DT UK No. 5, 2011

Fluoride scheme gets green light / News / Walking in a webinar wonderland / Do’s and Don’ts / Be prepared for a medical emergency / Being more in dentistry; Interview with CEOs of IDH and ADP / Are we deluding ourselves? / Computerised imaging / The Inman Aligner Part II - A progressive approach to smile design / In at the deep end / Surgery Design / Something for the whole team / Bridge2Aid celebrate six years of Hope Dental Centre in Mwanza / Classified

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February 28-March 6, 2011

PUBLISHED IN LONDON
News in Brief
Fancy some Comet?
45-year-old Detroit mum
Crystal Newman has a peculiar habit: she eats Comet,
a bathroom kitchen cleaner.
Reportedly, she would shake
out the powder, mix it with
water to form a paste and
then eat it. Comet’s warning
label cautions: “May be harmful if swallowed or inhaled.”
“It tastes the way it smells.
Leaves a metallically taste
in your tongue,” says Trent
when he tastes the Comet.
When asked if the cleaning
product had done her any
harm, Newman replied: “ No
issues, except for my teeth.”
Cosmetic dentist Demi Kasanis, gave Newman a new
smile by replacing twenty two
of her teeth with titanium implants. The implants reportedly cost her $75,000. “Her
mouth was rampant with
decay and infection. This is
what eating Comet for thirty
years can do,’’ says Kasanis.
Listen with your teeth
Sonitus Medical, Inc., a medical device company that
manufactures the world’s
first non-surgical and removable hearing prosthetic
to transmit sound via the
teeth, today announced that
it has received FDA clearance for its SoundBite Hearing System. The FDA 510(k)
clearance is the first for the
company and the product.
The SoundBite Hearing System was found to be safe and
effective in two pivotal clinical trials, which supported
the FDA clearance. One study
evaluated the safety and efficacy of the SoundBite system
over a period of one month in
28 patients. A second study
evaluated
the
long-term
safety of the device over a six
month period in 22 patients.
Key safety and efficacy
measures evaluated in the
studies included the SoundBite system’s benefit and
impact on auditory performance, improvement in
speech intelligibility, oral
health, and overall comfort.
Roaring pain
Root canals are hard on the
patient. But if the patient is
a lion, the root canal is perhaps even harder on the
dentist.This was the case for
Mumbasa, an African lion
at the Brit Spaugh Zoo in
Kansas, who after grabbing
onto his fence he chipped an
inch-long tooth. According
to reports, zookeepers had
48 hours to save Mumbasa’s
tooth before the lion would
lose it for good. The Zookeepers had to quickly assemble a team. The procedure
was successfully performed.
www.dental-tribune.co.uk

News

Clinical

Young and CROOKED

The point of perfection

Teen films on dental hygiene hit
the headlines

page 4

Michael Sultan discusses root
canal treatment

VOL. 5 NO. 5
Clinical

Events

B2A celebrates success

The Inman Aligner II

Tif Qureshi discusses bleaching
and bonding

Hope Dental Centre in sixth year

pages 20-23

page 30

pages 13-14

Fluoride scheme
gets green light
Judicial Review of fluoridation decision in Hampshire says process
was not illegal
legal challenge against the
process. The judge expressed
sympathy for people who disagreed with fluoridation but said
there was no illegality in the decision-making process.
“It is not the law that fluoridation can only occur when a majority of the local population agree.
Parliament has firmly entrusted
area-specific decision making
to the relevant SHA. This SHA
have not acted unlawfully and
no court can interfere with their
decision.”

Fluoridation of Southamptons water was
not an illegal process

he High Court has ruled
that a health authority was
not acting unlawfully in
seeking to add fluoride to Southampton’s tap water.
The proposal by South Central Strategic Health Authority (SCSHA) to increase the level
of fluoride in water to one part
per million, was given the goahead in February 2009 after research showed the move would
significantly
improve
dental
health. However, resident Ms
Milner, who was backed by local
anti-fluoride campaign groups,
took legal action to challenge the
decision, claiming that the SCSHA
tried to illegally force the fluoridation of Southampton’s water.
At a judicial review, Mr
Justice Holman dismissed the

During the hearing, Ms Milner’s counsel David Wolfe had
argued that residents would
have “no choice” but to drink
fluoridated water. Campaign
groups, which backed the
mother-of-three’s case, said potential side effects range from
bone cancer to thyroid problems
and brown spots on the teeth.
However, the British Dental
Health Foundation welcomed
the High Court’s decision and
urged more SHAs to follow suit.
Chief Executive of the BDHF,
Dr Nigel Carter, said: “The verdict will be of a great benefit to an
area where tooth decay amongst
under-fives has been a problem.
Though there has been opposition, robust scientific research
supports the fact that fluoride
significantly
improves
oral
health and there is no evidence to
suggest that it can have any negative impact on overall health.

The British Dental Association (BDA) also welcomed the
decision. BDA Scientific Adviser
Professor Damien Walmsley
said: “The BDA is pleased with
the result because it is likely to
encourage consultation on similar schemes in other parts of the
country where fluoride could help

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[2] =>

2 News

United Kingdom Edition February 28-March 6, 2011

Understanding the impact of alcohol use

A

new report launched today by the World Health
Organisation
(WHO)
has stated that wider implementation of policies is needed
to save lives and reduce the
health impact of harmful alcohol drinking. Harmful use
of alcohol results in the death
of 2.5 million people annually,
causes illness and injury to
many more, and is increasingly
affecting younger generations.
The Global status report on
alcohol and health analyses
available evidence on alcohol
consumption,
consequences
and policy interventions at glo-

bal, regional and national levels. It stated that:
• Nearly 4 per cent of all deaths
are related to alcohol. Most alcohol-related deaths are caused
by alcohol result from injuries,
cancer, cardiovascular diseases
and liver cirrhosis.
• Globally, 6.2 per cent of all
male deaths are related to alcohol, compared to 1.1 per cent of
female deaths. One-in-five men
in the Russian Federation and
neighbouring countries die due
to alcohol-related causes.
• Globally, 320 000 young people aged 15-29 years die annu-

ally, from alcohol-related causes, resulting in 9 per cent of all
deaths in that age group.
Endorsed by WHO’s Member States in May 2010, the
Global Strategy to reduce the
harmful use of alcohol was to
promote a range of proven effective measures for reducing alcohol-related harm. The
measures include taxation on
alcohol, reducing availability
through allowing fewer outlets
selling alcohol, raising age
limits
for
those
buying
and using effective drinkdriving measures.
Nearly 4 per cent of all deaths are related to alcohol

Pioneering partnership between Smile-on, Free State

I

n a groundbreaking agreement, the Central University of
Technology, Free State, South
Africa (CUT) has joined forces
with UK-based leading provider of
blended learning resources Smileon Ltd for the provision of a range
of the company’s resources to support CUT’s educational vision.
The contract was signed by
Noam Tamir, CEO of Smile-on and
Jeanné Oosthuysen, Lecturer
and programme manager at CUT,
at the recent Clinical Innovations
Conference South Africa. This
will see five of Smile-on’s leading
educational
resources
being
integrated into CUT’s dental programme: The Bleaching Business,
Communication in Dentistry: Stories from the Practice, Key Skills in
Primary Dental Care, Clinical Pho-

tography, and Dental Nursing Education for Tomorrow (DNNET).
Commenting
on
the
news, Ms Oosthuysen said:
“The vision of CUT is to be a
globally connected African university of technology that focuses
on the needs of Southern Africa
and supports graduates for citizenship with skills and competencies in appropriate technologies.
“For me, learning is a way
to interact with the world – it is
a lifelong process. As modernday educators, we are constantly
faced with this challenge to adapt
and change in order to broaden
our horizons and expertise. CUT
and the University of the Free
State are the only higher educational institutions in the central

region of our country. The lack of
a School of Dentistry in the Free
State presents a big challenge, as
CUT is offering the only training
in dentistry from the central region of South Africa. This problem
has been addressed by cooperative links and support systems that
has been established with international experts in this field of research and education in dentistry.
“Resources in dentistry, dental education colleagues and
other support systems are often
only available at dental faculties
in Johannesburg, Pretoria, Cape
Town and Durban. This challenge is the reason for wanting to
be involved with Smile-on and being a pioneer of blended learning
for dental assisting in South Africa.”
Noam Tamir, CEO of Smile-on

Mercury negotiations

T

he FDI Mercury Task
Team, led by the FDI
President
Elect,
Dr
Orlando da Silva, participated in the second session of
the United Nations Environment Programme Intergovernmental Negotiating Committee

Published by Dental Tribune UK Ltd
© 2011, Dental Tribune UK Ltd.
All rights reserved.

Dental Tribune UK Ltd makes every
effort to report clinical information and
manufacturer’s product news accurately,
but cannot assume responsibility for
Editor
Lisa Townshend
Tel: 020 7400 8979
Lisa@dentaltribuneuk.com
Advertising Director
Joe Aspis
Tel: 020 7400 8969
Joe@dentaltribuneuk.com

(INC 2) to prepare a global
legally binding instrument
on mercury that took place
in Chiba, Japan from 2428th January.
The FDI’s team is working in
close co-operation with mem-

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
Sam Volk
Tel: 020 7400 8964
Sam.volk@
dentaltribuneuk.com

Design & Production
Ellen Sawle
ellen@dentaltribuneuk.com

Editorial Assistant
Laura Hatton
Laura.hatton@dentaltribuneuk.com

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

bers of the International Association for Dental Research to
articulate to the I NC that dental amalgam currently constitutes an important element in
maintaining and protecting
global public health, as reflected in FDI General Assembly
Resolution on Dental Amalgam (GA 2009) and Dental
Amalgam Motion (GA 2010).
Importantly, FDI made
an intervention at the I NC
2
plenary
session
highlighted strategies that phase
up effective prevention for
dental caries and associated
health
programmes
that we believe will result
in the phase down of restorative materials, including dental amalgam. This will lead to
the reduction in the use of all
dental restorative materials
and ensure optimal oral health,
particularly for those most
disadvantaged and in need of
treatment. DT

L-R: Desiree Hutchinson (Smile-on South Africa), Noam Tamir (CEO Smile-on), Jeanné
Oosthuysen (Lecturer and programme manager at CUT)

commented “At Smile-on we share
the vision of connecting our peers
to a global network and we are de-

lighted that by working together
with CUT we can help bring much
needed resource to this region.” DT

Tribunal by day,
happy couple by night

A

wife has told reporters
that she is still ‘’happily
married’’ to her dentist
husband - despite suing him at
an employment tribunal.

Even though the case was made
against her husband, the mother-of-three says the case has
not affected her relationship
with her husband.

Helen
Hutcheson,
46,
claimed that her husband,
John Hutcheson, had promised her that she would be paid
£3,000-a-month when she became a full-time member of
staff; however, he had failed
to keep his promise and when
she was eventually taken on
at the clinic in August 2009
she was paid a wage of £1,500
a month.

Although Helen had worked
for her husband for ten months,
the judge at the tribunal in
Aberdeen ruled that there was
not a formal contract before
that and as a result her claim
was thrown out.

Helen
originally
began
working at the Rosemount
Dental Clinic in Aberdeen in
2008 after agreeing to work
unpaid for a year to show she
was worth employing, however,
she quit and launched legal proceedings for unfair dismissal.

According to a British Dental Surgery Association survey, the figure that Helen was
promised was ‘‘many times
higher’’ than the average
wage for a branch manager
in Scotland.
Both John and his business
partner Karen Robertson denied such an agreement had
been made. DT

[3] =>

News 3

United Kingdom Edition February 28-March 6, 2011

Editorial comment

s I write, there
is considerable turmoil
in the profession
over the upcoming GDC meeting
where the Council
will decide whether
or not to rescind
the use of ‘Dr’ as a courtesy title
by dentists. This is quite an emo-

tive subject for dental professionals, with conversations flowing
from all channels about the move
either demeaning the status of
dentists, or being against the use
of Dr to be at the level of surgeon,
and every degree in between!
For me, I find the inconsistent
use of ‘Dr’ to be the confusing issue. When speaking to dentists (I

do that sometimes you know!) I
never know whether to use ‘Dr’,
‘Mr’ or ‘Oi’ – though I do find that
‘Oi’ works best.
Before I go, I can’t let this
week go by without mentioning the YouTube video by NHS
Northamptonshire. For those not
in the know, this is a two-minute
viral video spoofing the classic
‘vampire in the bedroom’ scene
with the twist of bad oral hygiene.

Although it was released in November 2010, it seems to have
captured recently the imagination
of the tech-savvy dental fraternity.
‘True Blood’ it isn’t, but is it an appropriate approach to get young
people interested in
visiting the dentist? Go
to http://www.youtube.
com/watch?v=hxHzh
NajwZU&feature=you
tube_gdata_player and
see what you think. 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@dentaltribuneuk.com

ARF x 36k

he General Dental Council
has successfully processed
36,962 annual retention fee
(ARF) payments from its dentist
registrants.
The deadline to pay the fee
for 2011 was 31 December 2010.
Nearly 5,000 of those who paid
used the regulators’ eGDC website
www.eGDC-uk.org.

This allows users to:
• Log their Continuing Professional Development (CPD) hours;
• Update their registered address
or complete a Direct Debit instruction online;
• Access their Annual Practising
Certificate information;
• Have control over many of their
registration responsibilities 24/7.

40% of denture patients are
concerned about denture odour1
Yet many denture wearers fail to keep their
dentures clean2.
That’s because brushing dentures with ordinary toothpaste can scratch
denture surfaces3. And scratched surfaces can lead to bacterial growth4
leading to denture odour.

886 dentists were removed
from the register for not paying
their ARF – so far 171 applications
for restoration to the register have
been received. 514 dentists voluntarily requested that their names
be removed.
If a dentist missed the deadline
to pay their ARF they will need to
apply to be restored to the register.
Practising while not registered is
considered illegal practice and
the GDC will take action through
the criminal courts. Dentists who
want to return to the register must:
• Complete a form to apply for restoration
• Have a medical examination and
provide a character reference
• Pay a fee of £696 – which includes the ARF
• If they were practising overseas
while off the register, they must provide a letter of good standing from
the relevant authority of the country/state in which they last worked
• If they were working in the UK
when their name was removed
from the register, they and their
employer will need to explain the
circumstances in a letter.

Scanning electron microscope (SEM)
images at 240 minutes confirm a significantly
higher build up of Streptococcus oralis on
denture materials previously cleaned with
ordinary toothpaste vs. a non abrasive solution5

Poligrip denture cleansing tablets effectively
remove plaque and tough stains6 without
scratching3, to leave dentures clean and fresh.
Poligrip Total Care denture cleansing tablets
also kill 99.9% of odour causing bacteria.

Recommend Poligrip denture
cleansing tablets to help your
patients control denture odour

If this has occurred they are
advised to contact their solicitor or
defence organisation before submitting their application.

References: 1. GlaxoSmithKline data on file, 2010. 2. Dikbas I et al, Int J Prosthodont 2006; 19: 294-8.
3. GlaxoSmithKline data on file Study L2630368 2006. 4. Charman KM et al. Lett Appl Microbiol. 2009;
48(4):472-477. 5. GlaxoSmithKline data on file Study NPD/EU/062/07 2008. 6. GlaxoSmithKline data on
file Study USNPD 016 and CS5244.

Further information can be
found at www.gdc-uk.org or by
calling 0845 222 4141. DT

POLIGRIP is a registered trade mark of the GlaxoSmithKline group of companies.

SM1859_12 Poligrip Cleansers Advert - Dental Tribune.indd 1

SPEAK, EAT AND SMILE
WITH CONFIDENCE

17/09/2010 17:06

[4] =>

4 News

United Kingdom Edition February 28-March 6, 2011

Young and CROOKED

n engaging short film
geared towards the younger generation is making
headlines. CROOKED, now available on DVD, is a light-hearted tale
of Samantha, a 12-year-old girl
who is obsessed with losing her
last baby tooth, (which happens to
be crooked). Her fascination lies
with her determination to get the
perfect smile...and, of course, win
the heart of the new boy at school.
Throughout the film, Samantha provides subtle but constant
encouragement to turn brushing
and flossing into a daily habit;
throughout her time at school
she brushes her teeth after lunch,
and happily visits the dentist. And
although the films goal is dental

hygiene education, CROOKED
becomes a balance of information
and teen entertainment.
The idea for CROOKED occurred when a man who had experienced serious health problems
approached Florida filmmaker
Todd Thompson and his Orlando-based production company,
Stars North. The man’s hope was
that Thompson could create an
educational film that was entertaining and would teach the
importance of dental health to
young audiences.
The result was CROOKED,
a 17-minute film that stars Kendall Ganey (The Little Princess,
Ace Ventura Pet Detective), Bo

Mitchell (October Road, Eastbound and Down) and introduces Sarah Grace Ackerman and
Justin Garcia.
Featured in the 2011 American
Dental Association® Catalogue,
CROOKED is available online
at
www.dentalmovie.org
or
www.amazon.com.
Reports have stated that a
percentage of sales from the
film will be donated to National
Children’s Oral Health Foundation: America’s Toothfairy®, a
nonprofit organisation dedicated
to delivering oral healthcare to
underserved children. For more
information,
please
visit
www.ncohf.org DT

Films on teeth are fast becoming a popular choice for educating children © Stars North

Tooth loss linked Teeth the Musical
to breast cancer scoops global film prize

new study suggests that
women may be more
than 11 times more
likely to suffer from breast
cancer if they have missing teeth and gum disease.

The study carried out by the
Karolinska Institute in Sweden
on over three thousand patients, showed that out of the 41
people who developed breast
cancer those who had gum
disease and loss of teeth were
11 times more likely to develop
cancer.
As this appears to be the first
study presenting such findings,
Chief Executive of the British Dental Health Foundation,
Dr Nigel Carter, believes more
needs to be done in order to
confirm the results.

Dr Carter said: “If future
studies can also testify to the
link between missing teeth and
breast cancer, more has to be
done to raise public awareness
on the issue. The British Dental Health Foundation has a
history of campaigning for
better oral health, and the findings presented in the study
indicate another clear link
between your general and
oral health.” DT

The study was carried out in Sweden

he team who made a
13-minute film to get
kids brushing their teeth
is off to Canada this weekend
having just won the ‘Best Education Award’ at the Picture
This Film Festival (PTFF).
PTFF
is
a
competitive and exhibition festival,
which features films that are
about disability and films on
any subject that were produced, directed and written
by people with disabilities.
Teeth the Musical DVD has already scooped the 2010 Patron’s Prize at the National
Oral Health Promotion Group
annual
conference,
adding
to the 2010 Education Business Award from Somerset
County Council.

JUMPcuts animated film
‘Teeth the Musical’ was produced with and for learning
disabled young people.
Travelling to Canada will be
member of the cast and Bridgwater College student, Freddie Wolfman accompanied by
film-maker Tom Stubbs, part
of Biggerhouse Film, who together, with registered charity
Somerset Film, makes up the
JUMPcuts partnership.
Tom Stubbs said to reporters: “This is a great honour and
a fantastic opportunity for Freddie and I to present our film to
an international audience, to fly
the flag for Somerset creative
business and he talent of disabled film-makers.”

Working with fellow Calgary winners Purple Field Productions, the film-makers are
supported by the local branch
of AC Mole and Sons, and Aardman Animation, who generously donated an original Wallace
and Gromit drawing signed by
Nick Park to help fund the visit.
Teeth the Musical is suitable
for learning disabled audiences
aswell as for primary school students and is available on DVD
from
www.jumpcuts.org.uk.
A Bristol-based senior dental officer said to reporters earlier this week: “I have never
seen anything like Teeth the
Musical anywhere else. It is
absolutely fantastic in all respects.” DT

‘Proportionate and effective’ approach

he vast majority of those
who work in health
and social care are
committed individuals with a
strong sense of professionalism who aspire to deliver the
highest standards. However,
where there is poor practice or
behaviour that presents a risk
to the public, it is vital that swift
action is taken, whether by employers, or by national regulatory bodies.
The regulatory system is
becoming increasingly complex and expensive and requires continual Government
intervention to keep it up to
date. The Government must
move to a proportionate and
effective system that imposes
the least possible costs and complexity, while maintaining safe-

ty and confidence for patients,
service users, carers and the
wider public.
Recently, Health Secretary
Andrew Lansley presented
‘Enabling Excellence’ to Parliament regarding this debate. He
said: “Regulation of healthcare
workers and social workers
makes an important contribution to safeguarding the public, including vulnerable adults
and children. But we need an
approach to professional regulation that is proportionate
and effective.
At the moment, most processes - such as registration,
investigation and complaints that regulators need to have are
set out in ‘rules’. Devolving powers to the regulators will give

them greater freedom to define
their own processes without
approval from the Privy Council or Department of Health.
Voluntary assured registration
is intended to improve standards and drive up the quality of
care without imposing the costs
of mandatory regulation.

regulation and strengthen the
social work profession. The
Council for Healthcare Regulatory Excellence will also become more independent and
self-funding. They will review
the efficiency of all regulators,
with a view to reducing the
overall costs of regulation.

The Council for Healthcare
Regulatory Excellence (CHRE)
will set the standards for registers and accredit organisations
meeting its standards, meaning
the public and employers would
be able to easily identify what
register a worker belongs to.

The Health Secretary also
announced to Parliament today that herbal medicine practitioners will be regulated
from April 2012. The four
UK health departments have
agreed that the Health Professions Council (HPC) should
hold a statutory register of
practitioners who supply unlicensed herbal medicines to
people to enable the supply of
herbal medicines to continue
after 30 April 2011. DT

The abolition of the General
Social Care Council forms part of
our wider programme of social
care reform which will deliver
a more independent model of

Andrew Lansley

[5] =>

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[6] =>

See what you
are missing...

United Kingdom Edition February 28-March 6, 2011

GPS to map bat teeth
B

Carl Zeiss
ProErgo

iologists at the University of Massachusetts
Amherst have “mapped”
the topography of bat teeth. The
clever use of GPS technology has
been designed in order to better
understand how toothy ridges,
peaks and valleys have evolved
to allow different species to eat
everything from hard-shelled insects to blood and nectar.

Carl Zeiss
OPMI® Pico

Using a method based on
geographic positioning systems,
the researchers could characterise the topography of the
bats’ molars in a way similar to
how geographers characterise mountain surfaces. The researchers calculated a measure
of dental complexity that reflects how “rugged” the surface
of the tooth is and were able to
illustrate a trend from relative
simplicity of the shearing molars
in insect eaters and omnivores
to high complexity of the crushing molars in fruit eaters.

Carl Zeiss
EyeMag Sports
2.5x loupes

Researchers could characterise the topography of the bats’ molars in a way similar to
how geographers characterise mountain surfaces

Working with field-collected
bat skulls, researchers Sharlene
Santana and Betsy Dumont of
UMass Amherst, with Suzanne
Strait of Marshall University,
W. Va., compared the structure
of molars across 17 species of
the New World leaf-nosed bats
that specialise in a variety of different diets (insects, fruits, and a
combination).

They found that the molars
of fruit-eating species had sharp
outer edges that likely allow
them to pierce tough fruit skin
and pulp. By contrast, the molars
of insect-eating species were less
complex, possibly because of
their smoother shearing surfaces. The study is published in the
Feb. 16 online issue of the journal Functional Ecology. DT

Sweet taste of HPV cure?

N

ew scientific research
from New York based
Cacao Biotechnologies
is uncovering potential new applications for the antioxidantrich cacao beans, which could
spur an innovative approach to
treating human papillomavirus
(HPV), a precursor to oral and
cervical cancer.

Carl Zeiss
EyeMag Pro
prismatic
loupes

There are existing vaccinations for the HPV virus, however, they only effective against
a small number of high-risk,
cancer-causing HPV strains
and are not free of serious side
effects including convulsions

Carl Zeiss
GTX

V2 LED
Illumination

Stand F22
Visit us at The Dentistry Show on

and paralysis. As stated in the
research article, “Vaccination
will not cure someone who is already infected with the virus, so
even with massive public health
education campaigns, HPV will
not soon be eradicated because it
is so widely spread in the adult
population.”
According to Penny Hitchcock, Chief of the Sexually Transmitted Diseases Branch of the US
government’s National Division
of Microbiology and Infectious
Diseases, further research on
topical microbicides and effective vaccines is critical.

Building on the work of Cacao Biotechnologies’ co-founders
Drs Mark Guiltinan and Siela
Maximova of Penn State University, scientists Dr Randall Murphy and Daniel Preston of Cacao Biotechnologies developed a
suite of epicatechin-based super
antioxidant compounds from cacao. The research article stated
that based on the shape and an
analysis of cocao molecules some
epicatechin oligomers should
have strong antiviral properties.
Testing proved their theory correct and they had developed an
antiviral compound specifically
powerful against HPV. DT

B2A 2011 golf tournament

T

qualifying competition in June,
Hankley Common provides the
perfect setting for B2A’s tournament this summer.

Voted the 50th best golf
course to play in the UK by Golf
World Magazine and soon to host
the Open Championship pre-

Starting the day with a
light breakfast, followed by
18 holes and topped off with a
delicious three course lunch,
prize giving and a special auction with a round of Golf at
the prestigious Loch Lomond
up for grabs – this year’s tournament is set to be the best

he Bridge2Aid (B2A)
2011 golf tournament
is on and the team are
delighted to announce that
the hugely popular and now
annual event will be held at
Hankley Common Golf Course,
in Farnham Surrey on August
30th, 2011.

Nuview Ltd, Vine House, Selsley Road,
North Woodchester, Gloucestershire GL5 5NN
Tel: 01453 872266 Fax: 01453 872288
E-mail: info@nuview-ltd.com
Web: www.voroscopes.co.uk

Hankley Common will host the B2A summer tournament

yet! If you’re a budding golfer, keen to host a day out for
your team or simply looking
to support the charity, there
are now 25 teams available to
book in one of Surrey’s finest
golf courses.
A team of four can be booked
now for just £488. For more
information on the day or to
book your team contact Stuart Thompson now on 01483
304944. DT

[7] =>

United Kingdom Edition February 28-March 6, 2011

MSc Blog 7

Walking in a webinar wonderland
Elaine Halley on deadlines, daughters and the bread-and-butter of dentistry

he time has flown past
since my last blog – but
I am happy to report
that I did manage to get my
final six cases for Unit 3 Anterior
Aesthetics in and complete
on time. This sounds so straightforward when I write it now
– and does not reveal the reality which was that despite my
best intentions, I was still texting
my treatment co-ordinator last
Saturday to ask her ‘how do I
export the patient chart again?’,
and snapping at my family on a
Sunday afternoon to the tune
of ‘I just need peace to get this
DONE....and then I can play
with Barbie, test you on your
geography and paint your
nails (not all the same child I
hasten to add!)’ Thank goodness the Six Nations started the
following week or I would have
had no hope of playing the ‘Go
and ask Daddy’ card...

Fiona Clarke let us know about
some changes to the course –
we have four case reports to do
in this unit which are not due
in until September, but need a
500-word ‘defence’ in addition
to our case reports. There was

aesthetics – both direct and
indirect. Luckily, I have just
taken bitewings for a team
member who shall remain
nameless – and I may be able to
get two or even three posterior
quadrants of restorative work

from her!!
We haven’t had a webinar
for several months – I knew I
was missing something in my
life...! DT

A-dec 300

Simple. Smart. Streamlined.
A-dec 300 is designed for the health of your practice. Because your every movement counts, every detail
matters. That’s why A-dec 300 is setting a new benchmark for optimal ergonomics, smart efficiencies, and
lasting value. By asking what’s going to help you feel great at the end of the day, A-dec has arrived at a
treatment room solution that ensures an easy, continuous flow that is as healthy as it is natural.

We also had a January deadline for the end of Unit 6, which
was a final assignment based
around designing a clinical research project. I must admit,
that as a general practitioner,
I have found the research unit
the most interesting but also
the most challenging. I particularly found this final assessment to be a challenge – I guess
with years of experience and
because restorative dentistry
is my bread-and-butter, I have
plenty to say in the case reports
under the ‘discuss your use of
materials and justification’,
and ‘discuss what could have
gone better or you would have
done differently’ always leaves
me with a torrent of justifications for the end result I see
before me.

In a world that demands dependability, A-dec delivers a proven solution without a single compromise.

‘Define your structured
search making use of MESh
terms and Boolean Operators’ leaves me a little less
than verbose. I did try – I
went back through my notes,
re-listened to webinars but
still I found my writing in this
area felt a little like my 10-year
old daughter’s sentence construction. Something along the
lines of ‘And then I would...’
Being as this counts for 60 per
cent of my Unit 6 mark – we’ll
have to wait and see!
The web platform now lets
us keep track of our marks
across all the completed
units. We had our introductory
webinar for Unit 4 where the
rest of the year was mapped
out. Part of the webinar was
carried out by Wolfgang Richter who outlined some of the
subjects that will be covered
under Posterior Aesthetics.

something about a complex case
with 1,000 words to write but
all will be revealed at the next
residential in June. Eddie Scher
is heading that up so should
be good – but a few webinars
to get through first. Posterior

Chairs
Delivery Systems
Lights
Monitor Mounts
Cabinets
Maintenance
Infection Control

To learn more, contact A-dec at 0800 233 285 or call your local authorised A-dec Dealer. Visit our website: www.a-dec.co.uk
A-dec Dental UK Ltd
Austin House, 11 Liberty Way, Nuneaton, Warks, CV11 6RZ. Tel: 024 7635 0901 Fax: 024 7634 5106 Email: info@a-dec.co.uk

A-dec 300 streamlined.indd 1

03/11/2010 15:38:15

[8] =>

8 Money Matters

United Kingdom Edition February 28-March 6, 2011

Do’s and Don’ts
David Brewer discusses raising finance for
practice purchase

I

t is a tough time at present
for many associate dentists
with a double whammy
of
the
poor
economic
climate and increased practice

costs putting the practice profits
under increased pressure – and
one area the practice owner can
make savings is on the percentage share paid to associates.

The days of standard 50
per cent paid to associates are
no more with 40 per cent and
lower becoming increasingly
common place.

Practices can make savings on percentage shares

With continued uncertainty

ARE YOU CQC READY?
WE ARE!

over future UDA values and
further NHS cut-backs life is
only going to become even more
challenging for the associate
and it is little wonder that more
associates than ever before
are looking to become masters
of their own destiny by considering practice purchase
However...the days of obtaining easy money from the
banks simply because you are
a dentist are long gone.
The banks are taking a
much more critical approach
to any funding requests and it

• NEW CQC Outcomes Systems
for Dental Practices

‘The banks are
taking a much more
critical approach
to any funding
requests and it is
therefore essential
that when
approaching them
for funding that
you get it right
first time’

• NEW Compliance Declaration
Audit Tool
• NEW Infection Control System

(incorporates the NEW 10 criterion from the
2008 Act, supporting forms and audit tool)

is therefore essential that when
approaching them for funding
that you get it right first time –
if you are ill prepared and the
bank initially declines your
proposal it is then very difficult
to overcome that initial decision - all the more important
therefore to engage the services of an expert BEFORE you
speak with your bank.

All our NEW CQC Systems can be bought online at our
website or we can send you an invoice if you prefer.
See our demo videos of the above at
www.requireddentalsystems.com

SEE U
S
AT THE ON STAND
G51
DENTI
STRY S
4&5
HOW
MARC
H, NEC

Here are a few do’s and
don’ts to ensure your proposal
has maximum chance of a positive outcome:-

DO

ensure you approach
your bank well in advance of
any proposed purchase.

DO NOT leave it to the last
moment. It can take up to three
weeks just for a basic lending decision due to the banks
ever more in depth assessment
process. If a property valuation
is needed you could potentially
double this time.

REQUIRED DENTAL SYSTEMS Limited, Unit 102A Glen Douglas Drive, Glasgow G68 0DW
Tel/Fax: 01236 782477 Email: peter@requireddentalsystems.com

DO ensure you have up to
date financial information to
present to the bank (associate

10918 required dental ad.indd 1

18/02/2011 15:47

[9] =>

United Kingdom Edition

accounts, bank statements etc).

NOT

present your
bank with accounts which
are two years old and a big
pile of monthly schedules and
expect them to add them up
(that is one guaranteed way to
annoy them).

DO have an up to date CV
detailing all relevant professional and clinical experience
(the banks will be looking for
a good spread of experience
ideally covering a number
of practices).

fire way to annoy the banks is
to make a change re ownership
structure at last minute. Your
accountant will be best placed
to provide advice.

DO NOT leave the legal
process to chance. Especially
if there is an NHS contract involved ensure you use a solicitor who fully understands
the process.

DO expect the bank to want

February 28-March 6, 2011

you to put down a contribution
towards the purchase. Obtaining 100 per cent funding is rare
nowadays so expect to put down
between 10 to 20 per cent of the
purchase price.

DO NOT accept the first offer from your bank - make sure
you shop around to obtain comparisons (If your bank knows
you have only approached them
they WILL offer less attractive
rates/fees)

DO NOT forget to include
details of managerial experience on your CV (the banks will
be looking critically at your CV
to provide them with confidence that you can both manage the practice/ staff).

ensure you detail all
relevant information on the
application forms – especially if you have savings (it does
not mean you need to put all
available
savings
towards
the purchase; however banks
are more inclined to lend to
people who already have savings and have demonstrated
ability to save)

rankly

Money Matters 9

DO engage the services of an independent firm to liaise with the
banks on your behalf – both to
package your proposal to maximise chance of a positive result but also to negotiate terms.
REMEMBER the bank staff
are tasked to maximise income
for the bank – most dentists are
very good at their day job but
not when it comes to negotiating. Let the experts negotiate
with the banks on your behalf –

ultimately you will be the beneficiary securing more attractive
terms which may not have been
available if you approached the
bank direct.
Finally... DO remember to
take a short holiday before you
purchase (you will need it...)
and DO enjoy becoming a practice owner - it is certainly not
an easy ride however ultimately
much more rewarding and you
are in control of your future DT

peaking

DO NOT try to hide any existing borrowing you have. Ensure everything is detailed as
the bank will only find out later
when it undertakes its in-depth
credit searches

DO undertake your research
of the local area and find out
why current owner is selling

DO NOT go to the trouble and cost of preparing a
detailed
50-page
business
plan. Most banks will simply not read it and most of the
time it is not needed. A brief
summary of your purchase
proposals and proposed working arrangements post purchase should suffice – together with an outline profit/loss
forecasts which you/your advisor can normally prepare by
using the vendor’s accounts as
a starting point.

Raising Finance?

DO decide as early as possi-

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

ble in the process if you are to
purchase in your sole name or
as limited company. If freehold
property involved again advise
ASAP if this is to be owned in
own name, joint with spouse or
limited company. Another sure

About the author
David Brewer joined Frank Taylor
and Associates in the role of healthcare business development manager
in 2010. He has worked with the dental
profession for more than 15 years arranging finance and banking arrangements. He can be contacted on 07817
758548 or david.brewer@ft-associates.
com. Frank Taylor and Associates has a
specialist finance division, Loan Hunter that arranges loans for practices. For
more information, call 08456 123424

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

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

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

[10] =>

10 Feature

United Kingdom Edition February 28-March 6, 2011

Be prepared for a medical emergency
David Howarth discusses AED (Automated External Defibrillators)

Heartsine Samaritan PAD

Defibtech Lifeline AED

A

s we all know, medical emergencies within
dental practices are
rare; the most common problems being fainting, hypoglycaemia,
choking,
seizures,
asthma and anaphylaxis, even
rarer are cardiac problems
such as angina, heart attacks
and cardiac arrest.
However, despite the rarity of these problems, medical
emergencies can happen at any
time in a dental practice, so
we all need to be prepared to
deal with them should they occur and the GDC is very clear
in its expectations.
• All members of staff need to
know their role in the event of
a medical emergency
• At least two people are available to deal with medical emergencies when treatment is
planned to take place
• Members of staff need to
be trained in dealing with such
an action
There is also an expectation from our customers and
members of the public that
dental
practitioners
and

per cent.
dental care professionals are
competent in dealing with medical emergencies.
Back in July 2006, the UK
Resuscitation Council released
recommendations
regarding
standards for managing resuscitation and medical emergencies for dental practitioners and
dental care professionals in
general dental practice.
The recommendations include the following regarding
AED availability and training:
• All clinical areas should have
immediate access to an AED
• dental practitioners and dental care professionals should all
undergo training in Cardio Pulmonary Resuscitation (CPR),
basic airway management and
use of an AED.
Hew Mathewson, now past
President of the GDC “Welcomes these guidelines and
congratulates the authors on
their considerable work that
has led to the publication”
(March 2006).
Dealing with medical emer-

gencies is just one of the recommended core subjects per
CPD cycle with a suggested
minimum number of 10 hours
(defibshop.co.uk offer CPD accredited training in the use of
an AED including CPR which
takes four hours every 12
months and is worth four verifiable CPD points)
Sudden Cardiac Arrest can
happen to anyone at anytime

“When the shock is delivered within five minutes of the
sudden cardiac arrest, 50
percent of individuals survive,”
said Deborah DiSanzo, vice
president and general manager of cardiac resuscitation at
Philips Medical Systems, manufacturer of the popular HS1 &
FRx defibrillators.
So the question that needs

‘However, despite the rarity of these problems, medical emergencies can happen at
any time in a dental practice, so we all need
to be prepared to deal with them’
and the only effective treatment
is an electric shock delivered by
an AED.

addressing is “Why wouldn’t
your practice purchase an
AED?”

The time from arrest to delivery of the first shock is the
single most important determinant factor in survival. For
every minute that goes by the
patient’s chance of survival
reduces between seven – 10

They are very simple to
use, with only one or two buttons to operate.
Once activated the AED will
provide clear voice prompts,
reminding the user to call for

the emergency services and
where the electrode pads
should be placed.
As soon as the pads are attached to the patient the AED
will monitor the patient’s heart
rhythm and decide whether to
deliver a shock or not.
Some machines (semi automatic) will instruct the user to
push a button whilst others will
deliver the shock automatically
(fully automatic).
Most defibrillators also provide clear verbal instructions
on how to perform CPR during
that part of the rescue protocol, the Lifeline View from Defibtech even has a small LCD
screen with a colour video to
prompt the rescuer. How amazing is that!
Not having an AED available to use on a collapsed patient
may result in a member of the
dental team being challenged
if it can be shown that it could
have favourably influenced
the outcome, especially if the
action of a dental care professional differs from the recommendation / guidelines from

[11] =>

United Kingdom Edition

such an authoritative body as
the Resuscitation Council.defibshop.co.uk offer more than
10 different defibrillators for
less £1,000, and if you choose
to lease that could be as little as £1.48 a day so again the
question that needs addressing
is “Why wouldn’t your practice
purchase an AED?”
We can’t think of a reason……………can you?
Lots of defibrillators to
choose from and here are six of
the most popular.
Cardiac Science Powerheart
G3 Plus
The Powerheart AED G3 Plus
is the newest defibrillator
offered by Cardiac Science and is available
in semi automatic
or fully automatic
versions.
“Rescue
Coach”
intuitive
prompts are designed
to guide the rescuer
through the rescue
process and provide instructions. Prices start
from £1000 + vat.

Feature 11

February 28-March 6, 2011

‘The time from arrest to delivery of
the first shock is the single most important determinant factor in survival. For
every minute that goes by the patient’s
chance of survival reduces between
seven – 10 per cent.’
ations. Built to US military
standards for ruggedness and
exceeds standards for splash
and dust resistance.
The
Lifeline
AED
is
lightweight
at
only
two
kg,
pads
are
preconnected (adult or paediatric) and is also
available in
semi automatic
or fully
automatic
ve r sions.
Prices
start
f r o m
£916.00
+ vat.

Defibtech Lifeline (Standard five year battery
option)
Defibtech
Lifeline AED is a
robust
one
piece
unit
built
for
real life
situ-

Zoll AED Plus Lay Responder
The Zoll AED Plus is the only
AED on the market which
offers a full rescue capability providing the rescuer with
feedback to assist in CPR and
is aimed at both basic life support users and healthcare professionals. The AED Plus is
easily distinguishable by its
lime green colour and use of
a single electrode rather than
two. Zoll were recently awarded the national defibrillator
contract from the British Heart
Foundation. Prices start from
£1,000 + vat.
Medtronic Lifepak CR Plus
Medtonic Lifepak CR Plus
is available in either semi
automatic or fully automatic
versions
It is designed to be used by
the minimally trained rescuer with the semi automatic version only
requiring three steps
to a potentially life
saving defibrillation shock whilst
the fully automatic version
only requires
the rescuer
to apply the
pads. Prices
start from
£1,295 +
vat.
Heartsine Samaritan PAD
The only UK
manufactured
defibrillator
on
the market this fantastic
defibrillator
only uses three simple
icons and verbal instructions, the Samari-

Laerdal Heartstart First Aid HS1

tan PAD will clearly guide the
rescuer through each step. The
Samaritan PAD is activated by
pressing the green on button.
The pads and battery pack are
packaged together (one expiry date to track) and the unit
prompts the rescuer visually
and verbally.Prices start from
£799 + vat.
Philips / Laerdal Heartstart
First Aid HS1
A compact semi automatic unit
aimed at individuals trained
in basic life support but who
would be expected to use
the equipment infrequently.

hours if you choose our e-learning option for the theory element of the course. If you prefer
pure instructor led training the
course lasts up to four hours
and cost the same only £300
+ vat if ordered at the same
time as you purchase your defibrillator.
Email Paula Leech or Margaret Green for a full copy
of the Resuscitation Council
Guidelines and to register for
our newsletter and information
on defibrillator special offers
savealife@defibshop.co.uk
or
call 0845 071 0830. DT

Clear calm voice instructions guide the rescuer through
each step of defibrillation including CPR coaching.
CPD Accredited AED / CPR
training
defibshop.co.uk offer CPD accredited training in the safe use
of the defibrillator you choose
to purchase and CPR.
Our experienced trainers
come to your practice to train
your staff in as little as two

About the author
David Howarth is the Managing Director of defibshop.co.uk the UK’s
number one online distributor of defibrillators, consumables and CPD
verifiable training. Established in 2003
defibshop offers impartial advice on
which defibrillator best meets your
company’s needs and budget, and remains the only distributor of every
manufacturer’s defibrillators in the
UK. The defibshop website is the most
comprehensive resource for defibrillators on the web and it includes, 360
degree images, full technical specifications, comparison tables, videos, cost
of ownership over five years graphs
and latest news articles.

Are you equipped for an emergency?
Saving minutes, saves lives
Dental Defibrillator Package – Quote reference RF269 for special offer
Includes free carry case, rescue ready kit, 2 sets of adult pads & 1 set
of paediatric pads
For further information, contact:
BOC Healthcare Customer Service Centre, Priestly Road, Worsley, Manchester M28 2UT, United Kingdom
Phone 0161 930 6010, bochealthcare-uk@boc.com, www.bochealthcare.co.uk or www.boclifeline.co.uk
The stripe symbol and the letters BOC are registered trade marks of The BOC Group Limited. Both BOC Limited and The BOC Group Limited are
members of The Linde Group, the parent company of which is Linde AG. Reproduction without permission is strictly prohibited. © BOC Limited 2011

407770-Healthcare Dental Defibrillator Package advert 262x80.indd 1

14/02/2011 14:46

[12] =>

12 Interview

United Kingdom Edition February 28-March 6, 2011

CAD/CAM SYSTEMS | INSTRUMENTS | HYGIENE SYSTEMS |
TREATMENT CENTRES | IMAGING SYSTEMS

Being more in dentistry
Dental Tribune speaks to the CEOs of IDH and
ADP about the recently announced merger of the
businesses, and finds out what the future holds

C3+/C4+/C5+ – GREATER COMFORT
FOR YOU AND YOUR PATIENTS

business at IDH. It has been a
challenging time but an enjoyable one.”

Designed
for dentists,
by dentists.

Richard is very excited by
the future opportunities that’s
the merger can provide. For
him, it is all about being able to
invest in the business and develop it and the dental professionals under its umbrella for
the benefits of patients. One of
the positives about the merger
is that we will be able to invest
in our practices and help our
teams to continue improving
patient care.

Take advantage of exceptional ergonomics
and stylish design at affordable prices.
Enjoy every day. With Sirona.

he news regarding the
merger of Integrated
Dental Holdings (IDH)
and Associated Dental Practices
(ADP) caused a stir when it was
first announced at the end of
January, with its potential (subject to regulatory approval) to
create the largest dental group
in the UK.
And it is pretty large! When
completed, the merger will
have more than 450 practices,
with approximately 2,000 dental team members treating
more than 3.5 million patients per year. But what does
this mean for the future of
the groups?
To find out, I asked Richard
Smith (CEO of IDH) and David

NHS and with PCTs and the
Department of Health from
working
in
the
hospital
sector,
David
brings
valued experience to the
new business.
Richard believes that the
current situation in dentistry is
very similar to the one which
faced pharmacists a few years
ago. With a change in regulations and a fundamental need
to look at the way the sector
worked, pharmacies needed to
develop new working practices
to survive and be successful.
With the shake-up of the NHS
system and a return to a more
centralised
commissioning
structure, dental practices have
to do much the same. Another
similarity he has seen is the

‘I feel that by working together we can
bring real benefits to patients but also to
the careers and professional lives of dentists
and the dental teams’

Sirona Dental Systems Ltd., 7 Devonhurst Place,
Heathfield Terrace, Chiswick, London W4 4JD
Telephone: 0845 0715040
e-mail: info@sironadental.co.uk
www.sironadental.co.uk

The

Dental

Company

Hillier (CEO of ADP) to give
me further insight into the reasons behind the merger. Both
Richard and David are new to
the area of dentistry, but
each has a solid background
in healthcare. Following a
career in the retail sector, Richard spent the last five years
as managing director of Lloyds
Pharmacy, guiding the business through a period of major change in the pharmacy
sector to maintain its position
as one of the leading community pharmacy chains in
the UK. David’s healthcare
credentials span a longer
time period, having entered
healthcare in 1998. With expertise in dealing within the

fractious nature of dentistry,
where working together for a
common goal is rarely seen.
Richard said: “I feel that by
working together we can
bring real benefits to patients
but also to the careers and professional lives of dentists and
the dental teams.’’
Having joined IDH in July
2010, Richard was very much
thrown in the deep end of both
dentistry and the proposed
merger. “Yes it has been a
whirlwind introduction to dentistry! No sooner had I started at
IDH when we began exploring
the possibility of merging with
ADP so I had that happening
whilst getting familiar with the

“One way we intend to do
that is the establishment of a
clinical academy, where we
can provide opportunities for
skills development for clinicians and all members of the
practice. We want to support
our staff to develop their skill
sets, allowing their ability to offer a wider range of treatments
to grow.”
David’s time with ADP only
started in September 2010 so
his experience is very similar to
Richard’s. He commented: “I’ve
only had a short period to get to
know the business. We became
aware that there was this opportunity for merging with IDH
very shortly after I joined so I
had to do two things; I first had
to know where the business
was and where we could take it,
and would it [the merger] be a
good move for the company and
for the shareholders. “
He is very positive that the
merger will create a grand future for both the companies
and the patients they provide treatment for. “I think it
gives a great opportunity to
create a company with real
scale which is able to actually
bring up a new level of professional, to provide better resources, better investment, and
better support to the dentists in
the field.
“I think the bigger you are
you are able to have more resources to use in areas such as
training and development – I
think it’s one of the big advantages of being a large organisation. I think there are bigger
opportunities for people to develop specialist skills in their
professional development, both
for dentists and nursing staff.
A larger organisation would be
able to offer better career opportunities and to actually put
those skills to good use.’’ DT

[13] =>

Clinical 13

United Kingdom Edition February 28-March 6, 2011

Are we deluding ourselves?
Michael Sultan discusses the point of perfection in treating root canals

tually wonderfully efficient
had little bearing on the canal’s
ver the years dentists
cutting instruments that preoriginal anatomy but just enhave
been
preparpare a canal much faster than
larged in the direction the file
ing root canals with
was previously possible.
In
wanted to go in. We then moved
the intention of removing inreality, all these instruments
onto the next instrument that,
fected and inflamed material
do is create pretty shapes that
again, gives us a false sense of
and ultimately making them
9361 DBG ClinicalGov The probe 338x244.qxd:Layout 1 1/7/10 13:39 Page 1
bear no relation to the canal’s
security: NiTi. These are aceasy to seal. The result of all
their efforts would reveal itself in a post-treatment X-ray
as a pretty, neatly shaped root
filling fully sealing the mythical region known as the “apical third”. When we saw those
satisfyingly smooth, regular
shapes we deluded ourselves
into thinking that we had done
the perfect job.
However, if we were to clear
that tooth, we would uncover
an irregularly shaped canal
system with an intricate network of interconnections. Years
back the only reason the radiographic result looked so wonderful was because the material
we used to create these root fillings - the silver point - was so
radio-opaque. The reality, as we
all know, is that the tool we rely
on most - the radiographic film

‘However, if we
were to clear that
tooth, we would uncover an irregularly
shaped canal
system with an
intricate network of
interconnections’

- is a two-dimensional image of
a three-dimensional space and
is woefully inadequate.
Gutter Percha
And so we moved on to gutta
percha; after all, how can a
rigid piece of metal possibly
seal an irregular canal? However, this material wasn’t rigid
and the canal needed to be well
prepared so that we could adapt
our filling material. Yet again
we were under the illusion
that we were doing a good job.
Yes, our radiographs would reveal impressively filled canals,
but what they did not show
us was actually how clean the
canal was, whether a rubber
dam had been used during
treatment, whether our irrigant had been saliva (no dam)
or the industry-gold standard
of bleach.
In the old days clinicians
would use stiff, rigid, stainless steel files to try and shape
these canals, the results often

natural anatomy. This nicely
shaped canal, narrow at the tip
and gently flaring out to the orifice, hopefully encompassing
the whole canal system somewhere in between, is really
being shaped to receive our fill-

Clinical Governance including
Patient Quality Measures Is your practice compliant?

ing materials.
Basic Flaw
The problem is that the instruments are so conducive to efficiently cutting the canals,
à DT page 14

Are you waiting to find out when
the Care Quality Commission*
inspect your practice?
Have you addressed all 28 CQC
outcomes?
Your compliance with Clinical Governance
and Patient Outcomes will be questioned
with the introduction of the Care Quality
Commission*, HTM 01-05 and the increase
in PCT practice inspections.
Would you like to know how you would fare when your
practice is inspected and have the opportunity to take
corrective action?
The DBG Clinical Governance Assessment is the all
important experience of a practice audit visit rather than
the reliance on a self audit which can lead to a false sense
of compliance. The assessment is designed to give you
reassurance that you have fulfilled your obligations and
highlight any potential problems. We will provide help
and advice on the latest guidance throughout the visit.

The areas the DBG assesses are:

premises including access, facilities, security, fire
• Your
precautions, third parties and business continuity plans.
governance including Freedom of Information Act,
• Information
manual and computerised records, Data Protection and security.
• Training, documentation and certificates.
• Radiography including IRR99 and IR(ME)R2000 compliance.
infection and decontamination including HTM 01-05
• Cross
compliance and surgery audits.
emergencies including resuscitation, drugs,
• Medical
equipments and protocols.
• Training, documentation and certificates.
• Waste disposal and documentation and storage.
• Practice policies and written procedures.
• Clinical audit and patient outcomes including quality measures.

The assessment will take approximately four hours of your Practice Manager’s time depending on the number of surgeries and we
will require access to all areas of your practice. A report will be despatched to you confirming the results of our assessment. If you have
an inspection imminent then we suggest that you arrange your DBG assessment at least one month before the inspection to allow you time
to carry out any recommendations if required. Following the assessment you may wish to have access to the DBG Clinical Governance
Package with on-line compliance manuals.

For more information and a quote contact the DBG on 0845 00 66 112

20
YEARS

www.thedbg.co.uk
Please Note: Errors and omissions excluded. Any prices quoted are subject to VAT. The DBG reserves the right to alter
or withdraw any of their services at any time without prior notice.

*England only.

[14] =>

14 Clinical
ß DT page 13

remaining fairly central
throughout
the procedure.
Much of
t h e

time
the canal walls are
not even being
touched and, worse
still, there is debris being produced which is
pushed laterally into
the canals’ irregularities. In fact, it doesn’t
really matter which
NiTi file system we use as they
all have this same basic flaw.
To completely remove any
debris and bacteria, of course
irrigation is vital. However,
for irrigation to work successfully the solution has to get to
the right area. It has to be activated properly, it must be able
to access the canals, and be

United Kingdom Edition February 28-March 6, 2011

replenished regularly. Simply
syringing it in and leaving it to
sit passively in the canal simply
does not work.
Complex Biofilms
Bacteria do not just float about
in the tooth’s canal. They are
made of highly complex
biofilms that are firmly attached to the
walls
of
the
canals and unless
we physically remove
them,
the
canals
will never
b
e

a tooth. It is given an almost
mystical status with the ability to cap pulps, cause roots to
grow, apexes to close and to kill
all bacteria in sight. It may well
be highly alkaline (if it hasn’t
degraded to calcium carbonate in the jar) and kills bacteria
well, but if bacteria are trapped
in a muddy pool of debris
the calcium hydroxide will
be unable to reach it. One of
the prime causative agents of
endodontic failure is E.faecalis,
which is resistant to alkaline
solutions anyway. To compound
problems further, the purpose of a root canal filling is to
entomb any residual bacteria so
that they are no longer viable.

clean. To this
end we need to aggressively move the
irrigant in and out of the
canal walls to remove the bacteria within them.
As an inter-appointment
dressing we generally use calcium hydroxide, which is often regarded as the most important dressing we can put in

This
fluid
tight
root
filling
will deprive the
bacteria
of
their food
supply
a n d
c a u s e
them
to
wither and die.
The
problem
is

Lay down and relax
in Australia.

‘This fluid tight root filling will deprive
the bacteria of their food supply and cause
them to wither and die.

that all root filling materials
leak (it is just a question of
extent) and the bacteria themselves lay dormant, waiting
patiently for leakage and their
next supply of food.
Despite all our best efforts,
even when we think we have
a technically beautiful root filling and an excellent 3D seal
of the canals, we still heavily
rely on the final coronal seal
of the tooth. Many studies
have shown that a great root
filling coupled with a poor
coronal seal will unfortunately
lead to failure.
With all these weak spots
in our procedures it is perhaps surprising that we
have any success
rate at all and yet
despite
all
w e
do,
succ e s s
rates
remain
high
(95 per cent
in uninfected teeth and about
80 per cent in re-treatment).
So I will not be abandoning
endodontics just yet to be seduced by larger pieces of titanium but I acknowledge the
gaps in our knowledge and procedures, and am thankful that
our patients have innate abilities to heal.

ularities whilst continuously
vibrating and pumping irrigant through its hollow central
lattice. In the future we will be
using systems that actively kill
bacteria rather than one that
just relies on the constant flow
of irrigants. In this field, photoactivated disinfection systems
may show great promise for the
future.
Insane
Those who repeat the same
task over and over again,
expecting a different outcome
each time, are accused of
being insane. I think that
we are all guilty of trying to refine an already flawed approach
and what we really need is
a complete paradigm shift in
our methodology and to stop
really deluding ourselves about
what is going on when we treat
root canals. DT

In order to progress and
move forward, we will have to
rethink how we overcome the
aforementioned problems. In
this respect I think the most exciting product on the market at
the moment is the Self Adjusting File (pictured). This ingenious device expands to touch
all canal walls and their irreg-

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Dentists strive for the ‘picture perfect’ root canal

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 Eastman
CPD, University of London. In 2008 he
became clinical director of EndoCare a group of specialist practices. For further information please callEndoCare
on 0844 893 2020 or visit
www.endocare.co.uk

[15] =>

United Kingdom Edition

February 28-March 6, 2011

Clinical 15

Computerised imaging
Joe Oliver discusses the importance of computerised cosmetic imaging in
treatment planning of the aesthetic case
dentistry today. It poses both
difficulties for the ceramist as
well as the clinician. Communication of shade has in the
past been a major problem but

fortunately nowadays laboratories are able to see patient digitally to alleviate this communication problem. Obviously
shade is not the only consid-

eration. Shape, contour and
surface texture also play important roles. This is where the
cosmetic imagery is so important. In many instances

multiple visits are required to
achieve a successful outcome.

o what is computerised
cosmetic
imaging? Putting it simply,
it is the digital manipulation
of a photograph to simulate
changes in form and colour
of the teeth. Imaging allows
yourself, the patient, specialists and the technician to
visualise the proposed treatment. It is an excellent way to
co-diagnose with the patient
the proposed smile design.
Remember that many of our
patients are self-conscious
about their smiles and find it
difficult to discuss them.
Using imaging, the patient is
able to visualise various treatment options.
To the dentist, imaging is
an invaluable tool to visualise
slight changes within the parameters of smile design to see
if such changes “suit” the overall look of the patient and fit
their personality. This could re-

Professor Giovanni Zucchelli DDS PhD
19th 20th 21st May 2011 9am - 5pm
Of interest to Periodontists and those with a special interest in Periodontology
Soft tissue plastic surgery in the aesthetic area of the mouth: from the management of gingival recession to the treatment of
vertical bony defect. [17 hour verifiable CPD]
Cost: £2,050 exc VAT for access to the 3 day course

Places for these courses are limited to 30 attendees, so early booking is recommended
Book tickets via our website: www.seminarsthirtyeight.com, by telephone on 07738 287764
or by email to catherine@seminarsthirtyeight.com
Dr Benjamin Watkins DDS & Dr Pirooz Zia BDS, MScD
12th March 2011 9am - 1.30pm
Of interest to the whole Team
1/ Key Prosthetic Considerations For Restoring Anterior Single Tooth
Implants: A Prosthodontist’s Perspective suita whole team
● Historical advancements in anterior implant aesthetics
● The 5 most important keys to successful implant aesthetics
● The effect the emergence profile has on soft tissue aesthetics
● The key criteria for the selection of prefabricated vs. custom implant abutments
● Advanced concepts to improve the appearance of malpositioned implants
2/ A Practical Review of Modern Endodontic Diagnosis: All the practical clinical steps necessary to gather the information required
to make an accurate pulpal and periapical diagnosis will be reviewed. [4 hour verifiable CPD]
Cost: £275 (Dentist) £185 (DCP) exc VAT

‘Providing a printed
picture at consultation allows the
patient to discuss
the proposed smile
design with their
partners and members of their family’

Dr Massimiliano Di Giosia DDS Cert Orofacial Pain (USA)
19th March 2011 9am - 1.30pm
Of interest to Dentists and DCPs
Introduction to dental sleep medicine, the role of the dentist in the management of snoring and obstructive sleep apnoea
[4 hour verifiable CPD]
Cost: £250 (Dentist) £175 (DCP) exc VAT

Dr Jason Smithson BDS (Lond), DipRestDent RCS(Eng)
2nd April 2011 9am - 5pm
Of interest to Dentists
Direct resin artistry: anterior and posterior including a live demonstration of the techniques used. Microscope with video feed
[6 hour verifiable CPD]
Cost: £350 exc VAT

late to changes in incisal length
and
width
or
comparing changes in embrasure
spaces. Providing a printed
picture at consultation allows the patient to discuss
the proposed smile design with
their partners and members of
their family.

Dr Marc Cooper DDS
12th May (evening) 13th May 2011 9am – 4.30pm
Of interest to Dentists
The power of ownership and leadership. The course aims to enable dentists to become and operate as powerful leaders of their
practices [8.5 hour verifiable CPD]
Cost: £495 exc VAT

Once the design has been
decided upon diagnostics need
to be made. Again the imaging picture is a very useful
communication tool with the
technician to visualise the end
result one is aiming to achieve.
Case Example
The replacement of two units
in the upper labial segment is
probably one of the most difficult challenges in cosmetic

Book tickets via our website: www.seminarsthirtyeight.com

à DT page 16

[16] =>

16 Clinical

United Kingdom Edition February 28-March 6, 2011

ß DT page 15

Consultation
A young 21-year old lady
attended the clinic requesting
the replacement of existing
bonding on UR1 and UL1. The
bonding had been originally
placed several years before,
and has had to be replaced a
number of times due to breakage .The bonding in place was
two years old. The patient
was unhappy with its poor
colour match, it being chipped
and general texture. She was
also worried as regards the
thinning of her incisal edges.

R4 Practice Management Software
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Clinical Stages
Computer imaging: At the
consultation, patients are encouraged to discuss their cosmetic dental problems as well
as their general dental health.
The appointment is one hour
long and a good half of this
time is taken by the patient
talking and myself listening.
Once I have determined the
overall aims of the patient, the
imaging is carried out taking
in all about 20 minutes. This

‘Once I have determined the overall
aims of the patient,
the imaging is carried out taking in
all about 20
minutes. This is
undertaken with the
patient by my side,
so they can give
their design input’

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is undertaken with the patient
by my side, so they can give
their design input, under
my guidance.
A realistic image must
be produced which can be
achieved clinically. The patient
must also realise that the picture is a simulation and the
end result would not be an exact match. The image is then
printed as part of the treatment
plan and also sent to the lab as
a guide for the fabrication of
the diagnostics.
Preparation: At the preparation appointment the patient
was shown the diagnostic
wax-up which met with her
approval and matches the imaging. The preparation stent
was at this stage placed over
the teeth to be prepared, to
see if any pre-recontouring
was needed along the lines of
the APR/APT technique described by Gurel. Aesthetic preevaluative temporaries were
then placed.
Once depth grooves were

[17] =>

United Kingdom Edition February 28-March 6, 2011

neers were tried in to check
the fit and also to ensure the
design of the provisionals
had been duplicated and everything matches the original imaging picture.
The patient at this stage is
asked to comment. I seat the
veneers altogether as this tends
to be less complicated.

Estetica A4 SELECTED:Layout 1

placed and the incisal edge
reduction achieved the temporaries were removed and the
grooves joined to produce a
uniformly prepared surface.
The gingivae was retracted
using cord followed by Expasyl. After two minutes the
Expasyl
was
thoroughly
washed off and a full arch impression was taken.
After such records were
taken, an antiseptic agent was
liberally applied to the preparations as well as a primer to
seal the dentinal tubules. This
acts as a desensitiser and
prevents micro leakage.
Provisionals
were
then
placed. These prototypes allow the patient to assess the
shape of the final restorations and if any adjustments
need to be made they can
be implemented prior to the
fitting of the final restorations.
Final photographs and alginate impressions were taken of
the prototypes.

25/2/09

13:42

Page 1

I tend to review my patients
several days later to ensure
gingival settling and to see

Clinical 17
if adjustments need to be made.
Conclusion
Cosmetic imaging is something that can be easily
integrated into many practice environments. It is a tool
that is not a substitute to other
diagnostic methods but an
invaluable adjunct to them.
It has been shown to increase
patient acceptance of treatment
plans. In this case example,
you can see it accurately
depicts the final end result. DT

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Trimmer. At this stage the veReferences
Magne P, Belser U - Bonded Porcelain
Restorations in the Anterior Dentition.
Quintessence 2002
Dawson P. - Functional Occlusion from
TMJ to smile design. Mosby 2007
Gurel – The science and art of porcelain
laminate veneers. Quintessence 2003

About the author
Joe Oliver is
the founder of
The Welbeck
Clinic; a highly
acclaimed dedicated centre
for
cosmetic
dental excellence in the
London Harley
St district. With
more
than
15000 veneers fitted, he is a
pioneer in cosmetic dentistry,
performing in the region of
200 complete smile makeovers a year. He is one of the
founders of Cosmetic Dental
Seminars, which runs stateof the-art courses in aesthetic
dentistry, www.cosmeticdentalseminars.org

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[18] =>

This is a company promotion

The Dental Directory:
Experts on Digital
Imaging Equipment
D

igital Imaging is an
extremely fast
growing area
within today’s dentistry
field, and one that may
require a dentist to make a
substantial investment in
terms of equipment. Due
to the complex nature of
Digital Imaging, the
necessary equipment
currently available is often
highly advanced and
relatively new to the

market. With this in mind,
it is vital that suppliers
keep up to speed with
industry developments;
and one that has is The
Dental Directory.

Dr Boota S Ubhi is the
Specialist Periodontist and
Implant Surgeon at the
Birmingham Periodontal
and Implant Centre. He
works alongside Dr Tuss
Tambra who is an
American trained Specialist
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Initially The Dental
Directory offered me a
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service was excellent, and
as a result I’ve been a
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that I would seek the
assistance of The Dental
Directory when it came to
choosing and installing new
Digital Imaging equipment
in my practice, and it
paid off.’

Dr Ubhi’s multidisciplinary
practice specialises in
treating patients with
advanced periodontal
problems, fixed and
removable prosthodontics
and Implant therapy. Dr
Ubhi was entered onto the
General Dental Council’s
Specialist Register in
Periodontics in 2000 and

has been accepting
referrals for advanced
dental care since 1996. Dr
Tambra is a registered
specialist Prosthodontist in
Canada, UK and USA.

In addition to this, the
practice facilities which
include a large lecture
room and dedicated
surgical suite allow them to
provide training to

and after treatment.
Five years ago, Dr Ubhi
changed to using both the
intra-oral and extra-oral
digital imaging supplied by
The Dental Directory. He
was extremely pleased with
how this worked out and
investigated the CT
scanner options.

Having read research
produced by the University

‘The equipment arrived
promptly and was exactly
to spec; I was delighted.
The whole experience was
thoroughly well-planned,
low stress and professional;
qualities that I’ve come to
expect from The Dental
Directory.’
referring dentists and their
staff to enable them to gain
the understanding and
confidence to deal with
advanced dental care. The
Surgical and Prosthodontic
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bone augmentation and the
Prosthodontic aspect of
Implant therapy. Nurse’s
courses are also run and
cover a range of topics
including basic implant
techniques, care of
instruments, sterile
techniques, implant kits
and care of patients before

of Manchester, Dr Ubhi
learned that the i-CAT
scanner provided the best
quality images, and most
importantly, the lowest
dose of radiation available
on the current market.
After intensive
consultation, The Dental
Directory supplied Dr
Ubhi with a Gendex
GXCB-500 CBCT System.

‘After considering the
necessary specifications, I
approached several
different suppliers, one of
which was The Dental
Directory. I discussed my
requirements with them

and they were extremely
knowledgeable. They have
a dedicated Digital Imaging
Manager, Mohammed Latif
who is on hand to offer
advice and explanation.
Their expertise was
invaluable and made me
feel confident that my
choice of equipment and
supplier was the right one.’

The Gendex GXCB-500
provides powerful,
instantaneous diagnostic
and treatment planning
tools; giving distortion-free
images to reveal critical
anatomical details. This
scanner is one of many
pieces of Digital Imaging
equipment available from
The Dental Directory, and
Dr Ubhi is extremely
happy with his purchase.
He feels that the addition
of 3D imaging to his
practice means that he is
providing a much higher
standard of care for his
Implant cases. The
planning and execution of
his treatment is much
quicker and safer due to
the on site CT scanner.
He explains,

‘The i-CAT scanner is
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was arranged efficiently by
The Dental Directory and
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exactly to spec; I was
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experience was thoroughly

[19] =>

This is a company promotion

[20] =>

20 Clinical

United Kingdom Edition

February 28-March 6, 2011

The Inman Aligner Part
II - A progressive
approach to smile design
Dr Tif Qureshi discusses alignment, bleaching
and bonding

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4-5 March 2011 NEC Birmingham

he following article is
Part II in a series discussing the use of the
Inman Aligner as a tool for
MICD.1 The first article demonstrated that standalone treatments offer patients an alternative to fixed braces, which
are unsightly and have long
treatment times, and to expensive clear aligner treatments in
suitable cases.
This article will demonstrate that patients who desire a more traditional smile
makeover can achieve beautiful results in a more progressive manner that allows
them to make their choices
along the way.
This often results in virtually no removal of tooth structure
and a treatment result with
the responsibility of decisionmaking shared between dentist
and patient.
Moreover, the subject matter of this article could potentially start one of the most controversial debates in cosmetic
dentistry for years. We are not
only discussing a radically different approach to smile makeovers, but critically a sharply
different approach to the traditional methods of planning
smile design.
What would you choose?
Patients
entering
cosmetic
practices are often assessed at
the initial consultation. They
have digital photographs taken
and perhaps study models are
made. Normally, dental imaging software is used to show
patients what can be achieved.
These ingenious programmes
can help patients realise what
is possible. Naturally, care
must always be taken when
promising treatment results
that are viewed digitally.
While
computer
imaging can be a very powerful
tool to help the patient see
the potential in his/her smile,
I believe it also can make a
patient focus on a certain prescribed goal that may not be
the only way of satisfying his/

her wishes. Dentists using imaging would ideally create a
set of five to ten different outcomes of varying degrees of
improvement to allow the patient to make a more informed
decision. While ideal, it is not
certain that dentists actually
present different levels of treatment to their patients digitally.

the ABB concept) should be offered to improve the incisal
edge outline. This combination
of treatments also works well
because the Inman Aligner is a
removable appliance and only
needs to be worn 16 to 18 hours
a day. This means simultaneous bleaching is very possible
and straightforward.

Even if they were able to
see various images of their
teeth, it can still be difficult
for a patient to really see and
feel the suggested changes in
their mouth. One can question
the ethics of allowing patients
to commit to a potentially irreversible procedure based on
2-D photographs.

A recent study from Sweden
indicates a cost-benefit advantage of treating patients with removable appliances in general
dental clinics, rather than with
fixed appliances at specialist orthodontists.2 The conclusion of this study is significant,
since a popular choice amongst
aesthetic dentists in the UK
is removable orthodontics.

Three-dimensional
waxups can also be very useful at
this stage. If a patient is keen
on the image, going to an additive wax-up can sometimes
allow for a direct preview tryin using a silicone stent taken
from set-up. Temporary material of variable shades can be
tried in directly, without any
bonding to allow the patient to
see the proposed outline, form
and overall aesthetics.
Despite this, veneers are
often used to treat alignment
issues and it is very difficult
for patients to appreciate the
alignment of their own teeth
with wax-up or imaging. By
approaching these cases with
a different protocol in mind, a
dramatically less invasive treatment plan becomes evident.
Alignment
The first step is to look at the
patient’s tooth alignment. Misaligned teeth often cause issues
in gum heights, line angles,
light reflections, shades and
tooth length. Correcting the
misalignment first can create
a completely different perception of the apparent problems.
Next, the teeth should be
bleached. This can be done either immediately after the teeth
have been aligned or preferably
simultaneously.
After alignment and bleaching, edge bonding (we term this

The cases outlined below
highlight patients who either,
at the start of treatment, or for
years, had originally wanted
veneers and had a specific result in mind that only veneers
could have offered quickly.
They were all concerned
about the degree of preparation required, so undertook
alignment first. Then, part of
the way through, started
bleaching and very quickly
changed their minds about
what they wanted once they
saw their own teeth improve.
Case I (Figs 1–8)
Laura was concerned about her
very prominent central incisors. She wanted to have them
straightened and had considered veneers. She had ruled out
conventional orthodontics and
invisible braces because she
wanted a quick treatment and
did not want anything stuck to
her teeth, which is the reason
that she had refrained from
orthodontic treatment. Several
years ago, she may well have
had veneers placed.
On viewing her teeth before
the occlusal photograph, it was
quite clear that this would have
involved massive preparation
of the upper central teeth. Preparation would have been well
into dentine and may have even
involved elective endodontics.

[21] =>

United Kingdom Edition February 28-March 6, 2011

Her lateral teeth would have
needed little preparation, but
the emergence profiles would
have been poor, creating unrealistic aesthetics and a possible
periodontal risk later on. Instead, the alignment was completed with an Inman Aligner
in ten weeks. Her treatment
sequence is detailed below.
BACD-style digital photographs
were taken and the amount of
crowding was calculated using
an electronic crowding calculator, which can also be done by
arch evaluation of the patient’s
study models.
We measured the ideal
curve and subtracted this
measurement from the total mesio-distal widths of the
teeth being moved.3 The results
showed that there was only
1.6mm crowding. This seemed
less than one would have
expected; the reason for this
was that because the laterals
were being pushed out, the
arch was being expanded, thus
creating space.
It was clear from the photographs that despite the obvious
crowding, there was some less
obvious irregular tooth wear. It
was important to indicate this
to the patient, as this would
become more evident once the
misalignment had been corrected. The patient was quoted
for three incisal composite tips.
She opted for an Inman
Aligner with an incorporated
expander. These expanders are
a very handy way of creating

Looking at her post-alignment result, the golden proportion, gingival heights and axial-inclinations had improved
dramatically, all without a
hand piece being picked up
and in the space of nine weeks.
What was very clear to the
patient at this point was that
she only needed some simple
bonding to improve the incisal
edge outlines. Without the use
of an anaesthetic, the edge outlines were prepared with very
slight roughening of the edge,
bonding of hybrid composite
on the load bearing edge and a
micro-fill on the facial surface.
The edges were then polished.
The patient was thrilled
with the result we achieved
using an Inman Aligner and
some simple bonding. She described that when she had once
considered having veneers,
she had hoped for a similar
result. There are still minor
imperfections, but, in my opinion, these contribute to her
natural beauty.
There is a stark contrast between the treatment selected
and the potential treatment approaches in this case. Where
once a patient, who refused
orthodontics, would have consented and received highly
aggressive tooth preparations
to achieve correct alignment
with veneers, now a removable aligner and some simple
bonding were able to achieve a
similar and arguably better result in less than three months
with not a micrometer of tooth

‘There is a stark contrast between the treatment selected and the potential treatment
approaches in this case’

extra space either to treat cases
that are more complex or to use
instead of performing interproximal reduction (IPR).
In this case, no IPR was
performed. We planned to get
nearly all space by using the
midline expander. The patient
was instructed to turn the midline screw once a week after
one week of wear. Each turn is
1/4 of a revolution and equates
to 0.25mm. At week six, bleaching was started with soft rubber sealed trays. After nine
weeks, the patient had expanded 1.8mm and her teeth were
in alignment. (As a rule, less
than 2.5mm expansion with
an incorporated expander is
easily tolerated.)

reduction needed.
Case II (Figs 9–17)
This young lady had been
attending my practice for some
time and was aware of porcelain veneers, having seen our
previously advertised cases. We
had spoken about the aesthetic
benefits of veneers years before.
However, on reviewing her
case, it was clear that we could
improve her alignment dramatically with an Aligner in a
short period.
We took an occlusal image of her anterior teeth and
outlined the amount of tooth
structure that would have to
be removed to produce veneers
that would look aesthetic. It

was immediately apparent to
the patient that alignment of
her teeth would offer a possibly better treatment outcome.
Her case was suitable for an
Inman Aligner and as only
2.5mm crowding was present,
this meant it could be treated
quickly and simply.

estingly, the patient’s perception of her smile had changed
dramatically. Owing to the ~
improved line angles, whiter teeth and balanced gum
heights, her eyes were now
only drawn to the irregular
outline caused by chipping and
differential wear.

Her Inman Aligner was fitted and IPR performed progressively over three visits.
At week eight, upper and
lower bleaching trays were
constructed
even
though
her alignment was not yet
complete. Home whitening
was begun with clear and concise instructions.

The patient then enquired
about fixing the edges. We offered to bond the incisal edge
with virtually no preparation. A hybrid composite (Tetric Flow, Ivoclar Vivadent)
was placed palatally and incisally with a micro-fill on
the facial surface. This was
done in B0 and B1 shades
to match the bleaching. The
patient was delighted with the
result and a wire retainer was
bonded immediately.

We used rubber trays with a
deep seal cut into the model to
create a tight dam effect. Over
two weeks, her teeth whitened
nicely and at week ten, she
returned for a review. Inter-

Despite some clear deviations from her ideal simu-

Clinical 21

lated smile, the patient explained that she felt her smile
after alignment was better
than she had imagined her
veneers would have been.
Had veneers been placed,
we could perhaps have corrected the golden proportion more
fully, balanced the zeniths,
improved the canine outlines,
widened the buccal corridors,
etc. However, that was clearly
not what the patient desired.
Should she later decide that
she does need further improvements, we can proceed with
already straightened teeth. The
ABB smile design is progressive
and not sudden or rushed. In
this manner, the patient is given
the opportunity for decisionmaking in his/her treatment
and the responsibility in choice
is shared.
à DT page 22

[22] =>

22 Clinical

United Kingdom Edition

February 28-March 6, 2011

ß DT page 21

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Case III (Figs 18–26)
This patient presented with
what she described as a “wonky smile”. She had previously
looked into the possibility of
having porcelain veneers placed
so understood some of the aims
of smile design. However, on
studying her teeth, it became
clear that there was potential to
pre-align first. Her upper right
central was mesially rotated
by approximately 30° and her
laterals were slightly in-standing and mesially inclined.

was re-examined. Once her
teeth had been straightened, it
became evident to the patient
that her problem concerned
edge shape, which had actually worsened with alignment
owing to differential wear. In
fact, the left central was 2.5mm
shorter than the right. It was
very clear to the patient that

‘There are many anecdotal stories about
patients who had technically beautiful veneers placed but found that these simply did
not meet their desires’

Furthermore, she had fairly
stained teeth, with the canines
two shades darker than the
centrals.
On examining the occlusal
view, the patient became aware
of the extent of aggressive tooth
pre-paration that would be required to place a veneer. She
understood that her teeth needed to be aligned first before
we decided on the next step in
design. An Inman Aligner was
used over the period of eleven
weeks to de-rotate the front
tooth and to tip out the laterals.
At week eight, bleaching was
begun using 35- to 45-minute
a day H2O2 gels. Simultaneous
whitening is a very attractive
part of aligner treatment, as
it helps with patient motivation. After alignment, the case

composite was polished verti
cally using rubber sticks (PoGo,
DENTSPLY DeTrey) to try to
blend in with surface anatomy
to mask the join. The process
was repeated on the lateral.
The patient was held in retention using her aligner and
an impression was taken for a
wire retainer to be fitted two
weeks later. It was especially nice to retain the natural
aesthetic characterisation of
this patient.

only these incisal edges needed
building in order to achieve the
smile she desired.

Ceramic work, as beautiful
as it can be, would certainly
have changed her appearance
more; some may say for the
better, but that was not what
the patient actually wanted.
She wanted her own teeth to
have correct length and look
straighter and whiter.

For placement of the incisal
edges at week 12, no local anaesthetic was administered.
Other than slight roughening
of the worn incisal edges of
the upper left 1 and 2, no other
preparations were needed. A
tetric hybrid composite (Tetric
Flow, Ivoclar Vivadent) was
built up free-hand on the incisal edge and palatal surface
to match the outline of the other central.

Shared responsibility
The ABB concept can truly be
described as minimally invasive. At the same time, it actively involves the patient in
the treatment, giving him/her a
feeling of being in control and
taking responsibility for his/
her treatment. This has been
proven to be of great significance when measuring patient
satisfaction of treatment results.4

A small amount of white
opaquer was dotted in to match
the facial surface and was simply filled with a nano-hybrid
composite (Venus Diamond,
Heraeus) for high polish. The

There are many anecdotal stories about patients who
had technically beautiful veneers placed but found that
these simply did not meet
their desires.

[23] =>

United Kingdom Edition

makeover into stages and reassessing at each point.
With ABB, it is possible
to align, whiten and bond a
case in less than 12 weeks,
which previously might have

The problem is that even
with no-preparation veneers,
an irreversible procedure has
been undertaken and this has
been done mainly based upon
the treating dentist’s opinion,
with the patient having very little input.
In my experience, every patient that I have treated according to the ABB concept has accepted the result happily, even
though technically it might not
be perfect from a smile design
point of view. Nowadays, with
rising levels of litigation, one
would have to question the
wisdom of selecting a treatment path that could result in
conflict over one in which the
patient participates in key decisions and sees his/her own
teeth improve.
I believe this approach firmly sits alongside MICD core
principles, which recommend
a more minimally invasive and
patient-led approach.
Conclusion
I understand the controversy
in challenging the traditional
approach to smile design, but
the new mantra of progressive
smile design is vital when we
are looking to give our patients
what they actually want. Previously, pre-whitening was
always a way of giving our patients an alternative view of
their teeth. Now, and more significantly with alignment techniques, patients can make their
own decisions and massively
reduce the risks by breaking
down the process of a smile

About the author
Dr Tif Qureshi is
Vice-President
of
the British Academy of Cosmetic
Dentistry.
He
presents hands-on
courses and lectures on the Inman
Aligner worldwide.
For information on
course dates and
training, please go
to
www.straighttalks.com
or
www.inmanaligner.
com. Alternatively, contact. Caroline
Cross on +44 207 255 2559 or at info@
straight-talks.com.

February 28-March 6, 2011

required eight to 10 veneers,
four times the cost and significant tooth preparation. Thus, a
dramatic contrast in pathways
has been created. If a patient
is happy after alignment, whitening and minimal bonding,

Clinical 23

then this has to be viewed as
a success.

for it. After all, what would you
choose to have? DT

This UK technique is now
a significant new treatment
discipline in itself and cosmetic dentistry will be better

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

[24] =>

United Kingdom Edition February 28-March 6, 2011

In at the deep end
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The swimming pool is now underneath the therapists suite without water

F

inding the ideal premises to
convert into a dental practice can involve months of
targeted searching. It’s fair to say
that most would probably consider a domestic property with
an indoor swimming pool as an
unlikely and somewhat unusual
candidate for refurbishment.

theatre. All the requirements of
the Disability Discrimination Act
and new proposed cross-infection legislation had to be met and
the layout needed to ensure efficient workflows could be put in
place to enable a NHS and private
specialist dentistry business to
be viable.”

However, orthodontist David
Gale, not put off by the building’s
atypical feature, has converted its
interior into a fabulous Specialist
Orthodontic Referral Centre in a
prime Hampshire location.

Complex work
The work required was extensive:
“The refurbishment was fairly
complex and involved removing
the back of the property, building an extension, stripping out all

David’s search for a new location began in 2006 after five
successful years’ operating out of
rented premises in Fareham. It
was clear the practice was outgrowing its premises and as the
building could not be altered to
meet new regulations, he began
to look for an alternative location
in which to create a specialist orthodontic centre.
Proportions
The property David settled on
was a large private house with an
indoor swimming pool just five
hundred metres down the road.
Chosen because of its ideal proportions to convert into a purpose
designed specialist practice it
also benefited from two hundred
adjacent public car parking spaces and direct access to the M27
making it easy to reach from
Portsmouth, Southampton and
South Hampshire.
David acquired the building
in 2006 and, after almost a year
in planning, the redevelopment
work started in earnest. He recalls the overall objectives of the
project: “I gave my architect a
challenging brief, to transform
the current building and pool
into three surgeries and a lecture

tion and procurement. Using the
same software as the architect
they modelled surgery layouts to
ensure all the equipment fitted to
a layout we were happy with.”
On the choice of dental chair
David explains: “I chose Belmont equipment for my previous
practice as it was highly recommended by my dental dealer.
Despite intensive use over five
years the chairs proved to be extremely reliable so they were my
first choice for the new practice.
I chose the Cleo I model for all

‘I gave my architect a challenging brief, to
transform the current building and pool
into three surgeries and a lecture theatre’

the electrics, plumbing and waste
services and removing all floors,
ceilings and some walls before
being rebuilt. The lecture theatre
was installed over the top of the
swimming pool. The project took
eight months to complete and
we opened the new practice in
February 2008.”

the surgeries as I wanted a ‘knee
break’ chair so patients could get
in and out quickly and easily and
so we could talk with them sitting
up. A lot of orthodontics is communication. The small footprint
of the Cleo I means that the team
can move around the chair more
easily.”

David turned to DESS Ltd to
procure all the practice equipment and dental chairs and Planmeca for the radiographic equipment. David had worked with
DESS since 2001 and used their
services in his previous premises.
He explains why he chose to use
them for this project.

A show of success
In 2010 on the back of the success
of the new practice, David decided to carry out further enhancements, converting the existing
lecture theatre into a three chair
orthodontic therapist treatment
suite. This time the six-week
project was ‘self-contained’ and
with the builders working over
the weekend to join the new suite
to the main practice, there was no
disruption to patients.

“The DESS team has always
delivered an excellent service
so I had no need to consider alternatives for the refurbishment
project. They were fully involved
in all aspects of the surgery design, dental equipment selec-

Reflecting on the refurbishment and the practice he has created David feels that although it

[25] =>

Special Feature 25

United Kingdom Edition February 28-March 6, 2011

took nearly two years from purchase to completion, this kind of
project can’t be hurried. He has the
utmost praise for the project team.
“I have to say that we all really enjoyed working together
and have stayed in touch. I’ve
treated many of their children since so it’s been nice for
them to benefit from the new
practice they helped to build.”
When asked what advice he
would give anyone undertaking
a similar project David is clear:
“You really need to choose people with a good reputation. They
almost certainly won’t be the
cheapest but in the long run it is
cost effective as it saves mistakes,
chasing up and your stress. I’d
also really recommend employing a building contract manager
so you don’t need to micro manage the project and can keep the
day job going. Mine was planned
and managed by an architect and
an independent quantity surveyor
so my main role during the building was to make quick decisions
when required, so I didn’t hold up
progress.”

Chair in therapists suite

Patients lounge

Form &
Function

The move to the new building
has enabled David and his team
of 17 staff to provide a much
improved service to more than
10,000 patients.
“Not only is the practice a
bright and welcoming environment in which to be treated, it is
also laid out to maximise the efficiency of workflows for the staff
and to ensure we can stay ahead
of regulatory requirements. I am
hopeful we have thought of everything and the building is future
proof.” Of course, time will tell.
For more information about
the David Gale Specialist Orthodontic Referral Centre please visit
www.david-gale.co.uk. DT

Fresh Air &
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The unique Cleo II ‘Surgery System’ with folding and extending legrest permits
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About the author
David Gale is a registered specialist
orthodontist with The General Dental
Council, and is a member of the British
Orthodontic Society and British Dental
Association. His main objective is to
help every patient achieve his or her
ideal smile, in a relaxed and friendly
environment. David qualified from
university as a dentist in 1989 after
which he worked within the UK hospital service. He became a Fellow of the
Royal College of Surgeons of England
in 1993 having gained the Fellowship
in Dental Surgery (oral surgery). Following a postgraduate education in
most of the dental specialties David
was selected for a three-year orthodontic specialist training in 1994. In 1997
David was awarded the Membership
in Orthodontics from the Royal College of Surgeons of England and also
gained a university Masters in Science
Degree in orthodontics. Following further higher specialist hospital training
David was awarded the Fellowship in
Orthodontics from the Royal College
of Surgeons in 1999, which led to consultant accreditation in 2000. David
worked as the consultant orthodontist
at the Royal Hospital Haslar, Hampshire for two years. David has authored
scientific papers and has presented
lectures at National and International
specialist conferences. He is also a National Dental Nurse examiner. In 2002
David set up the Specialist Orthodontic
Referral Centre in Fareham which is
now his professional home.

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[26] =>

26 Surgery Design
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United Kingdom Edition February 28-March 6, 2011

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An exciting range of Gendex imaging products enhance this comprehensive
range of surgery equipment, with the flexibility to fit all working spaces.

Tailored solution for your
Surgery
Having worked with dentists
for over thirty years, Clark
Dental understands the
importance of all aspects
of surgery design from the
overall aesthetics to practice
ergonomics. Clark Dental
works with you to transform
your unique vision into a
stunning reality.
Using the very latest in computer-aided design (CAD), Clark Dental enables
practitioners to get the clearest vision possible of any proposed design, whilst
also allowing adjustments to be easily made to ensure that the final plans meet
your every requirement.
From the initial discussions and planning, Clark Dental are there to support you
right through to project completion, assisting you in every aspect of the work
from sourcing, installing and training on a wide range of dental units, digital
imaging systems, decontamination solutions and cabinetry from their network
of leading suppliers to advising on compliance and the latest regulations.
Clark Dental has a tailored solution to fit your own unique requirements.

The new ORTHOPOS XG 3D – Proven
x-Ray capabilities now with Cone Beam
CAPABILITIES
A pioneer in the field of imaging technology,
Sirona is proud to announce that the world’s
most popular panoramic x-ray system - the
ORTHOPOS XG – is now 3D ready!In addition
to offering diagnosticians high quality
cephalometric and panoramic imaging
capabilities, the highly flexible ORTHOPOS
XG 3D READY can now also be upgraded to
include cone beam facilities, making it a riskfree and future-proof investment.
Already proven to offer excellent image
quality, along with low patient radiation doses, the ORTHOPOS XG 3D now
offers practitioners unrivalled choice when it comes to in-house diagnostics
and treatment planning. GDPs and orthodontists will love the selection of
wide-focus x-ray programmes, whilst implant dentists will enjoy the detail and
accuracy of the new 3D function. Compatible with CEREC, the ORTHOPOS XG
3D offers a range of advantages: • Seamless workflow – obtain a wide range of
clinical images with just a few clicks of the mouse
• Simple operation with intuitive touchpad and automatic sensor rotation
• Up to 8cm x 8cm optimised 3D field of view

For information regarding the full range of KaVo products available Freephone
0800 218020 or contact your preferred KaVo Dealer Partner.

For further information, contact Clark Dental on: 01268 733 146 or email:
enquiries@clarkdental.co.uk

For more information on cutting-edge equipment solutions, please call Clark
Dental on: 01268 733 146 or email: enquiries@clarkdental.co.uk

TENEO is awarded
the iF communication
design award 2010 for
the EasyTouch user
interface
In addition to the
iF Gold Award for
the overall design of the TENEO treatment centre from Sirona, the centre’s
innovative user interface has now been awarded the prestigious award for
outstanding communication design. The special EasyTouch communication
design supports intuitive usability thanks to its clear, formal structures and the
uniformity of its design elements. EasyTouch is the treatment system’s control
panel. The dentist can use EasyTouch to easily call up the entire range of TENEO
functions and to control patient communication on the unit directly. A wireless
foot control can also be used to operate all functions hands-free without
causing a breach in the hygiene chain during treatment. The EasyTouch user
interface also offers the integrated implantology and endodontics function.
The dentist uses EasyTouch to control the implantology motor integrated
in the treatment center, as well as torque and speed. With the endodontics
function, EasyTouch displays the complete file menu. The award will be
presented on September 3, 2010 at BMW Welt in Munich, Germany. TENEO
and the EasyTouch user interface was designed by the Darmstadt-based Puls
Design und Konstruktion.
The EasyTouch user interface from TENEO
For further information please contact: Sirona Dental Systems 0845 071 5040
Info@sironadental.co.uk

DentalAir.com offers new
Lunch and Learn sessions
Dental compressed air
compliancy is the subject of
National Health guidelines
and C.O.S.H.H. legislation,
so it has never been so
important for your practice’s oil free compressors, dryers, filtration and
pipework to be in full working order.

The Dental Directory:
Big Savings for BACD
Members
The Dental Directory has a
history of providing quality
products across the whole
spectrum of the dental industry, and the outstanding service they provide has
earned them a reputation for excellence.
BACD members can now receive an exclusive membership benefits package
by registering their details with The Dental Directory.
Working hard behind the scenes with The Dental Directory, the BACD have
put together a great member benefit scheme, and can now offer product
incentives including:
• Some of the highest discounts available in the UK
• A significant loyalty rebate
• Exclusive promotions
Dental professionals can use these offers across a wide range of Dental
Directory products including the new, complete range of facial aesthetic
products, as well as facial aesthetics training.
With over 26,000 products in stock, The Dental Directory can meet every
dentist’s needs. As home to one of the UK’s largest equipment sales and after
sales departments as well as 34 field based consultants, you’re ensured the
best possible service every step of the way.
For more information email BACD@dental-directory.co.uk or telephone
Sally Slater on 01376 391206. If you have an existing account number, please
quote this.

Discover the integrated capabilities and outstanding ergonomics of the A
dec 500 dental chair as it is designed to deliver a higher level of functionality,
reliability and customer support than any other dental chair available today.
For more information, please call your authorised dealer or contact us on; 024
7635 0901, www.a-dec.co.uk

To help ensure your team is up-to-date with the latest legislation, DentalAir.
com, a leading provider of compressed air to dental surgeries, now offers
‘Lunch and Learn’ sessions for the whole dental team, held either during the
lunch break or at the end of the working day at the dental practice.
Each talk lasts approximately one hour and attendees will learn about the risks
involved with compressed air and vacuum systems within the dental practice.
By the end of the session, delegates will understand the implications regarding
health and safety and the NHS relating to the use of compressed air in the
workplace.
The cost for the Lunch and Learn talk is just £295 including VAT – a small price
to pay for patient safety and your peace of mind.
For more information on Lunch and Learn or DentalAir.com’s range of packages
for every practice please contact the team on 0800 975 7530.

In life we’re often expected to multi-task and really should expect the same
from technology. The Cleo II & Clesta II do just that and offer an array of different
delivery options that cater for even the most demanding of requirements.
The Cabinet Module, Mobile Cart and Over-the-Patient options are,
for example, available in both air and electric. For more information call 020
7515 0333.

Industry News
Listerine Total Care Enamel Guard
Enamel Guard – protects enamel against acid
erosion and bacteria which can cause caries
Listerine Total Care Enamel Guard is uniquely
formulated to defend tooth enamel against
acid erosion and the plaque bacteria, which
cause caries, in three distinctly different ways;
its high fluoride content remineralises and
hardens enamel, its essential oils are highly
active against pathogens that attack enamel
and as a mouthwash it can reach all enamel
surfaces more easily than a toothpaste.
Studies have shown that dental plaque may
constitute a barrier to fluoride uptake, so managing the plaque biofilm is
key to helping maximise fluoride uptake and reducing the risk of caries. It’s
important therefore to understand that Enamel Guard contains essential oils
which have been proven to penetrate the biofilm effectively and help kill more
plaque bacteria than any other daily use mouthwash.
With the potential to provide all round protection for enamel, Listerine Total
Care Enamel Guard is a logical adjunct to the oral hygiene regimen offering
protection against acid erosion and the plaque bacteria which cause caries.
For more information and a free sample of Listerine Total Care Enamel Guard,
please contact Johnson & Johnson on 0800 328 0750.

Recommend TANDEX
GEL to help maintain
good interdental
health
Patients
who
are
susceptible to plaque,
periodontitis
and
caries will find TANDEX
GEL particularly useful
in helping to maintain
good oral health.
Used in combination
with an interdental brush, the gel makes cleaning the awkward, narrow
spaces between the teeth quicker and easier, helping to dislodge plaque and
food debris.
TANDEX GEL can be easily applied on an interdental brush and used to help
effectively fight bacteria, strengthen tooth enamel and slow the process of
demineralisation. As it is alcohol free, the gel is suitable for all patients to use.
With a unique combination of fluoride and chlorhexidine, TANDEX GEL has
been proven in clinical trials to reduce the presence of streptococci mutans
in saliva and plaque.
TANDEX GEL has also been formulated to have a pleasant taste, making it even
easier for your patients to incorporate into their daily oral hygiene routines.
For more information on TANDEX GEL or any other of TANDEX’s products
please visit www.tandex.dk

Join The Dental Plan and get free marketing and branding advice from
the Dental Planet
Wondering how to increase referrals and grow your practice bottom line?
Then why not join The Dental Plan. Every practice that joins The Dental Plan
stands to benefit from free access to savvy online dental marketing resource,
The Dental Planet, which provides a wealth of templates and protocols that
can help you to expertly promote your services to new and existing patients.
Professional-looking brochures and newsletters will become a breeze, allowing
you to stylishly advertise your services, as well as special offers, to both new
and existing patients without having to incur exorbitant fees from design
companies. Joining The Dental Plan is simple and set-up, brochure design and
all initial training are free of charge. In addition, The Dental Plan team can also
offer you targeted professional advice to help you:
• Enhance the worth of your practice
• Grow your customer base and develop hard-to-beat patient loyalty schemes
• Implement comprehensive and efficient practice protocols, including Admin
and HR without having to reinvent the wheel
For a FREE initial practice analysis or for more information, please contact The
Dental Plan on 01 526 2556 or email:
info@thedentalplan.co.uk www.thedentalplan.co.uk

[27] =>

United Kingdom Edition

February 28-March 6, 2011

Dentistry Show Preview 27

Something for the whole team
With a conference programme for everyone in the team and more than 200 exhibitors, this Year’s Dentistry Show has it all

T

aking place at the NEC
Birmingham
March
4-5, 2011,the Dentistry
Show is a world class two-day
action-packed event for dental professionals. With more
than 55 speakers, five conference streams, live surgery
demonstrations and more than
200 suppliers all under one
roof, there really is plenty for
you to listen to, learn from and
put into practice. And all
for FREE!
Choose from the following
conference streams:
Aesthetic Dentist: We all know
that the business of dentistry is
changing rapidly and that cosmetic dentistry and facial aesthetic treatments are a huge
growth area. As the standard
of dental health has improved,
patients have begun to have raised
aspirations for their appearance. With the right knowledge,
the skills of a dental surgeon
can be maximised to combine the latest in surgical and
aesthetic dentistry with contem-

porary facial rejuvenation.
The specialists in our Aesthetic
Dentist
conference
will provide you with a thorough insight on key aesthetic
subjects as they relate to a cosmetic dental practice and more
importantly show you how to
combine these aesthetic treatments with your business:
bringing your patients closer
to achieving their aesthetic goals
and allowing you to benefit
from the financial opportunity
provided by this growth area.
Dental Business: The Dental
Business conference is geared
towards helping practice managers run successful and profitable practices. We have researched key areas that a
distinguished practice manager needs to be experienced in
and we will be highlighting the
importance of having an organised system in place for
planning,
budgeting
and
managing the processes in the
Practice.

A-dec Solutions
At A-dec, we offer
the
industry’s
most
innovative
technologies and
solutions, which
have been created
to improve the
performance,
safety and comfort
for
both
the
dental team and
patients. Examine
the difference A-dec can make for your practice. Our chairs, lights, cabinets,
delivery systems, and sterilisation systems are engineered to be fully integrated
and perform beyond expectations.

There are also a range of
topics to give updates on both
Employment Law and SEO and
internet marketing, as well as
ideas on marketing your practice and motivating your team.
Hygienist and Therapist Symposium: Due to feedback and
high demand, we have increased

cal issues through to the latest
thinking in patient management
and treatment modalities.
Nursing Network: As the dental market in the UK continues
to grow, the programme will
focus on the largest section of
registered DCPs – dental nurses. Covering core CPD subjects

‘There really is plenty for you to listen to,
learn from and put into practice’

the conference programme for
the Hygienist & Therapists Symposium. A carefully selected
speaker line up will provide
Hygienists & Therapists in all
areas of practice with a range of
cutting edge lectures to increase
knowledge and awareness of
opportunities within their chosen field. Content will include
areas of core CPD such as ethi-

such as radiography, special
care, orthodontics, implants
and oral hygiene, speakers will
deliver a thought provoking
programme
explaining
the
skills and attributes required
to move forward in the dental team. Including subjects
such as business skills, ethics
and professionalism, attendees
will have the chance to partici-

For more information about A-dec products and services, contact us on
Freephone 0800 233285 or 02476 350901. The full A-dec range can be viewed
on our web pages at www.a-dec.co.uk

Carestream
Dental at the
2011 Dentistry
Show
Carestream
Dental (formerly known as PracticeWorks) will once again be exhibiting their
extensive range of cutting edge technological solutions, specifically designed
for the dental profession at this year’s Dentistry Show, which takes place at the
NEC Birmingham, 4-5 March 2011.
Delegates visiting the Carestream stand will also be able to find out how the
newly updated R4 practice management system can assist them in streamlining
practice functions such as patient consent and HTM 01-05 compliance, thanks
to several handy new modules, including E-Forms and Steritrak.
The Carestream team will also be on hand to demonstrate the benefits of
Oralinsights, a revolutionary interactive 3D oral healthcare education system.
Proven to improve brushing techniques, Oralinsights provides DCPs with an
important tool in promoting better preventative oral hygiene in fun one-toone sessions that are bound to engage children.
Carestream continues to lead the field when it comes to practice management
software and imaging equipment. Their cutting edge digital sensors such as
the RVG 6500, intra-oral cameras, and cone beam diagnostic equipment, all
combine the highest quality images with intuitive functionality to ensure
optimum diagnostics.
For more information, contact Carestream Dental (formally known as
PracticeWorks) on 0800 169 9692 or visit
www.carestream.co.uk

Not all loupes are the
same - take a close look
at ExamVision™ Loupes –
Stand C2
ExamVision™ loupes are
available in a range of styles
and magnifications to suit
every need and we pay
attention to the smallest
of details to ensure that your custom-made ExamVision™ loupes meet the
highest standards of quality, comfort and performance.
ExamVision™ frames are specifically designed to support oculars and they are
lightweight and perfectly balanced so they remain comfortable, even during
long procedures. Our new wrap-around sports frames are made of titanium
and have special lenses that are capable of taking higher prescriptions than
most sports frames.
Evident’s team of optical consultants will be available throughout the Dentistry
Show to assess your needs and provide expert advice on exactly which loupes
will suit you best.
Visit us on Stand C2 at The Dentistry Show and you’ll soon find out that it’s the
quality of our loupes and the service we provide that ensures our customers
are never less than delighted.
We make no apology for stating that ExamVision™ loupes are the best on the
market and invite you visit Stand C2 and see why all loupes are definitely NOT
the same. For more information on ExamVision™ loupes, FreeCall 0500 321111
or visit www.evident.co.uk

Nuview at The Dentistry Show 2011
Nuview are looking forward to demonstrating
to clinicians how magnification and
illumination equipment can take their practice
to the next level at The Dentistry Show 2011,
taking place at the NEC in Birmingham
between 4-5 March.
Visit stand F22 to find out how dental
microscopes such as the OPMI Pico, by
world-renowned designer and manufacturers Carl Zeiss, are revolutionising
endodontics and restorative dentistry.
Delegates interested in dental optics with integrated video and photographic
capabilities can find out more from the Nuview team about the options available.
Nuview also offers cutting edge surgical loupes such as the EyeMag Pro
and EyeMag Smart ranges, offering a wide choice of magnification options,
extending from 2.5x (EyeMag Smart) – 5x (Eyemag Pro x3.2 – x5) magnification,
a variety of working distances, and both headband and spectacle frame user
modalities.
Also on display will be Nuview’s revolutionary Continu water-based
disinfectant range – tough on germs but gentle on hands and surfaces. Alcohol
Free, Continu is active after 30 seconds and continues working for several days
after application to prevent microbial contamination of treated areas.
Take your practice into the 21st century – visit the Nuview stand at the 2011
Dentistry Showcase.
For more information please call Nuview on 01453 872266, email
info@nuview-ltd.com or visit www.voroscopes.co.uk

A-dec will be attending and exhibiting at The Dentistry Show from 4th-5th
March on stand F54 at the NEC.
The A-dec team look forward to welcoming you to our stand, where we will
be exhibiting.

pate and debate their future career path.
Aesthetic
Technician:
The Aesthetic Technician programme will provide topical
issues in key aesthetic areas.
In accordance with the growth
areas of the UK dental market, the programme will focus
on the private dental sector;
including the areas of implantology and cosmetic dentistry.
There are more than 11
speakers featuring in our extensive programme of seminars. Speakers from the UK and
around the world will present
a wide range of engaging topics from everything from Smile
Design to CAD CAM. The line
up of speakers will present
dental technicians and laboratory owners with the fantastic
opportunity to learn, challenge
and debate.
For more information about
the 2011 Dentistry Show, go to
www.thedentistryshow.co.uk DT

Refresh your approach to oral hygiene with Curaprox
Dental professionals eager to find fresh ways to improve their patients’
preventive healthcare regimens should visit the stand of Swiss oral health
care specialists, Curaprox, at this year’s Dentistry Show, taking place at the
NEC in Birmingham between 4-5 March. Curaprox offers dentists and DCP’s
an extensive range of innovative oral healthcare solutions, from gentle yet
extremely durable inter-dental brushes, to their cutting edge mouthwash,
Curasept, clinically proven to offer patients the full benefits of a CHX-based
mouthrinse without side effects such as staining. Dental practitioners may also
be interested in the new specialist packs available from Curaprox, designed to
complement treatment in a number of areas, including orthodontics, implant
detnistry and periodontics. Patient Education is another arena in which
Curaprox excel. Thanks to iTOP, their customisable individually-taught oral
prevention programme, dental professionals can maximise the effectiveness
of their patient education sessions, helping to foster a preventative approach
to oral hygiene, as well as boost attendance levels.
Find out why Curaprox is the number one choice for Swiss dentists, and how
their ground-breaking oral healthcare products can help inspire your patients
and motivate your team.
For more information please call 01480 862084, or email info@curaprox.co.uk
www.curaprox.co.uk

Prestige Medical stand D30
Prestige Medical say that they
have booked a larger stand this
year in order to showcase the
full range of decontamination
solutions they can now provide for
dental practices.
The stand will include a
decontamination room layout
featuring a stylish new version of
the Advance autoclave; the recently-launched Universal Hand Piece Cleaner;
UltraClean II Under Bench and Bench Top Washer Disinfectors together with
Modwood cabinetry, Ultrawave ultrasonic cleaner and Elga Biopure RO water
system.
All these products are available from Prestige Medical - providing dental
practices with a ‘one stop shop’ for their decontamination needs. The Prestige
Medical team will be also happy to offer expert advice on the requirements of
HTM 01-05.
More information is available from Prestige Medical direct by calling 01254 844
103 or email to sales@prestigemedical.co.uk
For more information contact: Christine Bowness, Sales & Marketing Manager
on 01254 844 101 or email christine.bowness@prestigemedical.co.uk

[28] =>

28 Dentistry Show Preview
READY… New Power Pen
Laser
QuickLase have a number
of soft tissue management
laser systems and have now
launched a New Power Pen
Laser.
The 810nm single
wavelength technology has
2w power for the laser pen
and 3w and 5w power for the desktop lasers. The Dual 810nm and 980nm
wavelengths technology has 8w and 10w power for ultimate coagulation and
ablation/cutting. With NO OTHER LASER LIKE IT with this technology, QuickLase
are the market leaders in this area with over 2200 lasers sold in the dental field.
The new Power Pen Laser is being launched at £2250 and the Special Limited
Edition Colour 3w laser sold at £1780 plus vat. All lasers come complete with
all accessories and a carrying case as well as on-line training.
In addition, QuickWhite launched their new ‘LowCost’ whitening for both insurgery Peroxide and home Carbamide whitening, the teeth whitening brand
is well known for its effectiveness, fast whitening. It’s the most economical kits
sold in the market at £19.50 per patient and supported by patients marketing
in addition to the new Eco packaging option.
Visit us at stand C40 or Call 01227 780009 for further offers or visit
www.QuickLase.com

United Kingdom Edition February 28-March 6, 2011

Visit the dental splint experts
at The Dentistry Show
Attendees of The Dentistry
Show 2011 on March 4-5 will
experience world-class clinical
and business conferences at the
National Exhibition Centre in
Birmingham.
The show includes conferences, information and displays from some of the
top performers within the dental industry, including dental splint specialists,
and Solutions4Snoring (stand F42), who will be giving dental professionals an
insight into their latest products and appliances.
S4S offer laboratory-made dental solutions for the treatment of debilitating
conditions including:
• Bruxism
• TMJ dysfunctions
• Nocturnal clenching
• Snoring and sleep apnoea
S4S is the exclusive provider of products and appliances such as Sleepwell, NTItss, SCI and Grindcare, which have already benefited dentists and patients alike.
Visitors to the S4S stand will be able to see the products firsthand and witness
interactive demonstrations and practical sessions. S4S also provide and
sponsor occlusion and snoring CPD training courses for dental professionals
and information can be found at the stand.
For more information, please contact S4S on: 0114 250 0176 or email:
info@s4sdental.com www.s4sdental.com

Discover Digital Impressions - Straumann Stand
D40
Dentists interested in the latest digital technology
should look no further than Straumann (Stand D40)
at this year’s Dentistry Show.
As technology in dentistry advances, digital
equipment is succeeding and now the area of
impression taking has come into the spotlight. As one
of the least pleasant aspects of a visit to the dentist,
impression taking is uncomfortable for the patient
and has a high potential for inaccuracy. Digital
Impressions provide a clean, safe, highly accurate
method of taking impressions that saves time and
money in the practice, by reducing chair time and the
cost of remakes.
Straumann’s digital impression system; Cadent iTero can be used to easily
scan and take digital impressions of single-unit cases as well as more complex
restorative and cosmetic full-arch treatment plans. Onscreen visualisation
of the scan in real time ensures that preparations are completed to an ideal
standard and that there is adequate occlusal clearance to achieve excellent
cosmetic and restorative outcomes.
Visitors to Stand D40 will be able to view a full demonstration of iTero and be
entered into Straumann’s draw to win an iPad.
For a demonstration of Cadent iTero visit Straumann on Stand D40 call
01293 651230 or visit
www.straumann.co.uk / www.straumann-cares-digital-solutions.com

KaVo Dental Limited
2011 is the year of KaVolution.
KaVo/Gendex offer added value
with a full range of high quality,
innovative products including;
handpieces, dental equipment
and imaging systems, maximising
the capabilities of the 21st century
dental practice.
KaVo/Gendex
offers superior quality and ergonomic design to aesthetically improve working
environments in the dental surgery.

The Dental Magnification Specialists
Are you sitting as you should? Are you
seeing as you should? Choosing the correct
equipment to facilitate vision and posture
is very important. Surgitel loupes provide
superior optical performance and large depth
of focus. Oakley frames provide comfort,
adjustability and style. Combine these with
co axial LED illumination and you have the
perfect combination to enhance vision and
posture. The global dental microscope range
provides the highest specification in dental
microscopy, vision and posture without compromise, with full upgradability and
documentation (digital photography and video) for record keeping, education
and assistant participation. The latest LED technology Global products
are supported by qualified factory trained service engineers nationwide.
Visit us on stand M30 to Experience this Equipment and discuss show offers
and affordability.
DP MEDICAL SYSTEM LTD
15A OAKCROFT ROAD
CHESSINGTON
SURREY
KT9 1RH
0208 391 4455
www.dpmedicalsys.com / sales@dpmedicalsys.com

Visit Cannon Hygiene
at the Dentistry Show
Cannon Hygiene –
Stand J107
Visit Cannon Hygiene
at the Dentistry Show –
Experts in Dental Waste
Management: Dental
professionals across the
UK know they can count
on Cannon Hygiene for
their dental waste management, leaving them free to get on with the job of
patient care. Cannon can be relied upon to ensure that dental waste disposal
complies with the very latest legal requirements and government guidance.

The KaVo Team will be available to discuss exciting new products including
the new high quality and highly competitive Expert Series and the ultimate
SMARTtorque Turbine at low prices.
On show will be the KaVo Primus 1058 unit and the Team will be happy to
discuss the unbeatable range of surgery equipment offering KaVo quality,
innovation and ergonomically designed units at highly economical prices.
Speak to us about 3D imaging and the next generation in Cone Beam CT
Scanners from i-CAT.
For information on the KaVo/Gendex portfolio, please call 01494 733000 or
visit us at The Dentistry Show.

This year, dental professionals requiring a quality dental waste management
service and products can visit Cannon’s expert team who are available to
demonstrate an extensive range of dental waste disposal products, including
amalgam and related waste, x-ray waste and clinical and sharps waste disposal
services. Cannon can supply bespoke product packages to suit customer
requirement.
A market leader for over 50 years, Cannon also provides quality washroom
hygiene solutions and consumables.
Telephone 0844 225 0965 for more information.

Septodont showcase new product
innovations at 2011 Dentistry Show
Septodont, the UK’s leading supplier
of dental anaesthetics, is pleased to be
exhibiting at this year’s Dentistry Show,
following a highly successful 2010
launch of BiodentineTM, a bioactive
breakthrough in dentine replacement.
Continuing to lead the way in the
manufacture and supply of 100 per
cent latex free anaesthetics, Septodont,
through new product innovations, has also proved to the market its ongoing commitment to pioneering research and development in all aspects of
dentistry.
With more than 75 years’ experience in dental pharmaceuticals, Septodont
is highly committed to innovative research and development in this field,
and following the successful launch of BiodentineTM, the first all-in-one,
biocompatible and bioactive material that can be used wherever dentine is
damanged, that commitment has never been more prevalent.
Visit stand C44 at the Dentistry Show on 4th -5th March at the NEC to find
out more about BiodentineTM as well as RaceGel®, a brand new gel specifically
designed to make gingival preparation procedures easier and more
comfortable for patients, and Ultra Safety Plus, the sterile, single use, aspirating
syringe system equipped with a needle stick injury prevention device.
Alternatively visit www.septodont.co.uk or call 01622 695520 for more
information.

Visit Smile-on at the Dentistry Show 2011
Dental professionals looking for convenient ways to learn new skills and
fulfil their CPD quota should visit the team at Smile-on on stand D45 at the
Dentistry Show 2011 (March 4-5 at the NEC, Birmingham).
Over the past decade Smile-on has built an unrivalled reputation in the field
of dental healthcare as the authoritative provider of learning solutions. Their
interactive learning products include ‘e-learning’ packages for undergraduate
and postgraduate qualifications, revalidation and CPD requirements for the
whole dental team.
At the Dentistry Show, delegates can find out more about Smile-on’s range of
popular courses including:
• MSc in Aesthetic and Restorative Dentistry – a ground breaking online post
graduate degree
• DNSTART - for new dental nurses seeking to obtain a solid grounding in the
basics as stipulated by the GDC
• DNNET - a flexible education update for both established and training nurses
Attendees will also learn about Smile-on’s CORE CPD Online Resource Centre
which gives clinicians direct access to the core subjects of study, including:
• Cross infection control
• Radiography
• Handling complaints
• Legal and ethical issues
• Medical emergencies
Each module is presented with specifically designed e-learning programmes,
interactive webinars, and in-practice training sessions. Smile-on looks forward
to seeing you at the exhibition. For more information call 020 7400 8989, visit
www.corecpd.com or email info@smile-on.com
The Smile-on team will be on hand to talk you through their catalogue of
programmes and can, at your request, take you through a short demo so you
can instantly see the benefits of learning in this way.
Don’t forget to sign up for the Smile-on weekly newsletter which delivers the
latest news in the healthcare industry straight to your inbox. The Smile-on
newsletter has been running for over 10 years and goes out to over 26,000
dental professionals. Each week you will receive articles on hot topics,
interviews with the good and the great in dentistry and all the latest news. If
you can’t wait for the show go to www.smile-on.com/news to subscribe for
free today.

Have you ordered your free Patient Referral Leaflets?
Call 0844 335 6354 or visit www.waterpik.co.uk

[29] =>

Approximately 6,000 people in the UK annually are
diagnosed with oral cancer - with an estimated
2,000 deaths every year
(Source: British Dental Health Foundation, www.mouthcancer.org)

Oral Cancer – prevention, examination, referral has been designed to support all health professionals
by updating their knowledge, highlighting the importance of oral cancer screening, and providing
practical tools for communicating with patients and colleagues

The programme comprises four topics:
1: The facts - Providing a background into the incidence, causes and development of oral cancer
2: Team Approach - Looking at all aspects of communication both within the team and with patients
3: Screening Examination - Practical advice on improving the opportunistic screening procedure in practice
4: Case Studies - Providing first hand experiences of examining, making referrals and living with oral cancer

For more information call us on 020 7400 8989 or log on to www.smile-on.com

[30] =>

30 Events

United Kingdom Edition February 28-March 6, 2011

Bridge2Aid celebrate
six years of Hope Dental Centre in Mwanza

B

ridge2Aid (B2A) are
delighted to celebrate
six wonderful years of

the Hope Dental Centre in
Mwanza, Tanzania and share
this success with the UK Dental

community, without the support of whom, improving oral
health in this area would not
Dr Ian Wilson, founder of B2A and HDC

have been possible.

The AOG and Smile-on in association with The Dental Directory bring you

THE

Clinical Innovations
CONFERENCE 2011

Hope Dental Centre was officially opened in February 2005
by B2A as a response to the
lack of dental care in the city of
Mwanza, where only eight dentists existed at that time to treat
one million people. Through
B2A funding and donations
from the dental industry, the
Centre now provides a wide
range of high quality dental
services with affordable prices,
to ensure that the oral health
needs of all members of the
Mwanza community are met.
The Centre, which has
grown over six years to include

‘Thank you to the
dental professionals who have fundraised to support
the Centre’
two surgeries, three clinicians,
four nurses, a practice manager,
receptionist and admin staff,
with most staff of Tanzanian
origin, sees around 250 patients
per month on site, as well as
visiting an additional 250 patients at remote mine sites and
has greatly improved oral
health in the region.

Friday 6th and Saturday 7th May 2011
The Royal College of Physicians,
Regent’s Park, London
Confirmed Speakers are:
Nasser Barghi, Eddie Lynch, Julian Webber, Wyman Chan, Tif Qureshi, Julian Satterthwaite,
Trevor Burke, Bob McLelland, Peet Van Der Vyver, Wolfgang Richter, Liviu Steier,
James Russell, Jason Smithson, Eddie Scher

Contact us on 020 7400 8967 quoting DTUK10 to get your early booking discount

With all profits from Hope
Dental Centre donated to the
work of B2A, the Centre and
B2A clearly would not be where
it is today without the help and
support of the UK Dental Community. Thank you to the dental
professionals who have tirelessly fundraised to support the
Centre and our teams, the support of the UK dental trade who
continue to donate material and
equipment, and an extra special
thank you to A-dec who have
donated, shipped, installed and
now service, two chairs.
For
further
information on Hope Dental Centre
visit
www.hopedentalcentre.
com or to find out about how
you can help us to continue
to improve oral health in Tanzania over the next six years
visit Bridge2Aid now at www.
bridge2aid.org or contact us directly on info@bridge2aid.org
or 0845 0047559. DT

[31] =>

Classified 31

United Kingdom Edition February 28-March 6, 2011

19/10/09 17:03:31

THE YEAR CERTIFICATE COURSE IN
NO
AESTHETIC DENTISTRY
W
CENTRAL LONDON

FRIDAY 8th APRIL - FRIDAY 2nd DECEMBER 2011 (9 DAYS)

4T I N I T
HY
EA ' S
R

Topics covered include:
‣ Smile Design & Management of the Aesthetic Case
‣ Digital Dental photography
‣ Porcelain Veneers, including no-prep & minimal-prep veneers
‣ Computerised Cosmetic Imaging
‣ Multilayered Anterior Composites
‣ Tooth Whitening tips and tricks
‣ Aesthetic Crowns, Onlays & Inlays
‣ Excellence in Posterior Composites
‣ Medicolegal aspects of Cosmetic treatment
‣ Restoration of the root Þlled tooth
‣ Marketing of Cosmetic services
‣ Management of toothwear including the ÒDahlÓ concept
‣ TMJ, Occlusion & Articulators
‣ Multidisciplinary treatment planning, e.g. Periodontics & Orthodontics

9 days of state-of-the-art dentistry

Hands-on sessions

Courses are run by Dr Ian Cline and Dr Joe Oliver, as seen on Channel 4Õs 10 years younger. The course
will consist of lectures, structured tutorials, demonstrations, videos, evaluation of scientiÞc papers, and
hands-on sessions. Fees are £540 per day, fully inclusive. Please visit the website or call the number
below for full details, including numerous testimonials and an application form.

Friendly, relaxed, informal teaching
WEBSITE www.cosmeticdentalseminars.org | EMAIL cdseminars@mac.com| TEL 0207 252 4210 | POST 7 Bury Place London WC1A 2LA

To advertise here please contact Sam Volk
on 0207 400 8964

Untitled-4 1

[32] =>

new
Welcome to a new
layer of Sensodyne
expertise in dentine
hypersensitivity
Today you can go further than treating
the pain of dentine hypersensitivity
with Sensodyne. Today you have
new Sensodyne® Repair & Protect
containing NovaMin® calcium
phosphate technology. NovaMin®
builds a reparative hydroxyapatite-like
layer over exposed dentine and within
the tubules1-5
Starting to form from the first use5, this reparative layer
creates an effective and lasting barrier to the pain of
dentine hypersensitivity6-8, with twice-daily brushing.

Explore a new layer of
opportunity with Sensodyne
Repair & Protect

Visual representation of dentine cross-section
and dynamic reparative layer

Specialist in dentine hypersensitivity management
References: 1. Burwell A et al. Journal of Clinical Dentistry 2010; 21(Special Issue): 66–71. 2. LaTorre G & Greenspan DC. Journal of Clinical Dentistry 2010; 21 (Special Issue): 72-76. 3. Efflandt SE et al. Journal of Materials
Science: Materials in Medicine 2002; 13(6):557−565. 4. Clark AE et al. Journal of Dental Research 2002; 81 (Special Issue A): 2182. 5. GlaxoSmithKline data on file SF/EU/05/10 Earl J, 2010. 6. Du MQ et al. American
Journal of Dentistry 2008; 21(4): 210−214. 7. Pradeep AR & Sharma A. Journal of Periodontology 2010; 81(8):1167−1173. 8. Salian S et al. Journal of Clinical Dentistry 2010; 21 (Special Issue): 82–87.
SENSODYNE, NOVAMIN and the rings device are registered trade marks of the GlaxoSmithKline group of companies.

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[cover] => DT UK No. 5, 2011

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Table of contents

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