy is incredible allowing for an optimal prosthetic position and high
initial stability. Both the micro and macroscopic design features of this implant
are cutting-edge, and it comes with the backing of a pioneering company for
implant dentistry.
“It is an implant that I can see myself growing with.”
For more information on Nobel Biocare please call 0208 756 3300,
or visit www.nobelbiocare.com

For more information call Clark Dental on 01268 733 146, email
info@clarkdental.co.uk or visit www.clarkdental.co.uk

Powerfloss meets the growing
demand for irrigation
Portable, battery free and costeffective, the Powerfloss from
Oraldent is set to take the market by
storm as interest in water jet dental
irrigators grows.
“Irrigation is now recognised as an
essential part of our hygiene regime,
especially for patients who have
implants or crowns, for example,” says
Powerfloss inventor Dr Roy Sennett,
who jointly developed the product
with engineer Bernard Sinclair. “It gets
into areas where normal floss and dental picks can’t.” The Powerfloss directs
water at high pressure in single spurts, giving excellent control to users who
find it easy to clean under bridges, braces and other devices they could not
reach with conventional floss.
Powered by a pump that is primed manually, the Powerfloss requires no
battery or other power source. It consists of a removable reservoir component
and a nozzle that can be stored inside the reservoir to make it easier to carry
or pack.
The Powerfloss is available now with a recommended retail price of £14.99.

Waterpik Water Flosser
“easier and quicker than
flossing”
Cristina De Rossi, manager
of a busy Dental Practice
in Central London, has had
a very positive experience
using the Waterpik Cordless
Plus Water Flosser.
“I have always found it quite
difficult to floss between my
back teeth” she says, “but the Waterpik® Cordless Plus helps to reach difficult
areas, especially around wisdom teeth. It also helps when your teeth are quite
tight together and there seems to not be much space left for normal floss.”
Ms De Rossi has also found that the Cordless Plus saves her a lot of time and
effort compared to manual flossing. “It works very well. After normal flossing
you always have to rinse to remove the plaque and debris dislodged but with
the Waterpik® Cordless Plus you do both in one go.

EndoCare – committed to
Endodontics, dedicated to care
At EndoCare, we’re dedicated to
treating dental pain in all its forms.
Our team of Specialist Endodontists
are all experts in their field and
are fully committed to providing
outstanding levels of care and
support.
At EndoCare we particularly excel in
treating anxious or nervous patients,
and will look after your patients every
step of the way.
Thanks to our level of expertise in
the field of root canal treatment and dental pain, we are more than happy to
take referrals for challenging issues such as hot pulp, re-treatment, and remedial
surgery. In all cases, referring practices can be assured our primary considerations
are always for patient’s wellbeing, and wherever possible, the preservation of the
original tooth.

All in all, I have found it easier and quicker than flossing.”

To learn more about how we can become an important extra member of your
dental team, contact EndoCare today!

For more information on Waterpik® Water Flossers please speak to your
wholesaler or visit www.waterpik.co.uk. Waterpik® products are widely
available in Boots stores across the UK.

For further information please call EndoCare on 020 7224 0999 or visit
www.endocare.co.uk

Man of the moment
This year Zaki Kanaan was
awarded UK Dentist of the
Year in the Dental Awards
and voted second in Private
Dentistry’s ‘Elite Twenty’ dentists in the country. And this week Zaki was
officially appointed as Philips’ Dental Adviser.

Dining out with dentures!
The makers of Poligrip® are delighted to announce the winner of a restaurant
meal for two in the Poligrip Support Kit 2011/2012 prize draw is a patient of York
House dental practice, Chesham.

Zaki qualified from Guy’s Hospital in 1996 and achieved a Master’s Degree
from the GKT Dental Institute in 2001. He also sits on the Board of Directors
of the British Academy of Cosmetic Dentistry as Vice-President and Scientific
Director. He is also an editorial consultant for Dental Implant Summaries and is
a member of the Association of Dental Implantology.
He will be acting as a spokesperson for Philips and presenting on behalf of the
company as well as authoring articles and providing his expert opinion in the
press, via webcasts and live webchats, on the Company website and in social
media Zaki’s first public appearance since his appointment will be on at the
BDTA Dental Showcase in October.
To meet Zaki Kanaan at the BDTA please visit the Phillips stand K16, if you can’t
attend the show, visit www.sonicare.co.uk/d or www.philipsoralhealthcare.
com. You can also preregister for talks on the Philips stand by calling 0800 032
3005 or 0800 0567 222 For more information about Zaki Kanaan, please visit
www.K2dental.co.uk

The prize draw was open to all patients receiving a Poligrip Denture Support
Kit. These support kits include top tips, advice and information to help denture
wearers adjust to their new teeth, a denture bath and brush, and a money off
coupon for any product in the Poligrip range.
Support Kits are available free of charge to dental surgeries, clinics and labs, and
can be requested by calling 0845 600 0441.
The makers of Poligrip produce products for denture wearers, including denture
fixatives to help block food particles getting trapped between the denture and
the gum, making denture wearing more comfortable, and denture cleansers to
help maintain good oral hygiene.

Cost-Effective Teeth Whitening
from WhiteWash
WhiteWash Professional Whitening
Strips provide a new option for the
UK dental market bringing cost
effective whitening to your patients.
WhiteWash Professional Whitening
Strips are mouldable plastic strips
coated in the optimum amount of whitening gel to simply, safely and effectively
whiten teeth. With a unique gentle whitening formula that helps to limit tooth
sensitivity, WhiteWash Professional Whitening Strips are designed to follow the
contour of teeth, enabling users to safely and comfortably achieve whiter teeth
by applying the strips for 60+ minutes once a day for 14 days.
Formulated by a group of UK dentists WhiteWash Professional Whitening
Strips use a patented formula, and feature advanced seal strips with nonslip technology for maximum comfort and safety. Each pack of WhiteWash
Professional Whitening Strips contains enough strips for 14 applications (14
upper strips, 14 lower strips).
To learn more about the technology that’s taken the USA by storm, contact
WhiteWash today.
For more information call 0844 68 69 150, email info@whitewashlaboratories.
com, or visit www.whitewashlaboratories.com

Diamonds are forever
Dental Sky supply a wide range of top
branded burs including their own Dental
Advisor™ ++++½ rated R&S Diamond Burs.
Dental Sky is now offering you a chance to
collect Diamond Points on your bur purchases
to exchange for High Street vouchers in time
for Christmas. Purchase any bur from the
current Dental Sky catalogue between 1st
June and 30th November you will receive one
Diamond Point. At the end of the programme
your points will be added up and converted into shopping vouchers which
you will receive in time for your Christmas shopping. Each point is worth five
pence. You get to make your choice from Marks & Spencer, John Lewis (which
includes Waitrose), Sainsbury’s or Love2Shop (redeemable in over 20,000 retail
stores across the UK). How great is that?
So make sure you register with your Account Manager on 0800 294 4700 or via
their website www.dentalsky.com and start saving your Diamond Points now.

[30] =>

30 Editorial Board

United Kingdom Edition

September 10-16, 2012

Dental Tribune UK
Editorial Board
Dr Neel Kothari
BDS Principal and General Dental Practitioner
Dr Stephen Hudson
BDS, MFGDP, MSc
General Dental Practitioner

Dr Richard Kahan
DS MSc (Lond) LDS RSC (ENG)
Endodontic Specialist

Mr Amit Patel
BDS MSc MClinDent MFDS RCEd MRD
RCSEng
Specialist in Periodontics & Implant
Dentist Associate Specialist Birmingham Dental Hospital
Professor Nick Grey
BDS, MDSc, PhD, DRDRCSEd,
MRDRCSEd,
FDSRCSEd, FHEA
Professor of Dental Education, National
Teaching Fellow, Faculty Associate
Dean for Teaching and Learning School
of Dentistry, Manchester
Professor Andrew Eder
BDS, MSc, MFGDP, MRD, FDS, FHEA
Director of Education and CPD, UCL
Eastman Dental Institute

nt Abutments

uire on the

atory Implant

implants
the journal of

launch the Complete
ery patient is unique
ia abutments , we can
to your patient.

2

oral implantology

Mr Raj RajaRayan OBE
MA(Clin Ed), MSc, FDSRCS,
FFGDP(UK), MRD,
MGDS, DRD

aving you

£100

*

Baldeesh Chana
RDH, RDT, FETC, Dip DHE
President, BADT and Deputy Principal
Hygiene and Therapy Tutor, Barts and
The London School of Medicine and
Dentistry

£25
£140
£185

£350

TO £100 per unit

†

Arch® Crown . † T&C Apply

| event review

The Clinical Innovations Conference 2012

idden Charg

es!

ar pricing
promise
hidden ch
ar
no shocking ges
bi
of the mon lls at
th.

| user report

Impression techniques for Implant dentistry

| case study

Pam Swain
MBA LCGI FIAM MCMI BADN®
Chief Executive, British Association of
Dental Nurses

Dr Peter Galgut
PhD (LMU), MPhil (Lond), MSc (Lond),
BDS (Rand), MRD RCS (Eng), LDS RCS
(Eng), MFGDP (UK), DDF Hom, ILTM
Periodontal Consultant

compare to Stock prices*?

w:
s:

Professor Liz Kay
Foundation Dean and Professor of Dental Public Health
Plymouth University Peninsula Schools
of Medicine and Dentistry Dean of the
Peninsula Dental School, Plymouth

Dr Paroo Mistry
BDS MFDS MSc MOrth FDS (Orth)
Specialist Orthodontist

Dr Trevor Bigg
BDS, MGDS RCS (Eng), FDS RCS (Ed),
FFGDP (UK)
Practitioner in Private and Referral
Practice

2012

Mrs Helen Falcon
Postgraduate Dental Dean, Dental
School, Oxford &
Wessex Deaneries

Mr Raj Rattan
Associate Dean, London Deanery

Vol. 2 • Issue 2/2012

t Centre

Dr Stuart Jacobs
BDS MSD (U Ind)
Full-time Private Practitioner
Shaun Howe
RDH
Dental Hygienist

Mr Amit Rai
BDS (Hons) MFGDP (UK) MJDF RCS
Eng FHEA
General Dental Practitioner
DFT1 (VT) Programme Director, London Deanery

Implant therapy of edentulous patients

Illustrations & images courtesy of Amman Girrbach ©

03/09/2012 16:03:06

Vol. 2 • Issue 2/2012

roots
magazine of

2

Published by Dental Tribune UK Ltd

endodontology

© 2012, Dental Tribune UK Ltd.
All rights reserved.

2012

Dental Tribune UK Ltd makes every
effort to report clinical information and
manufacturer’s product news accurately,
but cannot assume responsibility for
Group Editor
Lisa Townshend
Tel: 020 7400 8979
Lisa@dentaltribuneuk.com

| event

Clinical Innovations Conference 2012

Publisher
Joe Aspis
Tel: 020 7400 8969
Joe@dentaltribuneuk.com

| user report

Ultrasonic irrigation

| research

Root canal morphology

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

Sales Executive
Joe Ackah
Tel: 020 7400 8964
Joe.ackah@
dentaltribuneuk.com

Design & Production
Ellen Sawle
Tel: 020 7400 8970
ellen@dentaltribuneuk.com

Editorial Assistant
Laura Hatton
Tel: 020 7400 8981
Laura.hatton@
dentaltribuneuk.com

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

Follow us on Twitter
Roots_issue2_2012.indd 1

28/06/2012 10:32
28/06/2012 10:27

[31] =>

United Kingdom Edition

Classified 31

September 10-16, 2012

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

Selling Your Practice?
Please contact:
Nick Ledingham BSc, FCA
Tel: 0151 348 8400

n Professional Sales Agency
n Practice Valuations
n Nationwide Service
n Register of Buyers

Email: mail@moco.co.uk
Website: www.moco.co.uk/dentists

N SDAL
National Association of
Specialist Dental Accountants & Lawyers

N SDAL
Whatever your management role.....
National Association of
Specialist Dental Accountants & Lawyers

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
National Association of
Specialist Dental Accountants & Lawyers
and provide a practical management training pathway for
dentists, DCPs and practice managers.

Telephone: 01904-670820
Email: martyn.bradshaw@pfmdental.co.uk
Web: www.pfmdental.co.uk

rankly

- 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

S

ILM Level
3 Certificate in
N
SDAL
Management
National Association of
Specialist Dental Accountants & Lawyers

peaking

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

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

Raising Finance?

www.umdprofessional.co.uk

DO engage the services of an independent firm to liaise with the Banks
on your behalf – will ensure proposal is packaged for best chance of a
positive response and also to negotiate best terms.
DO ensure you provide an accurate summary of your current position
including all savings and existing borrowing.

DO expect the Bank to want you to put down a contribution towards
the purchase.
DO undertake your own research of the local area and find out why the
current owner is selling.

Tel: 08456 123 434
01707 653 260
www.ft-associates.com

1559COR FTA 140x100mm AD1.indd 1

Follow us
@franktaylorassc

MULTI-SYSTEM IMPLANTOLOGY CERTIFICATE COURSE AT
TRAFFORD GENERAL HOSPITAL, MANCHESTER
Recognised by University of Salford
Applications are invited for a hospital based “certificate” year course
(one day a month) starting on 16th November 2011.

DO ensure your CV is up to date with particular focus on any past
Managerial experience.

Search for Frank Taylor and
Associates

COURSE ANNOUNCEMENT

This unbiased multi system clinical course in its 20th year is designed to teach
practitioners how to incorporate implant treatment to their practices safely with
the back up of three most documented implant systems according to the FGDP/
GDC Training Guidelines. Astra, Nobel Biocare and ITI/Straumann, the market
leaders in implantology for their unique indications, predictability, research and
documentation, are taught step-by-step during the year course. Each participant
will have the opportunity to place implants in their patients under supervision. The
course has been granted approval by the FGDP (UK) for accreditation towards
its Career Pathway’.

COURSE CONTENTS AND BENEFIT
• Keynote consultant/specialist speakers from UK and abroad
• Certification for three major implant systems and GBR techniques
• Prepare for Diploma examinations or further academic study (e.g. MScs)
• Benefit from extensive network of accredited UK Mentors
• Clinical practice support and advisory service
• Implant team with highly proven 20 years’ clinical research and teaching
experience
• Become an ITI member (with complimentary 1st year’s subscription)
• Receive complimentary editions of four ITI Treatment Guides
22/02/2011 22:35
FOR FURTHER INFORMATION: Professor T.C. Ucer, BDS, MSc, PhD,
Oral Surgeon, Oaklands Hospital, 19 Lancaster Road, Manchester M6 8AQ.

Tel: 0161 237 1842 Fax: 0161 237 1844 Email: ucer@oral-implants.com

www.oral-implants.com

Untitled-3.indd 1

06/05/2011 16:35

[32] =>

W

Proface
– New and innovative
More
reliable
caries detection

NE

Visit us on
Stand K15
at BDTA
Showcase

Scan the QR code
with your mobile phone
for more information
on Proface

With the award winning Proface from W&H, you can:
> Visually identify the scope of caries infection using
Fluorescence
Aided Caries
Excavation
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Caries
seen differently:
Illuminating
opened
cavities
with the
>Proface
Prevent
over-excavation
of dentine
light
probe clearly reveals
dentine infected with caries.
> Reduce
the risk
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caries
beneathminimally
fillings and
crowns
This
innovative
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Minimiseand
invasive
probing
pain-sensitive
patients
minimises
theforrisk
of caries recurrence!
W&H (UK) Limited

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Now
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) [page_count] => 32 [pdf_ping_data] => Array ( [page_count] => 32 [format] => PDF [width] => 842 [height] => 1191 [colorspace] => COLORSPACE_UNDEFINED ) [linked_companies] => Array ( [ids] => Array ( ) ) [cover_url] => [cover_three] =>

[cover] => DT UK No. 22, 2012

[toc] => Array ( [0] => Array ( [title] => News [page] => 01 ) [1] => Array ( [title] => Does your continuity plan hold water or will it be powerless to help when the rains come? [page] => 08 ) [2] => Array ( [title] => Training day: Jane Armitage looks at staff training [page] => 10 ) [3] => Array ( [title] => Perio Tribune [page] => 11 ) [4] => Array ( [title] => Dental patient bib holders source of bacteria [page] => 24 ) [5] => Array ( [title] => In search of the confidence element [page] => 25 ) [6] => Array ( [title] => Complications in the leasehold system [page] => 26 ) [7] => Array ( [title] => Industry News [page] => 28 ) [8] => Array ( [title] => Dental Tribune UK Editorial Board [page] => 30 ) [9] => Array ( [title] => Classified [page] => 31 ) ) [toc_html] =>

Table of contents

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