DT UK No. 29, 2012

News / The Minimally Invasive Dentistry Show! / What Does Your Facebook Page Say About You? / The dangers of “tunnel vision” in dentistry / Just one small change can be the start of something great / Why improving your practice is a mystery – part 14 / The Missing Business Plan / Local Healthwatch: what will it mean to you? / Posterior Composites in General Practice / Dentine hypersensitivity: Simplified / Industry News / Dental Tribune UK Editorial Board / Classified

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December 10-16, 2012

PUBLISHED IN LONDON
News in Brief
Dentist knocks down dog
walker
Kay Nolan, a dentist at Padiham Dental Practice near
Burnley, knocked down Stuart Mather whilst texting at
the wheel. She had pulled
into a layby to write the message, but only sent it once
she had set off again. The
collision occurred on June 6
in Higham, Lancashire. Mr
Mather was taken to hospital but later died, as did
his dog. Nolan has admitted
the charge of causing death
by careless or inconsiderate driving. She will be sentenced at Preston Crown
Court on December 17.
NHS Dental portal
NHS Dental Services is rolling out the NHS dental portal to all providers and performers. The new dental
portal, allowing dentists in
England and Wales secure
access to both contractual
information and the details
of their NHS activity, is now
live. Performers working in
primary care will be able
to view and download their
monthly pay statements
the moment they are produced rather than waiting
for them to arrive by post,
and check their superannuable contributions. The
portal also allows providers
to give staff and performers
full or partial access to contract information via the
portal.
Dentistry news programme
ITN Productions have announced it is producing a
news programme dedicated
to the dentistry profession,
which will be available to
view at the Dentistry Show
and online on ITN’s online
Healthcare News Channel.
The programme will feature interviews with industry-leading representatives
covering topics such as
direct access, the CPD cycle, and the latest industry
changes. “I am really excited to be working with ITN
Productions for The Dentistry Show next year” says
Lucy Pitt, Group Marketing
Manager at organiser CloserStill Media Healthcare.
“Key stakeholders will be
updating all concerned on
Direct Access which could
see a huge shift in the scope
of practice for DCPs, and
this together with general
industry trends and future
focuses from the trade will
be covered within this news
programme giving everyone a voice, and further
helping to cement The Dentistry Show on the map”.

www.dental-tribune.co.uk

News

£2.5 m makeover

Glasgow dental school gets
upgrade

page 4

VOL. 6 NO. 29

Clinical

White night

CRISIS fundraiser a success

page 6

Composite

Trevor Bigg gives an overview

Clinical

Dentine Hypersensitivity
Fay Goldstep looks at treatments

pages 25-27

pages 22-24

X-ray warning of
unsafe scanners

Handheld scanners found to be dangerously faulty
problems we immediately flagged
the issue with professional dental bodies, so they could tell their
members, notified the Department of Health; and also asked the
MHRA to consider taking action.

The Tianjie Dental Falcon Scanner

cut-price X-ray machine
thought to be being used
at some dental practices
has been found to be ‘potentially
lethal’.
This is according to a report
splashed across the front page of
last Monday’s (3 December) Daily
Mirror under the headline ‘Lethal
X-ray machine at dentists’, which
describes how a series of imported hand-held x-ray scanners
could be lethal to both users and
patients.
The Tianjie Dental Falcon
scanners, which are for sale on
various websites for as little as
£200, were tested at King’s College Hospital in London after the
Health Protection Agency (HPA)
raised concerns over the devices.
Richard Paynter, Deputy Director of the Health Protection Agency’s Centre for Radiation, Chemical and Environmental Hazards,
said: “One of HPA’s roles is to
give advice on the health effects
of radiation exposure. When we
became aware that these X-ray sets
were for sale on the internet our
Dental X-ray Protection Services
group bought and tested one.
“When we found the set posed

“We’re delighted that MHRA
is now taking such positive steps
to ensure public and occupational
protection from unnecessary radiation exposure.”
Donald Emerton, Clinical
Evaluator at King’s College Hospital said: “When we tested the Xray machine, we found it did not
properly protect either a potential
patient, or the person operating it.
“Over time someone operating this machine, such as a dental
assistant, would be exposed to unacceptable levels of accumulated
radiation and this would have an
increased risk to their health. I
certainly wouldn’t want someone
to use this piece of equipment to
take an X-ray of me.”
The scanners were found to
‘expose users and patients to 10
times the normal level of radiation
– dramatically increasing the risks
of cancer and organ damage’, said
the report in the Daily Mirror.
Investigators also found that the
scanners had botched wiring and
a lack of lead insulation to protect
patients and users against radiation leakage.
At least one dentist in the UK
is known to have used the device,
and many others have said to have
been interested in buying one.

Bruce Petrie, of the MHRA’s
Medical Devices Enforcement
Team, said: “It’s vital that dentists and dental staff do not buy
these dental X-ray machines
from eBay or other websites because they are not approved and
not safe for dentists or patients.
“We have seized 13 of these

X-ray machines from the distributor and we are working
with eBay and other governments to ensure dentists and
patients are protected. We urge
anyone who has bought one of
these machines to contact us on
the MHRA’s hotline on 020 3080
6701 or at counterfeit@mhra.
gsi.gov.uk” DT

[2] =>

2 News

United Kingdom Edition

December 10-16, 2012

Government crackdown on binge drinking

M

inisters are proposing a
minimum price of 45p
per unit of alcohol sold
in England and Wales as part of
a package of measures aimed at
reducing problem drinking and
its associated risks for health
and society as a whole.

Alcohol could see a minmum 45p per unit price

In addition to the introduction of minimum pricing, the
Home Office wants a ban on
multi-buy promotions, such as
two-for-one offers, and a new

health-related objective for alcohol licensing.
This latter measure would
mean
licensing
authorities
would be able to consider alcohol-related health harms when
managing problems relating to
the number of premises selling
alcohol in their area.
Damian Green, the government’s policing minister, commented: ‘The evidence is clear

- the availability of cheap alcohol
contributes to harmful levels of
drinking.
‘It can’t be right that it is possible to purchase a can of beer
for as little as 20p.’
Figures suggest that irresponsible drinking costs the taxpayer £21 billion per year, with
hospitals admitting 1.2 million
patients with alcohol-related
problems last year alone. DT

Australian example should be followed, charity urges

O

n Saturday 1 December, Australia became
the first country to
strip all tobacco products of
branding and replace them
with graphic health warnings
designed to reduce the number of tobacco-related deaths.
The new law means all
cigarettes will now be sold in
olive green packets containing graphic images warning of
the consequences of smoking,
legislation that organisers of

Mouth Cancer Action Month
believe should be enforced in
the UK.
The news comes on the final day of the campaign, and
is welcomed by Chief Executive of the British Dental
Health Foundation, Dr Nigel
Carter OBE.
Dr Carter said: “Any legislation designed to put people off smoking, particularly
young people taking up the

habit, is one the Foundation
fully supports.
“These
particular
images are extremely graphic.
If people continue to turn a
blind eye to the dangers posed
by smoking, they are putting themselves at real risk
from a number of diseases
and should see what damage
smoking does.” DT

Examples of the new packaging

Aspire Academy shapes ‘leaders of
tomorrow’ at The Dentistry Show
T
he all new ‘Aspire
Academy’ will be running its first conference for newly qualified dentists on Friday 1st March at the
2013 Dentistry Show.
Hosted by Raj Rattan, the
free to attend conference will
offer clinical and professional
insight into being a modern
dentist and a future prac-

tice owner, with presentations from Nilesh Parmar and
Prem-Pal Sehmi, Kevin Lewis,
Elaine Halley and Daz Singh.

to a discounted after dinner
ticket for the “The Big Heart
Party” in aid of Heart Your
Smile.

Five sessions, each with
a mini-ipad up for grabs, together with a host of online
content and offers from SmileOn will be available for delegates who attend, followed by
networking drinks and access

Dentists who qualified between 2007 and 2011 can register to access a free delegate
place at www.thedentistryshow.co.uk/aspire DT

Chair of Public Health England’s Advisory Board announced

P

rofessor David Heymann
has been confirmed as
Chair of Public Health
England’s Advisory Board.

He is currently Chairman of the Health Protection
Agency and in his new role
will
Chair
the
Advisory
Board that supports the Chief
Executive of Public Health
England in delivering its
mission to protect and improve the nation’s health,
address inequalities and improve the health of the poorest fastest.
Health Secretary Jeremy

Hunt said: “I am delighted to
confirm Professor David Heymann as Chair of Public Health
England’s Advisory Board.
He brings a wealth of experience to the role as a public
health scientist and doctor at
both national and international level.”
Professor David Heymann
said: “I feel very privileged to
be appointed as Chair of Public Health England’s Advisory
Board. Public Health England
offers an unrivalled opportunity to make a real difference
to the health and wellbeing of
the nation.

“I am looking forward
to continuing to work with
Duncan and his team and am
confident that we have the
expertise to support local government as they take on their
new responsibility for improving and protecting the public’s
health, as well as working in
partnership with the NHS and
other stakeholders locally and
nationally.”
Chief Executive of Public
Health England Duncan Selbie
said: “I am greatly looking forward to working with David
in pursuit of our mission and
ambition.”

Professor
Heymann
will take up post formally as
Chair of Public Health England’s Advisory Board on
1 April 2013, when Public
Health England becomes fully
operational. DT

David Heymann

[3] =>

United Kingdom Edition

Editorial comment

ell, here we
are... the last
Dental Tribune of 2012! My, how
time has flown this year.

We have seen a lot happen
this year – not only for the profession but at Dental Tribune as
well. One notable event for the

Preferred
CQC chair
announced

ollowing an open and
rigorous
recruitment
exercise, David Prior
has emerged as the Government’s preferred candidate
for the post of Chair of the
Care Quality Commission.
The Secretary of State for
Health has today invited the
Health Select Committee to
hold a public pre-appointment
scrutiny hearing and report
on the candidate’s suitability
for the post, in line with proposals for scrutiny of key positions in which Parliament has
an interest.
After a hearing, the Committee will set out its views
on the candidate’s suitability
for this post. The Secretary
of State will then consider
the conclusions of the Committee’s report carefully before deciding whether or not
to proceed with the appointment.
David Prior is Chairman
of Norfolk and Norwich University Hospitals Foundation
Trust and Chair of an Academy School. David qualified as
a barrister and spent ten years
in the Steel Industry. Between
1995-2002 he served in a number of political roles, including as MP for North Norfolk,
Deputy Chairman and Chief
Executive of the Conservative Party and a member of
the Trade and Industry Select Committee. He has been
Chair of a wide range of private companies. DT

David Prior

DT team was the British Dental
Editors’ Forum Young Writer of
the Year Award. This year our
very own Laura Hatton received
this accolade, the first time that
a non academic has won the
award. If you didn’t read her
now award-winning series on Sir
Harry Baldwin but would like to,
drop me an email and I’ll happily

News 3

December 10-16, 2012

send them to you.
We also saw the establishment of an editorial advisory
board. This collection of people
covering all sectors of the profession has been a great support for
the team at DT and I would like
to extend my thanks to them for
everything they’ve done this year.
in fact they were so good I intend
to work them harder next year!
I would also like to thank the

readers and advertisers who help
make DT happen. Without our
supporters, we would not be able
to produce Dental Tribune to the
quality and frequency that we do.
Without our readers, there would
be no-one to send it to. So my
heartfelt thanks!
So, all of us at DT
would like to wish you a
Merry Christmas and a
peaceful New Year. we
will see you in 2013! DT

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

[4] =>

4 News

United Kingdom Edition

December 10-16, 2012

Vitamin D could prevent tooth decay
the December issue of Nutrition Reviews, encompassed 24
controlled clinical trials, spanning the 1920s to the 1980s, on
approximately 3,000 children
in several countries.
“My main goal was to summarise the clinical trial database so that we could take a
fresh look at this vitamin D
question,” said Dr. Philippe
Hujoel of the University of
Washington, who conducted
the review.
Review shows the benefits of Vitamin D

new review shows that
vitamin D could help
prevent dental caries or

tooth decay.
The review, published in

The clinical trials he reviewed were conducted in the
United States, Great Britain,
Canada, Austria, New Zea-

land and Sweden. Trials were
conducted in institutional settings, schools, medical and
dental practices, or hospitals.
The subjects were children
or young adults between the
ages of two and 16 years, with
a weighted mean age of 10
years.

just a coincidence is open to
debate,” Hujoel said. “In the
meantime, pregnant women
or young mothers can do little harm by realising that vitamin D is essential to their
offspring’s health. Vitamin D
does lead to teeth and bones
that are better mineralised.”

The vitamin D question
takes on greater importance
in the light of current public
health trends. Vitamin D levels in many populations are
decreasing while dental caries levels in young children
are increasing.

Hujoel added a note of caution to his findings: “One has
to be careful with the interpretation of this systematic
review. The trials had weaknesses which could have biased the result, and most of
the trial participants lived in
an era that differs profoundly
from today’s environment.” DT

“Whether this is more than

Microcracks in jawbone can lead to stronger bones

recent article in the Journal of Oral Implantology
suggests that introducing
microcracks in the jawbone can
stimulate bone growth.

microcracks are created in the
jawbone. A biological response
then takes place: proteins, stem
cells, and other growth factors
work to regenerate the bone.

The article describes an
approach to oral implant surgery for patients with severely
atrophic jaws that stimulates
bone activation of the future implant location.

After 45 to 90 days, implant
surgery can take place. Solid
titanium disks are implanted
into the bone bed and covered
by biomaterial. A rigid, screwfixed prosthesis can then be
immediately loaded and become functional.

Dental patients with severely atrophic jaws have poor
quality and quantity of bone in
which to place an implant. Using the Osteotensor, a purposedesigned instrument, a series of

The authors of the article
report the case of a 74-yearold woman treated with this
technique after she declined

to undergo a bone grafting
procedure. Forty-five days
after microcracks induced
bone activation, the same Osteotensor instrument could
no longer penetrate bone at
23 of 42 impact sites. After 90
days, none of the sites could
be penetrated. Softer, type IV
bone had been transformed
to harder, type II bone, and it
was safe to proceed with implant surgery.
Two years later, the patient’s implants were osseointegrated, and the regenerated
bone had become functional
bone. DT

Glasgow Dental School
gets £2.5m makeover

The technique was used on a 74-year-old patient

Patients put off
dentist due to cost

media Facility in memory of the
late Professor Geddes, who was
a pioneering dental surgeon and
oral biologist and the first woman
to hold a professorship in dentistry
at a UK university.

Glasgow University tower

ental services and teaching at the Glasgow Dental
Hospital and School have
completed a £2.5m refurbishment
programme.
NHS Greater Glasgow and
Clyde (NHSGGC) have invested
almost £2m on a significant project to modernise the hospital’s
restorative dental clinics and expand the central instrument de-

contamination unit.
To complete the package of
enhancements at the hospital The
University of Glasgow have also
invested £500,000 in transforming
a traditional biochemistry laboratory into a multi-media teaching
facility.
The new teaching suite is to be
named the Dorothy Geddes Multi-

At a special event to officially
open the new facilities NHSGGC
Chairman Andrew Robertson
said: “The benefit of these investments will reach many thousands
of dental patients treated each
year. The newly refurbished and
expanded decontamination unit
will serve not only the dental hospital but also 17 community dental clinics in and around Glasgow
offering the very highest standard
of instrument decontamination
available.
The refurbishment includes
a newly expanded central decontamination unit, new restorative
dentistry clinics, a full 3D projection system, and a virtual microscopy suite. DT

Money is an issue for dental patients

ccording to a new survey,
almost one third of people
are putting off going to the
dentist because of the cost.
The survey, carried out on behalf of the Irish Dental Association, found that there has been an
increase in the number of patients
who wait until they experience
pain to visit a dentist.
Three quarters of dentists surveyed said they have seen an increase in the number of patients
who arrive at a surgery in pain
while 93 per cent of dentists have

seen a marked increase in the
number of extractions performed.
Significantly, 91 per cent of dentists have seen a decrease in patient attendance.
Dr Peter Gannon of the IDA
said the results were alarming.
“The simple preventive treatments that were available were
key to maintaining good dental
health for many people. It is worrying to see such problems so
soon and I am concerned that we
we are returning to the days of extractions and dentures” he said. DT

[5] =>

Aspire Academy - for tomorrow’s leaders
Friday 1st March at the Dentistry Show

Free to attend

www.thedentistryshow.co.uk/leaders
Offering newly qualified dentists a clinical and professional insight into being a
modern dentist and a future practice owner. If you qualified between 2007 and
2011 then this is for you - it’s what you don’t get taught at dental school.
• Free to attend
• Membership to the Aspire Academy
• A mini-ipad up for grabs in each of the 5 sessions
• A host of online content and special offers from Smile-on
• Networking drinks after the Show
• Discounted party ticket for the Heart Your Smile Ball
Hosted by Raj Rattan with presentations from Nilesh Parmar &
Prem-Pal Sehmi, Kevin Lewis, Elaine Halley and Daz Singh
Register for free by 18th January and book your place
alongside the leaders of tomorrow.
smile-on

healthcarelearning
inspiring better care

[6] =>

6 News

United Kingdom Edition

December 10-16, 2012

Lack of fixtures review could
drive down value of practice
C

hanges to the Capital
Allowances Act could
affect practice owners
wishing to sell up.
“You could benefit from a
tax refund now as well as laying important groundwork in
advance of selling your practice. The earlier one of these
claims is done the better because as well as a potential tax
refund, it provides additional capital allowances going
forward”,
said
NASDAL
member Nick Hancock of
specialist dental accountants

NASDAL’s Nick Hancock

Albert Goodman.

tal allowance position.

Until now, he explained,
the ‘qualifying fixtures’ have
normally been left as part of
the freehold acquisition price.
For a commercial property being sold after 5 April 2014, one
of these reviews must be undertaken as part of the sales
process. After that date, the
vendor and the purchaser will
need to specifically agree the
sales price of those fixtures,
usually by making a joint election under Section 198 of the
CAA 2001 to achieve the capi-

Failure to carry out a fixtures review could drive down
the value of the practice. Nick
explained: “If qualifying assets
are not identified with a Section 198 election being agreed,
then effectively the buyer and
all subsequent owners will
have no opportunity to make
a capital allowance claim on
qualifying fixtures going forward. This could well have a
detrimental effect on the sale
proceeds figure when you try
and sell your property.” DT

All change for Careers Day 2013

A

number of new features including a CV
clinic, business room
and hands-on demonstrations
will be on offer alongside
the regular mix of practical
advice, lectures, and exhibition at next year’s BDA UCL
Eastman Careers Day, the
newly-published programme
reveals.
The annual event, which
takes place on 8 February at
London’s Hotel Russell, gives
young dentists the chance to

explore a range of career options and specialisms. Each
of the eight rooms at the
event will offer a full programme centred around a
particular theme such as
general practice, specialities,
business and finance, experience building, and hospitals
and special care.

their ORE exam and a dedicated hands-on demonstration
programme where a range of
experts will demonstrate new
clinical techniques on phantom head simulators. There
will also be a dedicated CV
Clinic offering delegates the
chance to get one-to-one advice with the speakers.

For the first time in 2013
the day will also include a
special programme of guidance sessions for those who
are studying or have passed

There will also be a panel
discussion looking at the organisation of dentistry in the
future. The panel will include
Chief Dental Office Barry

Tooth agenesis linked to
family history of cancer

I

ndividuals
with
tooth
agenesis have an increased risk of having a
family history of cancer, a new
study in the Journal of Dental
Research has found.
Researchers from the University of Pittsburgh School of
Dental Medicine recruited 82
individuals and 328 individuals with no birth defect from
the same institution to carry
out the study.
Tooth
agenesis
was
assessed in permanent teeth

Cockcroft alongside Professor
Andrew Eder, Professor of Restorative Dentistry and Dental Education at the Eastman
Dental Institute, Elizabeth
Jones, Dean of Postgraduate Dentistry for the London
Deanery, and Peter Ward,
Chief Executive at the BDA.
The discussion will be chaired
by Dr Judith Husband, Chair
of Education and Ethics for
the BDA’s Principal Executive
Committee.
Speaking

ahead

of

the

event, Dr Judith Husband,
said: ‘Those starting out on
their career in dentistry will
find, at the Careers Day, everything they need to help them
take those essential first steps.
I am pleased that we are once
again working with the UCL
Eastman Dental Institute to
host this event.’
A full programme for
the day and booking information is available on the dedicated event page on the BDA
website. DT

White night for CRISIS

M

embers of the dental
community
braved
the cold to gather for
a fundraiser with a difference!
Aptly
named
the
Ice
White party, the event saw
more than 200 guests come together at the swanky Holborn
House club in central London for an evening of dancing
and entertainment to raise
money for the homeless charity CRISIS.

and was defined based on the
age of the participants and
when initial tooth formation
should be radiographically
visible.
The results showed that individuals with tooth agenesis
had an increased risk of having a family history of cancer
(p = 0.00006). Despite this, the
researchers concluded that
prospective studies are needed to confirm if tooth agenesis
can be used as a risk marker
for cancer. DT

Organiser of the event,
dentist Nilesh R Parmar commented: “The Ice White party
was a huge success and I am
overwhelmed by the support
of the entire dental community. It was an overwhelming
event to organise but with
help from Louise (Manan
Ltd) and Raj Bhandot (owner
of the club Holborn House),
we were able to really impress our guests. So far we
have raised £3,261 for CRISIS
with donations coming in
through the justgiving page

All white for CRISIS

on a daily basis. I would like
to thank all my sponsors for
their financial support and
help with the Ice White party,
and look forward to working
with them again next year!”

To donate to CRISIS via the
Ice White page, go to www.
justgiving.com/theice-whitexmasparty. DT

[7] =>

United Kingdom Edition

News

December 10-16, 2012

Wrigley oral healthcare programme
appoints new global manager
Kent as the new Global Manager. Wrigley has hired the senior
health comms specialist to drive
the further development of the
Programme which is focused
on helping dental care professionals and patients better understand the role of sugarfree
gum in their oral care routine.
Matthew will be based in Wrigley’s UK headquarters putting
the spotlight on the UK as leading the way in better oral health.
WOHP operates in 47 countries
around the world and is grounded in more than two decades of
clinical research.
Matthew Kent

he Wrigley Oral Healthcare Programme (WOHP)
has appointed Matthew

Matthew has a wealth of experience in both the UK and
internationally. Previously Associate Director of London-based

healthcare agency 90TEN, Matthew was responsible for delivering innovative solutions in public
relations, medical education and
treatment adherence through
smart healthcare communications with a creative edge. Prior
to 90TEN, Matthew held a senior position at Tonic Life Communications in New York where
he specialised in delivering high
impact programmes for brands
and companies in pharmaceutical and consumer health.
Commenting on the appointment Louisa Rowntree, Communications Manager of the UK
Oral Health Programme, said:
“Matthew has great strategic
and planning skills coupled with
a track record of delivering well

executed healthcare communications. His international background will be key to delivering
the Programme’s oral health
messages globally as well as promoting the great work the Programme is doing in the UK.”
Matthew added: “This is an
exciting time for Wrigley in
oral care and I’m delighted to
be driving the global Wrigley
Oral Healthcare Programme
from here in the UK. Much
of what happens in the UK
informs and inspires our activities across the world, from
educational resources to public policy outreach. I’m looking forward to providing new
creative and strategic insight,
to further engage dental pro-

fessionals and their patients on
the benefits of chewing sugarfree gum as part of an oral care
routine.”
The benefits of chewing
sugarfree gum are well documented and it is a clinically
proven way to look after oral
health whilst ‘on the go’. The
science behind chewing is simple - chewing sugarfree gum
after eating and drinking stimulates the flow of saliva which
washes away food debris, helps
neutralises damaging plaque
acids and remineralises tooth
enamel. The proven benefits
of chewing sugarfree gum provide a strong reason for dental professionals to recommend
chewing to their patients. DT

IDH to launch dental academy
I

ntegrated Dental Holdings (IDH) has announced
the creation of a Dental
Academy, providing leading
edge clinical training for its
dentists, which will launch in
Spring 2013.
The vision behind the
Dental Academy is to deliver world-class training programmes initially for IDH
staff, as part of IDH’s commitment to the development of its
people and the highest standards of dental care across the
UK. Once established, The
Academy will also open its
doors to the wider profession
and offer high-quality devel-

opment for non-IDH dentists.
The state of the art facility and training centre will be
based in Manchester, and include a fully functioning dental practice offering both NHS
and private dentistry. The facility will have lecture rooms,
seminar rooms and surgeries equipped to demonstrate
treatments. This will include
decontamination
treatment
facilities, radiography training facilities and a phantomhead room.
All forms of training
are there to up-skill dentists
so they can provide more
complex
treatments
and

will also cover their general
CPD* as well as nurse, hygienist and therapist training. Both hands-on and web
based teaching methods will
be available.

tomers. Our ambition is for
The Academy to improve the

standard of dental practice in
the UK.” DT

Richard Smith, CEO at
IDH says, “Dentistry is a rapidly changing industry in the
UK, developments in preventative care and cosmetic solutions have increased the industry’s need for an enhanced
skill mix from dentists. As
the largest employer of dentists and practice staff in the
UK the Academy is our way
of responding to the changing needs of our staff and cus-

ADI appoints official DCP Committee Member

Denplan Announces
New Life Presidents T

ollowing its acquisition
by Simplyhealth, Denplan
has announced that its
former Chairman, David Phillips and former Non-Executive
Director, Meredyth Bell, have
accepted roles as Life Presidents
at Denplan.

The Life President role
has been created to recognise
David and Meredyth’s commitment to Denplan over the
years and their ongoing involvement and support for the dental
profession.
Denplan Managing Director,
Steve Gates commented: “I’m
thrilled that we have been able
to secure the services of Da-

vid and Meredyth. In their new
roles as Life Presidents they will
continue to play a key role in a
number of Denplan activities
and remain ambassadors for the
business. They have both been
instrumental in the success of
Denplan and their ongoing experience and input will continue to
be warmly received, alongside
our other expert advisors.” DT

he
Association
of
Dental
Implantology (ADI) has elected
Juliette Reeves as their first
official Dental Care Professional Committee Member.
Juliette, a hygienist, will
represent dental care professional (DCP) members on
the ADI Committee over the
next two years, as announced
at the ADI’s annual general
meeting on Monday 19 November.

L-R David Phillips and Meredyth Bell

The
ADI
Committee,
which comprises 15 clinicians
and one technician representative from around the
UK, meets on a quarterly basis to direct the future of
the organisation on behalf
of its 2,000 members. Juliette will be involved in liais-

ing with and representing the
ADI’s DCP members, ensuring that their interests are
being met.

of implant dentistry develops
and the number of implant
placements increases, it is
critical that the dental team
also progresses.” DT

Juliette is a successful
hygienist
and
nutritionist
with more than 30 years’ experience. Her main areas of
interest are nutritional influences in periodontal disease, stress and bone density.
Juliette
has
received
training in implant maintenance from master class
academies in Geneva, Liechtenstein and more recently in
the US.
Juliette says, “I am delighted to have been given the
opportunity to work with the
ADI Committee on behalf of
my fellow DCP’s. As the field

Juliette Reeves

[8] =>

8 MSc Blog

United Kingdom Edition

December 10-16, 2012

The Minimally Invasive Dentistry Show!
Ken Harris talks MI and the MSc in Restorative and Aesthetic Dentistry

he media and certain
groups within our own
profession seem intent
upon exposing “the unpleasant and unacceptable face of
cosmetic dentistry” to para-

phrase our former premier,
Ted Heath.
The media have been on
this tack since the dawn of
time (or at least the dawn of

the TIMES) and it goes something like this. Dentist butchers perfectly healthy teeth
in the name of cosmetic improvement, shock horror!!!

The profession responds
with alarm and a new philosophy is hastily trotted out
to pacify the indignant Daily
Mail readership. Atraumatic
extraction anybody? Perhaps a

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no-prep veneer?
Yes folks, it’s the Minimally
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art of fighting without fighting. A very laudable ideal, but
many of us actually practice
“Realistic Dentistry” driven
by real patients who demand
real results and not some
faddish, here today, gone tomorrow solution. Furthermore many patients (at least
my patients) just want their
teeth to look good, and are not
too concerned about how it
happens.
However,
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e base
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covered, check. We know our
Carbamides from our pure
peroxides, check. Even internal bleaching of single teeth
has been blitzed, checkitty
check!! That should hit any
media objections clear out of
the park, surely?
Now don’t get me wrong,
tooth bleaching should be the
first offering of any self-respecting dentist when the evil
cosmetic dental devil comes acallin’, but it will not straighten teeth or replace lost tooth
tissue … which is where it all
gets a little messy.
Let’s quickly rewind back
to the heady days of spring
when our anterior aesthetics module began. As well

[9] =>

United Kingdom Edition

as
tooth
whitening,
we
have also touched upon the
minimally
invasive
miracle that is “rapid orthodontics” (another fashionable,
fad?). On a more traditional
note, we have been lifted to
celestial heights of ecstasy
watching the prodigiously
gifted Dr Gregory Brambilla in
action. I would suggest there
are few better exponents of
the art of direct resin, and we
are so fortunate to have him
lead the direct composite resin module.
The latest minimally invasive offering, the concept of
“Pragmatic Aesthetics” was
also introduced during this
module by the ever likeable
Professor Trevor Burke, but I
do wonder just where we are
allowed to draw the line with
“pragmatic”. I’m equally not
convinced my patients would
compromise aesthetics for
tooth preservation to the degree as was suggested. Furthermore, it takes real skill
to convincingly rebuild teeth
with composite resin, and I’m
sure Trevor would agree he’s
no Gregory Brambilla, I know
I’m not.
Equally, boiling down aesthetic dentistry to just sticking bits of composite to teeth,
admirable though it is, seems
just a teensy bit reductive
I feel, and a truly excellent
module concerning the restoration of root filled teeth suggests a tacit agreement by our
tutors that we should not put
our drills away just yet.
However, for now we have
been asked to demonstrate
just our minimally invasive
credentials by providing two
simple aesthetic case reports
to test our progress. As a card
carrying Manchester University student, I was looking forward to the traditional long
summer break, and we were
duly rewarded for all our hard
work with all of August off;
hurrah for the holidays!! The
holiday smile was soon wiped
from my face however, when
the case report deadline was

announced as early September; hold the Ambre Solaire!
Nothing too complex said
our tutors; it’s not about showing off, but more about learning your limitations, Hmmmmm! My first case involved
whitening and direct composite resin to restore a traumatised upper central incisor.
Think I managed that one
OK (thank you Dr Brambilla).
The other, a case of replacing

MSc Blog

December 10-16, 2012

two old PFM crowns with all
ceramic alternatives. Unfortunately case reports are not
as simple as they sound when
you have to back up your decision making with academic
references from the literature. I guess that’s what being
an academic is really about,
and why I am doing the MSc
after all.
Fast forward to an early
September evening in London

with the lethargic city nursing
a post-Olympic hangover; it’s
the eve of our second residential course. Speaking of hangovers, many of us are meeting
at a local hostelry to trade MSc
stories and reignite old friendships. This is what the MSc is
really about, socialising with
like–minded colleagues.
However, when the child of
morning, rosy-fingered Dawn,
appears we begin four days of

intense teaching starting with
the excellent Professor Burke
on posterior aesthetics followed by two whole days with
the awe-inspiring Prof Nasser
Barghi keeping the Anterior
end up. Bring it on!
I’ve just discovered there
is also the little matter of another essay, and this time it’s
a big one. A whopping 2,500
words is required. I’m hiding
behind the settee!! DT

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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.

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[10] =>

10 Social Media

United Kingdom Edition

December 10-16, 2012

What Does Your Facebook Page Say About You?
Rita Zamora urges practices to look at their Facebook page

hat is the personality of your Facebook
Business Page? Is it
friendly, fun, positive, cheerful, inspiring, serious, gross,
depressing, or boring? Whether
you set an intention for what

you want your Page to deliver-or
not-at some point it will say a lot
about you.
If one of your goals is to keep
your practice name and face in
front of patients and potential

So, think twice the next time
you want to post a nasty periodontal mouth photo, root canal video, or bare implant abutment. While we in the dental
industry may find that fascinating, for the most part the gen-

new patients, consider what
most people want from Facebook. There is no dislike button
for a reason. People are socializing, liking things, and sharing
meaningful photos with friends,
family and colleagues.

Call us on +44 (0)151 342 0410 Advanced Dental Education

Core Curriculum Series 2012/13 UK
21⁄2 Day Lecture & Hands On
with Dr Ian Buckle 23hrs CPD: £1995+VAT for each module

20 LIM
DE IT
LE ED
GA TO
TE
S

Lecture & Hands On

Call us on +44 (0)151 342 0410 Advanced Dental Education

Autumn-Winter 2012/13

Date

Wirral

Module 2 Treatment Planning,
Functional Aesthetic Excellence

Sept 27th - 29th

London

Module 3 The Art & Science of Equilibration

Nov 29th - Dec 1st Wirral

Module 4 Restoring Anterior Teeth

Jan 31st - Feb 2nd Wirral

Occlusion & Aesthetics

“Thank you for your time and your
passion is inspirational, I genuinely feel
privileged to have attended .”
Mark Durnall Cornwall

“Since doing the courses
skills Academy
have improved
“Themy
Dawson
UK has
made
a massive
difference
beyond my expectations
- uptake
of work
and to how
I doincreased
my dentistrymassively.”
making it now
therefore my income has
Tim Earl East Sussex
Ian Buckle (BDS)

completely predictable.”nnegan Belfast
Greg Finnegan Belfast

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

An Introduction
SEMINAR
LIVE DEMO
Special
offer - 10% to
offOcclusion,
Comprehensive ExaminationVENUE
& Records Oct
18th-20th
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8.30am-5pm
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Function & Comprehensive Dentistry
Przemek Popielarek Ireland

Treatment Planning
A career path change and discovering my passion
“ Dentistry
Comprehensive
This
seminar is recommended either as a stand
alone lecture or as

1 Day Seminar With Dr. Ian Buckle £195+VAT 6hrs CPDoffer ends Sept 21st 2012Manchester
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⁄2 Day Live Demo (Max 12 People) £190+VAT 4hrs CPD
London Heathrow
Manchester | London | Leicester | Edinburgh
Leicester

Jun 15th 2012

Jun 16th 2012

Sep 21st 2012

Sep 22nd 2012

Oct 5th 2012

Oct 6th 2012

My first experience of the Dawson academy was Edinburgh
a BDA lecture in Birmingham,
where
met3rd
Ian2012
Nov 2nd
2012I firstNov

an introduction to The Dawson Academy
Curriculum
Series.
BuckleCore
and was
impressed with
both his knowledge and enthusiasm. I had studied previously under well

(Part of The Dawsonrespected
Academy
Core Curriculum)
speakers, Bill Comcowicz and Roy Higson, so my knowledge of occlusion was already at a
For further
information on this introductory
course, basic
1
level. Core Curriculum of learning and team events, please contact:
⁄2 Day
Hands On +44respectable
2info@bdseminars.com
Ian Buckle (BDS)
(0)151 342 0410
www.bdseminars.com
The Dawson Academy UK | Hilltop Court | Thornton
Common
Road
| Thornton
Hough
| Wirralvery
| CH63
| UK
The Dawson
academy
however
brought
something
new4JT
to my
career progression. In 2009
with Dr Ian Buckle 19hrs
CPD:
£1695+VAT
“The Dawson Academy UK has made a massive
WIRRAL THE DAWSON CENTRE UK
Wirral,
Merseyside
Moiz
Mohammed
Principal
July
12
-14
2012
BDS(UBrist)
Extensive experience in restorative dentistry with over 10 years of
specialised postgraduate training on all
cosmetic and reconstructive aspects
of dentistry. He continues to lecture on
Cosmetic dentistry and has completed
the prestigious Dawson academy foundation course ,based in St Petersberg.
He is a member of numerous organisations which focus on stable and functional aesthetic outcomes.

I undertook the first set of four modules for the coredifference
curriculum
and found that importantly all the
to how I do my dentistry making it now
fragmented
piecesUK
of knowledge that I had were able
to come
together so that I could finally start to
completely
predictable.”
LONDON
Gregpractice.
Finnegan Belfast
implement the concepts of complete dentistry into the
The course offers a pragmatic and
Heathrow, London UK
systematic approach from carrying out a comprehensive
examination
through together.”
to treatment planning and
“The glue
that sticks dentistry
September 27 – 29 2012
Sean Corry
Magherafelt
implementation. From 2010 onwards I have successfully
completed
a significant number of cases, from
full mouth rehabilitations to complex implant work.
To change a career path is no easy task. Having worked for many years I struggled to apply the principles

LEARNING OBJECTIVES
This course providesthatthe
participant
I had learnt.
Focusing on the approach of a systematic diagnosis and treatment plan I began to
Establish
step-by-step
process
for treatment
planning
my treatment decision making in a different
way. Iaused
the three
dimensional
approaches
with a programmedapproach
approach
to
any restorative case, from the simplest to the most complex.
taught by Dr Buckle and started to visualise and create plans in the diagnostic wax up phase myself
emphasis will be placed on the four options of
rather than planning,
expect a technician toyou
guess where theSpecial
teeth should
go and what they should look like.
diagnosis and treatment
treatment (reshaping, repositioning, restoring and surgical
This alone improves clinical and diagnostic skills and
coupled with the additional modules of anterior
correction).
will discover how torestoration
visualise
optimum
and equilibration
helps to make important
treatment making decisions in the planning phase
Explore why 90% of mistakes occur not during the restorative
rather than start treatment with no concept of how phase,
it will concludean unfortunate
errorplanning
many ofprocess.
our
but rather during
the treatment
dentistry from an aesthetic,
functional,
profession have made and are still making.
Plan and visualise ideal aesthetics and ideal function.
At
this
transitional
time,
Dr
Buckle
is
there
to
help.
He encourages bringing models and helping with the
biological and structural perspective.
Design programmed treatment planning processes and

treatment making decisions, while always insistingintegrate
that the into
all the
records
are as accurate as possible.
your
practice.
Special emphasis will be placed onPoor
therecords
four options
treatment
mean allof
further
stages are compromised. Unlike many of the restorative gurus out there, Dr
Discover the need for/value of quality records.
is always approachable.
(reshaping, repositioning, restoringBuckle
and surgical
correction), so
Master the 16 functional and esthetic components of
that the correct option(s) are chosen for each patient. Additionally,
healthy, functionally correct dentition.
This course
truly changed
my practicing
career and I am now doing the kind of dentistry I could only
each student will learn how to segment
largehas
treatment
plans,
so
Investigate how the teeth should be positioned in space for
have imagined a few years before. I have since gone
on to the advanced set of modules and slowly have
optimum aesthetics, phonetics and function.
that patients with financial issues can receive optimum care over
gained the confidence to tackle complex and difficult cases.
Identify specifically how to utilise the diagnostic photographs
time. The focus of the programme is to integrate a comprehensive
in conjunction with mounted diagnostic models to visualise
treatment planning process into their
practice. Suggestions
will
The Philosophy
of the Dawson approach
really emanates
fromcourse
PeterofDawson
himself, possibly the most
an optimum
treatment.
also be made on creating time andimportant
a placefigure
for optimum
treatment
in the advancement
of complete dentistry,
and Ian Buckle,
along
with
Johnoptimum
Cranham,
Create a segmented
treatment
plan
so that
care
can name
be delivered
a longer
period
time.
Glenn Dupont,
Wilkinson
Andrew Cobb(to
a few)over
have
brought
thisofphilosophy
forward.
planning. Finally, a consultation process
will beDewitt
discussed
inand
detail,
They
teach withcase
a passion
and desire
to spread their
knowledge
asaPeter
would
have wished
Creating
time and
place Dawson
for treatment
planning.
ensuring each participant will enjoy
a healthy
acceptance
rate.
when the academy was first set up.

“

For further information on this introductory course, basic Core Curriculum of learning and team events, please contact:
info@bdseminars.com

‘While social media
is a newer communication tool,
an important old
rule of business still
applies—people do
business with people they like’

traditional and online forms
of information to learn about
businesses in depth. Not only
will potential new patients visit
your website, they will also
likely want to watch videos
about you, read reviews, and
see what Facebook has to show
about you.
While social media is a newer communication tool, an important old rule of business still
applies—people do business
with people they like. What are
you passionate about? Do you
support a specific non-profit
organisation? Do you enjoy biking? Have a love for family road
trips with your kids? Fancy riding horses? Or perhaps you like
to read motivational books?
Chances are some of your patients share similar interests.
These hobbies or interests can
all serve as pathways to connect with others.
Consider a commitment to
follow an 80/20 guideline in
which 80 per cent of the time
you are posting things to help
grow relationships. Let people

+44 (0)151 342 0410

bd_2482_irish-2-aw3.indd 1

Take a look at your Page
right now. What sort of photos
do people see when they visit?
Are there smiling faces, pictures of real people, and pleasant or interesting things to look
at? If your Page is dominated by
clinical information and photos of teeth, hopefully you are
catering to a clinical audience.
The good news is you can easily change your posting strategy
and makeover your Page at any
time.
If you are interested in making genuine connections with
patients and potential new patients in social media, you will
need to get comfortable sharing some personality. Why?
According to Google research
(zeromomentoftruth.com) people are visiting on average ten

Venue

Module 1 Comprehensive Examination & Records Oct 18th - 20th

eral consumer does not.

02/03/2012 09:17

[11] =>

United Kingdom Edition

get to know you via photos or
links to the non-profit you support or hobbies you or your
team enjoy. Then 20 per cent
of the time you can post away
about dentistry. Let others get
to know, trust, and like you and
your team by stretching a bit
outside of your comfort zone.
If you find your temptation to
sell dentistry overwhelming,
consider a Facebook ad. The
great thing about social media
is you don’t have to commit to
anything long term. Explore
some new ideas and see how
they work.
When it comes to making
emotional connections with
people, there is no greater opportunity than with your Facebook cover photo. One of the
biggest visual additions of the
2012 Timeline redesign was
that of the cover photo. The
cover photo is the landscape at
the top of your Facebook Business Page. It is the first and
most powerful message you
share about your practice. And
it’s your best opportunity to immediately emotionally connect
with visitors.
Facebook
recommends
your cover photo tell a story
about your practice. Note:
let your cover photo tell your
story literally means illustrate
your story—with photographs,
not text. Let a rich and engaging photograph illustrate what
your practice is all about. Some
practices create graphics and
add text details like the doctor’s
name, practice name, or some
of the same information that is
already located in the page title or “About” section located
immediately below their cover
photo. Perplexing why some
clutter up a great photo with
redundant text.
Most importantly, many
practices are unaware of Facebook terms regarding cover
photos. Below is an excerpt:
Section B of Facebook Pages
Terms: Cover
All covers are public. This
means that anyone who visits
your page will be able to see
your cover. Covers can’t be deceptive, misleading, or infringe
on anyone else’s copyright. You

About the author
Rita Zamora is an
international
social media marketing consultant and
speaker. She and
her team actively
co-manage dozens
of dental practices’
social media programs. Her clients
are located across the United States
and internationally. She has been
published in many professional publications. Rita is also Honorary Vice
President to the British Dental Practice Managers Association.
Learn
more at www.DentalRelationshipMarketing.com or email rita@ritazamora.
com.

Social Media 11

December 10-16, 2012

iv. calls to action, such as “get it
now” or “tell your friends.”

that best represents your practice. Your cover photo might be
a photo of your entire team, the
dentists, your beautiful practice
interior, or a montage of several photos. Brainstorm with your
team and choose your photo
as a group. Know that it is as
easy as the click of a button to
change out your cover photo.

ii. contact information such as
Take advantage of the greata website address, email, mailest opportunity to illustrate your
ing address, or information
in aPage
photograph
that
should
go in
your
page’s
A4 Insert
October
2012
UK_DSC
UK A4 practice
04/11/2012story
7:18 AM
1

Remember that photos of
teeth, while great to showcase
your dentistry, will likely not

may not encourage people to
upload your cover to their personal timelines.
Covers may not include:
i. price or purchase information, such as “40% off” or
“download it on socialmusic.
com”;

“about” section;
iii. references to Facebook features or actions, such as “like”
or “share” or an arrow pointing
from the cover photo to any of
these features; or

lead to human connections or
stronger relationships. Don’t
let opportunities to make connections with prospective new
or existing patients slip away.
Human connections lead to
trust, and trust results in increased word of mouth, greater
referrals, higher case acceptance and strong loyalty. What
does your Facebook Page say
about you? Do you like what
you see? DT

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[12] =>

12 Comment

United Kingdom Edition

December 10-16, 2012

The dangers of “tunnel vision” in dentistry
Michael Sultan warns against seeing every problem as a nail

A

pecially if you happen to work
exclusively in one area of the
profession, or your special interests lead you down a very
particular way of thinking.
This can be quite a dangerous
trap to fall into in my mind,

merican
psychologist
Abraham Maslow once
said, “If you only have a
hammer, you tend to see every
problem as a nail.” I think as a
profession, it can be very easy
to develop “tunnel vision”, es-

and can ultimately undermine
the level of care we can provide to patients – both in terms
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brought me as an Endodontist. When it came to treating
people whose teeth had a good
prognosis, technically as students we could all do the root
fillings, but we were encouraged to apply the knowledge
and experience we had gained
in general dentistry. It wasn’t
good enough then, just to
complete the root filling – we
also had to consider the practical factors that would impact
upon our GDP colleagues.
We’d then have to put on our
restorative dentistry hats and
consider how our treatment
planning would fit with other
areas of dentistry beyond just
the RCT itself.
Of course this is all well
and good when the patient’s
teeth have a good prognosis,
but when the prognosis is not
so good, we have to think very
carefully indeed. Suppose
for example the tooth was

[13] =>

United Kingdom Edition

lost. Is the patient suitable
for a bridge or an implant, or
should we attempt “herodontics” to try and save a tooth
because if we don’t, the alternative is far worse?
Tunnel Vision
Rather than having “tunnel vision”, and seeing everything
just through our eyes as Endodontists, a crucial part of
Specialist practise is the treatment planning and diagnosis.
We have to bring together
a very broad knowledge of
general dentistry and Specialist dentistry before we do
our treatment. With so many
different facets to modern
dentistry, this approach is
more important today than it’s
ever been.
For example, it’s becoming
increasingly common that a
lot of people who haven’t been
to the dentist in a long time
decide to have orthodontics.
They may have some sort of
short-term orthodontic appliance, and the first thing their
dentist does is send them for a
full mouth scan. Lesions and
poor root fillings are picked
up at this stage, and we often
have many Orthodontists coming to us and asking whether
root filings are required, or
what the best solution is, taking into account the current
state of the patient’s overall oral health. We then have
to work in conjunction with
our Orthodontist colleagues
to form a sort of “compro-

‘To be a good Specialist – especially
in this day and age
– you really can’t
have “tunnel
vision” and just
think about your
own narrow field
of dentistry.’

mise” solution that leaves the
patient with the best overall prognosis for their longterm oral health. This may
include suggesting alternative treatment plans based on
a thorough assessment of
all the various health risks,
as well as practical and cosmetic factors.
Holistic approach
To be a good Specialist – especially in this day and age
– you really can’t have “tunnel vision” and just think
about your own narrow field
of dentistry. As an Endodontist for example, I cannot just
focus on infected teeth. I have

to treat people holistically,
and work in the best interest of the patient in terms of
their overall wellbeing, and
not just the health of a single
tooth. Though in some of my
more complex cases patients
can technically be root filled,
it may not be in their best interest in terms of their overall
oral health.
Of course while I am talking broadly here about “tunnel vision” among Special-

December 10-16, 2012

ists, the same points are true
of special interest dentists,
and
colleagues
who
focus on treating particular
types of cases. As a profession,
we should all endeavour to
look beyond the narrow field
of our own areas of interest
and expertise. By considering the “bigger picture”, this
doesn’t just make us better clinicians, but it makes us better
dentists too. DT

Comment 13

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 and 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 Easman 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.

[14] =>

14 DCPs

United Kingdom Edition

December 10-16, 2012

Just one small change can be
the start of something great
Mhari Coxon asks you to disclose your patients

O

kay...so this is my last
column for 2012. And I
decided to indulge myself. I am putting out a request

to you all to make one small
change in your practice for a
huge impact on the oral health
of the nation. Many of you will

know of my slightly obsessive
desire for every practice to
disclose every patient at every
oral health visit.

The impact of the clear
visual for the patient is such
an important way to improve
someone’s home care routine

and help them to maintain the
motivation that they require.
Take a picture and print it out
for them, or even use their
own phone, and you have a
reference for them to return to
during the gaps between visits. Keep score simply so they
can see a record of years of
scores and use to to motivate
and monitor them throughout
their life. One simple thing
has so many positive results.
It still frustrates me that I
see patients in their 50s who
when I explain I will use a dye
to show where they find hard
to clean say “Oh yes, I had that
done at school.” How can we
be getting it so wrong? What
happens when we get out in
practice that stops us from remembering the basics for patient care?
So...I thought I would give
you some solutions to the common barriers that stop people
from implementing this powerful motivational tool in their
practice.
Patients don’t want it
Like anything new you are
bound to meet a little resistance. The longer the patient

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‘How can we be
getting it so wrong?
What happens
when we get out in
practice that stops
us from remembering the basics for
patient care?’

has been coming, the more
resistance is likely. It is quite
easy to defuse this.
Write to them – send a letter saying how much you are
looking forward to seeing
them at their next hygiene
session. Explain that to help
you help them better you will
be putting a simple dye on the
teeth (reinforce - don’t worry
it all comes off when we polish you at the end of the session) to show where they find
hard to clean. It would be really helpful if they bring what

[15] =>

United Kingdom Edition

they normally clean with with
them too so you can help them
get the best out of their home
routine. Feedback from patients in practices where this
has been implemented has
been very positive.
Lack of time
Time is the most common reason people give for not being
able to disclose. I am glad to
say that I can provide a solution even for someone who is
restricted heavily by appointment times.

I don’t have a hygienist in
my practice
That is not a barrier to this.
This type of interaction can
be carried out with great results by a dental nurse trained
to deliver oral hygiene advice. Patients actually quite
like that the dental nurse
can’t put anything sharp near
them and find it easier to be
honest about their habits, or
lack of them, with a dental
nurse. What is interesting is

DCPs 15

December 10-16, 2012

the amount of job satisfaction the dental nurse carrying
out the disclosing and advice
feels from providing this service which can be charged for
where appropriate to bring
more profit in to the practice and a better wage for the
trained nurse.
The other benefits
The other benefits we have
seen in practices that have
added this as a standard ser-

vice is an improvement in
oral health product sales, increased recommendation of
friends to the practice and
more positive feedback in the
patient questionnaires.
Patients are often more
open to longer sessions of
periodontal treatment and
the costs involved when they
have more awareness of their
health. Referring to a specialist can be easier to recom-

mend and more accepted.
Furthermore, CQC will like
you for it and the worrying
trend for periodontal related
litigation cases will not be a
worry for you and your practice.
Go on, try making a small
change in your practice and
measuring the bigger impact
it will have on your patients.
You won’t be disappointed. DT

Get the patient to do it –
Have some of the cotton bud
disclosing solution and a
laminated instruction card at
reception then send them off
to the rest room to do the job
for you. The patient will have
a look for certain while there
so you end up with a patient in
the chair ready to listen about
advice in your short appointment.
It costs too much
It is actually a very inexpensive thing to implement and
the patient will start to view
their healthy mouth differently. In fact, in practices where
we implemented this, we saw
and increase in the uptake
of non essential dentistry. It
seems the patient was much
more likely to chose aesthetic
treatments such as whitening
or straightening if they were
more interested in their oral
health. So, for a very small investment the long term ROI is
high.

About the author
Mhari Coxon has
20 years’ experience in dentistry,
working
as
a
nurse, receptionist,
oral health advisor and ultimately
hygienist in a variety of practice
environments. She
is passionate about her profession. At
present, she works as Senior Professional Relations Manager for Philips
Oral Healthcare and clinically as a
hygienist in central London. From
Chairing the London BSDHT for 3
years, and working as an MD; Mhari
excels at motivating and co-ordinating a team and utilising skills, decentralising leadership and developing
self efficacy in members. Throughout
her career Mhari has developed hygiene protocols and plans in practices
which have continued to be used with
great success. Mhari is Clinical Director for CPDforDCP Ltd, a training
company offering motivational and
interactive development courses to
the dental team. A keen writer, Mhari
is on the Publications Committee of
Dental Health, the British Society of
Hygienists and Therapists (BSDHT)
Journal, has a conversational column in Dental Tribune and writes
articles for many other publications
and online sites. As a speaker Mhari
has presented regionally, nationally
and internationally for many groups
including Talking Points in Dentistry,
the British Orthodontic Society Specialist group, the BSDHT, the BDA, the
International Symposium of Dental
Hygiene, the dentistry show and many
others. In 2006 she was the Probe
Awards hygienist of the year, and was
highly commended in 2010. 2011 saw
her placed 15 in the Dentistry Top 50
most influential people in the UK.

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[16] =>

16 Practice Management

United Kingdom Edition December 10-16, 2012

Why improving your practice
is a mystery – part 14
The practice perfection journey begins soon says Jacqui Goss

his is probably the time of
year to look back at what
we’ve covered in my se-

ries of articles – the journey so
far, if you like. We’ve considered
telephone conversations with pa-

tients and how to make sure enquirers become clients. Following this I discussed the look and

atmosphere within and without
a practice – and the impression
this creates. Then we spent some

time discussing various ways of
gathering feedback from patients
and what to do with the information collected. Marketing and
dealing with complaints were the
next topics – with an emphasis
on the role of your front of house
team in each of these.
Quite a journey but I
did write in the first sentence
that it was only ‘the journey
so far’. There’s more – much
more – to come. Just as clinical
dentistry
is
becoming
less about drills and wet
fingers and more about intraoral
cameras and dental lasers, so developing a dental practice is constantly changing too.
Here, I’ll give you a taste
of what I’ll cover in my
new
series
of
articles
beginning in 2013 and suggest some (Christmas holiday?) research and reading you
can do.
The editor and I have not
firmed up the title of the new
series but something along the
lines of ‘The Z to A of dental practice development’ is favourite.
No, I haven’t mis-typed that – I do
mean Z to A, not the other way
around. Perhaps ‘Bottom to Top’
would be a more accurate way
of describing the approach I’ll be
taking.
For
me,
the
development (and the ongoing journey towards perfection) of
a dental practice begins not
with the dentist principal securing another qualification but with
the recently recruited receptionist picking up a discarded sweet
wrapper as he or she enters the
practice in the morning. Too esoteric? Let me explain.
If a culture of seeking perfection in all things is embedded deep within the psyche of a practice team, a new
member will automatically adopt
the same approach and, aware of
the poor impression it may give
patients and potential patients,
will pick up the wrapper.
As preparation for what I
shall write about next year and
because I’m sure that, like me,
you’ll get bored over the Christmas break here’s some suggested
reading.
I would visit your local
library and get out a load of
books on marketing, business development and market

[17] =>

United Kingdom Edition December 10-16, 2012
research. You needn’t read all of
each one or them all – just ‘skim
read’ through to store key phrases and terminology in your mind.
One book I do recommend reading all through is
The Jelly Effect: How to Make
Your Communication Stick, by
Andy Bounds. It’s been out a couple of years so secondhand copies are available via the Internet
if you don’t want to spend the RRP
of £8.99 for the paperback version (it’s also available as an eBook). I’m happy to quote part of
the description of the book from
the publisher’s (Capstone) website: Like throwing jelly at a wall,
poor communication never sticks.

about. And once you are
trained, it will be your front
of house team who will initiate the process of selling
your cosmetic dentistry skills to
patients.
Dental Tribune contributor,
Glenys
Bridges,
runs
a dental reception course entitled Purely Practical Reception
Skills and there are a handful of people such as myself
who undertake on-site training
for front of house staff.

Practice Management 17

There is also the Campaign
for Administrative Standards
and Professional Education
for Receptionists and Practice Managers (CASPER) –
being led by Glenys and Jane
Armitage (another Dental
Tribune contributor). Back in
April they circulated a statement that ‘when it comes to
the non-clinical aspects of
dental care there is a massive
black hole in terms of training
and ongoing development requirements’.

Their statement went on to
say: ‘to consistently achieve an
excellent dental experience for
patients, a range of quality management skills are required, such
as planning services, auditing
performance, creating, implementing and evaluating SMART
objectives and gathering feedback on clinical and non-clinical
aspects of care’.
I
wholeheartedly
agree
and was delighted to be one
of the dental professionals

they invited to work with them
to urge the GDC and CQC
to formalise a non-clinical
curricular framework. The work
is ongoing and you should keep
an eye open for more news.
That’s about it for 2012. I’ll
leave you with a story about President Kennedy (quoted by Andy
Bounds). The President asked a
NASA janitor who was sweeping
the floor: “What do you do here?”
The janitor replied: “I’m helping
to put a man on the moon.” DT

Too
much
information
and not enough relevance
is a problem that pervades
almost all business communication. So what’s the answer? More relevance and a lot
less jelly.
I
won’t
spoil
your
enjoyment of the book by saying
much more about it but the key to
his well-argued contention is the
word relevance. What you, your
staff, your website and your marketing say about your practice
must be relevant to what patients
and prospective patients want. So
forget listing your qualifications
and say instead how by straightening their teeth you will make a
person look younger.
The other area I suggest you bone up on is training and personal development
– particularly for your front
of house staff and manager(s).
If I can draw a parallel with
the Olympics, these members of your team are like the
lead runners in a relay squad
and patients are the batons. If
they make a poor start with
a patient or, worse still,
metaphorically
drop
the
baton
there’s
no
chance
of you, as anchor woman
or man winning. That’s why
I constantly advocate having a
well-trained, highly motivated front of house team – they
are, in effect’ your ‘shop window’
to the public and patients. They
can also be your marketeers and
market researchers.
Before you rush off to do a
course on, say, cosmetic dentistry,
check with your reception staff
that it’s something patients or prospective patients are enquiring

About the author
A proven manager
of
change
and
driver of dramatic
business growth,
Jacqui Goss is the
managing partner
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[18] =>

18 Practice Management

United Kingdom Edition December 10-16, 2012

The Missing Business Plan
The second in our series about Pia Mint

aving started her new
job at the Endeavour
and Hope dental practice
with enthusiasm, by the end of
her first week there Pia Mint was
feeling anxious. She wondered
how she could ever settle in and
make this practice run as well as

her previous practice had done.
When she was appointed the
partners convinced her that their
practice was well organised and
compliant. They had certainly
‘talked the talk’ about how their
practice ran but now she had

discovered that they were most
definitely not ‘walking the walk.’
On Monday she kept thinking, “I can’t be looking at this correctly, I must be missing something, I’ll look again!”

By Tuesday she was angry because what she was discovering
was not what she was promised
about how the practice operates.
By Wednesday Pia was worried. Her spirits were at rock
bottom. She kept thinking about

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conversations she had heard between practice managers at the
local practice managers’ group.
They had said on more than one
occasion that they felt like they
were just used as scapegoats
when things went wrong. Pia
had come to realise that a great
deal ‘went wrong’ in this practice. In fact, it is would be more
surprising if things ever went
right, based on the lack of structure and low team morale she
had discovered.
By Thursday she was starting
to think about how she could reconcile herself and just keep going
in her new job role. The thought,
“I could just fit in and do my best,
at least I will get paid at the end
of the month. I just need to be
able to show that I have done
my job. Just as the practice has
staggered on in the past, I am
sure it can continue move forward in the same way. However,
this is not what I wanted from
this work role, but perhaps it’s
what I will need to settle for!
Pia did not sleep well
on Thursday night and was tired
when she arrived for work on Friday morning. When she arrived
she found the front door was
unlocked, because the last person to leave on Thursday night
had forgotten to lock up.
Then when she opened her
email she discovered that
she had received a strongly worded complaint from a
patient who had attended a
review on Monday. The patient had settled her account
before leaving. Then on Wednesday had received a letter from
the practice saying she had been
undercharged and needed to pay
an additional £25.00.
Heavy hearted she continued
to scan down her emails and saw
one from Kate, a practice manager with whom she had become
friendly at the local managers’
group. The subject bar read
‘Congratulations on your new
job!’ Pia opened the mail.
Kate ran a large local practice with an excellent reputation.
She was always very upbeat and
her practice was well known for
running like a well oiled machine. In that moment, feeling
tired, overwhelmed and hopeless
she clicked on ‘reply’ and typed
‘Oh Kate, what have I done?’ then
she clicked on send.
Before long Kate responded
with an invitation for a lunch time
coffee. Pia readily accepted, she
so needed to talk to a supportive,
knowledgeable friend. They met
up in a coffee shop at 1pm. After
their initial greetings, when they
sat down Kate said to Pia: “You
look worn out” Pia agreed and
said that she felt worn out. Kate
went on to say: “Can I offer you
the benefit of my experience as a
practice manager?”

[19] =>

United Kingdom Edition December 10-16, 2012
Pia nodded her head and
Kate went on to say: “Don’t tell
me anything about the problems you are having. Just let’s
accept that there are problems
and rather than getting bogged
down in them, I strongly advise
you to direct that time and energy toward creating solutions.
In my experience it’s always a
case of cause and effect. One
cause will result in multiple effects; so when the single cause is
managed so too are the multiple
effects.”

thepracticebusinessplan”saidPia.
“Well”, he replied, “The
thing is that although Jon-Luke
and I have discussed business plan type stuff, we have
never actually gone so far as to
commit it to paper. In short, I
guess the plan is to survive.”
What do you think Pia
should do?
Pia was disappointed, yet hopeful. She was beginning to see
how she could improve the prac-

Practice Management 19

tice. Her next project would be
to get the practice’s business
plan up and running as the basis
for making sweeping improvements.
At home that night she
searched the Internet and found
a range of proformas. But how
could she create a business plan
without the required skills and
know how?
She decided to call Kate, to
ask her how she had produced
her first business plan and Kate

explained that she had professional help from a company
who came into the practice and
in a practice meeting to help
them to produce the initial plan,
from then on they were able
to keep up-to-date by conducting regular reviews. Pia now
needs to convince her employers
that the cost of engaging a dental consultant, to help them to
develop their first business plan
would be an excellent investment which would see an excellent return.

On Monday morning Pia
spoke to the partners, who
gave her the green light to
research
the
market
and
seek out the most appropriate service provider to work
with them to develop their business plan. The one provider that
stood out to her was MINT Nationwide, who would spend the
morning with the management
team and the afternoon engaging the team to play their individual roles in the success of
their practice. DT

Pia sipped at her cappuccino
and looked at Kate who continued: “Effective businesses management begins with a definition
of the purpose of the business.
You need to be clear about what
the practice wants to achieve.
This definition will be the practice’s objectives. Then based
upon this definition, you can determine the most effective ways
to bring those objectives to fruition. This will involve creating
clear, agreed policies and procedures”.
Pia thought for a while and
said: “It sounds like a plan”.

Advanced Defence Sensitive
blocks 92% of dentine tubules
in just 6 rinses in vitro*

“Yes”, said Kate, “It’s a business plan, does the practice have
a practice business plan?”
“They
said
they
have
one, but I have not seen it”, replied Pia.

Kate continued: “In my mind
the business plan is the most
essential document for practice management. The role of
a practice manager is to progress the practice smoothly
and effectively to secure the
objectives set out for the next
one, three, and five years’’.

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technology that blocks dentine tubules deeply for lasting
protection from sensitivity.2,3
In just six rinses Advanced Defence Sensitive blocks
92% of dentine tubules; twice as many as the leading
recommended pastes.1,4

Pia decided that when she
got back to work she would ask
the partners for a copy of the
business plan and see what they
came up with.

It can be used alone for lasting protection,3 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.4,5

By 2pm Pia was back at her
desk. Following her chat with
Kate she felt much more positive and was beginning to see the
way forward. When she had the
business plan to work from she
would be able get to grips with
what she needed to do.

* Based on % hydraulic conductance reduction

At the end of the afternoon
session she asked one of the
partners, Hugo Hope, if she
could have a word with him
before he left. He agreed and
entered her office (which was
also the staff room). “I wonder if I could have a copy of

Contact info
Specific Nationally recognised qualifications for dental professionals are
available from centres around Britain
and in home learning formats from
MINT Nationwide.
See www.mintnationwide.co.uk

References:
1. Dentine Tubule Occlusion, DOF 1 – 2012.
2. Tubule Occlusion Stability, DOF 3 – 2012.
3. Relief of Hypersensitivity, DOF 4 – 2012.
4. TNS – Sensitivity Market Research 1 – 2012.
5. Combination Tubule Occlusion, DOF 2 – 2012.
UK/LI/12-0494m

Recommend Advanced Defence Sensitive
for expert care when you’re not there

Do not recommend this product if patients have a history of kidney disease, hyperoxaluria, kidney stones or malabsorption syndrome, or take high doses of vitamin C (1000mg or more per day).

04075_ocdlis_sensitive_teaser_DT_sp_fa2.indd 1

10/11/12 10:39 AM

[20] =>

ST
AN

United Kingdom Edition December 10-16, 2012

Local Healthwatch:
what will it mean to you?
Amanda Atkin explains about Healthwatch and
how local Healthwatch will affect dentists

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he Health and Social Care
Act 2012 is a weighty document running to more
than 450 pages. As the Health and
Social Care Bill it had a bumpy
passage through Parliament beginning in January 2011 and it
did not receive Royal Assent until
March 2012. Shadow health secretary, Andy Burnham, committed to repealing it at the recent
Labour Party Conference. Billed
(excuse the pun) as the most
extensive reorganisation of the
structure of the NHS in England
to date, the Act abolishes PCTs
and Strategic Health Authorities.
Here, I’ll concentrate on Part
5 of the Act – Public Involvement
and Local Government.
Paragraph 181 amends the
Health and Social Care Act
2008 as follows: A committee
of the [Care Quality] Commission known as “the Healthwatch
England committee” is to be
appointed in accordance with
regulations. Further on, under
a heading of Local Healthwatch
organisations, the Act makes
amendments to the Local Government and Public Involvement
in Health Act 2007.
Essentially, these changes
flow from the Coalition Government’s desire to give more power
and control over public services
to members of the public – often
categorised as ‘no decision about
me without me’. The White Paper Equity and excellence: Liberating the NHS said that the NHS
would ‘be genuinely centred on
patients and carers’ and ‘give
citizens a greater say in how the
NHS is run’. Hence Healthwatch
– to strengthen the collective
voice of local people.
Healthwatch England
Launched on 1 October 2012,
this organisation styles itself as
‘Your national spotlight on local
services’. It is an ‘independent
consumer champion for health
and social care in England’.
Healthwatch England is an independent committee of the CQC
and the Chair of Healthwatch
England, Anna Bradley, formerly
Chief Executive of The National
Consumer Council, also sits on
the board of the CQC. This is recognised as a potential conflict of
interest but we are assured that
‘robust governance’ is in place to
deal with this.
Essentially, Healthwatch England is a national body which will
coordinate feedback from a network of local organisations and

use the information to influence
national policy. It promises that
the voices of people who use
health and social care services
will be ‘heard’ by the Secretary
of State, the CQC, the NHS Commissioning Board, Monitor (the
independent regulator of NHS
trusts) and every English local
authority.
Healthwatch England will
also help local Healthwatch organisations to be set up in every
local authority.
Local Healthwatch bodies
There must be local Healthwatch
organisations in every English
local authority area able to start
on 1 April 2013. These Healthwatch organisations are to be
commissioned by local authorities with help and advice from
Healthwatch England.
Local Healthwatch organisations will have a number of the
following roles and responsibilities. They will have a seat on local health and wellbeing boards –
which were also set up under the

Of critical concern to dentists
in my view is the bullet point on
the Healthwatch website which
states that local Healthwatch organisations will:
• have the power to enter and
view services.
Turning to the DH document
Local Healthwatch: A strong
voice for people – the policy explained, the above statement
is nuanced somewhat. It states
that the legislation will allow
for, and in some cases require,
regulations to be made covering
[among other things]:
• the duties on services-providers to allow entry to authorised
representatives of local Healthwatch.
In many ways Local Involvement Networks – LINks – (see
below) are the forerunner of local Healthwatch organisations.
LINks representatives have what
is commonly called ‘enter and
view’ authority in terms of visiting premises where health and

‘These changes flow from the Coalition
Government’s desire to give more power
and control over public services to members of the public – often categorised as ‘no
decision about me without me’
Health and Social Care Act 2012.
These boards, which are already
working in ‘shadow’ form, also
get going in earnest from April
2013.
As well as having a seat for
a representative of the local
Healthwatch organisation, these
boards must include a local
elected representative, a representative of each local clinical
commissioning group, the local
authority director for adult social services, the local authority
director for children’s services
and the director of public health
for the local authority. Their remit is to ‘improve the health and
wellbeing of their local population and reduce health inequalities.’ The local Healthwatch is
expected to influence how health
services are commissioned and
set up.
Local Healthwatch organisations will also provide information, advice and support about
local services and pass recommendations to Healthwatch England and the Care Quality Commission.

social care activities are carried
out. The use of this authority has
been mixed across the country. In some cases the CQC and
LINks have coordinated inspections and ‘enter and view’ visits.
It is anticipated that Healthwatch
England will produce advice for
local Healthwatch organisations
and the CQC to maintain similar
liaison.
Importantly, the 2007 Health
and Social Care Act stated that
only the following services-providers are required to allow entry:
• A National Health Service trust;
• An NHS foundation trust;
• A Primary Care Trust;
• A local authority; or
• A person prescribed by regulations made by the Secretary of
State.
Healthwatch England would
have to draw up specific regulations to add to this list. At this
stage, it’s probably best to assume
that authorised representatives
of local Healthwatch organisations will act in a similar way to

[21] =>

United Kingdom Edition December 10-16, 2012
LINks representatives – have no
right of ‘enter and view’ to dental
practices.
Seventy-five local authorities were chosen to be ‘pathfinders’ for local Healthwatch.
In one exercise, nine of these
were surveyed for their experiences. Some stated that before
April 2013 they intend to build
a profile for local Healthwatch
within their local authority and
NHS organisations to embed local Healthwatch as a significant
partner in the planning and commissioning processes [for health
and social care]. It was also
thought that local Healthwatch
organisations might develop a
quality certification mark.
The Local Government Organisation has published a document entitled Supporting Healthwatch Pathfinders – Building
successful Healthwatch organisations. This includes 15 case
studies for pathfinder local authorities with the broad finding
that many intend transitioning
from LINks to local Healthwatch.
Indeed, back in March 2011 the
DH produced a HealthWatch
(before it became Healthwatch)
Transition Plan explaining how
the work, community and structures of LINks could be built up.
LINks
If local Healthwatch organisations sound familiar, you may be
thinking of Local Involvement
Networks (LINks). These are local individuals and community
groups who work together to improve health and social care services. There have been problems
with LINks which is why they’re
being replaced by local Healthwatch organisations. LINks have
rarely involved a wide cross-section of their local communities,
few people know about them and
they are not brought together under a national umbrella.
While local Healthwatch
organisations will be commissioned by their local authority
and accountable to them, Healthwatch England will provide consistent advice and information
from a national viewpoint. It will
also develop partnerships with
other national bodies to raise
awareness of local Healthwatch
and hopefully increase involvement by a wide range of local
people.

About the author
Amanda
Atkin
runs Atkinspire Ltd
and offers practices support, training and consultancy on information
governance, CQC
compliance,
National
Minimum
Standards
and
HTM 01-05. Her bespoke service supports practices as they embed the
required standards within their daily
routines – to ensure a high quality
service and patient safety at all times.
e amanda@atkinspire.co.uk
www.atkinspire.co.uk

I should also mention Local
Professional Networks (LPNs),
which will be an integral part of
the national NHS Commissioning
Board (NHS CB) and the 27 local
NHSCB teams (called Local Area
Teams (LATs)) – also due to come
into effect from 1 April 2013.
LPNs will be embedded into LATs
to ‘provide local intelligence and
expertise as part of the local
commissioning
infrastructure
and into the quality improvement
work for primary care’.

Practice Management 21

How will Healthwatch affect
you?
You could, if you choose, have
nothing to do with local Healthwatch and may never be directly affected by it. I suggest this
would be a mistake. More so
than LINks, local Healthwatch
organisations will likely have
considerable influence over local
health and social care provision.
As (an independent) part of the
CQC, Healthwatch England will
also have influence at national

level – informed by feedback
from local Healthwatch organisations. Particularly active local
Healthwatch organisations may,
in time, arrange with the CQC to
visit yours and other local dental practices to ‘enter and view’.
And who’s to say they won’t develop local health service quality
standard marks?
I believe you should look out
in the coming months for news
of the development of your local
Healthwatch organisation. The

Local Government Association
is leading the implementation
of local Healthwatch and there
is much useful information, including briefings, publications
and events on its website www.
local.gov.uk (search for ‘healthwatch’).
Healthwatch is less ‘Big
Brother’ and more vox populi
(voice of the people). DT

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[22] =>

22 Clinical

United Kingdom Edition

December 10-16, 2012

Posterior Composites in General Practice
Trevor Bigg gives an overview of restorative composites

Fig 2. 45 pre-treatment

Fig 1. Right Bitewing

F

or the majority of dentists, general practice
has changed beyond
recognition over the past decade. Minimal Invasive Dentistry, digital imaging and the
computerisation of records,
amongst many other changes,
have altered the way dentists
practise in their surgeries
throughout the country.
But, although this is hardly
ever mentioned, the greatest
change that has occurred in
the day-to-day running of a
general practice has been the
increasing use of composite
filling materials in the restoration of posterior teeth.
Amalgam or Composite?
Dental amalgam has been the
material of choice for restoring posterior teeth during the
past 160 years. Despite repeated attempts to prove the
dangers to the patient of using
this material no significant
link has been shown and, on
July 28, 2009 the US Food and
Drug Administration stated
that unless the patient is allergic to mercury “the levels (of
mercury) released by dental
amalgam fillings are not high
enough to cause harm in patients.” 1
So, if amalgam is considered safe for patients, the only
reason for banning its use is
due to the impact of dental
amalgam on mercury in the
environment, (although this is
considered to be only 0.1 per
cent of the worldwide burden 2
and the result of a recent study

indicating that over one-third
of an American’s mercury exposure is from tuna!) Even
though there are many other
sources of mercury in the
environment, the continued
action from pressure groups
in Europe led to the European
Union (EU) commissioning
the BIO Intelligence Service
(BIOS) to review the potential
for reducing mercury pollution from dental amalgam and
batteries, as next to chloralkali production for batteries (to be phased out by
2020), dental amalgam will be
the largest mercury use in the
EU. 3
In June this year, a joint
DoH and DEFRA meeting issued a statement that the UK

1
2
3
4

Poor moisture control

Difficult cavity accessibil-

ity

Large cavities

Large interdental spaces
to be bridged.

It is at this point that some
readers may be thinking that
the banning of amalgam is
long overdue, but it must not
be forgotten that amalgam, for
all its faults, is a very forgiving
material and even the EU is
aware that there are situations

‘The greatest change that has occurred in
the day-to-day running of a general practice has been the increasing use of composite filling materials in the restoration of
posterior teeth’
should support the EU strategy to reduce the environmental impact of mercury,
and should, subject to certain
exemptions, support a ban on
the use of dental amalgam
from 2016.
The exemptions, which
would be reviewed after five
years to identify if they were
still required, would allow
amalgam to be used under the
following conditions:

in day-to-day practice when
without its use the patient may
be ill-served. Composite resin, on the other hand, is very
much more ‘technique sensitive’ and requires skill, experience and relatively expensive aids to enable satisfactory
placement.
Why should we place posterior composite restorations?
After 2016, dentists in the EU
will no longer be able to place

Fig 3. 45 post-preparation

amalgam restorations as a
routine procedure. In the long
term our patients may be better served by the placement of
posterior composites as:
• The placement of posterior
composites in Class II cavities is successful and predictable. Using composite and not
amalgam increases the lifespan of the tooth.
• Composite is the ‘material
of choice’ for initial posterior
cavities.
Amalgam should
only be used in already heavily restored dentitions in older
patients.
Why is composite resin better than amalgam at increasing the lifespan of a tooth?
• Less sound tooth needs removal during preparation
• Adhesive bonding means
that non-retentive preparations can be used (Figs 1, 2, 3
& 4)
• Adhesive bonding improves
the marginal seal and reduces
ingress of oral fluids and bacteria into the cavity, which is
the commonest cause of pulpal damage and death

• It reinforces the remaining
tooth structure
• It increases fracture resistance of the remaining tooth
• It can be used to repair or
refurbish restorations without
total replacement. 4
And not forgetting:
• It has an aesthetic tooth colour
However, composite is not
‘tooth-coloured amalgam’ and
must be handled and placed
differently.
Who will teach how to place
composite restorations?
Older dentists had little teaching in the use of composite
resin for posterior teeth at
Dental School. Only 13 years
ago, Effective Health Care was
able to report that composites
are 1.7 to 3.5 times more expensive than amalgam with a
5-year survival rate only half
that of amalgam. 5
Over the past 10 years,
techniques, materials and aids
have improved so that Opdam’s study published in 2007
showed that survival rates for

[23] =>

United Kingdom Edition

Moisture control:
Moisture control is essential,
but a rubber dam is not mandatory!
Rubber dam is mandatory
for root canal treatment and
strongly advised in areas of
difficult access and for certain procedures, such as the
placement of posterior Resin
Bonded Bridges. However, the
financial cost of rubber dam
precludes its use for routine
restorative work in most NHS

composite fillings at 5 and 10
years was greater than that for
amalgam. 6
But although there has
been a substantial increase
in composite teaching at our
Dental Schools over the past
10 years, recent research
showed that erroneous techniques were still being taught.
These included beveled enamel margins; causing a thin
‘flash’ which fractures later
and the use of transparent matrix bands and wedges; based
on the old idea that composite
contracts towards the light. 7
So can lectures and ‘handson’ courses help teach dentists good practical techniques?
The majority of dentists attending a course on posterior

‘There are always
aspects of any lecture, no matter how
esoteric, that can be
applied to general
practice, but what
the participant really wants to learn
are practical tips,
which can be applied to their dayto-day work’
composites are working for
the NHS either fully or parttime. Unfortunately, too many
courses are aimed at private
practice, and a form of private
practice that even a full-time
UK private practitioner would
not recognise. Experts from
Europe describe how to place
the perfect posterior restoration over a two-hour appointment and others spend a
morning describing, in great
detail, occlusal anatomy and
mandibular movement.

Clinical 23

December 10-16, 2012

Fig 4. 45 post-treatment Shade A2 Ceram-X

practices.
Does this affect the longevity
of the subsequent restoration?
One study has shown that rubber dam incorrectly applied
affected the proximal contact
strengths of posterior composites leading to food impaction
and periodontal problems.8
So rubber dam is no sub-

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There are always aspects
of any lecture, no matter how
esoteric, that can be applied
to general practice, but what
the participant really wants to
learn are practical tips, which
can be applied to their day-today work.
Some Practical Tips
Imagine the scenario, one that
occurs many times during the
week: a patient attends with a
fractured tooth and is booked
in to a half-hour appointment.
(Fig. 5)
How can we fill that tooth
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à DT page 24

[24] =>

24 Clinical

United Kingdom Edition

monds, as they can cause deep
surface scratches and loss of
filler particles

ß DT page 23

stitute for a good technique
and it’s the quality of moisture
control that is important, not
how it is achieved. (Fig 6)

• Direct the bur from the tooth
to the filling to reduce iatrogenic damage

Matrix techniques:
On the advice of the Chief
Dental Officer, all dentists
should be using single-use,
disposable matrix bands, as it
is impossible to clean assembled conventional bands such
as Siqveland adequately. 9, 10

• Remove ‘high-spots’ and
contacts on the tooth-restoration junction
• Do not ‘over-carve’ the surface,
as deep fissures can make cleaning more difficult in some cases
and could predispose towards
fracture

The use of disposable products such as Omni-Matrix
(Ultradent) and AutoMatrix
(Dentsply) provide affordable,
well-fitting matrix bands that
act as a mini-dam in keeping oral fluids out of the prepared cavity. The band must

• Etch and wash the finished
restoration and use the remaining bonding agent to re-seal
the margins and repair surface micro-cracks 12 (Fig. 8)

Fig 5. The fractured tooth

Place a 0.5 mm liner
at first, as the base of a
thicker layer may be further than the maximum depth
of 4 mms when a matrix band
has been fitted or a deep cavity is present. The initial thin
layer is self-leveling as it flows
into the irregularities of the
cavity floor and may increase
marginal adaptation in the
gingival margin area. It also
acts to stabilize the matrix
band, preventing slippage if
little tooth is left supra-gingivally. (Fig. 7)

‘On the advice of
the Chief Dental
Officer, all dentists
should be using
single-use, disposable matrix bands’

be shaped so that the correct
contact area is produced on
the proximate tooth to reduce
the risk of food packing and
drifting. A sectional matrix,
such as Palodent (Dentsply) is
excellent at producing a good
contact, but care should be
taken in older patients as the
wide contact area produced by
wear over time is not reproduced by most sectional systems.
Bulk fillers:
Returning to the original scenario, already 5-10 minutes of
the half-hour appointment has
been used. To enable the rapid
placement of a composite restoration a new generation of
flowable composites has been
developed to use as a liner or
bulk filler, such as SDR (Dentsply), Venus Bulk Fill (Heraeus) and Tetric EvoCeram
Bulk Fill (Ivoclar Vivadent).
These generally overcome
the problem of light-activated
composites shrinking while
curing, by means of a polymerisation modulator that reduces
shrinkage stress and force at
the tooth-restoration interface. This shrinkage stress
is one of the causes of post-operative sensitivity almost immediately after placement of
the restoration and one study
from Dentsply has shown
elimination of post-operative
sensitivity when a bulk filler
is used. 11

December 10-16, 2012

Fig 6. AutoMatrix band

Place a further layer of
liner, or bulk fill if the
cavity is deep, allowing a
minimum of 2 mms of conventional composite occlusally to
improve wear resistance and
appearance. Adaptation of the
second layer of flowable or
conventional composite is enhanced by the smooth surface
left by the initial lining.
Finishing techniques:
Good finishing techniques reduce the failure rate caused by
secondary caries in composite
restorations:

Fig 7. SDR lining placed

• Trim using a copious quantity of water as coolant, as overheating the composite encourages rapid shrinkage causing
failing margins in time
• Try not to use ‘coarse’ dia-

Conclusion
Posterior composite restorations
are ‘technique sensitive’ and do
require training and experience if
a good restoration is to be placed
in the limited time available in
general practice.
Materials research is slowly improving the outcome of
these restorations and part of
a dentist’s Continuing Professional Development should
be in engaging in these advances so that a long lasting, functional and aesthetically pleasing restoration can be provided
in a realistic time-scale, to the
benefit of the dental health of
our patients and the financial
health of our practices. DT

About the author
Dr Bigg has been
working in private
practice in West
Oxfordshire
for
nearly 40 years
and treated up to
four
generations
of some families.
He takes referrals
for cosmetic dentistry, the non-invasive restoration of
the worn dentition and treatment of
Temporo-Mandibular Dysfunction. Dr
Bigg has the Membership in General
Dental Surgery at the Royal College
of Surgeons, London and Fellowships
from the College of Surgeons in Edinburgh and London. He is a past
President of the British Society for
General Dental Surgery. He lectures
at home and abroad on crown and
bridge updates, posterior and anterior
composites, bleaching and Minimal
Intervention Dentistry. He also runs
‘hands-on’ courses on Contemporary
Aesthetic Dentistry and Posterior
Composites and presents Webinars on
Bleaching and Posterior Composite
Restorations.

References:

Fig 8. Restoration after re-bonding

Although the manufacturers state that it is possible to
bulk fill using these materials
in 4 mm increments, anecdo-

tal evidence suggests the following protocol:

1. FDA News Release July 28 2009 2. ICDigest 2012 3. Study on the potential for reducing mercury pollution from dental amalgams and batteries. Final Report July 11 2012.
BIO Intelligence Service, European Commission – DG ENV 4. Successful Posterior Composites by Christopher D Lynch 5. Effective Health Care April 1999 Volume 5 Number 2
ISSN: 0955-0288 6. A retrospective clinical study on the longevity of posterior composite
and amalgam restorations. Opdam NJ, Bronkhurst EM, Roeters JM et al. Dent Materials 2007 23: 2-8 7. State-of-the-art techniques in operative dentistry: contemporary
teaching of posterior composites in UK and Irish dental schools. Lynch CD, Frazier KB,
McConnell RJ, Blum IR and Wilson NHF. British Dental Journal 2010 209: 129-136 8.
Influence of rubber dam on proximal contact strengths. Rau PJ, Pioch T, Staehle H-J, et
al. Oper Dent 2006 31: 171-175 9. Advice for dentists on re-use of endodontic instruments
and vCJD. CDO for England. April 2007 10. An investigation of the decontamination of
Siqveland matrix bands. Whitworth CL, Davies K, Palmer NAO and Martin MV. British
Dental Journal 2007 202; 4: 220 11. Clinical evaluation of Class I and Class II restorations. Burgess J and Muñoz C. (Contact Dentsply for further information) 12. Efficacy
of composite surface sealers in sealing cavosurface marginal gaps. D’Alpino PH, Pereira
JC, Rueggeberg FA, Svizero NR, Miyake K and Pashley DH.Journal of Dentistry 2006 34:
252-259

[25] =>

United Kingdom Edition

Clinical 25

December 10-16, 2012

Dentine hypersensitivity: Simplified
Dr Fay Goldstep looks at treatments to ease this sensitive subject

A

ll dental practices have
patients with dentine
hypersensitivity.
Many
patients avoid dental treatment
because of their hypersensitivity. Surprisingly, most practices do not have a systematic
approach for diagnosing and
treating this condition. This is
simply because it seems too
complicated. There is a multitude of products. What works?
Why does it work? Many practitioners have had poor success
in the past with sensitivity treatments and are reluctant to try
again. Today’s products are effective and easy to use. The following discussion will attempt
to bring simplicity and clarity
to the subject of diagnosis and
treatment of dentine hypersensitivity.

pain (Fig. 2).2
theory for the mechanism that
symptoms2:
flows in an inward or outward
causes dentine hypersensitivdirection, depending on presity is the hydrodynamic theory
sure differences in the surDiagnosis
• caries
first proposed by Brännström in
rounding tissue. This fluid shift
Prior to establishing the diag•
pulpitis
1963.15 When dentinal tubules
activates pain receptors in the
nosis of dentine hypersensitiv•
marginal leakage
intra-tubular nerves or superity, one must first rule out other
in vital teeth are exposed and
à DT page 26
pulp and
the patient
feels Ad
conditions
that 21/06/2012
exhibit similar
open,
the fluid
the tubules
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Definition
Dentine hypersensitivity is defined as a short sharp pain arising from exposed dentine in response to:
•
•
•
•
•

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and cannot be ascribed to
any defect or pathology.1
The three essential components of dentine hypersensitivity are (Fig. 1)2:

1
2

exposed dentine surfaces

open tubule orifices on the
exposed dentine surfaces

3

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patent tubules leading to
vital pulp

Dentine hypersensitivity has
been reported to affect up to 57
per cent of the general population.3–10 It occurs most frequently in patients of 30 to 40 years of
age.11 All teeth are susceptible
but canines and premolars are
the most affected.12, 13
A 2002 international survey of 11,000 adults revealed
that only half of the affected
individuals had talked to their
dentist about their sensitivity
and only half of this group actually received treatment recommendations.14 Many patients do
not wish to burden the dentist
with this problem, or they may
feel that it may not be taken seriously.
Mechanism of action
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[26] =>

26 Clinical

United Kingdom Edition December 10-16, 2012

à DT page 25

•
•
•

restoration fracture
cracked tooth
polymerisation shrinkage

It is important to use specific
clinical descriptors with the patient (like brief, sharp, localised)
to differentiate dentine hypersensitivity from pulpal pain (which
is prolonged, dull, aching, poorly
localised and longer lasting).2
Risk factors for dentine hypersensitivity include16:
•
•
•
•
•
•
•

periodontal disease
gingival recession
para-function (abfractions)
acidic diet
xerostomia
bleaching

These factors predispose the
patient to the essential components of dentine hypersensitivity: exposed, open and patent
dentinal tubules leading to vital
pulp. There may also be passage
of fluids through the enamel. The
enamel may be thought of as a
semi-permeable membrane that
allows passage of fluids and small
molecules through the organic
defects between the enamel crystals. With time, the organic channels become plugged owing to
the formation of organic biofilm.
When this occurs, the bidirectional flow of fluids stops and so does
the pain. During bleaching, the
organic plugs may be dissolved,
reopening the enamel channels
and causing sensitivity.17
Treatment
The first line of treatment for dentine hypersensitivity is of course
prevention. All of the predisposing factors must be dealt with
first. This may not be an easy task.
Periodontal disease, recession,
occlusal forces and diet present
many challenges. The treatment
of sensitivity is much simpler in
comparison.

Fig. 1_The essential components of dentine hypersensitivity are exposed dentine surfaces with open patent tubules leading to a vital pulp. (Image courtesy of GSK)

Figs. 3a & b_In the concentrations used for toothpastes, stannous fluoride is more effective than sodium fluoride in occluding dentinal tubules.(Courtesy of Procter & Gamble)

Table I_Treatment of dentine hypersensitivity.

rides, fluoride varnishes, tissue
fixatives, oxalates, remineralising
agents and Pro-Argin Technology.
The second group of products
works by depolarising the nerve
so that it cannot transmit the pain
response.
Occlusion of dentinal tubules

If we review the mechanism
of action of dentine hypersensitivity, it is easy to understand the
wide range of products available for treatment. The product
must either block the movement
of fluid in the tubules or stop the
transmission of the pain response
to the pulp. For added simplification, it is important to focus on the
active ingredient, and not on the
multitude of products (Table I).

Fluorides - Fluoride application is believed to work through a
reaction between the fluoride ion
and ionised calcium in the tubular fluid. This reaction forms an
insoluble calcium fluoride precipitate in the tubule.18 Different
fluorides show differing efficacies. Stannous fluoride is more
effective than sodium fluoride in
the concentrations used for toothpaste formulations (Figs 3a & b).

Products are available for inoffice or at-home application.
Treatment should not be restricted to one option only. This is not
a one-size-fits-all solution. Different treatments may be tried and
modified based on the patient’s
response.

Fluoride varnishes - Fluoride
varnishes may be used for sensitivity relief but are chiefly indicated for caries control and remineralisation. The desensitisation
effect is transient, since the material is abraded soon after placement. Many applications may be
necessary for increased efficacy. It
is thought that the benefit comes
from the physical blockage of the
tubules by the varnish base rather
than the fluoride itself.18

The first group of products
works by occluding the open tubules and decreasing pulpal fluid
flow. This group includes fluo-

Fig. 2_Fluid shifts in the dentinal tubules activate pain receptors to cause pain. (Courtesy of GSK)

Tissue fixatives - Tissuefixative desensitising products
contain agents such as glutaraldehyde or HEMA. These agents
bind to tissue fluid proteins in the
dentinal tubules and the superficial cells of the subadjacent pulp
and denature (coagulate) these
proteins. These products cannot be placed near the gingival
epithelium, since they may cause
necrosis of the gingiva, as well
as loss of the biological attachment.17
Oxalates - Desensitisers containing metallic salts, predominantly oxalates, form insoluble
chemical precipitates in the peritubular dentine. No acid etch
or light curing is needed. They
cause no irritation of the gingival tissue. One example is Super
Seal (Phoenix Dental). Super Seal
forms a complex with the calcium-rich zone of the peritubular
dentine to create a crystal plug.
This effectively shuts down dentine sensitivity almost entirely
(Fig. 4).19
Remineralising pastes Remineralising pastes are used
in the office or at home to restore
the minerals that have leached
out of patients’ teeth owing to car-

Fig. 4_Super Seal forms a complex with the calcium of the peri-tubular dentine to create a crystal plug across the dentine tubules.(Courtesy of Tammy Bonstein)

ies, diet, etc. These pastes have
the added advantage of reducing
sensitivity through tubule occlusion. Two active ingredients have
been shown to be the most effective for this purpose:

Novamin (calcium sodium
phosphosilicate bio-active glass)
and amorphous calcium phosphate:
Novamin-containing
toothpastes have been shown to
reduce dentine hypersensitivity significantly, with continued
home use.20, 21 The effect is cumulative up to about six weeks and
then stabilises.

ACP: ACP forms a protective
mineral barrier of hydroxyapatite that occludes the exposed
dentinal tubules (Fig. 5a & b).22
ACP is most effective in the form
called Recaldent (casein phosphopeptideamorphous calcium

phosphate) in which the casein
portion (derived from milk) binds
the ACP to the tooth surface,
where it can do its job. Recaldentcontaining pastes are placed on
the affected areas after regular
brushing.
Pro-Argin Technology - In
healthy patients, saliva is normally very effective in reducing
dentine hypersensitivity. Saliva
provides calcium and phosphate,
which over time occlude open
dentine tubules. Pro-Argin Technology was developed based
on this role that saliva plays in
naturally reducing hypersensitivity.23, 24 The Pro-Argin formula
contains arginine, an amino acid
found in saliva. The positively
charged arginine binds to the
negatively charged dentine surface. This attracts a calcium-rich
layer from the saliva to infiltrate
and block the dentinal tubules
(Fig. 6).16

[27] =>

United Kingdom Edition

December 10-16, 2012

More than 50 years of
knowledge and innovation.

Fig. 5a & b_ACP forms a mineral barrier of hydroxyapatite, which occludes the exposed dentinal tubules. (Courtesy of GC)

1962 the very latest in
dental technology
Fig. 6_The Pro-Argin formulation attracts a calcium-rich layer from the saliva to infiltrate and block the dentinal tubules. (Courtesy of Colgate)

This technology is available for in-office application,
through a paste that is delivered
by prophylaxis cup. There is also
toothpaste for at-home use. The
in-office paste has been found to
provide immediate and lasting
relief of hypersensitivity for four
weeks when it is applied as the
final polishing step of a professional cleaning.25 It has also been
found to decrease dental prophylaxis discomfort when used prior
to the procedure.26
Depolarisation of the nerve
The second major group of desensitisation products works by
depolarising the nerve that transmits the pain response. After the
nerve has been depolarised, it
cannot re-polarise and this diminishes its excitability. The ingredient that produces this effect
is potassium nitrate.27 According
to the FDA, for a potassium nitrate
toothpaste to claim to be desensitising, it must contain five per
cent of the ingredient. Potassium
nitrate penetrates the enamel
and dentine to travel to the pulp
and exerts a calming effect on the
nerve. This effect can be thought
of as anesthetic-like.28
Potassium nitrate products
are ideal for whitening sensitivity.
Whitening sensitivity occurs due
to the easy passage of peroxide
through the enamel (a semi-permeable membrane) and dentine
to the pulp. Desensitisation products that work by occluding the
dentinal tubules are ineffective in
preventing the passage of the tiny
peroxide molecule, which can
travel in the interstitial spaces between the tubules.28

Potassium nitrate can be delivered in several effective ways to
counteract whitening sensitivity:

Pre-brushing with five per
cent potassium nitrate toothpaste
for two weeks pre-whitening and
during whitening: It takes approximately two weeks for the
potassium nitrate to be at peak
desensitisation efficacy.29

Whitening tray delivery of a
potassium nitrate toothpaste for
ten to 30 minutes during whitening treatment: This appears to be
very effective for more acute sensitivity.28 It is preferable to use a
toothpaste without sodium lauryl
sulphate, which is the primary ingredient in most toothpastes, and
creates the effect of foaming. Sodium lauryl sulphate has been associated with increased gingival
irritation, especially on prolonged
contact.

Syringe delivery of potassium nitrate and fluoride: The
material is applied as needed for
specific areas of sensitivity.

Potassium nitrate incorporation into the whitening gel itself:
Bleaching efficacy does not appear to be affected by this addition.30

Conclusion
Treatment of dentine hypersensitivity is a simple, clear process.
It starts with a differential diagnosis, ruling out other possible
aetiologies like caries, pulpitis,

cracks, marginal leakage, etc.
Next, an attempt is made to eliminate predisposing factors such as
periodontal disease, para-function, acidic diet and xerostomia.
At the same time, the patient
is evaluated with respect to the
potpourri of potential desensitisation ingredients and the
products that contain them. It
is essential for the dental practitioner to be familiar with these
ingredients, their mechanisms
of action, benefits and indications. Some patients may require more than one type of
treatment. The treatment is
fine-tuned until a successful
solution is found. There is no
longer a reason for any patient
to endure dentine hypersensitivity. Simple answers have
been found to this long-time
problem, and the dentist has
gained a patient for life. DT

Sirona Orthophos XG Family
• Proven, tested, reliable - the
most sold OPG unit worldwide
• Superior image quality through
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2012 the very latest in
dental technology

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

About the author
Dr Fay Goldstep
has been a featured speaker in
the ADA Seminar
Series, and has lectured at the American Dental Association,
Yankee,
American
Academy of Cosmetic
Dentistry, Academy of General Dentistry, and the Big Apple dental conferences. She has been a contributing author to three textbooks and has
published more than 20 articles. She
is a Fellow of the American College of
Dentists, International Academy for
Dental-Facial Esthetics and Academy
of Dentistry International.Dr Goldstep
is a consultant to a number of dental
companies and maintains a private
practice in Toronto, Canada.

Sirona Dental Systems, Lakeside House,1 Furzeground Way,
Stockley Park, Heathrow, London UB11 1BD

0845 0715040
sirona.com
info@sironadental.co.uk

[28] =>

28 Industry News

The Castellini Skema
6 – Comfort and easy
repositioning guaranteed
Built with technical precision
and incorporating the latest
in dental technology, the
Skema 6 expands on the
quality and attention to
detail that Castellini has
shown through the entire
Skema range
Available in the UK from six regionally based Sales & Service centres, the
Skema 6 is a completely modern and ergonomic dental experience that
provides maximum comfort and ease-of-use. The Skema 6 boasts Memory
Foam Upholstery, Integrated Apex Locator, and Surgical Implant Motor
with peristaltic pump with irrigation set for 2 instruments, Surgison Bone
Scavenging interchangeable with Piezo Steril Scaler all this even with Wireless
Foot Control.
With our commitment to quality and reliability we can offer up to a 4 year
warranty which includes all parts required for the annual preventative
maintenance service

United Kingdom Edition

Looking for a new challenge?
At Centre for Dentistry we believe we offer the
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Working in partnership with Sainsbury’s we’ve
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Here at Centre for Dentistry we will work closely with you, managing the brand
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learn more about our vision, contact Centre for Dentistry today.
For more information, visit www.centrefordentistry.com or email partners@
centrefordentistry.com

December 10-16, 2012

The modern solution to endodontic clutter
Modern root canal therapy is a technically
dependent procedure requiring ultrasonics,
electronic apex locators, irrigation delivery
systems, constant torque auto reverse electric
motors and a large number of wires, foot
pedals and clutter, says endodontist Simon
Cunnington.
“The ASI delivery system is the 21st century
solution to these problems. With excellent
technical support, the individual practitioner
can contribute specific requirements. The carts can house all of your
endodontic apparatus, plus built in air compressors, suction and a closed water
supply from just one standard electrical outlet. They can accommodate either
left- or right-handed individuals. The sophisticated design would compliment
any dental surgery and is easy to clean. Not a week goes by without a patient
commenting on how “space age” my surgery appears,” he says.
Having owned an ASI cart for three years without fault, Simon is supportive
of the range and the service he received when ordering it from Clark Dental.
For more information call Clark Dental on 01268 733 146, email
info@clarkdental.co.uk or visit www.clarkdental.co.uk

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

Medical emergencies: are
you prepared?
Medical emergencies can
happen at any time. That’s
why it’s essential your staff
are up-to-date on the latest procedures for emergency situations, so they can
react swiftly and effectively to any foreseeable occurrence.
At dbg we have over 20 years’ experience working closely with dental practices,
providing bespoke training solutions that are both informative and engaging.
Our foreseeable medical emergencies theory course includes:

The Dental Directory – Great
service repaid with customer
loyalty
With attention paid to delivering
the very best customer service,
The Dental Directory is known
for providing complete customer
satisfaction. With over 27,000
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The Dental Directory is a veritable
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• In-house practice specific training.
• Practical CPR Demonstrations on resuscitation manikins.
• ‘Hands on’ practical session for all the team including the use and application
of automatic external defibrillators to build confidence.
• Bespoke Emergency Protocol.
• Advice and recommendation on your existing practice emergency response
kit and the treatments you provide with a demonstration of our unique ‘track &
trace’ emergency drugs system with tamperproof seal.

Amanda Cain, Senior Dental Nurse at Whickham Dental Practice in Newcastle
Upon Tyne says:

For more information call dbg on 01606 861 950,
Or visit www.thedbg.co.uk

For more information, contact The Dental Directory on

“We have been using The Dental Directory for more than 20 years and they are
our preferred choice every time. The customer service is great; our rep Denis is
a huge fountain of knowledge. I email him a lot with queries and normally I get
an instant response. If he doesn’t know the answer, he makes sure to find out for
me. He is fabulous.”

Precise Scaling with Dental Sky’s TriScaler
The new high quality R&S Tri-Scaler
Compact from Dental Sky is surprisingly
economically priced.
With
a
detachable,
autoclaveable
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incorporates a power function switch for complete flexibility. Five tips are
included with the Tri-Scaler Compact.
The larger Tri-Scaler Aqua benefits from the same features as the Compact with
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With 8 scaler tips included the Tri-Scaler Aqua represents excellent value for
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For further details or to place your order please contact Dental Sky directly on
0800 294 4700.

0800 585 586, or visit www.dental-directory.co.uk.

The London Smile Clinic
Goes IncognitoTM in
Germany
Exclusive Invite-Only
Event
Dr Preet Bhogal was
one of a select group of
orthodontists invited by
IncognitoTM to an exclusive
trip to the company’s hightech laboratory in Germany. The elite group were flown to Bad Essen on 15th
November 2012.
They took a tour of the facilities, met the technicians and were the first to see
the company’s very latest developments in orthodontic braces. The exclusive,
invite-only event included talks from key opinion leaders from Germany and
the UK. “It was good to see what’s at the forefront of lingual orthodontics,” says
Dr Bhogal, Specialist Orthodontist at the London Smile Clinic, “so we can be
amongst the first in the world to be using these systems.
“Together with learning the latest cutting-edge techniques, there are huge
benefits that I will be able to pass on directly to our patients.”
For more information, please contact 020 7255 2559 or visit
www.londonsmile.co.uk/refer - your patients will be glad you did!

Dr Paulo Malo to Speak at The
Dentistry Show 2013
The Dentistry Show 2013 promises
to be a highlight of the year, with
over 300 exhibitors and more than
50 top quality speakers presenting
lectures, hands-on workshops and
live demonstrations with up to 65
hours of free vCPD available.
Dr Paulo Malo will be giving a lecture
about the All-on-4™ technique as
part of the “Aesthetic Dentist” conference in 2013. “The technique isn’t subject
to the same limitations as is bone grafting for traditional implants, and the Allon-4™ is consequently more cost-effective with a shorter treatment time, and
also causes far lees pain for the patient,” he says. “My lecture at The Dentistry
Show will cover these issues, as well as showing delegates how far they can
push the boundaries of the technique. “I think the combination of conference
and exhibition at such events is also very useful for delegates, as it offers the
opportunity to compare products and brands and really get in-touch with the
modern dental industry.” The next show will be held on 1st and 2nd March
2013 at NEC Birmingham. For more information, visit www.thedentistryshow.
co.uk, call 020 7348 5269 or email dentistry@closerstillmedia.com

Nobel Biocare Sponsors
Introductory Implants Course
Newcastle Dental Hospital, in
conjunction with Nobel Biocare,
offers an exciting two-day course
called ‘Starting with Implants’ to
introduce GDPs to implant dentistry.
This varied two-day programme takes place early each year and offers 12 hours
of verifiable CPD. Delegates will attend lectures, treatment-planning seminars,
observe live surgery, and have the experience of placing implants in manikins.
Course leader Mr Matt Garnett is a consultant in Restorative Dentistry. “Dental
practitioners will be able to better inform patients about implant possibilities,”
he says. “They’ll know which patients would benefit from implants and when
they should look to refer. They will also be able to explain the different stages of
treatment involved.”

The revolutionary
Powder-Free CEREC® Omnicam
The launch of the revolutionary powderfree CEREC® Omnicam from Ceramic
Systems, the UK CEREC® Specialists,
enables continuous full colour image
streaming and makes the unique benefits
of the CEREC® System even easier to use.
The CEREC® Omnicam enables continuous
data acquisition for the generation of full colour 3D virtual models of single
teeth, quadrants and full arches. Powder-free, it saves time and eliminates the
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the CEREC® Omnicam and CEREC® System enable Dentists to cut down their
Laboratory Bills by up to 90%.

Elements of the course include pre-operative evaluation, treatment options
from single tooth loss to fully edentulous patients, and surgical and prosthetic
techniques. The course costs £750, which includes all materials, meals and
refreshments, and takes place from 13th to 14th March 2013 at Newcastle Dental
Hospital.To book your place call 0191 282 5131 or email anne.jacobs@nuth.nhs.uk

CEREC® enables Dentists to create high quality and durable chairside allceramic restorations in the most cost-effective and efficient way. Quick,
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crowns, veneers and crowns for the anterior, premolar and molar regions inhouse in one visit.

For more information about Nobel Biocare call 0208 756 3300,
or visit www.nobelbiocare.com

For further information contact Ian Pinner on 01932 582905, e-mail i.pinner@
ceramicsystems.co.uk or visit www.ceramicsystems.co.uk

Special price on ‘No touch’ hand
dispenser
Buy a ‘No touch’ PracticeSafe Hand
Disinfectant Gel Dispenser for only £50.00
when you buy 2 packs of 4 x 650ml
PracticeSafe Hand Disinfectant Gel.
The ‘No touch’ hand dispenser from Kemdent
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hand disinfectant gel. No contact is required
with this dispenser so Dental professionals
just need to hold their hands under it. No
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The PracticeSafe Hand Disinfectant Gel Dispenser provides a correct dosage
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For information on the full range of Kemdent disinfectants, ChairSafe,
PracticeSafe, PracticeSafe Soak and InstrumentSafe visit the Kemdent website
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New Hand Disinfectant Gel from Kemdent
PracticeSafe Hand Disinfectant Gel is the new rapid
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Buy 2 packs of the new 4 x 650ml PracticeSafe Hand Disinfectant Gel from
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For information on the full range of Kemdent disinfectants, ChairSafe,
PracticeSafe, PracticeSafe Soak and InstrumentSafe visit the Kemdent website
www.kemdent.co.uk

[29] =>

United Kingdom Edition

Get ahead with a project manager
says Roger Gullidge
Dentists who are building their own
new practice should always use an
independent project manager, says
Roger Gullidge of Roger Gullidge
Design.
“It is possible to project manage a
build yourself, if you have experience
of such projects and can afford to
take months off from your dental
practice,” says Roger, who has two
decades of experience in building dental practices. “If you don’t meet those
criteria it is my sincere belief that you should hire a project manager with as
much experience of building dental practices as you can find.”
While taking on project management duties can provide a cost saving, it rarely
proves cost effective. Dentists spend so much time away from dentistry that
their income suffers, and they are unlikely to manage the build as efficiently as
a more experienced manager.
Roger Gullidge Design is a specialist design and project management
consultancy specialising in the dental sector. Call 01278 784442 for more
details or visit: www.rogergullidgedesign.com

New Dental Product wins
Highly Commended award in 2
Categories.
After being shortlisted at the UK’s
most prestigious Packaging Awards
at the London Park Lane Hilton
on Wednesday 14th November.
Topdental’s new product Virofex
won Highly Recommended in two
categories, Best New Concept and also
Innovation of the Year. Judge’s comments in the winners brochure included
“Ingenious” and “Brilliant”. Virofex is a high level alcohol free disinfectant,
supplied in pre-dosed cartridges which are then mixed with tap water by a
release system in the trigger spray bottle. This reduces packaging by 72% and
replaces bulk storage of disinfectant chemicals. The Virofex cartridge dispenser
is mounted onto a wall or cupboard with supplied adhesive tabs so eliminates
the need for large 5 litre containers in the surgery or store room. The dispenser
is also coated with a silver ion material to remove bacteria such as MRSA from
either hands or gloves. The mixed solution can be used in conjunction with
micro-fibre lint free wiping cloths or directly onto the medical device, it can
be used on all surfaces even acrylics and metals. Virofex is available in the UK
from Dental Directory.
See www.ukpackagingawards.co.uk for more information on the awards and
www.virofex.com for more information on the product.

Build Wealth at The
Dentistry Show 2013 With
Lansdell & Rose at Stand
D51
While
attending
The
Dentistry Show 2013 don’t
forget to visit the Lansdell
& Rose stand (D51) and
discover the tax savings
you could make. The specialist business accountants have an in-depth
understanding of dentists’ financial needs. With intelligent tax management,
Lansdell & Rose are dedicated to seeking out sustainable, long-term solutions
that maximise their clients’ profits. Talk to the accountancy experts from 1st –
2nd March 2013 at The Dentistry Show 2013, which is being held at the NEC
Birmingham. The friendly and professional team provide strategic thinking and
meticulous attention to detail to alleviate the pressures of running a practice.
Offering peace of mind, Lansdell & Rose ensure your accounting is always
efficient and up-to-date. Based in Kensington, London, Lansdell & Rose deal
exclusively with owner managed clients, principally dentists and doctors, and
specialise in the incorporation of dental practices.
Contact Lansdell & Rose – it’s the easy way to minimise your tax costs and
build wealth. For more information please visit www.lansdellrose.co.uk or call
Lansdell & Rose on 020 7376 9333.

9000 3D Extraoral
Imaging System from
Carestream Dental
“It’s crucial to what we do”
Colin Campbell is the Clinical
Director for Campbell and
Peace Specialist Practice
in Nottingham and he has
used the 9000 3D extraoral
imaging
system
from
Carestream Dental for almost three years.
“It’s been an amazing addition to our practice kit, we just couldn’t work without
it now,” says Mr Campbell. “It’s crucial to what we do on a day-to-day basis.
“It’s allowed us to visualise planning of implant cases in a way that we were
never able to see before - and to have it at our fingertips in the practice, rather
than having to outsource, means that it’s benefited our patients massively.
“We were one of the first practices in the country to get the 9000 3D and I’ve
recommended it to a lot of people because it’s great. It’s the basic standard of
care we should be using now.” The 9000 3D extraoral imaging system combines
focused-field 3D technology with dedicated panoramic imaging and offers the
highest resolution and lowest radiation in its class.
For more information, contact Carestream Dental on 0800 169 9692 or visit
www.carestreamdental.co.uk

December 10-16, 2012

Sident Dental Systems
Over 30 years experience with Sirona
products
With over 30 years experience of working
exclusively in partnership with Sirona, to
promote the world’s premier brand of high
tech dental equipment and support their
many loyal customers, when you buy Sirona
Equipment from Sident Dental Systems you
not only get the best price and exclusive Special Offers, but you also get access
to the best sales support in the UK!
So if you are re-equipping buy your Sirona Equipment from Sident Dental
Systems, the UK’s only Specialist Supplier of Siemens /Sirona equipment.
Sirona Specialists, Sident Dental Systems offer the choice from the complete
range of Sirona Treatment Centres, 2D and 3D digital and film based x-ray
apparatus – including the very latest Orthophos XG 3D digital panoramic
machine, their extensive range of Sirona handpieces, and auxiliary items
including SiroLaser, SIROEndo and DAC sterilisation units.
Wherever possible potential clients are invited to visit The Courtyard, Sident’s
state-of-the-art training and showroom facility in Chertsey, where they will be
able see the complete product range in action. They will then be able to identify
the best solution for their individual needs. For further information call Sident
Dental Systems on 01932 582900 or email j.colville@sident.co.uk

Virofex – Perfection in Global Disinfection
Virofex is the comprehensive and versatile
disinfectant, which doesn’t harbour the
complications associated with alcohol-based
cleaning products.
Virofex cleans and disinfects to the highest levels.
It’s safe and effective on a wide range of surgery
surfaces, from glass and metals, to plastics including
perspex, chair upholstery, all worktops and even plastic parts on medical devices.

Industry News 29

Service that Counts
If you are setting up your own
dental practice, there is a long
list of different elements to
consider. When it comes to the
actual premises, you must be
sure you are working with the
best in the business to design
and furbish your new practice.
Tavom is widely recognised as one of the worldwide leading manufacturers
of dental cabinetry. Supplied by RPA Dental, you can trust the experts to help
you through the entire process from design to installation. Dr Ghasoon Smith
from Bexton Dental Care in Cheshire was delighted by the service she received.
“It was obvious from the outset that RPA Dental were the right choice and their
professionalism, adaptability and attention to detail was exemplary,” she says.
“Throughout the process from planning to completion, RPA Dental’s advice and
guidance enabled us to create a state-of-the-art practice. I cannot recommend
them enough for the way in which they have handled the project, delivered on
time and their continuing involvement following completion.”
For more information call Tavom UK on 0870 752 1121 or visit the Tavom
website www.tavom.com. For RPA Dental on 08000 933975,
or visit www.rpadental.net

WhiteWash Laboratories – “an excellent
company to work with”
WhiteWash Laboratories is a leading provider
of exceptional oral care products, including
Professional Teeth Whitening Strips, NanoSilver
Toothbrushes,
and
Professional
Whitening Toothpaste with Silver Particle
Technology.
Dr Libby Allen of Bishopton Lane Dental
Practice, Stockton, says:

Virofex comes in small cartridges which ensures:
• No staff contact with chemicals
• No spills and no waste
• The correct amount will always be used
• It is easy and quick for the whole team to use
The Virofex cartridge is simply inserted into the neck of a Virofex bottle, which is
filled with 500ml of tap water. The bottle then needs a gentle shake to activate
the disinfectant, which then stays active for up to 12 months. Available from
The Dental Directory, Virofex is a powerful and thorough disinfectant effective
against MRSA, HIV, Influenza A, Salmonella Typhimurium and Clostridium
Difficile amongst many other viruses, bacteria and spores that your practice may
bear. For more information, contact The Dental Directory on 0800 585 586, or
visit www.dental-directory.co.uk.

Invest in Your Career
With the UCL Eastman Dental Institute
For highly supported and flexible learning
to enhance your career without impacting
on your practice, come to the world’s
leading academic centre for dentistry: the
UCL Eastman Dental Institute.
With programmes for the whole dental
team, delegates can choose from a diverse range that includes:
• University Certificate and Diploma level programmes
• Short courses and Continuing Professional Development
• Masters, Doctorates and Specialty training
Recognising the hectic schedules of modern dental professionals, UCL Eastman
has developed training solutions to fit any busy lifestyle. Participants can choose
from a variety of full-time, part-time or modular training programmes. They
also have flexibility in terms of format - be it on-site, distance learning or online
education. Offering hands-on clinical and laboratory sessions using cuttingedge facilities, in addition to experienced tutors and accomplished guest
lecturers, delegates – and their patients - will experience the benefits in the
practice straight away. Further details of programmes available can be accessed
from: www.ucl.ac.uk/eastman/cpd

“WhiteWash Laboratories is an excellent company to work with, and the rep,
Chris, will always go out of his way to help us whenever we need anything.
“Personally, I like the products a lot, and my nurses also use them and achieve
excellent results. WhiteWash Professional Teeth Whitening Strips are good for
people who can’t afford to have more expensive tray whitening treatments. It’s
a much more realistic expense for many people. I’ve also had some cases where
patients have gone on from using the strips to then having other whitening
procedures as well.”
For more information call 0844 68 69 150, email
info@whitewashlaboratories.com, or visit www.whitewashlaboratories.com

dfyt.com – great for patients,
great for you
Oral hygiene sales not generating
enough income? Stacks of unsold
products taking up too much space?
To make the most of your oral
hygiene product sales use dfyt.com for the easy, hassle-free solution. dfyt.com
(don’t forget your toothbrush) is a subscription-based delivery service that
delivers new toothbrushes direct to your patients’ doors.
The system offers many fantastic benefits including:
• 10% guaranteed income from every order your patients make
• No need to carry stock
• Patients save money, with further discounts on large orders
• Improve and maintain patient oral health
• No administration or registration fees payable.
The dfyt.com system is simple. Simply register today to receive your free
marketing pack with all you need to get started, including your own unique
practice code. Patients who use this code on their orders will receive 5% extra
discount on their orders, and will benefit from receiving regular oral hygiene
deliveries direct to their door.
dfyt.com – great for patients, great for you. For more information on how dfyt.
com can benefit your patients’ oral health, visit www.dfyt.com For further
dental enquiries, email conor@dfyt.com For sales, email graham@dfyt.com

Carestream Dental and R4 Practice
Management Software:
“I think it’s a great system”
Jacqui Dougan is the Practice Manager of Eight
Dental in Glasgow and has used the R4 Practice
Management Software from Carestream Dental
for almost three years.

Chris Barrow Live at BKH:
“Business coaching has got us
enthusiastic”
Dr Alastair Kennedy is one of three directors
of Gaskell Dental, a general dental practice
based in Knutsford, Cheshire, and a client of
business coach Chris Barrow.

“I make good use of R4, particularly for patient
appointments, financial work and reports,” says
Mrs Dougan. “It’s more efficient than relying on a paper system. Appointments
are easier to control; as are the six-month recalls. I think it’s a great system.

“I like his views. I know he calls a spade a
spade and I thought that’s what we need,”
says Alastair. “I thought he’d be the best
person to give us a bit of a shake up.

“Just before I joined the practice I had training from Carestream Dental on how
to use R4. It was very beneficial and showed me everything I needed to know. It’s
quite an easy system to follow.

“Business coaching has got us enthusiastic. We’ve already made quite a few
changes and we’re still ongoing. In fact, Chris has given us enough pointers to
work on for another year or more!

“The customer support team are excellent. Recently, I required assistance and
rather than talk me through the process the gentleman dialled in remotely to our
R4 system, and was able to show me how to fix the problem.”

“I think the majority of dentists of my age, in their 50s, probably haven’t got
much of a business head on them because we were never taught much of that
side of things. In the current climate it’s much more necessary to treat it as a
business and do things in a businesslike manner.”

For more information on R4 from Carestream Dental please call
0800 169 9692 or visit www.carestreamdental.co.uk

For more information about Chris Barrow Live at BKH please call 0161 820 5466
or email Chris Barrow at chris@bkh.co.uk

[30] =>

30 Editorial Board

United Kingdom Edition

December 10-16, 2012

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

t Centre

nt Abutments

uire on the

atory Implant

implants
the journal of

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

2

oral implantology

aving you

£100

*

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s:

£25
£140
£185

£350

TO £100 per unit

†

idden Charg
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s!

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

| user report

Impression techniques for Implant dentistry

| case study

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
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

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

Arch® 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

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

Follow us on Twitter
Roots_issue2_2012.indd 1

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

[31] =>

United Kingdom Edition

rankly

Classified 31

December 10-16, 2012

S

Whatever your management role.....

peaking

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

ILM Level 3 Certificate in
Management
designed for senior nurses and
receptionists and new managers
taking their first steps in management

ILM Level 5 Diploma in
Management
for existing practice managers
and dentists

ILM Level 7 Executive Diploma
in Management

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.

for dentists and practice business
managers, and accredited by the
Faculty of General Dental Practice as
part of the FGDP Career Pathway

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

www.umdprofessional.co.uk

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

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

Follow us
@franktaylorassc
Please contact:
Nick Ledingham BSc, FCA
Tel: 0151 348 8400
Email: mail@moco.co.uk
Website: www.moco.co.uk/dentists

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

N SDAL
National Association of
Specialist Dental Accountants & Lawyers

N SDAL
National Association of
Specialist Dental Accountants & Lawyers

[32] =>

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[cover] => DT UK No. 29, 2012

[toc] => Array ( [0] => Array ( [title] => News [page] => 01 ) [1] => Array ( [title] => The Minimally Invasive Dentistry Show! [page] => 08 ) [2] => Array ( [title] => What Does Your Facebook Page Say About You? [page] => 10 ) [3] => Array ( [title] => The dangers of “tunnel vision” in dentistry [page] => 12 ) [4] => Array ( [title] => Just one small change can be the start of something great [page] => 14 ) [5] => Array ( [title] => Why improving your practice is a mystery – part 14 [page] => 16 ) [6] => Array ( [title] => The Missing Business Plan [page] => 18 ) [7] => Array ( [title] => Local Healthwatch: what will it mean to you? [page] => 20 ) [8] => Array ( [title] => Posterior Composites in General Practice [page] => 22 ) [9] => Array ( [title] => Dentine hypersensitivity: Simplified [page] => 25 ) [10] => Array ( [title] => Industry News [page] => 28 ) [11] => Array ( [title] => Dental Tribune UK Editorial Board [page] => 30 ) [12] => Array ( [title] => Classified [page] => 31 ) ) [toc_html] =>

Table of contents

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