DT UK No. 5, 2013

News / Speakers announced for the Clinical Innovations Conference 2013 / Money Matters / Bridging the gap between porcelain and fibre-reinforced composite bridges / The importance of occlusion / 10 Top Tips - Financing the purchase of your first dental practice / “Setting Up On Your Own” / Turn your good practice into a great one – part two / Integrated Care Pathways / Industry News / Dental Tribune UK Editorial Board / Classified

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Table of contents

March 11-17 2013

PUBLISHED IN LONDON
News in Brief
ADAM launch jobs board
In partnership with Dental
Angels Recruitment UK, the
Association of Dental Administrators and Managers (ADAM)
is delighted to announce the
launch of a Jobs Board accessible via their website. This
exciting new development not
only enables anyone within
dentistry to advertise vacancies
on the association’s website but
also to seek out new opportunities, delivering a ‘one stop
shop’ for recruitment in the
dental field. ADAM Vice President, Hannah Peek said: “I’m
thrilled to see this Jobs Board
going live on our website. I
think it will prove very popular
with our members not only in
terms of helping them promote
their vacancies to a wider audience but also in assisting those
looking for a new challenge
or to return to the profession
to see what’s available within
their field of expertise.”
Dentist’s billboard scares
children
The director of a day care centre in Atlanta has called for a
billboard to be removed as it
has scared several children.
The billboard, which is an advertisement for Georgia Prosthodontics, is located right next
to the day care centre. The ad
shows a graphic before and
after close up photo of a person in need of dental work.
Ami Bombardieri, the director
of the day care, said she’s had
many children in tears over
the photo on the billboard.My
biggest concern is that it’s not
age appropriate,” Bombardieri
said. Bombardieri told CBS
Atlanta News parents have requested that the ad be removed
so their children don’t have to
look at it.
New Zealand move to plain
tobacco packaging
New Zealand will be following
Australia’s footsteps and start
introducing plain packaging
for tobacco later this year. Marketing imagery will be stripped
and replaced with graphic images of the damages caused
by smoking, and all colours
and design of the packs will be
standardised. Associate Minister of Health Hon Tariana Turia
said: “Current tobacco packaging not only helps promote
smoking to young and vulnerable people, it also helps keep
smokers smoking. This move
to plain packaging will remove
the last remaining vestige of
glamour from these deadly
products. “I am delighted that
New Zealand is on track to be
the second country in the world
to legislate for plain packaging. This is another major step
on the pathway to becoming a
Smoke-free nation by 2025.”

www.dental-tribune.co.uk

News

Money

Cash boost

Dentistry gets £30 million

page 2

VOL. 7 NO 5
Clinical

Selling?

Jeff Williamson gives a guide to
selling an incorporated business

page 12

Practice Management

Great practice

Biting remarks

The importance of occlusion

pages 19-20

The journey towards practice
perfection continues

pages 24-25

Future unclear for Clearstep
as administration looms
Chaos for Clearstep clinicians and patients as clear aligner firm
goes to the wall

housands of patients and
practitioners have been
left mid case as Clearstep, the clear aligner company
has officially gone into administration

eyexpert.com. The main issue
was the inability to talk to
someone and get clarity on the
situation so they could move
forward with finding alternative
solutions for their patients.

Following weeks of rumours
and confusion, insolvency specialists FRP Advisory has announced that the company has
indeed been put into administration. A spokesperson for FRP
commented: “The company has
gone into administration, and
unfortunately all of the staff
have been made redundant. It’s
a sad day; it’s the end of the line.

Support from the trade has
been welcomed, with many
orthodontic treatment system
providers offering support and
advice where needed. Dental
Protection too has issued a briefing offering advice. One of its
main messages for practitioners
states The four key principles to
follow in order to minimise the
dento-legal consequences of these
situations are :

“All practitioners will be written to, and will be receiving letters shortly. For more information, contact FRP Advisory on
02030054000.”
For practitioners, the announcement has given closure to
the first chapter of a situation that
will have repercussions for some
time to come. Dental practitioners are left with the situation of
patients now needing alternative
treatment plans; many of which
will have paid in advance. Practitioners are also left counting the
cost of treatment plans that they
paid for in advance for patients.
During the weeks of uncertainty, patients and clinicians
have been taking to social media
to vent their frustrations at the
lack of information coming from
Clearstep. One clinician took
to Facebook, many discussed
their anger on dental online forums and patients voiced their
concerns on sites such as mon-

1) Find out the facts rather
than acting on the basis of rumour and hearsay information. In a fluid situation, you
need to be doing this on a daily
basis and trying to speak to reliable, authoritative sources of information.
2) Stay in close and regular communication with the patients involved. Make sure that they are
talking to you rather than to third
parties, so that you give yourself
as much opportunity as possible
to influence and control events.
If patients feel the need to seek
advice from a second clinician
and are perhaps told (rightly or
wrongly) that aligners were never the correct treatment approach
in the first place, their dissatisfaction will be all the greater.
3) Let the patients see you understand their concerns, that you are
doing your very best to achieve
the best possible outcome for

them, and you will ensure they are
not financially disadvantaged.
4) Do something positive –
be proactive, don’t just cross
your fingers and hope for
the best. Assess the situation of
each patient individually, prioritise their needs, and explore
all the available options in the
best interests of each individual patient. Keep full records

of all of this, including any phone
calls that you make, and detailed notes of all discussions and
the name(s) and contact details of all the people that you
speak to.
Dental Tribune has made repeated attempts to contact the
management team at Clearstep,
without success. DT

[2] =>

2 News

United Kingdom Edition

March 11-17, 2013

Dental clinic helps adults with severe phobia
nership with the University Hospital of Hartlepool. The clinic can
now provide a new general anaesthetic service for adults who have
a severe phobia of visiting the
dentist; a first for the north east.

Queensway Dental Clinic

ueensway Dental Clinic in
Billingham, Teesside has
announced a new part-

Whilst approximately one in
four members of the public suffer
from Odontophobia, only five per
cent of the population suffer from
a ‘severe dental fear’. In a bid to
tackle this issue, Queensway Dental Clinic has partnered with the
University Hospital of Hartlepool
to provide a general anaesthetic

service for those patients who
have a severe phobia.

troduced this general anaesthetic
service.”

Managing Partner, Dr Paul
Averley, Queensway Dental Clinic, explains: “There are a small
number of people whose phobia
of the dentist is so severe that they
haven’t attended check-ups nor
had their dental issues attended to
for many years, sometimes even
decades, resulting in substantial
oral health issues. It is for these
patients for whom all other pain
and anxiety control methods have
been exhausted, that we have in-

Private adult patients wanting
to undergo dental treatment with
the support of general anaesthetic
will attend an initial assessment
at Queensway Dental Clinic in
Billingham, where Dr Paul Averley will ensure that all patients
who are to be put forward for a
general anaesthetic have genuine oral health needs and severe
anxiety issues which cannot
be met using other methods, such
as conscious sedation.

If the patient is deemed suitable they will have an appointment
made for them at the University
Hospital of Hartlepool where an
experienced team from Queensway comprising a lead dentist,
anaesthetist and nurse will work
with the Hospital’s staff to provide
treatment and after care.
For dentist and patient information on the general anaesthetic
service, visit www.queensway.
co.uk. DT

Dentistry gets £30
Five per cent of dental
patients make complaints million cash boost
plaining.
When people complain, or
consider making a complaint,
they tend to complain or want to
complain directly to the practice where they had the treatment. More than a third (37 per
cent) approached or would approach their dental practice to
make a complaint.

Dental complaints aren’t as common as previously thought

survey of more than 1,600
people across the UK has
revealed how few patients think about complaining
about their dental professionals.
Two per cent of those who
say they have visited a dentist

say they have complained or
even considered making a formal complaint about a dental
professional during the last 12
months. Specifically, 95 per cent
say they had never complained
and 93 per cent of these say they
have never considered com-

However, 32 per cent of
those who’d complained, or
considered making a complaint, weren’t sure who to
complain to. The survey also
asked those who had considered making a complaint, what
prevented them from doing so.
Twenty nine per cent said they
did not know where to start and
a further 26 per cent said they
didn’t know who or where to
go to for information on how to
complain. DT

Opportunities for dentists with the TA
nity for dentists looking to do
something extra with their
time and seek a rewarding
experience outside of normal
working hours.

ast month, the UK Army
began broadcasting a series of live television adverts filming Territorial Army
(TA) members live from operations.
The TA LIVE recruitment
drive is intended to demonstrate the wealth of the opportunities for specialist professionals such as dentists with
the TA and raise awareness
of the Army’s current recruitment targets.
The Royal Army Dental
Corps provides an opportu-

The Royal Army Dental
Corps (RADC) is responsible
for the maintenance of the
Army’s dental health. TA personnel with the RADC serve
in dental centres, in many locations around the world, but
they are soldiers too and have
a role within field hospitals
during military operations.
As part of TA LIVE, over
150 TA recruitment events
took place across the country
throughout February. TA units
also took over the city centres in London, Birmingham,
Cardiff, Glasgow, Liverpool,
Newcastle and Portsmouth on
16th February to put on sev-

en extensive TA open events
to demonstrate to the public
what the TA is all about.
Each unit brought a range
of specialist equipment and
supplies to put on demonstrations and educate the public
about the role of the TA and its
importance to the UK Armed
Forces. Stands included TA
ambulances, assault boats,
weapon displays, armoured
vehicles, mobile bridges, air
portable dozers and lightweight vehicles.
For
more
information
about the career opportunities
available for medics and other
specialist professionals in the
Territorial Army, visit www.
army.mod.uk/join or call 0845
600 80 80. DT

he
Department
of
Health has announced
a £30 million boost for
NHS dentists. This will allow
more patients to register with a
dentist, and get their oral health
checked.

Barry Cockcroft, Chief Dental
Officer for England said: “Having
a healthy smile is so important
and I hope this £30 million will
see thousands of new patients
pick up the phone and register
with an NHS dentist.

Lord Howe, Health Minister, said: “Since May 2010 more
than a million new patients are
seeing an NHS dentist.

“Having stained teeth, unhealthy gums and bad breath is
not only bad for your health, it is
so damaging for confidence too.”

“We want to make sure that
this progress continues and that
dentists give the highest standards of care as well as treating
more patients. That’s why we
have invested this extra £30 million in funding.

Dental surgeries have been
applying to the local NHS to access the extra funds which will allow them to take on new patients
and fund extra clinics.

“Better oral health is a key
priority of the Government and
we recently extended the dental
pilot programme which will see
preventative care at the heart of
dentistry going forward.”

This is the second year
the Government has made extra dental funding available.
Dental practices can use the extra funds to either put on extra
clinics, attract new patients or
buy in new services such as orthodontics. DT

Dentist admits illegal practice

he General Dental Council (GDC), has successfully prosecuted a woman for
the illegal practice of dentistry.
Ms
Joana
Antunes
Catre Dos Santos, who was
working as a dentist at
the Advanced Dental Clinic,
25-27
Moorland
Road,
Burslem, Stoke-on-Trent ST6
1DS appeared at Newcastle-under-Lyme Magistrates’ Court.
She
pleaded
guilty
to
four offences of unlawfully practising dentistry whilst not registered, contrary to Section 38 (1)
and (2) of the Dentists’ Act 1984.
Ms Santos has never been
registered with the GDC.
She has been fined £600 for
each of the four offences and ordered to pay £1,500 towards the

GDC’s costs.
In addition she must pay a
victim surcharge of £120 and a
total of £248 in victim compensation.
Chief Executive of the GDC
Evlynne Gilvarry said: “People
who practise dentistry unlawfully pose a significant risk to
the patients they treat. The GDC
is committed to ensuring public
safety and I hope this prosecution
sends a clear message to others
who may be tempted to practise
without being registered with the
GDC.” DT

[3] =>

United Kingdom Edition

News 3

March 11-17, 2013

Editorial comment

ast week saw
the
Dentistry
Show, the first
major event of the
dental calendar. This
show has been going from
strength to strength and really
is becoming a major force in
the dental exhibition sector.
One of the big talking

New application
offered in
implant surgery

ental techniques to
modify
the
alveolar ridge have been
around for many years, often
as a means of support for dentures. As dental implants have
now become common procedures, so has pre-implant
preparation of the bone. The
ridge-split procedure is one
such method of widening and
augmenting the alveolar ridge
that is finding renewed interest.
A new article in the Journal
of Oral Implantology presents
a detailed description of the
alveolar ridge-split procedure.
The alveolar ridge is the bony
ridge on both the upper and
lower jaws that contains the
sockets of the teeth. Establishing an alveolar ridge of proper
dimensions has become essential with the advent of rootform endosseous dental implants, the most common type
of implants.
The ridge-split procedure
described in this article is a
form of ridge widening or augmentation. In cases of narrow
alveolar ridges, it has proven
to be consistently successful.
Use of this minimally invasive technique has many advantages in the pre-prosthetic
stage of dental implants; low
risk of inferior alveolar nerve
injury, less pain and swelling,
and no need for a second surgical site as donor are among
the benefits.
Because of differences in
bone density, the ridge-split
technique requires a single
surgical stage in the maxilla,
or upper jaw, and a two-stage
approach in the mandible. The
two stages of mandible surgery consist of corticotomy,
a bone-cutting procedure,
followed by splitting and grafting performed three to five
weeks later. The staged approach of the ridge-split procedure has shown a higher
implant success rate and
better buccal cortical bone
preservation. DT

points at the event was the allowance of an illegal whitening company to take a stand.
Due to a sustained protest by
event goers this stand was
withdrawn a few days before
the opening of the show.
This story is interesting for
a couple of reasons. One – it

shows that the companies providing illegal whitening services and training are coming
to realise that they need to be
a bit more legit to survive in
the era of new regulation; and
two – practitioners are becoming more united in protecting
their patients and promoting
best practice of whitening pro-

cedures. Groups such as Stamp
out Illegal Whitening and the
Tooth Whitening Action Group
are beginning to make a lot of
noise against illegal bleaching… we should be applauding their efforts
and getting behind the
cause. DT

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

[4] =>

4 News

United Kingdom Edition

March 11-17, 2013

Children’s oral health initiative launched
GAGE, a $1.75 million initiative
designed to improve children’s
access to oral health care.
The program will be available to North Philadelphia
children under the age of six
and their families who are enrolled in the state’s Medicaid
plan. The goal is to eventually
expand the initiative to other
parts of Philadelphia, Pennsylvania and country.
Project ENGAGE

emple University Kornberg School of Dentistry
has launched Project EN-

“Project ENGAGE is an example of a new health promotion
system that will reach out to children and families to assist them

in getting dental care and remove barriers that prevent these
children from having a dental
home,” said Amid Ismail, dean of
the Kornberg School of Dentistry.
Currently, fewer than 30
per cent of the children under
six living in the five zip codes
surrounding Kornberg’s North
Philadelphia campus have access to proper dental care, often
due to lack of awareness of the
importance of oral health, limited transportation and access to
qualified dental care providers.
One of the program’s goals is to
increase that access to at least 60

per cent of the children.
The new program will create
an oral health registry that will
use dental claims information
and operating and emergency
department histories to identify
children most at risk of developing any health issues as a result
of tooth decay.
Community health workers
will provide these children and
their families, including siblings
and pregnant women, with information, counselling and assistance in scheduling dental appointments. Public health dental

hygienists will also be available
to provide in-home care and additional treatments, such as fluoride varnishes and sealants.
The program will also provide training for primary care
physicians to encourage preventive screenings and to apply dental varnish, while also
giving general dentists who do
not currently provide dental care
for very young children the support and information needed
to care for children. Studies
show that children should begin
seeing a dentist before their first
birthday. DT

New drug combination could prevent neck cancer
which included preclinical and
clinical analyses, were published
in Clinical Cancer Research.

New cancer therapy

new drug combination
shows promise in reducing the risk for patients
with advanced oral precancerous lesions to develop squamous
cell carcinoma of the head and
neck. The results of the study,

“Squamous cell carcinoma of
the head and neck (SCCHN) is
the most common type of head
and neck cancer,” said Dong
Moon Shin, M.D. “The survival
rate for patients with SCCHN
is very poor. An effective prevention approach is desperately
needed, especially since we
can identify patients who are
at extremely high risk: those
with advanced oral precancerous lesions.”

Based on prior research suggesting a role for epidermal
growth factor receptor (EGFR)
and cyclooxygenase-2 (COX-2) in
promoting SCCHN, Shin and colleagues believed combining an
EGFR inhibitor and a COX-2 inhibitor could provide an effective
chemopreventive approach.
They found that the combination of the EGFR inhibitor erlotinib and the COX-2 inhibitor
celecoxib was more effective for
inhibiting the growth of human
SCCHN cell lines compared with
either drug alone.

Eleven patients with advanced oral precancerous lesions were assigned to treatment
with erlotinib and celecoxib. Tissue samples from the patients
were obtained and evaluated
pathologically at three, six and
12 months after therapy initiation. Biopsies at baseline and follow-up were available for seven
patients.
Pathologic examination of
the biopsies indicated that three
of the seven patients had a complete pathologic response; that is,
there was no longer evidence of

the precancerous lesions in the
follow-up biopsy sample. Among
the other patients, two had a partial pathologic response and two
had progressive disease.
“Finding that this drug combination caused some advanced
premalignant lesions to completely disappear was great
news,” said Shin. “Advanced
premalignant lesions rarely regress, so our data are proof-ofprinciple that a combination
chemopreventive strategy with
molecularly targeted agents is
possible.” DT

The benefits of breaking up Dental X-rays increase
and can threaten oral health, with
an amusing encounter between
celebrity Antonio Banderas and
the ‘Food Gang’™ – a group of
mischievous creatures that represents some of the foods that linger longer.

new national TV advertising campaign launched
by Wrigley on 14th February is encouraging consumers to chew sugarfree gum after
eating and drinking, especially
when they are on-the-go. Its
theme – ‘Break Up With Lingering Food’™ – focuses on how the
foods we eat linger in the mouth

Independent research shows
that chewing sugarfree gum
for 20 minutes after meals and
snacks can help teeth healthy because the increased production
of saliva helps clean the mouth
and neutralise the plaque acids
that may damage tooth enamel.
The new high profile campaign is
part of Wrigley’s increased commitment to promoting the proven
benefits of chewing sugarfree

gum to consumers as an effective
part of their oral healthcare routine in a world where snacking
and ‘grazing’ are on the increase.
Louisa Rowntree, Wrigley
Oral Healthcare Programme
Manager in the UK says: “Wrigley
is spreading the message to UK
consumers that chewing sugarfree gum benefits oral health, especially for people who are busy
and eating and drinking on-thego. The Wrigley Oral Healthcare
Programme supports this through
our work with dental professionals, to help them understand and
educate their patients about the
benefits of chewing and encourage them to Eat, Drink, Chew.” DT

Dentist tackles desert for charity

r Mark-Steven Howe
from Broadway Dental
Care in Worcestershire
is heading to Africa in April to
compete in one of the toughest
foot races on earth.
He will take part in the 28th
annual Marathon Des Sables, a
156 mile challenge which consists of six consecutive mara-

thons, in aid of the Air Ambulance.
The marathon will take place
over six days. The rules of the
race state that all runners must
carry all their own belongings
throughout, except water.
Dr Howe said: “Looking after
your feet will be important and

not believing you are indestructible. I have done iron man events
before. I just have to get on with
it, it is all about pacing yourself.”
Dr Howe, who is looking forward to the challenge and concentrating on his training, says
he hopes his patients will pop
into his surgery to sponsor him
and show their support. DT

brain tumour risk

rior studies have suggested
that frequent dental and
medical screening is associated with an up to five-fold increase in the risk of benign brain
tumours. However, Chinese researchers have found that no such
association may exist between
malignant brain tumours and diagnostic dental X-rays.
In order to evaluate the risk of
developing began and malignant
brain tumours in relation to the frequency of dental X-rays received
in oral and maxillofacial care,
the researchers conducted two
studies. The first study involved
4,123 patients diagnosed with
benign brain tumours and 16,492
healthy controls, while the second
study was conducted among 197
individuals with malignant brain
tumours and 788 controls.
Patient data analysis demonstrated that the risk of benign brain
tumours increased as the frequency of dental diagnostic X-rays increased. However, no significant
association was found between
malignant brain tumours and
dental diagnostic X-ray exposure.

The study was conducted at the
China Medical University in collaboration with several other scientific health institutions throughout China.
According to the American
Brain Tumor Association, an estimated 69,720 new cases of primary brain tumours are expected
to be diagnosed in 2013 in the US,
including both malignant (24,620)
and benign (45,100) brain tumours. Meningiomas, which are
primarily benign brain tumours,
represent 34 per cent of all primary brain tumours, making them
the most common primary brain
tumour.
The study was published online on 13 February in the Annals
of Oncology ahead of print. DT

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6 News

United Kingdom Edition

March 11-17, 2013

Age affects presence of artifacts in CBCT scan

atient age can play a role
in the presence of artifacts
due to movement during
a dental cone-beam CT (CBCT)
scan, according to a short communication in Dentomaxillofa-

cial Radiology.
Researchers from Glasgow
Dental Hospital and School
wrote: “Our aims were to assess the number of patients who

showed signs of movement artifact during CBCT acquisition
and how many of these required
retakes for diagnostic reasons,”
they wrote. “Our hypothesis was
that patients at the extremes of
age were more likely to move
during scan acquisition.”

movement artifacts in nine scans
from the 200 included in the
study, although only 0.5 per cent
of the scans required a retake for
diagnostic reasons. These nine
scans were primarily in patients
younger than 16 years of age and
older than 65 years of age.

The research team used Xoran i-CAT Classic software to analyse 200 randomly selected dental
cone-beam CT scans in patients
whose ages ranged from eight
to 89 years. They assessed the
images in cross-sections at the
coronal, sagittal, and axial views.
After analysing the selected
CBCT images, they found signs of

The researchers thus analysed a second sampling of
dental CBCT scans specific to
these two age groups: 65 scans
for those younger than age 16
and 37 for those older than
65. In this analysis, seven patients younger than age 16 (10.7
per cent) showed double bony
contours, and 86 per cent of

these scans were in male patients. In the over-65 age group,
they found that eight patients
moved (21.6 per cent) and that
62.5 per cent of them were female.
While some movement may
not affect image quality, it can
affect the spatial resolution,
the researchers noted. They
suggest using a removable
chin rest and shorter acquisition times, although the latter
can increase signal-to-noise
ratio in the resulting images,
they added. DT

Ancient teeth bacteria record disease evolution

NA preserved in calcified
bacteria on the teeth of
ancient human skeletons
has shed light on the health consequences of the evolving diet and
behaviour from the Stone Age to
the modern day.
The ancient genetic record
reveals the negative changes in
oral bacteria brought about by the
dietary shifts as humans became
farmers, and later with the introduction of food manufacturing in
the Industrial Revolution.
An international team, led
by the University of Adelaide’s
Centre for Ancient DNA (ACAD)
where the research was performed, has published the results
in Nature Genetics. Other team

members include the Department
of Archaeology at the University of
Aberdeen and the Wellcome Trust
Sanger Institute in Cambridge
(UK).
“This is the first record of how
our evolution over the last 7,500
years has impacted the bacteria
we carry with us, and the important health consequences,” says
study leader Professor Alan Cooper, ACAD Director.
“Oral bacteria in modern man
are markedly less diverse than
historic populations and this is
thought to contribute to chronic
oral and other diseases in postindustrial lifestyles.”
The

researchers

extracted

DNA from tartar (calcified dental
plaque) from 34 prehistoric northern European human skeletons,
and traced changes in the nature
of oral bacteria from the last hunter-gatherers, through the first
farmers to the Bronze Age and
Medieval times.
“Dental plaque represents the
only easily accessible source of
preserved human bacteria,” says
lead author Dr Christina Adler,
who conducted the research while
a PhD student at the University of
Adelaide, now at the University of
Sydney.
“Genetic analysis of plaque
can create a powerful new record
of dietary impacts, health changes
and oral pathogen genomic evolu-

Teeth hold the key to bacterial change history

tion, deep into the past.”
Professor Cooper says: “The
composition of oral bacteria
changed markedly with the
introduction of farming, and
again around 150 years ago.
With the introduction of pro-

cessed sugar and flour in the
Industrial Revolution, we can
see a dramatically decreased
diversity in our oral bacteria,
allowing domination by cariescausing strains. The modern
mouth basically exists in a permanent disease state.” DT

Pilot underway for mouth cancer screening scheme

ore than a hundred
dentists from fifty
dental
practices
across the UK have started the
Mouth Cancer Screening Accreditation Pilot Scheme.
The scheme, which is
supported by Henry Schein,
DPAS
and
ProDentalCPD,
is the brainchild of Dr Vinod Joshi, Founder of the
Mouth Cancer Foundation. It
will recognise dental practices that demonstrate a visible

commitment to increasing
public awareness of mouth
cancer
screening
to
all
patients and to establish a
documented referral pathway with a local specialist
department.
The practices who have
signed up to take part in the
pilot will start the annual
membership
programme
today ahead of the official
launch at the BDA Conference
on Saturday 27th April 2013.

They will road test all aspects
of the initiative to ensure
it runs smoothly. The pilot
practices will work through
the
accreditation
process
and act in a focus group
capacity by feeding back
on the scheme, its methods, quality and efficiency.
On completion of the relevant
criteria
they
will
receive
full
accreditation when the Mouth Cancer Screening Accreditation
Scheme launches.

Full membership includes
access to a dedicated section
of the charity website and
FREE one hour CPD element
as well as professional development and training modules
suitable for all members of the
practice team to ensure regular screening benefits practice
patients.
The Mouth Cancer Screening Accreditation Scheme is
open to any dentist registered
with the GDC or any den-

tal practice whose clinicians
are registered with the GDC.
Dentists who take part in the
pilot scheme will receive associate accreditation when
the Mouth Cancer Screening
Accreditation Scheme launches. For more information or to
take part in the pilot scheme
please contact the Mouth
Cancer Foundation via info@
mouthcancerfoundation.org
or call +44 (0) 1924 950 950 for
more information. DT

Concern over illegal whitening in Ireland

he body representing the
Irish dental industry has
expressed
reservations
that companies offering cosmetic
tooth whitening services in Ireland may not be operating in compliance with new European laws.
As reported in thejournal.ie, a
European directive which came

into force last October places a
limit on the amount of hydrogen peroxide – the key bleaching agent – that can be used in a
whitening solution administered
by dentists.
However, the Irish Dental Association says it asked four tooth
whitening businesses to provide

details on the whitening gels
they used, and none could do so.
Meanwhile, only one of the four
said their practice was overseen
by a qualified dentist.
The European rules also require a dentist to approve the administration of the whitening gel
in the first instance, and requires

a full clinical exam of the patient
before the process can begin.
IDA
representative
Tom
Feeney said the purpose of the
directive was to ensure patient
safety but that this was being
threatened by the continued operation of others outside the law.
He also warned that tooth

whitening products bought over
the internet may not be in compliance with the European rules,
and that their safety could therefore not be guaranteed.
The issue is to be discussed
at the Irish Dental Association’s
next national council meeting in
three weeks’ time. DT

[7] =>

United Kingdom Edition

March 11-17, 2013

Elegant design and easy handling are a winning combination.

CT analysis of tumours may be
biomarker in oesophageal cancer

C

T texture analysis of primary tumours may be a
potential imaging biomarker in localised oesophageal
cancer following neoadjuvant
chemotherapy, according to research presented at the 2013
Cancer Imaging and Radiation
Therapy Symposium.
This study evaluated the tumoural texture analysis on baseline and post-treatment CT scans
of 31 patients with localised resectable oesophageal cancer patients with a median age of 63
and who received neoadjuvant
chemotherapy between 2007 and
2010. CT scans were performed
before and after the use of chem-

otherapy and prior to surgery. All
patients received platinum and
fluorouracil-based chemotherapy followed by surgery.
Primary tumours became
more
homogenous
following chemotherapy, as entropy
decreased and uniformity increased. Smaller change in skewness following chemotherapy
was a significant prognostic facto.
Lower baseline entropy and lower post-treatment MGI were also
associated with improved survival, although they demonstrated
only a trend toward significance.
“Though these results are
for a very small number of pa-

tients, they suggest that the tumoural texture features may
provide valuable information
that could help us to distinguish
which patients will do well following chemotherapy and which
ones will do poorly,” said Connie
Yip, MD, the lead study author, a
clinical research fellow at King’s
College London, United Kingdom and an associate consultant
in radiation oncology at the National Cancer Centre, Singapore.
“As a biomarker for treatment efficacy, this technique could save
patients from unnecessary surgery and provide more definitive
guidance in developing patient
treatment plans with improved
outcomes.” DT

‘Snackers’ at greater risk of problems

Nearly half (42 per cent) of
the UK dentists and hygienists polled identified ‘grazers’
– people who eat small meals
and snacks throughout the day
– as one of the groups most at
risk of developing oral health
problems.
And the majority (84 per cent) believe that
awareness of the oral healthcare issues surrounding ‘grazing’ is low. Snacking, rather

than eating three meals a day,
prevents the mouths’ pH levels from stabilising and the
acid attacks caused by food are
more frequent and prolonged.
The survey also identified
office workers as the worst
culprits for snacking at their
desks, with 40 per cent admitting to snacking throughout the day. People who drink
wine or mixed long drinks
three or more times a week
(51 per cent) and coffee
shop regulars (23 per cent)
were also high risk categories, suggesting how modern
work and lifestyle trends are
contributing to poor oral

health habits.
The majority (79 per
cent) of dental professionals questioned believed that
most patients are failing to
follow even the simplest oral
care recommendations – such
as brushing for two minutes
twice a day. Dentists’ concerns are substantiated by the
consumer research, which
revealed that a fifth of office based employees (21 per
cent) regularly miss brushing their teeth in their rush to
get to work. And when they do
brush a massive 88 per cent fail
to do so for the recommended
two minutes. DT

Fitness to Practise changes
start to show results

F

urther work is underway
to improve the General
Dental Council’s handling of complaints against
dental professionals.
A raft of changes, which
began in 2011, have already
been implemented to its Fitness to Practise system, and
further improvements are
currently taking place.
Some key measurements
show the progress made so
far:
• The number of cases completed at the investigation
stage within six months of
being received has increased
from 68 per cent at the end of
2011 to 85 per cent at the end
of 2012;
• There has been an increase
of 13 per cent at the end of
2012 for cases progressed

from Investigating Committee
to reaching a Hearing within
nine months compared to the
end of 2011;
• There has been a reduction
in the length of the queue of
cases awaiting a hearing to
129 at the end of 2012 compared to the 155 at the first
quarter of 2011;
Some of the changes introduced to try to tackle are:
• Procedures throughout the
entire process have been reviewed and improved and new
operating guidance has been
published to document the
new system;
• More Investigating Committee meetings are being
scheduled and legally qualified Investigating Committee
managers have been appointed to support the Committee

to ensure that all information
needed to make decisions is
provided to the committee;
• A new triage process has
been introduced to scrutinise
cases as soon as they arrive to
plan what action needs to be
taken, or to close cases early
on if appropriate to do so;
• The National Clinical Assessment Service is providing
early clinical input to cases
before the initial assessment
of a case to ensure that caseworkers are fully apprised of
the significance of clinical
matters raised from an early
stage in the case. DT

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D

entists and hygienists
across the UK were
polled alongside 1,000
consumers by sugarfree gum
brand Extra® to examine current oral health understanding
and behaviour.

[8] =>

During 2012,
834 Dental Practices
made a choice…

With the dental profession facing ever-increasing regulatory
and running costs, getting the right deal from your dental
supplier has never been more important. That’s exactly what
834 dental practices did in 2012 by opening a new account
with The Dental Directory.
The Dental Directory recognises this and wants to assist
every dental practitioner in the country by continuing to cut
the prices on everyday, essential dental products.
Despite considerable price increases from dental product
manufacturers, The Dental Directory is the ONLY dental
dealer who did not increase the vast majority of its prices
during 2012.

Independently Verified
Best Priced Dealer
The Dental Directory, along with all other major dental
dealers, submits their sales out data every quarter to an
independent research company, Strategic Data Marketing
LLC. They then analyse all of the data on behalf of the large
dental product manufacturers.

SDM compared the final selling out prices
of 25 top-selling branded products from
the categories shown below. These are
the final prices charged to customers,
after all discounts and promotions have
been applied, and they found that
The Dental Directory were an average of
5.4%† cheaper than our competitors
during 2012!

An average

5.4%

cheaper
on the top 25
best-selling branded
products!

Dare to Compare
We continuously compare our prices with our largest
competitor – the American-owned, $7billion turnover,
multi-national dental dealer, Henry Schein Minerva.
In a recent comparison of 100 like-for-like
products featured in the Henry Schein
Minerva Essentials Mini Catalogue and
Dental Directory manufacturer dedicated
flyers, our prices were found to be an
average of 7.21% cheaper.*

An average

7.2%

cheaper

on 100 like-for-like products
on promotion during
November 2012!

† SDM DPMSS Q1, Q2 & Q3 2012. Product categories: Anaesthetics Injectable/Cartridges, Endodontics Files & Reamers Nickel/Titanium Files, Alloys & Accessories Amalgam Capsules,
X-Ray Film Intraoral, Evacuation Cleaners, Endodontics Files & Reamers Files, Hand Instruments Surgical Instruments Suture Material, Infection Control Sterilants/Disinfectants Surface
Towelettes, Impression Trays Disposable Single, Infection Control Sterilising Supplies Pouches, Endodontics Filling Materials & Accessories Heated Gutta Percha Refills, Infection Control
Barriers Glasses/Goggles, Small Equipment Prophy Units Inserts, Anaesthetics Needles, Pins Latch & Hand Driven, Hand Instruments Hygiene Instruments Curettes/Scalers Posts
Prefabricated Refill, Oral Hygiene Fluoride Rinse, Endodontics Filling Materials & Accessories Gutta Percha Points.
* Comparison between Henry Schein Minerva Essentials Mini-catalogue and The Dental Directory dedicated flyers & Value Plus flyer November 2012.

[9] =>

[10] =>

10 CIC 2013

United Kingdom Edition

March 11-17, 2013

Speakers announced for the Clinical
Innovations Conference 2013
10th annual event to be biggest yet!

C

elebrating 10 years of
success, the widely anticipated Clinical Innovations Conference 2013 (CIC)

will be held 17 - 18 May at the
Millennium Gloucester Hotel in
Kensington. Brought to you by
Healthcare Learning: Smile-on,

in collaboration with the AOG,
the event is renowned for providing up-to-date, quality education specifically for the dental

profession.
Various lectures and practical workshops will cover a range

of different topics, exploring the
latest clinical techniques and introducing delegates to the newest innovations and products in
dentistry. The internationally
recognised selection of speakers
will include names from the very
forefront of the industry, with
the likes of Richard Kahan, Jansie Van Rensburg, Wyman Chan,
Ian Buckle and Louis Mackenzie
already confirmed.
For experienced lecturers
such as Dr Jansie Van Rensburg, the CIC provides a fantastic platform to discuss the latest
developments in the UK market.
Dr Van Rensburg obtained his
degree in dentistry at the University of Pretoria, South Africa,
before completing a two-year
extended course in Orthodontics
at the Conquest Hospital in Hastings, East Sussex. Dr Van Rensburg has lectured at numerous

‘I was delighted to
accept the invitation to speak at
this year’s CIC and
I will be discussing various simple
approaches to performing safe and
predictable everyday dentistry’

Times have changed...
but PANAVIA is still the cement by
which others are judged

dental events around the globe,
and also has a special interest
in fibre reinforced composite
restorations. In addition, he was
nominated for ‘Trainer of the
Year’ in 2005 by Stick Tech Ltd.
in Finland.
Dr Van Rensburg is looking
forward to his first experience
of CIC, and he will be discussing
an innovative new technique in
restorative dentistry.
“I was delighted to accept
the invitation to speak at this
year’s CIC and I will be discussing various simple approaches to
performing safe and predictable
everyday dentistry,” he explains.
“I will go on to look at a specific
technique that has only been
developed in the last couple of
years by Swedish dentists, using
a new type of sectional matrix
system.

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“This innovative system allows for an adjacent wedge and
protecting shield to be used in
order to safeguard both the teeth
and the gingiva when preparing

[11] =>

United Kingdom Edition

and drilling the affected tooth.
One of the major problems faced
when performing posterior composite restorations is creating
tight proximal contact between
the restoration and the adjacent
tooth. Failure to do this of course
increases the risk of trapped
food and plaque formation. The

‘This conference is
a great way of discovering new products, techniques,
ideas and perspectives in a variety of
different areas’

riching the learning experience
available to delegates. Not only
does this provide access to the
very latest equipment and technology within aesthetic and restorative dentistry, but it also encourages delegates to broaden
their knowledge of the industry.
In addition to all this, the
evening of Friday 17th will also
see the Clinical Innovations
Awards, offering delegates an

CIC 2013 11

March 11-17, 2013

opportunity to relax and network within the profession while
enjoying delicious cuisine and
live entertainment. The winner
of the Award will be announced
during the evening, celebrating
the latest, most innovative products to be developed and introduced to the dental market.
Although he has not yet attended the CIC, Dr Van Rensburg
believes such events are hugely

beneficial for dental professionals to attend.
“I think the combination of
lectures, workshops and trade is
brilliant,” he says. “As dentists,
we love our gadgets, and we love
seeing new things. This conference is a great way of discovering new products, techniques,
ideas and perspectives in a variety of different areas. I can’t
understand how I have never

attended this excellent event before, but I am now greatly looking forward to May!”
Registration for the CIC 2013
is now open, so book soon to
avoid disappointment! DT

Contact information
To find out more or to book your
place, please email info@healthcarelearning.com or call 020 7400 8989

3
Celebrating 10 years of innovation

new system provides a high
quality filling with a much more
reliable tight proximal contact,
encouraging a higher standard
of oral health.
“In addition, this new technique boasts an accuracy that
enables practitioners to avoid
creating a proximal marginal
overhang, which is also very
often associated with posterior
composite restorations. This
method can therefore be performed much quicker than others, and in an industry where
time is money, this can be a
hugely significant benefit. It is
one of the quickest, safest and
easiest sectional matrix systems
available in the UK, and in most
cases, it produces highly predictable results.
“During my lecture at the
CIC, I will discuss how this carefully designed matrix/wedge
combination works, giving a
step-by-step guide to using the
product and highlighting its
advantages to both the patient
and the dentist. Of course, all
techniques and products have
limitations and it is also important to know and understand
these in order to achieve the best
results, so I will consider these
too. I believe this matrix system
however, could provide a solution to the daily problems associated with restorative dentistry in
the UK.”
Over the course of the two
days, the CIC will provide up to
14 hours of verifiable CPD, helping delegates to meet the GDC’s
requirements for continued registration. For the second year
running, the event will also host
sessions for the London Deanery
DFT Conference, designed specifically to captivate and inspire
London Deanery Foundation
students, and introduce them to
the modern dental profession.
Hands-on workshops, live
clinical demonstrations and a
quality trade exhibition will also
be presented in May, further en-

Friday 18th and Saturday 19th May 2013
Millennium Gloucester Hotel, London Kensington
Speakers include:
Nasser Barghi
Irfan Ahmad
Louis Mackenzie
Ash Parmar
Ian Buckle

BOOK NOW for early booking discount
cic@healthcare-learning.com
020 7400 8989

smile-on

healthcarelearning
inspiring better care

[12] =>

12 Money Matters

United Kingdom Edition

March 11-17, 2013

Selling an incorporated business?
How do you get the money out?
Jeff Williamson looks at your options...
Options

shares.

1

4

Director’s loan account
Repaying your Director’s loan account will not incur any tax so do
this first.

2

Dissolve the Company
Extra Statutory Concession C16
is no longer available so you will
probably have to undertake a solvent liquidation of your Company.
You will need a firm of Insolvency
Practitioners and the likely cost is
£1,500 to £2,500.

W

ith many dental practices now trading as
a Limited Company,
Jeff Williamson from specialist dental accountants PFM
Townends considers how such
status affects your exit strategy
from the business.

Second time around
For the vast majority of cases
this will have been the second
time that you have sold your
business, the first being the
incorporation of your self-employment business.

Asset sale
For the purposes of this article
we are considering a Company
that has sold its assets and the

Indeed the proximity of your
business sale as a Company to
the date of your original incorporation is crucial, as it will

‘It definitely pays to have clear tax advice
alongside pensions and investment advice
to ensure available reliefs and allowances
are fully utilised. Early planning is strongly advised’
Shareholders are contemplating how to deal with the sale
proceeds sitting in the Company
bank account.

have a bearing on not only the
level of your Director’s loan
account that remains outstanding but also on whether there

has been any appreciation in the
value of the Goodwill over that
period.
Corporation tax
The Company will pay corporation tax on the uplift in value of
the Goodwill since incorporation. Remember that because you
were “connected” at the time of
incorporation you have been unable to claim any tax relief for
the annual amortisation or writing down of the Goodwill so your
base cost is unaltered for tax purposes.
If, however, you set up a Limited Company and purchased a
Practice from an unconnected
third party, you were able to
claim tax relief on the annual
amortisation of the Goodwill.
So when the Company sells its
Goodwill it will pay tax on the
proceeds less the unamortised
amount of the original Goodwill.

The reserves paid to you, as
the shareholder, will be taxed as
capital and so long as you don’t
delay, the distribution should
qualify for Entrepreneur’s Relief
and therefore 10 per cent capital gains tax. This is a second tax
charge on the sale proceeds!

3

Dividend stream
The company could pay the reserves out to the shareholders
over time as dividends. If you are
a basic rate tax payer then there is
no tax to pay on dividend income,
unless of course the dividend
pushes you beyond the basic rate
tax threshold where you would
then pay 25 per cent income tax
on the (net) dividend received.
So subject to other income
levels, dividends may avoid tax
altogether but it will take longer
to move the money out of the
Company. If you retire at 55 you
might consider deferring potentially taxable pensions until age
60 and drawing dividends for five
years. This route can be especially useful where both spouses own

Reinvestment within the
Company
You always have the option to
keep the Company going and
purchase another business or
perhaps invest in property without suffering the exit tax.
You may be able to claim Reinvestment Relief if you use the
Goodwill sale proceeds to purchase new Goodwill of another
business and this will enable you
to defer the corporation tax arising on the original sale.
This can open up several
planning opportunities for accumulating capital and involving
your children as shareholders to
begin planning for Inheritance
Tax.
Conclusion
Selling your business is just one
component of your retirement
plan. It definitely pays to have
clear tax advice alongside pensions and investment advice to
ensure available reliefs and allowances are fully utilised. Early
planning is strongly advised. DT

About the author
Jeff
Williamson
is a chartered accountant
and
leads the dental team at PFM
Townends
LLP.
PFM
Townends
LLP provides specialist dental accountancy services for associates and
practice owners. To contact Jeff and
his team call 01904 656083 or visit
www.pfmdental.co.uk

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[13] =>

United Kingdom Edition

March 11-17, 2013

Money Matters 13

That was painless!
Brian Carter explains why finance really can benefit both the practice and the patient

s he brushed his teeth,
John looked forward to the
morning with a sense of
foreboding. Not only did he have a
visit to the dentist to look forward
to but it was also a new dentist –
what would he be like? John had
called into the practice when he
moved to the area 20 years ago
and had gone there ever since.
Dr Down had been an NHS dentist when John first went to the
practice. John understood that Dr
Down had recently provided some
treatments on a private basis but
what they were and why he offered them John was not quite
sure – Dr Down had not been a
great communicator.

carpet. The wooden chairs had
been swapped for armchairs. The
newspapers and magazines were
up to date and a tea and coffee
machine had replaced the old water dispenser.
Most importantly, the ‘bar-

ricade’ had been replaced with
a desk. The two receptionists,
each in smart new uniforms, both
looked up with a smile and a ‘good
morning Mr Phillips’ when he entered. Their badges said ‘Jenny’
and ‘Sue’ – so they do have names!

John sat down as requested
and noticed there was a new flat
screen TV on the wall introducing various treatments that were
available and how you could
spread the cost if required – that

seemed a good idea. He had only
been looking at the screen for a
couple of minutes when another
smiling young woman came and
introduced herself as the new
à DT page 14

Sterilizing?

What would you choose?

There was one occasion when
Dr Down had talked to him about
a private treatment but it was
in medical terms and he hadn’t
really understood the benefits.
When Dr Down finished by saying: ‘I don’t expect you want that
anyway’, it made his decision easy
– John didn’t have it.
However, John had become
comfortable with the practice –
he had even got used to the receptionists who barely looked up
from behind their ‘barricade’ before directing him to one of a row
of seats that had not been changed

‘There was one
occasion when Dr
Down had talked to
him about a private treatment but
it was in medical
terms and he hadn’t
really understood
the benefits. When
Dr Down finished
by saying: ‘I don’t
expect you want
that anyway’, it
made his decision
easy – John didn’t
have it’

55 minutes.
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in the 20 years he had been attending. John wondered what the
receptionists’ names were.

When John arrived at the
practice he briefly thought he had
come to the wrong place. The
floor tiles had been replaced with

Optima: the fastest vacuum

autoclave on the market.

Optima

He took one last look in the
mirror. He was not blessed with
the whitest teeth and there were a
couple of crooked ones at the top
but he looked after them and they
were all his own!

23 minutes.
The standard cycle time of the
new Optima autoclave.

That’s a big increase in the number of instruments
you can sterilize and a big reduction in cycle
times. Over a working week, month and year that
adds up to a huge time saving and increase in
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[14] =>

14 Money Matters
ß DT page 13

Patient Co-ordinator, Patricia. He
accompanied her to a private area
where she explained that her job
was to find out a little more about
patients and explore concerns
they had about their teeth before
they saw the dentist. She also ensured that patients understood
any suggested treatments after
they’d seen the dentist.
Initially John became a little
apprehensive – this was complete-

United Kingdom Edition

ly different to what he was used to.
However, she was very pleasant
and within a couple of minutes
he was telling her of his concerns
about the colour and unevenness
of his teeth. He had never discussed such issues before and Dr
Down had never asked him.
As soon as they had finished,
Patricia took him into the treatment room and introduced him
to the dentist – Peter Johnson.
Another smile and a pleasant
‘good morning’ – he had entered a

whole new world! Peter explained
that he would initially carry out an
examination and then consider
any specific concerns he had discussed with Patricia. Having performed the examination and taken some X-rays, Peter considered
the unevenness of John’s teeth as
well as the discolouration.
He explained that tooth whitening and an invisible brace on
the top jaw could resolve these issues. These treatments were not
available on the NHS but could be

carried out on a private basis and
the total cost would be £2,000.
Whilst the treatment suggested sounded great and he would
love to have it done, John had
been a bit taken aback by the cost
and said he would need to think
about it. He thought to himself that
he would not be able to pay that
sort of sum at the current time.
As if reading John’s mind, Peter said he didn’t need to pay all
in one go as there were many op-

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March 11-17, 2013

tions for spreading the cost that
Patricia would explain in detail.
John recalled the message on the
TV and thought it well worth considering.
Once Peter had finished, Patricia took John back to the side
room and after ensuring he didn’t
have any further questions about
the treatment itself, she explained
the finance facilities. A range of
options was available. Interestfree finance was available over
twelve months and the monthly
repayments would be £166.67.
Alternatively, he could spread the
cost over a longer term. If he did
this John would need to pay interest at a rate of 9.9 per cent APR but
the monthly payments would be
lower. Over the longest term of 60
months the payments would be as
low as £42 per month – less than
£10 a week!
Based on these figures John
could easily finance the total cost
of the treatment. In actual fact he
was just paying off a loan for his
furniture so a similar monthly repayment would virtually go unnoticed. Patricia also pointed out that
if he paid a deposit the monthly
repayments would be lower still.

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Suddenly John’s concerns regarding affordability disappeared.
He realised he could easily afford
the treatment by spreading the
cost and pictured looking into the
mirror with straight white teeth.
All those years of not being happy
with his smile would be behind
him – John would be able to smile
without worrying about it!
John decided to pay a £200
deposit and finance the balance
on an interest-free basis over 12
months with a monthly payment of
£150 – an amount that was readily
affordable given his salary. John
completed a straightforward application form for the finance and
Patricia booked him in for his next
appointment to get the treatment
underway. It was all very painless.
As he left the practice, John
considered what a difference the
whole experience had been – he
would have to mention this to his
friends! DT
NB: Although this story is based
on actual case studies, all names
are fictitious.

About the author
Brian Carter has
been a director at
Dental
Finance
since 2001. The
company provides
consumer finance
facilities,
principally in the dental
sector. It offers
finance plans to
increase treatment take up, patient
satisfaction and improve practice
profitability. Previously, Brian worked
at Barclays Bank and then First National Bank in various management
roles. He is an Associate of the Chartered Institute of Bankers (ACIB).
For further information, please contact Brian Carter of Dental Finance
on 07801 951921 (direct line) or visit
www.financingfirst-dental.co.uk

[15] =>

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*vs. a standard manual toothbrush. †Based on 67 subjects in 2 clinical trials. Reference: 1. Data on file, P&G.

continuing the care that starts in your chair

[16] =>

16 Clinical

United Kingdom Edition

March 11-17, 2013

Bridging the gap between porcelain and
fibre-reinforced composite bridges
Dariusz Sinkiewicz presents a case

S

everal factors must be
taken into consideration
when replacing missing
teeth: cost of treatment, periodontal health, aesthetics, bi-

omechanical properties of the
prosthesis, as well as patient
expectations. Dental implants
are becoming the preferable
option in many clinical situ-

ations, however a number of
patients reject this option due
to high cost, length of time
needed for healing after implant placement or apprehen-

sion to surgical dental treatment. The minimally invasive
bridge can become the treatment of choice when dealing
with defect-free abutments.

‘This bridge was
designed as an
alternative to traditional porcelain
fused to metal resin
bonded bridge’

I would like to present a
case when innovative combined porcelain and fibrereinforced bridge was constructed and fitted. This
bridge was designed as an
alternative to traditional porcelain fused to metal resin
bonded bridge, which despite
obvious advantages like hard
tissue, preservation is becoming less desirable for aesthetically orientated dentists due
to discolouring of abutment
teeth caused by metal wings.
Case presentation
A 24 - year-old male patient
presented to our surgery with
missing upper front central

[17] =>

United Kingdom Edition

incisors and upper right canine which he lost four years
ago in a car accident. He
was extremely disappointed
with his acrylic denture and
requested fixed prosthesis
with life-like appearance.
The patient rejected implants
as
being
too
expensive,
however he stated it will
remain his preferable option
in future.
At this stage we discussed
minimally invasive bridges
and the patient felt it was
a right option for him. Our
treatment plan consisted of
traditional RBB to replace UR3
and a hybrid bridge to replace
missing central incisors. Due
to the small size of the UR3
pontic [width only six mm]

we opted for cantilever design
with full coverage of palatal
cusp of UR4 to increase bonding area and rigidity.
The preparation involved
only light chamfer line. This
bridge was fitted with Panavia
[Kuraray Co], and no preparation was made for UR2-UL2
bridge. Impressions, dyes
and working casts were made
using conventional methods
and materials. The next step
was to form a wax pattern
with inner canal, which
was filled with fibre-reinforced composite core at the
later stage. Small irregularities inside the canal will

create additional mechanical
anchorage. The wax pattern
was converted to replicate
in dental alloy using lostwax technique and then porcelain was added and tried-in
to ensure good aesthetic result.
Prior to glass fibre application Alloy primer [Kuraray
Co] was applied to sandblasted metal surface to increase
bonding strength of composite to dental alloy. At this

Clinical 17

March 11-17, 2013

with Gradia.

‘At this stage we discussed minimally invasive bridges and the patient felt it was a
right option for him’

stage we covered the labial
wall of the inner canal with
one mm of Gradia composite
and light cured. Pre-cut single
pre-impregnated fibre strip

was inserted [Dentapreg PFU]
and bonded to both ends with
flowable composite [Filtek,
3M]. The outer layer of composite was built incrementally

The strip must be completely embedded in resin to
protect glass fibres from oral
exposure; the retainers were
formed and light-cured using
the same principle. Additionally, after shaping and finishing, the bridge can be placed
into the light curing unit,
eg.Dentacolor XS [Kultzer], for
the final application of light to
à DT page 18

[18] =>

18 Clinical

United Kingdom Edition

ß DT page 17

maximise polymerisation of
fibre-reinforced
composite.
Bridge delivery involves the
same procedures as for all
bonded restorations.

‘Bonding areas of prosthesis were sandblasted, following by etching and application of bonding agent’

Abutment
teeth
were
cleaned with pumice and
Bonding areas of prosthesis
rubber prophy cup, etched
were sandblasted, following
with 37 per cent phosby etching and application
phoric acid and thoroughly
of bonding agent. Low-visrinsed, then lightly dried and
FMC_SC_DHT_advert_A2ZDental_final.pdf 1 22/11/2012 13:20:23
cosity, dual-cured resin luttreated with bonding agent.

CMY

ing material [RelyX Unicem]
was placed inside the retainers. After insertion, the excess of luting cement was
removed with floss and small

brush and prosthesis lightcured. The luting cement will
form unified structure with
composite retainers linking
them to the etched enamel.
Final occlusal adjustments
were made using a high-speed
hand piece and composite polishing bur.

March 11-17, 2013

well as long term provisional
restoration, providing many
benefits for patients resulting from aesthetic appearance of porcelain pontic, due
to the good adhesive property

Discussion
This type of bridge may prove
to be a successful way for
fixed tooth replacement in anterior and premolar areas as

of fibre-reinforced composite
and minimally invasive nature of resin bonded bridge.
Porcelain pontics and crowns
continue to be a mainstay
of fixed prosthodontics with
long track record of reliability, low plaque accumulation
and shade stability. Fibrereinforced bridges alone did
not gain wide spread acceptance among dental practitioners,
however
many
publications
underlined
high potential of this technique resulting from favourable mechanical properties,
good bonding and ease to
repair. Further improvements
and clinical developments
are needed to combine glass
fibre with porcelain pontic,
but this idea shows great
potential. DT

About the author
Dariusz Sinkiewicz is a dental practitioner at 1A Dental Practice in Bretton, Peterborough. During his career
he has developed an interest in resin
bonded bridges , particularly made of
fiber-reinforced composite. He has
recently constructed an innovative
combined porcelain and FRC bridge
which he believes has a potential to
be useful in some clinical situations.

References
1. M.A.Freilich,J.C.Meiers,J.P.Duncan,A
.J.Goldberg. Fiber-Reinforced Composites in Clinical Dentistry. Quintessence
Publishing Co,Inc 2000.
2. Estefan DJ, Dussetschleger F. Fabrication of resin-bonded three-unit prostheses
. Am J Dent. 1999; 12:51-52.
3. Vallittu PK, Sevelius C. Resin-bonded
glass fiber-reinforced composite fixed
partial dentures: A clinical study. J Prosthet Dent 2000; 84:413-418.
4. Vallittu PK. Prosthodontic treatment
with a glass fiber-reinforced resinbonded fixed partial denture: A clinical
report. J Prosthet Dent 1999; 82:132-135.
5. Bohlsen F,Kern M. Clinical outcome of
glass fiber-reinforced crowns and fixed
partial dentures .A three year retrospective study. Quintessence Int 2003;
34;493-496.
6. H.T.Shillingburg et al. Fundamentals
of fixed prosthodontics. Quintessence
Publishing Co, Inc. 1997.

[19] =>

United Kingdom Edition

Clinical 19

March 11-17, 2013

The importance of occlusion
Peter Bausch discusses occlusion and function

T

he correct physiological restoration of occlusion poses a major
challenge for every dentist
and technician. Even the
smallest high spot, measuring
just a few microns, can cause
dysfunction in a patient’s masticatory system. In restorative
dentistry, occlusal proportions are constantly changing. It is therefore essential,
for the benefit of the patient,
to understand and monitor
the function of teeth in static
and dynamic occlusion. Functional occlusion is important
for the overall health of the
patient. The interdisciplinary
verification of symptoms and
treatment is an integral part
of daily practice. Therefore,
checking the occlusion during
treatment is strongly encouraged.
Occlusion and the potential
effects of occlusal interference on patients
Every restoration, extraction,
prosthetic device and ortho-

‘The smallest occlusal interference
of just a few microns is disruptive
to the proprioceptors of the stomatological system’

dontic treatment changes the
static and dynamic occlusion.
The smallest occlusal interference of just a few microns
is disruptive to the proprioceptors of the stomatological
system. This can cause bruxism (clenching or grinding),
which can result in functional
disorder of the cranio -mandibular system. Overstraining
teeth, periodontium, muscles
and joints are the effects.
It is important not only to
detect, but also to avoid further functional disorder in the
cranio-mandibular
system.
The smallest interference to
habitual occlusion can cause
serious disturbances for the
patient. An acute functional
disorder such as clenching or
grinding can become chronic
in the long term.
Patients with new fillings,
crowns and bridges, or who

have undergone orthodontic treatment, who complain
of typical symptoms (cranio
mandibular dysfunction syndrome) should undergo examination of their occlusion
specifically. Premature contacts are often uncomfortable,
as the proprioceptors are sen-

sitive to pressure. The patient
will try to compensate for
the occlusal interference by
adopting a new habitual position, with consequences for
the attached tissue structures.
Position for occlusal
restoration

Essential to any kind of occlusal restoration is the position of the mandible. Most
patients are treated in their
habitual position of the mandible, which is the correct position for most patients. For
patients with more complex
restorations or patients suffer-

ing from temporomandibular
joint disorders, a new physiological positioning of the
mandible is essential. In most
cases, centric occlusion is the
new therapeutic position.

à DT page 20

[20] =>

20 Clinical

United Kingdom Edition

March 11-17, 2013

ß DT page 19

Centric relation is the position of the mandible relative
to the maxilla, with the intraarticular disc in place, when
the heads of the mandibular
condyles are against the most
superior part of the distal-facing incline of the glenoid fossa
(i.e. the mandibular condyles
are in their most superior and
anterior position).
For balanced occlusion in
a static position, the patient
should have enough ABC contacts on each quadrant in the
intercuspal position. In this
position, the teeth of the opposing jaws achieve complete
intercuspation and are in
maximum contact with each
other.

coloured edge of the contact
point is not part of the contact.
Just the lighter-coloured centre is the real contact area.
For occlusal equilibration,
only these areas should be adjusted. For a balanced occlusion, the patient should have
enough ABC contacts on each
quadrant.

The physiological influence
of interfering initial
contacts
For most of the patients, their
habitual position of the mandible in maximum occlusion
is the preferred position for
occlusal restoration. However,
even a tiny interfering pre-

Occlusal corrections can
be additive or subtractive. If
modification of the occlusal
relationship in patients who
have been grinding their teeth
over a long period is needed,
this may be challenging, as
they would already have lost
a significant part of their hard
tooth tissue. A splint is indicated for treating such patients (additive occlusion).

‘In order to reconstruct physiological
occlusion, correct
visual identification
of contact points is
essential’

Conclusion
The reconstruction of physiological occlusion is essential
for the complex functioning of
the entire stomatognathic system. There are various concepts of occlusion. For recording and analysing the complex
movement of the mandible, a
wide range of electronic devices are available.

maturity contact of only 20 μ
can trigger a compensatory
reaction, placing the mandible into a new physiological
position. This is a natural reaction of our biological system
to avoid higher forces focused
only on one area.

Beside all these tools, a
basic understanding of the
biomechanical design of an
occlusal surface is essential.
Today, we have a wide selection of different occlusion
indicators to visualise these
biomechanical structures. Soft
colour-impregnated
occlusion checking papers, in combination with thin occlusion
checking films, are optimised
for visual checking of the occlusal relationship between
the maxilla and mandible. DT

For example, if you are eating something and you chew
on a little grain of sand, you
automatically shift your mandible to a different position to
protect your teeth. A permanent “grain of sand” (occlusal
interference) can trigger an
overload of the biological system, in which case the patient
will have reached his or her
maximum capacity for compensation. Pain symptoms can
then become chronic.
Occlusal restoration
In order to reconstruct physiological occlusion, correct
visual identification of contact
points is essential. Occlusion
checking materials (articulating papers) with the effect of
progressive colour transfer are
helpful in identifying occlusal

About the author
forces in intercuspal habitual
position. Areas with higher
force loads can be identified
as darker-shaded markings
with higher contrast. These

markings likely indicate the
initial contacts. Areas with
less intense colour markings
indicate contacts with lower
occlusal forces or areas with

no contact. Upon close examination, these markings look
like a donut. The centre of
the contact point has a lighter shade. The more intense-

Dr Peter Bausch
Dr. Jean Bausch GmbH & Co. KG
Oskar-Schindler-Str. 4
50769 Cologne
Germany
pb@bauschdental.de

[21] =>

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[22] =>

22 Money Matters

United Kingdom Edition

March 11-17, 2013

10 Top Tips - Financing the purchase of your first dental practice
David Brewer offers practical purchasing advice

s we settle into 2013
many associates may
well be considering their
future options and in particular thinking about buying their
first Practice.
We hear of many associates
unhappy with their ‘lot’ and
only seeing potential tougher
times ahead so it is no wonder
the past 18 months have seen a
sizable rise in the number of associates looking to purchase.
FT&A Finance is headed up
by David Brewer who has more
than 20 years’ experience in the
dental market arranging funding for both first time buyers
and established practitioners.

Before any associates make
any decision to purchase David
has outlined the following top
tips that it is worth considering:-

It is certainly more challenging than previously to gain
finance, however the banks
ARE still lending but to whom
they perceive are the strongest
applicants – and all banks are
different. Do not go direct to
your High Street Bank – instead
find out about working with an
independent adviser who will
be able to provide you with an
overview of the whole market
(rather than just the thoughts of
one bank) and then work with

you on your proposal to ensure
you have the best chance of a
positive response and to negotiate best terms.

The good news is there
are currently eleven high street
banks who are lending to dentists – and they REALLY do want
to lend to you – Dentists have
the green light! And remember,
the cost of borrowing is currently at an historic low. Speak
to someone about Government
lending initiatives under FLS
or NLGS – it could mean your
cost of borrowing can be even
lower.

THE GOLD
GOLD
STA
NDA R D
STANDARD
PR ACTICE
IN PRACTICE
SA LES A
ND
SALES
AND
PURCHASES
PURCH ASES

mind corporation 020 7610 0300

fta-ad-evaluation_Andrew_amends:Layout 1 16/08/2012 17:27 Page 1

Frank Taylor & Associates
So,
areare
looking
forfor
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right
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BEBE
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AND
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company
who
is the
best,
with
a focus
on what’s
SALE OR
OR PURCHASE
PURCHASEOF
OFAADENTAL
DENTAL
PRACTICE,
AND the
each
client.
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alsoalso
justjust
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to beto
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and
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as as biggest; so come to Frank Taylor & Associates we’ll
and we’ll
Either
way,you’ll
you’llwant
want
talk
somebody
turn
sale
oror
purchase
intointo
Gold.
turnyour
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Gold.
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&&
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Associates
help.
have acted
on
behalf
of
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on
both
sides
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acted on behalf of clients on both sides of selling
many
years
andand
across
and purchasing
purchasingpractices
practicesover
over
many
years
across
1000s of
transactions.
This
is
why
we
are
seen
as
the
of transactions. This is why we are seen as the
Premier Sales
forfor
dental
practices
Premier
Salesand
andPurchase
PurchaseAgent
Agent
dental
practices
throughout the
throughout
theUK.
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For
information
on on
howhow
we can
helphelp
you with
a
Formore
more
information
we can
you with
a
sale
or
a
purchase,
call
us
for
a
confidential
conversation
sale or a purchase, visit us on stand HO5 for a
on
08456 123 434.
confidential
conversation or call us on 08456 123 434.

Callususnow
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on08456
08456123
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434ororemail
emailususatatteam@ft-associates.com
team@ft-associates.com
Call

30/10/2012 13:03

You need a sound business plan with realistic and
up to date figures. Again work
with an independent business
adviser as they know exactly
what the banks like to see and
the format in which to present
it. This should include:
• Your CV including confirmation of your current income
levels
• ‘Executive’ summary of your
proposal
• Financials for the subject
Practice
• Proposed working arrangements and impact on bottom
line profit
• Financial Forecasts (P&L/
Cash flow) including assumptions behind the figures

Are you buying on your own
or jointly? There are advantages
to a partnership but also certain
disadvantages which you need
to be made aware of.

An independent practice
valuation is vital. You need
to ensure that the figure being quoted by the seller is not
inflated and is realistic. This
report will also give any potential lenders the majority of the
background information that
they require.

Always seek specialist legal
advice from experienced dental
solicitors. It is false economy to
use a lawyer without this specialist knowledge, particularly
if there is any NHS element in
the purchase.

Choose the right lender.
Several of the major banks have
specialist dental lending teams.
This means that the decision
whether to agree to your loan
will be taken by people with
experience of the dental sector
and how a dental practice functions. Alternatively there are a
number of companies that offer
independent advice and search
lenders on your behalf – effectively doing the ‘leg work’ for
you enabling you to concentrate
on your dentistry. This can be
seen as the ideal option as you
will have had access to the full
range of lending deals on offer.

This is the boring but vital bit - most lenders will insist

upon life cover, income protection and practice/property
insurance. You should always
seek independent ‘whole of
market’ advice and from a specialist dental IFA.

Make sure you use a specialist dental accountant – especially if you are to purchase
your first Practice.

Enjoy it when it comes
to fruition! Owning and running
a practice isn’t for everyone but
for many it does bring enormous rewards and fulfilment.
Make sure you book on
one of our Beginners Guide to
buying a dental practice, they
provide a rich source of information and knowledge and an
opportunity to meet the team of
FT&A Finance. There is no cost
to attend one of our events, and
you get CPD points!
In 2012 we added to our
team and were fortunate to secure the services of Helen Skinner who will be known to many
dentists from her previous role
with RBS where she specialised
in the dental sector. Alongside
David and Helen is Dino Charalmabous, our specialist ‘whole
of market’ Dental IFA who can
assist with all practice and personal insurance requirements
as well as mortgages and investments. These experts are not
only knowledgeable and understand your sector but are totally
approachable and well known
for their efficiency and positive
can-do attitude. With over 93
per cent of their funding proposals approved by the Banks
they have a high success rate
as well as being able to secure
best terms so if you are considering making a purchase either
for your first practice or to add
to your portfolio or simply wish
to acquire new equipment. DT

About the author
David
Brewer
Head of FT & A Finance has worked
in the health care
sector for over 20
years and is responsible for securing many millions of pounds for
the dental profession to enable practice purchases.
For more information David can be
contacted on 07817 758548 or email
david.brewer@ft-associates.com

[23] =>

United Kingdom Edition

Business 23

March 11-17, 2013

“Setting Up On Your Own”
“Kitting Out” the Practice – Tangible Assets

his month, we will look at
kitting out the practice with
essential assets and equipment. You will be purchasing/
leasing an empty shell and effectively will be starting with a “blank
canvas”. You will therefore need to
consider the layout of the surgery,
planning design, equipment and
stock, IT system and suppliers.
Subject to any planning restrictions etc, or any restrictions in
your Lease (if applicable), you will
have free reign to design the layout of the surgery as you wish. Plan
in advance and have a detailed
idea of how you want the surgery
to look. Depending upon your
budget, you may want to engage a
designer or architect to help.
Every practice will need an
efficient and suitable IT system.
How will you know which one
would suit your practice? You will
need to consider what information it will need to hold, its accessibility capabilities and user
friendliness. To get significant
benefits from IT, you need to be
able to trust your IT systems. This
means having confidence in the
company supplying, managing
and maintaining them. Choosing
the right IT supplier is therefore
an essential part of selecting an
effective IT solution. Watch out
however for the cost of maintenance contracts. You need proper
maintenance but some costs can
be high and some providers try
and lock you into long terms. It is
a good idea to shop around.
You must purchase equipment
that is suitable for your requirements and needs. Dental equipment can be expensive and you
should not rush in making your
decision by purchasing the newest, most expensive equipment.
It is always worthwhile taking
advice from colleagues and other
dentists and at the same time, testing out equipment at exhibitions
or conferences. Some companies
may have showrooms where they
demonstrate their equipment and
this gives you a good opportunity
to try out the equipment. Research
all of the suppliers thoroughly to
ensure that they provide quality equipment as well as offering
reasonable servicing and repair
facilities.

tion for you. The high initial costs
in purchasing equipment may not
be feasible and, if so, you will need
to consider hiring equipment or
entering into a leasing arrangement. Be aware of the pros and
cons of leasing/hiring equipment.
The obvious advantage is that
there will be a minimal initial ex-

penditure, thereby saving costs in
the short run and enabling funds
to be directed to other areas of the
business i.e. marketing/advertising. However, whilst it will be a
minimal initial expenditure, it is
usually the case that leasing equipment will be more expensive than
buying in the long run. Addition-

more than looking at the pricing.
You will need to consider:
• Value for money
• Quality
• Reliability
• Accessibility

ally, you will have built up no equity in the equipment as you will
not have ownership (unless of
course the equipment is obsolete
at the end of the lease in which
case ownership would not matter).

How you decide on the importance of each of these factors
will depend upon your businesses
priorities and the overall business
strategy.

Choosing the right suppliers
for your practice will involve a lot

Next month: “Kitting Out” the
Practice – Intangible Assets DT

Tetric EvoCeram Bulk Fill
& Bluephase Style
®

The bulk-fill composite

The curing light

For even more efficient

posterior restorations
• Fill with up to 4 mm bulk increments due to lvocerin, the patented light initiator
• Sculpt and contour with ease as a result of the material’s smooth consistency
• Then light-cure for ten seconds using the short, 10-mm Bluephase Style light probe …
• … and the esthetic restoration is done!

Purchasing, and therefore
owning, equipment outright may
not always be a viable financial op-

Watch the Tetric EvoCeram Bulk Fill & Bluephase Style animation at:
www.ivoclarvivadent.com/bulkfill_en

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

www.ivoclarvivadent.co.uk
Ivoclar Vivadent Limited

TEC_BulkFill_BluephaseStyle_e_A4.indd 1

23.11.12 12:49

[24] =>

24 Practice Management

United Kingdom Edition

March 11-17, 2013

Turn your good practice into a great one – part two
Jacqui Goss continues with your journey toward practice perfection!

reviously, I outlined a
suggested practice development programme
based on an eight-step patient
journey. Here, I shall discuss
step one – how a prospective
patient finds out that you and
your practice exists. Arguably,

this is the most important
step; it’s the old ‘a journey of
a thousand miles begins with
a single step’ saying. Maybe in
this case it should be a journey of a thousand smiles…
Let

state

straight

away that I do not know exactly what you need to do to
attract a regular flow of
potential new patients. I know
from first-hand experience
some of the things that work
and can suggest ideas you may
care to try.

By common consent, word
of mouth referrals are the
most effective at bringing
prospective new patients to
your door – or at least to the
telephone. By most effective,
I mean a high conversion
rate from recommendation

While word of mouth marketing might be highly successful in terms of quality,
it can be difficult for dental
practices to generate sufficient quantity. You’re going to
be very lucky if even 10 per
cent of your patients actually
recommend you. Simply asking patients to recommend
you is unlikely to be very effective. You need to incentiv-

Curasept ADS 0.2% CHX
Conventional chlorhexidine mouthwashes lead to discolouration. Curasept, with
it’s patented Anti Discolouration System (A.D.S.), is proven* to prevent almost all
yellow-brown discolouration of the tongue and teeth without altering the
anti-plaque and antibacterial action of Chlorhexidine.
*Compare the studies at www.curaprox.com

with

to new patient appointment.
Word of mouth referrals are a
sort of informal network marketing. And network marketing has produced many large
and successful companies
(think Herbalife as just one
example).

A.D.S

Alcohol free
Does not alter taste perception
Increases patient compliance

Anti Discolouration System

‘While word of
mouth marketing
might be highly
successful in
terms of quality, it
can be difficult for
dental practices to
generate sufficient
quantity’
ise them – perhaps a free hygienist session or free electric
toothbrush for each recommendation that results in an
appointment.
You should also take a leaf
out of network marketing activity and give your patients
some particular benefits of attending your practice which
they can pass on. Consider a
postcard-size card with, say,
a photograph of the practice
team on one side (so much
friendlier than an image of the
inside or outside of your practice) and three or four bullet
points on the reverse. These
could be:
• Family-friendly practice –
we love kids!
• Tooth whitening and cosmetic dentistry a speciality
• Low-cost monthly payment
plans
• Late evening and weekend
openings

Special promotions available through your dental wholesaler

For excellent examples,
look at the ‘Thank you’ cards
and invitation cards Knight
Dental Design includes in its
information packs about its
laboratory.
Follow us on Facebook
Don’t overlook including
something as apparently mundane as ‘free parking’ – especially if you are a town centre
Curaprox_Curaspet_A4P_TR_019_12.indd 1

05/09/2012 15:14

[25] =>

United Kingdom Edition

March 11-17, 2013

Practice Management 25

negative content, but the relationship between emotion and
social transmission is more
complex than valence alone.
Virality is partially driven by
A lengthy article by Jonah
physiological arousal. Content
Berger and Katherine L. Milkthat evokes high-arousal posiman in the Journal of Markettive (awe) or negative (anger
ing Research in 2011 looked
or anxiety) emotions is more
at this subject in considerDon’t forget to include your
viral. Content that evokes
able detail and reported on
contact details on these referlow-arousal, or deactivating,
the research they’d done. To
ral cards. Then hand them out
Virofex A3 Advert - Tribune_Layout 1 22/01/2013 16:15 Page 1
emotions (eg, sadness) is less
quote from their summary:
to patients but not willy-nilly.
viral.’
‘The results indicate that posiJust as not everyone is suited
tive content is more viral than
to network marketing, not
every patient will feel comfortable recommending you.
practice. But do avoid listing
your qualifications or those of
your staff. In a network marketing scenario, people want
to know why a product will be
good for them not how clever
the people are who make it!

Choose patients whom you
know or who have confirmed
that they have a wide circle of
family, friends and colleagues
and who have said that they
are happy to recommend you.
In many ways, social media is a variation on word of
mouth recommendations –
people are likely to check and
respond to favourable reviews
and comments posted on Facebook, Twitter and so on.
Indeed, when research suggests that most people judge
a web page in just 10 seconds
and only read about a quarter
of the text on the pages they
visit, there’s an argument that
you’re more likely to gain enquiries through social media
than you are through your
website.
Be aware that merely having a Facebook page and/or a
Twitter account and posting
random images and tweets
will be highly ineffective. For
a start, by just having a Facebook page you are unlikely to
be comprehensively penetrating the social media opportunity. Research in the USA by
Shop.org, comScore and The
Partnering Group has shown
that many consumers use YouTube and Pinterest (an online
visual pin board) to browse
and research products. Think
in terms of having a presence
on a number of social media
and generating visual content
for sites such as YouTube and
Pinterest as well, of course, as
your own blog.

consider the potential ‘virality’ of what you put on social
media.

In a nutshell, your social
media content should be positive, emotional or interesting
(or combinations of these) if it
is to be engaging and, therefore, likely to be shared. Just
as with having a face-to-face
conversation, if you are fascinating, upbeat and personal
then people will respond positively. Unlike with a face-toface conversation, if someone
compliments you, your team
or your practice on social me-

dia lots of people get to read it.
And that’s all good.
My reading recommendation this time is the output
of Dental Tribune contributor and social media expert,
Rita Zamora (recently named
a Top 10 Dental Pro in Social
Media). Simply go to www.ritazamora.com to read her blog
and to sign up for Rita’s free
social media marketing updates. DT

Heavyweight
Disinfection
(Just add water)
Introducing Virofex,™ an innovative alcohol-free high level
surface disinfection system for use on non-invasive medical
devices.
Simply add 500ml of tap water to the system bottle, put one
Virofex cartridge into the neck, replace the trigger, shake for
a few seconds and it’s ready!
Fresh, perfect strength working solution every time,
without any spill hazard or the need for cumbersome and
dangerous 5 litre refill containers.

Concentrated
■ Each super-concentrated 8ml cartridge of Virofex
makes 500ml of working solution.
■ The lightweight cartridge refill pack is equivalent to
a heavy, cumbersome 5L container of conventional
disinfectant – and it can be wall-mounted.

Effective
Fill the system bottle with 500ml of clean cold water, place one cartridge into the
neck of the bottle and replace trigger spray. Gently shake the bottle for a few
seconds prior to use. Virofex will remain active for 12 months following activation.

■ Virofex is highly effective against bacteria, fungi, TB,
viruses and spores; including MRSA, C-Diff, HIV,
Hepatitis and RotaVirus.
■ Tests have shown that, even after 24 hours, surfaces
sprayed with Virofex have a high resistance to
contaminating organisms.
■ Even the dispenser pack itself is bactericidal!

Safe
■ Virofex is compatible with all surfaces and material
types – eliminating the need for different solutions.
■ Alcohol-free and non-flammable, Virofex does not
smell of harmful biocides.

Most of us have heard of
the term viral marketing –
self-replicating
information
that spreads from person-toperson mainly via social media. While you’ll be very lucky
to achieve worldwide viral
marketing, you should always

Available exclusively
in the UK from
The Dental Directory
and Topdental

About the author
Jacqui Goss is the
managing partner
of
Yes!RESULTS
dental
practice
management consultancy.
Many
practices
utilise
her knowledge and
expertise to considerably improve
their patients’ journeys.
Email: jacqui@yesresults.co.uk

For more information on this innovative new product,
call 01535 652 750 or email sales@virofex.com
Alternatively, watch our demonstration video on YouTube.
www.virofex.com

www.topdental.co.uk
01535 652 750

Call 0800 585 586

[26] =>

26 DCPs

United Kingdom Edition

March 11-17, 2013

Integrated Care Pathways
Glenys Bridges looks at patient needs

ll dental care providers
are required to place patient’s needs at the centre
of dental care provision. This
article looks at ways to develop
robust patient focused proce-

dures to enable them to work
as a team. Integrated care pathways can be used to define practical procedures for the delivery
of NHS care, which enables NHS
practices to create personal care

plans for each patient, within
the parameters of a standardised patient journey.
Integrated Pathways have
developed in line with the re-

quired outcomes that have been
stipulated in numerous dental
regulations since ‘Options for
Change’. It is a tool for ensuring continuous improvement,
whilst embedding patients’

Working to the Pathway’s
Standards adds considerable
organisational and financial
burdens upon Registered Providers and Managers. Time
they spend ensuring that Quality Management processes are
in place reduces the time they
have left to spend on other
work tasks. Only when dental
professionals working together
as a team and share the range
of tasks form the patient journey, can care pathways really
be integrated.

Beautifully functional
Introducing our stunning new range of in-surgery
furniture - combining style with practicality.

Available in a wide range of colours and configurations, these brand
new built-to-last cabinets are designed especially for dentists.
With touch sensor taps, metal cabinets, integrated basins and easy
to clean corian work surfaces, they are the perfect solution for the
modern dental surgery. Installation is quick and simple and can be
easily completed in a few hours.

wellbeing at the core of practice
culture. In the past if a practice
appeared orderly and caring, it
would have been assumed to
be providing high quality care.
Today’s regulators need to see
evidence of patient focused,
structured and systematic dental care provision.

Storage designed specifically for dentists

To see these cabinets for yourself and to learn more about other
products in our all-new in-surgery range, please visit us at Stand C05
at this year’s BDTA Dental Showcase.

The origin of UK Care Pathways is the Department of
Health’s (DOH) strategic objectives for public health, the NHS
and social care in England.
Their purpose is to improve
England’s health and wellbeing, so as to secure better
health, better care, and better
value for all.
The vision for health and
social care is focused around
five key priorities:

Alternatively, call us on 01903 858910 to request a brochure,
or visit our website at www.admor.co.uk

1
2
3
4
5

A patient-led NHS

Better health outcomes

More autonomous and accountable systems

Improved public health

Reforms to long-term and
social care
The objective is to find the
best way to develop, support
and mobilise the health and
social care systems to deliver
improvements for patients and
the public. Delivery support includes:

Call 01903 858910 or visit www.admor.co.uk
Admor, all your practice needs delivered to your door
Signage

Stationery

Furniture

Admin Supplies

Marketing

In-Surgery

• Performance monitoring and
evaluation
• Managerial and professional
leadership for external groups
• Building capacity and
capability
• Ensuring value for money
The Health and Social
Care Act 2008 provides the legal framework to develop the

[27] =>

United Kingdom Edition

standards care providers must
meet to secure the required
standards of quality and safety
of care. Under the terms of the
Health and Social Care Act 2008,
regulators have been appointed
in England, Scotland, Wales and
Northern Ireland to ensure local
needs are accounted for in the
development of care standards.

March 11-17, 2013

DCPs 27

Oral Health Assessment - New Patient

Oral Health Review- Returning Patient

The CQC makes sure that
care providers meet essential
standards of quality and safety. It
has a wide range of enforcement
powers to take action on behalf
of people who use services, if
services are assessed as being
considered unacceptably poor.
The CQC’s aim is to make sure:
• Improving care is provided for
everyone
• Voices of people who use
health and adult social care services are heard, by asking people to share their experiences
of care services. In some cases
patients and their carers work
alongside inspectors to provide a user’s view of services.
• Users’ views are at the heart
of its reports and reviews.
All leading to the improvement of the quality of care
provided; and decreased risk
of complaints and litigation.
As a practical tool, Care
Pathways lead to the development of Personal Care Plans
for each patient. The plan requires input from dental professionals accross the team
including adminstrators, to
meet the requirements shown
in the following diagram for
new and returning NHS and
non-NHS patients.
The end result of following these pathways is intended to be improved efficiency
and better use of resources.
The aim is to use the best
practices to standardise the
patient journey, whilst at the
same time providing individualised patient care and the
inclusion of patients in decision-making processes. This in
turn requires dental teams to
provide opportunities for patients to raise patient’s dental
IQs so that they can make informed decisions. DT

About the author
Gleny Bridges is
an
experienced
management
trainer and assessor with 20 year
experience
of
working with General Dental Practitioners and their
teams. In addition,
she has expertise and qualifications
in Counselling and Life Coaching. Her
first book Dental Practice Management and Reception was published in
2006 her second book: Dental Management in Practice was published
during 2012.

Achieving the most natural
enhancement with quality
education and training in nonsurgical Aesthetics. Our team of
surgeons, doctors and nurses can
be your resource, dedicated to
providing the highest calibre of
Aesthetics training. Courses are held in
London, Manchester and Birmingham, or,
we can come to your Practice.
Our training courses are open to Doctors, Dentists
and Nurses only with a valid GDC or GMC number.
Specialist courses in :• Botulinum Toxin (Foundation and Advanced Levels)
• Dermal Fillers (Foundation and Advanced Levels)
• Microsclerotherapy
• Chemical Peels
All courses are approved and accredited by Hamilton Fraser Insurance
Services (HFiS). We offer a 10% introductory discount on all course prices
with this feature.
Aesthetox Academy Limited, one of the leading UK training
companies in non-surgical Aesthetics.
Contact 0870 080 1746 or email treatments@aesthetox.co.uk
www.aesthetox.co.uk

[28] =>

28 Industry News
dbg at The Dentistry Show
2013 – come and see how
we can make your practice
perfect!
Managing your practice
need not be a chore. That’s why at dbg we offer a range of personalised
membership services to provide you with all the help and support you need.
By visiting our stand at The Dentistry Show 2013 you can learn more about
how together, we can make your practice perfect. Speak to our friendly and
experienced team to find out more about:
• Compliance support
• Business management services
• Training and CPD
• Materials and Equipment
• Engineering services
We’ve been working alongside dental practices for over 20 years, and pride
ourselves on understanding your practice needs. With over 5,000 members
across 7,000 practices, we offer a complete solution, allowing you to focus on
what you do best!
To learn more about how we can help make you practice perfect, visit us at
stand K45 at The Dentistry Show 2013.
For more information call dbg on 01606 861 950, Or visit www.thedbg.co.uk

Dental Saver
PERFECTION IN PREOWNED EQUIPMENT
DENTAL Saver has a special “below the radar” niche in the UK dental market;
over the last 25 years it has grown to be the largest UK dealer in pre-owned
dental equipment.
All equipment is sold with warranties, fully serviced, tested and refurbished
to an extremely high, often “as new” showroom standard. Dental Saver, a
company run by dentists, for dentists, has one very simple aim: to achieve
maximum predictable function and aesthetics for all clients needing dental
equipment (or cabinetry) at affordable prices, often enabling clients to save up
to 50 per cent on new prices.
Dental Saver’s buyers are extremely selective in what they accept for
refurbishment, all equipment is serviced in-house, and exhaustively bench
tested in their Bristol workshops. All worn or malfunctioning parts, and all
consumable items are usually replaced with new, refurbishment may include
new paintwork and upholstery before final reassembly.
Dentalsaver offers six month warranties on all pre-owned equipment, with
longer periods negotiable subject to additional costs (exclusions apply for
consumables and misuse contrary to manufacturer’s advice). Business tems
and conditions available on request.
For more information call 01275 853323 or 01275 343228
e-mail: ike@dentalsaver.co.uk web: www.dentalsaver.co.uk

Impressive service and support from
Clark Dental
With over 30 years’ experience in
dentistry, the team at Clark Dental offer
a complete surgery design service,
and can work with you to guide and
support you through every stage of
your project. Dr Raluca Mihoc of Poole
Dental Practice, Dorset, says: “We
decided to work with Clark Dental as
they came highly recommended to
us, and they were able to meet all our
design and equipment needs. “The whole process was very smooth. The Clark
Dental team installed two surgeries to our exact specifications, along with a
sterilisation room as well as all the fittings necessary to prepare a third surgery
for use at a later date. “As well as our superb A-Dec dental units, Clark Dental
also provided us with other equipment including the Schick Digital Imaging
System and the Nomad portable x-ray.
“Overall I’ve been very impressed with the service and support we’ve received
from Clark Dental. I am now very much looking forward to opening our third
surgery in the coming year!”

United Kingdom Edition

All On Board the All-on-4TM at
The Dentistry Show 2013
With Nobel Biocare on Stand G40
Allow Nobel Biocare to introduce
two new business growth areas:
the revolutionary All-on-4TM and
the new Esthetic Alliance Program
(EAP) on stand G40 at The Dentistry Show 2013 from 1st – 2nd March 2013 at
the NEC Birmingham. With an ageing population and the resulting ‘edentulism
boom’, the All-on-4TM concept is an excellent addition to implant dentists’
repertoire. Dentists can fit a fixed bridge on just four implants with no need
for invasive bone grafts or sinus lifts. Cases that require immediate extraction
can have an immediate bridge within the same surgical procedure – there’s no
need for a removable denture at any stage! Talk to Nobel Biocare’s skilled and
knowledgeable staff to find out more. For dentists who do not want to place
implants but would like to learn about the benefits of implant restoration, ask
about the advantages of EAP! EAP, or Esthetic Alliance Program, is a proven
program run by surgeons and supported by Nobel Biocare. Step-by-step, GDPs
are taught the basics of restorative dentistry while stronger referral networks
are forged between the referring dentists, surgeons and labs. Whether you
are a seasoned implantologist or just thinking of moving into restorative
dentistry, come to see Nobel Biocare at stand G40 and discover more about the
opportunities that await you!
For more information contact Nobel Biocare on 0208 756 3300
or visit www.nobelbiocare.com

Apolline – holds the answers to your
unanswered questions
In current economic times dental practices
need strong business support to survive
and thrive. Apolline offers tailored, practical
business support to dental practices in all
the important areas allowing you to get
back to what you do best! We provide first
rate hands-on business support and advice
to dental professionals to help you ensure you enjoy maximum productivity and
unrivalled success. Are you looking to outsource the business elements of your
practice so you can concentrate on patient care and clinical excellence? We have
that covered. We offer support with your management processes, your business
development and HR issues, your compliance and your KPI’s – everything you
need to allow your practice to succeed. High quality feedback is at the heart of all
successful businesses. Are you looking for help with how to get the best feedback
with the least effort? Apolline’s patient and staff satisfaction surveys & analysis
will provide a detailed round up of all this data. Want your dental practice to
excel but not sure where to begin? Look no further. Apolline workshops are held
twice a year and cover compliance related subjects in addition to important
training courses to guarantee that your practice stays current and up-to-date. In
these times of economic uncertainty, we will provide the certainty and stability.

March 11-17, 2013

Roger Gullidge Design - Bringing
over twenty years of experience
building dental practices to The
Dentistry Show 2013
Dental professionals looking to
build, develop or refurbish their
practice should make time to visit
Roger Gullidge Design on stand K16
at The Dentistry Show 2013 (March
1st-2nd at the NEC, Birmingham).
Specialising in the creation of exciting new environments for dentists to work,
Roger Gullidge Design provide support for many aspects of the building
process, from planning and feasibility to negotiating finance for a project.
Having spent more than two decades developing innovative dental practices,
senior design director Roger Gullidge has experience in everything from
design and architectural services to project management and interior design.
Whether developing modern new builds or renovating historic buildings,
Roger has gained a reputation for providing an extensive and thorough service
that is both versatile and imaginative.
Roger Gullidge Design is a specialist design and project management
consultancy specialising in the dental sector. Call 01278 784442 for more
details.

R4 Practice Management
Software: “keeps everything
running smoothly”
Dr Simon Shillaker, principal dentist
at Fareham Road Dental Surgery
in Hampshire, has been using R4
Practice Management Software
from Carestream Dental since 2002.
“I use R4 for everything,” says Dr
Shillaker, “from notes and booking
appointments to financial transactions. “A mainly NHS practice, we are almost
all doing EDI claims and, with four dentists and a hygienist on site, R4 is in use
every second of the day. “We’ve always found the charting facility easy to get
on with. Even nurses who are just starting out or who come from an agency
find it easy to pick up. “There are lot of benefits to R4 including the fact that it’s
not lost a record yet! We have instant access to information and the reception
team don’t have to juggle multiple diaries to book patient appointments – it’s
all in one place. “We computerised when we went up to three dentists. Now
we have four, it would be impossible with a paper system. R4 is so reliable and
keeps everything running smoothly.”
For more information on R4 from Carestream Dental please call
0800 169 9692 or visit www.carestreamdental.co.uk

For additional information or help and advise on a business issue please call
Apolline on 0114 209 6250 or visit http://www.apolline.uk.com

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

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

dbg stand proves a hit at The
Dentistry Show 2013
The dbg stand proved a great hit
with delegates at The Dentistry Show
2013. Visitors to the stand were able
to learn more about how dbg offer
a complete package of personalised
membership services to help relieve
the burden of compliance and
practice management. The experienced and knowledgeable team were on
hand throughout the Show to guide delegates on topics including:
• Compliance
• Business management
• Training and CPD
• Materials and Equipment
• Engineering
With over 20 years’ experience working closely with practice teams, dbg is
one of the most experienced names in dentistry. With over 7,000 members
from across the UK, the dbg team pride themselves on being able to offer the
complete personalised solution to all your business, compliance and training
needs. To find out how dbg can help make your practice perfect, contact the
dedicated team today. For more information call dbg on 01606 861 950,
or visit www.thedbg.co.uk

Essential inspections – as easy as one,
two, FREE!
At dbg we know how important
equipment is to the running of your
practice. That’s why we offer essential
equipment inspections at a special
discounted rate to all our members.
Buy any two essential inspections from
us and you will get a third inspection
absolutely free! Thanks to the flexibility of
our special offer, you can mix and match
essential inspections to suit your needs.
You may find you need Radiation & X-Ray Inspections for example, or you may
instead need Autoclave & Compressor Inspections. By working with dbg you
don’t need to deal with different companies for different devices – with us,
your equipment inspections will become completely hassle free! With dbg
you can be sure that our engineers will be there when you need them most,
and will only charge you for the job, not for the length of time it takes. Our
extensive network covers approximately 95% of dental practices in England,
Scotland and Wales. We even offer a free hand piece repair service.

EndoCare – best service,
guaranteed
At EndoCare we are solely
committed to the diagnosis and
treatment of dental pain and
infection. Our state-of-the-art
practices
located
throughout
London
offer
patients
a
comfortable, calming experience
and our dedicated team of experts are wholly committed to providing successful
Endodontic treatments, and an outstanding level of care. Here at EndoCare we
pride ourselves on offering exceptional service and support to all our referring
practices. We guarantee that we will give the best service to your patient and
communicate with you promptly as to what treatment is required, has taken
place and what is required in the future. We will also recommend the type of
restoration best suited to the case, appropriate timing, and any follow-up the
patient requires either with ourselves, or with you. We welcome referrals from
colleagues either by post, on-line or by telephone. In addition we would welcome
the opportunity to talk with you and meet you in person. We are currently
arranging CPD points for attending the practice and observing Endodontics.

Inman Aligner Training
The Inman Aligner is an innovative toothstraightening appliance, designed to reposition
anterior teeth safely and quickly. Straight Talk
Seminars are the only UK official trainers, and they
offer both hands-on and online courses for dental
professionals.

To find out more about how we can save you money on essential equipment
inspections, contact our team today!

To learn more about how we can become an invaluable extra member of your
team, contact EndoCare today.

“The idea of straightening patients’ labial segments appealed to me
immediately due to the high number of patients requesting to have their
small discrepancies corrected. The Inman Aligner allows me to offer patients
more choice in restorative and orthodontic treatments, reducing the amount
of aggressive preparations on the teeth, maintaining ethics and applying the
principal of minimally invasive dentistry!

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

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

For more information on Inman Aligner training please visit
www.inmanaligner.com or phone 0845 366 5477

Dr Ronak Patel from Victoria Dental Centre
attended the hands-on training course after
hearing about it from colleagues.
“The best experience when learning a new skill is to actually do it yourself, so
the hands-on course gave me a great incentive to book. The course itself was
a thoroughly enjoyable day, combining hands-on training with theory-based
and actual case examples.

[29] =>

United Kingdom Edition

Great value surface wipes available in 4 fragrances
xBuy 100 PracticeSafe disinfectant wipes for only £1.45
before the end of March. PracticeSafe 100 wipes and
100 wipe refills are available in neutral, lemon, fruit
and flower fragrances, so they are pleasant to use and
have no overpowering odour. These microfibre wipes
measure 185mm x 135mm.
PracticeSafe disinfectant wipes are alcohol based and
offer the highest protection against bacteria including
TB fungi and HBV/HCV/HIV/vaccinia. They are also
effective against MRSA and influenza A (H1N1) viruses
(pathogens of swineflu). They can be used to disinfect
hard surfaces and medical products such as hand and
angle pieces.
Kemdent is proud to announce that their full range of PracticeSafe disinfectants
comply with the newly reclassified EC regulations regarding the disinfection of
medical devices, and carry their CE mark with pride! For information on the full
range of Kemdent disinfectants, ChairSafe, PracticeSafe, PracticeSafe Soak and
InstrumentSafe visit the Kemdent website www.kemdent.co.uk

March 11-17, 2013

Sident Dental Systems
Over 30 years experience with Sirona
products
With over 30 years experience of working
exclusively in partnership with Sirona, to
promote the world’s premier brand of high
tech dental equipment and support their
many loyal customers, when you buy Sirona
Equipment from Sident Dental Systems
you not only get the best price and exclusive Special Offers, but you also get
access to the best sales support in the UK! So if you are re-equipping buy your
Sirona Equipment from Sident Dental Systems, the UK’s only Specialist Supplier
of Siemens/Sirona equipment. Sirona Specialists, Sident Dental Systems offer
the choice from the complete range of Sirona Treatment Centres, 2D and 3D
digital and film based x-ray apparatus – including the very latest Orthophos
XG 3D digital panoramic machine, their extensive range of Sirona handpieces,
and auxiliary items including SiroLaser, SIROEndo and DAC sterilisation units.
Wherever possible, potential clients are invited to visit The Courtyard, Sident’s
state-of-the-art training and showroom facility in Chertsey, where they will be
able see the complete product range in action. Finally Sident will undertake
a complete Project Management Service, including installation and post
installation service support, to enable these dreams to become reality.

Prices exclude VAT. Minimum order 6 units.

Industry News 29
Sirona receives “red dot” design award for
SINIUS
• SINIUS ranks among top 60 of over 4,500 design
products • Sirona was presented with the award at
the red dot gala • Patients notice the comfort and
design of SINIUS • Enhanced range of indications
The SINIUS treatment centre from Sirona is one of
the top 60 design objects of 2012. At the red dot gala in Essen (Germany) at the
start of July, representatives of Sirona and the Puls Produktdesign design agency
were honoured with the “red dot trophy” of the prestigious design award for the
Sirona product. Together with another 59 “best of the best,” SINIUS prevailed
over more than 4,500 products, and now carries the seal of winner ‒ the red
dot. Not only does the striking design and high comfort level of the treatment
centre attract the attention of experts: “We also receive feedback on SINIUS
from our patients – I have not experienced this with any other treatment center.
They notice that the patient chair is comfortable and comment on its modern
appearance,” says Dr. Gunther Landskröner from Bensheim. SINIUS has unique
functions and characteristics that allow the dentist to work efficiently and save
time.
Contact details for further information:

For further information call Sident Dental Systems on 01932 582900
or email j.colville@sident.co.uk

The Waterpik® Water Flosser –
ideal for patients undergoing
orthodontic treatment
Available with a specially designed
Orthodontic Tip, the Waterpik® Water
Flosser is the ideal oral hygiene
solution for patients seeking to
improve their oral health during
orthodontic treatment, and is
supported by a wealth of scientific
evidence to support its use.

WhiteWash Professional
Whitening Strips – “a convenient
and cost-effective first step
for patients considering teeth
whitening”
Formulated by UK dentists, WhiteWash Professional Whitening Strips are
mouldable strips that contain the optimum amount of whitening gel to safely
and effectively whiten teeth. Each course of strips contains 14 foil packets, and
each packet contains two mint-flavoured strips – one for the lower arch and one
for the upper, each providing excellent coverage across at least 4–4, and in some
cases, even 5–5.

In a study conducted by Sharma et al patients who used a Waterpik® Water
Flosser after brushing, removed up to three times more plaque than those who
brushed and used floss, and up to five times more than those who only used
manual brushing alone.

As a practice builder, WhiteWash Professional Whitening Strips are ideal, and
can be used in conjunction with regular tray whitening, or as a “top up” to more
advanced in-surgery whitening techniques.
Dr Paul Shenfine of Darras Dental, Newcastle-upon-Tyne, says:

Waterpik International, Inc. supplies a range of oral hygiene devices designed
to meet all your patients’ needs. These include models such as the easy to
use Cordless Plus Water Flosser, and the high specification Ultra model which
features state-of-the-art Water Flosser technology and provides the ultimate in
oral hygiene performance.
For more information on Waterpik® Water Flossers please speak to your
wholesaler or visit www.waterpik.co.uk. Waterpik® products are widely
available in Boots stores.

KaVo Estetica® E30 – A
truly unique dental unit
The Estetica E30 is an
accessible, affordable and
ambidextrous dental unit
which showcases KaVo’s
attention
to
providing
dental excellence.
The Estetica E30 features
a unique foot control
which presents an efficient
and hygienic approach to treatment. A simple left or right foot movement
allows its user to operate both the patient chair and the Estetica E30’s range
of instruments, leaving its user’s hands free to focus on the patient. The soft
upholstery of the Estetica E30 means that patient comfort is ensured during
treatment. The adaptable chair height (350mm-830mm) means that the
clinician will also be able to maintain a comfortable and healthy posture
throughout any procedure. Keeping the Estetica E30 safe and clean is easy
as many of the components are removable, such as the spittoon bowl,
handpiece holders and the swing arm. This ensures that time is not wasted
on cumbersome cleaning procedures. Available from The Dental Directory, the
Estetica E30 offers its user a stylish and flexible approach to clinical treatment
at an affordable cost.
For more information, contact The Dental Directory on 0800 585 586,
or visit www.dental-directory.co.uk.

For further information telephone 01253 404774 or visit www.mcrepairs.co.uk
where you can download a Freepost label and also see the various equipment
items they offer for sale.

Zesty: helping dental practices
make money from cancelled
appointments
We book flights, hotels and
restaurants online, 24 hours a day, 7
days a week. Why don’t we book our
dentist appointments in the same way?
Zesty is a new, easy to use online lead generation service that helps to increase
patient bookings at your practice. Cost effective and easy to set up, Zesty can
start sending you new appointment bookings in minutes, so what are you
waiting for? With more than one million people searching online for dental
services every month in London alone, Zesty can keep your practice busy with
same day, next day and future appointments.
Register your practice today and upload any free appointment times. “You
provide the appointments, Zesty supplies the patients…”
Simply email: hello@zesty.co.uk or visit www.zesty.co.uk or call 07775
967713 for more details

“I have used Whitewash now for approximately 6 months and find it a useful
adjunct to conventional home whitening as it is a convenient and cost-effective
first step for patients considering teeth whitening.”
For more information call 0844 68 69 150, email
info@whitewashlaboratories.com, or visit www.whitewashstrips.com

The Dental Directory – “They have everything that
we need and at a very cost effective price.”
The Dental Directory stocks over 27,000 different
products ranging from sundries to surgery equipment.
Whatever you are after, The Dental Directory is on hand to
help. With a team of knowledgeable and committed staff
available to solve queries about any product, The Dental
Directory guarantee the highest customer satisfaction
on every order. Wayne Wade, Dental Nurse at Pembroke
Dental and Implant Centre in West Sussex says:
“One of the many reasons we have stayed with The Dental Directory for so long
is our rep Louise, she is really good. She comes out to us all the time to deal with
any queries or returns. She is always on hand if we need any information and
she has always price matched, which is great. The Dental Directory’s range of
products is fantastic. Having recently made botox and filler products available,
they have everything that we need and at a very cost effective price.”

For more information, contact The Dental Directory on
0800 585 586, or visit www.dental-directory.co.uk

Fill faster with sonic energy
SonicFill is the new, fast and easy
composite bulk fill system for
posterior restorations. The first of
its kind, SonicFill enables clinicians
to perform posterior restorations with an easy-to-use, single-step technology
that combines the advantages of a flowable composite with a universal
composite. SonicFill reduces the time needed for placing, packing and
sculpting restorations by an incredible 30%. The SonicFill system combines
the expertise of two leading dental companies, comprising a KaVo handpiece
that enables sonic activation of a specially designed and conveniently
delivered composite from Kerr.
SonicFill’s proprietary sonic activation significantly reduces the composite’s
viscosity, which provides effortless placement and superior adaptation.
SonicFill quickly returns to a non-slumping, non-sticky and easy-to-sculpt
state. The composite’s superior strength results in low shrinkage and high
depth of cure up to 5mm with no need for any other material to cap.
Furthermore, a specially designed ergonomic, small nozzle Unidose tip
enhances access to the cavity and precise placement of the composite.
For more information or to arrange a free in-surgery demonstration, please call
01733 892292, email kerruk@kerrhawe.com or visit www.sonicfill.eu.

Helping you find your
bearings
With
over
25
years’
experience in the dental
handpiece repair industry,
MC Repairs Limited offer a reliable, efficient and extremely competitively
priced handpiece repair service with a 24 hour turnaround in most cases. They
are confident that they are the best value repair centre in the UK. Manufacturer
trained, their team of Repair Technicians have experience of repairing
handpieces, motors, scalers and couplings from all the major manufacturers
and other manufacturers too. MC Repairs offer a Freepost Service and free
no obligation quotations on all their repairs. All repairs are quoted the day
they are received and the vast majority are returned within 24 hours of
acceptance. MC Repairs use only the highest quality components, including
original manufacturers’ components, with all their repairs undertaken
to independently verified ISO 9001:2008 standards. As well as complete
overhauls, MC Repairs also offer a choice of very competitive Bearing Repair
Services starting from just £ 29.50 plus vat. All work carried our by MC Repairs
carry a warranty ranging from 3 to 12 months and they guarantee all materials
and workmanship for the full warranty period.

Sirona Dental Systems 0845 071 5040
Info@sironadental.co.uk

Design your new practice with
Tavom UK
Tavom UK has long been recognised
as
a
leading
international
manufacturer of Dental, Veterinary
and Medical cabinetry, and now all
products can be viewed from the
brand new website www.tavomuk.com.
The experts at Tavom UK will help you plan your new practice layout, ensuring
the design is tailored to your individual needs and requirements. Effective
ergonomics, easy-to-clean designs and quality materials, allow for an efficient
workflow, while meeting HTM 01-05 regulations and ensuring the safety of both
your staff and patients.
You are then able to choose which cabinetry style and colour you prefer from
and extensive product range, with a full pdf catalogue available to download
online. Unlike wooden cabinetry suppliers, Tavom furniture is built off-site,
reducing dust and disruption and eliminating the need for expensive labour
charges. Tavom cabinetry is precision made and delivered to your door ready to
be placed in position and levelled with adjustable feet.
To see how Tavom UK can transform your practice, please visit the brand new
website www.tavomuk.com, or call 0870 752 1121.

Luxurious Sophistication from
Plandent
Planmeca Sovereign from Plandent
is the most sophisticated dental unit
incorporating many revolutionary
features.
The streamlined profile of Planmeca
Sovereign combines the latest
technology with the very highest
quality components, resulting in a major step forward in working productivity,
patient comfort and durability. Quality is clearly evident in fit, finish and
materials. Control of the chair, through a simple iTouch screen, and working
access is exceptional due to the design of the motorised back and headrest
combined with the wide range of positions. The Planmeca Sovereign is the
only dental unit on the market with a motorised chair swivel and motorised
base unit. This unique combination provides a huge range of configurations
to suit your individual working style. You can even switch from right to left
handed in just 30 seconds at the press of a button. Available with state-ofthe-art operatory configurations complete with advanced lighting, instrument
packages and a comprehensive range of other components, the Planmeca
Sovereign will luxuriously enhance your working practice.
For further information please call Plandent on Freecall 0500 500 322.

[30] =>

GC

e single and

on system.

30 Editorial Board

January 28 - February 3, 2013

PUBLISHED IN LONDON
News in Brief

News

Heart Your Smile teams up
with The Dentistry Show
The Dentistry Show returns
for 2013 on 1st and 2nd March
at Birmingham’s NEC arena.
From 6.30pm on Friday 1st
March, The Dentistry Show
will be teaming up with Heart
Your Smile to put on the Big
Heart Party, at The Palace Suit,
Hilton Birmingham Metropole.
“Heart Your Smile is excited
to be launching the Big Heart
Party at The Dentistry Show,
as a celebration of all things
great about the dental industry.
Our Champions and Ambassadors will be acknowledged
along with all the great work
that they do. There is a raffle,
charity auction, photo both and
dancing until late,” says James
Goolnik, Founder of Heart Your
Smile. Tickets for the Big Heart
Party are available by emailing
ellie@heartyoursmile.co.uk
Hundreds of dentists failed to
renew registration
Over 700 dentists missed their
annual registration renewal
deadline with the General
Dental Council (GDC). Figures
from the GDC show that 723
dentists did not re-register and
were removed, while 737 voluntarily removed themselves,
and 96 applications have been
made for restoration to the register. The number of dentists
that did complete their registration renewal was 38,539.
The deadline was 31 December 2012 and those who failed
to pay the annual retention fee
(ARF) will now have to apply to
restore to the register, in order
to work legally in the UK.
MI Paste reduces white spot
lesions during ortho
A study, published in EvidenceBased Dentistry, has found that
the use of MI Paste Plus prevents and reduces the number
of white spot lesions during
orthodontic treatment. Sixty
patients undergoing orthodontic treatment were randomised
to receive either MI Paste Plus
(GC America, Alsip III) or a
placebo paste. There was a
53.5 per cent in the enamel
decalcification index score in
the MI Paste Plus group but an
increase of 91.1 per cent in the
placebo group at the end of the
12 week period. ICDAS scores
were added together to give an
overall score for all teeth; the
MI Paste Plus group score was
145 at baseline and 80 after
12 weeks, a 44.8 per cent reduction; in the placebo group,
the scores were 116 and 166
respectively, an increase of 43
per cent. It was concluded that
MI Paste Plus prevented and
decreased the number of WSLs
during orthodontic treatment,
with the placebo paste group
having an increase in the number of WSLs during the trial.
www.dental-tribune.co.uk

Social Media

Andrew Eder

Appointed Associate Vice President at ICL

Web design

Adrian Adler talks practice
websites

Feature

BACD

Charity misssion for 2013

pages 14-15

pages 12-13

page 2

VOL. 7 NO. 2
Money Matters

Time to buy

Ray Goodman discusses when
to buy a practice

pages 20-21

Use of dental amalgam
to be ‘phased down’
T

he result of a United
Nations treaty will see
a reduction in mercury
pollution, as agreed by more
than 140 countries at talks in
Geneva on 20 January.

need for dentists to care for
their patients.

toxicity if ingested.”

The treaty has been under
negotiation for four years, and
will be open for signature in
October.

The impact of mercury
pollution was famously seen
in Japan during the 1950s and
60s. Following mercury waste
pollution in the waters, residents near to Minamata bay
developed nerve disorders,
resulting in more than 900
deaths.

The treaty requires nations to “phase down the use
of dental amalgam”, and to
set objectives aimed at minimising its use. Mercury-free
alternatives will be promoted,
and education on the use of
mercury-free dental restoration encouraged.

The British Dental Association (BDA) has welcomed
the treaty. Dr Stuart Johnson,
member of the BDA’s Principal Executive Committee, and
leader of the FDI World De
ntal Federation Dental Amalgam Task Team at the negotiations, said:

Although mercury has long
been a benefit in oral health
care, it can be damaging to
health on a whole.

“Dentists in the UK recognise the environmental imperative to minimise mercury
emissions, but it was impor-

The World Health Organisation (WHO) says: “Mercury is highly toxic to human
health, posing a particular
threat to the development of
the (unborn) child and early
in life.

‘The ﬁnal treaty
strikes a sensible
balance, clearly
setting out an aim
for reduced use of
mercury, while recognising the unique
contribution it
makes to oral
healthcare’

“The inhalation of mercury
vapour can produce harmful
effects on the nervous, digestive and immune systems,
lungs and kidneys, and may
be fatal.
“The inorganic salts of
mercury are corrosive to the
skin, eyes and gastrointestinal
tract, and may induce kidney

“We are pleased to see that
this treaty has taken a pragmatic view, acknowledging
that the phase-down approach
advocated by the World Health
Organisation is a sensible
way to make progress. The
final treaty strikes a sensi-

Dr Neel Kothari
BDS Principal and General Dental Practitioner
Dr Stephen Hudson
BDS, MFGDP, MSc
General Dental Practitioner

tant that this treaty took account not just of the environmental agenda, but also of the

23/01/2013 18:05:49

roots

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

endodontolgy

2012

Professor Andrew Eder
BDS, MSc, MFGDP, MRD, FDS, FHEA
Director of Education and CPD, UCL Eastman
Dental Institute

| special

The Young Dentist Endodontic Award 2012

| technique

Three-Dimensional Obturation

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

| report

CBCT in Endodontics

implants

12/12/2012 17:31:01

Vol. 2 • Issue 3/2012

the journal of

3

oral implantology

2012

Dr Trevor Bigg
BDS, MGDS RCS (Eng), FDS RCS (Ed), FFGDP
(UK)
Practitioner in Private and Referral Practice
Baldeesh Chana
RDH, RDT, FETC, Dip DHE
President, BADT and Deputy Principal Hygiene
and Therapy Tutor, Barts and The London School
of Medicine and Dentistry
Dr Stuart Jacobs
BDS MSD (U Ind)
Full-time Private Practitioner

Dr Richard Kahan
DS MSc (Lond) LDS RSC (ENG)
Endodontic Specialist
Mrs Helen Falcon
Postgraduate Dental Dean, Dental School, Oxford
& Wessex Deaneries
Professor Liz Kay
Foundation Dean and Professor of Dental Public
Health
Plymouth University Peninsula Schools of Medicine and Dentistry Dean of the Peninsula Dental
School, Plymouth
Pam Swain
MBA LCGI FIAM MCMI BADN®
Chief Executive, British Association of Dental
Nurses
Mr Raj Rattan
Associate Dean, London Deanery
Dr Paroo Mistry
BDS MFDS MSc MOrth FDS (Orth)
Specialist Orthodontist
Dr Peter Galgut
PhD (LMU), MPhil (Lond), MSc (Lond), BDS
(Rand), MRD RCS (Eng), LDS RCS (Eng), MFGDP
(UK), DDF Hom, ILTM
Periodontal Consultant
Mr Amit Rai
BDS (Hons) MFGDP (UK) MJDF RCS Eng FHEA
General Dental Practitioner
DFT1 (VT) Programme Director, London Deanery
Sneha Gokhale- Gaikwad
BDS, MDS (INDIA)
Specialist in Periodontics and Implant Dentistry
Diploma in laser dentistry (Vienna, Austria)

Shaun Howe
RDH
Dental Hygienist

| feature

Guided implant surgery using CEREC

| user report

Laser-Lok: a case study

| industry report

A new protocol for immediate loading

cosmetic

20/12/2012 17:37:48

Vol. 2 • Issue 1/2013

dentistry_ beauty & science
1

2013

Published by Dental Tribune UK Ltd
© 2013, 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

-ænial you can reinforce
sthetic skills and ability
every restoration with
nks to the straightforward
tem. The choice of the
es is made according
he patient:

Group Editor
Lisa Townshend
Tel: 020 7400 8979
Lisa@healthcare-learning.com

amel for youngsters

mel for adults

el for your senior patients

des has never been easier!

Dental Tribune UK
Editorial Board

ble balance, clearly setting
out an aim for reduced use
of mercury, while recognising the unique contribution it
makes to oral healthcare. It
also recognises the important role that prevention can
play in improving oral health
and reducing demand for
fillings.” DT

Vol. 2 • Issue 3/2012

3

March 11-17, 2013

UN mercury treaty agreed by 140 countries

DTUK_issue2_1-5.indd 1

the journal of

United Kingdom Edition

| meetings

BACD Conference review

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

| opinion

Posterior Composites in General Practice

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

Sales Executive
Joe Ackah
Tel: 020 7400 8964
Joe.ackah@
healthcare-learning.com

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

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

| diary

Clinical Innovations Conference 2013

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

Follow us on Twitter
17/01/2013 16:01:53

[31] =>

United Kingdom Edition

Classified 31

March 11-17, 2013

S P E C I A L I S T D E N TA L A C C O U N TA N T S
- Assistance with Buying & Setting Up Practices
- Tax Saving Advice for Associates and Principals
- Incorporation Advice
- NHS Contract Advice
- Particular Help for New Associates
- Help for Dentists from Overseas
- National Coverage
- We act for more than 650 Dentists

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

N SDAL

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

National Association of
Specialist Dental Accountants & Lawyers

N SDAL
Dental Support Service
National Association of
Specialist Dental Accountants & Lawyers

N SDAL

Consistently achieves excellent results in all of
National Association of
Specialist Dental Accountants & Lawyers

its courses

We are now recruiting for the following courses:

N SDAL
National Association of
Specialist Dental Accountants & Lawyers

• NEBDN National Diploma for Dental Nurses
Starting May 2013
• NEBDN Certificate in Dental Radiography
Starting February 2013
• NEBDN Certificate in Oral Health
Starting March 2013
• City and Guilds Diploma in Dental Nursing
Starting June 2013
If you are interested in becoming one of our successes
Contact us for more details
Tele: 0208 555 9000
Email: info@dentalsupportservices.co.uk

Selling Your Practice?
n Professional Sales Agency
n Practice Valuations
n Nationwide Service
n Register of Buyers
Telephone: 01904-670820
Email: martyn.bradshaw@pfmdental.co.uk
Web: www.pfmdental.co.uk

[32] =>

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[cover] => DT UK No. 5, 2013

[toc] => Array ( [0] => Array ( [title] => News [page] => 01 ) [1] => Array ( [title] => Speakers announced for the Clinical Innovations Conference 2013 [page] => 10 ) [2] => Array ( [title] => Money Matters [page] => 12 ) [3] => Array ( [title] => Bridging the gap between porcelain and fibre-reinforced composite bridges [page] => 16 ) [4] => Array ( [title] => The importance of occlusion [page] => 19 ) [5] => Array ( [title] => 10 Top Tips - Financing the purchase of your first dental practice [page] => 22 ) [6] => Array ( [title] => “Setting Up On Your Own” [page] => 23 ) [7] => Array ( [title] => Turn your good practice into a great one – part two [page] => 24 ) [8] => Array ( [title] => Integrated Care Pathways [page] => 26 ) [9] => Array ( [title] => Industry News [page] => 28 ) [10] => Array ( [title] => Dental Tribune UK Editorial Board [page] => 30 ) [11] => Array ( [title] => Classified [page] => 31 ) ) [toc_html] =>

Table of contents

[toc_titles] =>

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