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[1] =>
March 26-April 1, 2012
PUBLISHED IN LONDON
News in Brief
A sweet finding
New research has suggested
that compared to 15 years ago,
the children of today’s society are eating less chocolate
and fewer sweets. The report
from the NHS Information
Centre revealed that between
1997 and 2010 chocolate and
sweet consumption fell by 39
per cent among four to tenyear-olds and consumption by
11 to 18-years-olds fell by 35
per cent. The World Cancer
Research Fund (WCRF) said
the fall in youngsters’ intake
of chocolate and sweets was
‘‘good news for the health of
children in the UK’. However,
around three in 10 children are
still either overweight or obese.
Sugary drinks risk
Recent research has suggested
that men who drink a single
fizzy drink each day may significantly increase their chances of having a heart attack. The
study, which was carried out by
scientists at the Harvard School
of Public Health in the US,
looked at data on 42,883 men.
They found that those who
drank a can of fizzy drink a day
had a 20 per cent higher risk of
heart disease than those who
didn’t have any fizzy drinks.
According to lead author and
professor of nutrition and epidemiology Dr Frank Hu, the
findings, which are published
in Circulation Journal, add to
a growing body of evidence
‘‘that sugary beverages are
detrimental to cardiovascular
health’’. Tracy Parker, a British Heart Foundation dietician,
said in a report that people
should not have fizzy drinks
every day. “Go for healthier
alternatives such as water,
low fat milk or unsweetened
juices, which are kinder to our
waistlines as well as our heart,”
she advised.
Dentistry on Radio 4
Bridge2Aid Founder and Clinical Director Dr Ian Wilson recently spoke to Radio 4’s Sandi
Toksvig as part of a Medics
Abroad feature during her
Excess Baggage programme.
Sandi also spoke to Dr Marie
Charles who runs an organisation which places volunteer
doctors and nurses in developing countries to impart their
skills to local medical workers.
Ian talked about the challenges
of access to basic dental services for people living in rural
communities and how he used
his dental skills and experience to start the Bridge2Aid
Dental Volunteer Programme
in Tanzania. Both Ian and Dr
Charles spoke about the importance of training local people in order to build capacity in
the healthcare system. To hear
the programme visit www.bbc.
co.uk/programmes
www.dental-tribune.co.uk
Event Review
Practice Management
News
VOL. 6 NO. 8
Clinical
Direct
Shock Trauma
Sim Man trains dental students
page 2
The fun of the show
.com
Direct
What’s your Kolbe?
Alun Rees asseses your team
pages 10-11
Dental Tribune looks back at
The Dentistry Show
Quick and predictable
Biju Krishnan on short-term
orthodontics
pages 14-15
pages 21-25
Direct.com
Music for
nothing?
.com
Direct
EU court rules dentists should not pay music royalties
I
n what has been called a move
of “common sense” the European Court of Justice has
ruled that dentists do not broadcast music for profit and should be
exempt from music royalties.
The ruling came about after a
case was brought against a Turin
dentist by an Italian agency that collects royalties. Reports on the case
stated that the judges explained
how patients do not go to
surgeries to listen to music but
“with the sole objective of receiving treatment”, and the number of
people in a typical dental surgery “is
not large, indeed it is insignificant.” A BBC report stated that the
ruling is legally binding across the
27-nation EU.
Dental Tribune spoke to PRS
for Music, who said: “PRS for
Music is aware of the guidance
given last week by the Court in
Luxemburg on licensing music
rights specifically for the rights of
performers and record labels in
dentists’ waiting rooms.
“This judgement has no immediate impact on PRS for Music’s licences to dentists in the UK,
and we have been advising our
customers as such.
“A PRS for Music licence pays
royalties to those that have written, composed and published music as defined in UK law and we
will be monitoring the next stage
of the process in the Italian Court
of Appeal.
“This judgment is unhelpful
and confusing to customers and
runs contrary to the rights of creators and performers to earn when
their music is used in business,
whatever that business is.”
Commenting on the impact on
dental practices in the UK of the
ruling of the European Court of
Justice in Società Consortile Fonografici (SCF) v Marco Del Corso,
the British Dental Association’s
Chief Executive, Peter Ward, said:
“The European Court of Justice
(ECJ) decision that dentists are
exempt from paying music royalties is significant. The BDA believes that this ruling paves the
way towards removing red tape
that impinges unnecessarily on
the running of a dental practice.
“We have sought assurances
from both the Performing Rights
Society and the Phonographic
Performance Ltd that it will refund dentists who have already
paid this year’s licence.”
Direct.com
The change, if applied to UK
dentists, will certainly make a big
difference, as practice owner Neel
Kothari, explained: “Finally a little
bit of common sense from the European Court of Justice. Of course
dentists don’t broadcast music for
profit, nor do GP surgeries, hospitals, schools or the majority of professions and trades where listening to background music makes
everyone’s working days just that
little bit more pleasant. Furthermore, having background music
is a great way to actually help the
performers sell their live and recorded music by allowing more
Direct.com
“We are seeking confirmation
of our understanding that this
decision applies equally to the
United Kingdom and should take
immediate effect. We also wish to
clarify whether or not video performances are covered by the decision.”
Direct.com
Direct.com
people to actually listen to it.
“I appreciate that the PRS are
representing their members, but
businesses up and down the UK
are sick and tired of having every
last penny squeezed from them at
a time when the nation’s economy
is in such dire straits (no pun intended). Unfortunately each little
‘fee’ like this one brings us one
step closer to eventually having to
pay for air. The late Luther Vandross sang that the ‘best things in
life are free’ hopefully this ruling
will be a small victory for common sense.”
Jonathan Morrish, Director of
PR and Corporate Communications, PPL said: “We are aware
of the decision and are currently
considering the details of the
judgement.” DT
Direct
Protected by
EschmannCare FIVE year warranty
protection now comes as standard
with Little Sister products...
Direct.com
And, when you buy from EschmannDirect, the first
two years of ServicePlan cover that protects
your EC5 warranty are included.
Direct
.com .com
Direct
Go Direct
.com.com
Direct
Call 01903 875787 or visit
EschmannDirect.com for details
Direct.com
[2] =>
2 News
United Kingdom Edition
March 26-April 1, 2012
‘Shock trauma’ to help train dental students
injured with ground-breaking
research and innovative medical procedures with one goal in
mind, to save lives,” said Thomas Grissom, MD, FCCM, associate professor of anesthesiology
at the School of Medicine.
‘Sim Man,’ a computerised,
life-size human simulation
mannequin utilised by Shock
Trauma will be part of the dental training, according to Gary
Hack, DDS, director of clinical simulation at the School of
Dentistry.
Sim Man in action
T
he University of Maryland’s School of Dentistry has teamed up with
the University of Maryland R
Adams Cowley Shock Trauma
Center for training future dentists to respond efficiently and
effectively to life-threatening
medical emergencies in a dental setting.
To enhance the School of
Dentistry’s current course work
in prevention and management
of medical emergencies, the
School has added a partnership
with the center known worldwide as simply ‘Shock Trauma.’
“It is a pioneer of trauma care
and is dedicated to treating
the critically sick and severely
Sim Man, made by the
Laerdal Medical Corp., electronically responds to treatments. The mannequin actually talks back to attending
health
care
professionals,
offers pulse and blood pressure
rates, responds to cardiopulmonary resuscitation (CPR),
simulates lung function, and
has other features like those of
a live patient in a dental chair,
including becoming cyanotic,
wheezing, or exhibiting pupillary responses.
“This new program will dramatically improve our students’
ability to respond to medical
emergencies, and my hope is
that we will be able to expand
this program to include training on how to screen for diabetes,” said Hack.
While a student or resident
attends to a simulated emergency such as a heart attack
on Sim Man, faculty instructors can monitor and change
the mannequin’s vital signs,
which are displayed on standard monitors that are found in
dental offices, via the computer. This control unit can access
the depth and effectiveness of
chest compressions being applied during CPR to the mannequin by the student, as well
as pulse rate, blood pressure
levels, and more.
“The exercise teaches residents to stay calm and act decisively during an emergency,”
says Gary Kaplowitz, DDS, who
is the AEGD associate director. Shock Trauma’s Sim Man is
much more than a plastic mannequin. He weighs 160 pounds
and simulates realistic and dynamic patient conditions.
The Sim Man exercise includes an immediate debriefing.
Kaplowitz said: “I think
many dentists are not fully prepared for medical emergencies, though they are aware of
the possibilities. These things
do happen and you never know
when. If a dental patient goes
unconscious in the chair, you
are it,” he told dental students,
residents and faculty at the debriefing. DT
Have
your
say
$2 million for research
into oral disease
A collaborative research
project that could significantly improve our understanding
of the role of Candida albicans
in gum and jaw disease has
been awarded $2 million by
the US National Institutes for
Health (NIH).
Howard Jenkinson, Professor of Oral Microbiology and Head of Research at
the University of Bristol’s
School of Oral and Dental
Sciences, has been funded
by the NIH since 2006 for research into Candida albicans
- the species of Candida that
causes most fungal infections.
This five-year programme
renewal is to develop further research into yeast infections and better ways to
control them.
The most common fungal infections in humans are
caused by Candida. More
generally known as yeast infections, these conditions are
uncomfortable for a healthy
person, but deadly for someone whose immune system is
weak or who is vulnerable after surgery.
More than 50 per cent of
the population have suffered
from yeast infections at one
time or another and this is one
reason why Candida generates
considerable interest from a
public health perspective.
Professor Jenkinson said:
“Candida albicans are a major
concern in public health. They
are quite resilient to antimicrobial agents and some of
the newer drugs are not yet
freely available. Once Candida are growing in the
body, they are very difficult
to clear. Therefore, one of
our research goals is to find
new ways of blocking the
ability of Candida to colonise
humans.”
Candida yeasts can live
quietly inside the human
body for many years. But they
have the potential to suddenly cause disease, often in response to antibiotic treatment,
hormonal changes, or reduced
immunity. Candida become
troublesome when they grow
filaments known as hyphae
that penetrate the body tissues. They cause painful conditions such as ‘sore mouth’
in denture users, but more
serious problems if the fungi
get into the blood stream and
infect the organs. This condition, known as candidaemia,
may be fatal.
Professor
Jenkinson’s
work has observed that Candida albicans interact very
closely with several different
types of bacteria in the human
body. These help Candida colonise and stimulate them to
produce hyphae.
Professor Jenkinson added:
“We have developed models
to study microbes growing
together under conditions
that mimic those in the body.
We do this by flowing body
fluids like saliva through
small incubation chambers in
which Candida and bacteria
are growing together. One
of our new ventures is to better understand the role of
Candida albicans in periodontal (gum and jaw) disease.
There is evidence that Candida may be involved together with bacteria in dissolving
away bone, causing teeth to
fall out.”
While the main focus of
this work is oral disease, the
research findings will apply
to Candida infections in other
parts of the body.
Professor Jenkinson’s collaborators include Dr Rich
Lamont, University of Louisville; Dr Aras Kadioglu,
University of Liverpool; Dr
Mark Ramsdale, University
of Exeter; Dr Mark Jepson,
Biochemistry and Dr Michele
Barbour, School of Oral and
Dental Sciences, University of
Bristol. DT
T
he Children and Young
People’s Health Outcomes Forum is gathering views from children,
young people, parents, carers, doctors, nurses and other professionals involved in
providing care to children on
the health outcomes that
matter most for children and
young people and how the different parts of the health system will work together to deliver these.
To take part, visit the Department of Health website.
http://healthandcare.dh.gov.
uk/children-say/
It wants to hear views on
four particular areas:
The Strategy will ensure
that the outcomes measured
are the ones that matter most
to children, young people,
their families and the professionals responsible for their
care. DT
• acutely ill children
• mental health
• children with disabilities
and long-term conditions
• public health
Please send your views and
comments by 30 April 2012.
The Forum will report to
the Government with independent advice that will inform the Children and Young
People’s
Health
Outcomes
Strategy.
Mouth Cancer Foundation
website gets new look
T
o celebrate 10 years as
the UK’s leading mouth
cancer
charity,
the
Mouth Cancer Foundation has
launched its brand new look
website at www.mouthcancerfoundation.org.
Speaking on the new look,
Founder of the charity, Dr Vinod Joshi, said: “The success of
the Mouth Cancer Foundation is
down to the interactive functionality of its website which members find really useful. There is a
great sense of community online.
The new website is fresh, inform-
ative and bursting with information to help patients and carers.”
In recent months the charity has experienced a record
number of hits to its website.
The online members’ forum is
also a hugely popular site for
the charity. As well as visitors
going to the site for information, they regularly request leaflets and merchandise on all aspects of head and neck cancers.
The signs, symptoms and
how to care for those with head
and neck cancer are the hottest
topics. DT
[3] =>
United Kingdom Edition
Editorial comment
M
arch 22 saw
the
19th
World Water Day – a UN-organised event focusing attention on the
importance of freshwater and advocating
for the sustainable management
of freshwater resources.
Focusing mainly on the use of
water in the production of food,
the campaign is aiming to raise
awareness of how our food choices and food production methods
use so much water.
‘What has this got to do with
dentistry?’ I hear you ask, and
on the face of it not a lot; but a
dental practice uses a tremendous amount of water every day.
According to the US-based Eco
Interventions
to change diet
A
study
published
on
The Cochrane Library
by the Cochrane Oral
Health Group, has reviewed
whether efforts by dentists and
other dental staff members
can be successful in changing
patients’ diets.
The researchers of the
study, One-to-one dietary interventions undertaken in a
dental setting to change dietary behaviour, identified
five studies, two of which
were concerned with diet advice given concerning general health, one of which was
about alcohol and one which
was about fruit and vegetable
consumption.
The researchers reported that in both these studies
there was a change to healthier behaviour following the
advice.
The authors also identified
three studies which attempted
to change sugar consumption
habits in order to reduce dental decay.
However, in two out of
these three studies there were
also other types of advice given so it was therefore impossible to say whether changes
in diet came about because of
the diet advice given or because they were subtly influenced by the other messages.
• The authors concluded that
the evidence for dietary advice aiming to change sugar
consumption is poor. Further
studies in this area should be
considered. DT
Dentistry Association a standard
dental vacuum system uses 300500 gallons of water a day - totalling 9bn gallons of water a year in
North America alone!
Talking food production the
first statistic you find on the World
Water Day website is that a human
being needs to drink two-four li-
News 3
March 26-April 1, 2012
tres of water every day. However,
to produce the daily food for one
person takes 2,000-5,000 litres
of water. As an example, it takes
about 1,500 litres of water to produce 1kg of wheat, but it takes
10 times more to produce 1kg of
beef; and meat consumption is on
the rise - from 37 kg per person
per year in 1999/2001 to 52 kg in
2050 (from 27 to 44 kg in developing countries).
Doing the maths, it is a fright-
ening to think about how much
water it takes for every human
activity. Let us all be part of the
solution by watching our water
use and making choices to reduce
our ‘water footprint’ (the total volume of freshwater that is used to
produce the goods and
services consumed by
an individual or a community or produced by
a given business) both
at home and in the
dental practice. 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
[4] =>
4 News
United Kingdom Edition
March 26-April 1, 2012
HPV pushes oral cancer cases past 6,000 a year
N
ew figures from Cancer Research UK have
revealed that the number of oral cancer cases diagnosed each year in the UK
has risen above 6,000 for the
first time.
A decade ago there were
more than 4,400 cases of oral
cancer. Now the latest figures
show this has risen to more than
6,200. Around two thirds of cases
are in men.
Oral cancer rates in the UK
have risen by around a quarter
in the last 10 years from around
six to eight cases per 100,000
people.
Experts believe that infections with high-risk strains
of the human papillomavirus
(HPV) may be a key reason
for the jump in cases of
oral cancer.
HPV infections are common
with up to eight out of 10 people
in the UK infected at some point
in their lives.
Infections are usually on
the fingers, hands, mouth and
genitals. Many strains of the
virus cause infections that
are harmless and get better on
their own. Most people will never know they had the virus.
But a few strains of HPV are
known as high-risk. If these
strains persist they can lead to
cell changes which could develop into cancer. One of these
high-risk strains is HPV-16.
Richard Shaw, a Cancer Research UK expert in head and
neck cancers, based at the Liverpool Cancer Research UK
Centre, said: “We have seen a
rapid increase in the number
of HPV16-positive cases of oral
cancer. We have also noticed
that patients with HPV-related
oral cancers tend to be younger,
are less likely to be smokers and
have better outcomes from treatment than those whose tumours
show no evidence of HPV.
ing at lifestyles 20 to 30 years
ago can help understand the rise
in cases.
“This raises questions as to
exactly how these cancers develop and why they only affect a
small proportion of people who
are exposed.
And while figures show that
the amount of alcohol bought in
the UK over the last 20 years has
increased by seven per cent – this
is unlikely to be a large enough
increase to explain fully the rise
in the rates of oral cancers.
“As HPV-related cancers appear to behave quite differently,
the Liverpool Cancer Research
UK Centre is also involved in
Cancer Research UK-funded
clinical trials to improve treatments.”
Traditionally,
the
main
risk factors for oral cancer
have been tobacco and alcohol. Oral cancers tend to take at
least a decade to develop so look-
Over the last 30 years, smoking rates in Britain have more
than halved.
Experts say this suggests other risk factors may be playing a
role – in particular HPV.
There
were
particularly
sharp rises in the incidence
rates of cancers at the base of
the tongue (almost 90 per cent
increase) and the tonsil (around
70 per cent increase) – two areas
of the mouth where cancers are
more commonly HPV-related.
Sara Hiom, director of information at Cancer Research UK, said:
“It’s worrying to see such a big
rise in oral cancer rates. But like
many other cancers, if oral cancer
is caught early, there is a better
chance of successful treatment.
“So it’s really important for
people to know the signs and
symptoms of oral cancer - mainly
mouth ulcers that just won’t heal,
any lumps or thickening in the
mouth, lips or throat, or red or
white patches in the mouth that
won’t go away.
“It’s not just doctors who have
a vital role to play.
“Dentists have an important
role to play in spotting oral cancer early and encouraging their
patients to take care of their
mouths.” DT
‘Five-a-day’ causing tooth decay
College of Surgeons, has been reported as saying that half of five
year olds show signs of enamel
erosion caused by fruit, particularly citrus fruits. She has called
for schools to ban fruit juice and
to offer milk and water instead.
A ban on serving fruit juice in schools has been suggested to help prevent tooth decay
in children
I
n response to news reports
about the risk of tooth decay
due to the inclusion of pure
fruit juice in ‘five-a-day’ recommendations, the Infant & Toddler
Forum (ITF) supports increased
awareness about the sugar and
acid content of juices, and the
risk of enamel erosion and subsequent dental caries in young
children.
Kathy Harley, dean of the
dental faculty at the UK’s Royal
their adult set in any case. However, the first teeth are just as
important as adult teeth, as early
loss of the first teeth can lead to
overcrowding when adult teeth
appear.
Younger children are also
at risk; the first teeth are just as
prone to dental caries as permanent teeth. It is important to take
special care of a child’s mouth in
order to prevent tooth decay and
avoid dental extractions and fillings.
“Fruit and vegetables are part
of a nutritious, balanced diet but
fruit is best given as pieces of fruit
rather than as juice. Fruit juices
are a source of vitamin C, helping
with the absorption of iron from
plant based foods; however, they
are acidic, high-sugar drinks and
can cause dental caries.
Judy More, paediatric dietician and member of the ITF, says:
“Parents often think that tooth
decay in children’s first teeth is
not important as they will grow
The sugars in sweet foods and
drinks are metabolised to acids
by the bacteria in dental plaque.
These acids, along with the acid
already present in drinks like
fruit juices, squashes and fizzy
drinks, cause demineralisation
or softening of the enamel.
“If fruit juice is given as a
drink it should be well diluted,
for example one part juice to
about six to ten parts water,
and should only be served in a
glass, cup or beaker, rather than
a bottle. Sucking slowly on sweet
drinks in a bottle increases the
risk of tooth decay.
Well diluted fruit juice, if
given, should be with meals and
snacks, and three-four oz or 100120ml is about right as a single
drink portion for one-three year
olds. Water and milk are the only
drinks that should be offered between meals and snacks.” DT
Charity calls for outright smoking ban
A
Cardiff-based charity,
Tenovus, has called for
an outright smoking
ban in Wales.
According to a BBC report,
the call was requested on the
same day that smoking was
banned within the grounds
of most Welsh hospitals.
The report stated that six of
the seven health boards in
Wales decided to prohibit
smoking in their grounds,
whilst the remaining health
board, Hywel Dda in Mid and
West Wales, is in the process
of developing a ban.
Even
though
smok-
ing shelters have been dismantled at hospitals where
outright bans are being
imposed, Richard Pugh, community development manager
for Tenovus, called for a much
more radical approach - a total ban on smoking.
“We’ve tapped away at
smoking here, smoking there
- stop smoking in cars, in restaurants, in public places,” he
said in the BBC report. “Sooner or later we will get to the
point where we stop smoking
altogether.
“So it’s time to think about
the bigger question - and let’s
do it now.”
Although Welsh government said it did not have the
power to introduce an outright
ban, it was reported that the
Welsh government’s actions
to tackle the harm caused by
smoking remained a priority.
A spokesman said the
government’s ultimate vision
was “of a smoke-free society
for Wales, in which the harm
from tobacco is completely
eradicated.”
Recently both the Welsh
government and Tenovus promoted their Fresh Start Wales
Smoking has already been banned in hospital grounds
awareness campaign outside
City Hall in Cardiff. The campaign aims to encourage parents and carers not to smoke
in cars carrying children. Stop
Smoking Wales will also be
available to provide information on its smoking cessation
service. DT
[5] =>
18th and 19th May 2012
Millennium Gloucester Hotel &
Conference Centre, London Kensington
info@smile-on.com | www.clinicalinnovations.co.uk | 020 7400 8989
Switch
on to new
ideas
Speakers:
Prof Nasser Barghi
Dr Richard Kahan
Prof Gianluca Gambarini
Dr Wyman Chan
Dr John Moore
Dr Ajay Kakar
Ms Jackie Coventry
Dr Mona Kakar
Basil Mizrahi
EA
RL
Y
Mhari Coxon
Fraser McCord
BO
OK
IN
G
DI
SC
OU
NT
[6] =>
6 News
United Kingdom Edition
March 26-April 1, 2012
FGDP(UK) elects new Dean
D
r Trevor Ferguson, (pictured), was elected to be
the 8th Dean of the Faculty of General Dental Practice
(UK) on 2nd March 2012. Trevor
will take over from the current
Dean Russ Ladwa in June. The
Faculty Dean is elected to serve
for up to three years, providing
clinical leadership and promoting the Faculty’s strategy and
policies in the professional and
public arenas.
Trevor Ferguson is a General Dental Practitioner who has
been practising in North Wales
for the past 25 years. He has
previous experience of vocational training, tutoring on postgraduate courses, University
teaching and maintains a continuing active commitment to
primary care dentistry. Dr Ferguson was a founder member
of the FGDP(UK) and has been
a member of the Faculty’s Board
since 1998.
Upon being elected Trevor
Ferguson said: “The achievements of the Faculty to date
have been remarkable, however we live and practise in very
challenging times. The future
success of the Faculty is dependent on increasing membership,
strengthening our position as
the standard setting organisation for general dental practice,
as a provider of postgraduate
education and training, and also
ensuring a greater voice in the
future of patient care. The next
few years are crucial and require significant vision and en-
thusiasm to achieve these goals.
I am delighted to have been
elected to the position of Dean
and I look forward to working
towards these goals, and articulating the Faculty’s position
within the Profession.”
Current
Dean
of
the
FGDP(UK) Russ Ladwa congratulated Dr Ferguson on his
election saying: “Trevor Ferguson has contributed hugely to
the FGDP(UK) to date. He has
all the right qualities to lead the
Faculty forward at a challenging
and critical time for our profession. I wish him well!”
Also elected on the 2nd
March were two Vice-Deans,
with Lawrence Mudford being
elected for a second successive
term and Naresh Sharma for the
first time.
In response to his re-election
Lawrence Mudford said: “I am
honoured and delighted to have
been re-elected as Vice Dean of
the FGDP (UK) in a year which
marks the Faculty’s 20th anniversary. I look forward to working alongside the Dean, Faculty
Board and staff to develop and
enhance patient care into the
future”.
Naresh Sharma said of his
election as Vice Dean: “After 20
years at the FGDP I am delighted to be elected as a Vice Dean.
It will give me great pleasure
to serve the Faculty and try to
shape a better future for our colleagues and our profession.” DT
A voyage of discovery for BDTA
M
embers of the dental
press gathered at the
Royal Institution in
London on 9 March 2012 for
this year’s BDTA Dental Showcase marketing theme launch.
The Royal Institution is an
independent charity dedicated
to connecting people with the
world of science, and with its
focus on discovery, innovation,
inspiration and imagination, it
was the perfect venue to launch
this year’s marketing theme of
‘A Voyage of Discovery’. At over
200 years old, the Royal Institution has seen the discovery of
ten chemical elements, and has
been the site of many scientific
experiments, including the research that told us why the sky
is blue.
The dental press gathered in
the Sunley Room of the Royal Institution for drinks before Tony
Reed, Executive Director of the
BDTA, formally introduced the
theme of this year’s marketing
campaign. Jane Harrison, who
works on the Institution’s Her-
itage team, then took guests on
a tour of the museum, showing
them the preserved laboratory
of 18th century scientist Michael Faraday and the state-ofthe-art nanotechnology lab that
sits opposite and is in use daily.
Guests also enjoyed a threecourse lunch, and after dinner
coffee was served dramatically
surrounded by dry ice.
Tony
Reed
commented:
“Launching the Showcase marketing theme is always a thoroughly enjoyable event, and a
great opportunity for the dental
press to gather. Having been the
location of so many important
discoveries and scientific developments, the Royal Institution
proved to be a great venue for
this year’s theme of ‘A Voyage
of Discovery’. It re-enforces the
fact that Showcase is still the
best place to see all the latest
innovations in dentistry, and to
discover what’s new.”
BDTA Dental Showcase 2012
takes place from 4-6 October
2012 at ExCeL London. For fur-
The theme of this year’s marketing campaign is ‘A Voyage of Discovery’
ther information visit www.dentalshowcase.com. DT
Key to immune system disease could lie inside the cheek
P
owerful new cells created
by Cardiff University scientists from cheek lining
tissue could offer the answer to
disorders of the immune system.
While the body’s immune system protects against many diseases, it can also be harmful. Using
white blood cells (lymphocytes),
the system can attack insulinproducing cells, causing diabetes,
or cause the body to reject transplanted organs.
A team from Cardiff’s School
of Dentistry led by Professor Phil
Stephens, with colleagues from
Stockholm’s Karolinska Institute,
have found a new group of cells
with a powerful ability to suppress
the immune system’s action. The
team took oral lining cells from
the insides of patients’ cheeks
and cloned them. Laboratory tests
showed that even small doses of
the cells could completely inhibit
the lymphocytes.
The breakthrough suggests
that the cheek cells have wideranging potential for future therapies for immune system-related
diseases. Existing immune system research has focussed on
adult stem cells, particularly
those derived from bone marrow.
The cheek tissue cells are much
stronger in their action.
Dr Lindsay Davies said: “At
this stage, these are only laboratory results. We have yet to recreate
the effect outside the laboratory
and any treatments will be many
years away. However, these cells
are extremely powerful and offer
promise for combating a number
of diseases. They are also easy to
collect – bone marrow stem cells
require an invasive biopsy, whereas we just harvest a small biopsy
from inside the mouth.”
The findings have just been
published online in Stem Cells
and Development. The team has
now been funded by the Medical
Research Council to investigate
the cloned cells further. DT
[7] =>
United Kingdom Edition
News 7
March 26-April 1, 2012
Study recognises value of YouTube for dentists
Using YouTube as a means of dental education is an area that has been described as
being ‘highly underdeveloped’
DTI: Researchers investigating
YouTube have suggested that
the potential of the online video-sharing platform and similar
social media sites as means of
dental education is highly underdeveloped. In a study, they
found that it could hold important implications for dental
professionals, as well as dental
education staff.
Owing to an increasing
integration of multimedia
sources into professional and
academic education, Dr Michael Knösel, an orthodontic specialist, and his team
from the University of Göttingen, assessed the value of
videos on YouTube related
to dentistry. Using different
search parameters, they discovered that there is wide variety of material available on
YouTube with high educational value.
Two assessors with an
academic background evaluated 60 videos in the general
category “All” and 60 videos
in the “Education” category.
The results were first sorted
“by relevance” and later by
“most viewed”.
According to the researchers, the informational value
of videos in the general category was perceived as generally poor, whereas the most
viewed videos in the educational category had the highest
educational value. Videos in
this category were concerned
with oral surgery and implantology (17), preventive dentistry (13), general dentistry
(16), as well as aesthetic dentistry and orthodontics (9).
Five videos were considered
to be entertaining rather than
educating.
Videos in the educational
category were mostly uploaded by practitioners but also
by academic institutions and
dental companies. The majority of videos in the general
category, which were aimed at
entertainment generally, were
mostly posted by patients and
laypersons, but there was
also a significant percentage
of videos with a commercial
purpose and posted by dental
manufacturers.
The assessors said that
videos in the educational category depicted an optimistic
view on dentistry, whereas
those in the general category
tended to be rather negative.
They found that between 68
and 93 per cent of the videos
represented dentistry accurately, and videos in the general category were inaccurate
in this regard.
The researchers recommended that more academic
institutions acknowledge YouTube as an effective supplementary medium for education. Currently, there are only
a few dental schools that run
their own YouTube channels.
The University of Michigan’s
School of Dentistry, for example, initiated its channel
more than three years ago and
recently surpassed seven million viewers.
“YouTube and similar so-
cial media websites offer
new educational possibilities for dentistry, but are currently both underdeveloped
and underestimated regarding their potential value.
Dentists should also recognise the importance of such
websites in relation to the
formation of public opinion
about their profession,” the
researchers stated. “We would
therefore like to encourage
educators to make greater
use of this medium, to work
to improve the quality of
videos, and to demand that
contents are updated on a regular basis.”
The
study,
published
in the December 2011 issue of the Journal of Dental Education (J Dent Educ.
2011 Dec;75(12):1558-68), was
conducted between six and
8 October 2010. The researchers used four search items
on YouTube (“dentist”, “dentists”, “dentist’s”, and “dentistry”). DT
Robotic surgery proves successful
ly appeared predominantly in
elderly patients with a history
of tobacco and alcohol use,
it’s increasing in younger patients: 30- to 50-year-old nonsmokers with the human papillomavirus (HPV).
Cancer of the tonsils and base of the
tongue has risen over the past few decades
O
ver the past few decades, doctors have
noted a surprising
trend in cancer of the tonsils and base of the tongue.
Though oral cancer previous-
Fortunately, the newer
form of cancer tends to be
less aggressive, and the latest approach to treating the
tumours can avoid the debilitating consequences of open
neck surgery or extensive
radiation. Robotic surgery
conducted through patients’
mouths provides excellent results in removing squamous
cell carcinoma at the back of
the throat, especially in patients with HPV, a Mayo Clinic
study published in the March
issue of Mayo Clinic Proceedings found.
“We were surprised that
the cancer cure results were
even better than the traditional treatments that we have
been doing, but that is probably almost as much of a matter
that these cancers are HPVmediated for the most part,
and they respond much better to treatment,” says author
Eric Moore, MD, a head and
neck surgeon at Mayo Clinic
in Rochester. “Importantly,
the treatment preserved patients’ ability to swallow and
their speech performance was
excellent.”
Dr Moore and his team
followed 66 patients with
oropharyngeal cancer who
underwent transoral robotic
surgery with the da Vinci robotic surgical system. Every few months, the patients
had imaging studies, scans
and exams to determine if
cancer was recurring. After
two years, researchers found
that patients’ survival rate
was greater than 92 per cent,
as good as rates for some other surgical and nonsurgical
treatments for oropharyngeal
cancer.
Because traditional surgery techniques to remove
throat tumours can be traumatic, requiring cutting and
reconstructing the jawbone,
neck and tongue, researchers were also interested in
patients’ healing after robotic
surgery.
“We found that with transoral robotic surgery 96 per
cent of patients could swallow a normal diet within three
weeks of treatment,” Dr Moore
says. Less than four per cent
required a gastrostomy tube,
which enables food to bypass
the throat.
The study provides preliminary data showing the robotic
surgery is a viable treatment
option, Dr Moore says. Continuing research involving
multiple medical centres will
investigate transoral robotic
surgery in a larger population
of patients with oropharyngeal cancer. DT
SmartSeal donate £5k to support Bridge2Aid
B
ridge2Aid (B2A), the
dental and community
development
charity
working in the Mwanza region of North West Tanzania,
has gratefully received a major donation from SmartSeal
of its innovative endodontic
root filling material.
The donation, worth in excess of £5,000, includes the
SmartSeal endodontic filling
material, PropointPTs – taper
points that match the Protaper
file system already in use by
B2A at its Hope Dental Centre
– and Smartpaste, which expands in the root canal to seal
any lateral canals.
Dental staff have been
using the SmartSeal full system at Hope Dental Centre
in Mwanza and with patients
at the five mines they visit
regularly since November
2011.
Dr Abed Mafwele, a den-
tist from Tanzania working
at Hope Dental Centre, comments: “SmartSeal is a very
good material. I am happy to
use this for endodontics and
have already had good results.”
Dr Paul Brind, principal
dental surgeon, Hope Dental
Centre, agrees: “SmartSeal is
a reliable, easy to use material
which is proving to be really
useful here in Tanzania. During our mine visits it enables
us to provide good quality endodontics using a very small
and portable kit.”
Hope Dental Centre is a
not-for-profit dental clinic in
Mwanza run by B2A. It employs three dentists and a dental therapist to provide primary dental care and oral health
education to the people of the
area. The funds generated by
the clinic go towards the development work B2A is doing
in Tanzania.
B2A is very grateful for donations from companies such
as SmartSeal because they
enable us to provide quality
treatment and generate funds
for the training of clinical officers across Tanzania, enabling them to equip and empower local health personnel
in the region.
For more information on
Bridge2Aid please visit www.
bridge2aid.org. DT
[8] =>
8 News
United Kingdom Edition
March 26-April 1, 2012
TV star opens The Smile Centre
tre in Lichfield.
She was joined by Lichfield
MP Michael Fabricant and more
than 80 specially invited guests
for the event at the new clinic in
Upper St John Street.
The Smile Centre Lichfield
is headed up by clinical dental
technician Matt Burnell, who
has joined The Smile Centre as
a director.
Matt Burnell and Barrie Semp of The Smile Centre with TV star Crissy Rock
A
ctress and comedienne
Crissy Rock has opened
a state-of-the-art denture
clinic in the Midlands.
Crissy, who was one of the
stars of the last series of ITV’s
I’m a Celebrity Get Me Out of
Here, launched The Smile Cen-
Burnell and The Smile Centre team will provide patients
with dentures, dental implants
and a full range of cosmetic dentistry.
Barrie Semp, founder of The
Smile Centre, and Matt Burnell
New team to transform
and revitalise CODE AFA
AFA for its members in the
coming months.
The new look Association
will work hard for members,
making its voice heard on
key industry issues such as;
regulation, best practice and
standards as well as forging
even closer links with membership and encouraging new
people to join.
F
acial aesthetics practitioners are being offered
a great new opportunity as CODE The Association
for Facial Aesthetics (CODE
AFA) - is given a facelift, appointing a new Chief Executive and Board.
Martin MacKenzie now
heads up the Association and
is currently appointing board
members as he announces
ground-breaking new developments set to transform the
Paul Mendlesohn, Chief
Executive of the wider CODE
organisation, will be working
with Martin. Together they
will develop AFA’s strategies
and build closer links with
other key industry associations to create an louder voice
for facial aesthetics and associated industries.
The AFA website - www.
the-face.co.uk - will be constantly improved and modules will be kept regularly
updated as valuable sources
of reference information and
practical advice. The AFA
Board will also put news sharing at the heart of its plans,
explains Martin: “There is
always a lot happening that
affects our members and their
facial aesthetics practice’s
so I not only want to keep
members informed, I also
want to increasingly represent their views within the
industry and give the AFA a
louder voice.”
Other changes include
the introduction of a new consultancy service for medical
clinics seeking CQC registration, based on the existing CODE Assure clinical
governance
system
for
dental practices.
In the coming months,
the AFA Board will be looking to grow the Association’s
membership
and
encourage current members to get
in touch with their ideas and
views on the future direction
of CODE-AFA. DT
decided to open in Lichfield after a surge in the number of patients from the Midlands visiting
his clinics in the North West of
England. More than six million
people wear partial or full dentures in the UK.
Matt Burnell said: “We are
hugely excited about opening in
the Midlands and the response
we have had already indicates
that there is a lot of demand
for the range of services we
can offer from our state-of-theart clinic.
“In addition to dentures,
we provide customers with dental implants and a full range of
cosmetic dentistry including
teeth whitening, orthodontics
and veneers.”
Crissy Rock, who famously
took out her own dentures when
asked to jump out of a helicopter
during filming of I’m a Celebrity,
said: “The Smile Centre is one of
the leading denture clinics in the
UK and it is really important that
patients do their homework and
ensure they choose the best possible denturist to look after their
treatment.
“Your smile is the first thing
that people notice and the confidence great teeth can give you
cannot be underestimated.” DT
For
more
information,
please visit www.thesmilecent
reuk.co.uk
Keeping up to speed
B
SI will now co-host the
most comprehensive medical device training library
in the world thanks to a collaborative partnership with the World
Medical Device Organisation
(WMDO).
This new agreement with
WMDO means that BSI will have
the capability to provide medical device professionals with unlimited access to a suite of online
medical device training courses
to complement BSI’s existing instructor led training portfolio.
The medical sector has recently highlighted the need for
a greater focus on professional
training at a time when budget
and time are at a premium. WMDO’s extensive catalogue of over
130 device-specific online training courses will therefore enable
BSI to provide new eLearning
techniques to bring medical device staff ‘up to speed’ with regulations and best practice processes through new distance learning
options. These online training
solutions will be of particular interest to start-up companies in the
medical devices sector who will
welcome greater flexibility and
cost-effectiveness of self-paced
learning. The first of the online
courses to be offered by BSI will
be around in-vitro-diagnostics.
“Partnering with WMDO will
allow BSI to broaden its online
training capabilities, through offering a portfolio of e-learning
medical device courses. These
courses are aimed at professionals interested in increasing their
knowledge of the medical device
regulations from product conception to post market surveillance,”
said Gary Slack, Global Director
Med Tech at BSI.
Danielle Giroud, Founder
and CEO of WMDO said, “We are
honoured to join with BSI tocomplement their educational program curriculum.” Giroud added,
“WMDO is focused on the creation
and delivery of innovative and effective eLearning solutions and
provides medical device professionals with online access to highquality learning resources that are
timely, relevant and engaging.”
For further information on
BSI’s new e-learning courses,
please visit medicaldevices.bsigroup.com DT
[9] =>
United Kingdom Edition
March 26-April 1, 2012
Interview 9
Make regulation proportionate
In the second part of this four-part series, Neel Kothari talks to Susie Sanderson
about dental regulation
CQC and HTM 01-05 should actually be demonstrating in their application that they’re improving patient safety or preventing harm
Susie Sanderson
N
K: The last year saw
a huge rise in legislation. What does the
immediate future hold with
regards to legislation? Are
there any signs that things
will get better or is it now here
to stay?
SS: There’s a whole raft of
stuff, isn’t there, that we have
to demonstrate compliance
to. I suppose you’re probably
talking about the things which
have been on most people’s
minds over the last two or
three years, and that’s HTM
01-05 and the CQC regulation.
CQC and HTM 01-05 should
be proportionate, evidence
based, relevant, cost effective;
they should
actually
be demonstrating in their application that they’re improving patient safety or prevent-
benefit analysis is an important exercise to conduct.
There is so much immediate
‘Dentistry is a low hanging fruit – it’s a
very easy area to access to implement regulation. Everybody knows where we are
and we’re in small units’
ing harm. I don’t think either
of them yet have published a
comprehensive evidence base
that confirms that. Both of
them are based on risk evaluation and the problem with
that is the level of risk which
is deemed to be acceptable.
Outcry
At the moment the approach
appears to be that in dentistry nobody should be
harmed at any time in
any way, no matter
what it costs
to do that.
And the
cost
communication through various media now when something goes wrong there’s immediately a public outcry and a
demand that something is done
about it.
Failures in patient safety in
health services get a lot of publicity. Dentistry is a low hanging fruit – it’s a very easy area
to access to implement regulation. Everybody knows where
we are and we’re in small
units. Now the fight that we’ve
been making and the noise that
we’ve been making and the influence that we’ve been trying
to sway over the last few years
is that even in dentistry, where
we are so easily identifiable,
regulation must be proportionate. There is no point in
spending hours and hours
and thousands of pounds
on something which is
very, very low risk. Common things commonly
happen – now let’s target
the common things first,
let’s get it proportionate,
let’s deal with the things
that are likely to happen
and be realistic about the
things which aren’t likely to
happen.
I actually think the changes
in the antibiotic prescription
for bacterial endocarditis is
that sort of sensible approach.
Let’s weigh up the risks, the
bacteriologists said, and quite
rightly a decision has been
made based on the risk and
benefit to the patient.
That’s a great example of
some really good, proportionate thinking, but the fight it
took to get that through was
just enormous. So that’s been
our thrust through all this –
challenging CQC at every point
to say: why are you concerned
about this, what is it going to
do to improve patient safety? I
don’t think that any dentist at
all would be concerned about
doing something which genuinely will improve patient
safety – a demonstrated risk of
harm which could commonly
happens.
Conundrum
I’ll tell you one of our conundrums. HTM 01-05 does have
some evidence based areas
and there is well publicised
challenge in some areas– such
as bagging instruments: ridiculous, silly things which
take a member of staff hours
in the day to do. We all intuitively think, what on earth is
the point of that? Well the Department of Health is obliged
to know that we’re right in our
intuition, so they’re doing the
research. It would help our efforts if we could confirm that
all dental professionals are following guidance as far as they
are able to though. We know
that the majority are but there
are occasionally reports of poor
practice which let us all down.
NK: So effectively, dealing
with those at the bottom,
rather than hampering those
people who are trying.
SS: It’s the bottom two per cent,
isn’t it and the disproportionate amount of resources we
all spend being tarred with
the same brush. . Regulation
is built on correcting the small
amount of failures, which in
turn creates detriment for
those who are already getting
it right. Risk mitigation arises
because of out of the ordinary
events like Dr Shipman, the
Bristol Babies and the Alder
Hey body part scandal. You get
one high profile episode which
then rolls out and you get a disproportionate regulatory load
on top of that.
The BDA is for and about
dentists, all the time, and I will
protect and support and look
after all our members to the
end, but actually everybody
needs to take what really needs
to be done seriously as well. DT
In my next article, Susie
Sanderson answers questions
on dental nurses.
About the author
Neel
Kothari
qualified as a dentist from Bristol
University Dental
School in 2005, and
currently
works
in Sawston, Cambridge as a principal dentist at High
Street Dental Practice. He has completed a year-long
postgraduate certificate in implantology and is currently undertaking the
Diploma in Implantology at UCL’s
Eastman Dental Institute.
[10] =>
10 Practice Management
United Kingdom Edition March 26-April 1, 2012
What’s your KOLBE™?
Alun Rees discusses ways to assess your team so you can get the best results
O
• Does your team fail to keep
their motivation?
ne of the biggest challenges to any clinician
and business owner is
the blending of individuals to
make a team. In reality;
• Do you recruit people then
find they aren’t quite what you
thought?
• Do have difficulties integrating the individuals into a team?
• Are you beset with problems
retaining staff?
Easy, Successful and Affordable
• Is your hygienist outside the
wire?
The KOLBE A Index is a
36-question survey completed
on-line that reveals the individual mix of striving instincts;
it measures energies in four
“Action Modes”:
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• More efficient procedure for the dentist
Developer of the Champions system / CEO
• Champions® implants: a wide range of innovative
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The KOLBE Wisdom™ Identifies the striving instincts that
drive natural behaviours focuses on the strengths of your
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Made in Germany
Dr. Armin Nedjat said,
• Do your associates fail to
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Tel. + 49 151 / 15 25 36 92
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CI Dental Tribune UK-297 x 420.indd 1
• Follow through – sorting
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Recommended by VIP-ZM
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27.02.12 13:59
• Implementation – handling
physical space and the ability
to operate manually. It measures durability and a sense of
the tangible
We “initiate”, “respond” or
“prevent” in each of these action modes. Initiation or insistence implies strong-willed
behaviour resulting from high
levels of energy in one action
mode. Prevention or resistance is the unwillingness to
act in an action mode due to
low levels of energy in that
particular mode.
[11] =>
United Kingdom Edition March 26-April 1, 2012
Practice Management 11
Conation doesn’t define
what you can or can’t do, rather what you will and won’t do.
A person’s MO is quantifiable and observable yet
functions at the subconscious
level. MOs vary across the
general population with no
gender, age or racial bias.
An individual’s MO governs actions, reactions and interactions. The MO also determines a person’s use of time
and his or her natural form
of communication. Exercising
control over this mental resource gives people the freedom to be their authentic
selves.
For a team to fit together it depends on the all members’ understanding their differences
Kolbe is different from other assessment tools that measure the cognitive, or intellectual, which controls thought,
and the affective, or emotional, which controls feelings, as
these can give inconsistent
results. An individual’s Kolbe
result doesn’t change significantly through their life.
Skills can be taught; personalities change but instincts
as measured by Kolbe are
hardwired into each and every
individual.
Hence the question: What’s
your KOLBE?
Some background - Kathy
Kolbe is a well-known and
highly honoured author and
theorist who has been working in the field of human behaviour for nearly 40 years.
From her scientific studies of
learning differences she devised The Kolbe Wisdom™,
which has been used by such
businesses as Kodak, IBM and
Xerox and many others around
the world. It is now available to
be used with smaller teams.
nate pattern (modus operandi,
or MO) that determines each
person’s best efforts.
These conative or instinctive traits are what make us
get things done. As Kathy Kolbe has written, “The conative
‘Skills can be taught; personalities
change but instincts as measured by
Kolbe are hardwired into each and
every individual.’
The Kolbe Wisdom™ is
based on the concept that creative instincts are the source of
the mental energy that drives
people to take specific actions.
This mental drive is separate
and distinct from passive feelings and thoughts. Creative instincts are manifested in an in-
is the clincher in the decision
making hierarchy. Intelligence
helps you determine a wise
choice, emotions dictate what
you’d like to buy, but until the
conative kicks in, you don’t
make a deal – you don’t put
your money where your mouth
is.”
Any interference with the
use of this energy reduces
a person’s effectiveness and
the joy of accomplishment.
Stress inevitably results from
the
prolonged
disruption
of the flow of energy. Others
can nurture this natural ability but block it by attempting
to alter it.
Individual
performance
can be predicted with great
accuracy by comparing instinctive realities, self-expectations and requirements. It
will fluctuate based on the appropriateness of expectations
and requirements.
When groups of people
with the right mix of MOs
function interactively, the
combined mental energy produces synergy. Such a team
can perform at a higher level
than is possible for the same
group functioning independently.
Team performance is accurately predicted by a set of
algorithms that determine the
appropriate balance and make
up of MOs.
Leaders can optimise individual and group performance
by:
One of the biggest challenges to any clinician and business owner is the blending of individuals to make a team
• Giving people the freedom to
be themselves
• Assigning jobs suited to individual strengths
• Building synergistic teams
• Reducing obstacles that
cause debilitating stress
• Rewarding committed use of
instinctive energy
• Allowing for the appropriate
use of time
• Communicating in ways
that trigger the effective use
of the natural, universal and
unbiased energy of creative
instincts
Any team depends on:
• The conative fit each individual has with his or her individual role
• The members’ understanding of the differences between
each other
• The management of the team
in using the talent available
In addition to its use in
building the right team, understanding of the concepts
help in every facet of the
practice of dentistry. When
the knowledge is applied to
clinical situations or ones of
patient choice and treatment
planning then resistance can
be handled and the correct
way of presentation used.
There are only three fully
trained and accredited KOLBE Consultants in the UK; I
am the only one experienced
in working with dentists and
their teams. I have been using this tool for nearly four
years and never tire of seeing
the improvement in individual
and collective results of using
the system.
The individual’s response
to reading their Kolbe assessment is usually a real “light
bulb moment” as they grasp
what their strengths are and
then understand why they
struggle with some tasks and
roles. The team builder also
gets clarity about why some
individuals merge into something greater than the sum of
their parts and others end up
getting in each other’s way
and perform poorly.
You consider yourself a
professional in the way you
work clinically, isn’t it time
you took your team building
as seriously? DT
About the author
Alun Rees trained
at Newcastle University and started
his career as an
oral surgery resident, before working as an associate
in a range of different practices. With
this solid foundation, Alun went on to launch two practices in the space of just 15 months,
a challenge in the toughest economic
conditions. After years of hard work
Alun finally sold his award-winning
business in 2005. Alun’s background
and experience give him a strong understanding of what others go through
to build a successful practice. He has
seen many different approaches and
learned his own lessons in the real
world. Alun now runs Dental Business
Partners to offer specific and specialised support for dentists, by dentists.
He has served as a media representative for both the BDA and BDHF and
is an authority consulted by the media and has featured on BBC2, Sky TV
and various radio stations. Raised in
South Wales, Alun has family roots in
West Cork where he spends as much
time as work allows. In other spare
moments he has run three London
marathons and lists rugby, real ale
and music as relaxation.
www.dentalbusinesspartners.co.uk
alun@dentalbusinesspartners.co.uk
For more information email Alun at
alunrees@mac.com, or alternatively
call 07778 148583 or 01242 511927
If you would like to find out more
about using these fantastic tools in
your practice or if you would be interested in a presentation to your
study group or society contact Alun at
alun@dentalbusinesspartners.co.uk
or on 07778148583.
[12] =>
Andalthisfromthestrilzerwith efaste rtueBcyleonthemarket!
12 Comment
United Kingdom Edition
March 26-April 1, 2012
Writing for the greater good
Michael Sultan calls for responsible reporting
A
s we are all too aware,
there is almost not a
week that goes by without
some form of dentistry-related
scare story hitting the headlines
of the national press. For the
sexually-depraved healthcare
professionals. I can’t help but
wonder then, if these stories really are in the best interests of
the public, if they really do work
for the national good.
most part, these stories seem to
embody everything that’s bad in
the world – they play upon the
fears and concerns of the general public and work to support
the stereotypes of greedy and
Evolution in action
The original LED turbine just got even better!
Many will have seen the
scare story that hit the headlines recently surrounding the
US dentist accused of medical
fraud. In the news story – reported by a number of sources
– a former dentist in the USA
pleaded guilty to using sections of paperclips instead of
stainless steel posts in a patient’s root canals. While I can
never for a moment condone
such a case of clear malpractice I do worry that these sorts
of stories are not constructive to the message of good
practice that we are trying
so hard to convey to our patients. Endodontics already
has a very poor press, and to
ContacW&HtodayforadviceonhwtocmplywithHTM01-5theLisawy.
‘While I can never
for a moment condone such a case of
clear malpractice I
do worry that these
sorts of stories are
not constructive to
the message of good
practice’
be compounded by a dentist
claiming large sums for putting something so cheap and
nasty in something obviously
so delicate is quite alarming.
Interestingly, the use of
pre-fabricated stainless steel
posts has been quite common
in dentistry over the years.
Historically, some dentists
(guilty as charged – but a long
time ago) have even been
known to use paper clips for
post impressions, with posts
being made of gold and various less “blingy” alloys lasting
for years.
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Colleagues will be aware
that the success of any endodontic treatment is down to
the effective cleaning of the
canals, with practitioners ensuring the canal is then fully
sealed to stop further infection. The most alarming aspect of the paperclip story
from our perspective then is
not so much that it was a paperclip per se, but more that
the paperclip would have
been non-sterile and would
always result in a poor fit, allowing bacteria to grow and
resulting in discomfort for
patient, retreatment or even
tooth loss. In the case of this
particular story, it will almost
certainly lead to jail for the
practitioner.
[13] =>
While we as dental professionals will be able to appreciate the nuances of the story
– and of course the fact that
cases like this are incredibly
rare – members of the public
will very likely view the story
differently. Indeed, why bother visiting the dentist at all if
this is how dentists behave?
My next example of dentistry in the media is perhaps
a little more subtle.
I remember quite specifically a case last year where
a poor woman from Brighton
died in the dentist’s chair – reportedly of an allergy to chlo-
‘How are we to
successfully fight
dental phobia and
other such anxieties
when the news only
ever seems to paint
dentistry in a
negative light? ’
rhexidine mouthwash. Now
I don’t for a moment want to
downplay the newsworthiness of this story, or indeed
the human tragedy that
the story represents. What
worries me more than anything in this case, is once
again how the general public
will perceive it.
As dentists we fight a constant battle against factors
that put people off attending
for regular check-ups and
treatment. One of the main
factors in this regard is that
of dental phobia – essentially,
fear of the dentist. How are
we to successfully fight dental
phobia and other such anxieties when the news only ever
seems to paint dentistry in a
negative light? How can we
highlight the great advances
in dentistry, reinforce messages of prevention and carry on
screening for problems such
as oral cancer?
So, what’s the solution?
Obviously we cannot and indeed should not ask for the
press to be stripped of their
freedoms. Instead, as in politics we should demand the
media show some sort of bal-
Comment 13
March 26-April 1, 2012
ance – especially in stories
that can potentially impact
upon public health. For a
start, I think there is a definite need for a more positive
approach to public health
stories in the general media.
I’m not talking about “brainwashing” here – what I’m
asking is that the press make
more of a conscious effort to
write stories that reflect some
of the good we healthcare
professionals do, instead of
Upto
always doing us down. I also
ask that they reflect stories accurately and fairly, with extra
attention given to the explanation of important scientific
facts.
In cases such as the paperclip trial, it would help if news
reporting went a little further
than just highlighting the
alarmist elements to the case.
In the story of the woman who
died from an allergy, it would
help if some balance were
shown either in the reporting, or as a separate feature.
This is the public health we’re
dealing with after all – the
wellbeing of the nation. Until
the media starts to take note of
some of the positives that can
be found in healthcare, and
starts taking a more responsible approach to healthcare
reporting, I fear an awful lot
of the good work we do will go
to waste. DT
a Whopping
o
O
United Kingdom Edition
OFF
Lasers - Whitening - Cameras - Curing Lights
Dr Michael Sultan
is a specialist in
Endodontics and
Clinical Director of
EndoCare. Dr Michael Sultan BDS
MSc DFO FICD is
a specialist in Endodontics and the
Clinical Director of
EndoCare. Michael qualified at Bristol University in 1986. He worked as a
general dental practitioner for 5 years
before commencing specialist studies
at Guy’s hospital, London. He completed his MSc in Endodontics in 1993
and worked as an in-house Endodontist in various practices before setting
up in Harley St, London in 2000. He
was admitted onto the specialist register in Endodontics in 1999 and has
lectured extensively to postgraduate
dental groups as well as lecturing on
Endodontic courses at Eastman CPD,
University of London. He has been involved with numerous dental groups
and has been chairman of the Alpha
Omega dental fraternity. In 2008 he
became clinical director of EndoCare,
a group of specialist practices. For
further information please call EndoCare on 020 7224 0999
or visit www.endocare.co.uk
Visit www.quicklase.com
Call us 01227 780009
QLQW40%Mag231211RG
About the author
[14] =>
14 Event Review
United Kingdom Edition
March 26-April 1, 2012
All the fun of the show
Dental Tribune looks back at this year’s Dentistry Show
One of the packed lecture halls
Delegates in action at the Dentistry Show 2012
W
ith the enormous
success of the Dentistry Show 2012 now
behind us, many delegates are
looking back at what was a fantastic event. With an extensive
selection of exhibitions, seminars, lectures and workshops,
practitioners were provided
with all the support and insight
they could possibly need and
the atmosphere was truly buzzing!
Among the many recognisable names speaking at this
year’s event was Chief Dental
Officer Barry Cockcroft, with
his talk “The Changing Face of
Dentistry”. His lecture encompassed a broad range of topics
ranging from the government’s
relationship with dentistry
through to oral health and the
future of the NHS. In a well-received speech he outlined the
coalition government’s three
main commitments to dentistry
in the UK of improving access,
developing a new contract
and improving oral health,
(although as Barry explained,
this commitment would be far
more complex than merely
“providing more services” or
“investing money”). But he did
give delegates reason to be optimistic!
Noting that although there
has been an increase in complaints regarding cosmetic
dentistry, Barry made it clear
that there are far more posi-
tives to be taken from UK
dentistry. He explained that
the NHS is certainly not a
“dead horse” just yet, and that
there is a lot to be said for
the government’s strong commitment to the oral health of
the nation.
During the 2012 Future
Dentist conference, there was
also an update delivered by
the GDC, which was hosted by
GDC Chairman Kevin O’Brien.
The topics covered were the
roles of the GDC, their strategy
for looking ahead, the challenges that face the GDC as an
organisation, and finally, the
future of the GDC and the future of UK dental governance.
Among the many workshops held at this year’s Dentistry Show, the Aesthetic Dentist conference was an area
that definitely delivered a great
response! Dr Jason Smithson
gave the conference an edge
thanks to his presentation on
exploring strategies for restoring structurally compromised
posterior teeth. He used a number of videos and case studies, and took the opportunity
to ‘cherry pick’ a selection of
particularly interesting areas,
discussing the Peripheral Rim
Theory, (where he compared
the surrounding enamel of a
tooth to a tin can!), and he even
found time to talk about volumetric polymerization contraction of photo cured, and light
cured composite resin!
Dr Richard Charon also
spoke at the conference and
encouraged the use of inhalation sedation in practice in an
effort to put those anxious patients at ease to help achieve
use the Modified Dental Anxiety Scale to give a final figure
that indicates how scared the
patient really is.
Among the most highly anticipated lectures hosted over
the course of the event was
that held by Dr Didier Dietschi.
Talking to a packed conference
room, Dr Dietschi addressed
the subject of “Conservative
restoration of aesthetics and
function in patients with severe
tooth wear”, and provided numerous case examples of how
his unique conservative approach can provide positive
cosmetic outcomes for patients
with tooth wear.
One of the key features of
Dr Dietschi’s approach is his
respect for what he calls, “bioaesthetics”. This involves paying particular attention to both
biology and bio-mechanics.
With his opinion that biology
and bio-mechanics are both incredibly important and should
‘With an extensive selection of exhibitions,
seminars, lectures and workshops, practitioners were provided with all the support
and insight they could possibly need ’
The live theatre was a great success
optimum treatment outcomes.
He screened a number of videos and written testimonials
from satisfied patients, as well
as videos of patients undergoing treatment.
be considered at the same level
as aesthetics in the clinician’s
mind, Dr Dietschi was keen to
express that he always thinks
twice before taking a bur to
prepare teeth!
Dr Charon also described
the differences between fear,
anxiety and phobia, and explained that the patient’s problem needs to be identified before deciding the best way of
managing their treatment. As
he explained, Dr Charon assesses patients’ level of fear by
simply talking to them, but he
suggested others might wish to
One of the six different conference streams was the Nursing Network, which brought
together information covering core CPD subjects ranging from special care and implants right through to oral
hygiene. Among the many respected speakers taking to the
stage was Mabel Slater, who
to a packed conference room
[15] =>
United Kingdom Edition
presented her lecture “Patient
care in practice, realising your
potential”.
In essence, Mabel’s talk
was all about the importance
of getting to know yourself
better so you can make the
best use of your skills. She discussed how an important part
of the self-reflection process is
to take stock of your skills and
work out where your strengths
lay, and concluded by demonstrating that once you find your
own “niche” in life, you will
truly be able to maximise your
potential.
Among the many workshops held at this year’s Dentistry Show, one of particular
note was Dental Protection’s
Annual Press Meeting. The
first speaker at the meeting
was senior dento-legal advisor
Sue Boynton, who gave a brief
but informative summary of
affairs within the Care Quality
Commission (CQC).
Dental Protection’s communications manager David
Croser then gave a lecture on
the Department of Health Consultation on the Management
of HIV Infected Healthcare
on Noam Tamir, who took the
opportunity to thank the many
partners that the company had
worked with over the years
and discussed the different
opportunities for Smile-on’s
customers from Core CPD to
a part-time MSc in Restorative
and Aesthetic Dentistry.
During the presentation,
communications officer for
Dental Protection, David Croser, highlighted the importance
of good record keeping, citing
Event Review 15
March 26-April 1, 2012
examples of where dental professionals had been made the
centre of a complaint that had
been incontestable because
the records were incomplete.
He warned that if current
GDC plans about streamlining the Fitness to Practise procedures go ahead, it will see
something like 1,300 patient
records a year being requested
by the GDC to decide the validity of a case – and wouldn’t you
rather your records told the
whole story?
Overall, the Dentistry Show
was an interesting balance between a conference and an exhibition. With more than 300
leading suppliers, 50 worldclass accredited conference
sessions and The Live Theatre, (which was once again another spectacular programme
of clinical procedures ranging
from implant surgery, composites, six month smile system,
and veneers), delegates really did have an action packed
two days!
It would seem without
a doubt that the Dentistry Show is an ideal model
for those seeking CPD and the
latest gadgets and we’re already looking forward to the
2013 event! DT
• On the Record is available
from Smile-on – visit www.
healthcare-learning.com/elearning/detail/view/productId/3 for more information.
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‘The Dentistry Show
was an interesting
balance between a
conference and an
exhibition’
Workers, which closed on the
9th of March 2012. This legislation was considered by many
to be discriminatory against
those with HIV given advances
in medical treatments.
Following this, senior dento-legal advisor Stephen Henderson provided delegates
with a General Dental Council
update. Upcoming changes included a reorganisation of the
committee structure to include
a Policy Advisory Committee,
as well as reviewing its guidance documents and addressing concerns regarding its
handling of Fitness To Practice
cases.
With dental protection a
hot topic of conversation, the
launch of Smile-on’s On the Record, was a welcomed addition
to the show. The programme,
which is the latest collaboration
between Smile-on and Dental
Protection, is a CPD resource
that educates the whole dental
team on how to take clear and
relevant records.
After a fantastic breakfast,
attendees were welcomed by
executive chairman of Smile-
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[16] =>
16 Practice Management
United Kingdom Edition March 26-April 1, 2012
Why improving your practice is a mystery
Jacqui Goss considers unlikely things to hear in a dental practice
O
n my desk, as well as
my computer, I have the
OED, my G3 iPad 2 and
a LaCie 1TB, silver USB 3.0 hard
drive (jargonistic information).
I’m sitting at my computer
wearing only fluffy slippers and
an old jumper (inappropriate information).
This morning I was told a
neighbour had been seen walking hand-in-hand with a man
who is not her husband (gossipy
information).
It may be ironic that I mostly
talk about what front of house
(FoH) team members and
other practice staff should say
to patients, but here I’m discussing what not to say, what
not to say directly to patients,
also what not to say in case
patients may overhear!
Like it or not, dentistry continues to evoke emotions ranging from mild concern to outright fear in many people. The
British Dental Association says a
quarter of the British population
suffer from some sort of anxiety before visiting a dentist. Fear
of the dentists even has its own
name – odontophobia (or dentophobia).
FoH staff may inadvertently
add to a patient’s anxiety by using words and terms common
in dentistry but threatening to
patients; for example: ‘surgery’:
A better alternative is ‘treatment
room’, ‘clinical area’ or ‘consultation room’.
Here are some more examples:
Drill – in the context of buying a power drill from B&Q,
the word is fine, in a dental practice it can conjure up all sorts of
unpleasant images in some people. ‘Handpiece’, is a good alternative.
Injection and needle are ‘nasty words’ – try some version of
‘‘give you an anaesthetic’’.
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Waiting room – although an
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are several alternatives, such as
‘patients’ room’, ‘seating area’
and ‘patients’ lounge’. It can be
tricky not to say: “Would you
like to wait in...?” but try saying something similar to “Please
take a seat in...”.
Bleaching is a good one, especially if you define it as using
hydrogen peroxide to whiten
teeth! Who’d want that done?
Fortunately, ‘teeth whitening’ is
an increasingly common phrase
and to avoid the word peroxide
you could say a ‘whitening gel’.
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of a professional, occupational,
or other group’) is often meaningless to outsiders as well.
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Dentistry is full of it – looking
at a few online dental dictionaries most of them contain at least
150 words. Fortunately, many of
them are likely to be confined to
the surgery, oops, I mean treatment room, and it is the responsibility of the clinical staff to explain them.
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The difficulty often comes for
FoH team members when they
are describing the practice to a
potential new patient or when
making follow-up appointments
for complex treatment.
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In the former case, they may
need to say the practice has an
endodontist/orthodontist/periodontist, but when I’ve tried these
words on my non-dental friends
[17] =>
United Kingdom Edition March 26-April 1, 2012
I get blank looks. People generally know what paediatricians,
cardiologists, gynaecologists and
so on do but not the various dental ‘odontists’ (maybe because
there are more hospital ‘soaps’
on television than ones about
dentists – discuss).
I suggest FoH staff (and other
team members in the practice)
should habitually follow words
such as periodontist with a shorthand definition – ‘a gum disease
specialist’, for example. An orthodontist could be a ‘specialist
in correcting misaligned teeth’
and an endodontist ‘specialises
in root canal treatment’.
Describing the reason for
a follow-up appointment has
potential pitfalls too. “I see you
need an appointment with the
‘Too much information and not
enough relevance is
a problem
that pervades
almost all business
communication’
hygienist for a scale and polish”, is hardly a thrilling sounding prospect. “I see the dentist
has recommended an appointment with Jacqui, our hygienist,
so she can help you maintain
healthy gums,” sounds much
more acceptable.
When we discuss the use of
language in my training sessions with dental staff, we often agree that there should be a
staff meeting where ‘scary’ and
jargon words and phrases are
brainstormed and alternatives
agreed. These preferred words
and phrases are then used all
the time in the practice – whether talking to patients or not. That
way they become the common
parlance, not an alternative language only used when patients
are around. They should also be
mirrored on your practice website and when posting on your
social media.
I invariably refer to a book
called The Jelly Effect by Andy
Bounds when discussing communication. If you throw jelly at
a wall it never sticks – just like
poor communication. According
to Bounds, too much information and not enough relevance is
a problem that pervades almost
all business communication. He
advocates a lot more relevance
and a lot less jelly. Put simply,
patients want to know what a
dental practice can do for them.
They’re less interested in what a
dentist who specialises in treating children is called, and are
Practice Management17
but in my many professional visits, it’s surprising what I do overhear. I needn’t give examples of
the sort of inappropriate things
(commonly described as ‘too
much information’) or gossip
patients shouldn’t hear – they’re
pretty obvious. You should also
be careful about what legitimate
So much for what FoH and
conversations with patients can’t
other practice staff mean pabe overheard by other patients
tients to hear. But how about
– and don’t overlook that a pawhat they might overhear? I
tient on the telephone may hear
don’t have particular sensitive
what’s 15:21:59
being said in the backhearing and
am not some 1sort03/08/2009
msc_ad_source_uk.pdf
ground.
of dental practice eavesdropper,
much more interested in how
they can help their child. Whether whitening gel contains peroxide, soap powder or ground up
cashew nuts is of less interest
than what effect it will have and
whether it is safe.
Some dental practices (and
many other places) play music
in the belief that it aids privacy
in terms of patients inadvertently overhearing conversations.
Unfortunately, such background
music has so many negative aspects (see www.pipedown.info for
more information) it’s probably
best avoided. You may, however,
wish to investigate sound masking systems, which are becoming
increasingly common in, for example, open plan offices, hospital
environments and schools. DT
About the author
A proven manager of change and driver of dramatic business growth, Jacqui Goss is the managing partner of
Yes!RESULTS. By using Yes!RESULTS
dental practices see an increase in
treatment plan take-up, improved
patient satisfaction and more appointments resulting from general enquiries. Yes!RESULTS turns good practices
into great practices.
Jacqui Goss Managing Partner
Tel: 08456 448066 Mob: 07795 562617
Email: jacqui@yesresults.co.uk
Website: www.yesresults.co.uk
Twitter: @Yesresults
www.facebook.com/Yesresults
http://uk.linkedin.com/in/jacquigoss
[18] =>
18 Events
United Kingdom Edition
March 26-April 1, 2012
British Dental Bleaching Society
Conference and AGM
Internationally acclaimed speakers, unrivalled knowledge sharing and
networking at free charity dinner for BDBS members
O
n the eve of the London
Olympic Games, don’t
miss out on the Annual
General Meeting of the British
Dental Bleaching Society (BDBS).
(At the Bleaching Society Up-
date Conference 2012, Thursday
26th July 2012, Royal College of
Surgeons).
Morning keynote speaker will
include Professor Bruce Matis,
Director of the Clinical Research
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Section at the Indiana University
School of Dentistry.
Dr Matis will draw upon his
decades of experience:
• Lectured and published extensively on whitening agents over
the last 20 years
• Consultant to the American
Dental Association
• Member of the International Organisation for Standardisation on
Tooth Whitening
• Reviewed the clinical research
into possible tooth damage caused
by bleaching
An Olympic guest
Dr Matis has more than one personal Olympic connection. He
was a member of the Torch Relay
Team for the Atlanta Games in
1996 and, as a nine-year-old child
in Finland; he was used as a translator for the USA’s women’s team
during the 1952 Helsinki Games.
The afternoon keynote speakers are:
• Dr Linda Greenwall, Chair of
the BDBS and founder of The
Dental Wellness Trust
• Dr Mervyn Druian, Pioneer in
the field of cosmetic dentistry
• Dr James Goolnik, Renowned
cosmetic dentist and most influential person in the 2011 Dentistry Top 50 poll
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Free charity dinner
The BDBS is hosting a charity dinner at the Royal College of
Surgeons to support the work of
the Dental Wellness Trust. The
London-based, non-profit charity
ensures the vulnerable and underprivileged in the UK and selected locations overseas have access to oral healthcare. Working
with partnership organisations
and volunteers, it facilitates innovative preventative-orientated
educational programmes, dentist
mentoring opportunities and pro
bono treatment for those in desperate need.
Free to BDBS members (with
a donation asked of attending
partners), the dinner provides
the ideal opportunity to network
with colleagues and bask in the
sumptuous settings of the Edward
Lumley Hall.
With an outstanding line-up of
speakers and attendance of highly
accomplished professionals from
across the globe, the BDBS AGM
is expected once again to be a tremendous success. DT
Visit www.bdbs.co.uk to find
out more!
[19] =>
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[20] =>
20 DCPs
United Kingdom Edition
Dental nurse education
Jane Dalgarno looks at evolution and demands in the profession
S
ince the implementation of
statutory registration with
the GDC)in August 2008, all
dental nurses have a legal obligation to become qualified and registered, thus enabling them to carry
out their duties as a dental nurse.
The recognition of the dental
nurse as a registered professional
has been one of the key drivers
for the development of a primary
qualification that is deemed fit for
purpose and continues to meet
the demands for lifelong learning.
Upon registration with the
GDC, a dental nurse should be
able to apply an evidence-based
approach to learning, practice
and decision making and furthermore, be able to practise safely
and effectively.
The purpose of education and
training therefore, is to produce
a [dental nurse] who has a full
range of skills and knowledge required for independent practice
and the challenges of professional
life (GDC, 2011).
Tempdent Dental Recruitment & Training
www.tempdent.co.uk
For Specialist Dental Recruitment and Training Services
March 26-April 1, 2012
A public consultation was carried out by the GDC in December
2010 on the draft learning outcomes. It is envisaged that these
will be incorporated into training
programmes and assessments
in the academic year 2012-2013
(GDC, 2010).
In response to this, the National Examining Board for Dental Nurses (NEBDN) and City &
Guilds (C&G), have reviewed
their existing suite of primary
qualifications to meet these learning outcomes. The National Vocational Qualification (NVQ) was
developed in association with
the sector skills council Skills for
Health who are responsible for
developing the National Occupational Standards (NOS). The NOS
are currently being reviewed to
ensure they remain fit for purpose
and support the curriculum set by
the GDC.
The NVQ offers a diploma on
the Qualifications and Credits
Framework (QCF). The QCF is an
integral part of larger vocational
reforms being introduced by the
Government to help develop the
economic performance of the UK
through an improved qualification system.
Dental Team Training
GCD verifiable CPD courses delivered across the UK in the comfort of your dental practice or our training centres
CPD courses include;
• Cross Infection & decontamination to HTM01-05
• Dental Radiography
• CPR including Medical Emergencies
• Safeguarding to Level 2 including CHild Protection & Vulnerable Adults
• Health & Safety
• Complaints handling & Ethics
• First Aid Appointed Person
• Ergonomics & Manual Handling
Dental Nurse Qualifications & Courses
Accredited primary & post registration dental nursing qualifications include
• Diploma in Dental Nursing (National Certificate)
• Dental Nursing Advance Apprenticeship (Diploma/NVQ 3)
• Oral Health Education Certificate
• Dental Radiography Certificate
• Dental Sedation Certificate
• Flouride & Impression taking courses starting mid 2012
Dental Office Team Qualifications
Accredited & government funded dental office team qualifications include;
• Management NVQ 3
• Customer Service NVQs 2 & 3
• Business Administration NVQs 2 & 3
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Objective Structured Clinical
Examinations (OSCEs) have been
around for many years and were
originally developed for use in
medical exams (Holsgrove, 2011).
OSCES can test a wide range of
clinical and professional skills
under controlled conditions and
are designed to allow candidates
to demonstrate their professionalism, skills and competencies.
(Holsgrove, 2011).
Dental Nurses undertaking
this route to qualification will be
sitting the new style exam from
May 2012. The National Certificate in its current format will be
offered to individuals on a resit basis only up until November 2012.
Although a change to the
examination structure by the
NEBDN has been necessary, the
financial implications of hosting
an OSCE has seen some dental
nurses choosing an alternative
route to registration, where funding may be available.
As training providers we continue to be challenged during this
time of transition and difficult financial climate, as we see dental
nurse education evolve to meet
the demands of its profession. DT
About the author
Jane Dalgarno started her career in
Dental Nursing in 1986, passing the
National Certificate in November 1993.
Jane is currently working towards (City
& Guilds) V1 award and the BSc in Primary Dental Care with Kent University.
Jane works as a Dental Nurse Tutor for
the Community Dental Services CIC,
Bedfordshire and runs the National
Certificate for Dental Nurses Course at
the Dental Access & Special Care Centre in Bedford. Jane is seconded council
member for education for the British
Association of Dental Nurses®.
[21] =>
United Kingdom Edition
Clinical 21
March 26-April 1, 2012
Conservative, quick and predictable
Biju Krishnan provides an overview on short term orthodontics
S
hort term orthodontics
or cosmetically focussed
orthodontics can be defined as orthodontic treatment
that focuses on the alignment
of teeth in the aesthetic zone,
has no detrimental effect
on the occlusion and can be
completed in less than nine
months.
As this paper aims to demonstrate,
cosmetically
focussed orthodontics is a very
powerful tool that does everything good cosmetic dentistry
should – it’s conservative,
it’s quick, it’s predictable, it’s
lasting and it’s relatively in-
‘As dentists we need
to be aware of what
it is, advise our patients accordingly,
and if possible offer
it as an alternative
or adjunct to conventional restorative and cosmetic
procedures’
expensive when compared to
alternative restorative procedures. As dentists we need to
be aware of what it is, advise
our patients accordingly, and
if possible offer it as an alternative or adjunct to conventional restorative and cosmetic procedures as part of
our obligations regarding informed consent.
We also need to understand
that cosmetically focussed or-
dality best suited to deliver
the result we are aiming for.
This paper shows how treatment can be carried out using
a fixed appliance but also be
aware that removable spring
appliances, as well as clear
tray systems can also be used.
Case presentation
Patient CR came to see me for
what I believe was a fourth
opinion regarding her “very
crossed teeth” and after a fairly convoluted history ended
with the all too common, “and
by the way I’m getting married
in …”, which in this case was
10 months.
So far the options she had
been given included:
molars and a treatment length
of around 24 months with a
fixed upper and lower appliance
• Treatment of the upper arch
only with 10 veneers - which
most likely would have meant
• Conventional orthodontics
with removal of two upper pre-
à DT page 22
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Fig 1 - CR001
thodontics is a philosophy of
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[22] =>
22 Clinical
United Kingdom Edition
March 26-April 1, 2012
ß DT page 21
Fig 3 - CR003
Fig 4 - CR004
Fig 5 - CR005
Fig 2 - CR002
the devitalisation of at least
two teeth.
After discussing again with
her the possible options, which
also included the ones she had
already been given, we decided
that we could attempt to gain
as much of an improvement
as possible with short term orthodontics possibly followed by
more conservative restorative
treatment if orthodontic treatment alone could not provide a
satisfactory outcome.
We opted for a fixed appliance and CR was fitted with this
in July 2010.
She attended monthly thereafter for a period of six months
during which time minimal interproximal reduction was carried out and arch wires changed
accordingly. At the end of this
period we arrived at a position where the patient decided
she was happy enough with
the appearance and wished to
conclude treatment. It was suggested that there was still room
for further improvement if the
appliance was left in place for
around two more months; however this was not possible due
to the impending wedding.
Once the appliance was removed we carried out a chairside tooth whitening procedure
followed by composite bonding
to even out some differential
tooth wear. The patient did not
feel the need for any further
cosmetic treatment and was
happy to finish treatment at this
stage.
Discussion
The most obvious question
when looking at cases such
as these is how space is created in what appears to be a
moderately severely crowded
arch without the removal of
any teeth. Knowing the answer still does not cease to
amaze. Looking back at this
case, and other such cases that
we’ve since completed, calculating how much space is required, predicting how much
space is available and how to
gain this space is one of the
keys to understanding shortterm orthodontics.
In short term orthodontics
space is gained in mainly two
ways:
• Interproximal reduction
• The arch rounding out
(Upper arch expansion can
also be used but brings with
it additional complexities and
considerations which for the
purposes of this overview I will
not be discussing.)
Interproximal reduction
Interproximal reduction, also
known as interdental stripping,
reproximation and tooth slen-
Fig 6 - CR006
gain a significant amount of
space. To understand this more
fully we need to go back to our
geometry lessons. Let’s think
of our arch as an arc or part of
the circumference of a circle.
The relationship between the
diameter and circumference of
a circle can be defined as pi or
3.14. Hence if we have a circle
‘In the vast majority of crowded cases we
treat, the amount of space that can
be gained by IPR alone is more than
adequate to give a considerable improvement in aesthetics’
Fig 7 - CR007
comes a very spaced case:
This can now be quite simply treated as the finished result below shows. This total
time taken to treat this case
was around four months.
Space calculation
There are three main ways to
calculate how much space is
required in the crowded dentition
Studies show that enamel
reduction does not appear to
expose the enamel to pathological changes that could lead to
caries and interdental stripping
can be considered a reasonable
therapeutic technique, especially if care is taken to avoid
abrasion in more gingivally located enamel
The maximum space gained
in this way in a complete dentition between the mesial surface of the first premolar to the
mesial surface of the adjacent
first premolar, is around 4mm.
In the vast majority of
crowded cases we treat, the
amount of space that can be
gained by IPR alone is more
than adequate to give a considerable improvement in aesthetics. However in conjunction
with the arch rounding out we
often do not have to remove the
full 4mm of enamel.
Rounding out the arch
As arches round out we can
that has a diameter of 1cm its
circumference is 3.14cm. Or
put more simply - the circumference of a circle is roughly
three times that of its diameter.
Hence for every one unit increase in diameter we get three
times the increase in circumference.
Now going back to the case
in question. When we look
again at the upper arch we
can see on diagram below, the
black line shows simplistically
how “flat” the anterior incisors are. The blue curve indicates the likely end position of
the teeth where the arch-wire
of the fixed appliance naturally wants to take them. It is
this “rounding out”, in effect
increasing the diameter of the
arc or circle that gives us quite
a significant amount of space
circumferentially.
This principle is usually
very dramatic in class 2 div 2
situations as the case below
demonstrates.
On first glance this appears
to be a very crowded case.
However, after just one month
of treatment and no IPR it be-
• Rounding out arches
• Levelling and aligning the anterior teeth
• Correcting simple to moderate crowding
1
• Correcting simple to moderate spacing
2
3
• Aligning gingival margins and
improving emergence profiles
Guesstimate based on clinical examination, models and
pictures
Measurement using Vernier Gauge
derising is the careful removal
of a defined amount of enamel
from the proximal surface of a
tooth.
even require extractions. In
summary short term orthodontics has roles to play in the following situations:
Ask the laboratory to assist
By far the most common
way used is option one and
with experience is very reliable. However the most accurate method is by measuring the mesial to distal
width of each individual tooth
from canine to canine, giving
us the required space, and then
to measure the length of span
of the teeth in the final position – the available space. Subtraction of one from the other
determines how much space is
required using IPR. However it
is possible that no IPR at all is
required, the above class 2 div
2 case being a good example of
this.
Discussion
Although the vast majority of
cases that are treated this way
tend to be of minor crowding,
minor spacing or misalignments, the above case of patient
CR does demonstrate that with
the proper understanding we
can also treat more dramatic
situations that would otherwise
necessitate significant destruction of healthy tooth tissue, or
• Rotations
• Up righting teeth that are
flared or tipped
• Pre-restorative
alignment
treatment
• Avoiding elective endodontics
Looking at the above list
gives us an idea of how valuable a tool short term orthodontics can be in the provision of
cosmetic dentistry.
The occlusion
In each case we need to also
understand that we do not intend to change the posterior
occlusion permanently or at the
very least detrimentally. Invariably changes in occlusion will
occur during treatment as quite
often the bite will be propped
open on the anterior teeth leading to mainly Dahl type movements posteriorly. However,
going back to our definition of
short term orthodontics, the
appliances are rarely worn for
over six months and any movement posteriorly will either
completely settle or not pose
any long term problems, as reported by N J Poyser et al; The
Dahl Concept: past, present and
future. British Dental Journal
198, 669 - 676 (2005), “The de-
[23] =>
United Kingdom Edition
velopment of adverse events is
very rare. If they do occur they
tend to be minor in nature and
transient with no long-term adverse sequelae.”
With further regard to the
occlusion, it is also critical that
when we come to retain the anterior teeth in their final position, we do not interfere with
the posterior occlusion settling.
We need to ensure that patients fully understand the role
of long term fixed and removable retention and we need to
provide retainers that hold the
anterior teeth in place while allowing the posterior occlusion
to readjust. Provision of conventional removable retainers
‘This concept is
quite different from
conventional orthodontics where it is
the intention to retain the whole arch
in the occlusion
that the orthodontist has determined’
3
Time – treatment should
not progress beyond six - nine
months or we are in the realms
of conventional orthodontics
and need to be appropriately
trained
Due to this subjective nature, it is very important to
define, before treatment commences, what the expectations
are of the patient and what we
can deliver as clinicians within
an acceptable time-frame. It is
important to have this discussion with patients using study
models and photographs, noting in particular what the
main concerns are of the patient and highlighting any areas
where there may be compromises in achieving the desired
outcome.
For example in the below
spaced case, there is a miss-
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This concept is quite different from conventional orthodontics where it is the intention
to retain the whole arch in the
occlusion that the orthodontist
has determined. As such we
have had to develop new concepts of retention to deal with
the unique challenges posed by
short term orthodontics, rather
than borrow directly from conventional orthodontic retention
protocols.
1
When the clinician feels
that no more aesthetic improvement can be gained
2
The patients is happy with
the appearance
ing lower incisor. As such we
will most likely be left with
residual spacing distal to the
canines or even between the
incisors. This should still deal
with the patient’s main concern
of significant anterior spacing
but we have to let her know of
this potential negative scenario
and offer the option of conventional orthodontics or make her
aware that further treatment
may be required if she feels
that residual spacing is still not
acceptable.
Similarly with this rather
crowded lower arch, we have
to accept that we will not be
able to move the premolars
into an ideal position, giving
a fuller smile, without changing the occlusion significantly.
Again discussion with the patient regarding a compromised
outcome needs to take place
à DT page 24
PERIODONTAL
such as an Essix retainer is not
good enough and could potentially lead to further problems,
and fixed retention alone can
be insufficient.
When is treatment complete?
In conventional orthodontics
the end point is achieved when
we have positioned the teeth
in, or as close as possible to, a
class one occlusion. This is a
very accurately clinically defined position. In short term orthodontics there is not a simple
way to measure clinically when
treatment is complete. The end
of treatment is subjective and
based on:
Clinical 23
March 26-April 1, 2012
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Gracey ad_GB_A4_2012.indd 1
16.02.12 14:38
[24] =>
24 Clinical
United Kingdom Edition
ß DT page 25
prior to treatment commencing, stressing our focus on the
anterior teeth only.
However quite often in cases
such as these, it is important to
remember that what we see as
potential aesthetic compromises are something patients are
not concerned about as their
main focus tends to be on the
anterior six teeth. In this case
the patient was indeed more
than satisfied with the outcome
when the arch was rounded out
giving the anterior six teeth a
more ideal symmetry and proportion.
As is common with many
of our short term orthodontic
cases, further, simple cosmetic
treatments will serve to enhance the above appearance.
Post orthodontic cosmetic
treatment
Unlike the situation with chil-
‘This type of cosmetic treatment encompasses everything thing that good cosmetic
treatment should do’
dren, in the majority of adult
patients, we find that immediately following a course of shortterm orthodontic treatment
there will invariably be some
degree of differential tooth
wear or unaesthetic “blacktriangle”
formation
which
may necessitate further cosmetic treatments. This is usually very simply dealt with by
composite bonding with or
without prior tooth whitening,
but the patient must be warned
of the potential for further cosmetic work at the outset.
In the case of patient CR it is
very noticeable that the incisal
edges are uneven and there is
a “black triangle” between the
central incisors. With “black
triangles” it is not uncommon
for papillary growth in this region to continue for some period so it may be advisable to wait
and see how much regrowth
takes place prior to further cosmetic work.
Conclusion
Although I feel it is still somewhat in its pioneering stages,
there is no escaping the fact
that short term orthodontics
is here to stay. We have to
be able to offer this option to
our patients as part of informed
consent when undertaking
any cosmetic procedure that
would otherwise lead to significant tooth surface loss to
achieve the desired cosmetic
result.
Fig 8 - CR008
Fig 9 - CR009
Fig 11 - CR011
Fig 12 - CR012
Fig 13 - CR013
Fig 14 - CR014
There needs to be continued education and discussion
to demystify some of the myths
and scaremongering regarding
occlusion and short term orthodontics, and we need to be able
to have an educated discussion
with our patients regarding this
as an option for treatment. We
also still need to treat conventional orthodontics with respect and work within very defined parameters in delivering
this very cosmetically focussed
treatment option.
However, echoing my earlier sentiments, this type of cosmetic treatment encompasses
everything thing that good
cosmetic treatment should do,
and with the right training, we
should all be capable of providReferences
1 Radlansky R. (1991) Morphology of
interdentally stripped enamel one year
after treatment. J Clin Ortho 23 (11)
748-750, 1991.
2.El-Mangoury N, et al. In vitro remineralization after air-rotor stripping. J
Clin Ortho 25 (2): 75-78, 1991:a
March 26-April 1, 2012
ing this treatment in one form
or another to our patients. DT
About the author
Dr Krishnan qualified from Dundee
University in 1993
and following several years in general practice completed a clinical
attachment in Oral
Surgery in 1999.
In 2002, he set up
DRAKE Dental Care and then Lubiju
in 2008 to focus on bringing to Scotland and developing advanced restorative, surgical and cosmetic procedures. Lubiju has received much
praise since its launch and was recently Highly Commended as Best
Specialist Practice in Scotland and
voted Best Private Practice in East
Scotland. Dr Krishnan was also recognised as one of Scotland’s outstanding
dentists in the most recent Dentistry
Awards. Dr Krishnan lectures nationally and internationally primarily
on short-term adult orthodontics, in
which he has pioneered new concepts
using the C-FAST Adult Brace System
which he personally developed.
For additional information please
contact Dr Krishnan by email on
biju@cfast-results.com or visit cfastresults.com.
Fig 10 - CR010
[25] =>
United Kingdom Edition
Fig 15 - IPR001
Fig 17 - RF002
Clinical 25
March 26-April 1, 2012
Fig 16 - RF001
Fig 18 - RF003
Fig 20 - RF005
Fig 21 - RF006
Fig 22 - RF007
Fig 23 - RF008
Fig 25 - TE001
Fig 26 - TE002
Fig 28 - TE003
Fig 29 - TE004
Fig 19 - RF004
Fig 24 - RF009
Fig 27 - SG001
[26] =>
26 Product Spotlight
United Kingdom Edition
March 26-April 1, 2012
NTI-tss: reviewing the evidence
T
he NTI-tss appliance
has gained in popularity over recent years
thanks to its high clinical
success rates in the treatment of migraines and other
conditions associated with
the Trigeminal Nerve System.
Indeed in 1998 NTI-tss was
officially approved by the
FDA (Food & Drugs Agency
USA), and is considered by
many to be the most effective non-drug FDA-approved
method of migraine prevention available.
Despite its growing recognition however, some quarters
have questioned the effective-
ness, and indeed the safety
of the device. In response
to these concerns, in 2008
Stapelmann and Türp conducted a systematic review into
all the available data on the
NTI-tss appliance!1 Their extensive review encompassed
nine
separate
electronic
databases; the NTI-tss manu-
facturer’s website (and all
its references); relevant textbooks on topics including
TMDs, occlusion and Bruxism;
and the FDA’s MAUDE database.
Given the research available, the review concluded that
evidence from randomised
controlled
trials
supports
the use of the NTI-tss appliance for the management of
TMDs and bruxism. Furthermore, the review supports
the judicious use of the NTItss oral appliance for patients
with acute, painful temporomandibular
joints
who
may require treatment that
can be implemented quickly, and in instances where a
reduction in EMG activity
of the closing muscles during tooth clenching or grinding is desired. To avoid
complications however, the
authors recommend that use
be limited to patients compliant with follow-up appointments.
Aside from its findings relating to the effectiveness of
NTI-tss, the Stapelmann and
Türp review is extremely
‘The Stapelmann
and Türp review is
extremely useful in
helping to dispel a
number of the safety ‘myths’ that have
come to light ’
useful in helping to dispel a
number of the safety ‘myths’
that have come to light
since the appliance was FDA
approved back in 1998. The
evidence pertaining to adverse events for example was
clear, and no incidents of appliance aspiration could be
identified in the FDA’s Manufacturer and User Facility Device Experience (MAUDE) database.
Given the importance of
any concerns surrounding the
safety of a product, it is worth
expanding upon these issues
in more depth.
One of the most common
concerns surrounding NTI-tss
relates to supra-eruption of
posterior teeth. Critics argue
that due to the product’s nature in treating cases of Bruxism, there is a possibility that
the induced hypofunction (ie
no occlusal contact at all) will
lead to the supra-eruption of
teeth. Research by Kinoshita
et al however, found that in
rats, it took at least eight full
[27] =>
United Kingdom Edition
days of hypofunction before
very minimal eruption occurred2. Given that NTI-tss
appliances are only worn during the night, and normal function continues during the day,
then this would suggest there
is no chance of supra-eruption
occurring through use of NTItss – and the lack of reported
cases on the FDA database
would support this theory.
A further common concern surrounding the NTI-tss
appliance is the likelihood
of patients swallowing or
even aspirating the device in
their sleep. In a technical
analysis of the NTI-tss however Dr Wes Shankland found
that tongue force required
to dislodge the device is far
greater than the mean maximum tongue-tip pressure of
the human being – and this
is not even to consider the direction of the forces required
to dislodge the device3. Given
these considerations, and the
fact that the forces generated
by a bruxism sufferer would
actually aid in retention of
the appliance, Dr Shankland
concludes that “it seems totally inconceivable, within
reasonable certainty, that an
NTItss [sic] appliance could be
dislodged by a patient while
sleeping.”4
If any further proof of
the suitability and safety of
the NTI-tss appliance were
needed, readers should consult the FDA website (www.
fda.gov). It should be noted
that thus far, for over 1.5 million NTIs in use, there has not
been a single reported case of
swallowing, aspiration, disk
perforation, or any other major concern linked with the
NTI-tss appliance. This is
particularly significant factor
when taken in light of other
base their decisions on the
very latest evidence-based
research relevant to their
field of study. Evidencebased research is, after all,
the benchmark by which the
best
healthcare
outcomes
can be achieved. In dentistry,
evidence-based research is
particularly important as it allows clinicians to form their
own,
independent
assessments of treatments and their
suitability for patients.
In light of some of the
mixed messages in the media concerning NTI-tss, the
Stapelmann and Türp review
is most timely. The authors
considered only the best
available evidence to establish their conclusions and
determined that “the NTI-tss
device may be successfully
used for the management of
Bruxism and TMDs”.1 The
review also suggests that the
NTI-tss splint may benefit pa-
• A list of references are available from the Editor
About the author
For more information on S4S call
0114 250 0176,
Email info@s4sdental.com or visit
www.s4sdental.com
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In any branch of the
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strive
to
is every reason for clinicians to embrace the NTI-tss
splint as an effective treatment
for Bruxism, migraine, and
TMDs. DT
tients with symptoms of TMD
and possibly those with migraines/headaches. As with
any treatment, one of the most
important considerations of
any practitioner should be
patient compliance. For the
best, most successful outcomes, clinicians should ensure patients’ willingness to
comply with instructions and
return as recommended for
follow-up care.. With these
findings firmly in mind, there
CosTech Implant Centre
‘In any branch of
the healthcare profession, clinicians
should strive tobase their decisions
on the very latest
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their field of study’
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Product Spotlight 27
March 26-April 1, 2012
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[28] =>
28 Industry News
United Kingdom Edition
‘Highly acclaimed’ facial
aesthetics training courses
Botulinum Toxin, dermal
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Dr Brian Franks BDS (U.Lond)
LDS RCS (Eng) MFGDP (UK)
FPFA ACIArb
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TePe Angle was developed to improve
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and an ionic action toothbrush.
Developed by dental professionals, the patented ingredient CloSYS ΙΙ in the
RetarDEX range is antimicrobial, killing both the aerobic and anaerobic bacteria
associated with plaque, tooth decay and gum disease. This clinically proven
professional formula interferes with the formation of biofilms, inhibits bacterial
regrowth and is used for complete periodontal and oral hygiene treatments.
Independent clinical tests have proven that the active ingredient prevents
bad breath (by eliminating odour-causing Volatile Sulphur Compounds) and
that both the toothpaste and oral rinse whiten teeth within 14 days (by gently
oxidising and lifting organic stains).
To receive further information on all our products or to place an order, please call
020 8868 1500 or visit our website: www.periproducts.co.uk.
WhiteWash Laboratories cause a stir at The
Dentistry Show
With thousands of delegates flooding the floors
of the NEC in Birmingham, The Dentistry Show
2012 was one of the highlights of the year so
far. Among the many exhibitors on display was
WhiteWash Laboratories, leading provider of
exceptional oral healthcare products. Visitors
to the WhiteWash Laboratories stand were keen
to find out more about the company’s innovative range of products including
its Professional Teeth Whitening Strips – mouldable plastic strips with preapplied whitening gel designed to follow the contour of your teeth for optimum
whitening. Delegates were particularly interested to learn more about this
innovative alternative to traditional whitening trays that offers a much easier,
more convenient and cost-effective way to whiten teeth.
As well as Professional Whitening Strips, visitors to the WhiteWash stand were
also treated to demonstrations of WhiteWash Laboratories’ two other innovative
products: Nano-Silver Whitening Toothbrushes and Silver Particle Professional
Whitening Toothpaste. By utilising advanced silver technology, both of these
products demonstrate superior anti-bacterial properties, for optimum oral
health. WhiteWash Laboratories would like to thank all delegates who took
the time to visit their stand, at The Dentistry Show 2012, and looks forward to
appearing at the next event.
For more information call 0844 68 69 150, email info@whitewashlaboratories.
com, or visit www.whitewashlaboratories.com or www.whitewashstrips.com
BKH Healthcare takes centre
Stage at The Dentistry Show
2012
Anticipation was high for the
launch of new dental corporate BKH
Healthcare at The Dentistry Show
2012. Delegates discovered a host
of benefits on offer for every member of the dental practice, ranging from userfriendly management tools to industry-recognised educational opportunities.
BKH Healthcare provides a full complement of services to assist the provision
of first-class dentistry. With a complete support framework for optimal practice
management and business development, principals can focus on what they do
best: treating their patients. Staff are your most important resource and BKH
Healthcare delivers a full syllabus of business skills and post-graduate clinical
training to develop the abilities of the whole dental team.
With new practices opening in carefully chosen locations, BKH Healthcare
is striving to raise the bar in dentistry and ensure that patients and dental
professionals reap the rewards. Join BKH Healthcare and enjoy deeper career
satisfaction, fulfilment and fun with the dental corporate that cares. For more
information about BKH please call 0161 820 5466 or email Al at: al@bkh.co.uk,
Chris at chris@bkh.co.uk or visit: www.bkh.co.uk Want to stay in touch with the
Barrow Kwong Hing Group? Connect with us here Facebook: www.facebook.
com/bkhgroup YouTube: www.youtube.com/BarrowKwongHing LinkedIn:
www.linkedin.com/company/barrow-kwong-hing-group
Twitter: Chris Barrow @ChrisBKH, Dr Al Kwong Hingv@AlanBKH
Nuview demonstrates marketleading magnification systems at
The Dentistry Show 2012
One of the undoubted highlights of
the dental calendar, The Dentistry
Show 2012 was a great success,
with many thousands of delegates
flooding to the NEC in Birmingham
for the two-day event. Among the
most popular stands at the Show
was Nuview – the exclusive UK distributor of Carl Zeiss dental microscopes and
loupes. Carl Zeiss manufactures some of the world’s leading magnification and
illumination systems, offering precision optics coupled with highly functional
ergonomic designs. Visitors to the Nuview stand were able to experience for
themselves the exceptional image quality and ergonomics offered by the Carl
Zeiss OPMI Pico dental microscope, and were also able to learn more about
Carl Zeiss’s leading range of dental loupes
With compliance and infection control high on every dental practice’s agenda,
delegates were also interested to learn more about Continu, the highly
effective, alcohol-free disinfectant, available from Nuview. With an efficacy
rating of 99.999 per cent and a contact time of only 30 seconds the Continu
range is yet another example of Nuview’s commitment to excellence in all its
operations.
Start your online educational
journey today with Smile-on
Smile-on has taken the
concept of eLearning to the
next level with the new ‘Library
of Products’. Each level is
named after bird; there is the
proud and beautiful lapwing,
the evocative Curlew, known
for its distinctive call and the social and hard-working Avocet.
The levels on offer now are:
• Lapwing (entry level) – dentists have a choice of 5/10 modules
• Curlew – dentists choose 10/17 modules with a free magazine
• Avocet – dentists choose 15/26 modules, which includes all Smile-on
literature and free place at The Clinical Innovations Conference 2012
Dahlia Hadad elaborates on signing up to the ‘Avocet’ programme: “I decided
to do the programme because of the vast range of information available, the
price was reasonable and appealing. I am interested in the whitening and
communication packages and which makes Avocet the perfect option for
me. The free access to webinars is a real bonus as it means that I can get any
questions I have fully prepared before login. This course is ideal for me as it
complies with my needs and fits in with me raising a family. The savings on
learning were huge.”
For more information please call Nuview on 01453 872266, email info@
nuview-ltd.com or visit www.nuview.com
For more information call 020 7400 8989 or email info@smile-on.com.
A demonstration of excellence by
Carestream Dental
The team from Carestream Dental
gave an impressive performance at
The Dentistry Show 2012, held in
Birmingham’s NEC complex. Thousands
of delegates took advantage of the
opportunity to see a wide range of
exciting products and services from
the industry-leading dental equipment
specialists. Carestream Dental provides state-of-the-art technology for digital
imaging and practice management systems, assisting practices to stand out
from their competitors and comply with the requirements of the CQC and HTM
01-05. Highlights of the event included: • R4 Clinical + practice management
software designed to help increase the efficiency and productivity of your
dental practice • CS 9300: outstanding extraoral imaging for all your diagnostic
needs. Incorporates 3D technology and multiple fields of view • CS 7600:
‘Scan & Go’ with fast and user-friendly smart plate technology for premium
quality intraoral digital images • CS 1600: multi-purpose intraoral camera with
unbeatable image quality Carestream Dental develops pioneering solutions
to deliver increased precision and confidence for diagnostics, and improved
productivity and workflow, so that dentists offer patients nothing but the best
possible care. For more information, contact Carestream Dental on 0800 169
9692 or visit www.carestreamdental.co.uk
CosTech Elite® Enjoys Great Success at
The Dentistry Show 2012
As one of the most prominent dental
laboratories to feature at The Dentistry
Show 2012, the CosTech Elite® stand was
busy with delegates keen to find out more
about the company’s wide range of services
for practices across the UK.
CosTech Elite® employs only the best GDCregistered managers and lab technicians
to produce its range of excellent dental restorations and prostheses, with
brands including DIO abutments and unique products such as ZirconArch® and
Thineers®.
With a reputation built on high-quality output and outstanding customer
service, delegates were keen to learn more about how CosTech Elite® can go
that extra mile for its clients. One such example is the CosTech Elite® fleet of cars
which it uses as part of its ELITE7 courier service. Groups of dentists are also
very welcome to visit the CosTech Elite® laboratory, and Elite managers and team
members are available to visit practices if required.
CosTech Elite® would like to thank delegates who took the time to visit its stand
at The Dentistry Show 2012, and looks forward to appearing at the next event.
dbg launch the Virtual
Compliance Office (VCO) at The
Dentistry Show 2012
One of the key exhibitors at The
Dentistry Show 2012 was dbg – one
of the industry’s leading names in
dental services. 2012 is set to be a big year for dbg, with this year featuring the
launch of its highly anticipated dbg patient plan that is set to cause a stir in the
industry over the coming months.
Furthermore, this year’s show marked the official launch of dbg’s brand-new
Virtual Compliance Office (VCO). The dbgvco is a secure, online location where
members can identify and work through CQC* requirements, and can also
manage CPD time, certificates and relevant documentation in all in one place.
The VCO proved a big hit with delegates who were interested to learn more
about the innovative new system that is free to dbg members. Delegates were
also particularly keen to take advantage of dbg’s special 25 per cent discount
for new members signed-up at the show.
For further information call CosTech Elite® on 01474 320 076, or email info@
costech.co.uk, or visit www.costech.co.uk.
For more information on dbg membership services and the newdbgvco, call
0845 00 66 112 or visit www.thedbg.co.uk
*England only (dbg members from Ireland, Scotland, and Wales can use the
compliance section as a benchmark for ‘’Essential Standards’’ of Quality &
Safety)
[29] =>
United Kingdom Edition
Continu delivers CQC compliant solution for
fast, effective disinfection of dentures
A recent CQC inspection commented that
“Inspectors could not find evidence to show
denture work was disinfected before fitting.”
Disinfecting dentures or other removable
orthodontic appliances quickly and safely
is not as easy as it may sound, but Continu
Mouthwear Disinfectant offers an ideal
solution.
The Continu Mouthwear product is simply
sprayed onto the appliance, left for 30 seconds
and then rinsed off to deliver effective and
compliant disinfection.
In addition to the mouthwear disinfectant, Continu offers a complete range
of alcohol free products for disinfection or cleaning of hands, surfaces, water
lines, dental impressions, ultrasonic baths and instruments.
With products designed to address every area of infection control within your
practice, Continu from Nuview delivers a comprehensive solution to reduce
the risk of cross contamination and maintain compliance with HTM01-05 and
CQC standards.
For more information please call Nuview on 01453 872266,
email info@nuview-ltd.com or visit www.nuview.com
Best ever value cone beam scanner
launched
The best ever value 3D dental X-ray
system has been launched by Morita
and the Dental Imaging Company. By
excluding anatomy outside the jawline,
the Reuleaux triangular X-ray field reduces
patient exposure by around 15 per cent.
Capturing posterior dentition that might
be missed by a conventional 80mm
cylindrical FOV scanner, the R100 field
includes relevant anatomy equivalent to a conventional 100mm cylindrical
diameter FOV. This enlarged field of view is important when planning implant
cases requiring surgical guides and full arch restoration. The same machine
also provides five smaller fields of view down to just 40mm diameter. Morita
R100 standard features • High speed, high quality, low dose image • Six field of
view options (40mm diameter to R100) • Easy and accurate automatic scout
positioning • Wide choice of panoramic imaging modes All Morita’s 3D units
include a unique automatic Dose Reduction feature. Built in Japan by J Morita
Manufacturing Corporation, Morita cone beam CT scanners provide world
renowned image quality. They give dentists confidence of high definition,
distortion-free pictures. The technology is proving increasingly indispensable
in implant dentistry, endodontics and oral surgery diagnosis and treatment
planning. Test drive the Morita R100 For your FREE demonstration call Robert
Pounds at The Dental Imaging Company Tel: 0845 602 4944,
Email: info@thedentalimagingcompany.co.uk
Does your demo unit need An MOT?
A couple of years ago Oral-B produced
some working display models to support
dental professionals in their efforts to
communicate proper brushing technique.
These units were provided free of charge to
dental practices and contain a mouth model,
all refill heads in the range, educational
literature as well as an Oral-B Triumph with
SmartGuide. Depending on the level of use,
some of these units may require an ‘MOT’
and that’s why Oral-B is inviting practices to contact them if any elements of
the kit require replacing. Their customer service team will be calling practices
over a three month period to see if they require any replacement parts. If
the unit is looking a little tired, after two years of hard work, Oral-B will even
replace the entire unit for free. Practices should contact the Customer Service
line on 0870-2421850.
The Oral B Triumph 5000 demonstration unit facilitates chair side instruction
and practical demonstration of the best brushing techniques and habits. This
tool will enable delivery of a much more powerful and long lasting message
and will be helpful in supporting communications with patients new to
electric toothbrushes and those whose regime needs modification. To ‘service’
your existing unit, call 0870-2421850.
March 26-April 1, 2012
CEREC® AC
Why buy your CEREC® System from Ceramic
Systems?
When you buy your CEREC® System from Ceramic
Systems you get the best price, exclusive special
offers and access to the best CEREC® after-sales
support in the UK! Ceramic Systems can offer
you: • Dedicated service and support engineers
•Countrywide product specialists for pre and
after sales support •Low cost finance • User
meetings • Dedicated training facility • Gold Club
for software upgrades, service and support • Courses by Ceramic Systems’
exclusive Trainer Dr Simon Smyth – the UK’s Number 1 CEREC® Trainer In these
challenging economic times, CEREC® enables Dentists to create high quality
and durable chairside all-ceramic restorations in the most cost effective
and efficient way. Saving Laboratory costs it enables Dentists to design and
create all-ceramic inlays, onlays, partial crowns, veneers and crowns for the
anterior, premolar and molar regions in one visit. Eliminating the need for
impressions, CEREC® utilises a digital impression taking technique to capture
the data used to design the restoration which is then milled in the milling unit.
Combined with adhesive bonding techniques, CEREC® creates biocompatible,
non-metallic, natural-looking restorations from durable high-quality ceramic
materials in a single treatment session - without the need for provisional
restorations. For details of their latest deals, contact Ceramic Systems Limited
on 01932 582930, e-mail j.colville@ceramicsystems.co.uk
or visit www.ceramicsystems.co.uk
Achieve a unique look for your
practice
Tavom has been producing bespoke,
cabinetry solutions for 35 years,
making them experts in avoiding
the stress that arises from practice
refurbishment. Furnishings should
reflect the personality of a practice
and Tavom makes cabinetry that is
unique to your needs.
RPA Dental, one of the leading suppliers of dental equipment, supplies Tavom
cabinetry.
“RPA Dental did a fantastic job in designing and installing our two new surgeries
and decontamination room. The whole project was managed by them and
came in on budget and on time, we were even able to continue working
throughout the transformation and we have been delighted with the results.
I would use RPA Dental again for any surgery work I was considering and
would recommend them to anyone else as they have a wealth of experience
in dealing with surgery planning and decontamination room design, and are
able to deliver exactly what they promise. Every aspect of the job from start
to finish including final decoration was expertly handled and could not have
gone smoother.” Dr Simon Hall.
To benefit from Tavom’s exceptional quality call Tavom UK on 0870 752 1121 or
visit the Tavom website www.tavom.com
For further information call RPA Dental on 08000 933975,
or visit www.dental-equipment.co.uk
Precise scaling with Dental Sky’s
Tri-Scaler
The new high quality R&S Tri-Scaler
Compact from Dental Sky is surprisingly
economically priced.
50 per cent discount on ChairSafe
Microfibre Extra Large Wipes
Buy three ChairSafe 250 Microfibre Extra Large
wipes before the end of March and get a 50%
discount. These Microfibre wipes are supplied
as a complete unit with ChairSafe disinfectant.
Refill rolls and ChairSafe disinfectant can also
be bought separately.
With a detachable, autoclaveable
handpiece the Tri-Scaler Compact
features three options – scaling,
periodontal and endodontic functions,
all at the simple press of a button. This
unique piece of equipment is very
simple to operate and incorporates a power function switch for complete
flexibility. Five tips are included with the Tri-Scaler Compact.
The larger Tri-Scaler Aqua benefits from the same features as the Compact with
the added benefit of a built-in water reservoir allowing you to add other clinical
solutions, such as saline etc. making the unit very flexible in its applications.
With eight scaler tips included the Tri-Scaler Aqua represents excellent value
for money.
For further details or to place your order please contact Dental Sky directly on
0800 294 4700.
A new DUAL intra Oral Camera with a built in 5” colour screen and capture and
save facility making it the easiest useable camera ever @ £830 ex vat
In addition, the new ‘Intenz kit’ combined (In-surgery & home) in a new
cosmetic package for a special trial price of £49.
Quicklase have a new lower price for the PowerDesktop Picasso 7 laser at a
special price of £3650 ex vat.
The PowerPen 4w Quicklase cordless laser is also at a special price of £1950 ex
vat. Its half the price of its competitor, has 3 customisable pre-sets.
Visit us or www.quicklase.com or telephone us 01227 780009
Effective against Bacteria, Fungus & Viruses:
MRSA
TB
Hep.B & C
Vaccinia
HBV
HCV
HIV
BVDV
H1N1
ChairSafe Microfibre wipes are made of
specialised fibres designed to provide superior removal of dust, dirt and
micro-organisms. In addition to this ChairSafe disinfectant used with ChairSafe
Microfibre wipes, contains a wetting agent which enhances the absorbent
properties of ChairSafe Microfibre wipes.
ChairSafe Microfibre wipes should be used with confidence to decontaminate
sensitive and non-sensitive surfaces and equipment in treatment areas and
decontamination areas. Surfaces in toilets and waiting areas should not be
forgotten. These low odour wipes are excellent for areas like these.
ChairSafe Microfibre wipes are low odour, non-drip and durable. They are
gentle on the hands but above all the combination of a Microfibre wipe with
ChairSafe disinfectant provides superior cleaning and disinfection of surfaces.
Phone Jackie or Helen on 01793 770090 to take advantage of the special offers
on this new wide range of Kemdent wipes
or visit our website www.kemdent.co.uk.
Make a dramatic improvement in your
smile
The LR Appliance from Oralign Ltd is
the smallest and most discreet of tooth
appliances for straightening front teeth. If
you want to see results, you do not have long
to wait. The appliance is easy to use, requiring
only 14-16 hours of wear a day. This means
the appliance can be fitted in easily with a
busy routine. It is ideal for use in both young and old.
For many years fixed appliances such as braces were the only option, but now
the LR appliance can straighten and improve in a matter of weeks. It can only
be used by certified dentists which means you can be sure of receiving the
highest standards of care.
“Compared to other systems the LR appliance is quicker and more cost
effective, with tremendous benefits to both patients and dentists. After the
excellent Oralign course I was very confident in offering this option for my
patients.” - Dr Hap Gill from Smile Studio.
The new LR Appliance is a faster way to a straighter smile.
For clinical information contact Dr Ross Hobson on 07710 243690
or email: ross@oralign.co.uk
For information on administration contact Dr Lester Ellman on 07973 875 503
or email: lester@oralign.co.uk Web: www.oralign.co.uk
Quicklase
Industry News 29
Buy your Sirona Equipment from Sident
When you buy Sirona Equipment from
Sident Dental Systems you get the best
price, exclusive Special Offers and access to
the best sales support in the UK! Sident can
offer you:
•
Comprehensive
bespoke
project
management
services
for
surgery
refurbishments • Factory trained engineers
• Product specialists to advise on design,
installation and on-site training • Low cost finance packages for all products
So if you are reequipping, buy your Sirona Equipment from Sident Dental
Systems, the UK’s only Specialist Supplier of Siemens /Sirona equipment. Sirona
Specialists, Sident Dental Systems offer the choice from the complete range of
Sirona Treatment Centres, 2D and 3D digital and film based x-ray apparatus
– including the very latest Galileos 3D digital cone-beam equipment, their
extensive range of Sirona handpieces, and auxiliary items including SiroLaser,
SIROEndo and DAC sterilisation units. To support these items they offer DURR
Suction and Dental Art Cabinetry, as well as other essential equipment. Clients
are also invited to visit The Courtyard, Sident’s state-of-the-art training and
showroom facility in Chertsey, where they will be able see the complete
product range in action. Sident also will undertake a complete project
management service, including installation and post installation service
support. For further information call Sident Dental Systems on 01932 582900
or email j.colville@sident.co.uk
Philips launches tooth whitening with reduced Hydrogen Peroxide
concentration in advance of new regulations
Philips has announced the introduction of the latest product to add to its
range of tooth whitening innovations – Zoom DayWhite 6 per cent HP with
ACP. This is an at-home teeth whitening formula, designed to be dispensed by
a dental professional, in the form of custom fit trays into which whitening gel
is applied. The trays are worn twice a day for 15 to 30 minutes depending on
the advice of the dental professional, and will give patients a noticeably whiter
smile within two weeks.
Zoom DayWhite 6 per cent contains Amorphous Calcium Phosphate (ACP),
which when combined with fluoride, spreads over the surface of teeth and
bonds with the enamel to provide enamel protection, improved luster and
shine, with reduced sensitivity when compared with teeth whitened without
ACP. The product provides patients with a healthy white smile and patients
who have used it experienced less fadeback to their original tooth colour after
six months.
Philips Zoom DayWhite 6 per cent HP with ACP is compliant with the new
European Commission directive which prohibits the commercialisation of any
whitening products in the European Union (EU) containing more than six per
cent hydrogen peroxide.
For more information visit www.philipsoralhealthcare.com. For the
teeth whitening app visit itunes.apple.com/us/app/philips-zoom/
id495865825?mt=8
Learn new skills to put
into your modern practice
at The Clinical Innovations
Conference 2012
The
Ninth
Clinical
Innovations Conference 2012 is one of the leading conferences on Aesthetic
and Restorative Dentistry. These topics are becoming increasingly relevant
in modern dentistry and the conference is geared to inform you on the latest
information through an exciting programme of experienced speakers.
The inspirational event held by Smile-on, the AOG and Dental Directory
will give you the opportunity to learn how to apply the latest aesthetic
developments through practical experience.
Confirmed speakers include Professor Nasser Barghi, Dr Wyman Chan, Dr
Richard S Kahan, Professor Gianluca Gambarini, Jackie Coventry, John Moore,
Basil Mizrahi, Ajay Kakar, Fraser McCord, Mhari Coxon and Mona Kakar.
Apart from the opportunity to listen to experts in the field, there is a chance
to debate, participate in question and answer sessions, and attend the
AOG Clinical Innovations Charity Ball, a great opportunity to relax and network.
Smile-on are now offering an early registration discount of 15% for
bookings made before 9th March 2012, avoid disappointment and put the
date in your diary.
For more information and to book a place, call Smile-On 020 7400 8989 or
email info@smile-on.com or visit www.clinicalinnovations.co.uk
[30] =>
United Kingdom Edition
March 26-April 1, 2012
Dental Tribune UK
Editorial Board
Dr Neel Kothari
BDS Principal and General Dental Practitioner
Luxator Extraction
Instruments
are now the preferred
method of
performing extractions
Dr Stephen Hudson
BDS, MFGDP, DRDP
General Dental Practitioner
Mr Amit Patel
BDS MSc MClinDent MFDS RCEd MRD RCSEng
Specialist in Periodontics & Implant Dentist Associate Specialist Birmingham Dental Hospital
Professor Nick Grey
BDS, MDSc, PhD, DRDRCSEd, MRDRCSEd, FDSRCSEd, FHEA
Professor of Dental Education, National Teaching Fellow, Faculty Associate Dean for Teaching and Learning School
of Dentistry, Manchester
Professor Andrew Eder
BDS, MSc, MFGDP, MRD, FDS, FHEA
Director of Education and CPD, UCL Eastman Dental Institute
Mr Raj RajaRayan OBE
MA(Clin Ed), MSc, FDSRCS, FFGDP(UK), MRD, MGDS, DRD
Dr Trevor Bigg
BDS, MGDS RCS (Eng), FDS RCS (Ed), FFGDP (UK)
Practitioner in Private and Referral Practice
Baldeesh Chana
RDH, RDT, FETC, Dip DHE
President, BADT and Deputy Principal Hygiene and Therapy Tutor, Barts and The London School of Medicine and Dentistry
Dr Stuart Jacobs
BDS MSD (U Ind)
Full-time Private Practitioner
Shaun Howe
RDH
Dental Hygienist
Dr Richard Kahan
DS MSc (Lond) LDS RSC (ENG)
Endodontic Specialist
Mrs Helen Falcon
Postgraduate Dental Dean, Dental School, Oxford & Wessex Deaneries
Professor Liz Kay
Dean of the Peninsula Dental School, Plymouth
Pam Swain
MBA LCGI FIAM MCMI BADN® Chief Executive
Mr Raj Rattan
Associate Dean, London Deanery
Published by Dental Tribune UK Ltd
3512-11201 © Directa AB
© 2012, Dental Tribune UK Ltd.
All rights reserved.
Luxator Extraction Instruments were invented by
a Swedish dentist to make extractions as trauma
free as possible. He developed subtleties in the
design only a practising dentist would appreciate
with an acclaimed and ergonomic handle design.
For this reason our Luxator instruments are
discernably different.
Dental Tribune UK Ltd makes every
effort to report clinical information and
manufacturer’s product news accurately,
but cannot assume responsibility for
Group Editor
Lisa Townshend
Tel: 020 7400 8979
Lisa@dentaltribuneuk.com
Publisher
Joe Aspis
Tel: 020 7400 8969
Joe@dentaltribuneuk.com
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
Tel: 020 7400 8970
ellen@dentaltribuneuk.com
Editorial Assistant
Laura Hatton
Tel: 020 7400 8981
Laura.hatton@dentaltribuneuk.com
Design & Production
Rachel Harrison
Tel: 020 7400 8951
Distributed in the UK by Trycare
Tel. 01274-88 10 44
Dental Tribune UK Ltd
4th Floor, Treasure House, 19–21 Hatton Garden, London, EC1N 8BA
Follow us on Twitter
[31] =>
United Kingdom Edition
Classified 31
March 26-April 1, 2012
SPECIALIST DENTAL ACCOUNTANTS
- Assistance with Buying & Setting Up Practices
- NHS Contract Advice
- Tax Saving Advice for Associates and Principals
- National Coverage
- Incorporation Advice
- Particular Help for New Associates
- Help for Dentists from Overseas
- We act for more than 550 Dentists
Please contact:
Nick Ledingham BSc, FCA
Tel: 0151 348 8400
Email: mail@moco.co.uk
Website: www.moco.co.uk/dentists
Dental Practice Finance
Are you buying a practice?
We can help with:
• Up to 100% finance
• The most competitive interest rates
• Presenting your finance application
• Profit and loss projections
• Advice on practice suitability
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What Dentists Need To Know’
0845 653 1020
Rutherford Wilkinson Ltd is authorised and regulated by the Financial Services Authority
21-23 Brenkley Way Blezard Business Park Newcastle upon Tyne NE13 6DS
Whether you are buying an NHS, Mixed or Private
practice, PFM can help you raise the required finance.
We also help associates buying a share in their existing
practice
PFM have many years experience of helping dentists to
purchase a practice. We are fully independent and have a
reputation for integrity and professionalism.
Visit www.pfmdental.co.uk for details of our regular practice
purchase seminars.
For more information contact Jon Drysdale on
01904 670820 / jon.drysdale@pfmdental.co.uk
[32] =>
«Nobel Biocare’s All-on-4
procedure is the key driver
for the growth of our
practice. It’s an affordable
treatment plan that patients
are likely to accept.»
Dr. Cyrus Nikkhah, BDS, FDSRCS (Eng), MClinDent (Prostho),
MRD RCS (Prostho) (Eng), Devonshire House, Cambridge
Reasons for high case acceptance
– Single surgical appointment
– Fixed teeth delivered same day
– Significantly less expensive than conventional treatments
– Clinically proven
– Often eliminates the need for bone grafts,
sinus lifts and nerve repositioning
– High stability with only four implants
Call + 44 (0) 208 756 3300 (UK),1800 677306 (Ireland)
or visit nobelbiocare.com/all-on-4
Nobel Biocare UK LTD, Phone +44 (0) 208 756 3300; Fax +44 (0) 208 573 6740
Nobel Biocare Ireland, Phone 1800 677306; Fax 1800 677307
© Nobel Biocare Services AG, 2011. All rights reserved. Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or is evident from the context in a certain case,
trademarks of Nobel Biocare. Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment
and availability.
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