DT UK No. 8, 2011

Time for a re-call / News / Around the world in 80 webinars / Regulations - regulations / Once upon a time...a title story / Save a tooth - treat the root / Getting Up-to-Date / Infection Control Tribune / Looking after the face of your practice / Creating a beautiful dental arch / Orthodontics / Industry News / Events / Classified

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April 18-24, 2011

PUBLISHED IN LONDON
News in Brief
Mammoth joke?
A Red Cross charity shop in
Umeå in northern Sweden
has received an unlikely donation. Quite unlike the usual
donations of clothes or decorations the team of volunteers
were given two sets of teeth
from a prehistoric mammoth.
They received the gift on
April 1st and thought at first
that it was an April fool’s joke.
The teeth, which were in possession of a resident at an
elderly resident’s home who
had passed away, are to be
checked out by the Swedish
Board of Agriculture; if they
are not of any monetary value then the charity shop will
be allowed to display them.
Art and science unite
Art and science have united
for a project needing 12,000
baby teeth to decorate a “coral castle”. The idea, which
came from a meeting between Professor Sara Rankin,
a biologist at Imperial College London, and the artist
Gina Czarnecki, is aimed to
inspire debate about adult
stem cells. They say arguments about stem cells are
focused mostly on the ethics
of using embryos and that
some scientists are trying to
grow new teeth using dental
pulp in milk teeth. Children
are being asked to donate
their teeth to the project,
called Palaces, which will
then create a magical sculpture out of them. The children won’t miss out however
on the tooth fairy as they will
be given an IOU toothfairy
token in return for their baby
teeth. The artwork will go
on display at the Bluecoat in
Liverpool in December and
then move to the Science Museum in London next year.
Teen hits high notes
A talented teenage singer
who was diagnosed with
oral cancer when he was just
ten years old, has realised
his dream of singing again.
Eddie Masih was left with
severe paralysis on one side
of his face after undergoing operations to remove
the tumour, which made
it very difficult to sing. But
he was determined to sing
again and Eddie recently came third in a World
Music Radio competition.
Having
been
encouraged by people’s positive
feedback and comments onsocial networking sites Eddie is now more determined
than ever to try and forge a
career in music and is looking forward to doing more
gigs and attending the X Factor
auditions in the near future.

www.dental-tribune.co.uk

News

MSc Blog

The future of dentistry
Students celebrate at awards

page 4

VOL. 5 NO. 8
Infection Control Tribune

Around the world

Elaine Halley on research and
reading

page 7

Infection prevention

Events

Better oral health

Richard Musgrave discusses the
importance of cleaning

Colgate delivers at the Dentistry
Show

pages 14-15

page 30

Time for a re-call

See low risk patients every two years, dentists are reminded

D

entists
are
being
reminded of their duty
to adhere to the National Institute for Health Clinical Excellence guidelines for
dental appointment recalls.
One point that has caused debate is that dentists in England are reportedly seeing patients more than they need to.
According to the briefing, this
is in breach of their government contracts.

recall interval is a professional
and ethical requirement and
helps patients to maintain good
oral health.”

NICE guidelines state that
adult patients should be recalled between three months
and two years, “based on a risk
assessment, taking into account
a checklist of risk factors, such
as alcohol and tobacco use”
whilst the recommended interval for children is between
three and 12 months.

“The opportunity to see
healthy patients to detect disease before it was serious
enough to produce symptoms and to institute a regular
programme
of
preventive
advice was the norm; therefore
it has taken time for patients
and the profession to adjust to
this change.

The guidelines also state
that “the new dental contract,
which will be based on registration, capitation and quality,
and remove the need to meet
a UDA allocation, is likely to
make the implementation of the
NICE guidelines easier.”

“Some patients still have
an expectation to be seen sixmonthly.

According to reports, England’s CDO, Barry Cockcroft,
has sent copies of the new
briefing to all dentists, stating
that the figures from April to
September last year show that
13 per cent of patients are being recalled for checks less
than three months apart, and
that 58 per cent of patients are
seen at three-to-nine month
intervals – “which means
that 71 per cent of people are
re-attending within a ninemonth period”.
It added that: “Ensuring patients are given an appropriate

A spokesperson for the BDA
said: “The NICE guidance on
recall intervals represented a
significant change for dentists
and patients alike. Six-monthly check-ups have been the
backbone of NHS dentistry
since its formation.

“As you know, the guidance states that the appropriate interval will depend on an
individual’s clinical and risk
factors- and according to
CDO’s letter, the dentist will
take a patient’s views on board
before making a final decision,
so there is an element of ‘agreeing this between patient and
dentist.
“Many patients want to see a
dentist more frequently (either
to pick up problems early, such
as gum disease, or for reassurance about their oral health)
and dentists have to change patient habits as well.
“The BDA agrees that recall
intervals need to be tailored to
the individual and based on the

risk status of the patient. There
are a wide range of risk factors
to decide upon the recall interval, including the following
major ones:
Smoking or tobacco use,
excessive alcohol use, cardiovascular disease, bleeding
disorders, anti-coagulants, immuno-suppression,
diabetes,
glucose medications, phenytoin, acid reflux, lack of fluoride, high caries in mothers
and siblings, recent and previous periodontal disease, high
sugar intake, high acid intake,

new decay, anterior fillings,
root caries, heavily restored
dentition, mucosal lesions,
poor oral health, plaque retention factors, low saliva flow,
tooth wear, no fluoride, poor
attendance pattern, and people
with special needs.
“The guidance doesn’t necessarily clarify, ‘how many?’ of
the risk factors or ‘how bad,’
these need to be to achieve
an ‘at risk’ status, so interpreting what is an appropriate
recall period for a given patient
may not always be clear cut.” DT

[2] =>

2 News

United Kingdom Edition April 18-24, 2011

New stem cell research
S

study shows for the first time
that they can in fact act as stem
cells in this way.

The study, funded by the
Medical Research Council, is
published today in the journal,
Proceedings of the National
Academy of Sciences (PNAS).

Perivascular cells are scattered throughout the blood vessel walls and are involved in the
first response to tissue damage,
as an increase in blood supply
travels to the site of the damage.
Therefore the number of these
cells is naturally increased
at the site. As these cells are
present in most human tissue,
they could be utilised to provide
an effective natural mechanism
for organ and tissue repair.

cientists from King’s College London have uncovered the first genetic evidence that shows cells found on
the surface of blood vessels can
act as stem cells to assist in both
organ growth and tis sue repair.

Up until now it has not been
possible to show that a blood
vessel (perivascular) cell can
transform into a different cell
in vivo (in animals), but this

The researchers carried out

experiments in rodent incisor
teeth,
which
continuously
sharpen themselves by the
shearing action of their tips. As
tissue is lost during sharpening,

this must be continuously replaced. The experiment showed
that perivascular cells act as
stem cells and differentiate into
specialised cells when needed.

The team found that when a
tooth is damaged, specific new
tooth cells (odontoblasts) are
made by these perivascular
cells to regenerate the tooth. DT

Secretary of State for Health to address
British Dental Conference and Exhibition

ecretary of State for
Health, Rt Hon Andrew
Lansley CBE, (pictured),
will address the 2011 British
Dental Conference and Exhibition on Thursday 19 May,
it has been confirmed this
week. Mr Lansley will speak
at 11am on the first day of the
event, which takes place at
Manchester’s Central Convention Complex.
Delegates at the event will
have the opportunity to hear
first-hand from Mr Lansley

about major reforms to dentistry in England. His appearance will come at a pivotal
time for dentistry as pilots intended to develop a new dental contract begin. Commissioning arrangements, too,
will be in the spotlight, as
discussions about the establishment of a new national commissioning board
that would be responsible
for dental care continue.
Mr Lansley is expected to participate in a question and answer session following his

address, which replaces the
previously-advertised appearance by Parliamentary UnderSecretary of State Lord Howe.

Dr Susie Sanderson, Chair
of the British Dental Association’s
Executive
Board,
said: “We are delighted to be
welcoming the Secretary of
State to Manchester for the
2011 British Dental Conference
and Exhibition. Dentistry in
England is in a period of transition that we hope will witness
the replacement of the flawed

2006 dental contract with a
system that works better for
patients and dentists alike.
Significant changes to commissioning arrangements that will
see dentistry commissioned
by a national board, rather
than primary care trusts, proposed in the Health and Social
Care Bill, are also being
debated.

Dentists from across England attending the event will be
keen to learn more about the
Government’s proposals.” DT

Special service award to civil servant

erry
Read,
Head
of
Oral Health and Dental
Education at the Department
of Health (DH), was honoured
by the Faculty of Dental Surgery
and the Faculty of General Dental Practice at their joint Diplomates Ceremony held on 1 April
2011, receiving a Special Service
Award to recognise his outstanding contribution to the faculties

and to dentistry as a whole.
In the citation given by
Professor Derrick Willmot, the
Dean of FDS, it was noted that
Jerry has risen rapidly through
the ranks at the DH, taking responsibility for many aspects
of dental and oral health including the development of
mandatory continuing profes-

sional development for dentists
and dental care professionals. He was appointed Senior
Principal Civil Servant in
1999 and is currently leading on
oral health promotion and dental
education.
Professor Willmot added
that: “one of Jerry’s most notable achievements was his tireless

Dentist jailed in UK
V

inisha Sharma, 37, who
worked as a dentist for
the NHS in Britain, has
been jailed for three years after
falsely claiming to possess dentistry degree from an institute
in Amritsar.
Following a complex investigation by the NHS Counter Fraud Service Sharma was
sentenced
at
the
Wolver
hampton Crown Court after
pleading guilty to seven counts
of forgery.
Over a nine year period

Sharma earned almost 230,000
pounds while working on the
basis of the false Bachelor of
Dental Surgery degree, which
she claimed to have completed
at the Sri Guru Ram Das Institute for Dental Sciences and Research in Amritsar.

Her deception was eventually uncovered following claims
that she had removed the wrong
teeth from a patient.
Judge
Amjad
Nawaz
described Sharma’s offences
as ‘pre-determined and delib-

erate’ breaches of the public’s
trust.
Reports quoted him saying:
“It does seem to me that the
level at which this offending
took place and the organisation
which must have gone behind
it in order to obtain the documents, was very pre- determined
and, in those circumstances, highly criminal. Much of
what, sadly, she was telling
people was a lie - that is the sad
truth behind the offending in
this particular case.” DT

and successful work over many
years to promote water fluoridation in the UK.”
Russ Ladwa, Dean of the
FGDP(UK), said: “Jerry Read
has played a key role in improving the oral health of the nation
during his career at the DH. His
help and advice to dental professionals and DH officials over the

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

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

years has been invaluable and
highly regarded.”
The Special Service Award,
an inscribed medal bearing
the arms of The Royal College of
Surgeons of England, is presented only to individuals inrecognition of their outstanding service to dentistry and the dental
faculties. DT

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@
dentaltribuneuk.com

Design & Production
Ellen Sawle
ellen@dentaltribuneuk.com

Editorial Assistant
Laura Hatton
Laura.hatton@dentaltribuneuk.com

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

[3] =>

News 3

United Kingdom Edition April 18-24, 2011

Editorial comment

T

here is a new
scheme concocted by the
Government to help
them cut red tape
and bureaucracy for
us poor little folk in
the real world. The
Red Tape Challenge,
launched at the beginning of this
month and due to run for two years,
aims to look at the 21,000 bits of
red tape and regulation across all
walks of British life with a view

to letting the public have their say
on what should stay, what should
be amended and what should be
consigned to the tape shredder.
According to the Telegraph, dentists have already availed themselves of this opportunity to voice
their displeasure about the CQC.
Dentist Ross Hobson is reported
as writing: CQC do not understand
that dentistry is a small business

and does not have large numbers
of staff to spend hundreds of hours
completing forms, undertaking
useless audits to ‘show on paper’
that compliance is met. There is far
too much reliance on box ticking
exercises, and total lack of understanding that professional staff are
professionally regulated and work
to the highest standards as their
commitment to the profession.
Dental professionals across
the country have been calling for

an opportunity to our their criticism about the CQC and whether
it is relevant to the regulation of
dental practice for a long time;
here now is a chance to do it. If
you feel strongly about the level of
regulation and red tape surrounding the dental profession, now is the time
to voice it: go to www.
redtapechallenge.cabinetoffice.gov.uk/home/
index/ DT

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

Proposals should
go further - BDA

G

overnment plans for dental public health are targeted in the right direction, but do not go far enough, the
British Dental Association (BDA)
has warned. While supporting
both the broad approach of the
plans and some of the specific
proposals in the Government’s
Healthy Lives, Healthy People
white papers, the BDA would like
to see a more ambitious approach
to dental public health.
The creation of a target for
improving the oral health of
five-year-olds, which reflects the
Government’s stated intention to
reduce the level of dental decay
in children, is a very positive step,
the BDA believes. With a generation of British adults with heavily
restored dentitions and complex
needs now entering later life, the
BDA believes that a target for improving the oral health of older
patients should also be set.
The targeting of a reduction
in the consumption of specific
food products is also supported by the BDA but they believe
that a stronger approach to reducing sugar intake would be appropriate.
An issue with the size of the
dental public health workforce
is also raised by the responses,
which warn that more Consultants in Dental Public Health are
needed. The BDA believes the expertise of these individuals must
be fully integrated into wider
public health structures and utilised in the formulation of the
proposed Joint Strategic Needs
Assessments and Health and
Wellbeing Strategies.
A major concern for the BDA
is the Government’s proposal for
a health premium, a proposal it
believes would see money pour
into areas that are able to demonstrate improvements, rather than
those that really need funding
to meet the challenge of changing behaviour. Furthermore, the
BDA’s response challenges Government to ring fence a dental element of the public health budget
in order to protect spending on
this vital area. DT

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[4] =>

4 News

United Kingdom Edition April 18-24, 2011

Celebrating the future of dentistry

O

Innovation and the Award for
Intercalated Studies were judged
by an independent panel of leading dentistry experts, including
Dr Amarjit Gill, President of the
British Dental Association, Professor Nairn Wilson, Dean and
Head of King’s College London
Dental Institute, Professor Trevor
Burke and Edward Attenborough, President of the British

n Saturday 2nd April at
the 2011 3M ESPE Dental Student Awards the
achievements of the country’s
brightest young dental rising
stars were celebrated.

an insightful debate on the future
of dentistry from some of the industry’s most influential figures.
This inspiring and eye-opening
debate embodied the theme of
the event.

Guest were welcomed at a
drinks reception where the finalists had a chance to network
with leading dental professionals
as well as the esteemed judging
panel. The awards were preceded by a morning on Innovative
Solutions for the General Dentist
– 2011 and Beyond with speakers including Dr Hein de Kloet,
Professor Trevor Burke and Dr
Avijit Banarjee and followed by

The three categories in the 3M
ESPE Student Dentistry Awards
2010-11 were the Award for Innovation, the National Award
for Innovation, which went to
Laura Cove, from Bristol Dental
School, and the Award for Intercalated Studies, which went to
Charlotte Currie from Newcastle
Dental School.
Both the National Award for

Dental Trade Association. The
judges were highly impressed
by the number of entries submitted and the calibre of the students entering across the three
categories, which made the judging process both challenging and
rewarding.
The winners all received financial support for research

projects, electives and intercalated studies.
The awards were open to all
third-year students as well as
those looking to undertake an
intercalated degree in UK and
Irish dental schools, through a
new dedicated and interactive
website,
www.3mespe.co.uk/
dentalstudents. DT

Winners of the Award for Innovation, Laura Cove, the winner of the National Award for Innovation and Charlotte Currie, winner of the
Award for Intercalated Studies together with the 3M ESPE Dental Schools judges; Professor Trevor Burke, Professor Nairn Wilson, President of the BDA Amarjit Gill, John Rafelt from 3M ESPE and Edward Attenborough, President of the BDTA.

Gum disease ‘more harmful than diabetes’

N

ew research suggests
that gum disease carries
a higher risk of causing
a stroke than diabetes, and its
impact is nearly the equivalent
of high blood pressure as a major cause of strokes.
High blood pressure (hypertension) and diabetes (diabetes
mellitus) are widely recognised
as major risks which contribute

to non-fatal strokes (ischemic
strokes). In recent years there
has been growing evidence of
the link between gum disease
(periodontitis) and strokes.
The latest research indicates
that people are twice as likely
to suffer a non-fatal stroke as
a result of gum disease, compared to diabetes. The data
also suggests its impact is
equivalent to people with high

blood pressure.
The research (see below),
was presented at the 89th International Association for Dental Research (IADR) General
Session and Exhibition in San
Diego last month, is another reminder of the serious
impact that poor oral health
poses to general health and
wellbeing.

Although
hypertension
and diabetes mellitus (DM)
have been two major causes
of ischemic stroke, the association between periodontitis and ischemic strokes is
still equivocal. Hence, the authors evaluated the association between periodontitis and
nonfatal ischemic stroke and
compared its impacts with
those of hypertension and DM.

talised
nonfatal
ischemic
stroke cases and 214 nonstroke population controls.
After controlling for potential confounders, periodontitis
was strongly associated with
ischemic stroke. In conclusion
it was stated that periodontitis is an evident independent
risk factor for nonfatal ischemic stroke and its impact is
almost same as that of hypertensionand higher than that of
DM. DT

Devon dentist cycles
for children’s charity Expert witness
dento-legal risks
D
T
A case-control study was
performed with 143 hospi-

evon Dentist Andrew
Pickering, (pictured), is
cycling from Lands End
to John O’Groats to raise money
for the Butterfly Hospice.

The 100 mile journey, which
will begin 14th May 2011, is being organised by Team 900, a
team from Devon who hope to
raise money and awareness for
the Butterfly Hospice in China.
The Butterfly Hospice opens
their doors to abandoned children who have less than six
months to live, giving loving end
of life care when the children
need it most.
The Butterfly Hospice was
started by Devon couple Alan and
Lyn Gould. Since they opened the
hospice in April last year they have
given end of life care to 18 abandoned babies. With the aid of sur-

gery they have good news for four
children who are now well and
six who are awaiting adoption.

Butterfly Hospice www.butterflych.org Registered charity
1116192 DT

Andrew has had kind donations and support and wishes
to thank all those that have supported him so far. Andrew would
like to extend special thanks
to Ivoclar Vivadent, Chris Fleet
from Fleet Hypnosis and Derek
Brunt for Juice Plus, Torquay
for their support for this worthy
cause.

he longstanding principle that an expert witness is immune from
being sued was overturned in
the Supreme Court decision
of Jones v Kaney. Having lost
their immunity, experts are
now exposed to the risk of being
sued in respect of evidence given
in court, says Dental Protection.

“We need a lot of support, we
need sponsorship for the charity and also we are looking for
corporate support for our team
while on their journey so that all
the money we raise can be sent to
Butterfly Hospice.”

Kevin
Lewis,
Dental
Director said: “Time will tell
if the removal of expert witness
immunity will lead to a significant increase in claims
against expert witnesses. Members of Dental Protection are
protected by an indemnity
that extends to expert witness
work and we will be closely
monitoring the impact of this

Andrew can be contacted at
Riverview Dental or on his email
andrewgdp@hotmail.co.uk

recent decision.”

“As a matter of good practice, expert witnesses should
follow the relevant guidelines
and rules, including the Civil
Procedure Rules and the General Dental Council’s guidance.
Provided they follow these
guidelines and standards, allegations of negligence can be
rebutted.”
Mr Lewis added: “We would
advise members who are involved in expert witness work
to keep us fully informed about
the type and extent of professional work they are doing,
so that they have access to the
appropriate indemnity at all
times.” DT

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6 News

United Kingdom Edition April 18-24, 2011

Widening access to dentistry
H

ow many 16-year-old students have set their sights
on becoming a dentist?
Some youngsters with that ambition face particular difficulties.
These include students from low
socioeconomic groups and those
studying at institutions with below
average results in national exams.
Yet many such students have the
talent and dedication to make excellent dentists.

On Tuesday March 15th the
Dental Institute at the University
of Leeds delivered a new ‘Becoming a Dentist’ information session
to provide some help to 92 West
Yorkshire students from groups

under-represented in the profession. For example 59 per cent
of them had home postcodes within the most deprived areas of the
UK according to the index of multiple deprivations. A similar proportion came from families where
neither parent had attended
university.

The programme the students
received included talks designed
to increase their insight into
dentistry, as well as information
about the admissions process,
and advice about meeting selection criteria. Four staff members
and six dental students delivered
the talks.

The feedback from those who
attended was outstandingly enthusiastic. Everyone rated the
event good, very good or excellent.
Comments included “it made me
more confident and motivated”;
“It was all useful”; “brilliant and
insightful”.
Following the success of this
new venture the Dental Institute
at Leeds hopes to develop and
extend this form of targeted support. The goal is to ensure that the
dental student body is representative of the communities it serves
whilst at the same time maintaining or improving academic and
professional standards. DT

92 students hear about dentistry from Leeds Dental Institute

‘Looks like a Candle’

Robot ate my molars
T
S
tudent Daniel Raabe, a
former PhD student in
the Queens School of Engineering at the University of
Bristol, has been awarded a
prestigious science prize after
he designed a ‘chewing robot’ to
help understand the wear and
tear of human teeth.

Daniel has also been awarded the Paul Roell Medal in the
prestigious 2010 Zwick Science
Awards for his PhD work in the
area of dental materials testing.

Department of Mechanical Engineering created the robot, which
mimics the action of a human
jaw. Currently, clinical tests of
new types of crowns and other
dental fittings, are usually tested
in human mouths and they are
often time consuming and by the
time a new material has been
evaluated the market has often
moved on.

There were 53 entries from
16 countries competing for the
prize.

The UK currently spends
approximately £2.5b each year
on dental materials, which either replace or strengthen teeth;
however a lack of an adequate
method of field testing is hindering dental development.

Working in collaboration
with the Department of Oral
and Dental Science, researchers at the University of Bristol’s

Reports have stated that Dr
Kazem Alemzadehv, senior lecturer in the Department of Mechanical Engineering at the uni-

versity, came up with the concept
after seeing aircraft simulators
using similar movements.

The design and development
of the chewing robot was carried
out by Daniel alongside Dr Andrew Harrison, senior lecturer
in the Department of Mechanical
Engineering.
Dr Tony Ireland, a tutor at
the Dental School, has also been
involved in the development and
testing of the robot.
Mr Raabe said to reporters: “By reproducing natural
bite forces and movements, the
chewing robot can help improve
and accelerate the process of developing new dental restorative
materials that may someday be
found in a person’s mouth.” DT

ECH-Naissance
Introduces denturevault™, have
produced what has been
described as a “revolutionary dental storage and cleaning container
that ‘Looks like a Candle’”.
After recognising an increasing demand for new hygienic
storage solutions for retainers,
TMD night guards, snore guards,
dentures, and even partial dentures the device, which was
revealed at the 2011 International Dental Show in Cologne,
Germany, has been designed so
people can discreetly clean and
store their removable dental appliances.

conspicuous sonic cleaners, and
the unsightly “teeth in a glass”
method.
However, denturevaultTM, (pictured), uses an elegant design
to create a faux-candle and this
discreet method of concealment
gives the user complete autonomy
in having their appliance always
within reach, overcoming the embarrassment and inconvenience
of traditional methods. DT

Until now, there has been
little choice for storing and
cleaning
dental
appliances
and traditional methods of storage
and cleaning have included the typical horseshoe shaped plastic case,

Patient softDentist celebrates mileware launched stone on top of the world

uring a seminar at the
Royal College of Physicians in London, Dr Tim
Donley helped launch myDentalScore, the new interactive software tool.
Dr Donley told Liz Chapple,
Director of Oral Health Innovations Ltd, that he believed myDentalscore would help motivate and
inform patients and make them
more likely to consult a dentist.

fter visiting a charity’s
table at a conference, Dr
Joseph Pawlik, a Mantua (USA) dentist, decided that
for his 60th birthday he would
travel to the other side of the
world and provide care to children in Katmandu, Nepal.

For more information, or to
invest in myDentalScore for your
website, go to www.previser.
co.uk/products/mydentalscore.
html DT

“I picked the farthest place I
could go, the most extraordinary
place,” Aurora Advocate quoted
the dentist as saying. “I would
go again at the drop of a hat.
It was really rewarding and interesting.”

He said: “I have been waiting
for something like myDentalScore
for some time now. How great it
is that the general public has an
opportunity to gauge their risk
for oral disease. This can only
help motivate the throngs of people with unmet dental needs to
seek care.”
MyDentalScore consists of an

online questionnaire which asks
about dental hygiene and history
as well as lifestyle and delivers a
score along with encouragement
to discuss the findings with a dentist. It is now available for dentists
to brand to their practice and add
as a link to their website.

Heading out with Global
Dental Relief, Pawlik ventured
for the first time outside of
North America to the bustling
city of Katmandu.

Liz Chapple and Dr Tim Donley

Staying in a Buddhist monastery, the team of dentists

treated children from the monastery’s school and orphanage, and also children from the
community.
“Most of these kids have
never seen a dentist,” he
was quoted as saying. “A lot
of them are in good dental
health. It’s surprising because
they don’t have toothbrushes,
but then, that’s probably because they don’t eat all that
junk food.”
In cases where there were
cavities present, Pawlik described how the treatment was
to fill them or extract the tooth
if it was bad.
“It just breaks your heart
when you have to take out their
front teeth,” he was quoted as
saying. “Over here, you can fix

them. There’s crowns. There’s
implants.”
The team of dentists spent a
week in the city, where Colgate
provided free toothbrushes for
the children. They then trekked
to the mountains for two weeks,
intending to treat children in
the villages there.
Having been invited to return to Nepal again, Pawlik said
he is determined to go back as
soon as he has the funds.
“The kids are unlike any
other kids in the world,” he
was quoted. “This is the first
time anyone has poked around
in their mouth, and they don’t
make a move. They’re very disciplined... they’re the sweetest
kids in the world.” DT

[7] =>

MSc Blog 7

United Kingdom Edition April 18-24, 2011

Around the world in 80 webinars
Elaine Halley on research, reading and falling by the wayside

W

ell – lo and behold
I managed to pass
the Unit 6 module!
This was the module all about
research which the University of Manchester decided we
needed to learn sooner rather
than later so that we have some
insight into research before
commencing
our
dissertations. (I am not entirely sure I
know the difference between a
thesis and a dissertation…probably shouldn’t admit that at
this point.)
Great intentions
So – after the trauma of getting
all the cases for Unit 3 in plus
the end of Unit 6 assignment
in, the pressure has eased off
and we are back to webinars
and electronic feedback forms.
I did start off with great intentions of getting my posterior
cases chosen and written up
as I went along – but that has
fallen by the wayside already.
In fact, it was the very presence of a deadline for this blog
which spurred me on to catch
up with the webinars. In my defence, this illustrates the flexibility of this course which does
adapt to your life – as long as
you remember there are deadlines which creep up silently
but surely!
The first webinar in Unit
4 was Trevor Burke on Posterior composites and I fooled
myself into the belief that I
had watched this live – until
my children asked me ‘what
was that man saying?’ and I
realised I had been distracted into family life and had to
re-watch most of it when I was

alone. And worse than that
– apologies Wolfgang – as I
was listening to your webinar,
my husband has banned me
from listening to any more webinars without headphones as
he
complained
that
he

bonding would be fascinating
to a farmer!
Latest controversies
So – Dr Wolfgang Richter’s
presentation on advanced composite techniques, introduced

‘I must confess to never having heard of the
University of Dental Medicine in Jena – and
as it has recently been voted the number
one of 31 Universities in Germany, I stand
shame-faced as to my ignorance’
could hear the ‘voices’ throughout the whole house! And I
thought current concepts in

some of the latest controversies in the science which can
influence us in clinical practice
– including whether we should
be disinfecting our cavities
with chlorhexidine to prevent
the reactivation of matix metalloproteinases. These MMP’s
are thought to be the reason
why composite bond strengths
degrade over time.
After presenting three or four

Prof Trevor Burke

Dr Wolfgang Richter

papers telling us that we should
do this, he then presented a paper which found that there was
no benefit and that with a selfetch system, the bond strengths
could be drastically weakened
– the overriding message being
that we must remember to be
cautious and critical of research
before jumping to change our
clinical practice. An excellent
illustration of how important
it is for us to research claims
independently before changing
our clinical routines.
University of Jena
This was followed by an
inlay/onlay lecture from a
very cheerful Dr Harald Kuepper from the University of
Jena in Germany. My postgraduate education to date has
been mostly US based and so
I must confess to never having heard of the University of
Dental Medicine in Jena –
and as it has recently been voted the number one of 31 Universities in Germany, I stand
shame-faced as to my igno-

rance. Perhaps Dr Kuepper has
never heard of Perth, Scotland
either..?
Time flies
This unit, there has been very
little notice as to when the lectures have been taking place.
This is very frustrating as although it is entirely possible
to watch the webinars live, you
do miss the opportunity to ask
questions. Although all the lecturers provide an email contact
– there is something about the
contemporaneous nature of the
chat box which is missing after
the event. Of course, the second
intake of students will have
started their first term. I hope it
is all going smoothly for them
– I remember it well and how
time flies when you’re enjoying yourself! I cannot believe
we are now over a year into our
studies... DT

About the author
Elaine Halley BDS
DGDP (UK) is the
BACD
Immediate
Past President and
the principal of
Cherrybank Dental
Spa, a private practice in Perth. She is
an active member
of the AACD and
her main interest is cosmetic and advanced restorative dentistry and she
has studied extensively in the United
States, Europe and the UK.

[8] =>

8 GDPUK

United Kingdom Edition April 18-24, 2011

Regulations, regulations

known about the GDC’s conduct
Committees and the way cases are
taken forward and tried.

Tony Jacobs discusses the hot topics of the dental profession

eelings have been riding high regarding the
methods and conduct of
the regulators of the dental profession, something that was just
not the case a few years ago.
To me it is not the fact the levels of respect to institutions

have changed, it is that so many
methods and operations of our
regulators have become illogical
these days, against the morals and
values of so many of the profession.
I feel the GDC have done some

things to address dentists’ feelings,
the ARF has risen, but there seem
to be steps being taken to prevent
the New Year’s administrative removal from the register if bank
account or cheque payment goes
astray. On a much more important level, an august and respected

body such as Dental Protection
has gone on record to criticise
the methods of the Professional
Conduct Committee of the GDC.
This article, in a DPL publication,
was read widely, discussed and
dissected and colleagues on GDPUK definitely made their feelings

The Pioneers of
Teeth Whitening

Talking of regulators, this part
of my GDPUK column does not
even start to capture the professions feelings of dismay and fear
of the lack of both credibility and
trust in the CQC. In the week the
CQC sent out 4,000 emails to the
wrong people, it became more and
more clear that no-one can believe
a single word communicated by
the CQC, either by email, on paper
or on the telephone. Their goalposts and not just moving, they
are on a perpetual roundabout!
The words “not fit for purpose”
must be the most common phrase
when CQC is mentioned.
At least GDPUK has a role in
allowing colleagues to share news
as it develops, to reassure one another the nightmare may soon be
over, and to share the responses
framed by the various representative organisations. Those organisations themselves may base some
of their response on the outcry on
GDPUK, but they will never tell
us that. It must be reassuring for
the leaders of those organisations
to review the vox pop as shown
on the site, and to develop policy
which echoes this.

%
30

There has been so much else
to follow this month; here is a
small sample.
A variety of surgery keyboards have been discussed,
some are more clinical appearance, and there is a wide variety of prices, for a few pounds
[almost disposable] to the higher quality shiny white ones.
One was recommended which is
not just washable, it’s dishwasher
proof.
A puzzling topic, which did
not get a full answer, but it seems
a worldwide regulation that pilots
cannot fly for 24 hours after having an LA. Have you heard of this?
No-one seems to know why.

%
22
%
16
%

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We have discussed the change
in the pattern of the genders
of students admitted to dental
schools. We wonder how this
will affect the profession in the
coming years, and this lead a
number of colleagues to reminisce
about their days as students. One
GDPUK colleague was awarded a
chair as Associate Professor, and
a friend of his from student days
remembered an answer given by
the now professor as to treatment
of a snail track ulcer in the palate
– “cut it out with an air rotor” said
the star pupil! DT

Tony Jacobs, 54, is a GDP in Manchester, in practice with partner Steve
Lazarus at 406 Dental. Tony founded
GDPUK in 1997, and the website now
has over 11,500 unique visitors each
month, who make 50,000 visits and
create over 2 million pages on the site
every month. Tony is certain GDPUK.
com is the liveliest and most topical UK
dental website.

[9] =>

Opinion 9

United Kingdom Edition April 18-24, 2011

Once upon a time...a title story
Roger King Cambridge GDP and Ex-Wellcome Research Associate in the History of
Medicine at Cambridge University, sheds some light on the Dr title debate

T

here seems to be some
confusion in the profession
regarding the story of how
the use of the title ‘doctor’ by the
medical profession came about,
and around the historical reasons
for and against its use by dentists.
I’d like to try to make the historical
context of this now-contentious title a little clearer.

the eighteenth century, a small
number of French surgeons, centered around Paris and epitomised
by Pierre Fauchard, began to specialise: teeth, eyes and childbirth

were prominent areas of surgical
practice to which they turned their
attentions.
Physicians, or ‘doctors’, have
retained their original title out of

Dentistry’s origins lie within surgery. Around the start of

So the debate will continue. Me?
I hold a doctorate - in history - but
my patients still call me ‘Mr’. DT

I WOULDN’T WORK
WITHOUT THEM

The physician’s services were
generally offered to those with the
means to pay well. He had attended a school of medicine, which in
England meant Oxford or Cambridge until relatively recently. In
order to gain entry to this medical
school, he (and, for this period,
it was only ‘he’) first needed to
hold a higher degree, the granting of which would require him
to defend an original thesis. This
degree had been in existence for
many centuries as the doctorate, a
word taken from the latin docere,
to teach. Thus, the physician was
a doctor before he even entered
medical school. As a theoretical
man, working on an intellectual
level, actual physical contact with
the patient was rarely required.

Physicians, then, took the
title of doctor because they already held a doctorate.
Surgeons, on the other hand, held
no degree and retained the title
of ‘Mr’. It can still be noted that
medical surgeons revert to the
‘company’ title with some degree
of pride, setting them apart from
their physician colleagues.

margin.

ORASCOPTIC
M A G N I F I C AT I O N
& I L L U M I N AT I O N

Throughout the seventeenth,
eighteenth and into the nineteenth centuries, three distinct
types of practitioner offered ‘orthodox’ (whatever that may mean
- the subject of a different debate)
cures: the physician, the apothecary and the surgeon. For the
purposes of this title debate, it is
the physician and the surgeon that
concern us.

The surgeon’s services were
employed by a wider population. The surgeon was a practical man - he had served a long
apprenticeship, usually seven
years, to a master and performed
a masterpiece (with no written
examination) to gain his right to
join the Barber-Surgeons Company. This was a guild, which took
its place alongside other liveried
companies, such as those of the
Goldsmiths, Coopers and Drapers. On 2 May 1745, royal assent
was granted to the formation of
the new, independent Company
of Surgeons.

courtesy. Dentists never held this
title historically - the universityconferred dental degree post-dates
that time when ‘doctors’ ceased to
hold bona-fide doctorates by some

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[10] =>

10 Feature

United Kingdom Edition April 18-24, 2011

Save a tooth - treat the root
Dental Tribune looks at the launch of the Saving Teeth campaign in the UK

H

aving a tooth drilled can
be the most nerve wracking idea for patients, and
can ultimately put them off having any kind of restorative tooth
treatment. The thing is, according
to experts, root canal treatment
should in fact be the first choice
where possible for anyone with an
infected tooth; however, every year
thousands of teeth are still being
pulled out as a result of infection.

Aesthetically, you would think
that patients would rather save
their tooth instead of living with a
gap or forking out for costly dental implants, but this is simply not
the case. Referring to the latest figures from the NHS, more than two
million teeth were extracted last
year, whilst only half a million
root canal treatments were carried out. These figures suggest
that patients are not receiving all
the information.
Anxieties
The recent Adult Dental Health
Survey showed that 30 per cent
of adults are extremely anxious
about having a tooth drilled, and
when someone feels anxious it’s
not easy to make decisions. So how
many of these patients made their
choice with all the information in
mind? Were they fully aware that
with modern techniques root canal therapy can be painless?
Patients should be informed

that if an infected tooth is left
untreated it will result in bone
loss, but they should also be informed that root canal treatment
can ensure the survival of their
tooth. In this day and age a variety
of cosmetic dental surgery is
available and patients could
easily assume that saving teeth
isn’t a top priority for dentists, or
even the best choice for the patient. Of course, if a tooth can be
saved, it should.
Fortunately for patients the
Saving Teeth Campaign has been
launched by the Harley Street
Centre for Endodontics, meaning
that for the first time in Britain
there will be a campaign that will
provide this much needed information for patients who are faced
with a tooth infection. The Saving Teeth Campaign aims to raise
awareness of the benefits of root
canal treatment and the choices
patients have.
The campaign’s key messages
include:
• Saving a tooth is, where possible,
better for the health of your mouth
• A well root-treated tooth covered with a crown can survive for
many years if not for the rest of
your life
• If a tooth becomes infected and
left untreated bone loss can occur
There is a similar campaign
in America fronted by the Ameri-

Juilian Webber and Trevor Lamb founders of the Saving Teeth campaign - www.savingteeth.co.uk

can Association of Endodontists
(AAE). The aim is to let patients
know that if they are faced with
tooth loss they can consider Endodontics and they achieve this with
photo competitions, articles in
newspapers and posters all over
dental practices. Compared to the
UK, there are more than 15 million root canals performed annually in the USA.
In support of their Root Canal Awareness Week, the AAE
carried out a survey which revealed that 70 per cent of Americans feared losing a natural tooth
although the same percentage
feared root canal treatment. What

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they didn’t realise was that root
canal treatment is the exact procedure that can save their teeth.
Economic Endodontics
The UK’s Saving Teeth Campaign
is fronted by endodontist Julian
Webber, a world leader in the field
of endodontics and his colleague
and fellow specialist, Trevor
Lamb. Supporters include recognised authorities in areas such as
restorative dentistry, oral surgery,
and the psychology of dentistry
along with patients and high profile supporters Michael Winner
and Peter Snow.
Talking about the campaign

Julian Webber said: “Endodontics
works when done properly and
it saves teeth. It’s an economical
way to preserve a tooth in function
and avoid tooth loss.
“Last year’s figures from the
Information Centre showed that
four times as many teeth were
taken out as there were root
treatments and I believe there
is scope for improving that ratio. If there’s a chance of saving
a patient’s tooth we as a profession should always do so.
Sometimes patients want in infected tooth taken out but we need
to make sure they understand all
the implications of their decision
and know what their choices are.
The literature clearly shows that
teeth treated with root canal treatment with adequate coronal restoration are just as likely to survive
as implant-retained restorations.”
Looking ahead to the future,
the campaign ultimately wants
to see figures showing that the
number of extractions in the UK
has gone down and to see the NHS
recognising and remunerating the
additional skills and costly equipment used by specialists and dentists with additional training.
Most importantly, Saving Teeth
wants to ensure that patients are
being encouraged to seek endodontics, either from their dentist
or from a specialist.
As Dr Webber explained, in
the end the campaign is about
getting dentists to appreciate that
their patients’ interests are really
paramount importance: “Where
possible if dentists think that they
can’t do a difficult case then referring to a specialist should be the
preferred option.”
“At the end of the day, endodontics is usually the best option
for patients and should always be
their first choice.” DT

[11] =>

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[12] =>

See what you
are missing...

United Kingdom Edition April 18-24, 2011

Getting Up-to-Date

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Dental Tribune looks back at an informative and
entertaining evening at the National Motorcycle
Museum in Birmingham...

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ral-B has a great reputation for delivering high
quality seminars, so I was
really looking forward to the 2011
lecture series called Up To Date:
Oral-B Scientific Exchange Seminars. Aimed primarily at dentists, dental hygienists and dental
therapists, the 10-date series of
seminars features a selection of
three well-respected speakers:
Nicola West, Trevor Burke and
Iain Chapple.
Each of the speakers’ presentations was based on the following:

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Iain Chapple: Periodontal Medicine: a window on the internal
medicine of the body. The biological base of Periodontology as a
discipline is vast, as illustrated by
the diverse nature of periodontal
research and its intimate relationship with general health and wellbeing. Medical approaches to care
employ a forensic and systematic approach to history-taking,
physical examination and clinical investigations, focussed upon
achieving a differential and ultimately definitive diagnosis. Once
this is made, medical management involves treating the cause
of the disorder by pharmacological or behavioural approaches
and/or preventing disease onset
or progression. This presentation will attempt to illustrate the
enormous scope of practice of
periodontal medicine, by guiding
delegates through a heavily illustrated and systematic approach to
investigating periodontal manifestations of systemic conditions.
It will illustrate the “tip of the iceberg” of this far reaching and oft
neglected aspect of periodontal
care.
Trevor Burke: A pragmatic approach to the treatment of tooth
wear. In the past, treatment of tooth
wear was often by the crowning of
affected teeth, or by a full oral rehabilitation, with many teeth being crowned, with the aim of protecting their surfaces from further
tooth wear. The irony, of course,
being that the treatment resulted
in much more massive destruction of the affected teeth than the
causative factors themselves. A
strange way to treat teeth which
were already compromised! However, advances in bonding techniques have enabled the use of
minimally invasive treatment using resin composite restorations
bonded to the worn surfaces. This
presentation will discuss the optimum bonding agents for the procedure, the principles of dental
aesthetics and how to achieve an
aesthetic improvement – the con-

cept of pragmatic aesthetics - and
will indicate the rates of success
which may be expected.
Nicola West: New Concepts in
Tooth Wear and Dentine Hypersensitivity. Tooth wear is a multifactorial condition of growing concern
and is becoming increasingly
significant in the management of
our patients. People are now retaining their teeth for longer, becoming more aware of their teeth
and treatment possibilities, and
expecting their teeth to last them
a lifetime. Although there is usually one predominant cause of
wear for an individual, a number
of wear processes often occur together, the most common form,
especially in the younger age
groups, being erosive tooth wear.
One of the effects of tooth wear,
erosive tooth wear combined with
abrasive wear, can lead to the
condition which we are all familiar with, dentine hypersensitivity.
Tooth wear, the fourth most common dental problem after caries,
periodontal disease and trauma,
is likely to increase in the future.
We need to know how to manage
these cases with preventive measures, and most importantly, when
to intervene restoratively, often
committing that individual to a
lifetime of dentistry.
Attending the event held at the
National Motorcycle Museum in
Birmingham, it was the turn of
Iain Chapple and Trevor Burke
to speak. With the room packed
to the rafters as more than 300
people attended the event, both
speakers had plenty to say.
Chairing the event was Dr
Stephen Hancocks, himself not
a stranger to the dental stage.
Prof Chapple was the first to
speak, discussing the ability that
dentists have to save lives by
their knowledge of the oral cavity and periodontal conditions
in particular relating to more
serious conditions manifesting
within the body. Using a series of
pictorial case studies, he illustrated the need for knowledge
and limitations in examination
when looking for signs of underlying disease.
He discussed the importance
of the medical history as this can
give clues as to what could be going
on. Couple this with the examination process, which starts as soon
as the patient enters the surgery,
and it becomes clear that it is possible to help a medical diagnosis
using oral diagnostic tools.
Prof Chapple concluded his
presentation with five main tips:

• Periodontal medicine is a large
subject, but we don’t see what we
don’t look for
• Never treat medical problems
surgically
• Avoid gingival biopsies
• Consider potential for multiple
pathology
• Interpret clinical investigations
with care
Next it was the turn of Philip
Bellamy, a principal researcher
at Oral-B, to showcase the company’s latest innovation in its research – Dental Plaque Imaging
Analysis (DPIA). This diagnostic
tool allows researchers to score
plaque levels during research in
an objective and reproducible
way, standardising their research
for future analysis.
After coffee it was time to hear
Trevor Burke discuss a pragmatic approach to tooth wear.
Prof Burke began by discussing
the ‘golden proportion’ and how
it relates to the aesthetic preferences for dentition. After discussing some of the literature on the
subject, he concluded that there is
no real consensus among dentists
with regard to smile design.
He then began to discuss the
causes of tooth wear in relation
to non-carious means: abrasion,
attrition, erosion, abfraction, resorption. Particular attention was
placed on erosion, which has
been an emerging topic over the
last few years and now is at the
forefront of oral care methodology.
Many of the causes of erosion are
lifestyle related ie acidic drinks,
gastric reflux, medication side
effects. Prof Burke then moved
onto the treatment of tooth wear:
the use of bonding to dentine
techniques, the ‘Dahl’ principle,
composites.
This was an interesting event,
for me personally I found Prof
Chapple’s presentation fascinating because of the potential dentists have to save lives (in fact Prof
Chapple said that his department
saves around ten lives a year because of their diagnoses).
There are still events scheduled for the coming weeks:
5 May Newcastle Life Centre; 12
May London The Royal College of
Physicians; 23 June Glasgow The
Hilton Hotel, Strathclyde; 30 June
Milton Keynes Horwood House
For more information or to
book a place, contact Event Organiser, Julia Fish – email julia@
ab-communications.com or call
07585 508550 DT

[13] =>

Infection Control Tribune
Infection Control Tribune

How clean is your water?

Infection Control Tribune

We did it!

Dentisan discusses biofilm

pages 16-18

Dental Tribune talk to the Hoghton Street Dental
Practice

pages 21-22

Hands-free electronic water
faucets found to be hindrance

A

new study has revealed
that old-fashioned, manual
faucets work better than
new hands-free faucets.

The latest electronic-eye sensors to automatically detect hands
and dispense pre-set amounts
of water have been installed in
the USA based Johns Hopkins
Hospital, however a study has
shown that they were more
likely to be contaminated with
one of the most common and
hazardous bacteria in hospitals
compared to old-style fixtures with
separate handles for hot and cold
water.
“Newer is not necessarily better when it comes to infection
control in hospitals, especially
when it comes to warding off potential hazards from water-borne
bacteria, such as Legionella
species,” Lisa Maragakis, MD,
M.P.H. senior study investigator
and infectious disease specialist,
was quoted. “New devices, even
faucets, however well-intentioned
in their make-up and purpose,
have the potential for unintended

consequences, which is why constant surveillance is needed,” says
Maragakis, director of hospital
epidemiology and infection control at Hopkins Hospital and an
assistant professor at the Johns
Hopkins University School of Medicine.

for bacteria to become trapped and
grow.

Although the new style hightech faucets cut daily water consumption by well over half, Johns
Hopkins researchers identified
Legionella growing in 50 per cent
of cultured water samples, which
were collected from 20 electroniceye faucets. In comparison, the
bacteria were found in only 15 per
cent of water cultures from 20 traditional, manual faucets. Reports
even stated that weekly water culture results also showed half the
amount of bacterial growth of any
kind in the manual faucets than in
the electronic models.

Infection control experts behind the latest study say that the
electronic devices were widely introduced in patient care
and public areas of hospitals
across the United States, where
the idea was to prevent bacterial
spread from people touching the
faucet’s water handles with their
dirty hands.

The precise reason as to why
there is a higher percentage in
bacterial growth on the hands-free
taps is still unknown; however,
researchers have suggested that
the valves offer additional surfaces

The Johns Hopkins researchers presented their findings at
the annual meeting of the Society for Health Care Epidemiology
(SHEA) in Dallas in April.

Reports have stated that as
a result of the study, which was
conducted over a seven-week
period from December 2008 to
January 2009, Johns Hopkins
facilities engineers removed all 20
newer faucets from patient care
areas and replaced them with
manual types. A hundred similar
electronic faucets are also being
replaced throughout the hospital,
and hospital leadership elected
to use traditional fixtures – some
1,080 of them – in all patient care
areas in the new clinical buildings currently under construction
at Johns Hopkins’ East Baltimore
campus. The new buildings are
set to open in 2012.
Lead study investigator Emily
Sydnor, MD, a fellow in infectious
diseases at Johns Hopkins, says
Legionella bacteria, commonly
found in water supplied from
public utilities, rarely cause illness in people with healthy immune systems, but pose a real
risk of infection in hospital
patients whose immune systems
are weakened from cancer chemotherapy, anti-rejection drugs after organ transplant, or from diseases such as HIV/AIDS. DT

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[14] =>

14 Infection Control Tribune

United Kingdom Edition April 18-24, 2011

Infection prevention
Richard Mugrave discusses cleaning and disinfection

S

ubstandard hygiene procedures used in the medical profession should never be tolerated. It not only puts
your patients in danger, it can
also put you and your team at
risk. It is necessary, therefore,
to enlist the use of the most

efficient methods of infection
prevention in your surgery. To
this end, it is essential that your
dental team are fully trained in
all methods of decontamination
and informed as to the different
types of harmful bacteria that
can lead to diseases, such as

MRSA and C.diff. Furthermore,
relevant inoculations should be
taken by all staff and recorded.
Before any decontamination
regimes can proceed, it is important to remove and replace
all disposable equipment in

the surgery after each patient.
Then, all areas and instruments
should be ‘zoned’ into ‘clean’ and
‘dirty’ sections. It is worth noting
that you should always clean
from the cleanest to the dirtiest
areas when decontaminating
any surface.

Decontamination can be
used as an umbrella term to incorporate cleaning, disinfection
and sterilisation procedures.
In the dental profession, this is
necessary for maintaining the
hygiene of surfaces and the reprocessing of instruments.
Cleaning:
This removes foreign particles,
such as dirt, from surfaces. It
is also the preliminary step in
reprocessing instruments, and

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‘All areas and instruments should be
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always clean from
the cleanest to the
dirtiest areas

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the successful sterilisation of
equipment as debris can shield
microbes from the steam of the
autoclave.

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Disinfection
This process aims to kill pathogens or render them inert. It is
most often achieved using bactericidal cleaning agents that
are effective against a wide
range of microorganisms.
Sterilisation
The ultimate stage in instrument
reprocessing,
sterilisation destroys all forms of
microbial life, including bacterial spores. It is a process
crucial for those ‘critical risk’

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Cleaning removes foreign particles such as dirt from surfac

[15] =>

ces

United Kingdom Edition April 18-24, 2011

instruments
and
implants
that penetrate human tissue,
as this is where the highest
chance of infection lies. The
autoclave has proved to be one
of the most effective methods of sterilisation. It involves
the use of a machine that subjects instruments to high pressure saturated steam created
using RO (reverse osmosis)
water or distilled water in the
reservoir.
When you look for products to aid you in your cleaning regime, it is important to
remember the type of materials you are cleaning and disinfecting. Sensitive materials
in the surgery, such as leather
and soft PVC are vulnerable to
strong alcoholic chemicals, so
gentle, alcohol-free solutions
would be advisable. Tougher
materials, such as glass, ceramics and laminate work surfaces
can be cleaned and disinfected
with alcohol-based products;
however it would be prudent
to use aldehyde-free solutions.
The largest area in the surgery is the floor and, as such, it
is a potential field for pathogens
to thrive. Look into using a powerful disinfectant with strong
particle loosening properties. In
addition, floors vary greatly in
material, so when purchasing
a cleaner and disinfectant, it is
worth making sure it has high
material compatibility.
Successful cleaning and disinfection products frequently
contain alcohol and yet, section 6.57 of the Department of
Health’s HTM 01-05 regulations
recommend caution when using alcohol based products,
especially on stainless steel,
as alcohol has been shown to
bind blood and fix protein and
biofilm. Clarification is needed
here as this only occurs if the
appliance is in contact with an
alcohol-based solution for at
least fifteen minutes. However,
using such a disinfectant will
only be in contact for a maximum of one or two minutes
with the surface. This is enough

Infection Control Tribune 15
About the author

time for harmful bacteria and
viruses to be destroyed, but nowhere near enough to fix any
proteins. DT
For more information call
0114 2543500 or visit www.
schülke.co.uk
Also view their surface decontamination website at www.
comparethemikrozid.com
9361For
DBG infection
ClinicalGov
The probe
338x244.qxd:Layout 1
control
train-

ing visit www.s4dental.com

1/7/10

13:39

Page 1

Cleaning is the primary step in reprocessing insreuments

Clinical Governance including
Patient Quality Measures Is your practice compliant?

Richard Musgrave
brought his knowledge and experience to schülke 6
years ago. Initially
working to develop
both the range of
infection
control
products as well as
the acclaimed infection control training division, Richard is now responsible for the UK marketing team. He
attributes the success of schülke to the
quality of its product and its dedication
to providing the best possible support
to the dental profession, both in the UK
and beyond. This commitment is demonstrated through schülke’s association with leading companies such as
Dental Protection Limited.

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

The areas the DBG assesses are:

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

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

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

20
YEARS

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

*England only.

[16] =>

16 Infection Control Tribune

United Kingdom Edition

April 18-24, 2011

How clean is your water?
Dentisan discusses the invisible menace of biofilm in dental unit water lines

he increased awareness
of decontamination and
cross infection control
procedures within dentistry and
legislative demands for compliance with HTM 01-05 have
made practices
consider their
Estetica
A4 SELECTED:Layout
1
obligations in regard to infec-

tion control more seriously. Of all
the aspects of decontamination
mentioned in the guidelines one
area that practices may be unaware of is their need to comply
with a minimum standard of water quality,
both Page
in terms
25/2/09
13:42
1 of the
water going into their treatment

centre and certainly in regard to
the output quality of that water ie
the water that goes into the patient’s mouth.
The problem of biofilm contamination of DUWLs has long
been an issue in dentistry, re-

search as early as 19631 first
raised concerns and since then
numerous studies have concluded that biofilm is prevalent
in dental unit water lines (DUWLs). This is mainly due to the
fact that in the majority of today’s
most commonly used treatment

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centres, water is delivered via
small bore tubing, providing an
ideal environment for the development of bacterial biofilms2.
The biofilm itself gives rise
to problems in two key areas:
one; the physical restriction of
the flow in narrow lumens and
two: in significant numbers of
planktonic bacteria in the output
water.
Biofilm
The term biofilm refers to a collection of microorganisms that
adhere to a surface and are surrounded by a protective and
adherent slime (known as the
extracellular matrix) which is
secreted by the bacteria. Biofilms are particularly prevalent
in water containing low concentrations of solids and low levels
of nutrients. As well as DUWLs,
biofilm can be found in streams
and rivers, cooling towers and
piped water systems etc.
Biofilms form when a few
individual bacteria in the free
floating (planktonic) state in water adhere to a solid surface such
as the wall of a pipe or tube. The
initial attraction to the surface
is weak, but subsequent bacteria continue to adhere directly
to those already attached and
behaviour of the aggregated organisms changes and starts to
produce an extra-cellular matrix.
This in turn increases adhesion
and enables more planktonic
bacteria to adhere easily to the
film, and so the process continues, increasing levels of biofilm
and causing water quality levels
to fall below those required by
the guidelines.

Significance of biofilms in
the dental practice
Biofilm is difficult to identify, remove or control because the susceptibility of biofilms to external
agents such as detergents and
disinfectants is quite small when
compared with that of individual
planktonic organisms and each
biofilm bacterium requires only
small amounts of nutrients in order to survive and flourish. Furthermore, the design of today’s
most commonly used treatment
centres makes the dental unit
water line the ideal substrate for
biofilm growth.
DUWLs provide an ideal environment for the growth of bacterial biofilms for the following
reasons:

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• They are non-toxic: the materials used for tubing are selected
for their non toxic properties and
flexibility to suit the mechanical
operation of dental units. Low
toxicity to humans also means

[17] =>

United Kingdom Edition April 18-24, 2011

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Dental unit water lines are a haven for pathogenic bacteria

low toxicity to bacteria.
• Water has a low flow rate: the
small bore tubes used in dental
units provide water at a typical
flow rate of 30ml/min. The behaviour of water flowing through
a tube means that the linear flow
rate decreases from the centre of

harbour many pathogens which
may originate from the input water or by retraction from hand
pieces and high bacterial loads in
output water have the potential to
cause infection in patients or dental professionals either by direct
contact or through the inhalation

‘Biofilms form when a few individual bacteria in the free floating (planktonic) state in
water adhere to a solid surface such as the
wall of a pipe or tube’
the tube to its wall. Low linear flow
rates favour bacterial adhesion.
• Water flows intermittently: water only flows through the tube
when instruments are in use,
causing minimal disruption of
the growing biofilm.
• Regular replacement of supernatant liquid: when instruments
are used or the system is flushed,
fresh liquid is brought into contact with the film, bringing with
it nutrients and new recruits to
join the film. The liquid moving
downstream towards the distal
end of the system carries bacteria released by the maturing film
along with excreted matter.
• The surgery provides an ideal
temperature range: dental surgeries are normally maintained
at “room temperature” for the
comfort of patients and staff. This
is good news for the film-forming
bacteria as they can thrive in this
temperature range.
Why is biofilm bad for the
practice?
The presence of biofilm is bad
news for the dental practice on
a number of practical levels not
least because the quality of output water is covered by HTM 0105 guidance and the presence of
biofilm makes compliance with
this standard very difficult. The
existence of biofilm can lead to a
reduction in water flow and even
tube blockage leading to unit
downtime and repair costs. In
addition, biofilm can potentially

of aerosolised mist. Research by
Reintaler in 1988 found that 30
per cent of dental staff presented
with the antibodies for legionella
and in the USA the figure was 20
per cent. Serious infection within
the dental practice overall is a
genuine, work-related hazard for
the dental team, and all aspects of
this issue need to be addressed.
But ultimately it is the practice of putting water into a patient’s mouth that does not meet
the standards required for drinking water that is problematic.
How would your patients react if
they were to hear that the hand
piece in their mouth contains
contaminated water?
HTM01-05 Compliance
Guidance and regulations continue to impact on the operation of
the dental practice and HTM 0105 deals extensively with DUWS
and gives some useful pointers
but there is general consensus
within the field that the guidelines lack substantive content on
effective measures to control and
prevent biofilm.
In section 6.78 the guidelines
state “Regular monitoring for
microbiological contamination
is not considered essential unless
there are obvious physical signs
of contamination such as poor
colour or smell.” The scientific
community however has long
recognised that water can ac-

commodate large numbers of
bacteria without any noticeable
change in colour or smell and
these symptoms are not an accurate indication of whether water
lines are contamination free.
The guidelines do clearly state
the acceptable maximum level of
microbiological contamination
in section 6.79 “Where monitoring is carried out the microbiological contamination expressed
as TVC (total viable count), the
number of viable bacteria per millilitre of water [cfu/ml]) should be
expected to lie in the range 100 to
200 cfu/ml.” This is similar to the
quality that would be expected
for mains supplies or bottled water.
The guidelines then go on to
indicate a range of measures that
can be used to reduce contamination and include the emptying
and storage of water bottles at the
end of each working day, the use
of disinfectants “periodically” as
a prevention measure, although
no definition of “periodically” is
provided and the flushing of water lines; “for two minutes at the
beginning and end of the working day and after breaks. They
should also be flushed for 20-30
seconds between patients.” Despite this recommendation however, the guidance acknowledges
that flushing has little effect on
biofilm build-up.
How clean is your water?
For many years the problem of
biofilm in DUWLs has been studied and data collected that clearly
demonstrates the presence of
biofilm reduces water quality,
making it unlikely to meet the
minimum standards required by
HTM01-05. In a study by Walker
et al 2000, 95 per cent of samples
taken from DUWLs had contamination levels above the current standard for EU drinking
water. So in order to establish the
quality of output water a practice
needs to be aware of the quality of its input water and then
regularly monitor levels of conà DT page 18

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[18] =>

18 Infection Control Tribune
ß DT page 17

tamination.
Effective solution
For over two years now, a manufacturing company based in
Derby has been studying biofilms in DUWLs and the associated water quality in these
systems. Extensive laboratory
evidence has been collected and
has clearly shown the challenge
of managing DUWLs within the
DH guidelines. The presence of
biofilm in a DUWL system will

add bacteria to the TVC of the
input water, so to have any
chance of compliance, the input
water TVC must be well below
the 200 cfu/ml limit.
The development by Dentisan of Bioclear as a solution
to the problem of biofilm was a
direct response to the research
findings. The challenge was to
develop a material that meets
all the needs of the dental practice in terms of ease of use, reliability and safety and yet is

United Kingdom Edition

effective in controlling and preventing biofilm and at the same
time not harmful to the dental
equipment itself.

system to maintain water quality
of < 200 cfu/ml, in line with HTM
01-05 section 6.79, subject to input water quality.

Practical development work
was undertaken at Nottingham
University School of Biosciences
using an initial grant provided by
Medilink, and in lab trials Dentisan was able to clearly demonstrate that Bioclear has proven
efficacy against the bacteria that
make up biofilm, inhibiting regrowth of the film and enabling a

Biofilm was grown in a flow
cell using bacteria obtained from
a dental unit water line sample and allowed to develop for
10 weeks, the images show that
the Pseudomonas aeruginosa
biofilm was effectively removed
by the product flowing through
the cell.

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April 18-24, 2011

Bioclear
Bioclear is a pH neutral, odourless,
non-tainting,
ready-touse solution that requires no
mixing. Supplied in one-dose
bottles (one bottle is one week’s
treatment per chair), Bioclear is
simply poured into the chair’s
water bottle, drawn through so
that it fills the water lines and left
for a minimum of 12 hours. Once
the treatment is complete the
lines should be flushed through
with fresh water until the water
runs clear.
Award Winning
The work undertaken in the development of Bioclear has been
recognised by a number of bodies and 2010 and 2011 have been
award winning years for Dentisan. Starting with the Lord Stafford Awards, which celebrate innovative collaborations between
businesses and Universities,
Dentisan secured the ‘Innovation
Achieved’ title, quickly followed
by becoming Regional Winners
and National Finalists in the
HSBC Business Thinking 2010
Awards in which Dentisan were
commended for their ability to
identify and meet market needs
and for the significant inroads
they have made in healthcare
and dentistry, by establishing
their own-brand premium infection control solutions.
2011 has continued in the
same manner when last month
Dentisan’s
parent
company
Quadralene was awarded the top
prize for Outstanding Achievement at the Medilink UK awards
2011– an annual event that
celebrates the latest technologies,
outstanding business achievements and international success
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Dentisan believe that the development of Bioclear can make a
huge contribution to the prevention and control of biofilm and
make DUWL decontamination a
problem of the past.

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To combat the problem of biofilm in your practice requires you
first to establish the current quality of both input and output water. Although there are differing
way to carry out this procedure,
in order to simplify the process,
Dentisan in association with
Henry Schein Minerva are providing a water quality test, free
of charge. This simple test uses
the 3M™ Clean-Trace™ Solution,
takes a matter of minutes and is
carried out by Henry Schein Minerva’s field sales consultants in
your practice. DT
References
1 Blake G C. The incidence and control of
bacterial infection of dental units and ultrasonic scalers. Br Dent J 1963; 115: 413-416.
2 Walker, J.T., Marsh ,P.D., 2004. A review
of biofilms and their role in microbial
contamination of dental unit water systems (DUWS). International Biodeterioration and Biodegradation 54, 87-98.

[19] =>

United Kingdom Edition April 18-24, 2011

Infection Control Tribune 19

The simplest of methods
Richard Musgrave discusses how to prevent infection through safe hand hygiene

T

he hands are a dental
practitioner’s most important tool and as such
need to adhere to the same stringent methods of cleaning as
all other equipment used in the
surgery. Both patients and staff
can be put at serious risk of infection from pathogenic invaders as a result of lethal bacteria
being spread around the practice environment by touch. This
makes good hygiene protocols
a must to prevent infection
transmission within a clinical
environment.

• Rotational rubbing of thumbs
clasped in opposite palms
• Rotational rubbing of fingertips in palms
This should take around 30
seconds and is more effective

with a liquid wash solution.
You should then rinse your
hands thoroughly under running water. It is essential that
this procedure is performed
meticulously not only after
visiting the toilet and before
handling food or drink but also

upon entering the surgery, before putting on gloves, after removing gloves, before leaving
the surgery and after clearing
a working area or handling any
instruments.

fective when combined with
the use of gloves and disinfecting alcohol rubs. The latter is
very effective in reducing the
spread of lethal bacteria such
as MRSA on the hands of dental staff.

Washing is made more ef-

à DT page 20

Patient safety rests in your hands

For instance, it is essential
that before any surgery begins,
any cuts or lesions on the clini-

‘Both patients and
staff can be put at
serious risk of infection from pathogenic invaders as a
result of lethal bacteria being spread
around the practice
environment by
touch’

cian’s hands must be securely
covered with a waterproof
dressing before touching a patient’s mouth, as blood or saliva
born viruses can enter or leave
the body via open wounds.
The simplest method to ensure the removal of germs is
the thorough washing of hands,
and if you use the correct hand
washing procedure with just
hot water and soap, you should
be able to destroy the majority
of bacteria.
All jewellery should be removed before washing as pathogens also collect on them. The
best washing procedure for
your hands using soap and water should involve:
• Rubbing palms together, including wrists

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decontamination cabinetry and furniture, washer disinfectors,
autoclaves and sterilizers, data recorders and printers. We can
also provide advice on the latest guidelines.

• Rub the right palm over the
back of the left hand, and left
palm over the back of the right
hand
• Rub palms together, with fingers interlaced
• Rub the backs of the fingers
to opposing palms with fingers
interlaced

For more information

Tel: 01254 844 103
E: sales@prestigemedical.co.uk
www.prestigemedical.co.uk

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[20] =>

20 Infection Control Tribune
ß DT page 19

However, there may be
some side effects in the regular
use of skin-cleansing products,
as it can be detrimental to the
condition of the skin. Indeed,
weaker skin is more prone to
skin complaints and cracking
and this can deter some practitioners from being quite so
strict in their hygiene.
In addition, occupational skin disease such as ec-

zema, are on the increase
in medical circles and can
be
exacerbated
through
excessive washing with perfumed soaps.
Therefore, it is important
that professionals do not leave
themselves open to long term
suffering. To this end, a delicate balance is required to ensure that hands not only remain hygienic, but also that
the professional does not suffer
any ill effects.

United Kingdom Edition

To help this, use soap-free
hand washes and find a rub
that can minimise dryness and
irritation. In addition, at the
end of each clinical session
after washing and drying your
hands, enlist the use of a waterbased moisturising cream or
lotion to maintain healthy skin
on hands and arms.
Allergies are also a severe
issue for many people, and
these can be linked to perfumes, colours and materials,

such as latex. Those with such
allergies can struggle to deal
with them in a clinical environment, as the materials that trigger them are so crucial to the
infection control procedures
used in many surgeries.
For example, the natural
rubber latex (NRL) is the material used in the manufacture
of medical gloves and yet the
number of people with allergic reactions to it is on the increase, especially among those

April 18-24, 2010

in the medical field.
These reactions are due to
the naturally occurring proteins within the material or
many other additives used
within poorer quality gloves
and can result in a red itchy
scaly rash, which may spread
to other areas.
Direct contact is not the only
thing that can trigger these reactions either. Inhaling latex
powder from powdered gloves
can also lead to these severe
issues and in the worse cases,
anaphylactic shock.
When wearing gloves is a
necessity for your work in the
dental industry, such allergies present a real obstacle in
maintaining hygiene regimes.
However, this problem is recognised by many supplies
of gloves and as such, latexfree surgical gloves are now
available. These can be worn
without discomfort whilst still
upholding rigorous infection
control policies.

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With the heightened awareness of infections and viruses
in the healthcare environment,
complying with the new HTM
01-05 requirements regarding
hand hygiene should be essential to every practitioner.
The best products should be
used in the washing, disinfecting and moisturising of their
hands. However, practitioners
need not put themselves at risk
in order to have the most effective solutions.
With this in mind, suppliers,
have produced hand disinfectants, along with soap free hand
washes and protective emulsion with the aim of getting the
perfect balance between infection control and your comfort.

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All staff members should be
advised to use hand-cleansing
products, such as these, to give
themselves and their patients
the best protection possible
from detrimental pathogens. DT

About the author
Richard Musgrave
brought his knowledge and experience to schülke six
years ago. Initially
working to develop
both the range of
infection
control
products as well
as the acclaimed
infection
control
training division,
Richard is now responsible for the
UK marketing team. He attributes the
success of schülke to the quality of its
product and its dedication to providing
the best possible support to the dental
profession, both in the UK and beyond.
This commitment is demonstrated
through schülke’s association with
leading companies such as Dental Protection Limited.
More information on the wide range
of hand care products available from
schülke visit www.schulke.co.uk or
call on 01142 543 500 www.s4dental.
com

[21] =>

Infection Control Tribune 21

United Kingdom Edition April 18-24, 2010

How we did it

Dental Tribune talks to practice manager Janet Edwards on infection control

W

ith all the changes to
dentistry with HTM
01-05 and CQC, one
practice has adopted the guidelines to suit them and work
with their practice and not
against it.
The changes that have been
made at Hoghton Street Dental
Practice has generated masses
of attention; practice manager
Janet Edwards has been invited
to speak at this year’s BDA conference and Schülke UK used
Hoghton Street Dental Practice
for the re-filming of their training packages in infection control.
Janet talked to Dental Tribune about their experience and
how they achieved and managed to comply in the best way
that they could…
“In the beginning we went
in to it blind with just the BDA
guidance on infection control.
To enable us to create a sterilisation room we took over another part of the building that
our practice was in. We relied a
lot on our equipment supplier,
Eschmann, and Martin Loftus,
Business Development Manager at Eschmann, was a great
help. Martin helped us with
the design, setting up the flowthrough and the completion
of the room. Initially we had
looked at dividing the room in
to two rooms but due to practicalities, it was decided that it
was best to leave it as it was. In
the room itself we’ve got four
underbench washers and four
autoclaves and at my other
branch site I’ve got three under
bench washers and three auto
claves. We basically complied
with best standards.”
However, complying with
best standards wasn’t the only
thing that Janet’s practice did.
After the draft of HTM 01-05
came out in 2008, and Martin Fulford, BDS MPhil DGDP
FIBMS, had audited for the
practice, advising on training
issues and even magnifying
lights, Janet started making additional advances towards infection control that have since
made her practices stand out.
“When the room was up
and running we developed our

own system that enabled us to
trace instruments: This way if
there is ever a query about a
patient over a blood born virus we can prove that the tray
of instruments that the patient
had been treated with had gone
through that particular washer,

“I believe no one else does
this and we’ve had quite a few
practices coming in to see how
we work it and how we’ve developed it and they’ve taken
some ideas away with them.”
Issues
However, as with any form of

on that particular cycle, in that
particular autoclave and we
would know that the daily tests
had been carried out on all the
equipment. Basically, we validate the disinfection and sterilisation for patient instruments.

“One of the issues that was
noticed when the washers were
in use was that the number of
hand piece repairs were inà DT page 22

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change, there were issues along
the way, as Janet explained:

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[22] =>

United Kingdom Edition April 18-24, 2011

Flu Season
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ß DT page 21

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creasing rapidly; we have since
put in a handpiece cleaner in
the machine which has drastically reduced repairs.”
Another point to remember
is cost. With changes to your
practice comes a price, such as
setting up the room, the costs of
running machines and changing your electricity supply.
“Many machines that are
used could overload the current supply that a practice has
and this is a cost that people
need to be aware of.” Janet said.
Going back to validation,
Janet explained the process of
having the machines validated
and serviced, the daily and
weekly tests for protein residue
and how the washer disinfectors and the autoclaves need to
have printers or data capture
loggers. Janet described how
they’ve not only got printers on
the autoclaves but how they’ve
also got data capture on the
washer disinfector: “The data
is downloaded on a monthly
basis and saved on two different computers so we’ve got it
backed up.”
The traceability side of
things is something extra that
the practice offers, but ultimately it’s a backup for the
practice.
Rotation system
Janet’s practice also has a heat
seal machine for the bagging
and storage of instruments, and
looking into finer details they
have a tray rotation system to
ensure that no trays are forgotten about. Janet also explained
that if a practice has just been
using autoclaves in the past
they would be used to a 12-15
minute cycle: however, with a
washer disinfector the cycle
time can be up to an hour.

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Nurse uses autoclaves

A nurse examines instruments for any particles

“You have to look at the
number of instruments that
you’ve got and the turnaround
time of getting those instruments back; we had to increase
on the number of instruments
that we had in the practice and
that added to the costs. These

did notice with the patients
was that when we moved to
the instruments being bagged
in the heat machine and breaking the seal in front of them, we
had comments from patients
saying “that’s new isn’t it?”.
When they do notice we explain to them that once the in-

‘I do realise that there is a lot of resistance
out there but it’s for the patient’s best interests; it helps regulate the industry’

are the sorts of things that people need to be aware of.”
“I do realise that there is a lot
of resistance out there but it’s
for the patient’s best interests;
it helps regulate the industry
in that area and if I was a patient then I would want to know
that my practice is as clean as
possible and that I’m not at any
risk of infection.
“If a patient asks us about
our infection control we show
them our sterilisation rooms
and we show them how our
instruments are being processed. Not many patients do
ask to be honest – they just
assume, but one thing we

struments have been sterilised
this is how they’re stored so
they don’t get dirty before they
enter the patients’ mouth.”
“In the end I think it’s important that you do as much as
you possibly can with the
premises and circumstances
that you’ve got; at the end of the
day it’s one of those things that
we can’t avoid.”
Janet will be speaking on
Thursday 19th May 2011 at the
British Dental Conference and
Exhibition at the Manchester
Central Convention Complex
(MCCC), Manchester, (Thursday 19, Friday 20 and Saturday
21 May 2011). DT

[23] =>

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[24] =>

United Kingdom Edition April 18-24, 2011

Looking after the
face of your practice
Jane Armitage discusses bad receptionists

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ith all the talk of
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the CQC and new contracts, it is very easy to drop the
baton and quickly become absorbed in other areas. It made
me think…
In December I was admitted to
Hospital and diagnosed with confirmed H1N1; on my discharge I
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Here I was struggling to breathe
and all I got was “sorry no appointments today, you will have
to ring again tomorrow”. I explained that the hospital had
asked for someone to check me,
but this made not the slightest
bit of difference. I also needed a
letter signed for the cancellation
of my holiday and it required returning within a set amount of
days or my claim would be void;
the reply I got was “It will be at
least three weeks - there other
people before you.” I didn’t question her and I walked away - all I
wanted was to be able to breathe,
I do find it helps.
What an impression this
young lady set for that practice.
I left feeling worse than when I
went in.
I rang the practice later, spoke
to a different receptionist and the
outcome was totally different.
So how does this behaviour fit in
to the CQC requirements? I am
sure there are certain CQC out-

comes where this action did not
meet the standards.
As a practitioner working in
surgery you can’t see what happens in the reception area; you
rely on the professional behaviour of your staff to represent the
standards you set. Speaking as a
manager, although you try, you
can’t see everything that is going
on. I believe the face of the practice is the receptionist. She is the
first contact point and her attitude
can determine if a patient stays or
leaves the practice. At the present
time as an NHS practice UDAs
are vital we need to achieve. As a
private practice you can’t afford to
lose patients at the first hurdle.
This has led me to question my own reception staff. Are
they all singing from the same
hymn sheet, do they go that
extra mile? Sometimes you take
things for granted everything’s
ticking over nicely, nobody’s
complained so why question.
Well, how many have felt uneasy with a receptionist’s attitude
or comment, not complained and
instead gone to a different practice?
How many lost UDAs, how
much lost income? You just
wouldn’t know.
With this thought I decided to
ask someone to contact the practice as a mystery shopper and ask
various questions, some problematic to the reception staff. As a
busy practice we quite often have
more than two receptionists so I
prayed that their training had
worked. The one area that we failed
was a trainee nurse answering the
telephone. No disrespect, but without knowledge and experience this
should be avoided at all costs, unless training under supervision.

Our trainee dental nurse has
had limited access to the reception. I understand she was only
trying to help during a busy time
but sometimes it is a better idea
to answer the phone and collect
the patient details and allow a
trained receptionist to ring them
back, rather than trying to accommodate and answer non
clinical questions when some of
the answers you are uncertain
of. This isn’t helping but could
create trouble for the practice.
Before tackling any question you
have to be certain of your answer, ensuring that any clinical
question is referred to the appropriate clinical person.
This exercise taught me
to ensure anyone answering
the telephone or face to face
conversations
with
patients
had the appropriate training before entering the world of patient
contact.
I have learnt from this experience, what I did to our staff may
not be nice way of checking but
it certainly is a worthwhile exercise where everybody can learn
from the outcome. DT

About the author
Jane Armitage is an award-winning
practice manager and has almost 40
years industry experience. She is currently a practice manager for Thompson & Thomas, and holds a Vocational
Assesors award. She is also a BDA Good
Practice Assessor, BDA Good Practice
Regional Consultant, and has a BDA
Certificate of Merit for services to the
profession. She has her own company,
JA Team Training, offering a practice
management consultancy service,
which includes on-site assistance covering all aspects of practice management with a pathway if required for
managers to take their qualification in
dental practice management. If you’ve
any memories of the early 1970s or any
specific choices of topics you’d like addressed, call Jane on 01142 343346 or
email janearm@ tiscali.co.uk.

[25] =>

Clinical 25

United Kingdom Edition April 18-24, 2011

Creating a beautiful dental arch
Dr Stephanie Lingenfelder discusses the treatment of mandibular and maxillary
crowding using In-Line Splints

ore and more adults
are willing to undergo
orthodontic
therapy for cosmetic reasons.
However, they usually want the
appliance to be as inconspicuous and comfortable to wear as
possible.
In many cases, splint therapy
can be applied successfully, e. g.
in case of anterior crowding in
the upper and lower jaw. In this
case the anterior crowding was
treated with In-Line splints from
Rasteder Orthodontic Laboratory. (www.in-line.eu).
Initial Situation
The 29-year-old patient was
not content with the position of the upper lateral incisors and expressed a desire to have them corrected
with a therapy which should
be as invisible as possible.

In addition to treatment with
the near-invisible In- Line
splint therapy the possibility of a lingual treatment was
also explained to the patient.
A combination of mandibular lingual and maxillary
plate apparatus would also
have been possible, but this
option was not acceptable
to the patient because of the
coverage of the palate and
the resulting impairment of
speech.

was shown a sample of an InLine splint so he could get an
impression of the material, the
robustness and the thickness of
the splint. This solution met his
need for comfort. Wearing is
comfortable, as the upper arch
splints rest on the teeth only.
The splints affect the patient’s
speech only slightly and are
visually barely noticeable.

Course of therapy
In this case, both the upper and
the lower jaws were treated
with five splints each. The patient was given new splints successively at individual checkup appointments, at intervals
of approximately six weeks.
To create additional space,
inter-proximal enamel was

slightly reduced in the mandibular front area. Care was taken
to ensure that the splints worn
had done their complete work
and were now seated precisely
and without tension.
In this particular case, in
the preparation of the splints
a tooth movement of about 0.5
à DT page 26

The proposal of a lingual
treatment took into account the
patient’s desire for an invisible
treatment, which could also
have rectified the deep overbite.
Braces made of tooth coloured
ceramics were rejected by the
patient on aesthetic grounds.
In the interview the patient
was comprehensively informed

‘From an orthodontic point of view, the
shape of the maxillary dental arch is relatively easy to correct. However, it is more
difficult to correct the deep bite and mandibular crowding’
The patient had a closed
bite with crowding in the mandibular and rnaxillary fronts,
as well as a deep bite (Fig. 1
and 2).
The greatest spatial problem was found in the area of
tooth 33 (Fig. 3).

about the various treatment options. Among other things, he

Fig 1

The clear choice for straighter teeth!

As a part of the diagnostics,
a model and OPG were produced. Clinical examination
yielded no other findings relevant for the treatment. As the
patient wanted only reshaping
of his arch in the anterior region, the agenesis of tooth 45
was not taken into account for
the treatment.
From an orthodontic point
of view, the shape of the maxillary dental arch is relatively
easy to correct. However, it is
more difficult to correct the
deep bite and mandibular
crowding.
Therapy Decision
The patient was informed first
that additional shaping of the
mandibular anterior segment
will be necessary to prevent
loss of dental support by the
necessary protrusion of the
median maxillary incisors.

In-Line®, the favourably priced
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Nick Partridge ·UK Sales Manager
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KFO_AZ_INLINE_186x132mm_4c_UK.in1 1

» In-Line® splints correct the
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» In-Line® splints have a continous
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04.05.2007 13:30:36
08.11.2008
15:39:16

[26] =>

26 Clinical
ß DT page 25

mm in the maxillary arch and
of about 0.4 mm in the mandible per splint was programmed
and implemented accordingly.
After six months, the treatment goal was essentially
reached after the wearing of
the fourth splint (Fig. 4 and 5).
By his compliance, the patient made a significant contribution to the excellent course
of the treatment, since he had
worn the splints for the recommended time of at least 18
hours a day.
Subsequently, the patient
received the fifth pair of splints
for fine adjustment and retention. For long-term stabi-Itzation, after initial hesitation on
the part of the patient, a 3-3

United Kingdom Edition April 18-24, 2011

wire retainer was bonded to
the rear of the anterior segment
of both arches.
Thanks to the patient’s very
good compliance, with InLine splints the planned result
was achieved in about the same
time period and with comparable results as with fixed appliances.
Despite the difficulty of
vertical tooth movements with
removable splints, a slight
bite elevation resulted in the
anterior region (Fig. 6). The
de-rotation and alignment of
the mandibular canines also
succeeded well, and the patient
is very satisfied with the results
achieved. DT

Fig 3

Fig 2

Fig 4
Captions
Figure 1: anterior maxillary crowding.
Figure 2 and 3: anterior mandibular
crowding
Figure 4: after wearing the 4th splint the
treatment goal was almost reached.
Figure 5 and 6: after wearing the 4th splint
the treatment goal was almost reached.

Fig 5

Fig 6

[27] =>

United Kingdom Edition April 18-24, 2011

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Orthodontics 27

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orthodontics
and
cosmetic dentistry, the Inman
Aligner provides clinicians with
a simple, minimally invasive
method of treating crooked
anterior teeth discreetly and
quickly, or preparing patients for cosmetic treatments like minimal prep
veneers. Time-pressed or remotely situated practitioners looking to obtain
accreditation now have a convenient way to do so, thanks to Straight Talk
Seminars. Their comprehensive six-week Inman e-course covers treatment
sequence, case selection and case type limitations.
“I found the online Inman Aligner course to be very well presented, concise
and comprehensive,” says Gilbert Ritchie of the Garioch Dental Practice in
Aberdeenshire, who recently completed the online course.
“The sectional format and assessments allows you to work through the
content in an organised manner…the online format as a result has proved to
be invaluable.” Covering all aspects of the treatment process in simple, easyto-follow video seminars, Straight Talk’s online accredited Inman programme
provides everything the busy practitioner needs to begin treating simple to
moderate cases immediately. It also serves as the perfect refresher, post handson seminar.
For more information, or to book your place, please contact Caroline on 0207
2552559 (UK) or visit www.straight-talks.com

Fuji Ortho LC
Fuji Ortho LC is the first
light-cured, resin reinforced
glass ionomer for bracket
bonding. Now you can
work faster and easier,
whilst securing the full
strength needed without
decalcification (white spots)
at debonding. Fuji Ortho LC delivers benefits that composites cannot claim.
Fuji Ortho LC is moisture friendly so it bonds perfectly in a wet field. It can be
used with either a non-etch or etch technique and no separate bonding agent
is needed. Because it is less technique sensitive you can dramatically reduce
chairside time.
Fuji Ortho LC light cures in 20-40 seconds with instant strength and the
material will even set chemically in the absence of light. You can insert levelling
wire during the same visit.
Advanced glass ionomer technology bonds brackets with ample strength for
even the most aggressive treatment, yet is easy to remove at case completion
without damaging the enamel. Final clean-up is fast and trouble-free.
After many years of clinical trials brackets were debonded without
decalcification. Fuji Ortho LC releases significant levels of fluoride to help
prevent decalcification and decay. Plus the fluoride toothpastes and
mouthrinses actually recharge its fluoride release capacity.
For further information please contact GC (UK) Ltd on 01908 218999 or
e-mail gcuk@btinternet.com

OPROshieldTM
Ortho
Gold orthodontic sports
guards
are
specifically
designed for wearers of
fixed braces. Designed with
patented
state-of-the-art
fin technology this self-fit
mouldable mouth guard
provides a unique inner
channel to ensure the best retention of any self-fit orthodontic mouthguard
in the world. The tough outer shell provides superior protection while the
inner channel houses the braces and provides maximum comfort. Stretch
zones around the mouth guard allow Oproshield TM to fit all mouths. The
OPROorthofins TM break down on biting and mould to the teeth. This mouth
guard also features posterior buffer pads for increased concussion protection.
OPROshields TM come with a substantial Dental Warranty and are the first
mouth guards in the world to achieve CE TYPE Certification to the latest
Standards. OPROshield TM Ortho Gold is presented in high quality point-ofsale packaging together with its own storage case and comes complete with
an instructional ‘how to fit’ mini CD.
To find out more about this very popular product or to place an order please
contact your local ORTHO-CARE sales representative or telephone our
Customer Services Team on 01274 392017. Email info@orthocare.co.uk or
visit www.orthocare.co.uk

Industry News
Universal Hand Piece Cleaner from Prestige
Medical
The Universal Hand Piece Cleaner from Prestige
Medical is designed to clean, oil and sterilize
dental hand pieces in just 12 minutes – speeding
up the infection control process in the busy dental
practice.
Busy dentists need a quick turnaround of hand
pieces, but waiting whilst they are manually
cleaned, oiled and then sterilized has meant that
the only alternative has been to buy extra sets in
order to keep up with demand!
The Universal Hand Piece Cleaner with its quick,
12 minute cycle will help to speed up throughput and therefore significantly
reduce the number of hand pieces the dentist needs to buy – considerably
reducing costs.
Consistently effective treatment of hand pieces can also help to increase their
life and reduce the need for maintenance.
The Universal Hand Piece Cleaner is supplied complete with a choice of six
hand piece adapters. Installation, commissioning and training is free and is
carried out by Prestige Medical service engineers.
More information is available from Prestige Medical direct by calling 01254 844
103 or email to sales@prestigemedical.co.uk

Hyflex CM – The
Regenerative NiTi File
from COLTENE ENDO
Coltène Whaledent is
pleased announce the
launch of Hyflex CM the
controlled memory NiTi
file which because of
no memory effect are
extremely
flexible
to
adapt to canal anatomy
to significantly reduce the
risk of perforation of the canal. This also allows pre-bending similar to stainless
steel files and are perfect for extremely curved root canals. Hyflex CM NiTi
files are multi-use and with autoclaving or with a glass bead steriliser the files
regain the original shape whilst also strengthening the file and with controlled
memory are up to 300 per cent more resistant to cyclical fatigue compared to
conventional NiTi Files which substantially helps reducing the incidence of file
separation. This is an amazing new product to add to the Coltène Whaledent
wide endodontic portfolio.
For more information visit www.coltenewhaledent.com or call Free phone
0500 295454 exts 223/224

For more information contact: Christine Bowness, Marketing Manager 01254
844 101 or email christine.bowness@prestigemedical.co.uk

The NEW Direct Composite
Veneer System from Coltène
Whaledent
Coltène Whaledent is proud
to present a new and easy
system for restoring anterior
teeth with COMPONEER the
polymerised,
prefabricated
nano-hybrid composite enamel
shells which combine the
advantages of direct composite
and prefabricated veneers. In
present practice the choice is
between a directly modelled
composite
restoration
or
elaborate
indirect
veneer
technology but now the
COMPONEER system offers
you another treatment option
with the advantage of a lower economic perspective to the Practitioner and
the Patient. A naturally aesthetic smile can be offered to the Patient in just
one session with this easy to use system which also allows for a high level of
hard tooth conservation and has a wide range of uses in aesthetic and clinical
applications.
For further information visit www.componeer.info or call Free Phone 0500
295454 extentions 223/224

The Dentaloscope: everything you need in
one place
If you suffer from neck or back ache from
spending hours a day leaning over patients,
or eye strain from peering through loupes at
minute dental fissures, then the Dentaloscope
may be the solution.
With its ergonomic design and cutting edge
technology, the Dentaloscope from Clark
Dental is a positive boon to any surgery:
“I have found that the use of this dual
view magnification technique has greatly
increased the accuracy of treatment. Defects
at preparation margins can be easily seen; root canal treatments have become
easier; cracks in tooth structure are easily visible and using the Dentaloscope’s
freeze frame feature they can be easily shown to the patient at specific points
during the treatment. In addition to this, as there are several standard video
outputs from the Dentaloscope, it is easy to capture live video of procedures,
making it invaluable for education and staff training purposes.” Said Dr Paul
Liano, Tangmere Dental Centre.
You can trust the Dentaloscope from Clark Dental to bring you comfort, top
quality imaging and staff training in one superb piece of equipment.
For more information on a wide range of cutting edge equipment solutions to
suit every budget, please call Clark Dental on 01268 733 146 or
email enquiries@clarkdental.co.uk

The BACD Accreditation Process:
Promoting Professional Excellence
The British Academy of Cosmetic
Dentistry offers its members the
chance to demonstrate their skill by
completing the BACD Accreditation
Process, and becoming an ‘Accredited
Member of the British Academy of
Cosmetic Dentistry.’ Members then
receive a commemorative plaque
that can be hung in their surgery to
advertise their credentials.
Achieving accreditation requires hard work and dedication, and is the ultimate
accolade for British dental professionals practising cosmetic dentistry, as it
demonstrates the practitioner’s ability to diagnose, plan and execute aesthetic
dental procedures to an agreed standard of excellence.
The process requires candidates to submit clinical cases for rigorous review,
and sit a viva exam in front of a panel of examiners to ensure that all BACD
accredited practitioners all demonstrate the same level of knowledge and skill.
The BACD promotes the practice of quality cosmetic dentistry and strives to
maintain a standard of excellence in cosmetic dentistry. Membership of the
BACD gives practitioners access to the knowledge and support of experts and
leaders in the field of cosmetic dentistry to enable their further professional
development in all areas of aesthetic dental practice.
For more information contact the BACD on 0207 612 4166 or
email info@bacd.com

NEW PRODUCT
INTRODUCTORY OFFER
Topdental (Products) Ltd,
the
leading
specialist
provider of every day dental
products has many new
offers this month.
Our current 20 page offer sheet is packed with savings, from discounted prices
to buy one get one FREE offers. Topdental are also launching a NEW PRODUCT.
Topdental Microbrushes consist of non-linting, non-absorbent fibres arranged
in a spherical shape. They hold solutions in suspension, eliminating dripping,
spilling and waste. The bendable portion allows for precise application in
difficult to reach areas.
Topdental Microbrushes can be used for the following:
• Sealants • Disclosing solutions • Dycal Applications • Etchants • Bonding
Agents • Hemostatic solutions • Cavity Linings • Fluoride Varnishing
Download the April offer sheet or see our website for details: www.topdental.
org You can also order on-line at www.topdental.org, where you will receive a
three per cent discount on all on-line orders including offers! If you would like
to receive a copy of their catalogue and current offer sheet please telephone
0800 132 373.
Topdental
0800 132 373
www.topdental.org
sales@topdental.co.uk

[28] =>

28 Industry News
What does your laboratory say about you?
Does your dental laboratory provide a flexible
service with quick turnaround times? Does
it have friendly, knowledgeable staff and a
personal point of contact?
Does it deliver restorations safely in their own
presentation boxes?
As a dental practitioner, you will know how
patients are increasingly demanding that they
get the most for their money. As a vital part of
your team, your laboratory must also respond to their requests.
CosTech Elite® is a laboratory that understands the pressure placed on
practitioners to provide reliable, aesthetically pleasing restorations in a short
amount of time.
Its team strives to ensure consistent quality through its expert group of GDC
registered Elite® technicians, who pride themselves on providing bespoke
solutions and superior craftsmanship, no matter how unique or challenging
the requirements.
The laboratory’s high-end Elite7® express service also guarantees a seven-day
turnaround on restorations with a money back guarantee if your laboratory
work is not received on time.
For more information on CosTech Elite’s® Elite7 service or for a free Elite®
Dentist pack call 01474 320 076 or visit www.costech.co.uk

New Infection Prevention Products
in UnoDent & Classic Ranges!
The Dental Directory is pleased to
announce these new additions to the
Infection Control products within the
UnoDent and Classic Ranges!
• Classic Touch-Free Auto Dispenser
(GHC 030) – Holds 650ml pouches of,
Surgical Hand Scrub (GHC 035), Pink
Hand Gel (GHC 040) or Hand Soap (GHC 045) for touch-free hand sanitisation.
• Classic Automatic Paper Towel Dispenser (CAU 080) – Sensor controlled to
prevent cross contamination.
• UnoDent Green Heavy Duty Nitrile Gloves (CGS 200-215) – Latex free and
available in small to extra-large sizes.
• UnoDent Long Handled Scrubbing Brush (CGS 220) – Fully autoclavable and
perfect for instrument cleaning.
• Classic Alcohol Free Hard Surface Disinfectant with Detergent – available in
1L bottle (GSC 335), 5L Refill (GSC 336) and in packs of 80 wipes (CAW 660),
330mm x 220mm.
The UnoDent and Classic products are from the quality, value for money ranges
exclusively available from The Dental Directory. All designed to offer your
practice a cost effective solution to Infection Prevention whilst conforming to
best practice and helping you to adhere to HTM 01-05 and CQC guidelines.
For further information on these Infection Prevention products from the
UnoDent and Classic Ranges or to order, please call 0800 585 586 or
visit www.dental-directory.co.uk

Sani-Tip® - ‘Single-Use’
Tips for Trouble-Free
Restorations
For
increased
patient
confidence in cross infection
control procedures, 80 per
cent of dentists with single
use disposable tips choose
Sani-Tip®.
Quick to install and change, with adapters available for the majority of syringe
types, converting to Sani-Tip is simple. Clear plastic tips provide secure
retraction and ensure 100 per cent visibility, allowing you to validate the
sanitary condition without obstructing the field of operation.
Available from DENTSPLY, Sani-Tips feature a tapered water spindle with a
central water channel with six separate water channels, guaranteeing precise
atomisation of dry air and water with no reduction in air pressure, whilst
eliminating moisture contamination and chances of adhesive failures.
Mike Coleman uses Sani-Tips in his three-surgery private practice and has done
for many years. “The fit of the tip via the adapter to the syringe is excellent and I
have never had leakage. I am constantly impressed with the accuracy of the tip
such that the air and water jets are completely independent unless the mixed
spray is required.”
Further still, DENTSPLY offers all Sani-Tip users free of charge adapters to fit the
majority of syringes.
For more information or to receive your free adapter, please contact DENTSPLY’s
Preventive team on +44 (0)800 072 3313

United Kingdom Edition

Aiding patient compliance with iTOP
Having implants fitted can be a trying time for a
patient, and the process doesn’t end when they
leave the surgery. Achieving patient compliance
can be difficult at the best of times and GDPs
should know that help is at hand, should they
need assistance in preparing and guiding
their patients. iTOP, the Individually Taught
Oral Prevention method, was designed and
developed by Dr Jiri Sedelmayer of Hamburg University, to teach GDPs and
dental Care Professionals the correct way in which to teach their patients about
all-important preventative care and oral hygiene.

April 18-24, 2011

This year iTOP, from Curaprox, brings you a one day course dedicated to
showing dentists how to motivate implant patients to carry out home care
maintenance regimes:
• Monday 13th June – Edinburgh Carlton Hotel
• Tuesday 14th June – Shrigley Hall Hotel, Cheshire
• Wednesday 15th June – Hendon Hall, London
• Thursday 16th June – Walton Hall Hotel, Stratford upon Avon
The cost of the course is £225.00 + VAT per delegate, and earns you 7 hours
verifiable CPD. With the implant seminar from iTOP, you can be sure of offering
the best advice on the most complex of cases.

First rate customer care from dental
experts Admor
From signage for your surgery, to patient
record and hygienist reminder cards, Admor
has everything you need to fully equip your
dental practice. Not only can Admor offer
you specialist and standard office essentials,
but it also provides superb customer service
every step of the way:
“We have received excellent service
from Admor over the past few years, the
frontline staff when ordering stationery are
extremely polite and efficient. I have dealt
with Tim quite a bit when ordering our
surgery’s internal signs and he has always
gone above and beyond to meet our needs.
The products are top quality and delivery is always prompt. All in all, the service
that Admor provides is second to none.” Sharon El-Nashar, Business Manager at
El-Nashar Dental Care, Devon
If you need efficiency, quality and excellent service, then Admor is essential
for your office essentials. Always emphasising the ‘care’ in customer care,
Admor works ceaselessly to meet your needs and, as a company dedicated to
dentistry, customer satisfaction is guaranteed.

For more information on the iTOP training system, or to book, contact Curaprox
on 01480 862084 or email info@curaprox.co.uk or visit www.curaprox.co.uk

For more information contact Admor at support@admor.co.uk or by calling
01903 858910.

Find your ideal candidate
with Dental Gateway
When agency fees are
eating away at your finances
and
their
‘middlemen’
don’t seem to understand
what you need from a
dental professional, turn to
Dental Gateway: specialist
recruiters for the dental industry.
Dental Gateway is the only online network for dental professionals and
provides a unique recruitment service for GDPs.
When you register with Dental Gateway you will be given access to thousands
of CVs from qualified and experienced candidates and can browse them time
and again for free. You can also post vacancies for free and ensure that your job
is seen by dental professionals across the UK.
You can contact candidates directly for a small fee, and with Dental Gateway
offering a free trial, your first vacancy post could potentially be completely
without charge!
Because we are dedicated to the dental industry we understand the
importance of finding the right candidate and we know that your staff are a
reflection of you and of your practice ethos.
So visit Dental Gateway, for a service dedicated to you.

The Dental Stock X-Change: Helping dental professionals to recycle their
old stock
It is important for a dentist’s surgery to be kept up to date with the latest
products and for GDPs to be seen to have access to these high specification
materials and equipment. However, when technology changes so fast, it can
be hard to keep up with the costs.
If you have a stock room overflowing with excess items but have no idea how
to dispose of them without leaving them to the mercy of the landfill, visit the
Dental Stock X-Change the UK’s first online market place to cater exclusively to
the dental industry.
General and veterinary dentists, nurses, students and technicians can all
benefit from using the Dental Stock X-Change to buy and sell dental products
and equipment. Not only could you find a bargain, but you can also do your
bit for the environment, by effectively recycling your old equipment and
redundant materials.
By buying and selling through the Dental Stock X-Change, you can make a
return on your old items, purchase top quality equipment at a fraction of the
retail price, and ensure that your unwanted stock finds a good home!
For more information visit www.dentalstockxchange.co.uk

For more information visit www.dentalgateway.co.uk or call us on
0845 094 4031

Treat yourself with
DENTSPLY Rewards
High Street dental practices
can benefit from significant
discounts off many of
their favourite DENTSPLY
products by simply visiting
w w w. d e n t s p l y r e w a r d s .
co.uk. For every DENTSPLY
product they purchase, the dentist earns rewards that can be spent on other
DENTSPLY products of their choice to suit the individual needs of their practice.
As the leading manufacturer of dental materials and equipment in the UK
and Ireland, DENTSPLY knows how important it is for clinicians to remain
competitive in the current economic climate. Dentsplyrewards.co.uk enables
practitioners to do just this by making it easier for them to trial new products at
a very low price. Clinicians can still continue to benefit from their usual dealer
offers and prices as all orders made on the website will be directed through
to the dentist’s dealer of choice and invoiced at their usual dealer prices. This
means that DENTSPLY Rewards are in addition to the usual benefits that they
receive from their preferred dealer. Secure and easy to use, dentsplyrewards.
co.uk provides dental professionals with an ideal way to save.
To register and start benefiting from your rewards today visit www.
dentsplyrewards.co.uk
For more information, or to book an appointment with your local DENTSPLY
Product Specialist, call 0800 072 3313 or visit www.dentsply.co.uk

UCL Eastman Certificate in Paediatric Dentistry
The Certificate in Paediatric Dentistry is a part time university modular
programme, which allows dentists to expand and solidify their knowledge
of paediatric dental care. Ideally suited to those working continuously with
children the course offers 26 days of full teaching over twelve months. The
seminars and practical classes are held in state-of-the-art facilities and are
assessed periodically by written and practical tests as well as case presentations
and viva voce exam. The five modules cover all aspects of paediatric care and
are divided into: • Oral disease – a review of common dental diseases and
their diagnosis, prevention and management • Restorative management
– restoration of the primary dentition and aesthetic restoration of fractured
incisor teeth • Trauma – how to manage dental trauma in children • Behaviour
management – non-pharmacological techniques and inhalation sedation
• Planning treatment in the developing child – an overview of treatment
planning and the role of orthodontics With the emphasis on on-going learning
and clinical support, GDPs are encouraged to discuss their own cases with
peers and mentors to facilitate their continued professional development.
Further details of this programme can be accessed from www.eastman.ucl.
ac.uk/cpd

A quality referral service at EndoCare
EndoCare, located on London’s prestigious
Harley Street, in Richmond and Watford,
offers referred patients a dental experience
that is second to none. The friendly team
led by Dr Michael Sultan are experienced
in treating nervous patients and have at
their disposal a range of techniques and
equipment to make the procedure as
comfortable as possible, including ‘the
Wand’, headphones and a wide selection of
films to watch during the procedure.
The practices’ dentists are experts in
their field and are dedicated to achieving
the highest clinical standards for each
individual patient. They promise to give referring dentists full support during
and after the procedure as well as a free after-care appointment six months
post treatment.
The specialists at EndoCare also frequently hold ‘Lunch and Learn’ sessions
for practitioners and the whole team at their practice. Lunch is provided
and attendees can enjoy entertaining and informative sessions on a variety
of clinical topics. CPD certificates are awarded to all those in attendance. If
interested please do not hesitate to contact us.

For more information, please contact Nisha Gosai, Registry Officer, on 020 7915
1092 or email academic@eastman.ucl.ac.uk

For more information about EndoCare please call 020 7224 0999 or
visit www.endocare.co.uk

UCL Eastman Dental Institute CPD course in Sports Dentistry
Practitioners with an interest in the dental need of sports people and athletes
can now take this specialist course in sports dentistry, consisting of 12 study
days over ten months, with talks from senior lecturers and clinicians from the
Eastman faculty and the London Sports Institute.
The dental aspects covered by the course include the prognosis and treatment
of dental and maxillo-facial trauma and the recognition of neurological injury.
The course also covers tissue healing, stress and TMJ Dysfunction and tooth
surface loss in relation to sporting activity.
Other topics covered are the psychology of sports injury, diet and nutrition,
medico-legal aspects of dental injuries and much more, making the CPD
course in sports dentistry an excellent multi-disciplinary course for those
wishing to expand their knowledge of the issues affecting athletes.
The course may be taken as either an optional module of the Restorative Dental
Practice programme, or as a stand-alone course and can give practitioners the
knowledge and confidence to advise doctors, physiotherapists and dieticians
on the appropriate dental care for sports men and women.
For further information or to register for September 2011, please contact
Victoria Banks, the Programme Administrator on 020 7905 1251 e-mail:
v.banks@eastman.ucl.ac.uk or visit www.eastman.ucl.ac.uk/cpd/gdps/
sports_dentistry/index.html

All-on-4™ - efficient for dentists,
affordable for patients
Nobel Biocare’s pioneering research and
development have enabled clinicians
to tackle complex rehabilitations of the
edentulous maxilla and the mandible
with ease, thanks to the truly unique Allon-4™ system.
Compatible with NobelGuide™, the
All-on-4™ system reduces the amount
of time the patient has to spend in the
chair and simplifies the entire dental
implant procedure. The system involves
the placement of two straight anterior
implants and two angulated posterior implants to hold a full arch restoration,
meaning that in many cases your patient can leave the surgery with a
functional, aesthetically pleasing set of teeth after just one treatment session.
The All-on-4™ system is also a highly cost-effective solution, opening up
the possibility of dental implant treatment to a wider patient base and to
potentially increase case acceptance and practice turn over.
Your patients will also find the All-on-4™ system noticeably less traumatic than
many other systems, as it avoids the need to completely rehabilitate the upper
and lower jaw. This means that they will benefit from a faster recovery time too!
For further advice and technical information please call 0208 756 3300 or visit
www.nobelbiocare.com

[29] =>

United Kingdom Edition

Zeiss EyeMag Pro prismatic loupes
from Nuview
Clarity of vision is essential for
delivering the highest quality
cosmetic restorations, as Dr Simon
Northeast BDS, PhD, FDS RCS (Edn)., a
Specialist practitioner and Consultant
in Restorative Dentistry at 611Oasis
Dental Centre in Sheffield, is only too
aware.
Offering a mixture of comfort and
pinpoint precision, EyeMag Pro prismatic loupes come in a range of 10 models,
offering a choice of eight different degrees of magnification - from x3.2 right
through to x5.
‘Having used simple “Galileo” type loupes for more than 25 years, I could not
believe the staggering jump in quality that EyeMag Pro prismatic loupes
provide: massive field width and depth at high magnification, pin sharp
detailed focus over the entire field, no colour fringing and easy set up.
The Eye Mag Pro F frames are stylish, sturdy and comfortable, allowing me to
wear them for long periods – sometimes up to 3-4 hours at a time.’
Available in both spectacle and headband carrier formats from Nuview, Carl
Zeiss EyeMag Pro loupes can help to improve aesthetic outcome and simplify
even the most complicated of dental procedures.
For more information please call Nuview on 01453 872 266 or
email info@nuview-ltd.com www.voroscopes.co.uk

Recommend Tandex to your
patients to maintain the health of
their teeth and gums
All dentists are aware that good
dental hygiene starts in the home,
but with an estimated 80 per cent
of the British population showing
signs of gingival inflammation, the
difficulties in patient compliance are
evident.
The interdental spaces are the most
vulnerable to the build-up of food
particles and bacteria. However, the British Dental Health Foundation has
shown that only a minimal percentage of people in the UK use dental floss.
Patients therefore need to be advised to use alternative methods, such as
interdental brushes and gel adjuncts.
Tandex supply a range of interdental brushes, such as the Flexi brush. These
are useful for everything from small spaces to complex bridges and implants.
Their soft bristles do not harm the delicate gingival tissue, yet they provide and
effective solution in the removal of plaque and debris.
Tandex gel makes these interdental brushes all the more efficient, as it reduces
gingival fluid flow as well as the bacteria count in plaque and saliva. In addition,
its alchohol-free formula helps to protect tooth enamel.
For more information on Tandex’s range of products, visit www.tandex.dk
25 years providing medical optics
DP Medical Systems is in its 25th year of
supplying market leading Optical systems to
the medical profession. The company’s mission
statement is “to make our customers lives easier
by means of vision enhancement, to be able
to see more clearly, safely and to significantly
increase their vision and working capabilities.”
See www.dpmedicalsys.com.
In Dentistry correct posture and enhanced
visual acuity are of paramount importance in all
specialties. This is recognised by leading dental
schools and teaching institutions which have
incorporated the Global Dental Microscopes
into their programmes. Global Surgical is now
internationally the system of choice by leading dental professionals.
Many thousands of UK dentists have also benefited by choosing Surgitel
Binocular Loupes and Lights in their everyday practice, testimonials supporting
this appear on the website. Surgitel provide the very highest quality for this
demanding application and are internationally recognised for this.
Technical support and after sales service is considered essential by the
company to provide the complete package.
Contact DP Medical Systems Ltd. for a no obligation discussion with one of
our regional product specialists to see how you can enhance your practice and
work life. DP Medical Systems Ltd. 0208 391 4455
sales@dpmedicalsys.com

Clear The Air With
Communication Courses
Disputes are not uncommon
occurrences in the dental
practice. Therefore, it is
worth learning preventative
measures that can be used to
avoid such disagreements,
and effective methods of
dealing with them if and when they do take place.
To help professionals run a smoother surgery, Smile-On has provided a series
of modules concerning communication in dentistry. Due to popular demand,
it has added three more topics to this series:
Communication and Consent: This defines the word ‘consent’ and teaches
professionals the most effective methods of gaining this from patients.
Practitioners will learn ways of clearly explaining treatment options to their
patients as well as methods of promoting patient autonomy.
Communication and Complaints: This will enable clinicians to better
understand the causes of complaints and how to avoid them. This module will
also teach professionals how to manage and resolve conflicts efficiently and
demonstrate how they can be beneficial to your business.
Recording Communication: This module discusses the value of recording
conversations and emphasises the need for sensitivity and confidentiality.
Practitioners will learn the types of conversation in the surgery that should be
recorded and those that should remain confidential.
For more information call 020 7400 8989 or email info@smile-on.com

April 18-24, 2011

The OPMI Pico Microscope from Nuview
The OPMI Pico dental microscope, designed by
Carl Zeiss and created especially for the dental
profession, represents a true advancement in
dental magnification and illumination. Already
revolutionising specialist areas like endodontics,
the Zeiss dental microscope can also change the
way general dentistry is practiced, as Dr Nigel
Slattery of The Dental Care Centre in Bolton,
found out:
“When I came across the Nuview stand at the
2010 Dentistry Show, I could not resist trying
their Zeiss OPMI Pico.
I am a tall person, and Nuview really understood
how to tailor their equipment to suit my needs. The 300mm focal depth was
important for my stature, and the five levels of increasing magnification
offered me flexibility for my general practise. The Pico MORA is also a must; it
really helps with tilting the scope head whilst sitting upright.
I remain impressed about how Nuview fitted the equipment into my surgery.
A dental microscope is an investment. It is also an immensely steep learning
curve, but the quality of the Zeiss Pico is very good and I really love using it. I
do not use the ‘scope on every patient, but when I do, it really makes my day.”
For more information please call Nuview on 01453 872266or
email info@nuview-ltd.com
www.voroscopes.co.uk

Increase your handpiece life with Bien-Air
Bien-Air has not lost momentum over the past 50
with their range of high quality, Swiss products. To
ensure longevity of your handpiece it is imperative
to look after it properly, thus maintaining its high
performance.
Aquacare from Bien-Air is a special pre-cleaner
used to remove physiological fluids such as saline.
Saline is often used as an irrigant and unless your
handpiece is cleaned thoroughly after use this
physiological salt water can sit in the handpiece
ducts wreaking havoc. Saline will crystallise if left
unchecked in as little as two hours and will attack
all metals, even high grade stainless steels such as
those found inside Bien-Air handpieces.
Aquacare is easy to use. Attach your handpiece to
the Aquacare spray nozzle and spray through the
handpiece and any external irrigation tube for a
period of two seconds. This effectively removes any residue and any remaining
physiological liquid that may be sitting in your handpiece. It is recommended
that you wipe the outer surface of your handpiece with Aquacare to remove
any saline deposits. You can then lubricate and sterilise as usual.
Aquacare is an important component of Bien-Air’s handpiece care procedure.
For further information please contact Bien-Air on 01306 711 303 or visit
www.bienair.com

Prevent needle stick injuries
with Ultra Safety Plus
For any dental professional
dealing with needles one
of the biggest safety risks is
contracting a blood borne virus
through a needle stick industry.
Septodont, a global leader in
dental pharmaceuticals and the
UK’s number one manufacturer
of dental anaesthetics, has
developed the Ultra Safety Plus
System to address this problem.
Indicated for the routine administration of local anaesthetics, the sterile, single
use, aspirating syringe system comes equipped with a needle stick injury
prevention device.
The needles also incorporate a bevel indicator to assist in orientating the bevel
to the bone as well as a transparent barrel to allow a clear view of aspiration.
The Ultra Safety Plus range includes 27g short, 27g long, 30g short and 30g
ultra short needles making it a not only safe but versatile choice.
For more information visit www.septodont.co.uk or call 01622 695520.

Problems of CQC registration when a practice is
changing hands New dental practice owners will inevitably
have a lot of paperwork and legal administration to contend with in the first
weeks and months of their new venture. Nowadays, of course, they also have
another dimension to consider: registration with the Care Quality Commission.
Unfortunately, there has been very little clarity from the Care Quality Commission
with regards to the effects of registration in respect of the transfer process, which is
a concern for those of you who are currently in the course of a purchase of a dental
practice. In its guidelines for dental practice owners, ‘A new system of registration
for providers of primary dental care services’ (August 2010), the Care Quality
Commission states that any new provider who intends to start providing a dental
service on or after 1 April 2011 must be registered with it before doing so. However,
CQC also says that only those currently in ownership of a dental practice are able
register with CQC. So, if you do become the new owner of a practice before the
April deadline, in theory you should be able to register as per usual. Of course, in
practice this is easier said than done, especially if you take ownership in a matter of
days or hours before the deadline. However, if you legally become the owner of the
practice after April 1, you will not be able to practice until your registration process
is completed. Practices that have not met the Commission’s essential standards
(and are not taking action to do so) will be closely scrutinised by the CQC and may
lose their legal licence to operate. So its seems as if ‘practice owners to be’ find
themselves between a rock and a hard place. This is especially important if the
practice in question does not currently match up to CQC’s guidelines, because as
the official owner, you may find the inspectors hot on your heels before you even
treat your first patient! For more information contact Ray Goodman on 0151 707
0090 or email rng@goodmanlegal.co.uk www.goodmanlegal.co.uk

Industry News 29
Bite Tech named one of the top
ten most innovative companies in
sports 2011
Bite Tech, the American company
famed for introducing Under
Armour Performance Mouthwear™
(UAPM) to the UK, has been
recognised as one of the USA’s top
ten most innovative companies in
the sporting arena.
The award comes as Bite Tech joins
forces with distributer Nuview in the
UK and recognises the importance of UAPM’s revolutionary technology, which
aligns the jaw to increase oxygen intake, boosting performance and reducing
the body’s production of cortisol.
The ‘top ten’ list also included American giants ESPN and Turner Sports and
is testament to the continuing success of the product. Already boasting the
patronage of 27 NHL teams, 60 Olympic athletes, and Auburn University’s
national champion football team in the USA, Bite Tech are a firm favourite on
this side of the Atlantic, with everyone from amateur runners to top rugby
clubs and the WRU signing up to experience the UAPM effect.
Dentists can benefit from becoming authorised suppliers of this award
winning, custom fitted splint and joining the new revolution in sportswear.
Call Nuview on 014530 872266 or email armourbite@nuview-ltd.com for
further information on the benefits of becoming an Authorised Provider
An evening with Dr David Garber
Highly acclaimed American Prosthodontist,
Dr David Garber will be hosting a one-off
evening at the Royal College of Physicians
on May 25th, 2011, entitled, ‘Evolving
Implant Aesthetics: Options, Alternatives
& Solutions’. This program is an alternate
perspective into how “aesthetics-driven”
implant dentistry has evolved, and why
it is essential to combine both the “pink”
and “white” aspects to achieve that
optimal cosmetic result. The evening
will include virtual treatment planning
for gingival outcomes, surgical augmentation, hygiene and maintenance
beyond aesthetics over the long-term, the adjacent implant dilemma and
submerged root alternative. Lecturing on multi-disciplinary approaches to
optimising aesthetics, Dr Garber’s programmes integrate restorative dentistry
and periodontic implants. At the cutting edge of implant prosthodontics
and an integral part of “Team Atlanta” with the Salama brothers and Ronald
Goldstein, Dr Garber will be talking on evolving implant aesthetics and the
role of BioHorizons implants in this area. Starting with registration from 6:00 –
7:00pm when refreshments will be served, the lecture will run from 7pm until
9pm in the Seligman Theatre of the Royal College of Physicians, with 2 hours
of CPD for all delegates. For more information on this special evening with Dr
Garber or to book a place please call 01344 752560 NOW, email:
infouk@biohorizons.com or visit our website at www.biohorizons.com

Outsourcing Governance With CODE
Recent research has shown that approximately
one third of dentists feel that their professional
‘morale’ is anywhere from low to very low,
and that the reason for this is the increasing
amount of bureaucratic governance imposed
upon the dental industry.
In order to boost morale, practitioners need a
way to free up their time to take care of what
really matters: their patients. It is now time to
follow the example of other industries and
start outsourcing governance to consulting
companies such as CODE.
With a wealth of experience in both dentistry and governance, CODE is the
ideal choice for principals and practice managers who are feeling frustrated or
overwhelmed by any area of governance.
CODE will work with practices every step of the way to ensure that every aspect
of the administration of governance is taken care of efficiently and effectively.
If you are worried about how to go about dealing with governance, or
concerned about how much time you are spending away from your patients,
contact CODE, for advice and help guaranteed to boost your morale.
Please visit www.CODEuk.com, email info@CODEuk.com or call 01409 254
354 for more information.

The effectiveness of ChairSafe
ChairSafe disinfectant foam cleaner is available
in 200ml bottles, 1L and 5L refill containers
and with the new Kemdent range of durable
and economy wipes. ChairSafe disinfectant is
alcohol free. It’s mode of action makes it very
effective against HBV/HIV/HCV/BVDV/Vaccinia,
bactericidal and fungicidal micro-organisms,
MRSA and influenza A (H1N1) viruses (pathogens of swine flu). ChairSafe
XL Wipes are available in 250 piece packs of Heavy Duty or 600 Economy
Wipes. They hold the disinfectant on the surface of the wipe enabling the
user to clean all surfaces effectively and evenly. This is an excellent time to
buy ChairSafe XL Wipes. They are available on a buy two get one free offer.
HTM 01-05 published by the DOH, recommends that Dental Chairs be cleaned
between every patient to minimise the dispersal of microorganisms. ChairSafe
is specially formulated to clean sensitive surfaces and equipment, including
the leather and synthetic facings of dental chairs. ChairSafe disinfectants
comply with the newly reclassified EC regulations regarding the disinfection of
medical devices, and all carry the CE mark.
For further information on special offers or to place orders call Jackie or
Helen on 01793 770256 or visit our website www.kemdent.co.uk. Issued by
Belinda Mayoh, Kemdent. Email: belinda@kemdent.co.uk Tel: 01793 770256
Fax: 01793 772256 Date: Feb 2010 Ref: BM020211/Csafe Associated Dental
Products Ltd Kemdent Works Purton, Swindon, Wilts, SN5 4HT, UK

[30] =>

30 Events

United Kingdom Edition April 18-24, 2011

Update on prevention & management of periodontal diseases

T

he recent Dentistry Show
held in Birmingham featured a number of symposia presenting the latest thoughts
in patient management and treatment modalities.
A session reviewing the latest

trends in evidence-based prevention and management of periodontal disease was presented by
Dr Anousheh Alavi, Colgate Scientific Affairs. This session provided
an overall perspective for an integrated team-based approach, with
particular reference to dental hy-

gienists and therapists, discussed
the evidence base and highlighted
gaps in our clinical practice which
could impact on the delivery of optimised prevention and care.
Dr Alavi began by revisiting
subgingival plaque and the char-

acteristics of biofilms, highlighting it is the particular composition of subgingival plaque biofilm
in a susceptible patient which
determines whether gingivitis
progresses to periodontitis. Dr
Alavi went on to briefly discuss
a patient based approach to the

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

THE

Clinical Innovations
CONFERENCE 2011

management of periodontitis, and
reviewed the merits of engaging
the whole dental team. The General Dental Council (GDC) publication ‘Scope of Practice’1 sets out
the skills and abilities each registrant group would bring to benefit
he patient. In addition, the GDC
‘Principles of Dental Team Working’2 document includes a section
on working effectively as a team.
She then summarised the evidence for what we advise patients to
do: Evidence based dentistry includes the integration of
best evidence, clinical judgement and patient values and
circumstance. There are varying levels of filtered and unfiltered information which determine the quality and strength of
evidence. Dr Alavi outlined the different degrees of strength of evidence as stated in the Department of
Health guidance document Delivering Better Oral Health- An evidence-based tool Kit for prevention3.
Delivering Better Oral Health
provides advice and support that
should be given to patients presenting with or at risk of periodontal disease, and includes a list
of conditions that predispose patients to periodontal disease. We
need to ensure we provide patients with evidence-based advice,
which requires us to be up to date
on latest evidence in effective mechanical plaque removal, effectiveness of chemotherapeutic agents
in toothpastes and mouthrinses,
and evidence for therapeutic dosage of active ingredients.
It is also important to remember, in light of recent emerging evidence, patients with periodontal
disease may be at risk of diabetes,
cardiovascular diseases, adverse
pregnancy outcomes and pulmonary diseases.

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

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

Dr Alavi concluded that as clinicians, we are as responsible for
the periodontal health of our patients and its maintenance, as we
are in diagnosing and managing
periodontal diseases. The prevention and management of periodontitis requires consideration of the
patient as a whole, and should be
seen as a life-long process, shared
between us and the patient. It is
our responsibility and duty of care
to assess the evidence for the advice we give and the efficacy of the
products we recommend on behalf of, and for patients. There are
key areas on mechanical plaque
removal which need more robust
research into patient home care
regimes to optimise periodontal
health, and this is a genuine opportunity for our current generation of clinicians. DT
References
1 Scope of Practice, General Dental
Council, 2009. 2 Principles of Dental Team
Working, General Dental Council, 2nd edition 2009. 3 Delivering Better Oral Health
– An evidence-based toolkit for prevention,
Department of Health, 2nd edition, 2009

[31] =>

United Kingdom Edition

Classified 31

April 18-24, 2011

Something to
Smile about!...
SmileGuard is part of the OPRO Group, internationally renowned for revolutionising the
world of custom-fitting mouthguards. Our task is to support the dental professional with
the very latest and best oral protection and thermoformed products available today.

Custom-fitting Mouthguards* – the best protection for teeth
against sporting oro-facial injuries and concussion.
OPROshield – a self-fit guard enabling patients
to play sport whilst awaiting their custom–fit guard.
NightGuards – the most comfortable and effective way
to protect teeth from bruxism.
Bleaching Trays – the simplest and best method for
whitening teeth.
Snoreguards – snugly fitting appliances to
reduce or eradicate snoring.
OPROrefresh – mouthguard and tray
cleaning tablets.

In 2007, OPRO was granted the UK's most prestigious business award,
the Queen's Award in recognition of outstanding innovation.

CONTACT US NOW!
OPRO Ltd, A1(M) Business Centre, 151 Dixons Hill Road,
Welham Green, Hatfield, Herts. AL9 7JE

www.smileguard.co.uk
email info@smileguard.co.uk or call 01707 251252

part of the oprogroup

* SmileGuard - the first to provide independent certification relating to
EC Directive 89/686/EEC and CE marking for mouthguards.

7320_09_3

mouthguard and tray
cleaning tablets

To advertise here please contact
Joe Ackah
on 0207 400 8964

Untitled-4 1

19/10/09 17:03:31

[32] =>

CORSODYL MOUTHWASH
SODY
R
O

YEARS O

RTISE

NEW

ALCOHOL FREE

M CARE

COMPARABLE TO CORSODYL
MINT MOUTHWASH IN –
• INHIBITING PLAQUE REGROWTH1
• REDUCING ORAL BACTERIA2
• SUBSTANTIVITY3
chlorhexidine digluconate

Now when you wish to recommend an alcohol free chlorhexidine mouthwash
recommend NEW alcohol free Corsodyl Mouthwash with confidence.

Product Information: Corsodyl Mint Mouthwash (clear, chlorhexidine digluconate 0.2%), Corsodyl 0.2% Mouthwash (alcohol free) (clear, chlorhexidine digluconate 0.2%) Indications: Plaque inhibition;
gingivitis; maintenance of oral hygiene; post periodontal surgery or treatment; aphthous ulceration; oral candida. Dosage & Administration: Adults and children 12 years and over: 10ml rinse for 1 minute twice
daily or pre-surgery. Soak dentures for 15 minutes twice daily. Treatment length: gingivitis 1 month; ulcers, oral candida 48 hours after clinical resolution. Children under 12 on healthcare professional advice only.
Contraindications: Hypersensitivity to chlorhexidine or excipients. Precautions: Keep out of eyes and ears, do not swallow, separate use from conventional dentifrices (e.g. rinse mouth between applications). In
case of soreness, swelling or irritation of the mouth cease use of the product. Side effects: Superficial discolouration of tongue, teeth and tooth-coloured restorations, usually reversible; transient taste disturbances
and burning sensation of tongue on initial use; oral desquamation; parotid swelling; irritative skin reactions; extremely rare, generalised allergic reactions, hypersensitivity and anaphylaxis. Legal category: GSL. PL
Numbers and RSP excl. VAT: Mint Mouthwash: PL 00079/0312 300ml £3.99, 600ml £7.82. Alcohol-free PL 00079/0608 300ml £4.08. Licence Holder: GlaxoSmithKline Consumer Healthcare, Brentford, TW8
9GS, U.K. Date of preparation: May 2010.
References: 1. Veihelmann S, Mangold S, Beck P, Lemkamp V, Schmid F-G, Schlagenhauf U. Hemmung des Plaquewiederbewuchses auf Zähnen durch die Chlorhexamed alkoholfrei Mundspüllösung [Inhibition
of plaque-regrowth on teeth by Chlorhexamed alkoholfrei mouthrinse]. Parodontologie 2008; 19 (3): 326. 2. GlaxoSmithKline data on file, Bacteria Kill Test, In Vitro, SGS 2007. 3. GlaxoSmithKline data on file,
substantivity report, Hill 2007.

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

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[cover] => DT UK No. 8, 2011

[toc] => Array ( [0] => Array ( [title] => Time for a re-call [page] => 01 ) [1] => Array ( [title] => News [page] => 02 ) [2] => Array ( [title] => Around the world in 80 webinars [page] => 07 ) [3] => Array ( [title] => Regulations - regulations [page] => 08 ) [4] => Array ( [title] => Once upon a time...a title story [page] => 09 ) [5] => Array ( [title] => Save a tooth - treat the root [page] => 10 ) [6] => Array ( [title] => Getting Up-to-Date [page] => 12 ) [7] => Array ( [title] => Infection Control Tribune [page] => 13 ) [8] => Array ( [title] => Looking after the face of your practice [page] => 24 ) [9] => Array ( [title] => Creating a beautiful dental arch [page] => 25 ) [10] => Array ( [title] => Orthodontics [page] => 27 ) [11] => Array ( [title] => Industry News [page] => 28 ) [12] => Array ( [title] => Events [page] => 30 ) [13] => Array ( [title] => Classified [page] => 31 ) ) [toc_html] =>

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