DT UK No. 3, 2016

Dental Tribune survey sees majority of British dentists rejecting Brexit / UK News / Sugar - sugar…honey - money / World News / Career opportunities and work–life balance in dentistry / Causes and treatment of breath odour / “I’m in love” - Why dentists prefer to use AquaCare / Show Tribune U.K. Edition for Dentistry Show

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DTUK0316_01_Title 12.04.16 16:39 Seite 1

DENTAL TRIBUNE
The World’s Dental Newspaper · United Kingdom Edition
Published in London

www.dental-tribune.co.uk

Vol. 10, No. 3

BERGMAN SPEAKS

AQUACARE

SHOW TRIBUNE

The Henry Schein Chairman and
CEO about public-private partnerships in dentistry and their
importance for the improvement
of oral health worldwide.
” Page 8

Dental Tribune UK talked to Keith
Morgan, Sales & Marketing Manager of Velopex International,
about the next big step in Contactless Dentistry.
” Page 15

Read all about one of the Uk’s
largest dental events in Birmingham
in our specialty section included in
this issue.
” Page 17

Dental Tribune survey sees majority of
British dentists rejecting Brexit
More than half would vote against the United Kingdom leaving the EU
By DTI

the poll, were split, with almost the
same number voting for the Brexit
as voting against it.

LONDON, UK: Were it up to dentists, the UK would remain a
member of the European Union
after the national referendum
in June. According to an online
survey conducted among Dental
Tribune Online readers between
February and March this year,
a slight majority of dental professionals would vote for staying in the EU rather than leaving
it.

Almost one-third of those who
responded to the survey said they
were in private practice, while onequarter said they were employed in
the National Health Service. Forty
per cent worked in practices that
offered both NHS and private dental care services.
Regarding the age of the respondents, more than half were between 30 and 50 years old, followed
by a large group aged 50 to 60.

After analysing the results of the
poll, Dental Tribune found that
more than 55 per cent of dentists
who participated in the survey intended voting against Britain leaving the EU, while 44 per cent were
in favour of a Brexit.
Britons have to decide on 23 June whether they want the UK to remain a member of the EU.

Less than 1 per cent were still
undecided on the issue, but perceived an overall more negative
future should Britain decide to
split from the Union.
Similar responses were given by
the participants when asked
whether a Brexit would have positive or negative consequences

for the country. A larger share of
dentists, however, replied “I do not
know” to this question.
The overall majority of respondents to the survey said they will
definitely vote in the referendum.
Only one in ten did not intend to
participate in it.

The poll was conducted among
16,000 recipients of the Dental
Tribune UK & Ireland weekly
newsletter, with almost half of all
replies from dentists in southern
England, particularly London,
which made up almost 20 per cent
of the survey respondents. There
was less participation by dentists

from the northern regions, with
slightly less than 30 per cent taking
part in the poll. Only one in ten
respondents were from the Midlands.
Dentists from Scotland, Wales
and Northern Ireland, who made
up 12 per cent of the participants in

Britons have to decide on
23 June whether they want the UK
to remain a member of the EU.
Mirroring the results of the Dental
Tribune survey, the latest national
polls indicate that the slight majority of the population will vote
to stay in the UK. However, 10 per
cent of eligible voters have still
not decided which way to vote.
Prominent political and economic
figures have argued that a decision
to leave the EU will have widespread negative consequences for
the UK.

Profits of private practices leap
over those of NHS in 2015
Eight per cent rise a direct result in fee income
By DTI
LONDON, UK: For the first time in
over a decade, private dental practices in the UK have achieved
greater profits last year than their
NHS counterparts. On average,
profits in private dentistry increased to £140,129 per principal
according to the latest figures released by the National Association

of Specialist Dental Accountants
and Lawyers (NASDAL), approximately £10,000 more than reported by NHS practices.
The last time private practices
were more profitable was in
2004/2005. The leap is a direct
result of an 8 per cent rise in fee
income, compared with NHS
practices, whose income through

fees only grew by 4 per cent last
year.
Overall, all types of practices
experienced a sustained recovery of profitability in 2015
compared with 2014, according
to Humphrey & Co. partner Ian
Simpson, who presented the
figures on behalf of NASDAL on
Tuesday.

However, Associates’ profits decreased slightly last year and this
could be attributed to increased
insurance and subscription costs,
he said.
“It’s positive to see that the
UK dental market has continued
to grow at a rate of around 4.4 per
cent with relatively unchanged
costs and prolonged recovery in

profitability,” NASDAL Chairman
Nick Ledingham remarked.
The figures were collected through
tax reports and accounts provided
by accountant members of NASDAL
across the UK. They are published
annually in March and reflect the
finances of dental practices and
dentists for the most recent tax
year, according to the association.

[2] =>

DTUK0316_02_News 12.04.16 13:17 Seite 1

UK NEWS

02

Dental Tribune United Kingdom Edition | 3/2016

The annual Pound rolling has begun
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PUBLISHER:
Torsten OEMUS
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newsroom@dental-tribune.com
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Periodontitis: Faster cognitive
decline in people with Alzheimer’s
By DTI
LONDON & SOUTHAMPTON, UK:
A number of studies have demonstrated that poor oral hygiene, a
common problem among elderly
patients, is a risk factor for developing Alzheimer’s disease. Now,

a joint research project led by
scientists at the University of
Southampton and King’s College
London has provided further evidence that periodontitis could be associated with increased dementia
severity and a more rapid cognitive
decline in Alzheimer’s patients.

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Fifty-nine non-smoking patients with an average age of 77.7,
mild to moderate dementia and
a minimum of ten teeth who had
not received treatment for periodontitis in the past six months
participated in the study. The patients underwent dental examinations by a dental hygienist at
baseline and at the six-month
follow-up. In addition, blood
samples were taken to measure
inflammatory markers in their
blood.
The presence of periodontal
disease at baseline was associated
with a sixfold increase in the rate
of cognitive decline in participants over the study period. Periodontitis at baseline was also associated with a relative increase
in the pro-inflammatory state
over the follow-up period.
The researchers concluded that
periodontal disease is associated
with an increase in cognitive
decline in Alzheimer’s disease,
possibly via mechanisms linked
to the body’s inflammatory response.
As the study only included a
limited number of participants,
the authors stated that the findings should be validated in a
larger-cohort study. In addition,
they highlighted that the precise
mechanisms by which periodontitis may be linked to cognitive
decline are not fully understood
and other factors might also play
a part in the decline seen in participants’ cognition alongside
their oral health. However, the
current evidence is sufficient to
explore whether periodontal treat-

ment might benefit the treatment
of dementia and Alzheimer’s disease, they said.
Periodontitis is a common disease in older people. The World
Health Organization estimates
that 15–20 per cent of adults aged
35–44 worldwide have severe
periodontal disease. The condition may become more common
in Alzheimer’s disease because
of a reduced ability to take care
of oral hygiene as the disease
progresses.
Higher levels of antibodies to
periodontal bacteria are asso ciated with an increase in levels of inflammatory molecules
elsewhere in the body, which in
turn has been linked to greater
rates of cognitive decline in
Alzheimer’s disease in previous
studies.
Dr Mark Ide, from King’s College London Dental Institute and
first author on the paper, said:
“Gum disease is widespread in
the UK and US, and in older age
groups is thought to be a major
cause of tooth loss. In the UK
in 2009, around 80 per cent of
adults over 55 had evidence of
periodontal disease, while 40 per
cent of adults aged 65–74 and
60 per cent of those older than
75 had less than 21 of their original
32 teeth, with half of them reporting periodontitis before they lost
teeth.”
The study, titled “Periodontitis and cognitive decline in
Alzheimer’s disease”, was published online on 10 March in the
PLOS ONE journal.

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INTERNATIONAL EDITORIAL BOARD:
Dr Nasser Barghi, Ceramics, USA
Dr Karl Behr, Endodontics, Germany
Dr George Freedman, Esthetics, Canada
Dr Howard Glazer, Cariology, USA
Prof. Dr I. Krejci, Conservative Dentistry, Switzerland
Dr Edward Lynch, Restorative, Ireland
Dr Ziv Mazor, Implantology, Israel
Prof. Dr Georg Meyer, Restorative, Germany
Prof. Dr Rudolph Slavicek, Function, Austria
Dr Marius Steigmann, Implantology, Germany

Published by DTI.
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DTUK0316_04_Primespeak 12.04.16 12:03 Seite 1

UK NEWS

Dental Tribune United Kingdom Edition | 3/2016

A new global language for dental
professionals
Primespeak launches patient communication series in the UK
MANCHESTER, UK: Many dentists
find it difficult to communicate
the right treatment options to
patients, who through false or
incomplete information on the
Internet present to practices with
unrealistic expectations. While the
majority of patient communication training programmes available today often focus on one or
more fixed strategies at a time,
there are other concepts that aim to
make this process more natural
and less stressful for the dentists.
One of them is Primespeak, an import from one of Australia’s leading
practice management companies,
which is currently making its largescale debut in the UK.
First introduced to the market
here by Sydney-based Prime Practice
three years ago, the seminar series is
now on an extended road tour in the
UK, stopping in cities like London,
Birmingham, Bristol and Belfast,

throughout the year and is made
possible through a partnership with
Henry Schein company Software of
Excellence. The series was recently
launched at a premier event in Manchester with 40 participants, where
Dental Tribune had the opportunity
to speak with some of the programme’s directors and trainers.
According to Prime Practice General Manager of Education and
Training Patric Moberger, one of the
key objectives of the programme is
to help patients take responsibility
for their own teeth and to understand the damaging consequences
of not looking after them. In order
to achieve this, the programme provides a number of tools and strategies that, when applied at the right
time and in the right combination,
can help dentists gain patients’ compliance with treatment, particularly
those who do not truly understand
the options before them.

Participants of Primespeak’s take-off seminar in Manchester.

“Primespeak is applied at its optimum for patients who think that
nothing is wrong because there is
no pain involved. It is quite like high
cholesterol: you do not feel the

consequences until it is too late,”
Moberger explained. “By stepping
away, we let the patient come to
you ask for a solution instead of
recommending something they
may not understand and thus want
to get involved in.”
“Normally in sales you move towards the patient with a solution.
All the tools that we are using with
Primespeak however are counterintuitive to sales training. The role
that the dentists and the team
have here is to make the patient
understand that things are going
on in their mouth and that they
offer the right solutions for them,”
he added.
Feedback from dentists who participated in Primespeak seminars
held in Australia and the US, where
the series has been available to dental professionals for many years,
has been very positive and encouraged the company, together with
word of mouth, to bring the concept to the UK. In addition to the
live seminars, it offers master

Patrick Moberger

classes, private consultations with
a trainer and a library of online
training videos. Seminars for dental assistants and front-end staff
are under consideration. Participants at the seminar in Manchester
responded positively to the programme.
“If a dental professional is looking to build trust quickly with patients, save time and gain greater
acceptance of treatment, that person should come to a Primespeak
Seminar. Time very well spent,”
commented a dentist from Hull.
Another participant from Glasgow said: “I cannot recommend
this course enough. It will remove
the pressure when interacting with
patients and is key to avoiding sales
pitching perception.”
Primespeak is holding its next
seminar in June in Birmingham.
Dentists or dental staff interested
in registering for the programme
can obtain more information at
primespeak.com/uk.

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DTUK0316_06_Alani 12.04.16 12:05 Seite 1

OPINION

Dental Tribune United Kingdom Edition | 3/2016

Sugar, sugar…honey, money
By Aws Alani, UK
The sugar tax is finally upon us, but
are corner shops or supermarkets
for that matter likely to worry about
this potentially threatening change
to their flagship product line? The
tax targets all drinks and equates to
a tax of 24 pence per litre on those
with the most sugar content. This
could potentially equate to an increase in the price to the consumer,
but bearing in mind that soft drinks
are more accessible and cost less in
the UK than water in many Third
World countries, it is doubtful that
things will change markedly.

try was worth £15.7 billion, with
over 14.8 billion litres in overall
consumption, which represents
a steady and exponential growth
that is likely to continue. One interesting observation is the slow
demise of the 330 ml can—it being
replaced by the 500 ml plastic
bottle. The larger bottle may represent better value for money, but
is less likely to represent better
health value, especially since a resealable bottle is more likely to be
sipped over hours than a can once
opened.

restaurants may not be as ironic as
I first thought!

masked by other ills while slowly
swelling corporate turnovers?

Erosive tooth wear seems to
have been forgotten amongst
overweight toddlers needing earto-ear clearances. From bulimics
who like to taste but do not like
their waist to the energy drink
crew who prefer machismo gothic
graphic designs, the younger generation is likely to experience
more dissolution of tooth tissue.
At the other end of the spectrum,
obese patients are more likely to

Society is forever changing and
food is now at the centre of how we
relate and connect with each other.
From Instagram posts of freshly
cooked home meals to wedding

“...food is an emotive
issue...”
cake bliss after inordinate tastings,
it seems to be important to everyone. As a result, food is an emotive
issue that affects oral and general
health in ways that may not be
readily apparent to our patients.
I have an old friend in Florida, who
I visited last year. He is a specialist
in periodontology and runs a successful, swish, modern referral
practice. As a matter of routine, he
tells patients they need to stop
carbohydrate intake post-surgery.
Once patients understand that this
improves outcomes owing to decreased plaque build-up on the
wound edges, they are receptive
to this brief change in their diet.
He also advocates periodontal medicine while identifying stress as a
risk factor for periodontitis.

There is the argument that taxing tobacco has had an effect on the
uptake of smoking and the consequent addiction, but the evidence
for this is relatively sparse and
weak. Although a worthy initiative,
taxing drinks may result in a
greater squeeze on those who can
afford it the least and I doubt
whether little Jimmy will stop his
tearful tantrums for penny sweets
as a result of a celebrity chef’s
campaign as our sugar saviour.
As a child of the eighties, these
celebrity-led campaigns remind
me of rock bands who decided that
African poverty should be on the
agenda, but this does not seem to
be as important to them now. It
would appear that it is easier to tax
sugar than to provide funding for
dentistry; unfortunately, there is
unlikely to be a symbiotic decrease
in caries as a result.
One could argue that sugar pollutes much in the same way that
inefficient power stations do. The
societal repercussions need to be
managed by all, with no or little
comeback for the fizz producers.
As carbonated drinks are so popular, these juggernaut companies
are powerful and, as a result, denting their progress with a tax is unlikely to truly positively affect the
general health of the population.
In 2014, the UK soft drinks indus-

Overconsumption of sugar
causes an inordinate amount of
health problems. Indeed, Type II
diabetes and obesity are leading
causes of death and disability in the
US, the birthplace of the canned,

develop diabetes, which in turn
makes them more susceptible to
periodontal disease.
Society’s gluttonous overconsumption is manufacturing pa-

Research by Prof. Iain Chapple in
Birmingham investigating the effect of diet on periodontal disease
confirms that one is what one eats
and the gingivae follow suit. Purely

“Society’s gluttonous
overconsumption is manufacturing
pathology unheard of 50 years ago.”
likely red, refreshment. These lifethreatening conditions are in
addition to our experiences of
sugar-laden drink devastation. In
contrast, but just as worrying, the
emerging evidence shows that
low-/no-calorie drinks (49 per cent
of drink consumption in 2014) actually fuel hunger and trick one’s
stomach into thinking that calories
are on the way, only to be disappointed, resulting in further foodseeking behaviour. The ordering of
diet beverages in all-you-can-eat

thology unheard of 50 years ago.
Lest we forget the ageing population among the tabloid’s sugar mania of the young—polypharmacy is
likely to increase caries owing to
a variety of co-morbidities, such as
a dry mouth or heavily sugar-supplemented medication. I have seen
restorations seemingly intact for
generations in hospital notes only
to sprout caries at the cavity margin within months of a new medicine being prescribed. Is there a pill
for every ill or do pills allow ills to be

health effects of smoking and the
related exacerbation of periodontal disease, only for it to become
important when teeth are all but
held in by the last tenuous Sharpey
fibre. Owing to their own lack of
awareness or lack of engagement
with a toothbrush, they can request

taxing sugar may not impact on
its consumption. Patients need to
be motivated to take ownership of
their health and relate this with
foresight to repercussions in the
future. It is this lack of responsibility and potential blame shifting
by patients that not only results
in poorer health, but also makes
providing National Health Service
care for all increasingly impossible
if prevention is the best cure. This
commonly occurs when patients
claim to be unaware of the oral

some sort of compensation or pursue a litigious course likely to involve an expensive implant-based
restoration. What may escape the
lawyers and the patient is that
previous periodontal disease is a
significant risk factor for implant
failure, and so the cycle is likely to
continue. Patients are responsible
for their own health and the lack of
recognition of this cannot be the
fault of the clinician.
Successful dental care requires
collective effort between the patient and the dentist. Health care is
a partnership in which both sides
have different responsibilities and
active roles, but if the clinician provides a service for ailments that the
patient could have prevented, the
question of self-governance arises.
Patients have a right to health care,
but they also have responsibilities
derived from the principle of autonomy. The patient’s physical and
mental integrity should always be
upheld and respected. In contrast,
autonomy identifies the human
capacity to self-govern and choose
the most appropriate pathway to
protect that integrity.
As such, capable patients exert
some control over lifestyle choices
that influence their well-being.
Unfortunately, regardless of the
imminent extra tax on the already
dirt-cheap confectionery, the innate responsibility held by the
patient to self-govern will always
trump our advice, treatment, knowledge or collective experience.

Aws Alani is
a Consultant in
Restorative Dentistry at Kings
College Hospital
in London, UK,
and a lead clinician for the
management of
congenital abnormalities. He can be contacted at
awsalani@hotmail.com.

[7] =>

DTUK0316_07_News 12.04.16 12:05 Seite 1

Dental Tribune United Kingdom Edition | 3/2016

WORLD NEWS

07

Poor root fillings result of stress and
financial pressure in dentistry
By DTI
GOTHENBURG, Sweden: A new survey
has linked the quality of root fillings to
the level of stress dentists experience
in performing the procedure and the
fee charged. Some dentists reported
that “good enough” was often a more
realistic goal than optimal quality in
light of the complexity of root fillings
and insufficient time allocated owing
to the associated treatment tariff,
among other reasons.
According to the study, which was
conducted as part of a doctoral thesis
at the Sahlgrenska Academy, only half
of all root fillings that are performed in
the Swedish public dental service are
of good quality. Moreover, more than
one-third of root fillings show signs
of apical periodontitis, which can lead
to acute symptoms, such as pain and
swelling, and may even spread and become life-threatening in some cases.
Aiming to investigate the reasons
dentists accept technically poor root
fillings, Lisbeth Dahlström, a senior

dental officer and researcher
at the Sahlgrenska Academy,
conducted group interviews
with 33 dentists from the
Swedish public dental service.

they were very concerned
about their patients, the
researcher said.
In order to improve the
quality of root fillings,
Dahlström suggested
measures such as increased opportunity for
continuing education,
time for discussion and
exchange of experiences
at the workplace, as well as
investment in equipment
that enhances treatment,
shortens the time needed
and improves visibility.

The results showed that
treatment was often associated with negative feelings,
such as stress and frustration,
and it was common for treatment to be performed with
a sense of a loss of control
owing to the perceived technical difficulty. Another cause
of dentists accepting poorer
root fillings was that allotted
time for treatment according
to the fee charged was insufficient, participants reported.

Each year, approximately 250,000 root fillings
are done in Sweden and
it has been estimated that
“The dentist then finds
A survey among Swedish dentists has established the potential for improving the quality of root fillings
there are at least 2.5 milthey are facing a dilemma, and thus reducing persistent inflammation associated with inadequate treatment.
lion root-filled teeth afto ‘go back’ to the treatment,
fected by periapical periodontitis.
to optimize quality, or to offer care
Regarding quality, the dentists inwas a more realistic goal than opwithin the framework of the comterviewed reported uncertainty as to
timal quality. However, despite the
Dahlström defended her thesis,
what constitutes reasonably acceptdifficulties experienced, the survey
pensation and, thus, risk accepting an
titled “On root-filling quality in
able quality. According to Dahlström,
also showed that the dentists wanted
incomplete root filling,” Dahlström
general dental practice”, on 4 March.
they often stated that “good enough”
to provide good treatment and that
explained.
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DTUK0316_08_Bergman 12.04.16 12:05 Seite 1

WORLD NEWS

08

Dental Tribune United Kingdom Edition | 3/2016

“I do not think we are doing a good
enough job”
An interview with Henry Schein Chairman and CEO Stanley M. Bergman
Henry Schein has been supporting
the Senior Dental Leadership Programme (SDL) since its launch in
2007. Last month, the company’s
long-term Chairman and CEO
Stanley M. Bergman delivered the
keynote address for SDL’s tenth
anniversary meeting in London in
the UK. Dental Tribune had the
opportunity to sit down with him
during the event to discuss the
motivation behind the initiative, as
well as public-private partnerships
in dentistry in general and their
importance for the improvement
of oral health worldwide.
Dental Tribune: Mr Bergman, in
your keynote at this year’s SDL
Meeting, you talked about some of
the key aspects that have made
your company one of the leaders
in oral health care worldwide.
Could you summarise these for our
readers?
Stanley M. Bergman: Henry Schein
has been a very successful company by focusing on doing well by
doing good. This requires balancing the five constituents that
comprise our Mosaic of Success—
customers, suppliers, investors,
Team Schein, and society. One
part of the mosaic is our commitment to society, which makes us
different from others in the industry. With our public-private
partnerships, we work with government as well as non-governmental organisations, customers
and suppliers to make a difference in society. This enables trust,
and with trust you can move
things forward—like advancing
oral health, for example, by
bringing together academia, professionals, public health officials
and businesspeople from around
the globe.
The SDL Programme tries to do exactly that. Is this why your company has supported this initiative
for such a long time?
The SDL is clearly the epitome
of a public–private partnership.
So far, it has been pretty successful in bringing together all members of the dental community,
including representatives of dental schools, like Harvard and
King’s College here in London, as
well as public health officials
from around the world and the
private sector.
There has been very good research in the last decade with
regard to oral health. What we
learnt from that is that we have
to focus not just on the teeth but
on the whole body. Good oral care
results in good general health,
which then results in a good quality of life. We use SDL to get that

aestethics. While I think we are all
a bit to blame for not getting the
message out, I still see dentists
who are focused too much on today versus the long-term, macro
picture. It is our job, through
public–private partnerships, for
example, to make sure that this

Where do you think the main impetus has to come from?
It has to come from the profession itself. I think the FDI World
Dental Federation is doing a good
job in this regard and I am quite
optimistic that it will lead us in
this area. We need to make the

“I believe that the only
way to achieve better
health is through more
preventive care.”

Stanley M. Bergman

message out to all constituents of
the dental community around
the world.
With dental diseases still occurring
in epidemic proportions around
the world, according to reports, is

to psychological diseases—are
still not recognised as noncommunicable diseases (NCD)
by the World Health Organization
(WHO) and, as a consequence,
their improvement is not considered to be beneficial for better

changes. This way, we would end
up with not only significantly
lower health care spending but
also a healthier world in general.

WHO understand the importance
of this. Sadly, there is only one
dentist in the WHO right now.
There should be more.

With all the work that the SDL Programme and other oral health initiatives have done and are doing,
how far do you think we have come
in achieving this goal?
The science is very new. There
have been a number of studies
published only in the last seven
to eight years that show a direct
correlation between oral health
and other health areas, like
cardiology. Dental schools like
Harvard are advancing this research and many others will

Also, dental schools are not
taking a strong enough position
on health care. It is part of their
history that they would not necessarily be part of the medical
school system. I remember the
big fight over the New York University dental school a decade
ago. There are also other dental
schools that are connected to
medical departments or institutions. We need more and more
of that. Dentistry has to be part of
total care.

“There is still too much focus on
the profession or on restorative
procedures or aestethics.”
there a general lack of leadership
in the profession?
I would not exactly call it a lack
of leadership. As you mentioned,
however—and the latest statistics show this—it is a sad fact that
there are over three million people in the world suffering from
dental caries alone. Unfortunately, oral diseases—in addition

quality of life and bringing health
care costs down.
The challenge we face is that the
dental profession is not doing
enough to make sure that oral disease is viewed as a key component
of the NCD category. There is still
too much focus on the profession
or on restorative procedures or

hopefully follow. However, there
are other areas, such as cancer,
where we have made good progress, but have not told people
that around the globe about
150,000 people die of oral cancer
each year. I do not think we are
doing a good enough job to convince the world of the importance
of oral health.

In your home country, the upcoming presidential election has put
health care and its delivery in the
forefront of the debate. Which system do you generally consider to
be better for achieving improved
health?
Generally, I do not think that
one system is better than the
other. I am a free-enterprise person and therefore I think you
have to allow those who wish to
have a private system to have
it. For those who cannot afford
private insurance, the government has to provide some
amount of care. I believe that
the only way to achieve better
health is through more preventive care. It is not about building
more hospitals, but preventing
people from getting sick. That is
what health care reform is all
about.
Thank you very much for the interview.

[9] =>

DTUK0316_09-10_Bellmann 12.04.16 12:06 Seite 1

Dental Tribune United Kingdom Edition | 3/2016

TRENDS & APPLICATIONS

Career opportunities and
work–life balance in dentistry
By Dr Christine Bellmann
Dentistry is among the most rewarding professions and has a
much broader scope of practice
than ever before. Young dental professionals who have finished their
studies and received their diplomas
will have to individually decide on
their career pathways. This choice is
both exciting and difficult, as there
are numerous options and opportunities to consider.

ning, as well as in case of illness.
Smaller teams can have the advan-

tage of being forced to take more
responsibility, from which great

knowledge can be gained in living
the concept of “learning by doing”.

World-class
technology,
bespoke
for every
patient.

The transition from dental student to young working dental professional requires extensive adjustment. At university, students
are told how to work, what to learn
and what goals they need to fulfil.
During practical work on patients,
they are supervised by experienced dentists.
As a working professional, it is
now up to each individual to assess
patients on his or her own and to
judge their needs and treat them
accordingly. It is not just dental
skills that are put to the test, however, as there are also other important skills that a working professional will need to have. These may
be skills that are not taught at dental school, such as communicating
with the patient, co-workers and assistants, as well as financial aspects
and legal issues in the dental clinic.
Acting correctly and appropriately is
a substantial challenge, and may be
overwhelming for some individuals.
Being aware of those requirements
is the first step to a successful transition.
Every graduate dental student
has to decide where and how to
embark on their professional careers. The majority of young dental professionals lay the foundation of their careers in private
or public dental clinics, but some
also remain at university to engage
in research or teaching careers.
Whichever way is chosen at this
stage, it does not need to be the final
decision. Paths can be changed and
new ones explored, but the decision should be thought through,
as the initial years in any profession
form and influence one’s future
career path.
Working in a dental office outside of university provides multiple options and opportunities.
Dental practices come in every
size and shape. There are small
clinics and very large practices.
Some have a specialisation or
orientation; others are general
dentistry practices. Each model
has, for every individual, certain
advantages and disadvantages,
depending on one’s expectations
and goals. A larger clinic, with
more dentists, usually gives everyone more flexibility in relation to
working hours and vacation plan-

Working in a clinic that has a
certain specialisation will help
a young graduate if he or she
wishes to specialise in the same
field, as knowledge can be gained
during the daily workflow and, in
combination with a postgraduate
course, it can make the perfect
choice. Choosing the right clinic
can be challenging and sometimes
the best choice is to go with one’s
intuition.

Cerezen is an innovative, custom-made in-ear
device that relieves the pain and symptoms of TMJD,
bruxism and other cranio-muscular conditions.
As well as significant efficacy in reducing a patient’s pain, Cerezen is
non-invasive, comfortable and discreet enabling it to be worn day and
night improving compliance.
It is easy to integrate Cerezen into your practice workflow and start helping
your patients relieve their pain and symptoms through the innovation of
Cerezen inserts.

Discover more about Cerezen or make an appointment
to become a Prescriber.

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cerezen.eu/prescribers

DISCOVER
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CEREZEN
at the Dentistry Show
23 April. See us
at stand K62.

[10] =>

DTUK0316_09-10_Bellmann 12.04.16 12:06 Seite 2

Dental Tribune United Kingdom Edition | 3/2016

Purpose of
specialisation
Many young dentists want to
specialise in one of the many fields
of dentistry. Once the decision has
been made on the area in which to
specialise, they should take their
time to work out what is the right
path of specialisation for them.
What is their goal after specialisation? What is the specialisation
AD

to be used for: to work in a private
dental clinic or establish their own
clinic; or to enter into research and
education at a university? And
what is the goal for the practice?
There are many programmes on
the market, and it is not always the
best decision to choose the most
expensive, most time-consuming
one or the one that is the furthest
away from home.
Since there are courses and postgraduate education programmes
all around the world, many young
dentists leave their home countries
to gain experience and specialisation abroad. That can be an amazing
experience and much can be gained
from it. However, it is not the right
choice for everyone, as it can hold
more challenges and risks than
might initially be expected. Studying or working abroad needs to be
thought through and well planned,
otherwise it can very easily end in
a major disappointment. At first,
working abroad may seem to be
a great opportunity and exciting,
and it certainly can be, but it may
not turn out that way. An accurate
assessment of the goals and the desired outcome of a life in a different
country needs to be conducted.
Others may decide to open their
own dental clinic or take over an
existing one. Running one’s own
business is a great opportunity to
work in a comfortable work environment because it is self-created. Aligning a dental office to individual expectations and having a financially
successful and well-run clinic can be
challenging. Like any other business,
strategies and standard operating
procedures in various fields need to
be established. It is not only the clinical abilities of the dentist that are
important. Equally important are
economic factors, such as analysis of
the local conditions, human resource
management, marketing strategies
and legal guidelines.
With so many exciting opportunities in the dental field and the
numerous options for how and
where to work, it is easy to lose track
of other important things in life.
Time with family and friends or
time for leisure activities is very important. Finding a healthy balance
between fulfilling career goals and
having rewarding downtime is the
key to a happy and healthy life. It
makes sense to take the time to
reflect on the past and think about
future expectations of life and, perhaps, write those down to keep them
in mind. During these decisionmaking processes, of all the possible
choices that have to be made, the
most important factor that should
be considered is one’s private life
and what one wants in life.

Dr Christine
Bellmann is the
Director of Dental
Gateway, a global
dental consulting
agency. She can
be contacted at
bellmann@dentalgate-way.com.

[11] =>

Dubai Clinical Masters Program
TM

in Esthetic and Restorative Dentistry

7 days of intensive live training with the Masters in Dubai (UAE)

2 sessions, hands-on in each session, plus online learning and mentoring.
Learn from the Masters of Esthetic and Restorative Dentistry:

Online access to our
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Registration information:
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University
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this course is created
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Tribune Group GmbH is an ADA CERP provider. ADA CERP is a service of
the American Dental Association to assist dental professionals in identifying
quality providers of continuing dental education. ADA CERP does not
approve or endorse individual courses or instructors, nor does it imply
acceptance of credit hours by boards of dentistry.

100

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Certificates will be
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Tribune Group GmbH is designated as an Approved PACE Program Provider by the Academy
of General Dentistry. The formal continuing dental education programs of this program
provider are accepted by AGD for Fellowship, Mastership and membership maintenance
credit. Approval does not imply acceptance by a state or province board of dentistry or AGD
endorsement. The current term of approval extends from 7/1/2014 to 6/30/2016.
Provider ID# 355051.

[12] =>

DTUK0316_12-13_Pereira 12.04.16 12:06 Seite 1

TRENDS & APPLICATIONS

Dental Tribune United Kingdom Edition | 3/2016

Causes and treatment of breath odour
By Dr Paola Gomez-Pereira, UK

Fig. 1: Classification of oral malodour (modified from Scully and Greenman).—Fig. 2a: Tongue with a slight coating.—Fig. 2b: Filiform and fungiform papillae histology of the human tongue
(https://www.med.umich.edu/histology/giLiver/oralCavity.htm).—Fig. 2c: Sketch of papillae with biofilm between releases of VOCs to the oral cavity.

Breath odour is the presence of
odorous volatile organic compounds
in the breath of individuals.It is a widespread problem, as it affects a high
percentage of the adult population;
30 per cent of the global population
suffers from chronic oral malodour and
74 per cent considers it an issue.1 Breath
odour has strong social implications
for the sufferer and it significantly
affects normal social interactions.

generally assessed by organoleptic
score, which is determined by a
trained odour judge, who measures
the strength of target odours and expresses the value according to a predefined scale from 0 (no odour) to 5
(strong malodour).

Breath odour can have physiological or pathological causes of intraor extra-oral origin (Fig. 1). Physiological odour includes morning
breath, which is transient and related to low salivary flow during
the night. Other lifestyle factors can
influence it too, such as smoking, as
well as the consumption of alcohol
or odoriferous foods and drinks
(garlic, onion and cabbage, among
others). These are fairly common
reasons for concern in the adult population, but can easily be rectified
by modification of beverages and
foods consumed, toothbrushing,
mouthrinses and tongue cleaning.

The tongue has a very complex
and rough surface structure covered with flexible papillae (Fig. 2b).
Those papillae vary in shape, size
and distribution pattern and give
the tongue a surface with numerous
crypts and fissures.7, 8 This constitutes a perfect microbial niche for
anaerobic bacteria to thrive and
form thick biofilms largely undisturbed. Bacteria can degrade a complex mixture of amino acids and
proteins from numerous origins
(diet, debris, cells) with their complex enzymatic machinery. Partic-

A niche for bacterial
biofilms

ularly the degradation of amino
acids, such as cysteine and methionine, produces VSCs with a very high
odour power.9 The bacterial density
on the tongue surface has been
related to the degree of breath
odour.10–12 For example, individuals
with noticeable breath odour (above
2.5 in the 5-point organoleptic scale)
have more than 1 × 108 bacterial
colony-forming units per cm2 of
the tongue, while individuals with
lower organoleptic scores harbour
lower bacterial numbers (approximately 1 × 107).12 Therefore, in order
to reduce breath odour in patients,
the tongue bacterial density must
be reduced and kept at low levels.

Treatment of oral
malodour
There are numerous over-thecounter products for oral malodour
and these can be divided into chemical and mechanical treatments.

Chemical treatments are mostly
mouthrinses specifically developed
for oral malodour, containing a
combination of antimicrobials and
metal ions. Commonly used antimicrobials are chlorhexidine and
cetylpyridinium chloride (CPC),
which have a strong effect in killing
bacteria. Metal ions, such as zinc,
bind to sulphur compounds and
form insoluble complexes (zinc
sulphide) that are not volatile and
are therefore non-odoriferous.10, 13–16
Another category of mouthrinses
for malodour contains chlorine
dioxide, which neutralises the sulphur gases and oxidises VSCs, while
the chlorite anions act as an antibacterial compound.17
While mouthrinses have the
potential to be very effective owing
to their antibacterial and oral malodour-masking properties, they
rarely provide a long-lasting result.
They are effective for a few hours,
but they have little effect on the

Pathological malodour, however,
is more challenging to treat. Extraoral breath odour can arise from
respiratory, gastrointestinal or
metabolic issues, which cannot be
addressed by oral hygiene, as these
do not originate from the mouth.2–4
Most cases, however, originate from
the oral cavity . Breath odour from
intra-oral causes arises from volatile
sulphur and organic compounds
(VSCs and VOCs, respectively)
formed as a result of the degradation of organic substrates by anaerobic bacteria on the dorsum of the
tongue, particularly at the back of
it.5, 6 It can also result from gingivitis
and periodontitis, and their combination with tongue bacteria.
However, in individuals with good
oral hygiene and gingival health,
the main cause is the bacteria on
the tongue (Fig. 2a).4 Breath odour is

Clinical studies have shown that
the use of mechanical methods reduces the tongue coating.10–21 However, the effect on malodour is very
short lived,19 which is probably due
to the reduction of the bacterial nutrients present in the tongue coating rather than the reduction of the
bacterial density itself.22 The limited
amount of bacterial removal from
the tongue’s complex surface is due
to the difficulty in reaching the
biofilm between the tongue papillae. Moreover, as the tongue tissue
is very flexible, the use of tongue
scrapers could flatten the papillae,
trapping the bacterial biofilm underneath and not removing it.

Combined approach
for all-day fresh
breath
The use of mouthrinses in combination with mechanical intervention could help the active ingredients penetrate deeper into
the biofilm than when used alone,
while simultaneously reducing the
tongue coating and bacterial density. The combined approach of
chemical and mechanical intervention could have a synergistic effect
on oral malodour to deliver full-day
3a

tongue bacterial density.18, 10 A possible cause of this limited effect on
the tongue is that the active components of mouthrinses cannot
reach the odour-producing bacteria. Biofilms that produce volatile
gases are mostly located deep between the tongue papillae (Fig. 2c),
where mixing and diffusion of active ingredients are difficult owing
to the small papillary spaces, the
viscosity of salivary molecules and
the low permeability of biofilms.
Guidelines for the treatment of oral
malodour by dental professionals
emphasise the need for tongue
cleaning using scrapers or brushes.

Figs. 3a–e: Philips Sonicare TongueCare+ brush head, BreathRx, and sketch of MicroBristles and BreathRx cleaning between tongue papillae covered with biofilm.

[13] =>

DTUK0316_12-13_Pereira 12.04.16 12:07 Seite 2

TRENDS & APPLICATIONS

Dental Tribune United Kingdom Edition | 3/2016

VSCs, such as hydrogen sulphide
and methanethiol, are toxic to periodontal tissue even when present
in very low concentrations, so it
has been hypothesised that they
can contribute to the progression
of gingival diseases.26 Therefore,
maintaining a good tongue cleaning
routine could have far-reaching
implications.
4a

Fig. 4a: Average and 95 per cent confidence interval of the organoleptic score at baseline, and 1 hour, 3 hours and 6 hours after
each treatment.—Fig. 4b: Total anaerobes at baseline, and 1 hour and 6 hours after treatment. Source: www.iopscience.iop.org

fresh breath, as has been shown in
recent studies.23, 20 In a recent clinical
investigation, we showed that the
combined use of a newly designed
sonic tongue brush with an antimicrobial spray delivered a significantly superior reduction in breath
odour than did the individual treatments.
Philips Oral Healthcare has recently developed and launched a
new sonic powered tongue brush
and antibacterial spray combination, Sonicare TongueCare+. The
brush has been designed to penetrate between the tongue papillae
and to provide thorough mechanical biofilm removal. Bristle dimensions and stiffness parameters were
optimised based on analysis of the
human tongue. The brush head
consists of 240 flexible elastomer
MicroBristles mounted on to a
Sonicare power toothbrush handle,
with 31,000 vibrations per minute
to help break up any tongue coating
and sweep away debris and bacteria
(Fig. 3).
TongueCare+ brush is used in
combination with the BreathRx antimicrobial tongue spray (Philips),
which contains antimicrobial
agents, such as CPC and zinc. In the
first proof of principle clinical investigation of this technology, it was
shown that the organoleptic score
and the tongue bacterial density can
be significantly reduced with a
single use of TongueCare+ with
BreathRx, measured up to 6 hours
(Figs. 4a & b). This combined treatment reduces breath odour significantly more than using TongueCare+ alone or BreathRx alone, supporting the idea that a combined
approach is likely more effective.
Moreover, TongueCare+ has been
shown to significantly decrease the
tongue bacterial density, which is
kept low for up to at least 6 hours,
indicating that the root cause of
breath odour is addressed with this
approach. This, this combination
provides a more effective and longlasting treatment option for people
suffering from breath odour.

Possible oral health
implications
Overall, it is of key importance to
integrate tongue cleaning into the
oral hygiene routine in order to have
fresh breath all day. Additionally, it
has been suggested that the tongue
can act as a reservoir of periodontal pathogens for the rest of the
mouth,24, 25 which could colonise
other areas and have an impact on
oral health in general. Moreover,
several studies have shown that

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

Conflict of interest: Dr Paola GomezPereira is a senior scientist at Philips in
Cambridge in the UK.

Dr Paola GomezPereira can be
contac ted at
paola.gomezpereira@philips.com.
AD

[14] =>

DTUK0316_14_Little 12.04.16 12:07 Seite 1

TRENDS & APPLICATIONS

Dental Tribune United Kingdom Edition | 3/2016

The iTOP experience

toothpastes and mouthwashes,
explaining the advantages and
disadvantages, and how to gain
the most benefit from them.

Providing thorough oral hygiene instructions in a clinical setting

You may question why you
need iTOP training, since surely
you learnt all of these skills at university? You would think that in

By Theodora Little, UK
“ITop” stands for “individually
trained oral prophylaxis”. You may
argue that hygienists deliver this
to their patients all the time, right?
Unfortunately, with the time constraints placed upon hygienists
in the UK, with 30- or 20-minute
appointments and many without
a nurse, the burning question is,
how we are supposed to give patients the essential care, as well as
effectively provide thorough oral
hygiene instructions?
We mention time and time
again that we strive for prevention and that this is key, but unfortunately all there is time for is
a scale and polish with a little oral
hygiene instruction. We are thus
placed in a vicious cycle of patients returning for each appointment with the same oral hygiene
as before. Habits remain unchanged.
At Curaden Dental Clinic, my
hygiene appointments last a minimum of one hour. Curaden is a
Swiss company, so this is something of the norm for it. The company takes great pride in offering
high-quality products and services
to patients, which is also why we
recommend CURAPROX products.
It is not just about their vibrant
colours, which initially attract attention, naturally; there is more
to the products than meets the

eye. CURAPROX uses CUREN filaments instead of nylon, and their
manual toothbrush contains
5,460 filaments—approximately
4,500 more than the average
manual toothbrush. All of this is
included in iTOP, since they only
use the best in their training for
dental professionals.
I suppose many will say I am
lucky to be able to offer hour ap-

PRINT
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The DTI publishing group is composed of the world’s leading
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pointments, but as a practice we
want the best for our patients.
Our practice focus is prevention,
and it is necessary to give time to
our patients to achieve this. On
occasion, the whole hour is used
for iTOP training only, with my

training to be a hygienist and
therapist, the most basic training
given would include correct and
efficient brushing of teeth. I am
somewhat ashamed to say that
not once during my time at university did we have intra-oral

brush correctly. I was trained as
a hygienist and therapist and
I did not know, nor was I shown
at university, until I completed
iTOP courses.
I have now completed my iTOP
beginner and advanced courses
and will hopefully attend the
teachers’ seminar later this year.
Going through this programme,
I started to realise that correct,
effective and thorough toothbrushing is somewhat of an art,
and it should not be dismissed so
easily. It is also something that
should not be rushed; great care
and time do need to be taken
to change a patient’s habits. Of
course, many may argue that patients will not want to spend x
amount to receive oral hygiene
instructions and that one cannot
teach an old dog new tricks.
I agree to an extent; however,
once one has gained a patient’s
trust and he or she understands
the value of this service, the patient will be more than happy to
accept. We all understand how
important it is to communicate
well with our patients, and this
combined with sufficient working time, allowing for iTOP, is one
of the greatest factors. Not only
are my patients satisfied, happy
and grateful, they are also
shocked that they have never had
training on how to brush properly. As a hygienist and therapist,
I too gain enormous job satisfaction and can honestly say I love
what I do.

“Going through this programme,
I started to realise that correct,
effective and thorough
toothbrushing is somewhat of an art...”
main emphasis on educating the
patient, starting with the basics.
I will discuss products in depth
with the patient, giving him or
her the full knowledge to understand the benefits of these. I will
also brush for the patient, not just
a few teeth but all four quadrants,
so he or she can feel exactly how it
is supposed to feel in each area.
I will of course then ask the patient to demonstrate toothbrushing to me afterwards. Usually,
I will brush my teeth at the same
time, as we can also learn from
watching others carrying out the
same task (and the patient will
feel less self-conscious).

demonstrations with a manual,
electric, sonic or any other toothbrush. Certainly, we had a lecture
on the different types of toothbrushing techniques used in the
past and the techniques we
should use now, and were then
told verbally how to use these
techniques. We also received slide
show lectures from company representatives who left us some
samples, but did anyone actually
teach me how to brush effectively? How do you really know
until you feel? You’re just supposed to know, right? Who taught
me? My parents? And who taught
them?

With floss and interdental
brushes, I do the same and will fill
out the full-mouth chart for the
patient to take home if more than
one size interdental brush is required. Moreover, I will discuss

Is it just expected that we
should know this basic oral hygiene care? Is it just common
knowledge? I think not, as I treat
many patients young and old and
they still do not know how to

I would encourage my fellow
dental colleagues not to disregard the importance of being
taught how to brush correctly
until you have had iTOP training.
It opened my eyes and made me
feel the difference, and now I can
pass my oral hygiene knowledge
on to my patients, because I believe my service should include
more than just cleaning their
teeth for them.

Theodora Little
is a dental hygienist at Curaden
Dental Clinic in
London. She can
be contacted at
newbondstreet@
curaden.clinic.

[15] =>

DTUK0316_15_Morgan 12.04.16 12:07 Seite 1

Dental Tribune United Kingdom Edition | 3/2016

TRENDS & APPLICATIONS

“I’m in love”
Why dentists prefer to use AquaCare
Abrasion has long been discussed as
a treatment in all areas of dentistry.
With AquaCare, UK-based Velopex
International has introduced an
innovative and contactless way to
abrade and polish teeth. The unit
combines four powder cartridge
systems with an easy-to-use multifunction handpiece—that can even
double via the foot control as a 3-in-1!

all he could say was: “I’m in love”. He
loves it because his patients love it.
AquaCare has become the official
partner of Styleitaliano and it
will soon be publishing cases on
www.styleitaliano.org.
What is the basic mechanism of
AquaCare and how does the handpiece work?

Fig. 1: Dr Pasquale Venuti used 53 micron aluminium oxide, then used electrosurgery
and isolated by means of Ferrior Clamps and teflon. The image is after sandblasting
and before etching.

application for periodontists, endodontists and orthodontists?
AquaCare is capable of delivering
abrading and prophylaxis media
all via the same handpiece. Why
buy a separate unit when all one
needs to do is change the cartridge?
Our multi-patient cartridge concept provides the clinician with the
capability of either changing the
cartridge (approximately 40 seconds) on the AquaCare or changing
media at the flick of the switch
(1 second) on the AquaCare Twin.
So what are the options? Our cartridges are colour-coded for easy
recognition: 29 µ aluminium oxide
(blue), 53 µ aluminium oxide (red),
sodium bicarbonate (white) and
Sylc desensitising and remineralising powder with 99.5 per cent
NovaMin (green). NovaMin can
also be found [in significantly less
percentage] in NUPRO Extra Care
prophy powder and Sensodyne’s
Repair and Protect toothpaste.

Dr Walter Devoto, Founder of STYLE ITALIANO, with the AquaCare Twin unit:
“Finally, the sandblaster of my dreams!”

Velopex International will present
AquaCare at the coming Dentistry
Show in Birmingham. Right before
the event, Dental Tribune talked to
Keith Morgan, Sales & Marketing
Manager, about the next big step in
Contactless Dentistry.

All the clinician requires is an
air line, which all dental practices
have; everything else is provided
in the AquaCare introductory kit.

Dental Tribune: Many dentists in
the US and Europe still prefer rotary
cutting instruments and their use
has been taught at dental schools
and faculties for many years. Why do
you see a need for change?
Keith Morgan: Dentistry is continuing the transition from mechanical dentistry to adhesive
dentistry. A growing number of clinicians, academics and key opinion
leaders are accepting that fluid
abrasion enhances the tooth surface for increased efficacy of bonding—it is also an invaluable tool in
the process of tooth stain removal.
It is less invasive for the patient and
there is no noise, vibration, generation of heat or creation of any
unpleasant smells. This process is
inexpensive, quick and incredibly
effective. Many dental schools teach
abrasion techniques, including
those in Germany, the world’s second largest dental economy. Elsewhere, abrasion is taking hold and
some leading dental institutions
now have an MSc programme.

“...the gentle effect of AquaCare on
the patient’s teeth and gums.”

Apart from the dentist’s perspective, patients too are driving
the change. Air polishing and fluid
abrasion are more convenient and
safe for patients. We have prepared
a leaflet for patients that answer
frequent questions about our technology. Dr Walter Devoto, founder
of Styleitaliano and a leader in aesthetic and conservative dentistry,
appears in the image. The moment,
he received the AquaCare unit,
he simply said: “Finally, the Sandblaster of my dreams! It is really
what We needed!” After two weeks,

This selection provides the clinician with choice, freedom and
flexibility to interpret the clinical
situation and provide his or her

Our handpiece is at the centre of
fluid abrasion. The unique Venturi
design tip allows for the solution to
be kept separate from the powder
and air and never clogs. This smart
single-use tip delivers a gentle
stream of solution and media directly to the tooth surface. The AquaSol
fluid is dispensed from an inverted
bottle. This dual purpose solution
also acts as a cleaning agent for the
AquaCare while providing a pleasant vanilla aroma for the patient.

preferred solution. Increasingly,
clinicians are using Sylc for periodontic, endodontic, orthodontic,
cleaning and paediatric treatments. Only in AquaCare units can
one change settings of pressure, solution and medium to allow one to
remove stains at 2.75 bar (275 kPa),
clear fissures by abrading and cutting at around 5 bar (500 kPa), and
work subgingivally at around 1 bar
(100 kPa) minimum pressure with
solution required.

What are the major advantages of
the AquaCare and AquaCare Twin
systems for general dentists? Could
you also please explain the areas of

Important note: In order to work
subgingivally, the pressure must be
reduced while remaining 3–5 mm
supragingival.

Fig. 2: Dr Thomas Taha used Aquacare 53 micron aluminium oxide cutting powder
to remove fractured and decayed hypo mineralised tooth tissue only without the
need for drilling.

Velopex International has coined
the term “contactless dentistry”.
Does contactless dentistry really

have the potential to revolutionise
common dental treatments, such
as cutting, caries removal, cavity
preparation, cleaning and polishing?
What is your vision?

indicates that consumers are likely to spend more money owing to
the ease of interaction. A practice
that introduces, for example, a
“Power Clean” under the brand of
contactless dentistry might benefit in this regard too. Contactless
dentistry is not exclusively for
prophylactic treatments. Other
treatments include preparations
for Class V cavities, use in orthodontic de-bonding and bracket
removal, and abrasion of occlusal
brown spot lesions prior to fissure sealing (without the needle)
—another practice-building enhancement, equating on the UK
NHS to 3 UDA's.
Is AquaCare available worldwide or
just in the US and Europe?

Fig. 3: Dr Jason Smithson: Particle abrasion with 29 micron alumina to remove
prismatic enamel and improve bond strengths prior to no prep direct bonding to
close black triangles which were secondary to periodontal disease.

Across the world, contactless
interactions are common in our
daily life. Now dentists can offer
patients contactless dentistry.
Good preventive dentistry and
oral health care can help prevent
cavities, gingivitis and periodontal disease, keeping patients’
smiles happy and healthy. Our
patient leaflet serves to aid the
dental health care professional
by explaining the gentle effect
of AquaCare on the patient’s
teeth and gums. Patients know
about contactless and enjoy the
speed of interaction, and research

Anywhere there is a patient, there
can be AquaCare. We continue to
support the profession through
our presence at trade shows and
conferences, most recently at
POSTERIOR2016 in Amsterdam,
and at the upcoming BudaBond
in Budapest in Hungary, the BioEmulation Colloquium in Los
Angeles in the US, Denplan Clinical
Conferences in the UK, plus national dental exhibitions across Europe,
the US, Canada and the UK.
Thank you very much for the interview.

[16] =>

[17] =>

DTUK0316_17-18_ST 12.04.16 12:08 Seite 1

SHOW TRIBUNE
The World’s Event Newspaper · United Kingdom Edition
Published in London

www.dental-tribune.co.uk

Vol. 10, No. 3

Wealth of offerings at DTS, Dentistry Show
Largest display of dental innovation and education for UK dental professionals at the NEC in April
By DTI
BIRMINGHAM, UK: The National
Exhibition Centre in Birmingham
is preparing for the next Dentistry
Show and Dental Technology
Showcase. Distinguished dentistry
lecturers Dr Didier Dietschi and
Louis Mackenzie are just two of
the confirmed speakers at the upcoming edition to be held on 22 and
23 April next year.
The show will again see a wealth
of continuing professional development (CPD) opportunities during an extensive two-day lecture
programme. In addition to the
Aesthetic Dentist Theatre, there will
be sessions specially tailored to all
members of the dental team and all
specialties, including endodontics,
periodontology and facial aesthet-

ics. Moreover, the Short-Term
Orthodontics Lounge will bring
professionals up to speed with
GDP orthodontics and the wide
range of appliances that are
available to practitioners today.
More than 7,000 visitors are
expected again for the show,
which will see over 400 manufacturers and distributors of
dental equipment exhibiting
their latest product developments and solutions in the
field. Following its successful
relaunch at last year’s edition,
Dental Tribune will once again
showcase its extended portfolio of publications at Booth
M100. Interview, photos and Photo from 2015. This year’s edition is scheduled to take place from 22–23 April.
daily news from the show
floor are also available online at
website (dental-tribune.co.uk) and
With over 100 laboratory-dedthe Dental Tribune UK & Ireland
Facebook page.
icated exhibitors at the Dental

Technology Showcase, experts will further demonstrate first hand the application of leading materials
and advancements in dental technology. In addition,
more than 30 hours of verifiable CPD will be on offer
(with 14 hours of vCPD
available), and highly popular features will be returning from the 2015 show,
including the CAD/CAM
Theatre.
Professionals interested
in attending the events
can register in advance on
the official website (www.
thedentistryshow.co.uk).
Information about the
programme and exhibition is also
available there.
AD

• Non-precious dental alloys on nickel-chrome
base System KN and System NH
• Non-precious dental alloys on cobalt-chrome
base System NE and System Duro
• Partial alloy System MG
• CAD/CAM discs on cobalt-chrome
base System NE-Blank and System Soft-Blank
• CAD/CAM disc on titanium base System Ti5-Blank
• Investment for crowns and bridges ADENTA-VEST CB
• Investment for partial denture ADENTA-VEST PA

0
3
2
.
o
n
booth
Adentatec GmbH
Konrad-Adenauer-Str. 13
50996 Koeln-GERMANY
Phone + 49 2 21 - 35 96 - 100
Fax
+ 49 2 21 - 35 96 - 170
info@adentatec.com
www.adentatec.com

[18] =>

DTUK0316_17-18_ST 12.04.16 12:08 Seite 2

SHOW NEWS

Show Tribune United Kingdom Edition | 3/2016

GC presents next generation
in universal bonding
Selecting the appropriate bonding for a given indication and
making sure to follow precisely the
different procedure steps is not
always easy. Convenience and having just one procedure to remember are perhaps the main reasons
many dentists nowadays prefer to
use universal bonding systems.
Based on the experience gained
with its previous adhesives such
as G-Bond and G-ænial Bond, dental materials manufacturer GC
(Booth 80) has introduced a onecomponent light-cured universal
adhesive on the market that is said
to achieve outstanding performance with all etching modes and in
all situations.
A result of years of research and
development, G-Premio Bond is
the universal bonding solution
for dentists who believe in zero
compromises, according to the
company. It is compatible with selfetch, selective etch and total etch
techniques, and performs equally
well in direct bonding cases, re-

pair situations and hypersensitivity treatment. G-Premio BOND
shows excellent, long-lasting bond
strength on both enamel and
dentin, regardless of the etching
mode. In fact in GC’s own research
on enamel and dentin in selfetch mode, G-Premio BOND
had the highest shear bond
strength values after thermocycling among all products tested.
A unique combination of three
functional monomers (4-MET,
MDP and MDTP), notably excluding HEMA, ensures excellent
stability and
bond strength
not just to
tooth tissue
but to all indirect substrates,
including composites, precious
and non-precious metals, zirconia
and alumina for all repair cases.
When combined with Ceramic
Primer II, G-Premio BOND will create a durable adhesion to any type
of glass ceramics.

The adhesive behaves like water,
despite the presence of fillers and
photo-initiators that help achieve
a strong bonding layer. With
G-Premio BOND’s optimal wettability and penetration and

a drying procedure that takes just
five seconds at maximum air pressure, an extremely thin film thickness of 3 µm can be achieved. These
characteristics and the absence of
HEMA guarantee the preservation

of the bonding layer over time, ensuring durable aesthetics without
discolouration.
Fears of patient discomfort from
post-op sensitivity are also eliminated in self-etch
and selective etch

modes. The tubules are opened
only slightly, while in total-etch
mode the tubules are fully infiltrated thanks to the product’s
ability to efficiently penetrate the
dentin.

Errors caused by the operator are
almost impossible with G-Premio
BOND, according to GC, owing to
a simplified procedure with low
technique sensitivity. That means
for instance that the bond strength
is not compromised if the waiting
time is cut short, drying guidelines
are self-explanatory and lightcuring is very efficient thanks to
the high photo-initiator content.
GC further added a visual control
to drying & light-curing, with the
liquid displaying a yellowish
colour before curing and a perfect
invisibility after curing.
G-Premio BOND helps to save
precious time with a 25-second
procedure in self-etch and 50 seconds in selective and total-etch. This
is especially useful in situations
where isolation is not optimal
or in cases involving children.
G-Premio BOND has a working
time of seven minutes in its dedicated dish, plenty of time for a
stress-free application. Dentists
will enjoy the hassle-free versatility of a one-bottle, easy-to-use
solution, according to GC. The
bottle design is supposed to protect the liquid from the heat of the
fingers and prevents solvent evaporation. Waste is also minimised owing
to a unique silicon bottle cover and
a thin nozzle that releases up to
300 small drops per bottle.

Quality.
We’ve been making clear
aligners for almost ten years.
We’ve gotten very good at it.

50% OFF YOUR FIRST CASE
Just visit us at booth B60 and register for free.

[19] =>

DTUK0316_19_ShowNews 12.04.16 12:28 Seite 1

Show Tribune United Kingdom Edition | 3/2016

SHOW NEWS

3DISC presents expanded digital
imaging portfolio in Birmingham
Dental equipment manufacturer
3DISC (Booth B52) invites the visitors
of The Dentistry Show to experience
the high diagnostic value of its digital imaging portfolio that include
the compact and fast phosphor
plate reader FireCR Dental and
FireCam HD intraoral camera.

The size of a shoebox, the FireCR
Dental fits into even the most
space-challenged clinics, according to the company, while the
easy-to-use software, network/
TWAIN interface and free software
upgrades make it a safe investment.

Dental,” said a Danish dentist, who
already uses the system.
With 5 megapixels, 3DISC’s newest intraoral camera FireCam HD
offers one of the highest resolutions on the market allowing clinicians to see every detail while
examining their patients’ teeth.
A touch-sensitive 360° action button allows to capture an image no
matter where you press in order
to prevent inconvenient work positions.
Furthermore, the device automatically adjusts focus and brightness for the best images possible

A full size 4c phosphor image
plate enables dentists to capture
more teeth and roots on the same
image, without having to stitch
smaller images together on a computer. The FireCR Dental PSP Reader
by 3Disc ensures fast and highdefinition images with five IP sizes.
Installing it takes just 15 minutes from
box to first image. The IP-protecting
magnetized tray ensures a longer
IP life, by keeping it completely flat,
avoiding to bend it during read-out.

“We have a FireCR Dental in each
of our exam rooms because it
increases our productivity. The
FireCR Dental is incredibly simple.
It is easy to install and easy to use
with a very unproblematic workflow. We received a good introduction, but even without training,
the system is intuitively easy to
use. I would definitely recommend
to all dentists who are about to
invest in new digital X-ray equipment to first consider a FireCR

Dentists can use the FireCam HD
during consultations to highlight
the patients’ need for treatment
by showing them a clear picture
of oral issues and to register
progress during on-going treatments.
More information on both products and the company’s other
products are available online at
www.3DISCimaging.com.

Adentatec: Whole range
of lab products on display
and titanium base. Its SYSTEM
SOFT-BLANK is a nickeland beryllium-free cobalt/chrome disc for
use in CAD/CAM processes.

Based in Cologne in Germany,
Adentatec (Booth 230) is a global
provider of non-precious dental

alloys on cobalt-chrome and
nickel-chrome base, as well as
CAD/CAM discs on cobalt-chrome

Furthermore, it is suitable for
soldering. SYSTEM SOFT-BLANK
is especially soft, good tensile and
homogeneous owing to special
heat treatment and features high

corrosion resistance and biocompatibility. According to the
company, it is available in many
diameters and measurements, for
almost every type of machines.
Established in 1997, Adentatec
offers a high-quality range of
products for dental laboratories.
All medical devices distributed by

the company are exclusively produced in Germany and are certified
to the highest standards (CE marking and US Food and Drug Administration), as it is committed to
the strict implementation of the
quality and process requirements
of DIN EN ISO 13485 and DIN EN ISO
9001 for its entire manufacturing
process.

EndoUltra for improved debridement
Dedicated to the industry, Vista
Dental Products has been offering
hundreds of quality dental products that include endodontic solutions for over 20 years. The
EndoUltra ultrasonic activator
EndoUltra is yet another example
of product innovation from the US
company.
Science has shown that irrigants
are more effective when they
are electromechanically activated.
Acoustic streaming and cavitation
of endodontic solutions significantly enhance cleansing of difficult anatomy. However, studies
have shown that low-frequency

(sonic) oscillation (160–190 Hz) is
not sufficient in creating acoustic

streaming or cavitation within the
canal space.

Available exclusively from Vista,
the battery-operated piezo ultra-

sonic (40 kHz) activation device is
capable of producing acoustic
streaming and cavitation in small
canal spaces. This results in significantly improved debridement,
disruption of biofilm, as well as
improved penetration of irrigants
into dentinal tubules, as well as the
removal of vapour lock, the company said. EndoUltra features special 15/02 activator tips, that resonate along the entire length of the
tip and do not engage tooth structure. They also feature depth markers at 18 mm, 19 mm, and 20 mm.
EndoUltra is available for UK dentists through Euro Dental Depot at
Booth M12.

[20] =>

Between 2012 and 2013 (latest available data) Birmingham’s workplace based
Gross Value Added grew by 6% - more than double the UK rate of 1.6%.
Source: Office for National Statistics (ONS) GVA data

77 foreign direct investment (FDI) projects were attracted to the Greater
Birmingham and Solihull LEP (GBSLEP) area in 2014 – up by 57% on 2013 and
the highest of all the LEP areas. The area also created the most jobs – a total of
4,841 - a 98% increase on the previous year. Source: UKTI

18,337 new businesses were registered in Birmingham during 2014 – an increase
of over 2,000 on the previous year, and more than any other city outside the
capital. Source: StartUp Britain analysis of Companies House data

At £21 billion to date in 2014 (Jan-Sept) exports from the West Midlands have been
the second highest in the country behind only the South East – and higher than
London. In 2013 the West Midlands reduced its balance of trade deficit by nearly
£6 billion, the biggest reduction of any region. Source: HM Revenue & Customs
Trade data, 2012/13

Between 2012 and 2013 Birmingham saw an increase of nearly 230,000 (32%) in
the number of international visits – the strongest growth in the country in absolute
terms and more than all other core cities put together.
Source: ONS International Passenger Survey

@business_bham
@visit_bham
@MeetBirmingham
www. m a r k e t i n gb i r m i ngham . c om

[21] =>

Birmingham was ranked as having the highest quality of life of any UK city outside
of London in 2013. In 51st place in the world rankings the city was ahead of
Glasgow (54th), Aberdeen (56th) and Belfast (63rd).
Source: Mercer Quality of Life Index

In 2013 Birmingham had the highest proportion of pupils achieving at least 5
GCSEs at grades A*-C including English and Maths of all the English core cities.
Birmingham also had the highest proportion of local authority run schools
receiving an ‘outstanding’ OFSTED inspection rating.
Sources: Department for Education, OFSTED

In 2013 5,480 people relocated from London to Birmingham, well ahead of its
nearest rivals, suggesting that affordable housing, good quality of life and relative
proximity to London are all making Birmingham a particularly attractive
proposition.
Source: ONS Internal Migration Statistics

In 2014 Birmingham was the most popular conference and event destination in
the UK outside London.
Source: British Meetings & Events Industry Survey 2014/15

Between 2003 and 2013 Birmingham’s population increased by nearly 96,000 –
well ahead of its nearest rival. Birmingham is also the youngest major city in
Europe and has seen the fastest growth in numbers of under 25’s of any UK city
outside London.
Source: ONS population mid year estimates

@business_bham
@visit_bham
@MeetBirmingham
www. m a r k e t i n gb i r m i ngham . c om

[22] =>

DTUK0316_22_ClearCorrect 12.04.16 12:09 Seite 1

ADVERTORIAL

Show Tribune United Kingdom Edition | 3/2016

ClearCorrect clear aligner therapy
discreetly improves crowding and constricted archforms
Today, there are more options available to those seeking orthodontic
services than ever before thanks
to advances in clear aligner therapy.
The rising popularity of ClearCorrect
and other clear aligner providers has
spiked over the past decade, and is
only expected to continue its aggressive growth trajectory.
According to a recent Azoth
Analytics research report, the
global invisible braces market is
expected to grow at an annual
rate of 12.16 per cent from 2016 to
2021. Now more teens and adults
are seeking orthodontic treatment for a wide variety of reasons, such as, improved aesthetics, affordability, and orthodontic
relapse.

ClearCorrect aligners are more
affordable than leading competing
brands, allowing doctors to pass
greater savings to their patients.
Doctors can easily submit digital
intraoral scans and manage their
cases on the user-friendly website
while also working with a designated customer service specialist.
ClearCorrect is suitable for most
treatment goals from minor cases
to more advanced crowding and
spacing complaints.

The Dental Tribune International
C.E. Magazines
www.dental-tribune.com

Dr Mark J. Bentele successfully
treated a patient’s chief complaint
of adolescent orthodontic relapse
with ClearCorrect. The patient had
a Class I right, Class I left molar relationship, with a Class I right, endon Class II left canine relationship.

was also given his sixth set to take
home. Next to complete the patient’s total treatment, a contact
check on tooth #27 was performed
to ensure patient compliance, and
teeth # 22 and 23 were correctly
aligned.
The patient progressed more
quickly than originally planned,
and only needed 16 sets of aligners
as opposed to 24 sets. At the end of
the ClearCorrect treatment, all objectives were accomplished and the
patient was instructed to wear retainers at night time indefinitely
(Figs. 4–6). Upon treatment completion, Dr Bentele’s patient was
very happy with the results and the
effectiveness of ClearCorrect clear
aligner therapy.

I would like to subscribe to

CAD/CAM
cone beam

€ 44/magazine (4 issues/year;
incl. shipping and VAT for customers
in Germany) and € 46/magazine
(4 issues/year; incl. shipping for customers
outside Germany).** Your subscription will
be renewed automatically every year until
a written cancellation is sent to
Dental Tribune International GmbH,
Holbeinstr. 29, 04229 Leipzig, Germany,
six weeks prior to the renewal date.

implants

cosmetic dentistry*

laser
ortho

DT Study Club (France)***
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prevention*
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4 issues per year | * 2 issues per year
*** €56/magazine (4 issues/year; incl. shipping and VAT)

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Dr Bentele submitted the case to
ClearCorrect and requested an improved upper and lower midline,
and also requested an idealized
overjet, improved overbite, and improvement of the constricted arch
forms while maintaining molar relationship (Figs. 1–3). Proclination
of the mandibular incisors was requested and #11 be distained into a
proper Class I relationship, and all
spaces were to be closed.
The ClearCorrect treatment plan
estimated 24 sets of aligners. The
patient was compliant wearing
each set of aligners for three weeks
(at least 22 hours a day). At the start
of treatment, facial translation of
premolars and canines occurred,
and then engagers were placed
on teeth Nos. 7, 10, 22 and 27 and
0.3 mm IPR was performed on
the mesial/distal #27. After the
engager placement, the patient received the fifth set of aligners and

Founded in 2006 by dentists,
ClearCorrect understands the needs
of both doctors and patients, and has
been proven effective for more than
20,000 doctors worldwide. Doctors
find that ClearCorrect is easy to
implement into their practice with
convenient access to online optional
training with marketing kits at their
fingertips. The company designs,
manufactures and supports its
products out of its headquarters
based in Round Rock, TX, USA.
Teens and adults can benefit
from clear aligner therapy due to
the aesthetic, affordability, shorter
treatment period, and lasting results.

ClearCorrect
21 Cypress Blvd, Suite 1010
Round Rock, TX 78665, USA
info@clearcorrect.com
www.clearcorrect.com

[23] =>

DTUK0316_23_Allessie 12.04.16 12:09 Seite 1

Show Tribune United Kingdom Edition | 3/2016

SCIENCE & PRACTICE

Marc Chalupsk

An easier way to detect bruxism
An interview with Bruxlab owner Michiel Allessie
About 8 per cent of the world population has bruxism, a condition commonly associated with sleep disorders. While existing home testing devices are expensive and not patient
friendly, Bruxlab (Booth N12) makes
it possible to detect the oral parafunctional activity in a cheap and
easy way. The Dutch company has
developed diagnostic tools to record
and quantify any grinding sounds
using machine learning, mobile app
technology and wearables. Dental
Tribune spoke with Michiel Allessie,
owner of Bruxlab, about the algorithm used to detect bruxism.
Dental Tribune: Mr Allessie, you have
been a general dentist with your own
practice for over 14 years. How have
you detected signs of bruxism in the
past, and what have been the major
disadvantages of conventional ways
of diagnosing sleep bruxism?
Michiel Allessie:The clinical signs
are always the same: excessive tooth
wear, sensitive teeth, headaches, fatigued jaw muscles in the morning,
etc. The problem is that sleep bruxism can stop spontaneously. Also,
a large group of bruxers are not
chronic bruxers. So, a dentist cannot
determine whether there is active
sleep bruxism and the patient is
a chronic bruxer using the conventional clinical signs. I see this as
a major disadvantage. Now, we can
track patients using our DoIGrind
app to see if there is active bruxism
and if it is chronic. Our Bruxsticker
makes it possible to measure movement of the lower jaw during sleep.
The integrated nano-accelerometer
and Bluetooth chip, in combination
with our app, record and filter toothgrinding sounds over multiple
nights.
If bruxism is left untreated, the
problems with chronic patients can
be very severe in the long term. For
non-chronic patients, the long-term
problems may be mild. I track those
patients with the app twice a year
to check that they have not become
chronic bruxers.
You founded Bruxlab in 2014 for effective treatment of bruxism using an
innovative app. What is the idea behind Bruxlab and how does it work?
What should dentists and patients
know?
We created an algorithm that can
filter any tooth-grinding sounds
and tooth contact sounds. The latter often indicate the beginning
of a clenching episode. I validated
the sounds using the gold standard,
polysomnography, better known
as a sleep test. This test will tell you
if there was muscle activity at the
same time that a grinding sound
was detected. The device on which
the app is loaded is placed next
to the bed and records and filters
any tooth-grinding sounds. On
average, we reduce 8 hours of sleep
to 5 minutes of relevant sounds.
The sounds are uploaded to the
cloud, where the dentist can listen

to them. Most dentists recommend
the app to prove to patients that
they are correct about suspecting
sleep bruxism.
Once bruxism has been detected
using the DoIGrind app, what treat-

ment options do you recommend to
dentists and patients?
This depends on whether the patient is a chronic and severe bruxer
or a non-chronic and rather mild
bruxer. For the chronic and severe
bruxers, I usually prescribe a splint

(night guard). For other patients,
I first try behavioural modification
through counselling to see if they
stop grinding and clenching. That
is the greatest advantage about this

product: you can use it over and over
again at no extra cost to the patient.
Thank you very much for the interview.
AD

[24] =>

LiSi
from GC
Master your

lithium disilicate

challenges

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

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[cover] => DT UK No. 3, 2016

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Table of contents

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