DT UK No. 25, 2012

News / Four days in London: MSc Residential / Setting up on your own / What’s in a name? / Appenticeships / The Patient Experience / Need a new challenge? / 25 Clinical tips for general practice part II / CBCT in Orthodontics / Choosing the right people; Michael Sultan discusses the importance of staff / Industry News / Dental Tribune UK Editorial Board / Classified

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Table of contents

October 29 - November 4, 2012

PUBLISHED IN LONDON
News in Brief
An App to make you beam
A new toothbrush has been designed to use your phone to tell
you if you are brushing enough.
The brush, designed by Beam
Technologies, connects to a
smartphone app to make sure
you spend enough time brushing your teeth. With the average person spending just 46
seconds brushing their teeth,
the Beam brush is designed to
change that – it is connected
to your phone via Bluetooth,
and times how long you brush
for. The app also monitors the
number of strokes and can alert
the user if they have forgotten
to clean their teeth. The toothbrush is manual, and works
by reacting to the body’s bioelectricity. This starts the timer,
and the information is then
automatically updated to measure progress through the user’s
phone. www.beamtoothbrush.
com/index.php
NICE tool counts cost
A new interactive tool developed by NICE and Brunel
University will help local authorities count the cost of tobacco-related harm in their communities. The tool also models
the longer-term cash savings
that authorities can expect by
putting tobacco control strategies in place. The Tobacco Return on Investment Tool is a
Microsoft Excel-based program
that evaluates a portfolio of tobacco control interventions and
in different payback timescales.
Packages of interventions can
be mixed and matched to see
which intervention portfolio
or package provides the best
‘value for money’, compared
with ‘no-services’ or any other
specified package. The tool is
accompanied by a package of
support materials, including a
user guide and technical report,
which can also be downloaded
from the NICE website.

News

Practice Management

Jolly good sports

The Apprentice

BDSA Sports Day great success

Jane Armitage looks at
apprenticeships

page 7

VOL. 6 NO. 25

Comment

Clinical

CBCT in Ortho

25 Clinical Tips

A look at 3-D cephalometry

Ashish B Parmar gives 13-25 of
his tips

pages 12-13

pages 21-24

pages 17-20

Don’t be scared of
Oct 31, celebrate!
In our exclusive interview with teeth whitening expert
Dr Wyman Chan, we hear that it’s all white now that the law
surrounding hydrogen peroxide use is changing...

his week marks the
date that sees the longlobbied for clarity in
the protracted debate over the
legality of tooth whitening.
According to the amendment carried last year by the
European Commission, tooth
whitening products containing up to six per cent hydrogen peroxide can now be supplied to patients for use as a
take home product, providing
certain conditions are met.
Dr Wyman Chan, a dedi-

www.dental-tribune.co.uk

cated teeth whitening dentist,
has been following the developments, and believes that
dental professionals should be
embracing the freedom that
the law amendments have given, not be wary of them.
He said: “It’s exciting, it’s
excellent news, and I think
we all should celebrate. Dental professionals, dental practitioners who are practising
teeth whitening should celebrate, should go and have a
party. It’s the first time in so
many years that we can do

teeth whitening legally from
October 31. Before then, even
now, we’re doing it technically
illegally. So that’s why I’m so
happy because I am a dedicated teeth whitening dentist.
It’s the only thing I do and
now I can do it without fear.”
One thing that Dr Chan
has noticed is that although
the amendment is supposed to
bring an end to the confusion
over what can and cannot be
done with regards to the supply of teeth whitening products to patients, it seems that

for many it isn’t clear what
the law is changing. “I’m bemused by the debate going on
in forums and also the position taken by many reputable
bodies - I won’t name any of
them. I think they didn’t read
the documents properly – I
think they have got it wrong.
That’s my opinion. Maybe I’m
wrong, but I’m confident I’m
correct. Let me explain why
I think that. Because this is
not new law, this is an amendment. They’re amending an
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16/10/2012 12:21

[2] =>

2 News

United Kingdom Edition

ß DT page 1

existing law. Actually it is
a Directive - 76/768/EEC Annex III.”
This Directive covers the
use of hydrogen peroxide in
consumer products across
four sectors including hair
and nail products; however for
dental professionals it makes
the most striking impact. The
amendment states: The SCCS
(Scientific Committee on Consumer Safety) considers that
the use of tooth whitening or
bleaching products containing
more than 0.1 per cent and up
to 6 per cent of hydrogen peroxide present or released from
other compounds or mixtures
in these products may be safe
if the following conditions are
satisfied: an appropriate clinical examination is carried out
in order to ensure there are no
risk factors or any other oral
pathology of concern and that
exposure to these products is
limited so as to ensure that

Dr Wyman Chan at work in his practice

the products are used only as
intended in terms of frequency
and duration of application.
These conditions should be fulfilled in order to avoid reasonably foreseeable misuse.
Those
products
should
therefore be regulated in a way
that ensures that they are not
directly available to the consumer. For each cycle of use
of those products, the first use
should be limited to dental
practitioners ... or under their
direct supervision if an equivalent level of safety is ensured.
Dental practitioners should
then provide access to those
products for the rest of the cycle of use. (European Union
Council Directive 2011/84/EU)
Dr Chan believes that the
confusion is many think the
directive is looking at tooth
whitening as a whole, including in-surgery (power) whitening. In fact, as a cosmetic
directive it is just concerned
with whitening products that

are supplied to patients (consumers) for take home use. He
said: “It’s great news for dental practitioners because now
the level is raised from 0.1
per cent (which was ineffective as a treatment) to six per
cent, which is very effective.
With six per cent take home
we can get excellent results.
It doesn’t matter what product
you use, with six per cent you
will get results. So the clarity we now have is nothing to
do with the debate people are
having at the moment – which
is about chairside [whitening].
This has nothing to do
with chairside – they are
amending the law about oral
hygiene products.
“The original Directive
came into force in 1976, regulating products directly available to the consumer as over
the counter products. That’s
why it was limited to 0.1 per
cent hydrogen peroxide because of daily use and long
term exposure. I agree with
the cosmetic commission of
the EU that it should be regulated, that the level should
not be more than 0.1 per cent
because you can swallow a
lot of toothpaste and mouth
rinse into the stomach every
day. So it was correct at that
time, 1976. In the early 1990s
teeth whitening became popular, it became the norm. In
1976 there was no such thing
as home whitening, it was
brand new technology. Things
seemed to be moving too
fast for the EU – they needed to catch up with the new
technology.
“They’ve
(SCCS)
been
debating for years the safe
amount for consumer self-

dosing application, and there’s
a lot of evidence from scientists, and they all agree that
up to six per cent is safe for
the consumer to take home.
Of course this is after they’ve
had a clinical examination there are conditions attached
which I think is fair, for example they need to be examined
by a dentist so now take home
whitening is officially a dental procedure. In addition the
first use should be by a dental
practitioner, or supervised by
a dental practitioner, so now
home whitening is very much
the practice of dentistry.”
Another big issue regarding whitening is the rise of
people outside of dentistry
providing tooth whitening
services to the public. With
the law amendment, Dr Chan
says this can help put a stop to
this, protecting patients further. “I think this amendment
has plus and minuses. A plus is
that there are a lot of non-dental
professionals – I’ll not call them
beauticians, as many are mechanics and bricklayers trying to
make some fast money - giving
customers hydrogen peroxide to
take home with them so that will
be stopped now. Trading Standards Agencies can stop anything
illegal in home whitening. For a
non-dental professional to use
products with more than 0.1 per
cent – that is illegal. If a nondental professional continues
using hydrogen peroxide at 0.1
per cent or less you won’t see
results. But by using six per cent
you do see results. All that is illegal now, so I’m quite happy.
“On the other hand, for those
non-professionals who are just
doing it chair side, then unfortunately this is outside the remit

October 29 - November 4, 2012

of Trading Standards regulation.
But the General Dental Council
has said all along that teeth whitening is a practice of dentistry.
So the General Dental Council
can prosecute illegal activity – it
can close them down.”
In an attempt to help dental professionals understand
tooth whitening and what can
be done, Dr Chan has partnered
with Healthcare Learning Smileon to develop a new educational
programme on the subject. “I’m
really excited about it, because
when it comes to legality a lot
of dentists are still confused because a lot of companies are
withdrawing chair side products and we need to review the
literature. A lot of clarity has to
be made in this field. We’ll be
able to supply dental professionals with the supporting documents about whitening so you
can cover the legality but it
will also aim to teach them
about the modern ways of doing teeth whitening effectively.
There is a lot of talk that chair
side whitening is all about
dehydrating the teeth but that
is just not true. I do a lot of
chairside whitening - you need
a lot of knowledge to make
it work. This programme is
so important because you’ll
learn how to do it properly. We
talk about chairside whitening, home whitening, how
to deal with patients with
sensitivity.” DT
To review the amendment
to the whitening Directive go
to
http://ec.europa.eu/consumers/sectors/cosmetics/
documents/directive/#h2-consolidated-version-of-cosmetics-directive-76/768/eec

Professional
Teeth Whitening with Wyman
Professional Teeth Whitening with Wyman
Through years of clinical research Wyman Chan
has revolutionised the teeth whitening process
Now you can learn for yourself with his
comprehensive and engaging eLearning programme
For more information contact 020 7400 8989 or
email info@healthcare-learning.com

Everything you need to get started with Wyman Chan’s award winning techniques

Coming Soon

[3] =>

United Kingdom Edition

Editorial comment

T

his week is a
landmark time
for dental professionals who supply tooth whitening
to their patients. Finally it will
be possible to provide patients
with take home whitening kits
that will provide results that
won’t see you looking over your
shoulder for the nice guys and
gals from Trading Standards.
Tif Qureshi, president of the
BACD, has released this statement: After many years of uncertainty regarding the legality
of tooth whitening in the UK,
the BACD welcomes the amendment to the UK cosmetic regulations as a result of European
Council Directive 2011/84/EU
that finally legalises tooth whitening by dental professionals.
Dental

professionals

ARF freeze
‘inadequate’

T

he GDC’s decision to freeze
the Annual Retention Fee
(ARF) at £120 for dental
nurses in 2013 is “inadequate”
says Nicola Docherty, President of
the British Association of Dental
Nurses.
The decision shows that the
GDC is “out of touch with registrants” says Nicola. “We have supplied the GDC with detailed information on dental nurse salaries,
showing that the £120 ARF causes
considerable financial hardship to
dental nurses. We have also requested that the GDC lower the
ARF for dental nurses to a fee more
in line with salaries - instead of
charging dental nurses the same
ARF as hygienists and therapists and that they implement a special
fee for those working part time.”
A recent salary survey conducted by BADN shows that the
majority of Registered Dental
Nurses are paid between £10,000
and £20,000 per year - in contrast
with hygienists and therapists,
whose recommended starting salary is £26,000. However, the GDC
has decided to continue charging
one ARF to all Dental Care Professionals, completely disregarding
the fact that dental nurses earn
less than half that of hygienists
and therapists.
“BADN has always supported,
and continues to support, registration in principle, as being in
the best interests of the patient.
However, the GDC’s heavy handed and insensitive implementation, including the imposing of an
unreasonable ARF, has alienated
many dental nurses and must be
rectified as soon as possible” said
Nicola. DT

October 29 - November 4, 2012

hope that this change signals
the beginning of a new era for
patient safety, in which only
registered dental professionals
will be providing tooth whitening treatments. This would be
in accord with the view of the
GDC that tooth whitening is
the practice of dentistry.

GDC does protecting patients
and re-affirm our support
for its work prosecuting nondentists illegally providing
whitening. We call on Trading
Standards departments across
the UK to embolden their approach in tackling non-dentists
who illegally provide whitening treatments and continue to
put the public at risk.

We commend the work the

And we call on the beau-

ty industry to ensure that its
members, and those who train
them, understand the new legal
framework and leave whitening to those who can provide
it legally, safely and in the best
interests of patients; the dental
profession.
The future’s bright,
the future is six per cent
hydrogen peroxide! 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@healthcare-learning.com

[4] =>

4 News

United Kingdom Edition

October 29 - November 4, 2012

Rise in confidence amongst dentists

C

onfidence
amongst
dentists has increased
dramatically since the
start of the year, according to
the latest Lloyds TSB Commercial Healthcare Confidence Index, with short term
optimism rising from minus
eight per cent in January, to
nine per cent, a positive shift
of 17 per cent.
This boost to sentiment follows a fall in confidence at the
start of the year, possibly on the
back of concerns about how
NHS contracts would be delivered in the longer term and
the stresses around the CQC.

Despite an overall rise in
confidence in the last six
months, increased financial
pressures are set to impact on
the dental sector, with more
than three quarters (77 per
cent) of practitioners saying
that they expect to see these
concerns increase in the next
five years.
Jas Matharoo, Director at
Nice Teeth Ltd, said: “An interesting figure to emerge out
of the latest report is that 58
per cent of dentists definitely
want to be involved in premises ownership.’’

Commenting on the survey results, Ian Crompton,
Head of Healthcare Banking
Services at Lloyds TSB Commercial, said: “It is encouraging to see overall confidence
returning to the dentistry sector. There are still concerns
about financial pressures and
the funding and impact of new
NHS contracts, but dentists
are perhaps becoming more
used to change than other primary care professionals, such
as doctors, who remain quite
pessimistic.
“By adopting a forward
looking approach to prac-

tice management and an increasingly flexible attitude to
service provision, dentists are
in a better position to adapt
to new regulations going
forward.
“We have a successful
history of advising and supporting businesses in the
healthcare sector, in a range
of disciplines. Our team of
relationship managers has a
strong knowledge and sound
understanding of the challenges facing these businesses
and we are determined to ensure that they remain financially fit for the future.”

The
Healthcare
Confidence Index was first published in August 2011 and is
now in its third wave. It aims
to provide an insight into the
attitudes and opinions of primary healthcare providers;
GPs, dentists and pharmacists,
over the next one to five years.
To view the full Lloyds
TSB Commercial Healthcare
Confidence Index please visit
www.lloydstsb.com/healthcare and to take part in the
next Healthcare Confidence
Index visit www.healthcareconfidenceindex.co.uk DT

Confidence in children improves dental health

A

new study, published in
the Journal of Dental Research has found that an
intervention designed to teach
children to be confident in the
face of challenges can have a
positive effect on their oral and
dental health.
In a cluster randomised
controlled trial involving 12
schools in Khonkaen, Thailand, and 261 schoolchildren,
children from the schools that
participated in an intervention
designed to bolster their “sense
of coherence” had “the ability to see life as a challenge in
which coping skills can be used
to deal with stressors”, and
showed significantly better oral
health-related quality of life

compared with children from
schools randomly assigned to a
control group. The children in
the intervention group also exhibited improved beliefs about
the importance of healthy dental behaviours and had better
gingival health than those in
the control group.
“This is a hugely important
study in the dental literature.
While there is some evidence
in dentistry of the benefits of
a sense of coherence, much of
this work is cross-sectional so
we don’t really know if sense of
coherence really brought about
any possible change,” said
study co-author Sarah R. Baker,
PhD, a health psychologist at
the University of Sheffield in an

interview with Medscape Medical News. “Our study is the first
intervention study to show that
altering sense of coherence can
influence oral health,” she said.
In the study, 12 different primary schools were randomly
assigned to the intervention
group or the control group. Fifth
graders, aged 10 to 12 years,
participated. Students assigned
to the intervention group received seven sessions over two
months focused on child participation and empowerment.
Each session lasted 30 to 40
minutes. The first four sessions
were classroom-based activities, involving didactic learning,
games, and discussions. The
last three were health-related

school projects that included all
students and staff, and involved
brainstorming, planning, evaluation, and implementation. The
intervention was delivered by
six teachers who went through
specialised, intensive one-day
training.
Results indicated that compared with the control group,
the children who received lessons in sense of coherence had
mean scores on the oral healthrelated quality-of-life questionnaire that indicated fewer
functional
limitations
and
other problems due to dental
health three months after the
intervention. Children in the
intervention group also showed
a greater sense of coherence

than did those in the control
group and were more likely to
rate healthy dental behaviours
as important. It also found that
more children in the intervention group than in the control
group had normal gingival
health three months after the
intervention.
In an accompanying editorial, Gary Slade, PhD, from the
University of North Carolina,
wrote: “One implication [of the
study] is that children’s gingival
health and oral-health-related
quality of life can be improved
by a school-based intervention
that targets the psychosocial
determinants of oral health
rather than oral health behaviours themselves.” DT

Dissolvable strip offers Old magazines pose health
pain relief for burns
risk in dentist waiting rooms

A

dissolvable oral strip
has been developed to
immediately
relieve
pain from burns caused by
ingestion of hot foods and
liquids, such as coffee, pizza,
and soup.
Lead researcher Jason McConville, PhD, and colleagues
from University of Texas at
Austin, designed the strip for
controlled delivery of a local
anesthetic, benzocaine, and
a therapeutic polymer. Benzocaine, commonly used as a
topical pain reliever in dental
products and throat lozenges,
was chosen for its non-irritating properties.
The strip is applied directly to the burned part of the
tongue, cheek or roof of the
mouth. It sticks to the affected
area and won’t interfere with
normal day-to-day activities,

as it quickly dissolves for instant pain relief and promotes
healing.
“We found these strips to
be non-toxic, which has huge
potential for anyone who
burns their mouth while eating and drinking hot foodsand that’s just about everyone,” said McConville. “The
strips look and behave similar
to breath freshening strips
that you might find at your local drugstore.”
Now based at the University of New Mexico, McConville and his team, will
explore creating a stronger
oral strip to treat more severe
burns lasting longer than twothree days. The next step in
furthering their research will
be to test the strips in humans
and experiment with tastemasking. DT

M

onica Symes, a dentist in
Lyme Regis, Dorset, says
an NHS infection control
worker warned her that keeping
back issues of Country Life and
Private Eye could make her fail
health and safety inspections.
According to reports, NHS officials have issued a warning to
dentists to stop keeping old magazines in their waiting room as
they pose a health and safety risk.
They believe that the magazines
could be responsible for helping
to spread bacteria and should
be thrown out after a week.
Since last April, all dentists
have been required to register
with the Care Quality Commission (CQC), which can inspect
their facilities and check they are
maintaining treatment standards.
However, surgeries and dental organisations have complained that
the bureaucracy has bogged them

down in red tape, and done little
to improve care of patients.

to relax and can ease the concerns
of anxious individuals.

Under the regime, dental
practices are required to explain
how they are “meeting the nutritional needs” of their patients
– the same question routinely put
to hospitals, which provide meals
for patients – as well as respecting
their human rights and protecting
them from abuse. Each surgery is
also required to set out a “statement of purpose” about what they
want to achieve.

“Too often, in recent years, it
has felt like regulation has been
designed to hinder, rather than
support, dentists’ efforts to care
for their patients.”

Dr John Milne, Chairman of
the British Dental Association’s
general dental practice committee, said dentists took cleanliness
and hygiene very seriously, but
suggested it was heavy-handed to
wage war on magazines.
He said: “Providing magazines
in waiting rooms for patients to
read is a good way of helping them

A spokesman for Dorset PCT
said the current advice to practice owners is that patient waiting areas should be kept clear of
unnecessary clutter to facilitate
regular effective cleaning. He
added: “There is no specific requirement for practices to remove
magazines within a specified
time period; however, practice
owners, as part of a cleaning
schedule, should ensure that magazines are in good condition and
free from obvious contamination.
This advice will be kept under review and may be modified in the
event of any future community infection outbreaks.” DT

[5] =>

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United Kingdom Edition

More than 50 years of
knowledge and innovation.

East Sussex practice offers
free dental implants

A

dental practice has performed complete dental
implants for free after winners were nominated on Facebook.
Brighton Implant Clinic’s
charity, The Smile Foundation,
provides dental implant treatment for those in need of urgent
surgery, but without the means to
cover its costs.
The
Smile
Foundation
launched a Facebook page earlier this year to change the lives
of people who need dental implants after oral neglect caused
by dedicating their lives to helping others.

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Oct 29 - Nov 4, 2012

“I’ve always wanted to give
something back for the support
I’ve had in my life. The Smile
Foundation is a way for me to

use my dental skills to help those
less fortunate than myself,” said
Dr Bruno Silva. Head surgeon at
Brighton Implant Clinic.
In 2006, Donald Rodriguez, a
carer, suffered a severe stroke,
causing the paralysis of his left
side. His dental health suffered
enormously as he lost the ability
to brush his teeth, resulting in
serious gum disease and infection. For both mental and physical
wellbeing, the dental implant procedure was essential to his continued health.
Bruno Silva saw Donald as
an ideal candidate for The Smile
Foundation, so carried out the
dental work, removing the infected teeth of the upper and lower
jaw, and replacing them with new,
strong dental implants. The procedure would have cost £12,500.

The Smile Foundation is using Facebook as a voting platform, where social networkers
can vote for those who deserve
treatment. Using Facebook
has allowed patients to interact with one another and write
why their nominations deserve
free treatment under the charity.
This year with the help of
Facebook Dr Silva has begun
offering regular opportunities
to win a ‘smile makeover’ tending to the winner’s every need.
So far we have seen hundreds
of cases where people’s teeth
simply need to be restored.
The prize is open to UK
residents who are between 21
and 99 years of age. The contest closes on November 29th
at 5.58pm. DT

Young dentists call
for DFT guarantees
Y
oung dentists are calling
for support for their demand for Government to
guarantee all graduates from UK
dental schools a Dental Foundation Training (DFT) place. The
demand comes in the British
Dental Association’s (BDA’s)
newly-published YDC Asks,
a mini-manifesto for young
dentists developed by the organisation’s Young Dentists
Committee (YDC).
The Committee is asking
those who support it to sign a
Government e-petition founded
by YDC Chair Dr Martin Nimmo. The petition argues that the
failure to allocate DFT places
to UK graduates both wastes
taxpayers’ money invested in
their training, because denying each individual a DFT place
means that they are prevented

from providing NHS care, and is
unfair to the graduates who
taken on significant amounts
of debt in order to complete
their studies.
The launch of the petition
follows a recent admission by
the Department of Health (DH)
that 35 UK graduates from the
2011 cohort have not been allocated DFT places. Each graduate, DH acknowledged, will
have cost the public purse approximately £150,000 to train.

Dr Martin Nimmo, Chair of
the BDA’s Young Dentists Committee, said: “It is perverse that
students who have strived hard
to pursue a career in NHS care
are being denied the training
places they need to fulfil that
ambition. This is a significant
waste of taxpayers’ money, and

a tragedy for the graduates who
have taken on large amounts of
debt in pursuing their vocation.
Given that there are some areas
of the UK where patients who
wish to access NHS care cannot
do so, it is also nonsensical.
“I urge all current and potential members of the profession, and taxpayers, to join
young dentists in calling for a
guarantee that this farcical situation will never be allowed to
happen again.”
YDC Asks also expresses
concerns that robust data should
be used in workforce planning,
that barriers to young dentists
becoming practice owners are
mounting and that careers in
dental academia and specialist
training must remain viable options for young dentists. DT

Link between rheumatoid
arthritis and tooth loss

R

esearchers in Australia
have found that those
with rheumatoid arthritis are likely to develop periodontal disease.
According to doctoral candidate Melissa Cantley from the
University of Adelaide, gum disease has a direct impact upon
joint tissue health, and arthritis

influences and alters healthy
tissue within the mouth.
The research found that
mice who suffered from periodontal disease would suffer major bone loss within the
joints, and that mice who had
rheumatoid arthritis showed
signs of major bone loss in the
jaws.

Research studies are currently being carried out to
see if it is possible to reduce
symptoms of rheumatoid arthritis by treating only periodontitis. Researchers hope
that it will be possible to help
relieve rheumatoid arthritis
by treating mouth conditions
such as periodontal gum disease. DT

[7] =>

United Kingdom Edition

October 29 - November 4, 2012

News 7

IDH show they’re good sports

DH
support
Dentist’s
Sports Day to show human
side of corporate dentistry

Integrated Dental Holdings
(IDH) competed among 1000
dental students from University’s across the country in the
annual BDSA (British Dental
Student Association) Sports
Day in Manchester.
As the largest dental employer in the UK, IDH sponsored the event, whilst providing water and fruit for
the players from one of their
mobile dental units. In a first
for this typically student-only
tournament, IDH teams* competed in both the football and
netball leagues.

Health staff
encouraged
to get flu jab

ealth staff are being
reminded to get vaccinated against flu to
cut the risk of it spreading to
patients and colleagues this
winter.
Frontline healthcare workers are more likely to be exposed to the influenza virus,
particularly during winter
months when some of the
people in their care will be infected. It has been estimated
that up to one in four healthcare workers may become
infected with influenza during a mild influenza season,
a much higher incidence
than expected in the general
population.
Director of Nursing Viv
Bennett says: “Flu can kill, so
in leading by example, and
recognising the importance of
having the flu vaccine yourself, you will help reinforce
the benefits of immunisation
and reassure people that it is
safe and effective.”
The NHS already faces
challenges around maintaining its workforce during times
of increased sickness, so it
is vital to reduce the impact
of flu to protect patient care.
Being vaccinated is the only
way to almost eliminate the
risk of flu spreading from staff
to colleagues, patients and
families. DT

Alex Handley, Graduate
Recruitment Partner at IDH
comments on the day, “Despite getting unceremoniously
thrashed by the competition
we had a great day! We got to
spend time with the students
on a social level and had the
chance to tell them, in an informal setting, about the ca-

reer opportunities at IDH.
We have a year round presence in all UK Dental Schools
where we are able to educate
the students on the dental
employment market, and we
welcome every opportunity to
support the next generation of
clinicians.” DT

Sensodyne
Repair & Protect

Advertisement feature

Powered by NovaMin®
Harnessing bone regeneration technology
for dentistry1
Sensodyne Repair & Protect is different. It has a
unique NovaMin® plus fluoride formulation which:
• Delivers calcium and phosphate into the
patient’s saliva2-4
• Provides favourable conditions for hydroxyapatite-like
reparative layer formation2,5,6

Repairing exposed dentine
In vitro studies have shown that the hydroxyapatite-like
layer starts building from the first use7 and is around 50%
harder than dentine.8

Protecting patients from the pain of sensitivity
The newly formed hydroxyapatite-like layer integrates with
the patient’s dentine by firmly binding to the collagen
within it.12,16
In vitro studies have shown that the reparative layer builds
up over 5 days9* and remains resistant to the chemical and
physical oral challenges that your patients may encounter in
their everyday lives.8-10,17

5 µm

Fluoridated hydroxyapatite-like
layer within the tubules at
the surface

Fluoridated hydroxyapatite-like
layer over exposed dentine

In vitro cross-section Scanning Electron Microscopy (SEM) image of hydroxyapatitelike layer formed by supersaturated NovaMin® solution in artificial saliva after 5 days
(no brushing)7

The reparative layer forms over exposed dentine and within
the dentine tubules2,7,11,12 and, with twice-daily brushing,
provides your patients with continual protection from
dentine hypersensitivity.13-15

Think beyond pain relief and recommend
Sensodyne Repair & Protect
*with twice daily brushing
References: 1. Greenspan DC. Journal of Clinical Dentistry 2010; 21(Special Issue): 61–65. 2. LaTorre G, Greenspan D. Journal of Clinical Dentistry 2010; 21(Special Issue): 72–76.
3. Edgar WM. British Dental Journal 1992; 172(8): 305–312. 4. Arcos D et al. Journal of Biomedical Materials Research 2003; 65: 344–351. 5. Lacruz RS et al. Calcified Tissue
International 2010; 86: 91–103. 6. de Aza PN et al. Materials Science: Materials in Medicine 1996; 399–402. 7. Earl J et al. Journal of Clinical Dentistry 2011; 22(Special Issue): 62–
67. 8. Parkinson C et al. Journal of Clinical Dentistry 2011; 22(Special Issue): 74–81. 9. Earl J et al. Journal of Clinical Dentistry 2011; 22(Special Issue): 68–73. 10. Burwell A et al.
Journal of Clinical Dentistry 2010; 21(Special Issue): 66–71. 11. West NX et al. Journal of Clinical Dentistry 2011; 22(Special Issue): 82–89. 12. Efflandt SE et al. Journal of Materials
Science: Materials in Medicine 2002; 26(6): 557–565. 13. Du MQ et al. American Journal of Dentistry 2008; 21(4): 210−214. 14. Pradeep AR et al. Journal of Periodontology 2010;
81(8): 1167−1113. 15. Salian S et al. Journal of Clinical Dentistry 2010; 21(Special Issue): 82–87. 16. Zhong JP et al. The kinetics of bioactive ceramics part VII: Binding of collagen
to hydroxyapatite and bioactive glass. In: OH Andersson et al (eds). Bioceramics 7, pp61–66. Butterworth-Heinemann, London, 1994. 17. Wang Z et al. Journal of Dentistry 2010;
38: 400–410.
SENSODYNE, NOVAMIN and the rings device are registered trade marks of the GlaxoSmithKline group of companies.

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23/07/2012 14:39

[8] =>

8 MSc Blog

United Kingdom Edition

October 29 - November 4, 2012

Four days in London: MSc Residential
Ken Harris tells all from the second Residential of the MSc in Restorative and
Aesthetic Dentistry
no cattle”.
He is an encyclopaedia of
all things ceramic; what this
guy doesn’t know about bonding techniques could be etched
upon the inside of a porcelain
veneer. Following an absorbing two days of both theory and
hands-on sessions we emerged
tired but happy and with lots of
state of the art clinical techniques easily applied in a busy
practice environment. This
residential course has such a
significant hands-on element

London’s iconic Tower Bridge

ow, what was I
drinking last night?
Ah, I remember now,
it’s the second MSc residential
course, and I’m not in Kansas
anymore. I’m in London, and
the upcoming four days constitute one of the highlights
of this MSc course. The venue
nestles close within the shadow of the Tower of London,
and just a rinse and spit from
the iconic Tower Bridge.
Answers on a postcard
First question, first day; “why
are we filling white teeth with
silver fillings?” answers on all
three sides of a postcard please
to the quixotic Professor Trevor Burke. Posterior composite
theory from the good prof with
practical skills demonstrated
by his faithful sidekick, Sancho Panza, in the shape of the
excellent Dr Louis Mckenzie;
then it was our turn.
Using an entirely new battery of instruments and matrix retainers it was “ShowTime”
with
a
hands-on
session where our composite
work was critiqued by our colleagues; squeaky bum time,
but great fun was had by

all. As suspected, it’s not
just me who spends an inordinate amount of time
carefully placing posterior
composites.
Eye-opening!
After a few drinks it’s suddenly
it’s bedtime. Funny how time
races when you are enjoying
yourself. “What art thou that
usurp’st this time of night?”;
a fire alarm had us all outside
at 3.00 AM appreciating Tower
Bridge by moonlight, as well
as a few other eye-opening
sights. An ecstasy of fumbling
then back to bed.
However, Aurora in her
saffron robe soon gave way to
Apollo in his flaming chariot,
and I made my way snail-like
to school, complete with shining morning face, to begin
the first of two days covering indirect restorations. Our
guide into the porcelain underworld (and hopefully out
the other side) was to be the
effervescent Prof Nasser Barghi from San Antonio. Here
is one (adopted) Texan who
by teaching 44 weekends
per year could definitely not
be described as “all hat and

‘‘A fire alarm had
us all outside at
3.00 AM appreciating Tower Bridge
by moonlight,
as well as a few
other eye-opening
sights. An ecstasy of
fumbling then back
to bed.’’
(ooh-err missus), I hereby
promise to never knowingly
lose one single megapascal of
bond strength.
All porcelained out, and being the culture vulture I am,
I decided to avail myself of
some of the more hedonistic
pleasures the big city had to
offer, and with the proximity
of Shakespeare’s Globe theatre
it seemed churlish not to take
advantage.
Standing room only
Richard III with the excellent

Mark Rylance in the title role,
what a piece of luck, but standing room only available, at the
admittedly bargain price of
just £5.00. However, after more
than three hours of standing (its Shakespeare’s second
longest play) I needed a very
large steak and something red
and chateau-bottled as a restorative. A memorable evening was complete with a stroll
home along the south bank of
the Thames, through certain
half-deserted streets with the
city stretched out against the
darkening sky, like a patient
etherised upon a table.
The final day began with a
hands-on root canal session in
the company of the irrepressible Dr Daniel Flynn and some
extracted teeth. Despite a wide
range of nickel titanium to play
with it still seems the 3 most
important tools remain Irrigation, irrigation and irrigation.
“Plus ça change”
Fatally flawed
The afternoon session introduced us to the wacky world
of Research Methods. We
listened first in bemused silence, progressing into unsettled mutterings and finally
erupting hilariously into almost outright disbelief. It appears that almost all research
is fatally flawed, especially the
abstracts. I was mightily uplifted to see such dissent for once,
as a normally placid profession
rose up as one to express goodnatured hoots of derision. We
stood against them, as proud
clinicians, and sent them (the
academics)
homeward,
to
think again. Such a feeling of
togetherness is rare in dentistry; altogether now … “I’m

Spartacus!!”. Inspirational, but
we all know what happened to
him don’t we.
A hugely enjoyable four days
with top flight speakers and
thought provoking discussions
amongst colleagues,(with the
occasional large sirloin thrown
in!). However, I still wonder
if we have learned enough
yet to placate the savage
beast that is the “once in a
generation
phenomenon”
known as Dr Martin Kelleher.
Check your screen for the latest odds !!!
A horse, a horse!
I suspect not, and with the
news that yet another disillusioned
dental
colleague
(name deleted to protect your
ears from the harsh clang of a
name being dropped) is selling his practice, I’m thinking; maybe we should all be
choosing the primrose path of
dalliance rather than studying (are you listening GDC?).
Maybe right now is the winter of our discontent; “a horse,
a horse my practice for a
horse!” DT

About the author
Ken Harris graduated from the dental school of the
University of Newcastle upon Tyne
in 1982 and passed
MFGDP(UK) in 1996.
He maintains a fully
private practice with
branches in Sunderland and Newcastle upon Tyne specialising in complex
dental reconstruction cases based
upon sound treatment planning protocols. He is one of only two Accredited
Fellows of BACD, holds full membership of BAAD and remains a sustaining member of AACD. He is currently
UK Clinical Director for the California
Center for Advanced Dental Studies
and the only UK Graduate and Mentor
of the Kois Center in Seattle.

[9] =>

United Kingdom Edition

Business 9

October 29 - November 4, 2012

Setting up on your own

Puja Patel discusses Unincorporated Business Structures

etting up your own practice
is an exciting career move
for any practitioner. There
will be a myriad of decisions that
will need to be made. The first and
most obvious is ‘Where do I start?’.

dental practitioners who believe
they operate under an expense
sharing arrangement when in fact
they are partners. This can lead to
entirely unforeseen and undesirable consequences.

Before deciding to establish
your own practice, make sure you
understand what’s involved, the
most critical steps, the timetable
and costs. It will take thought,
planning, management skills and
appropriate advice.

NHS dentists face particular

problems with such a mix up as
it has the potential of putting the
NHS contract in jeopardy. GDS
Contracts can be made with an
individual dental practitioner, a
partnership and a dental corporation. Accordingly, where multiple
dentists are signing up to a single

GDS Contract, they are almost certainly doing so as a partnership.
PDS Agreements differ in that they
cannot be made with partnerships
and are instead entered into by
a group of individuals (although
they are likely to be in partnership
by virtue of this arrangement).

Dental practitioners who sign an
NHS contract as a partnership,
are holding themselves out to be
a partnership to the PCT and are
jointly responsible under that NHS
contract for the obligations under
that contract.
If you are looking to operate
your new dental practice under
an unincorporated business structure, think very carefully how you
wish the relationship with your
colleague is to be governed. DT

First, you will need to decide
if you are going alone or with a
colleague and if the latter, in what
type of entity. Here, we look at unincorporated business structures.
A single-handed ownership
where you are the only dentist in a
new environment can be a daunting position. Therefore, many
dentists (who are not buying an
established practice) opt to start
from scratch with a colleague.

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There are various forms of
joint venture and it is important
to choose at an early stage the
most suitable arrangement. The
two forms of unincorporated joint
ventures which may be familiar to
dentists are expenses sharing arrangements and partnerships.

Rob Banks BDS, FDS RCS(Eng), MBBS, MRCPS(Glas), FRCS OMFS(Ed)
Consultant Oral & Maxillofacial Surgeon

Expense sharing arrangements can be distinguished from
partnerships by the degree of integration between the dentists. It
is important that dental practitioners understand the differences between expense sharing and partnerships to ensure their business
is protected and that there are no
nasty surprises at a future date.

Robert Banks, BDS
Consultant Oral & Maxillofacial Surgeon

The expense sharing arrangement is most commonly used
where dentists operate separate
dental practices but in close proximity. Whilst they continue to trade
as distinct businesses, the parties
agree to share common expenses
such as common areas, staffing costs, utilities or marketing.

The
only
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The complete solution provider, supporting you with:

A partnership is an integrated
joint venture and the dental business is the business of the partnership rather than of the individual
parties. A partnership business
is a closer relationship than that
envisaged by an expense sharing
arrangement.

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Whilst many dental practitioners in partnership set out with the
express intention of being a partnership, there are a number of

About the author
Puja Patel is a member of the Commercial Team at Lockharts and works
primarily in advising dentists, dental
care professionals and dental corporate bodies on the commercial aspects
of dentistry.

Call + 44 (0) 208 756 3300 (UK),
1800 677306 (Ireland)
or visit nobelbiocare.com

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Nobel
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Phone
+44
(0) 208
756 3300; Fax +44 (0) 208 573 6740, Nobel Biocare Ireland, Phone 1800 677306; Fax 1800 677307
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© Nobel
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Services
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reserved. Nobel
Nobel Biocare,
allall
other
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© Nobel
Biocare
Services
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Biocare, the
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NobelBiocare
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Biocare. Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability.
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trademarks are, if nothing else is stated or is evident from the context in a certain case, trademarks of Nobel Biocare.
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Disclaimer: Some products may not be regulatory cleared/released for sale in all markets.
M a U 0 0
Please contact the local Nobel Biocare sales office for current product assortment and availability.
1 2
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R Banks_Compl solu prov A3 UK rev.indd 1

2012-09-03 11.36

[10] =>

10 Opinion

United Kingdom Edition

October 29 - November 4, 2012

What’s in a name?

Alun Rees discusses the dental identity crisis

hat by which we call a rose.
By any other name would
smell as sweet.”
Shakespeare - Romeo & Juliet.
I think it’s fair to say that a lot
of dentists struggle for an identity of their own. Are you a den-

tal surgeon, a dental practitioner
or “just” a dentist? Many change
descriptions as they progress
through their careers; certainly
I believed dental surgeon had
a certain ring to it when I was
doing my hospital resident posts.
Pomposity usually precedes de-

flation as it was when I asked for
patients to be referred to the department of oral and maxillofacial surgery and was asked by
nurses and porters, did I mean the
dental clinic?

work? A quick look at Google
would have you believe that what
were once just “practices” are
now anything from surgeries,
smile centres, dental care, family dental health care centres, implant clinics and spas.

To add to this where do you

Be Legal . . .

Eventually I came from behind the names and realised that
if I wanted to be successful on my
own terms it was me that people
wanted to see. The process wasn’t
without wobbles, I had got so
used to being part of a “thing” that
I shied away from just being me
but once I became comfortable
with it I was happier and so were
the patients.

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They wanted a relationship
with a real human being whose
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could refer their friends when
requested. So I became Alun,
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Then we made it harder to
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asked was, “can I ask who referred you because Alun usually
only sees new patients on referral
from existing patients.” That was
said even when I was desperate
for patients - it implied exclusivity
and invitation. The follow up was
left to my reception team; if they
felt that the person on the phone
was someone who would fit with
us then they were able “to make
an exception” in their case. If
they made a fuss or demanded to
be seen then they wouldn’t have
suited us anyway so there was little point in starting a relationship.

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I have nothing against differentiation and during the first
decade of practice ownership I
changed the name of what I called
the place where I went to work
several times. Initially I implied
ownership of an area by taking the suburb’s name and adding the word dental. Next I was
influenced to promote health
(nothing wrong with that) so I became the suburb “dental health
care centre”.

At this point I’d like to introduce the difference between a
transaction patient and a relationship patient and why it’s i
mportant to attract the latter to
your practice if you want longterm success. Very few people are
entirely comfortable letting someone who they don’t know very
well and may, therefore not fully
trust, work in what is a very sensitive area. Don’t forget, no matter what you call yourself, your
area of expertise is the mouth
and most people don’t leap out of
bed in the morning with the cry,
“Fantastic, dentist today, hope it’s
a long appointment!”
So what’s the difference?

[11] =>

United Kingdom Edition

Transaction patients.
•Interested in price alone
•They believe all dentists are the
same
•They love Groupon or other dis
count offers
•They show no loyalty, you keep
the practice open for them on
Saturday and by Tuesday they
have found someone else
•They want the best deal you can
give them and are never afraid to
ask
•Ask for referrals and they want
to know what’s in it for them
•You make very little profit
On the other hand...
Relationship patients
•Seek trust and confidence
•They want to use friendly com
panies with familiar people and
reliable products
•They are lifetime patients.
•They will pay more and they
know it
•They find it emotionally tiring to
shop around
•Ask for referrals and they are
flattered and pleased to help
•They are profitable over the
long term
Exclusivity does not mean
unavailability, in fact quite the
opposite. Your business depends
upon you being able to give the
support and service to your patients that you would expect to
receive yourself.
Nor does it mean that you
have to be the only visible name
and face of the business. Your
qualities as a leader will be tried
and tested so you have to absolutely sure in what you are trying
to achieve. Your team and their
training becomes even more important so that everyone is aware

of the standards that you set for
yourself and expect from them.
Your systems must be able
to cope with everything that is
thrown at them. When those
patients with whom you have
worked so hard to build a
relationship are ready to commit to the treatments that have
been discussed, you and the team
are ready.
Your marketing must reflect

Opinion 11

October 29 - November 4, 2012

your desire to attract relationship patients. Your website should
have testimonials either in video
format or at some length, not just
sound bites. Your Internet activity
should exhibit the fact that you are
in this for the long haul.
There is of course an exception to this. If you are the sort of
person who shops around for the
cheapest deal you can get, who
objects to paying other professionals what they are worth and who

haggles over payments then you
are very unlikely to attract relationship patients.
Instead you’ll spend your time
saying “What’s the matter with
them? Why won’t they commit?”
not to mention spending a fortune
trying to attract more and more
transaction patients who will
leave you at the first marketing
email for cut price whitening from
the people down the road.

People aren’t stupid; they will
know that you’re after the profit
today and aren’t interested in
their long term needs and wants.
It’s unfortunate that the traditional NHS approach with its emphasis in making the patient “dentally
fit”, what ever that really means,
coupled with the removal of registration in 2006, does nothing to encourage a long term relationship.
So what’s the name for you
and your business? DT

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About the author
Alun Rees trained
at Newcastle University and started
his career as an
oral surgery resident, before working as an associate
in a range of different practices. With
this solid foundation, Alun went on to launch two practices in the space of just 15 months,
a challenge in the toughest economic
conditions. After years of hard work
Alun finally sold his award-winning
business in 2005. Alun’s background
and experience give him a strong understanding of what others go through
to build a successful practice. He has
seen many different approaches and
learned his own lessons in the real
world. Alun now runs Dental Business
Partners to offer specific and specialised support for dentists, by dentists.
He has served as a media representative for both the BDA and BDHF and
is an authority consulted by the media and has featured on BBC2, Sky TV
and various radio stations. Raised in
South Wales, Alun has family roots in
West Cork where he spends as much
time as work allows. In other spare
moments he has run three London
marathons and lists rugby, real ale
and music as relaxation. www.dentalbusinesspartners.co.ukalun@dentalbusinesspartners.co.uk
For more information email Alun at
alunrees@mac.com, or alternatively
call 07778 148583 or 01242 511927

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[12] =>

12Practice Management

United Kingdom Edition October 29 - November 4, 2012

Appenticeships
Jane Armitage looks at apprenticeships as a suitable staffing solution

W

orking in a busy dental practice can sometimes become hectic,
how often do you have a rota
and have to redo it as suddenly
you are short staffed due to illness etc.

Induction
A good induction programme
will benefit both parties. However with agency staff although
you will give an overview of what
is expected it is not in depth as
there isn’t the time, that nurse is

It’s at these times when you
wish you had an extra pair of
hands.
Yes we have the support of
agencies but this comes at a financial cost.

required in surgery to cover at
short notice so if you haven’t the
time to do a full induction and
having just done an overview
who’s at fault if something goes
wrong?

A4 Insert October 2012 UK_DSC UK A4 23/10/2012 11:56 AM Page 1

WOLF LED CORDLESS CURING LIGHT £ 159
Incl VAT

The Wolf light curing light, is a high-performance light source for polymerization of dental materials.It consists of a charger and a cordless handpiece powered by a rechargeable battery.
The unit is designed for use on a table and cannot be wall-mounted. The light source is a highperformance light-emitting diode (LED).
In contrast to halogen lights,the emitted light specifically covers the light wavelength between
430 and 480nm. The polymerization performance is so high that the exposure times can be reduced by 50% in comparison with a conventional halogen light (with light intensity typically
ranging from 600 to 800mW/cm2 ).

FLAT END TAPER
( box of 25 )

KUT 2068

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‘There’s nothing
worse than having to cancel a list
especially due to
staffing shortage,
this should never
happen’

F

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Length: 5
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FLAME
( box of 25 )

KUT 2202

M

OGIVAL ( CAD/ CAM PREP )
( box of 25 )

GROSS REDUCTION

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George Kirtley, DDS

ROUND
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£ 23.75
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CHAMFER
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KUT 4072

There’s nothing worse than
having to cancel a list especially
due to staffing shortage, this
should never happen. Normally
patients will accept illness or circumstances happen, however I
found myself in this position only
a few weeks ago. The reason for
cancelling was a parental bereavement to one of the dentists
even in this sad circumstance but
a couple of members of the public weren’t amused. So cancelling
due to staffing problems is not a
good idea.
In the past if we have a vacant post I would advertise and
employ a qualified nurse suitable
for the position. The advantage
of this is the qualified part and
also it delivers a service to the
patients and it maintains the current staffing levels. Even though
staffing levels are fine, an extra pair of hands is always wel-

Selected filling composites can be cured in as little as 5seconds if the light guide can be
placed in close proximity to increment.
Settable exposure times:
•5,10,15,20 sec
•Continuous mode (120 sec)
•Tack-cure mode

DIAMOND BURS

During last winter the
viruses struck and at one
point we had several staff off
sick at the same time which
meant juggling clinics, finding
relief staff who obviously are unsure where anything is (which
can add even more pressure to
the day). We worked through it
but it did make me think of an alternative suitable back up.

VAT ( 20%) to be added on all prices
DSCUK201201

come which is why I decided to
look at employing an apprentice
nurse. My reason for this was
although at that point we were
fully staffed, if we could train
an apprentice from scratch they
would work to our protocols
and hopefully quickly adapt. I
personally think that if a young
person has already enrolled at
College for the dental nurse
course that shows they already
have an interest; the requirement
is they enrol but then need to find
a placement.
At the time of writing the
cost to the practice is £2.60 per
hour for employees aged 16 – 18,
there is a slight increase coming
in October. This rate is not set
in stone and can be increased
at the discretion of the practice.

[13] =>

United Kingdom Edition

Extra money can always be paid
as an incentive. The apprentice
NMW applies to all 16-to-18 year
olds and to those aged 19 and
over in the first year of their Apprenticeship.

Eligible employers must have
never employed an apprentice
before or who have not been in a
position to commit to employing
an apprentice again within the
last 12 months.

If the apprentice is aged 19
and/or has completed their first
year of the apprenticeship you
must pay the national minimum
wage appropriate for their age.

I believe this is worth knowing; it’s a small amount but it’s
money that is available.

There is also the cost of supervision and training supplied
by the college, the National Apprenticeship Service will match
the employers commitment to
hiring apprentices by covering in
full the training costs or if over 19
a very small fee will be payable
by the practice.

October 29 - November 4, 2012

Practice Management13

training with no strings attached.
Downsides being after two years
you are likely to have become attached to this apprentice who is
aware from the onset there is no
guarantee of a permanent job on
qualification. This decision then
lies with you do you employ them
or start the process again. DT

Looking back this has been
one of the best decisions I have
made. It’s a cost effective way of

Apprenticeships provide back up staff who know your practice policies

The college course is NVQbased with day release once a
fortnight.
At the moment there is an employers’ incentive grant scheme
available until funding ceases
early next year.
This is aimed at eligible employers offering employment
through the apprenticeship programme. This scheme assists by
providing wage grants to anyone
recruiting an apprentice. The
criterion is The National Ap-

the UK’s Premium Endodontic Conference
Early Booking
price £199
(usual price £249)

Friday 1st February 2013

Experience some of the world’s greatest speakers in a breathtaking setting
Innovate with a brand new format of lectures
Network with your peers and speakers over a fantastic lunch and drinks reception

‘Looking back this
has been one of
the best decisions
I have made. It’s a
cost effective way
of training with no
strings attached’

First 50 delegates to sign up enjoy the ultimate lunch and learn with our speakers

G. John Schoeffel
prenticeship Service will provide
40,000 Apprenticeship grants to
employers recruiting 16 – 24 year
olds with a value of £1,500.
The £1,500 is in addition to
the training costs of the apprenticeship framework which are
met in full for ages 16 – 18 and 50
per cent for those aged 19 – 24.

About the author
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

Gary Glassman

Simon Cunnington

Gianluca Gambarini

Book now to secure your place
The conference will be held in the exclusive Altitude 360°
Altitude 360°, 29th Floor, Millbank Tower, 21-24 Millbank, London, SW1 4QP

Places are limited, book now with Smile-on on call 020 7400 8989
or email info@smile-on.com

[14] =>

14 Practice Management

United Kingdom Edition

October 29 - November 4, 2012

The Patient Experience
Glenys Bridges focuses on patient communication

W

orkplace
communication skills are
quite possibly the
most written about interpersonal skill. The reason for this
being that peoples’ sense of
wellbeing is directly linked to
the quality of their communi-

cation with their colleagues.
Many dental professionals
recognise that top-down communication in dental teams
frequently leaves a lot to
be desired. In some cases
this is due to the fact that implicit rules that have evolved

over many years which set the
tone of workplace communications.
Since the introduction of
care quality standards, there
is a requirement for practices
to develop explicit communi-

cation protocols characterised
by clearly defined policies,
procedures and protocols.
The objective of these protocols is to provide a communication framework that will
ultimately equip dental teams
to provide the highest pos-

“Cosmetic Interfaces:
Bringing It All Together”

Featuring

Dr Rafi Romano,
Dr David Garber &
Dr Maurice Salama

sible standard of dental care
to patients. An important
part of patient care is ensuring that patients have positive experiences every time
they contact the practice.
These positive experiences in
face-to-face
interactions
can stem from the warmth
and friendliness shown by
team and on a more formal
basis the language and protocols used in written communications. Most practices
have established guidelines
in place for face-to-face interactions, however many still
need to put into place protocols and procedures to govern the tone of the written
word in the following formats;
letters, notices and reports.
Written communications can
be effective communication
channels, as long as they
are
constructed
correctly
and abide by the following
guidelines:
Letters
Letters to patients should
have a businesslike but amiable tone. They should be concise and factually accurate. All
references and details in the
content of the letter should

‘An important part
of patient care is
ensuring that patients have positive
experiences every
time they contact
the practice’

The British Academy of Cosmetic Dentistry
Ninth Annual Conference 2012

Thursday 22nd, Friday 23rd and Saturday 24th November 2012
Manchester Central, Petersfield, Manchester M2 3GX

be checked and correspondence proof read before being
sent out, as errors can cause
confusion. Attention must
be paid to the correct use of
grammar, punctuation and
paragraphs, with avoidance
of the use of abbreviations,
jargon, or colloquial language. Letters must be signed
by the appropriate person
eg a report will be signed by
the dentist as verification of
the information within. But
a less formal letter to a patient can be signed by an
administrator.
Presentation
Letters must be produced on
practice stationery. The layout

[15] =>

United Kingdom Edition

must be reader friendly and attractive using the house style
and font. Correspondence
with patients will include new
patient letters to introduce the
practice; these letters provide
important opportunities to set
the tone of the relationship
between the practice and the
patients.
In
most
cases
template letters will be made
available ready to be personalised for use. Templates should
be signed off by the practice
management and in a format
that prevents errors in adding personalised content. In

Communication through letters can set
the tone between patients and practice

some cases styles and formats
could be used to appeal to patients based on their age or
demographic.
Emails
Whereas the etiquette for letter writing is generally understood, this is not the case
for email etiquette. In many
cases these days email is
the preferred method of communication. They are fast and
effective, but to ensure they
project the correct image of
the practice, guidelines should
be in place, since emails
sent out from the practice
reflect upon its friendliness
and professionalism. Therefore measures should be
put in place to ensure that
the language used is polite,
courteous, and appropriate.
Stringent measure should be
taken to ensure confidentiality is maintained and your
computer equipment is virus
guarded.
Practice protocols should

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

October 29 - November 4, 2012

‘Correspondence with patients will include
new patient letters to introduce the
practice; these letters provide important
opportunities to set the tone of the relationship between the practice and the patients’

be agreed about checking for
incoming emails and about
the required speed of re-

sponse. Practices should ensure their email is set up correctly. It should identify the

Practice Management15

sender, display the subject
matter in the ‘subject’ bar and
signatures should provide the
information legally required
for business emails.
The patient experience
is built up on many levels.
Most dental teams understand the influence of face
to face communications. If
they can raise the standard of
their written communication
skills up to the level of their
face to face communications,

dental teams will make progress in building lasting respectful relationships with
their patients.
These communication topics are covered in my new
dental reception course Purely Practical Reception Skills
Please email glenys@glenysbridges.co.uk for details . DT

[16] =>

16 Careers

United Kingdom Edition

October 29 - November 4, 2012

Need a new challenge?
Michael McCallion of FT&A Medical Recruitment offers jobseekers and
candidates some useful advice...

o you find yourself
clock watching after
lunch?!

Do you spend Sunday
nights dreading the upcoming
Monday morning?

rankly

Is the role not fulfilling
your expectations?
A new challenge is required
then. What should you be bearing in mind if you wish to get
the job of your dreams? Let’s
start at the beginning:

• Your CV. This may seem an
obvious thing to say but it needs
to be said because so many
professionals still get it wrong.
Do your best to avoid any gaps
in the employment history. If
there are gaps, make sure that
you can adequately explain
them. Not everyone is fantastic at spelling but you can get
it checked by someone who is!
Don’t embellish or lie – it will
catch up with you. An on the
ball recruitment agency will be
able to review your CV and offer
you advice on how and where to
improve it.
• How far will you travel? It is
wise to be realistic – particularly if you will beholden to public
transport!

peaking

Raising Finance?
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 ensure your CV is up to date with particular focus on any past
Managerial experience.
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.
Search for Frank Taylor and
Associates

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

• CRB, GDC etc. As you would
expect these all need to be in
order and up-to-date.
• Do you have good, solid references? Are you sure? It is not
uncommon for some candidates
to find that what they thought
were references expressing
how wonderful they were and
an ideal employee, are quite
different.
• What type of role is it that
you are looking for? Temporary, permanent – have you
considered a locum appointment? The more flexible that

may come as somewhat of a
surprise in a recruitment article for a professional magazine.
In our experience though it is
actually quite common for candidates of any education to get
it spectacularly wrong when attending interviews! All we suggest is that you give this some
consideration – what is the
role? Who am I meeting? What
level of seniority will I be looking to hold?
• Register with agencies that
you can trust. It generally
doesn’t cost anything to join an
agency but choose with care

‘A new challenge is required then. What
should you be bearing in mind if you wish to
get the job of your dreams? Let’s start at the
beginning’
you can be, the more posts will
be open and available to you.
• Salary. Quite possibly number
one on your list?! It is of course
a vital part of the process and
one of the most important reasons for choosing or not choosing a role. Your expectations
need to be realistic however.
It is tough out there and many
dental professionals can have
an overvalued opinion of what
they are worth. Have in your
mind the minimum that you
will consider and be open and
honest about the numbers with
any potential employer. There
is no point in accepting an offer
that you feel is too low and then
whingeing about it for months
to come – a frank dialogue is in
everyone’s best interests.
• Conditions and Benefits.
These can be somewhat overlooked as many push for the
salary above all else. A mistake
– pension provision, holidays,
flexible working hours can
make a ‘maybe’ job become a
‘definitely’.
• Appropriate dress and appearance for interviews. This

and ideally a name that has
been associated specifically
with the healthcare profession
for some time.
At FT&A Medical we are in
regular contact with so many
practices and professionals
– we are able to match up an
unprecedented number of candidates with vacancies. We are
able to do this through the extensive trust, reach and awareness in the dental marketplace
that Frank Taylor and Associates have built. DT

About the author
Michael
McCallion is Business
Development
Manager of FT&A
Medical
Recruitment. Michael has
huge experience
in healthcare recruitment having
worked in the sector for over 7 years, initially helping
provide the right medical and dental
staff to the MoD and the NHS. He then
worked as Business Development
Manager for an agency that supplied
the private as well as the public sector.
For more information on this news
release, please contact Chris Baker at
Corona Design & Communication on
0845 370 2211 or chris.baker@coronadental.co.uk

[17] =>

United Kingdom Edition

October 29 - November 4, 2012

Comment 17

25 Clinical tips for general practice part II
Dr Ashish B Parmar discusses tips 13-25 his ways to improve your clinical
dentistry for the benefits of patients

ne of the best ways of becoming a better dentist
is to learn from and be
mentored by top dentists. I have
been fortunate to be mentored by
world-class dental educators.

I use a soft tissue diode laser to
carry out artistic, minimal gingival
contouring changes. By placing
the zenith positions of the upper
teeth in the correct positions allows
more natural and attractive looking smiles. The theory and tech-

niques to do this can easily be
learnt, and the prices, of lasers has
come down a lot over the years.
I also use a “hard tissue laser”
to correct gummy smiles by doing gingival contouring followed

by the removal of bone subgingivally by up to 2mm to recreate
the biologic width. This allows
faster healing times, no need for
incisions (ie a non-surgical osseous recontouring technique) and
minimal or no post-operative dis-

comfort. The key point is that laser energy has a sterilising effect
and promotes faster and better
healing.

à DT page 18

I recently did a webinar for
Smile On. This second part of my
article is a follow up on this well
attended webinar; I will finish discussing some tips and advice to
allow you to offer a higher standard of dental care in your practice.
I will be talking about a range of
clinical techniques and dental
materials.
DISCLAIMER: I am not paid for
promoting or mentioning any dental materials. I will simply explain
the preferred products that I use
in daily practice, as well as on my
training Courses.
TIP 13: Laser Gingival
Contouring (Figs 1, 2, 3, 4)
Fig 1

Fig 2

For a look that’s hard to beat.
The new Luxatemp Star.

NEW !

Stunningly beautiful temporaries with proven durability:
Fig 3

The new Luxatemp Star offers outstanding results for
break resistance and flexural strength! The newest generation of DMG’s top material Luxatemp scores even better:

excellent stability, maximum fit and reliable long-term
color stability. No wonder experts recommend it.
Find out more at www.dmg-dental.com

Fig 4

AZM_LxStar_DE_2012.indd 1

27.03.12 17:15

[18] =>

18 Comment
ß DT page 17

Fig 5

United Kingdom Edition

October 29 - November 4, 2012

Fig 6

TIP 14: Fibre-Reinforced Composite Dentistry (Figs 5, 6 ,7)
I strongly advocate dentists to
learn about fibres in dentistry. I
use the everStick range of fibres
for numerous minimally invasive
procedures including:
• Periodontal splinting
• Fixed retainers after orthodontic
treatment
• Replacing a missing incisor,
premolar or molar tooth (stud
ies show success rates of over 10
years)
• Extraction of a tooth, resecting
the apical portion of the root and
splinting it to the adjacent teeth
in the mouth
• Making a custom fitting fibre
post, which is then used to make
a bonded composite core, before
crown preparation
• Reinforcement of large compos
ite direct restorations
Have a look at my practice
website at www.smiledesignbyash.co.uk/general-dentistry/
fibreglass_dentistry and also the
website www.sticktech.com.
TIP 15: Customised Composite
Shade Tab (Fig 8)
It is a good idea to purchase a
blank shade tab that GC make,
which can then be used to make a
customised shade tab with the different colours of composites you
have in your composite kit. This
will allow accurate shade matching ability when doing more
demanding anterior composite
build-ups using the layering technique. My preferred composite
products I use in practice are
G-aenial for the anterior teeth
and Kalore for the posterior teeth.
Have a look at www.gceurope.
com to find out more about
these composite products, as
well the very good App that GC
have developed to help dentists in complex anterior build
ups using the layering technique.
TIP 16: Use of Luxacore
(DMG), Luxabond (DMG) and
EverStick Posts (Sticktech) to
do a bonded Post/Core build up
(Figs 9, 10)
I use everStick Posts (0.9mm and
1.2mm fibres) to anatomically
adapt the flexible fibres in the prepared root canal after the root filling. Root canals are never circular
in cross section, which is why this
technique is superior than using
pre-fabricated fibre posts, which
are circular in cross section. I use
Luxabond as the bonding system,
and Luxacore to cement the post
and build up the core simultaneously. The tooth can then be prepared minutes later. The whole
clinical technique can be viewed
on a video (part of a series) on my
Academy website at http://www.
theacademybyash.co.uk/ClinicalCases-Videos/porcelain-veneersprep-videos.html.
TIP 17: Composite Veneers
(Figs 11, 12, 13, 14, 15, 16)

Fig 7

Fig 8

Fig 9

Fig 10

Fig 11

Fig 12

Fig 13

Fig 14

Fig 15

Fig 16

Fig 17

Fig 18

[19] =>

United Kingdom Edition

I have done a lot of porcelain veneers over the years. However,
increasingly I am using composite
as a material of choice in a number
of cases. Following simple orthodontic treatment using the Inman
Aligner or 6 Month Smiles, teeth
can be straightened quite well.
Composite can then be used to
make minor improvements (typically after teeth whitening has been
done). This particular case shows
the before and after of a patient
that required five anterior composite veneers. The patient was a
bruxist and I was not keen on providing porcelain restorations in
this case. The teeth were roughened slightly on the labial surfaces without any local anaesthetic
needed. The veneer build-ups
were done under rubber dam using a putty index made from diagnostic wax ups (to give an accurate
reference to the palatal aspects
of the teeth so that a thin enamel
palatal “wall” could first be built to
help with the rest of the layering
technique). The patient was delighted with the result, which only
required one long appointment.
TIP 18: The “Spade” Instrument
(Figs 17, 18)
The instrument shown here
(which I call the “spade”) is a
great instrument to help with easy
and quick shaping of labial surfaces of teeth that require composite
veneers, as well as during addition of flowable composite material when making trial smiles
using Luxatemp (DMG). It is a
Hu-Friedy instrument and the reference code is TNCCIB.

Fig 21

October 29 - November 4, 2012

Comment 19
under water spray can be used
to get smooth, precisely prepared
and finished tooth preparations. I
have been using NSK handpieces
for many years in my practices
and recommend the Ti-Max X95L
handpiece. You can contact Alex
Breitenbach at NSK on 07900
245516 for more advice on NSK
handpieces.

Fig 22

improve the appearance and stain
resistance of the temporaries.

TIP 21: Use of a Speed Increasing (Red Ring) Handpiece to
perfect Preparations (Fig 31)

I highly recommend the use of a
speed increasing handpiece in an
electric motor. Friction grip burs

TIP 22: Natural Die Material
Shade Guide (Ivoclar) (Fig 32)
à DT page 20

æ-motion
with G-ænial from GC

Create

The all-round composite for aesthetically invisible single and
multi shade restorations.

Introducing the age-specific shade selection system.

TIP 19: Learn to do the
Inman Aligner and 6 Month
Smiles (Figs 19, 20, 21, 22, 23, 24,
25, 26, 27)
I have found the UK courses to
learn about the Inman Aligner
and the 6 Month Smiles braces to
be excellent. I now use both these
braces in clinical practice for the
benefit of my adult patients. Visit
www.inmanaligner.com
and
www.6monthsmiles.com to find
out more.

With G-ænial you can reinforce
your aesthetic skills and ability
to match every restoration with
nature thanks to the straightforward
shading system. The choice of the
enamel shades is made according
to the age of the patient:
• JE - Junior Enamel for youngsters

Fig 19

• AE - Adult Enamel for adults
• SE - Senior Enamel for your senior patients
Fig 20

TIP 20: Luxatemp (DMG) and
Luxaglaze (DMG) for
Temporaries (Figs 28, 29, 30)
Luxatemp is a 5-star Reality rated
product and rightly so! It is the
number one choice for making
trial smiles by the leading cosmetic dentists in USA and UK. I have
been using it for many years, and
B1 is my favourite colour. You can
get Luxatemp Fluorescence or
Luxatemp Star (stronger - if you
require more durable transitional
restorations to last longer in the
mouth). The use of Luxaglaze light
cured varnish will significantly

Selecting the right shades has never been easier!

GC EUROPE N.V.
Head Office
Tel. +32.16.74.10.00
info@gceurope.com
http://www.gceurope.com
GC UNITED KINGDOM Ltd.
Tel. +44.1908.218.999
info@uk.gceurope.com
http://uk.gceurope.com

[20] =>

20 Comment
ß DT page 19

This is an essential shade guide
to have for doing Smile Makoevers properly. The prepared teeth
can be matched carefully with
reference to this shade guide.
The ceramist technician can then
ultimately produce model dies
of the matched colour. This will
help with precise colour matching as the porcelain build-ups are
done. You need to write down the
“Stump Shade” colour eg ND7.

United Kingdom Edition

Fig 22

Fig 24

TIP 24: Cementation with
Vitique (DMG) (Fig 35)
Vitique is my number one choice
for cementation of multiple porcelain restorations when doing
a Smile Makeover. I use the base
and catalyst together (even if I am
cementing porcelain veneers). My
favourite colours are Transparent
and B1 shades of the base, and
I use the “low viscosity” catalyst.
There is adequate working time
with this cement to work in a stress
free manner. I also use Vitique to
cement in porcelain inlays, onlays
and all porcelain crowns.
TIP 25: The Celebration (Fig 36)
One of the best rewards for me in
private practice is seeing the emotional reaction when a patient sees
their new smile for the first time.
We celebrate this important moment in the patient’s life by presenting her with a nice bouquet
of flowers, a signed card by the
dental team with the before and
after photographs. We also celebrate with non-alcoholic champagne served in crystal glasses
on a silver tray. Our patients are
genuinely touched by the special
effort we go to during this “Celebration”. We also send the patient
for a complimentary photo shoot
with a professional photographer.
The patients love the photos taken
showing their increased confidence, because of their new smile.
They get a complimentary photograph from the photographer, and
we get the images that we want
for our marketing use eg to go on
the website as a case study. Please
have a look at the Reveal for Dina,
one of my patients who had a
complex Smile Makeover, on my
Academy website at http://www.
theacademybyash.co.uk/ClinicalCases-Videos/porcelain-veneersthe-reval.html.
Summary
I have mentioned DMG a number of times as I genuinely believe

they make world-class dental materials. You can visit their UK website if you want more information
ie
uk.dmg-dental.com/start.uk.
You can also contact Paul Willmer
from DMG on 07530 450598.
I hope you found these 25
Clinical Tips useful. However,
clinical skills are only one of the
important jigsaw pieces needed
to create a successful and profitable dental practice. You can visit
my informative teaching website
www.theacademybyash.co.uk for
a lot of useful articles, videos and
other material free of charge. Also
have a look at the practice website
for patients www.smiledesignbyash.co.uk.

Fig 23

TIP 23: Using a Top Dental Laboratory (Figs 33, 34)
My private practice is in Chigwell,
Essex. I use Rob Storrar from Amdecc Dental laboratory (www.amdecc.com) based in Basildon for
Smile Makeovers for my patients.
For my Academy, I have a close
working relationship with Castle
Ceramics (www.castle-ceramics.
com). It is a real pleasure to have
technicians who are passionate,
knowledgeable, skilled, artistic
and who have a good understanding about occlusion.

October 29 - November 4, 2012

Fig 25

Fig 26

Fig 27

If you would like to chat to me
to find out more about the unique
and inspiring 8-day Hands-On
Smile Design & Occlusion Course
I offer, then you can email me at
training@theacademybyash.co.uk
or phone me on 07971 291180.
You can also have a chat with my
Manager Cheryl on 020 85000544,
in case I am not available.
This popular Course occurs
only twice a year, and I limit
the training to six dentists per
Course. DT

Fig 35

Fig 28

Fig 29

Fig 36

Fig 30

Fig 31

About the author
Fig 32

Fig 33

Fig 34

Ashish B Parmar
(Ash) is a private
dentist and has a
unique state-of-theart practice in Chigwell, Essex called
Smile Design By Ash
(www.smiledesignbyash.co.uk). Ash
is a national and
international lecturer and was one of
the main dentists on the three series of
Extreme Makeover UK, and also on The
Only Way Is Essex. He offers an outstanding 8-day Course which includes
training on leadership, vision creation,
goal setting, step by step techniques in
doing Smile Makeovers, treating advanced cases (e.g. wear cases), lasers,
fibre-reinforced composite dentistry,
photography, communication, case
presentation skills, team development,
occlusion, etc. Ash has written numerous clinical articles in dental journals
and is well recognised for his passion in
cosmetic dentistry – using both composite and porcelain techniques. To find out
more about the unique training Courses
run by The Academy By Ash, visit www.
theacademybyash.co.uk, or send an
email to training@theacademybyash.
co.uk. Alternatively, you may phone Ash
personally on his mobile number 07971
291180.

[21] =>

United Kingdom Edition

October 29 - November 4, 2012

Clinical 21

CBCT in Orthodontics

Prof Giampietro Farronato, Dr Francesca Bellincioni, Dr Margherita Colombo, Dr
Daniela Falzone, Dr Salvadori Sara, Dr Gaia Passaler & Dr Gianfranco Santamaria

T

he aim of orthodontic
diagnosis is to identify
dento-alveolar,
skeletal
and functional alterations in the
maxillo-facial complex. Diagnosis and treatment planning are
based on a combination of study
models, intra-oral and extra-oral
images, and radiographs, traditionally consisting of panoramic
and cephalometric radiographs.
Cephalometric analysis (CA)
plays an important role in diagnosis and treatment planning.

tional CA and up to 20 times less
than during multi-slice-CT exams
(Table I).3
At the Orthodontic Department at the University of Milan,

CA is performed with a new 3-D
methodology that allows for an
easy, effective and repeatable way
to decrease operator-driven errors.4 It is based on the identification of 18 points (10 median and

8 lateral), all of which are identified on a hard tissue CT section
and verified on the two remaining
CT sections. Further verification
is then performed on the volume
rendering generated by SimPlant

OMS (Materialise). The 18 points
determine 36 measurements on
the sagittal, vertical and transversal dimensions (Fig 2). At the Unià DT page 22

Traditional CA is based on
three different X-ray projections:
latero-lateral
teleradiography,
postero-anterior teleradiography
and axial projection. However,
conventional radiographs are limited because they provide a 2-D
representation of 3-D structures.

‘The recent introduction of CBCT in
combination with
computer software
allows the application of this new
methodology to
different fields of
dentistry, including
its successful use in
orthodontics’

The traditional system, analysing
the three dimensions separately,
is insufficient because dento-facial alterations often take place in
3-D space.
Thus, the limits of traditional
CA are:
• Errors in radiographic projection, resulting in enhancements
and distortions
• Operator errors in the measurement systems
• Errors in the identification of the
cephalometric landmarks owing
to superimposition of anatomic
structures
-Inability to evaluate the three dimensions of the craniofacial complex.1
The recent introduction of
CBCT in combination with computer software allows the application of this new methodology to
different fields of dentistry, including its successful use in orthodontics (Fig. 1).2 Owing to CBCT, the
3-D morphology of the cranial
skeletal structures can be represented properly. With CBCT, the
patient is exposed to similar levels of radiation as during convenThe Academy A4 Advert FINAL.indd 1

21/09/2012 10:53

[22] =>

22 Clinical

United Kingdom Edition

October 29 - November 4, 2012

ß DT page 21

versity of Milan, 44 skeletal Class
I normodivergent patients were
selected from an archive of 500
CBCT scans. The cephalometric diagnosis of a skeletal Class I
normodivergent relationship is
based on the School of Milan. The
same patients were then analysed
with 3-D cephalometry. The results allowed the identification of
a normal range of values for each
measurement (Table II).
The 3-D technique goes beyond
the limitations of 2-D analysis in
many ways:
• effective representation of true
3-D morphology of the cranial
structures without distortion,
avoiding projection and identifi
cation errors
• reduced operator bias because
the measurements are pe
formed automatically
• simplicity and repeatability in
the identification of landmarks,

‘The introduction
of 3-D imaging
techniques has
revolutionised the
planning phase of
combined orthodontic and surgical
treatment’

using true anatomic structures
without superimposition or the
problems of geometric construc
tion
• ability to obtain CA using the
three dimension
• dento-skeletal alterations can
be analysed in 3-D in order to
determine appropriate treat
ment.
Combined orthodontic and
surgical planning
The introduction of 3-D imaging
techniques has revolutionised the
planning phase of combined orthodontic and surgical treatment.
The use of the computer, together
with dedicated software, allows
for a fast, precise and standardised procedure. 3-D virtual planning entails the following:
• CBCT scan
• high-definition impression
• reference aligner
• digital scan cast
• CBCT digital cast interface
Using virtual planning, it is
possible to obtain the virtual visual surgical treatment objective
and the virtual orthodontic model.
High-definition impressions are
obtained using polyvinyl siloxane,
which guarantees well-defined
details while allowing for the dou-

Fig 1

Fig 2

Fig. 1_The i-CAT Classic, a cone beam 3-D dental imaging system (Imaging Sciences
International).

Fig. 2_3-D rendering and cephalometric landmarks.

Table I_Effective radiation dose (background radiation 8 μSv/day).

Table II_Normal values range.

Fig 3
Fig. 3_Digital cast.

ble-pour method. Double-poured
casts are necessary to obtain an
adequate scan and require the
use of both a full cast and individual dental elements selected
from a second cast. Single dental
element scans allow for proper
analysis of contact points. An optical cast scan is performed using
structured-light scanners, which
produce a 3-D image captured by
a camera. In this manner, a group
of points is determined by the software, which then determines the
coordinates of the acquired points
and finally creates the 3-D image
(Fig 3).5
Moreover, the digital dental
cast is then combined with the

CBCT scan, which allows for a
very detailed analysis of both the
bone (through the CBCT scan)
and the dental structure (through
the cast scan). CBCT does not provide enough data regarding all the
dental details necessary to produce the orthodontic model (Fig.
4).6
In order to superimpose the
two records properly, a specific
three-contact point bite registration wax, known as the reference
aligner, has been introduced. The
reference aligner needs to be applied to the teeth when the highdefinition impressions are taken.
It is made of Moyco (an extra-hard
wax) and consists of a supporting

Fig 4
Fig. 4_CBCT digital cast interface.

[23] =>

United Kingdom Edition

arch and three spheres. These
are made of calcium-based glass,
which has cast-pouring radiopaque properties. The wax is applied during CBCT and is placed
between the cast arches during
the optical scan (Fig 5).
It is remarkable that the wax
thickness does not significantly
influence the accuracy of the radiographic scan and consequently
the results of the CA. The software
is able to recognise the presence
and size of the spheres in the CBCT
scan and matches them to those
corresponding areas on the cast.
This is currently the only method
that allows for an overlap with an
error margin of less than 0.1 mm.7
Once the data has been collected,
it is possible to perform different
kinds of analyses before the surgical treatment. The software presents powerful segmentation tools
that allow the splitting of the
maxillo-facial complex from the
mandible, providing two separate
images.

Fig 5
Fig. 5_Reference aligner.

October 29 - November 4, 2012

according to the ratios needed to
build the surgical splint, which
will be used during the surgical
procedure. The digital cast superimposition reduces the treatment planning phase, as it is not
necessary to reveal the facial arch
or to use the articulator. In fact,
all the data can be sourced from
the combination of the CBCT and
cast scans. Recent studies focus
on the enhancement of the system
through the development of an intra-oral scanner, which will allow

Clinical 23
direct 3-D impressions, skipping
the conventional impressions,
which-although precise-can be
influenced by manual errors.9,10
Although complex, using software offers many advantages
because it enhances both orthodontic and surgical techniques,
while ensuring a very high quality
result. In fact, a CAD/CAM techà DT page 24

CBCT Scanner
2nd Hand i-CAT Next Gen
4 years old, fully maintained unit
with Warranty until January 2013

This feature is relevant in or-

• Flat Panel Sensor Technology –
superior 3D image quality with resolutions
from 0.4mm down to 0.125mm
• Large Scan Height and Diameter –
scans up to 13cm in height and 16cm in
diameter - perfect for craniomaxillofacial
scans or orthodontic applications
• Medium Field of View Scans - reduce the
scan height and width to 8cm x 8cm – perfect
for implant scans
• Adjustable scan heights - adjust the
scan height from 13cm down to 2cm for
routine scans
• Fast scan times - 4.8 to 26.9 seconds
• Low Dose - measured by SEDENTEXCT
to be one of the lowest dose CBCTs on the
market in both the maxillofacial and single
jaw categories

‘Although complex,
using software offers many advantages because it
enhances
both orthodontic
and surgical techniques, while ensuring a very high
quality result’

thodontic and surgical planning
for calculating bone movement.
The clinician can select the tissues to be moved following a
procedure similar to the manual
one. For example, it is possible
to select the osteotomic lines in
order to simulate a forwards or
backwards mandible shift, finding
the exact shift needed (in mm) to
properly correct the malocclusion
(Fig. 6). Once the bone correction
has been finalised, it is possible to
create a 3-D orthodontic model
and display the resulting dental
correction to be obtained by the
end of the treatment.

Full manuFacturer’s warranty
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Finally, shifting back the bone
structure (and the dental arch
with the final model) to the original maloccluded position, it is possible to obtain the target cast to be
reached before the surgical treatment. On the cast, it is then possible to build successive images using CAD/CAM techniques to track
progress towards orthodontic presurgical treatment.8

www.ctscan.co.uk
IDT Dental Products Ltd, Unit GC Westpoint, 36-37 Warple Way, London W3 0RG. Tel. +44 (0)20 8600 3540
i-CAT is a Trade Mark of Imaging Sciences International LLC

Virtual surgery has a twofold
objective: firstly, to verify that the
planned shifts are in fact feasible;
and secondly, to position the cast

Only One available sO call nOw!
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10/08/2012 08:31

[24] =>

24 Clinical
ß DT page 23

nique allows for a standardised
procedure and easy quality checking, in comparison to traditional
operator-performed techniques,
which are open to in-accuracies.
Creating customised multibracket appliances
In virtual orthodontic and surgical
planning, it is possible to create
a digital orthodontic model once
the bone bases have been shifted
towards their proper position.
The latest dental shift software is
able to perform single-element
segmentation automatically. The
operator can obtain a full 3-D
visualisation of the dento-alveolar
relationship and can consequently modify tip and torque, rotate
and shift dental elements in the
3-D space in order to simulate the
orthodontic treatment.
In order to display the results
of the pre-surgical orthodontic
treatment immediately, the software shows two overlapping images, differently coloured to distinguish the initial situation from
the ideal one (Figs 7 & 8). As a
result, a digital model is created,
containing all the details to reach
a functional occlusion.
The first step in the process
of creating a customised bracket
is possible thanks to CAD/CAM
technology.11,12 The CAD/CAM
technique entails two phases:
the design phase (CAD) and the
manufacture phase (CAM),13 performed through computers that
send instructions to milling machines in order to create the endproduct.6 These machines work
either through removal (such as a
CNC cutter) or through addition—
stereolithography (SLA), 3-D print
or plastic materials/composites,
laser sintering (SLS) or laser fusion (SLF) of metal materials.
The elements that allow the
bracket customisation depend
on its base. The base is designed
through the CAD software and
placed on the centre of the dental surface. The software will
then allow us to customise the
bracket (Figs. 9 & 10). In designing the bracket, it is possible to
distinguish between a partial and
a complete customisation. The
first entails the customisation of
the size and shape of the bracket
portion facing the dental surface,
but features a standard angle in
the non-customisable portion of
the twin bracket. Complete customisation entails the additional
modification of the angle between the bracket base and the
twin portion. This is the ideal,
considering that the spatial parameter of the dental elements

About the author
Prof Giampietro Farronato
Institute for Clinical Orthodontics /
Clinical Orthodontic Institute
Via Commenda, 10
20122 Milan, Italy
giampietro.farronato@unimi.it

United Kingdom Edition

might vary according to the
different malocclusions.
Once the design phase has
been finalised, the brackets are
ready for manufacture by a milling machine. These machines,
which mill very small items, need
to be run in a standardised environment with maintained conditions to guarantee high precision
while minimising the possibility of
errors. Consequently, the higher
the precision required, the larger
the milling machine will be. It is
also necessary to place the machine in a dedicated environment
with a special floor cover with
amortising panels that stabilise
the cutter and partially absorb the
vibration produced.

Fig 6
Fig. 6_3-D rendering and selection of anatomic structures.

Moreover, a very small cutter
of approximately 0.001 mm needs
to be used. For example, considering that the smallest cutters can
remove up to 3 per cent of a millimetre each time, three to four
passes will be required to create
the mesh facing the tooth (Fig 11).
The technological progress
represented by CAD/CAM as described is based on the digital
design feature and the computerautomated manufac - turing process.14 The main advantages are
better control of the production
process and a significant reduction in operator-driven errors,
while enabling the use of sophisticated materials, such as Grade 5
titanium, which was not possible
with traditional techniques.15 DT
Fig 7

Editorial note: A list of references is available from the publisher.

Fig. 7_Pre- and post-treatment maxillary superimposition.

Fig 8

Fig 10

Fig. 8_Pre- and post-treatment mandibular superimposition.

Fig 9
Figs. 9 & 10_Customised bracket details.

Fig 11
Fig. 11_Bracket mesh.

October 29 - November 4, 2012

[25] =>

[26] =>

26 Comment

United Kingdom Edition

October 29 - November 4, 2012

Choosing the right people
Michael Sultan discusses the importance of staff

ment, and putting them fully at
taff are fundamental to any
ease.
business. This is especially
true in dentistry where
As anyone who has ever set
nursing staff in particular work
up their own business will ap“on the front line”, speaking and
1200116_iChiro_UK-A4_Mise en page 1 29.03.12 15:26 Page1
preciate, finding the right staff
interacting with patients, guidcan be a very difficult task, and
ing them through their treat-

even when you think you’ve
found the right person, sometimes it just doesn’t work out. In
these cases, it can often be just
as hard to get rid of team members as it can be to employ them
in the first place!

So, finding the right staff can
be a challenging process – one
made even more testing by the
time commitments we must
make to the general day-to-day
running of our practices. Of
course the solution is to make

Free iPad 3 WiFi
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Contra-angle.

sure we employ the right people
in the first place, but very often
this is not as easy as it may seem.
A part of the problem stems
from the fact CVs just don’t tell
us what we need to know. They
depict a very two-dimensional
view of a person, and are often
filled with the same phrases
(such as “team player”, “good
timekeeping”, “excellent organisation” etc) that make is
extremely tricky to distinguish
between candidates. And things
aren’t always made easier at
the interview stage either. Often
we will find we ask the wrong

‘Finding the right
staff can be a challenging process
– one made even
more testing by the
time commitments
we must make to
the general day-today running of our
practices’

questions, or aren’t able to sufficiently judge potential employees based on a short, and very
formal conversation.

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A4 Indesign.indd 1

10/09/2012 11:39

How then, are we supposed
to find out what people are really like?
Here at EndoCare, we’ve recently taken to asking candidates a
set of questions they might not
normally expect. Aside from all
the regular sorts of questions
you might field in an interview,
we’ve devised a few extras that
we think help us to learn a little more about the people who
want to come and work for us.
Naturally, these questions are all
“loaded” in a sense, but equally
they’re not designed to bring
about any kind of fixed response.
Ultimately, they help us build a
better picture of “who we’re really dealing with”, and hopefully,
they give candidates a similar
impression in turn.
One of the first questions we
like to ask is: “What did your
father do?” This isn’t a middleclass type of question designed
to judge a person’s background.
More it is a question designed
to shed light on a candidate’s
work ethic, and their general
approach to working life. For
example at EndoCare, we pride
ourselves on going the extra

[27] =>

United Kingdom Edition

mile for patients, and so we like
to employ people who share our
same ethic for work, whose parents may have imparted upon
them some sense of going beyond the normal hum-drum of
9–5. That’s why we’re always
interested to learn of candidates
whose parents may have worked
long hours – who may have demonstrated the need to go that little bit further to “get the job
done”.

October 29 - November 4, 2012

‘The conversation that emerges from the
questions “What did you want to be when
you were young?” really can shed some
interesting light on a person!’
empathy is absolutely critical.
That’s why at EndoCare we rate
empathy and warmth of feeling
as two of the most important
facets to any of our members of
staff.

Of course there’s no right
or wrong answer to any of our
questions, and even with the
last one the answer is never
going to be as simple as yes
or no. What these questions

Comment 27

do is give us an opportunity to
learn a little bit more about the
people we may potentially employ. Obviously these questions
won’t work for everyone as
each business is different, and
each dental practice will have
its own way of doing things.
At EndoCare for example, we
want genuine hard working,
aspirational people who are
fundamentally caring at heart,
and so we form our questions
appropriately.

So, when the time comes
around to find a new member of
staff, ask yourself, what are your
practice values? How do your
staff members reflect these values? Though these might seem
like simple points to consider,
they really do require an awful
lot of thought. After all, staff are
important – they are at the heart
of everything a dental practice
does – and for this reason, it pays
to choose your questions carefully! DT

Another question we like to
ask is, “What did you want to
be when you were young?” and
as a follow-up, “What did your
parents say?” As an employer,
naturally we look for a positive
attitude in our employees. We
are also looking for people who
demonstrate some sort of aspiration. Though I doubt many people can honestly say they wanted
to be a dentist, or a dental nurse
growing up, the responses we
tend to get are an interesting reflection on the people we’re interviewing. For example, those
with parents who would crush
their aspirations (even if they
wanted to be an astronaut!),
tend, in general, to be less aspirational as individuals and less
motivated to push themselves to
enhance their careers. Obviously there’s an element of generalisation here, but the conversation
that emerges from the questions
“What did you want to be when
you were young?” really can
shed some interesting light on a
person!
Our third and final question
we like to ask potential employees is, “Are you ‘touchy feely’?”
or the slightly more refined
question, “Are you a warm, empathetic person?” From experience, empathy and compassion
are two elements to a person’s
nature that just can’t be taught.
Either you’re a naturally warm
person, or you aren’t. There really isn’t an in-between here.
For someone working in the caring profession that is dentistry,

About the author
Dr Michael Sultan BDS MSc DFO
FICD is a Specialist
in Endodontics and
the Clinical Director of EndoCare.
Michael qualified
at Bristol University in 1986. He
worked as a general dental practitioner for 5 years before commencing specialist studies at
Guy’s hospital, London. He completed
his MSc in Endodontics in 1993 and
worked as an in-house Endodontist
in various practices before setting
up in Harley St, London in 2000. He
was admitted onto the specialist register in Endodontics in 1999 and has
lectured extensively to postgraduate
dental groups as well as lecturing on
Endodontic courses at Eastman CPD,
University of London. He has been involved with numerous dental groups
and has been chairman of the Alpha
Omega dental fraternity. In 2008 he
became clinical director of EndoCare,
a group of specialist practices.

honigum.
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For further information please call
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Or visit www.endocare.co.uk
* The Dental Advisor, Vol. 23, No. 3, p 2-5

AZM_Honigum_DeEnItFr_1203.indd 1

02.04.12 09:47

[28] =>

28 Industry News

United Kingdom Edition

View dry mouth in a new light at the
BSDHT Conference
GlaxoSmithKline Consumer Healthcare (GSK),
the makers of Biotène range of products, is
sponsoring a lecture at the annual BSDHT
conference in Liverpool next month with
the aim of raising awareness of how dental
hygienists and therapists can support their patients that suffer from xerostomia
(dry mouth). The lecture has been specifically developed for the conference by
dental hygienist Rhiannon Jones. Designed to include elements of interaction
using audience keypads, the presentation aims to cover both the prevalence
and causes of the condition. More specifically, Rhiannon will give insight into
the impact on the patient and the role of the dental hygienist and therapist in
discussing the condition and making simple suggestions to improve quality
of life. Dry mouth affects around 20% of the population and is especially
common in those taking 3 or more drugs. The Biotène range has been
developed specifically for people with dry mouth and can be recommended
for daily use. Biotène OralBalance Saliva Replacement Gel offers patients
long lasting dry mouth relief. Biotène Moisturising Mouthwash and Biotène
Fluoride Toothpaste offer gentle hygiene for dry mouths and are free from
sodium lauryl sulfate (SLS). The lecture is scheduled to take place as part of the
scientific programme on Friday the 9th November 2012 at 09.15 and 14.15 at
the ACC, Liverpool. BIOTÈNE is a registered trade mark of the GlaxoSmithKline
group of companies.

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ChairSafe Economy wipes should be used for daily
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These wipes have a sheet size of 24cm x 14.5cm
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economy wipes comply with the newly reclassified EC regulations regarding the
disinfection of medical devices, and carry their CE mark with pride! The Alcohol
Free disinfectant used with ChairSafe Economy wipes adsorbs and penetrates
into the cell wall of bacteria, fungi and the envelope of viruses. It attacks the
phospholipid membrane, altering its structure-causing disorganisation and
faults. Essential molecules begin to leak out from the cell rapidly reducing its
action and destroying them.

Dental Sky held a fund
raising
day
on
27th
September for Dentaid’s
Uganda
project.
With
the assistance of their
customers, the sales team
were able to raise money
by holding one of their
famous Vendor Day events.
Customers were offered
amazing deals on Dental
Sky’s own brand products;
R&S, Medibase, Clinix and Dento Viractis, and Carla Sutcliffe, the General
Manager, made a pledge that ten per cent of the promotion’s proceeds would
go directly to Dentaid to assist with their work in the rural villages of Uganda.
The atmosphere in the sales office was electric with support coming in from
the Dental Sky customers. Nathan Aris, the youngest member of the sales
team, said “I played a shocking round at the Dentaid Golf Day, so I’m only
too glad to redeem myself today by helping to raise money for the Uganda
project”. Andy Jong, Dentaid’s CEO, commented “Dental Sky has certainly
reached for the sky on behalf of Dentaid, raising a fantastic £2013 total from
their Dentaid Vendor day. Our thanks go to them and their customers. This gift
will make a life enhancing contribution to our oral health projects in Uganda,
chosen by the Dental Sky team to be the recipients of their support.”

Build your practice with WhiteWash
Professional Whitening Strips
For many years, trays have been the
simplest at-home whitening method –
but not any more! Now, with WhiteWash
Professional Whitening Strips patients
can take home their very own at-home
whitening system on the same day!
Created by a group of UK dentists
WhiteWash Professional Whitening Strips use a patented slow-release formula
that is both gentle and highly effective. Each strip contains the exact amount
of mint flavoured whitening gel that is needed to both evenly and effectively
whiten the teeth, while non-slip technology ensures maximum comfort and
safety. As a practice builder, WhiteWash Professional Whitening Strips are
excellent, and can be used in conjunction with regular tray whitening, or as a
“top up” to in-surgery power whitening. Because they offer excellent value for
money, WhiteWash Professional Whitening Strips are a good starting point for
patients who may not otherwise opt for whitening, and can lead to further
whitening treatments being adopted further down the line.

W&H for the latest in technological innovation and
unbeatable promotions
W&H were delighted to report a successful Showcase with
new exciting and innovative products being launched.
W&H launched the exciting new range of Synea Fusion
handpieces at this year’s Dental Showcase. Many dental
professionals took the opportunity of buying these new
high quality Synea Fusion handpieces at the amazing
introductory offer of half the normal retail price. The
award winning innovative Proface caries detection
system was also a popular exhibit which attracted a lot
of interest throughout the exhibition. As always many
attendees took the opportunity to visit the W&H stand
to view the current decontamination equipment range
and to discuss their requirements. There was interest
in the full decontamination equipment range and
especially the ThermoKlenz washer disinfector dryer.
The new affordable rental scheme with monthly fee allowed customers to see
how easy it can be to include HTM 01-05 compliant decontamination protocols
within their budgets. For more information about W&H products and services
including the current 3-months’ free rental offer on W&H decontamination
equipment, call 01727 874990 or contact your preferred W&H distributor. W&H.
People Have Priority. www.wh.com

25 Year Life Expectancy
How frustrating is it when one of your spot lights at home
goes, seemingly only a few months after it was last changed?
This scenario will not present itself in the surgery with the
new LED operating lights from Takara Belmont. They have
a life expectancy of 40,000 hours, which translated, means
around 25 years for the average user. Longevity is not its
only benefit. It is designed to reduce eye fatigue, by virtue
of its 5,000 Kelvin neutral white colour temperature, a feature
which also makes it ideal for colour matching. Flexibility of use is also ensured as
its intensity control can be adjusted between 4,000 and 32,000 LUX so that it can
effectively be customised to address the light conditions of individual treatment
rooms. Environmental considerations concern us all, and the new Belmont 900
Series LED Operating Light emits less heat and consumes less power, offering
an estimated 80% power saving over a traditional halogen bulb. Cross infection
matters have also been covered; the unit has a touchless sensor to turn the light
on/off as well as allowing the user to switch to a composite cure mode setting so
that you can work uninterrupted with composite-cure materials.

For information on the full range of Kemdent disinfectants, ChairSafe,
PracticeSafe, PracticeSafe Soak and InstrumentSafe visit the Kemdent website
www.kemdent.co.uk
For further information on special offers or to place orders call Helen on 01793
770256 or visit our website www.kemdent.co.uk. Issued by Belinda Mayoh –
Kemdent email belinda@kemdent.co.uk Tel: 01793 770256, Fax: 01793 772256
PR ref BJMOctCS Date; April 2012 Associated Dental Products Ltd. Kemdent
Works, Purton, Swindon, Wiltshire SN5 4HT.

To learn more about how your practice can benefit from this fantastic new
practice-builder, contact WhiteWash Laboratories today!
For more information call 0844 68 69 150, email
info@whitewashlaboratories.com, or visit www.whitewashstrips.com

As the 10 LED lights are encased in a one piece cover there’s no risk of dust or
mist build-up and the unit is easily cleaned. The Belmont 900 Series is available as
either a unit, ceiling or track mounted option. Having developed operating lights
for over 40 years the company is confident in the quality of their equipment and
therefore all units carry a 5 year warranty.

October 29 - November 4, 2012

A Christmas surprise from dbg
As a great big THANK YOU for being a dbg member, we
would like to offer you a special gift!
We’ve got a range of mouth-watering Christmas
hampers, ready for you when you place an order with
us by 19 December 2012.
• Spend £250 to receive a small hamper.
• Spend £500 and receive a medium hamper.
• Spend £1000 to receive a large hamper packed full of
all your favourite Christmas treats.
To take advantage of our fantastic Christmas surprise,
you will need to be quick! It’s first come first served, and
orders must be placed by 4:30pm on the 19 December.
We’ll dispatch all hampers on the day of your order, so
postal service permitting you will receive your gift before Christmas.
Merry Christmas and a Happy New Year from all the team at dbg!
For more information call dbg on 01606 861 950,
Or visit www.thedbg.co.uk/shop

Waterpik International
demonstrates exceptional oral
hygiene products at the BDTA.
As one of the largest and most
successful dental exhibitions in
the UK, the BDTA Dental Showcase
attracted many thousands of
visitors to the ExCel in London for
an extremely successful 3-day event.
One of the most prominent stands at
this year’s Dental Showcase was that run by Water Pik, Inc. – the company that
invented the Water Flosser, an innovative and highly effective alternative to
traditional floss. With models including the Waterpik® Nano™, Cordless Plus,
and Ultra Water Flosser, delegates were keen to witness the launch of two
brand new products: Waterpik® Complete Care and the Sensonic® Professional
Plus sonic toothbrush.
To celebrate the new product launches, Water Pik, Inc. hosted a special
giveaway competition while sharing with delegates the extensive research
supporting Waterpik® Water Flossers as part of a comprehensive oral hygiene
regime.
For more information please speak to your wholesaler or visit www.waterpik.
co.uk. Waterpik® products are widely available in Boots stores, Argos and
selected Lloyds Pharmacies.

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

For more information call 020 7515 0333.

No brainer offers
QuickWhite launched their
new QuickWhite Intenz
combined in-surgery 6%
hydrogen peroxide and
home
16%
carbamide
syringes kits to conform
to the new whitening
regulation. This is an add on to their famous competitive in-expensive
Quickwhite carbamide to boost up your surgery income, the teeth whitening
brand is well known for its effectiveness, fast whitening and as a manufacturer
the cost to you is down. They are the most economical kits sold in the market
starting from £24 per patient and supported by patients marketing
.
In addition, QuickLase have their NEW dentaLase Desktop lasers. The 3.5w
power at £2250 and the 8w PowerDesktop for £3980.
The Quicklase PowerPen cordless laser selling at special price of £1950. It is
half the price of its competitor, with 3 easy selectable customisable pre-sets.
Celebrating our 20th year serving dentistry with special offers, Call us on 01227
780009 for further information or visit www.QuickLase.com

NEW PermaCem 2.0
Special Introductory Offer!
To coincide with the launch of their NEW PermaCem
2.0 self-adhesive luting cement, DMG have introduced
a Special Offer Intro Kit containing a 9ml PermaCem
2.0 Smartmix Syringe and 5 mixing tips for just £ 55.00 plus vat. Available in
A2 Universal, A3 Opaque or Transparent shades the Intro Kit will be available
until 31st December 2012. DMG’s NEW PermaCem 2.0, which is perfect for
use with all crown and bridge restorations including zirconia-based allceramic restorations, was introduced because of the problems associated with
other cements. Zirconia-based all-ceramic restorations deliver the perfect
combination of aesthetics and reliability that patients expect. Until now,
however, clinicians have had to accept a compromise between reliable adhesion
and overall aesthetics. But, by launching PermaCem 2.0, DMG has introduced
a completely new generation of self-adhesive luting cement. This new selfadhesive cement provides outstanding adhesive strength to zirconia without
the need for separate etching and bonding steps. PermaCem 2.0’s special ‘Flow
2.0’ adhesive monomer formula enables superior natural self-adhesion without
the compromises associated with traditional permanent cements. PermaCem
2.0 achieves an exceptional adhesive strength to other materials as well. This
includes oxide and silicate ceramics as well as metals, composite restorations or
glass-fibre reinforced root posts. Its recently developed ‘Flow 2.0’ formula also
facilitates easy handling and incredibly simple excess removal.
Alternatively contact your local dental dealer or DMG Dental Products (UK) Ltd
on 01656 789401, fax 01656 360100,
email paulw@dmg-dental.co.uk or visit www.dmg-dental.com

Periproducts would like to thank
all the dental care professionals
that visited our stand at the BDTA
Dental Showcase
The BDTA Dental Showcase was
a huge success. The brand name
change, the updated pack design and the new UltraDEX products that have
joined the already highly recommended and successful range were very well
received: • UltraDEX Recalcifying & Whitening Toothpaste, dual powered by
SensiShield® and iQ+ ActiveOxi Technology™ • UltraDEX Wire-Free Interdental
Brushes coated with iQ+ ActiveOxi Technology, • UltraDEX® Anti-bacterial
Coated Interdental Tape, powered by Stabilised Chlorine Dioxide Developed,
used and recommended by dental care professionals and backed by extensive
scientific research, the UltraDEX® range (formerly known as RetarDEX) delivers
fresh breath confidence, whitening maintenance and exceptional oral health.
The clinically proven technology is antibacterial and works with the natural oral
pH level. It releases the appropriate amount of active ingredient to meet the
individual needs of each mouth. UltraDEX eliminates odour-causing Volatile
Sulphur Compounds (VSC) on contact, gently whitens teeth by lifting organic
stains and breaks down bacterial plaque biofilm. Bacteria cannot become
resistant and regrowth is inhibited. Our free verifiable CPD training sessions
and our personalised UltraDEX Oral Healthcare Kits/Trial Kits also picked up a
lot of interest. Periproducts would like to thank all the dental care professionals
that visited our stand at the BDTA Dental Showcase.
For further information please visit our website www.periproducts.co.uk or
email dental@periproducts.co.uk

[29] =>

United Kingdom Edition

“Hip grafts are the past, Zygomatic
implants are the future”
Earlier this year, over 100 delegates
from dental practices and laboratories
across the North of England came to
Mercedes Benz in Wakefield for an
evening course entitled ‘The End of
Full Dentures’. Facilitated by Nobel
Biocare, and featuring presentations by
Dr Sharif Khan and Dr Andrew Dawood,
the event examined the possibilities
created by use of Branemark System®
Zygoma implants with the innovative All-on-4TM solution. Delegates enjoyed
drinks, buffet and free CPD, as well as the opportunity to talk to delighted
patients who had received the treatment. “With zygomatic implants, patients
who previously were described as untreatable or in need of major intervention
such as bone grafting, are treatable,” says Dr Dawood. “Not only this, but they’re
treatable in one stage with immediate loading. They come in without teeth
and leave with teeth that same day.” “As far as we’re concerned,” says Dr Khan,
“hip grafts are the past, zygomatic implants are the future.” Dr Julie Burke, a
clinical lecturer in oral surgery and specialist in oral surgery at Leeds Dental
Institute, attended the evening. “I was sceptical about the title ‘the end of
dentures’ beforehand,” she says, “but I realised that dentures just can’t compare
to what can be provided by implant-retained bridges.” For more information
contact Nobel Biocare on 0208 756 3300 or visit www.nobelbiocare.com

EndoCare – exceptional
patient-centred care
At EndoCare we pride
ourselves on our caring,
patient-centred approach.
For us, maintaining the
health and satisfaction
of our patients is always
our number one priority,
alongside building excellent
relationships with all referring practices. As one of the UK’s leading Endodontic
referral centres, our team of highly skilled Specialist Endodontists are among
the leading names in their field, and are wholly dedicated to the diagnosis and
treatment of dental pain. Our outstanding patient-centred service really is
second to none, with the same high level of care available from any one of our
state-of-the-art practices located throughout London. Each one of our light,
airy and modern practices are designed to put patients fully at their ease, and
provide the best and most comfortable experience possible. We particularly
excel in treating anxious or dentally phobic patients, and are also more than
happy to take on complex or especially challenging cases. To learn more
about Endodontic referrals and how we can become a crucial member of your
practice team, call EndoCare today.

October 29 - November 4, 2012

Grahame Gardner enhance Urbane range
Grahame Gardner have enhanced their
phenomenally popular Urbane scrubwear
range with the addition of 9534, a new
longer length tunic. This flattering style of
tunic boasts the same high quality design
features as the rest of the Urbane range,
and is available in a wide selection of bold
colourways.
The Urbane Scrub range has become a firm
favourite of dental surgeries since it was
launched in the UK 6 years ago. The range
presents all the comfort associated with
scrubwear, but the unique designs also include side darts, contrast trims and
other desirable design features making Urbane a collection of distinction.
Grahame Gardner offer a number of scrub ranges, for further information please
call 0116 255 6326 or take a look at www.grahamegardner.co.uk.

All DF Exclusive™ websites feature:
• Modern, cutting-edge design.
• Mobile compatibility (including iPhone and iPad).
• “Hot buttons” including calls to action for more effective selling.
• Personalised content specific to your practice.
• Up-to-date, immersive treatment information.
• A unique practice blog that you can run from your practice (good for SEO).
• Full GDC compliance.
To help you make the most out of your DF Exclusive™ website, the experienced
Dental Focus team will guide you through every step of the process, working
closely with you to realise your practice vision in electronic form. The team will
also be able to guide you on the best ways in which to make the most our
of your website, and will optimise your content to help you achieve Page 1
Google Ranking for natural search. To learn more about how you can benefit
from a bespoke DF Exclusive™ website, contact the Dental Focus team today!
For more information call 020 7183 8388, or visit www.dentalfocus.com

dbg – catering for all your CPD needs
Time is running out for the completion of verifiable CPD
training during this current cycle. But don’t worry, there’s
still time to book and undertake the training you need if
you get in touch with us today!
Here at dbg we offer fully accredited training course on a
whole host of core subject including:
• Foreseeable Medical Emergencies
• Infection Prevention Control and Decontamination
• Basic Fire Safety Awareness/Fire Marshal
• Manual Handling, Dental Ergonomics and Working at
Heights
• COSHH & Legionella Awareness
• Dental Radiography & Radiation Protection
• Manual Handling & Ergonomics
Each of our training courses has been designed to be relevant and highly
engaging, and will keep you informed and up-to-date on all the latest
developments in dentistry.
To make things even easier for you we can conduct nearly all your training at
your own practice – that’s right, we’ll come to you! This means you don’t need
to worry about being away from your practice, or any unnecessary costs. With
dbg training courses, you can quite literally earn while you learn.
Book with us today and receive a massive 20% off our member course prices*.
That’s 20% off training and a whole weight off your mind! For more information
call dbg on 01606 861 950,
Or visit www.thedbg.co.uk *Terms and conditions apply.

Working in partnership with
dental professionals to provide
expert care
Johnson and Johnson is pleased
to introduce the first in a new expert range from LISTERINE® – a twice-daily
mouthwash built on potassium oxalate crystal technology that blocks dentine
tubules deeply for lasting protection from sensitivity.1,2
Advanced Defence Sensitive blocks 92% of dentine tubules in just 6 rinses in
vitro*3; over twice as many as Sensodyne® Rapid Relief and Colgate® Sensitive
Pro-ReliefTM p0.053. It is widely accepted that sensitivity pain arises from
exposed dentine tubules in response to everyday stimuli4 such as cold drinks.
Therefore, effective and robust blocking of dentine tubules offers the greatest
prospect for lasting relief of dentine hypersensitivity.5 Advanced Defence
Sensitive can be used alone for lasting protection2, or in combination with the
most recommended paste from the leading sensitivity brand, to significantly
increase the number of tubules the paste blocks in vitro.6,7 With the arrival
of Advanced Defence Sensitive mouthwash, Johnson and Johnson is looking
forward to working closely with dental professionals to deliver advanced
treatment outcomes for patients. Recommend Advanced Defence Sensitive
for expert care when you’re not there.
For further information on LISTERINE® Advanced Defence Sensitive, please
contact Johnson & Johnson on 0800 328 0750.

Diplomacy saves the
day with Roger Gullidge
Design
Tactful communication and
persuasive diplomacy from
Roger Gullidge, founder
of Roger Gullidge Design,
saved the day for Ajiaz Syed
when he was preparing
to launch Pearl Dental in
Streatham.

Diamond Temp LC
Diamond Temp is a one component
material, no mixing is required
and it can be used immediately
after the preparation of a cavity for
placement of a clean, temporary obturation. Its indications include application
in inlay/onlay technique.

“If it wasn’t for him the whole thing would have been a complete disaster” says
Ajiaz. “He was absolutely brilliant to work with, he listened to everything I said
to him and helped as far as possible with some ideas I had that I wanted to
implement in the practice.”

Diamond Temp can be cured in a time saving way, achieving a layer thickness
of 7.5mm in 20 seconds using a conventional halogen or LED light.
It has an elastic consistency to assure easy removal without the need of a drill.

When disagreements with building contractors threatened to derail the
development of the practice, Roger Gullidge stepped in to mediate, quickly
finding a resolution that all parties could accept.
“It helped me feel that I had regained complete control of the project, but
without Roger’s intervention the builders would probably have left,” say Ajiaz.

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

Grow your practice with a DF
Exclusive™ website
For over a decade the Dental Focus®
Web Design team have been creating
beautiful bespoke practice websites
that don’t just attract patients, they
convert them. Now, you can set your
practice apart from the competition
with your very own DR Exclusive™
website.

Industry News 29

Tight deadlines and shortage of space no
problem for The Dental Directory
The fitting and planning of two new surgeries
in one dental practice is always a challenge,
especially when shortage of space and tight
deadlines complicate matters. But The Dental
Directory is more than prepared to cope, says
Shirley Perry of Dawley Family Dental in Telford.
The practice had two surgeries fitted. The first
saw a former staff room, kitchen area and toilet
converted into a surgery/dental education suite to allow for increased education
and possible future expansion. The second was an existing surgery that needed
refurbishment and new equipment. “The planning and fitting of the surgeries
was done by Martin Gregory at The Dental Directory, and he was absolutely
brilliant,” says Shirley. “Literally, if you have a query about anything and you ring
him he will drop everything and be here. The service we have had from him has
been amazing.”
With a foundation dentist due to join the practice there were tight deadlines to
meet, something that The Dental Directory achieved without a problem.
For more information, contact The Dental Directory Equipment Department on
0800 585 585, or visit www.dental-directory.co.uk

In prolonged root treatment requiring more than one sitting Diamond Temp
provides a particularly good seal of the cavity and protects it from germinal
invasion.

Buy 2 syringes before the end of October to receive a 25% discount. Offer price
£34.37 plus VAT.

To take advantage of this special offer ring Helen on 01793 770090 or visit our
website www.kemdent.co.uk and follow us on twitter.com/kemdent.

Dentaid
The oral health charity, Dentaid, is constantly
looking for funding to support the unceasing
number of requests for help from projects
worldwide.
A recent pro
gression at Dentaid is the development of the
DentaidBox. Building on the success of Dentaid’s
portable chair we have now added a portable light
and suction unit. Along with an instrument kit and
pressure cooker for sterilisation everything fits into
a wheelie bin, making it a complete portable dental surgery. The first Dentaid
Box was donated to the charity Foodstep in Uganda by the Rotary Club of
Kyengera in March 2012.
At a cost of £1500, a DentaidBox will make possible basic oral care in low
resource settings, providing help to large numbers of individuals in a very
cost-effective way.
An exciting programme of fundraising events has been organised for 2013
including dental volunteering trips to Uganda and Morocco; Trekathons;
cycling, running and golf events for the energetic; or there is an A-Z of
fundraising ideas for the many Dentaid supporters who like to do their own
thing!
Dentaid can supply items to help you – posters. T-shirts, collection boxes,
balloons, sponsor forms – and friendly advice!

Curasept ADS®: Chlorhexidine Treatment
For All Patients
Oral health experts Curaprox have
capitalised on the antimicrobial properties of
Chlorhexidine (CHX) to create Curasept ADS®
(Anti Discolouration System) mouthwash.
Available in three strengths (0.2%, 0.12% and
0.05%), the CHX-based mouthwash is ideal for
most patients, including those with sensitivity
or who have recently undergone invasive
dental treatment. Recognised as one of the most effective treatments for
gingivitis, CHX successfully fights plaque and reduces inflammation, bleeding,
caries and bad breath.
Unfortunately, long-term use of CHX-based products can cause staining of the
teeth, a tingling sensation in the mouth and altered taste perception. However,
the unique formula of Curasept ADS® eliminates these unpleasant side effects
while preserving its antiseptic potency. Alcohol-free, the mouthwash is also
gentle on the mucous membranes while helping patients to achieve a clean and
healthy mouth.
The Curasept ADS® range of complementary products includes gel and SLS-free
toothpaste to take full advantage of the efficacy of CHX.
For free samples or for more information please call 01480 862084,
email info@curaprox.co.uk or visit www.curaprox.co.uk

It Doesn’t Have To Be A Right-Handed World
Patients won’t need any assistance navigating their
way into the new Compass Treatment Centre from
Takara Belmont; with a delivery unit that can rotate
behind the chair, it provides an easy and unobtrusive
welcome. Nurses will also benefit from this feature as it
provides the ideal position for essential clean and prep
work. The unique centrally mounted pivoting mechanism allows the Compass
to convert easily from right to left handed use in less than 90 seconds, without
the need for any tools! An ambidextrous unit is great for practices where a
room is shared, or for those who want the flexibility in the future. As well as
optimising efficiency and performance, the chair is designed to be relaxing
with an ergonomically designed lumbar support and double articulating
headrest to ensure patient comfort. The Compass also launches the new
comfort upholstery option, designed for those looking for a touch of luxury,
whilst the standard seamless option is ideal for hospitals and health authorities
where infection control is paramount. Flexible options are also available on
the Compass, it can be supplied as either ‘A’ air or ‘E’ electric specification and
can be ordered with or without the spittoon. Features include a removable
spittoon bowl with 180° rotation and independent arm-mounted vacuum
accessories. The Compass also benefits from Takara Belmont’s free 5 year
extended warranty, offering additional peace of mind when purchasing
capital equipment. Most practitioners work within a fairly restrictive physical
environment, isn’t it paramount then that the equipment you have works to
your advantage? To find out more about the Compass Treatment Centre from
Takara Belmont please call, without obligation, 020 7515 0333.

[30] =>

30 Editorial Board

United Kingdom Edition

October 29 - November 4, 2012

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

Vol. 2 • Issue 2/2012

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Impression techniques for Implant dentistry

| case study

Mr Amit Rai
BDS (Hons) MFGDP (UK) MJDF RCS Eng FHEA
General Dental Practitioner
DFT1 (VT) Programme Director, London Deanery
Sneha Gokhale- Gaikwad
BDS, MDS (INDIA)
Specialist in Periodontics and Implant Dentistry
Diploma in laser dentistry (Vienna, Austria)

Shaun Howe
RDH
Dental Hygienist

| user report

Mr Raj Rattan
Associate Dean, London Deanery

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

†

The Clinical Innovations Conference 2012

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

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

onArch® Crown . † T&C Apply

| event review

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 Stuart Jacobs
BDS MSD (U Ind)
Full-time Private Practitioner

e' compare to Stock prices*?

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

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

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

2012

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

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@healthcare-learning.com

| event

Publisher
Joe Aspis
Tel: 020 7400 8969
Joe@healthcare-learning
.com

Clinical Innovations Conference 2012

| 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@
healthcare-learning.com

Design & Production
Ellen Sawle
Tel: 020 7400 8970
ellen@healthcare-learning.
com

Editorial Assistant
Angharad Jones
Tel: 020 7400 8981
Angharad.jones@healthcarelearning.com

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

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28/06/2012 10:32
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[31] =>

United Kingdom Edition

October 29 - November 4, 2012

Classified 31

Whatever your management role.....
S P E C I A L I S T D E N TA L A C C O U N TA N T S

you can find a qualification to benefit you and your practice.
UMD Professional's range of qualification courses are
accredited by the Institute of Leadership and Management
and provide a practical management training pathway for
dentists, DCPs and practice managers.

Please contact:
Nick Ledingham BSc, FCA
Tel: 0151 348 8400

ILM Level 3 Certificate in
Management

Email: mail@moco.co.uk

designed for senior nurses and
receptionists and new managers
taking their first steps in management

Website: www.moco.co.uk/dentists

- Assistance with Buying & Setting Up Practices
- Tax Saving Advice for Associates and Principals
- Incorporation Advice
- NHS Contract Advice
- Particular Help for New Associates
- Help for Dentists from Overseas
- National Coverage
- We act for more than 650 Dentists

N SDAL
National Association of
Specialist Dental Accountants & Lawyers

N SDAL
National Association of
Specialist Dental Accountants & Lawyers

ILM Level 5 Diploma in
Management

Selling Your Practice?
N SDAL

for existing practice managers
and dentists

National Association of
Specialist Dental Accountants & Lawyers

ILM Level 7 Executive Diploma
in Management
for dentists and practice business
managers, and accredited by the
Faculty of General Dental Practice as
part of the FGDP Career Pathway

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

N SDAL
National Association of
Specialist Dental Accountants & Lawyers

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

For full details, course dates and venues contact Penny Parry on:
 020 8255 2070  penny@umdprofessional.co.uk

www.umdprofessional.co.uk
COURSE ANNOUNCEMENT

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 7th November 2012.
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) (worth £200)
• Receive complimentary editions of five ITI Treatment Guides (worth £350)
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

[32] =>

HELP PROTECT YOUR PATIENTS’
HEALTHY GUMS

NEW

NEW

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TWICE DAILY BRUSHING WITH
A FLUORIDE TOOTHPASTE

TWICE DAILY USE OF MOUTHWASH
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EFFECT ON PLAQUE1

INTERDENTAL CLEANING FOR
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THE CORSODYL DAILY RANGE OF PRODUCTS
NOW OFFERS EVEN MORE CHOICE FOR PATIENTS
WHO WISH TO MAINTAIN THEIR GUM HEALTH

RECOMMEND THE CORSODYL DAILY RANGE
Reference: 1. Claydon N et al. J Clin Perio 2002; 29: 1072-1077.
CORSODYL is a registered trade mark of the GlaxoSmithKline group of companies.

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[cover] => DT UK No. 25, 2012

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Table of contents

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