DT UK No. 9, 2012

News / A budget summary for dentists / Improving practice performance / Endo Tribune / Safeguarding pensionable pay and the ARR / The Ninth Clinical Innovations Conference 2012 / Professional standards / Industry News / Editorial Board / Classified

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April 9-15, 2012

PUBLISHED IN LONDON
News in Brief
A sweet diet...
A new study has identified
that people who eat chocolate regularly are slimmer
than those who people who
don’t. Although the findings do not state that eating
chocolate will help you lose
weight, lead author Dr Beatrice Golomb, an associate
professor at the University
of California, San Diego, said
in a report that she hopes,
through further research to
better understand what’s going on. In the study, Golomb
and colleagues reviewed
food questionnaires filled out
by nearly 1,000 people who
were asked how often they
ate chocolate. The researchers then tried to find any connections between chocolate
consumption and the body
mass index (BMI) of the participants. The study found
that those participants who
regularly ate chocolate had
a lower BMI than the other
participants. The results
were even the same when
the researchers adjusted
their statistics, so the participants were not affected
by age, gender, education or
fruit and vegetable consumption. Golomb cautioned that
the study does not say that
chocolate consumption will
help people lose weight.
One smiley school
With National Smile Month
only a matter of weeks away,
St Marie’s Catholic Primary School and Nursery are
showing off their ‘Smileys’
as part of the campaign, organised by the British Dental
Health Foundation. on Friday
30 March the school had a
dental theme for the day. “It
is always a pleasure to hear
about schools taking part in
National Smile Month, and
St Marie’s is no exception”,
Dr Carter said. With around
eight or nine children in
every class already suffering from tooth decay in primary schools across the UK,
National Smile Month is the
perfect opportunity to discuss
and promote oral health.
Born in 1977, National Smile
Month has coincided with
some major improvements in
oral health levels in the UK.
Taking place from 20 May to
20 June 2012, it is the UK’s
largest and most successful
oral health campaign. With
the help of more organisations raising the importance
of oral health, Chief Executive of the Foundation, Dr
Nigel Carter, believes further
advances can be made. To
register for your free ‘Smileys’ visit www.smilemonth.
org for further tips and ideas
of how to get involved.
www.dental-tribune.co.uk

Practice Management

News

Capped and cut

Government imposes Responsibility Deal

page 4

Improving practice
performance

Amanda Atkin on when things
go awry
pages 9-10

VOL. 6 NO. 9
Endo Tribune

Money Matters

Excellence in endodontics

Safeguarding your pension

pages 11-13

page 24

Daniel Flynn discusses microsurgery

David Paul discusses the ARR

CQC announces
regulatory fees update
Regulator decreases fees for some location bands

F

ollowing
two
consecutive consultations
on the fees that it charges to health and social care
providers, the Care Quality Commission (CQC) has
announced changes to its
fee structure and the amounts
that certain providers have to
pay under the Health and Social Care Act 2008. These have
been approved by the Secretary of State for Health.
The fees reflect government guidance to CQC that it
must recover the costs of regulation from providers.
The responses received
to both consultations have
led to the following changes in the fees that CQC
charges
providers.
These
included:
• Bringing providers of outof-hours services, who will
be registered from 1 April
2012, into the scheme using
the same bandings and fees
scale as for “Dental and Independent Ambulance Services”
providers
• Reducing the lowest banding for the category “Adult Social Care providers without a
ccommodation” from £1,000
to £720
• Reducing the charges for the
third and fourth bandings for
the category “Dental and Independent Ambulance Services” providers from £6,000
and £12,000 to £4,000 and

£10,000 respectively
• Charging a flat rate annual
fee of £1,500 to certain Primary Care Trusts
• Changing the basis of charging fees from turnover to
locations for the Health Protection Agency, NHS Blood and
Transplant and NHS Direct
(NHSD)
The banding and fees
scale for services that provide
dental services, independent ambulance services or
out of hour’s services are determined with reference to
the number of locations at
or from which those services
are provided. The fees are
as follows:
Number of locations - Fee
payable
1
2 to 3
4 to 10
11 to 50
51 to 100
More than 100

£800
£1,600
£4,000
£10,000
£24,000
£48,000

CQC chief executive Cynthia Bower said: “Our approach to fees is based on fairness
and on raising only as much
income as we need to cover
the costs of regulation. We
have listened to what providers have told us during both
these consultation and have
made changes to address concerns and make the fees that
we charge transparent and as
proportionate as possible.”

Later this year the CQC
will be launching another consultation about its
longer-term
fees
strategy
from 2013/16, which will include specific proposals for
fees for 2013/14.
These proposals will be
for providers of NHS gen-

eral practice and other primary medical services who
will be registered with CQC
from 1 April 2013, as well
as potential changes to fees
for independent healthcare
providers. DT

[2] =>

2 News

United Kingdom Edition

April 9-15, 2012

£4m for innovative solutions to tackle healthcare problems

he government has announced £4m of funding for businesses to
develop ideas to address some
of the biggest health problems
of our time.
The Department of Health
has opened two new competitions with up to £2 million of
funding each to develop technological and innovative solutions that can:
• Change people’s behaviour in order to reduce the
impact of obesity and alcohol
related diseases
• Improve the number of
patients taking their medication as prescribed
Obesity and alcohol related diseases and patients

not taking their medication
as prescribed are major
health challenges. Alcohol
and obesity related diseases
cost the NHS over £7bn each
year and between 6-10 per
cent of all hospital admissions could be preventable if
prescription medication was
taken correctly.
Businesses are invited to
come up with innovative solutions to these challenges. This
could be anything from a device which helps people monitor what they eat or drink or a
personalised care package to
help people take their medication as prescribed.
Health Minister, Lord Howe
said: “Technology and innova-

tion have an important role to
play in helping to address the
healthcare challenges facing
the NHS. That is why we are
investing £20 million in new
and creative ideas and projects which can make a difference to patients’ lives.
“Today’s competitions provide an opportunity to develop
innovative solutions for some
of the biggest health problems
of our time and we look forward to seeing the results.”
Sir David Nicholson, Chief
Executive of the NHS said:
“Investing in innovation is vital for a modern and efficient
NHS- it will benefit the patient, the taxpayer and UK plc.
The Small Business Research

Initiative (SBRI) is a key part
of the Innovation, Health and
Wealth agenda, which aims to
spread innovation throughout
the NHS.
“These competitions provide vital funding for businesses to explore, develop and
test new technology before it
becomes commercially available. Organisations are invited to submit their ideas which
could have a real impact on
patients and the NHS.”

The competitions will be
run through the Small Business
Research
Initiative
(SBRI) process and are open
to all organisations not just
those in the health sector.

Recent competition winners
include Eykona Technologies
Ltd. who has developed a novel 3D wound imaging system
which allows healthcare professionals to monitor chronic
wounds more effectively and
tailor treatment accordingly.
This system is currently being
sold to the NHS.
The competitions will be
managed by NHS London and
NHS Midlands and East.
Businesses can find out
more about the competitions
by attending a briefing session, held in London on 12th
April. More details are available at www.innovateuk.org.
uk/SBRI. DT

NASDAL comments on the Budget

igh earning dentists
have reason to celebrate following the
announcement by Chancellor
George Osborne that the 50 per
cent income tax rate on earnings over £150,000 will reduce
to 45 per cent from April 2013.
This could be off-set, however,
if they are buying or selling very
expensive properties. Stamp
Duty Land Tax on residential
properties over £2 million will
be increased to seven per cent
from five per cent.
The main rate of corporation tax is going to come down

which will also benefit higher
earning dentists who have incorporated and who earn more
than £300,000. For most of the
profession, however, the tax
position will remain unchanged
in the years ahead.
Alan Suggett, Chartered Accountant of UNW LLP media
officer for NASDAL, welcomed
the announcement that the
Chancellor is going to introduce tax avoidance legislation – known as an anti-abuse
rules - in next year’s finance
bill: “Dentists will be aware of
tempting schemes for reduc-

ing tax which sound too good
to be true and are usually to be
avoided. The new legislation
will stop the ultra-aggressive
and contrived arrangements,
eliminating the temptation–
which will prove to be a good
thing as they usually come
to regret having entered into
them.”
Of all George Osborne’s announcements, the increase in
tax on tobacco by 37p is most
potentially divisive, celebrated
by non-smokers and the medical and dental professions,
which support smoking cessa-

Overweight students are
risking losing their teeth

study, undertaken in Japan, has looked at the oral
health and eating habits
of more than 800 university undergraduates, and compared the
levels of gum disease between
students who were classed as
underweight, normal weight and
overweight.
The study found that students
classed as overweight, that regularly ate fatty foods and rarely ate
vegetables, were at an increased
risk of severe gum disease likely
to result in tooth loss. Students
classed as underweight or normal weight were not exposed
to the same risk. The study also
suggested that young people who
were overweight, but frequently
ate vegetables were less likely to
suffer from severe gum disease.
The findings are food for
thought for around 450,000 students who start university in
the UK each year. Current esti-

mates suggest that over one in
four young people aged 16-24
are classed as overweight in the
UK, and potentially at greater risk
of gum disease and tooth loss.
Chief Executive of the Foundation, Dr Nigel Carter, said: “Starting University is an exciting time
for every student, but perhaps not
for their oral health.
“One of the key ingredients to
good oral health is a balanced diet,
something I’m sure many people
who have gone through university
will admit to foregoing.
The myth about the higher
cost of healthy eating is one the
BDHF believes must be overcome
in order for good habits to become
the norm, and Dr Carter believes
there’s a perfect opportunity
around the corner to do just that.
“National Smile Month is an
ideal opportunity for colleges and

universities to urge students to
think about what they’ve eaten
throughout the semester and how
they can put it right not just during the campaign, but ensure that
a good, balanced diet remains part
of their lifestyle.
“Whether it’s a healthy canteen on campus grounds or an
initiative from one of the many
dental schools, promoting a better
diet to combat weight problems
and improve oral health can make
a difference.”
National Smile Month, which
runs from 20 May to 20 June
2012 is the UK’s biggest annual
reminder to look after their oral
health. The campaign encourages everyone to brush their teeth
for two minutes twice a day with
a fluoride toothpaste, cut down
on how often they have sugary
foods and drinks and to visit their
dentist regularly, as often as they
recommend. DT

tion, and reviled by smokers
with no intention of giving up!
George Osborne’s third
budget speech, which took 58
minutes, two minutes longer
than the previous year, was the
second shortest in 150 years. DT
Key changes:
• The top rate of income tax of
50 per cent on over £150,000
will reduce to 45 per cent from
April 2013
• The main rate of corporation tax will be cut to 24 per
cent next year and will fall 22

per cent from 1 April 2014. The
small company rate remaining
at 20 per cent
• The personal allowance (PA)
will rise to £9,205 from 6 April
2013, and age related allowances for pensioners will be
phased out over time as the PA
increases
• A cap will be introduced on
unlimited income tax reliefs
for anyone claiming more than
£50,000 of relief. The cap on a
variety of different reliefs will
be restricted to the higher of 25
per cent of income or £50,000

ADI implant courses
for dental nurses

ue to the resounding success following the launch of the
ADI Dental Nurses’ Course
last year, the ADI is continuing the Original Dental Nurses’ Course for 2012 and has
created an Advanced Dental
Nurses’ Course.
The
Original
One-Day
Course on Dental Implants
for Dental Nurses aims to
increase
the
understanding of dental implantology to
dental nurses. The course
caters
for
the
inexperienced dental nurse, offering
nurses the knowledge and
confidence to support the
operator
with
surgical
implant
placement
and
subsequent restorative appointments.
The Advanced One-Day
Course entitled ‘Surgical Dental Implant Procedures for
Dental Nurses’ has been cre-

ated for dental nurses who are
experienced in assisting with
implant placement or have
completed the Original OneDay Course.
The course aims to examine the dental nurses’ role
in assisting with advanced
surgical
procedures
in
implant
dentistry.
Upon
completion, nurses will recognise the instruments required, the process and the
indications for each of the
procedures.
The courses are located in
London and Edinburgh. Both
courses are booking up fast,
with the first 2012 London
date for the Original Nurses’
Course already full. For more
information visit www.adi.org.
uk or call the ADI on 020 8487
5555. DT

[3] =>

United Kingdom Edition

News 3

April 9-15, 2012

Editorial comment

T

ime really
does
fly
when
you
are having fun!
Here we are, mid
April already and
conference
season is rapidly approaching. I will
basically be living from a suitcase over the next few weeks
as trips to Manchester et al
beckons.
A bit closer to home, 1819th May sees the much an-

Cradle
to grave

T

he 2nd John McLean
Honorary
Symposium
has been organised in
order to increase the funding
of The John McLean Fellowship, which was formed in May
2010 to not only fund academic
and clinical research, but also
to honour John for his contribution to dentistry.
During his lifetime John
achieved international renown
as a highly regarded dental
practitioner, scientist, author
and keynote lecturer. His work
was underpinned by a passion
for science and astute insight of
trends in dentistry and it is without doubt that his contribution
to his fields of special interest
and expertise in dentistry cannot be underestimated.
The theme of this year’s
meeting is “Dental Health: Cradle to Grave” and will be held in
the new seminar suite at Castle
View Dental in Windsor on Friday May 4, 2012. The suite can
seat a maximum of 55 delegates
so early booking is advised to
avoid disappointment.
Speakers include Edwina
Kidd; Jim Page; Cheryl Butz; Ian
Needleman; Tim Watson; Mike
Wise; John Besford and David
Winkler.
The goal is to raise a minimum of £15,000 for the McLean
Fellowship.
A minimum donation of
£300 to the John McLean Fellowship is suggested to secure
your place for this unique event.
Your donation will help promote
and nurture student research in
dental materials and enhance
the opportunities available to
those beginning their career in
this vital aspect of dentistry.
Contact David Winkler at
david@castleviewdental.net for
more details. DT

ticipated Clinical Innovations
Conference, held at the fabulous Millennium Gloucester
Hotel in London. With a top
line-up of speakers such as
Nasser Barghi and DT contributor Mhari Coxon, attendees are assured of a lively
thought-provoking conference
and plenty of networking opportunities.

Of course no self respecting conference would be complete without a party, and the
Clinical Innovations Conference is no exception! The organisers have teamed up with
charitable
association
the
AOG to present a charity ball
with all the glitz and glamour
you’d expect. Proceeds from
the event go towards the AOG

Chitrakoot Project, providing
dental care to families in the
Indian village of Chitrakoot
and its surrounds.
For more about
the Clinical Innovations Conference, go
to www.clinicalinnovations.co.uk or
call 02074008989. 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

April 9-15, 2012

Alcohol industry sheds a billion units

H

ealth Secretary Andrew
Lansley announced recently that a billion
units of alcohol will be shed by
the alcohol industry through
an ambitious plan to help
customers drink within guidelines.
The initiative, which is part
of the Responsibility Deal, is
being spearheaded by 34 leading companies behind brands
such as Echo Falls, First
Cape and Heineken and will
see a greater choice of lower
strength alcohol products and
smaller measures by 2015.
Market intelligence suggests consumers are increasingly looking for lower strength wines. In the

past year, demand for lower
and non-alcoholic beer has
soared by 40 per cent across
all retailers.
Key commitments include
new and lighter products, innovating
through
existing
brands and removing products
from sale. They include:
• Sainsbury’s have pledged to
double the sales of lighter alcohol wine and reduce the average alcohol content of own
brand wine and beer by 2020
• 25 million units will be gradually removed from Accolade
Wines including Echo Falls
Rosé and Echo Falls White
Zinfandel

• Brand Phoenix - have committed to taking 50 million
units of alcohol out of their
wines - by reducing 0.8 per
cent ABV on all FirstCape full
strength red wines
• Molson Coors, the UK’s largest brewer, has committed to
remove 50 million units by December 2015
• 100 million units will be removed by Heineken
• Own brand super-strength
lager will be removed from
sale by wholesaler Makro
• Tesco, the leading retailer for
low alcohol drinks, will reduce
the alcohol content of its ownlabel beer and cider and ex-

pand its range of lower alcohol
wines and beers, already the
biggest selling range in the UK
Health Secretary Andrew
Lansley said: “The Responsibility Deal shows what can be
achieved for individuals and
families when we work together with industry. We know it is
an ambitious challenge to work
in this way but our successes
so far clearly demonstrate it
works. We will work hard to
engage even more businesses
and get bigger results.
“Cutting alcohol by a billion
units will help more people
drink sensibly and within the
guidelines. This pledge forms
a key part of the shared responsibility we will encourage

as part of the alcohol strategy.”
Estimate suggest that in a
decade, removing one billion
units from sales would result
in almost 1,000 fewer alcohol
related deaths per year; thousands of fewer hospital admissions and alcohol related
crimes, as well as substantial
savings to health services and
crime costs each year.
Chief Medical Officer Professor Dame Sally Davis said:
“Drinking too much is a major
public health issue. By cutting
out units from many of our
best-known brands, this initiative will help people to continue to enjoy a sensible drink
while lowering their unit consumption.” DT

Researchers find bacteria on dental bib holders

T

he sterilisation protocol
for dental bib holders
is inconsistent and can
result in the presence of bacteria such as pseudomonas and
micro-organisms, researchers
from Germany have proved. In
a study, they found bacteria on
more than two-thirds of reusable bib holders.
The researchers at the Witten/Herdecke University in
Witten, Germany, examined 30
metal and plastic bib holders.

“The analyses of the bacterial load showed that 70 per
cent of all reusable bib holders were contaminated with
bacteria. The predominant
colony types identified were
staphylococci and streptococci. On several bib chains,
we also found various bacterial rods, pseudomonas, fungi and other types of cocci,”
said Prof Stefan Zimmer, lead
investigator of the study and
scientific director at the Witten/Herdecke University. “Al-

All aboard the Smile Train

though the bacteria found in
this study were all non-pathogenic, in principle reusable bib
holders can cross-contaminate
dental patients.”

bib holder can enter the body
when a patient touches the bib
holder or neck after a dental
visit and then rubs an eye or
touches the mouth.

The bacteria found on the
bib holders do not usually
cause disease in healthy people, but can be a threat to immunosuppressed patients, as
well as young children and the
elderly, who often have compromised immune systems.
Bacteria from an unsterilised

Cross-contamination
can
also occur when a bib chain
is splattered with saliva,
plaque, blood and spray from
the mouth, when it catches
onto hair and accumulates the
wearer’s sweat, make-up or
discharge from neck acne, and
if the dental worker applies

A

kind hearted dentist is going the extra mile for a
children’s charity. Dr Greg
Paysden, (pictured), who runs two
dental practices - one in North
Manchester and another in Salford - has set his sights on running
the Wilmslow Half Marathon in a
bid to raise money for Smile Train.
Formed in 1999, Smile Train

“It’s hard to believe that children are being treated in this way
over something that isn’t their
fault and can be fixed so easily. By
running the Wilmslow Half Marathon I hope to gain as much support as possible and bring a smile
to a child’s face.”
To contribute visit: www.justgiving.com/GregPaysden DT

Several
other
studies
have found similar results.
Three US studies found unacceptable levels of microbial contamination on dental
bib holders, including pseudomonas, E. coli and S. aureus, the most common cause
of staph infection. DT

Calories to be capped and cut
have all joined the fight against
obesity and are leading the way
in signing up to the Responsibility
Deal’s calorie reduction pledge.

is the world’s leading cleft charity
providing free cleft lip and palate surgery to children in developing countries. It also provides
free cleft-related training for
doctors and medical professionals. To date, it has helped more
than 725,000 individuals across
more than 80 of the world’s
poorest nations.
Speaking of his efforts to raise
funds that will help Smile Train in
its invaluable work, Dr Paysden
said: “A lot of children affected
by clefts are considered outcasts
by society. This can mean they
are excluded from education and
overlooked for job opportunities.
In worse case scenarios, some are
even killed or abandoned at birth.

a dirty bib chain with gloved
hands before the examination
or cleaning.

England has one of the highest rates of obesity in Europe and
some of the highest rates in the
developed world. More than 60
per cent of adults and a third of 10
and 11 year olds are overweight or
obese. Consuming too many calories is at the heart of the problem.

Calories in food will be cut

T

he country’s biggest supermarkets, food manufacturers, caterers and food
outlets are joining forces to help
cut five billion calories from the
nation’s daily diet, the Health Secretary Andrew Lansley recently
announced.
Asda, Marks & Spencer, Morrisons, Sainsbury’s, Tesco, Waitrose, Coca-Cola Great Britain,
Kerry Foods, Kraft, Mars, Nestle,
PepsiCo, Premier Foods, Unilever,
Beefeater (Whitbread), Subway
and contract caterer Compass

Making commitments today to
cut and cap calories are some of
the world’s biggest food and drink
manufacturers and best known
brands. More than three-quarters
of the retail market has signed
up. The following examples highlight some of the initiatives being
taken:
• Asda will develop a new reduced
calorie brand across a wide range
of products that will contain at
least 30 per cent fewer calories
than their core Chosen by you
brand
• Coca-Cola Great Britain will reduce the calories in some of its
soft drinks brands by at least 30

per cent by 2014
• Mars will cap the calories of
their chocolate items to 250 calories per portion by the end of 2013
• Morrisons will launch a range of
healthier products developed by
their chefs and nutritionists
• Premier Foods will reduce calories in one third of their sales by
the end of 2014
• The Subway brand has committed to offer five out of their nine
Low Fat Range Subs
• Tesco is on track to remove 1.8
billion calories from its soft drinks,
will expand its Eat, Live and Enjoy
range of low-calorie meals and is
making it easier for shoppers to
spot low-calorie options
Health Secretary, Andrew
Lansley said: “Eating and drinking
too many calories is at the heart of
the nation’s obesity problem.
“We all have a role to play –
from individuals to public, private
and non-governmental organisations – if we are going to cut five
billion calories from our national
diet. It is an ambitious challenge
but the Responsibility Deal has
made a great start.” DT

[5] =>

United Kingdom Edition

News 5

April 9-15, 2012

National Conference on CPD in dentistry

he General Dental Council (GDC), is holding a
national conference 17
April 2012 focusing on the role
of Continuing Professional Development (CPD) in dentistry.
Bringing together a wide
range of speakers from across
the four countries of the UK,
the event will consider the
themes of:

• Contribution of CPD to quality
dental care
• Examining quality & access to
CPD
• GDC registrant perspectives
The free event will be held at
the Royal Institute of British Architects, 66 Portland Place, London W1B 1AD 10am-4pm.

It will be of particular interest to those involved in developing, designing and delivering
CPD for dental professionals,
but anyone with an interest is
welcome to attend.
To attend you must register
on the GDC website at www.
gdc-uk.org/Aboutus/Research-

andconsultations/cpdreview/
Pages/CPD-review-event.aspxConference.
Speakers include:
• Kevin O’Brien, Chair of the
General Dental Council
• Barry Cockcroft, Chief Dental
Officer for England
• Professor Andrew Friedman,

University of Bristol
• Judith Husband, Vice-Chair of
the British Dental Association
• Nicola Doherty, President of
the British Association of Dental
Nurses
• Donncha O’Carolan, Chief
Dental Officer for Northern Ireland DT

• CPD and professionalism
• Effectiveness of CPD in dentistry

KwickScreen wins
prestigious
prize

wickScreen has won
the best start-up business at the Lloyds TSB
enterprise awards. In their
newsletter, a spokesperson for
KwickScreen said: “It really is
a great honour to win such a
prestigious prize and we are
grateful for everyone’s support
along the way. We only started
selling the KwickScreen just
under two years ago and now
we have been adopted by more
than 40 NHS trusts.
“Thank you everyone for
your continued support, it really means a lot to us.”
A KwickScreen help provide infection isolation, improve privacy and dignity and
they can even be personalised
thanks to a method which
means any design can be printed on the screens. According
to the KwickScreen newsletter,
several hospitals have brought
the screens to hide unsightly
equipment and to brighten up
the hospital environment for
both patients and staff.
The Lloyds TSB Enterprise
Award was set up to show that
Lloyds TSB is committed to the
small and medium sized business market. It is also a way
of helping to encourage new
start-ups and enterprises. DT

DISPLACE

DISLODGE

DESTROY

The regime that
shows plaque bacteria
no mercy
Brushing and flossing/interdental cleaning are pivotal to oral hygiene. They displace
and dislodge dental plaque bacteria that can cause gingivitis and periodontal disease.
But bacteria from other areas of the mouth can recolonize on teeth quickly.1
Using LISTERINE® after mechanical cleaning destroys oral bacteria effectively, killing
up to 97% in vivo.2 This lowers the bacterial burden in the mouth and in plaque that
reforms.3 And when used for 6 months, LISTERINE® can reduce plaque levels by up
to 52% more than brushing and flossing alone.4 In addition, LISTERINE® Total Care
products offer various levels of fluoride and other benefits to suit patients’ needs.
So recommend LISTERINE® as the final step in your patient’s daily
regime, to finish the job started by mechanical cleaning.

References:
1. Barnett ML. JADA 2006; 137: 16S-21S.
2. Data on file FCLGBP0023+28, McNeil PPC.
3. Fine DH, et al. J Clin Periodontol 2005; 32: 335-40.
4. Sharma N, et al. JADA 2004; 135: 496-504.
The Kwikscreen

Finish the job. Finish off with Listerine.

ID:UK/LI/12-0084

03930_ocdlis_DentalTribune_FullPage_ad_297x210_fa1.indd 1

1/31/12 5:50 PM

[6] =>

United Kingdom Edition

S&Sdental

services

April 9-15, 2012

Planmeca appoints
South West distributor
deal directly with the Planmeca
factory to get the best prices for
these award-winning pieces of
equipment.

Planmeca Sovereign, just one of a range
of Planmeca products available from S&S
Dental Services

&S Dental Services has
been awarded sole south
west-based distributor status for Planmeca dental equipment.
The Planmeca tie-up means
S&S Dental is now the only dealer based in Devon, Cornwall,
Dorset and Somerset who can

Paul Sutcliffe, owner S&S
Dental Services said: “We are
delighted to be an official distributor for Planmeca. We’re a
great match as they specialise in
the design and manufacture of
high tech dental equipment and
we are known for our excellent
service and extensive product
knowledge.
“Dentists chose Planmeca
products because they are cutting edge, not only in terms of
technology, but also in terms
of design. Gone are the days
when surgeries look sparse and
somewhat frightening. Planmeca products are very stylish
and play a key role in helping
to make visiting and working in

the practice a more enjoyable
experience for patient and dentists.”
Plymouth-based S&S Dental
Services provides a one-stop
sales and service shop to more
than 1000 practices throughout
the south west. They have been
awarded the Planmeca contract
because of its established reputation in the dental field. The
south west enjoys a high concentration of dental surgeries
using Planmeca, so S&S Dental
will be able to provide a local
service to these dental clinics
and practices using, as well as
introduce these fantastic hightech products to those who are
looking to invest in new equipment.
For more information about
S&S Dental and Planmeca, call
0844 272 4561.

Profits down, costs up in
NASDAL stats for 2010-2011
but this is not always 50 per cent
of the full UDA rate agreed with
the Primary Care Trust.

he annual benchmarking statistics just issued by NASDAL reflect
the wider economy in 20102011, the most recent year for
which figures are available.
Fee income is down for both
the NHS and private sectors,
profits are generally down
and costs have increased. The
average net profit for a typical
dental practice has reduced
from £139,569 to £125,691.
Calculated annually by
NASDAL firm Humphrey and
Co, the statistics are gathered from a sample of practices across the UK to provide
average
‘state-of-the-nation’
figures. They are used by
NASDAL accountants to help
dentists and dental practices
benchmark their figures. A
limited version of the statistics
is made public at an annual
press conference to produce a
snapshot of dental practice finances across the country over
recent years.

The statistics reflect the fee
income of both NHS and private
practices. To fit in either category, you must have a greater
than 80 per cent commitment.
In NHS practices, fee income
has fallen by three per cent,
whilst profits fell by nearly 10
per cent compared to the previous year and are now back
down to 2005/6 levels.

Ian Simpson, Chartered Accountant and Specialist Dental
Advisor, said that while private
practice appeared to be surviving reasonably well despite the
economy in 2010-11, mixed
practices had suffered. He added, larger practices had experienced the greatest impact on
profit.

Private practice fee income
has remained static but rising
costs have led to a seven per
cent drop in net profit. The
average UDA rate paid to practices appears to have remained
static at around £25 over the last
three years. While the highest
UDA rate paid to a practice was
around £44, the highest to an associate was £33.50.

Nick Ledingham, NASDAL
chairman, of Specialist Dental Accountants Morris and Co,
speaking at the press conference, said the figures provided
an interesting insight into how
dentists and their patients responded to an economy in the
doldrums. He believes the NHS
fee income has dropped because fewer non-exempt patients were going for treatment
and some dentists were opting
not to fulfill or were unable to
fulfill their NHS contract. He
believes mixed practices which
have fared least well are best
placed to prosper as the economy recovers.

The profit of Associates has
continued to fall and in 20102011 stood at around £68,000
compared to £71,000 in the previous year. The majority of associates still enjoy a 50 per cent
agreement with their principal

He added: “NASDAL clients
will benefit hugely from the
statistics as their accountants
will be able to benchmark their
results and work with them to
ensure they are well placed to
maximise their potential.” DT

[7] =>

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
R

LY

Fraser McCord
Mhari Coxon
Amit Patel
Anthony Roberts

BO
O

KI
NG

DI
SC
O

UN

T

[8] =>

8 Budget 2012

United Kingdom Edition

April 9-15, 2012

A budget summary for dentists
Jeff Williamson highlights the areas affecting dentists in the recent Budget

ome dentists may be able
to breathe a sigh of relief following George Osborne’s 3rd Budget on Wednesday 21st March. There were
no big surprises, not least because The Budget was widely
leaked to journalists beforehand. In general, the effect of
The Budget is likely to be neutral or even positive for many
dentists, although it highlights
the need for careful tax planning over the next few years.
What didn’t happen…
Contrary to rumours the
Chancellor
didn’t
remove
higher rate tax relief on pension
contributions.
Those
dentists making pension contributions in any shape or form
can hang onto this generous
tax perk for at least foreseeable future.
Despite the Liberal Democrats pushing for the loss of
tax free cash from pensions,
this hasn’t happened. This particularly benefits those close
to retirement, especially those
with significant NHS Pension
benefit or large personal pension funds.

payers, although the loss of
the increased personal allowance (£9205 in 2013/14) for
those with income in excess of
£100,000, is likely to be widespread amongst dentists. This
shouldn’t be ignored and can
be mitigated with pension contributions.
The headlines…
The highest rate of Income
Tax will be reduced to 45 per
centfrom the current 50 per
cent for those earning in excess of £150,000, from April
2013. Some careful planning
may be required to time the
withdrawal of income (salary/
dividends/drawings) to ensure
the reduction has maximum
personal impact. We advise

roughly equivalent to the average UK house price (£140,000).
Whilst relatively few dentists
will be affected by this it may
set a precedent for future
increases to stamp duty at a
lower threshold.
The Personal Allowance
will increase to £9,205 from
April 2013, benefiting those
with income under £100,000. If
you pay your spouse and have
previously set their salary in
line with the personal allowance you should revisit this.
However the level of income
at which National Insurance
is paid should also be considered. The increase to the personal allowance will unfortunately be partially offset by the

‘Contrary to rumours, the Chancellor
didn’t remove higher rate tax relief on
pension contributions’
dentists reassess their business year end timing with their
accountant as this may be critical to saving tax.

Stamp Duty on house pur‘High earners’
have avoid213860_BDJ_Nobel
8/2/12
13:10 chases
Page 1over £2 million is to
be increased to a staggered further raids on income or
ing seven per cent. On a purcapital taxes. There were no
chase of £2 million the amount
negative changes to the rate
of Stamp Duty paid will be
of tax paid by higher rate tax

decrease in the threshold for
paying higher rate tax. Therefore the increase to the personal allowance is likely to benefit
dentists to a limited extent.
Tax avoidance continues
to be a target for the Chancellor and is estimated to cost the
Treasury £5 billion a year. A
General Anti Avoidance Rule

The effect of The Budget is likely to be neutral or even positive for many dentists

(GAAR) is set to be adopted,
targeting contrived or artificial
schemes. Dentists considering
non-standard ways to avoid
income tax should exercise
caution as such schemes
may well be subject to future legislation. If you are
part way through a tax avoidance scheme when the loophole closes this can be hugely
problematic.
There was a slight softening of the proposed Child Benefit reduction, with the much
vaunted ‘cliff edge’ being
raised to £60,000 from January
2013 and a phasing in of the
cut for those with income more
than £50,000. As many dentists

earn in excess of £60,000 loss
of Child Benefit is likely to
be widespread in the dental
community.
Corporation Tax reductions
are likely to benefit incorporated practices over the next three
years. However most will fall
outside the main corporation
tax reduction to 22 per cent in
2014. The ‘smaller profits’ rate
has already fallen (as per previous budgets) to 20 per cent,
for companies with profits
under £300,000. It is this rate
that will be applicable to many
incorporated dental practices.
The good news is that corporation tax rate levied on the slice
of profits between £300,000
and £1.5 million, known
as the ‘marginal rate’, will
fall. Practices considering incorporation should discuss
the impact of this with their
accountant. DT

‘Tax avoidance
continues to be
a target for the
Chancellor and is
estimated to cost
the Treasury £5
billion a year’

Limited places
available!

Enrol today! Call for details
About the author
PFM
Townends
LLP are chartered
accountants dealing
exclusively
with
dentists.
They provide a full
range of accountancy services including payroll to
practices, practice
owners and associates. Please contact Jeff Williamson on 01904 656083
or visit www.pfmtownends.co.uk for
further information.
TR213860

[9] =>

United Kingdom Edition

April 9-15, 2012

Practice Management 9

Improving practice performance
Amanda Atkin considers what you should do when things go awry

W

e have multi-skilled
healthcare professionals in this country who provide dental health
care to the population. Dedicated, committed and highly
skilled dental teams are focused on offering high quality
care for patients within and
without the NHS. However,
sometimes things can go a
little awry and their professional integrity is called
into question.
If this happens the overriding concern is always for
patient safety but professionals also need support and
sensitively to ensure they are
treated fairly by the organisation employing them. After
all, for the majority, an episode of sub-standard performance will not spell the end
of a career.
With the right support and
management of the situation
most professionals will continue with their work and the
treatment of patients. Quick

‘The over-riding
concern is always
for patient safety,
but professionals
also need support’

and effective intervention
regarding performance concerns should result in the desired outcomes – which must
always include support for the
practitioner. Importantly, all
concerns must be treated in a
fair and consistent manner.
Consider these questions:
• What constitutes a performance concern?
• Who could/should raises
concerns?
• Do those who could or
should raise concerns know
how to do so?
• Who should manage a performance concern once it has
been raised?
• Do you know the answers to
these questions?
A
‘poor
performance’
reporting
system
should

your boss, however, it is
be simple enough to folimportant to remember your
low so that everyone knows
reasons for raising a concern
who to speak to and what
at this point. Your in-house
will be done, whomever the
process and procedure will
concern involves. Sometimes
have 15:21:59
identified individuals
it is difficult
to voice 1 conmsc_ad_source_uk.pdf
03/08/2009
who will be able to help at
cerns especially if it relates to

this point.

or not following a task through

Performance concerns may
relate to:

• An inability to handle a reasonable volume of work to a

• Standard of work – for
example frequent mistakes

à DT page 10

[10] =>

10 Practice Management
ß DT page 9

drive etc

required standard

• Poor punctuality and unexplained absences

• Unacceptable attitudes toward patients

• Lack of skills in tasks/methods of work required

United Kingdom Edition April 9-15, 2012

• Acting outside limits of competence

• Consider the risk to patient
safety

systems are in place to support the individual

• Poor supervision of the work
of others when this is a requirement of the post

• Consider what your options
are

• Know if this concern needs
to be dealt with formally or informally

• Ensure you are fully aware
of the process you need to follow

• A health problem
• Lack of awareness of required standards

•
Unacceptable
attitudes
towards work or colleagues
– for example, uncooperative behaviour, poor communication, poor teamwork,
lack of commitment and

• Consistently failing
achieve agreed objectives

to

If you have one of the
above concerns, what comes
next? Below are some important thoughts you may have
and actions you may take:

Easy, Successful and Affordable

• Ensure you know how to inform the individual
• Ensure you know that the

• You have a duty to work
within your knowledge, professional competence and
physical abilities

Champions® Implant System
(R)Evolution in Implantology and Prosthodontics:

This responsibility includes
making sure that you:

MIMI® Method (Minimally Invasive Method of Implantation)

The Champions® can be
fully integrated into the
treatment services offered
in regular dental offices.

More than 2 800 dental offices and clinics are ‘Champions’,
and they performed more than 50 000 implantations last
year. Do you want to be a new 'Champion' too?"

You can smile again!
We have a special offer for
you: the Surgery Kit for
one-piece and two-piece
Champions® implants for
€ 500 instead of € 700!

Advantages
• Suitable for MIMI® – Win-Win situation for patients and
dentists
• Patient friendly

Dr. Armin Nedjat

• More efficient procedure for the dentist

Developer of the Champions system / CEO

• Champions® implants: a wide range of innovative
implants and accessories, which can be used for
many indications

• Get and follow medical advice if you know that you have
a serious condition which you
could pass on to patients, or
that your judgement or performance could be seriously
affected by a condition or illness

OuR OFFER FOR YOu

"I have developed the Champions® implant system, a reliable
and innovative implant system that can be routinely used in
the day-to-day work of dental offices.

Tel. + 49 151 / 15 25 36 92
armin@championsimplants.com

unt
Disco
€ 200
e
v
a
S

• Get help if you have any other problems which are affecting or may affect your professional performance

OFFER FOR New CuStOmERS
• If a turnover of at least 50 implants is reached within 6
months, the surgical kit will be your property..
• You can choose 20 implants, which you can keep for two
months. You will only have to pay the used implants.

• High quality at affordable prices
• Excellent primary stability

• Only carry out a task or type
of treatment if you are sure
that you have been trained
and are competent to do it

Should you require further information, you can contact our
Service team. You can also go to our Web site to find our offer
for new customers and also further information at:

• Optimal immediate loading
• Excellent prosthodontic restorations
• Innovative solution and successful treatment

www.champions-implants.com

• Made in Germany with great precision and
of the highest quality materials
• Free MIMI® marketing
• Free forum for all Champions® customers
• Champions®-surface – rated one of the best
(studies on demand)

Fanny Rougnon-Glasson
Tel. +49 151 / 15 25 57 18
fanny@championsimplants.com

I®
le for MionIM
Suitabasiv
Method
e Implantat

One-Piece Implants

€ 74

Minimally Inv

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Thread lengths 6 · 8 · 10 · 12 … 24 mm

+ VAT

Courses about the minimally invasive
implantation method (MIMI®) and the
Champions® implant system

• Co-operate fully with any
procedure for investigating
concerns which applies to
your work

The course starts on Wednesday at 2:00 P.M. and ends on Saturday afternoon

* Also available in "Classic"

❏ June 13 – June 16, 2012

Zircon Prep-Caps

59 €

& 510(k) registered

WIN! &Titanium Prep-Caps

35 €

FDA (USA)

Course content

Theory: Presentation of the Champions® implant system and the MIMI®
method · Practice: Live surgeries with one-piece and two-piece Champions®
implants.

Champions®-tulips
Ø 2.5 · 3.0 · 4.0
Thread lengths 8 · 10 · 12 · 14 … 24 mm

The course includes

two-Piece Implants

Course fee € 3 200 (VAT excluded)

 Free loan of the surgical kit
 Inner cone with integrated “Hexadapter”
 Micro-close connection < 0.6 μm
 Price VAt included:
Healing Cap (with implant)

• Do not put anyone off raising
a concern about your health,
behaviour or professional performance

Continuing education in mallorca

ed

t includ
Prep-Cap no

23 €

Implant Analog Set

23 €

Impression Coping

10 €

5 nights in a double-room, breakfast included, transfer to the dental office,
day rate, lunch, coffee break, 2 dinners, course script, A3 Certificate, incl. for
accompanying person.

€ 59
tle
Gingiva-Shut

Please arrange your flight schedule. For transfers, please give us your flight arrival time.

+ VAT

the courses will be presented in a friendly and relaxed atmosphere,
and dentists will be able to incorporate Implantology as an
additional treatment in their dental office.

included

The courses will be taught by Dr. Armin Nedjat, an
experienced Dental Implantology specialist. He has placed
and restored more than 20 000 implants.

Ø 3.5

4.0

4.5

Medilas Opal
diode laser 980
by Dornier medtech

5.5

Thread lengths:
6.5 · 8 · 10 · 12 · 14 · 16

4 999 €
from

www.champions-implants.com
incl. online-shop & about 120 videos
(instructions & implantations)

+ VAT

Several clinical cases online!
Champions-Implants GmbH
Tel.: +49 67 34 / 91 40 80 · Fax: +49 67 34 / 10 53
info@champions-implants.com

CI Dental Tribune UK-297 x 420.indd 1

In my next article, I’ll discuss turning around poor performance. DT

Course participants: minimum 3, maximum 10

0€

Customizable and glueable
titanium abutment

What the GDC says you
should do regarding performance concerns is contained
in its code of behaviour Standards for dental professionals.
Its guidance can be summarised as follows:
• The duty to put patients’ interests first and act to protect
them must override personal
and professional loyalties

Made in Germany

Dr. Armin Nedjat said,

• Decide what to do

About the author
Amanda
Atkin
runs
Atkinspire
Ltd and offers
practices
support, training and
consultancy
on
information governance,
CQC
compliance, National Minimum
Standards
and
HTM 01-05. Her
bespoke service supports practices
as they embed the required standards
within their daily routines – to ensure
a high quality service and patient
safety at all times.
amanda@atkinspire.co.uk

Recommended by VIP-ZM
association of innovative-practicing dentists

www.atkinspire.co.uk

27.02.12 13:59

[11] =>

Endo Tribune
Endo Tribune

Endo Tribune

Rubber dam hazards

Treating Patients

Flexibility and strength

Dr Sander Loos provides a case report

Dr Philippe Sleiman discusses root canals

page 14-15

Endo Tribune

The effect of ultrasonic irrigation

Dr Kenneth Serota

James Prichard provides an in-vitro study

pages 16-17

pages 18-19

pages 20-22

Excellence in endodontics
Daniel Flynn discusses endodontic microsurgery

Fig 1 Pre-operative periapical radiograph

one are the days of the
clumsy
apicectomy
and amalgam retrograde fillings. Endodontic surgery has evolved to become a
technically accurate, highly
predictable procedure with
remarkable success rates.
Implant technology has
meant many teeth of questionable prognosis are extracted
in the name of future predictability. While implants have
been a wonderful adjunct
in the dental armature, our
primary role as dentists is to
try and conserve the existing
dentition that have good long
term prognosis.
Classically
an
apicectomy was a treatment of last
resort, using large bulky instruments, rough approximations and excess amounts of
amalgam. The biological ramifications of additional canals,
cracks, apical deltas and poor
initial root canal treatments
may have been overlooked resulting in poor success rates.
This
has
understandably
resulted in a negative perception of apical surgery amongst

Fig 2 Pre-operative CBCT scan confirming 1 canal present and large periapical radiolucency

the dental profession who
erroneously believe success
rates to be around 60 per cent
when the actual figure for endodontic microsurgery is over
91 per cent after five to seven
years (1).
Modern techniques and
equipment have transformed
the procedure. Using CBCT
scans from the outset we can
plan surgery exactly; three
dimensional picture of bone
loss is clear as is the posi-

multiple episodes of pain
and swelling from the UL5.
There was an initial root canal treatment and subsequent
retreatment
provided
by
a competent GDP using rubber
dam and sodium hypochlorite irrigation. There was a
well-fitting
new
crown
placed and no associated periodontal pocketing greater
than 3mm.

of gutta percha and sealer.
The CBCT scan provided very
useful information at this
point. Although the treated
canal appeared centered in
the root there was a question
whether there was a second
canal present in the tooth.
Also there appeared to be an
apical bulbosity present which
could mean multiple paths of
exits present.

Radiographic
examination (Fig 1) revealed a large

A provisional diagnosis of
acute exacerbation of chronic
apical periodontitis was made
and treatment options discussed with the patient (who
had just paid for and was satisfied with a new crown.)

‘Endodontic surgery has evolved to become
a technically accurate, highly predictable
procedure with remarkable success rates’

tion of anatomically sensitive
structures; lengths can be accurately measured and existing treatment such as posts
and MB2s assessed.
The following case is an
example of the techniques
which we now use. The patient
presented
following

radiolucency associated with
the UL5. There was an overextended root canal filling.
On CBCT (Fig 2) a clearer
picture of the size of the apical radiolucency emerged and
its relationship to adjacent
anatomical structures was
visualised. There was one canal present with an overfill

1
2
3

Root canal retreatment
through the crown

Endodontic microsurgery

Extraction +/- prosthetic
replacement
A mucoperiosteal flap was
raised with micro-blades that

Fig 3 Pre-operative clinical view

produce neat, precise incisions as they cut in multiple
directions. Once the flap was
raised, the perforation in the
buccal plate was identified
and root tip located. The granulation tissue was curettaged
and haemostasis achieved.
Following
resection
of
3mm of the root tip perpendicular to the long axis of
the tooth a retropreparation
was completed with ultrasonics, then sealed with MTA.
The tissues were compressed
and the flap closed with 5/0
monofilament sutures that
were removed painlessly after
72 hours as reattachment had
taken place.
At the four-month review
the buccal swelling had completely resolved and radiographically there was significant healing present.
The patient was delighted
with the outcome of treatment.

à DT page 12

[12] =>

12 Endo Tribune

United Kingdom Edition April 9-15, 2012

ß DT page 11

There
are
significant
differences between the above
microsurgical techniques and
traditional surgery approaches.
1. Osteotomy size
The use of smaller instruments, magnification and illumination allows access to
the root tip, often without
removing any additional buccal bone should the plate be
already perforated. Staining

Fig 4 Soft tissue removed

Fig 5 Haemostasis achieved, parallel resection of root tip and retropreparation sealed
with MTA

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the PDL makes it easier to differentiate between bone and
root tip. The smaller the size
of the osteotomy, the quicker
the healing (2)
2.Bevel Angle
Traditionally the root was resected at 45 degrees for access, visualisation and sealing
purposes. But, this method
results in the exposure of a

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Fig 6 Soft tissue sent for histological
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greater amount of dentinal
tubules and may not remove
enough of the apical anatomy
lingually. Modern techniques

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‘The use of smaller
instruments,
magnification and
illumination allows
access to the root
tip, often without
removing any
additional buccal
bone should the
plate be already
perforated’
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using a cut perpendicular
to the long axis of the toot
result in exposure of far
fewer tubules, enables a
smaller
osteotomy,
retention of more buccal bone and
no periodontal communication. There is less chance of a
lingual perforation in the
retro-preparation and it is
easier to identify the apices of

[13] =>

Endo Tribune 13

United Kingdom Edition April 9-15, 2012

the roots.
3. Root end resection
It is recommended to remove
3mm of the root tip. At this
level 98 per cent of apical
ramification and 93 per cent
of lateral canals are removed
(3). Following resection it is
critical that the root end is

Fig 7 Examining a resected root tip with
a micro-mirror and implant (4)

‘Endodontic microsurgery is a great
option to keep in mind when planning
treatment ’

other improvement. Superior
to amalgam in terms of sealability and biocompatibility,
it is more difficult to place
and doesn’t give as aesthetically pleasing result when

viewed on a radiograph postoperatively. Critically MTA
results in regeneration of
periodontal ligament and cementum cells and appears to
have inductive effects on bone

and tissue cells. Super-EBA
has also shown favourable
results using microsurgical
techniques.

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

Endodontic microsurgery
is a great option to keep in
mind when planning treatment and has an added bonus
for patients being the least
expensive intervention when
compared to endodontic retreatment and crown, extraction and fixed partial denture,
or extraction.

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Fig 8 Post-operative radiograph

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Fig 9 Four-month review (Almost complete healing and asymptomatic)

inspected under high power
visualisation,
stained
and
viewed with micro-mirrors.
Identification of isthmuses,
cracks and lateral canals may
be treated at this stage.
4. Retropreparation
Micro-hand
pieces
and
burs are no longer the ideal
treatment
for
retropreparation. Instead, diamond coated ultra-sonic tips
are excellent for allowing the
operator to clean along the
original canal, the isthmus
and minimise microcrack formation.
The use of MTA as a root
end filling material is an-

About the author
Dr Daniel Flynn
BDentSc MFDS
RCSI MClinDent
MRD
RCSEd
qualified
from
the Dublin Dental
Hospital, Trinity
College, Dublin
in 2002. Daniel
has recently joined the EndoCare
team headed by Dr Michael Sultan.
Daniel lectures and provides handson courses for general practitioners.
He also teaches Endodontics at the
Eastman Dental Institute for Oral
Healthcare Sciences.

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[14] =>

14 Endo Tribune

United Kingdom Edition April 9-15, 2012

Do we treat patients based
on radiolucency?
Dr Sander Loos provides a case report
pain, consulted the emergency
Just after Christmas, on 26
December
2010, a 76-year-old
DT_AdvertGBP_29.03.2012.pdf
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4:33:09 PM The patient indicated
that he felt a throbbing pain
male patient, who was in great

tist took radiographs of teeth
#36 and 37 and an orthopantomogram (OPG; Figs 1 & 2).

in his lower left jaw. The pain
was unbearable and had kept
him awake all night. The den-

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After another sleepless
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27 December. The analgesics
did not give him pain relief
and he was starting to become
desperate. The second dentist
confirmed the original diagnosis and referred the patient
to an oral surgeon because an
endodontist was not available
at short notice. He requested
apical surgery on tooth #37.
The following day, the oral
surgeon took another OPG and
concluded that surgery was
not the best treatment option
in this case because the apex
was located too close to the
nervus alveolaris inferior and
access to the apices of tooth
#37 was difficult.
He also confirmed the diagnosis of an AP and suggested extraction or endodontic
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Although the radiograph
did not show the full anatomy
of tooth #37 and its surrounding structures, the dentist diagnosed apical periodontitis
(AP) and advised an endodontic retreatment or extraction
and an implant. To make the
patient comfortable for the
time being, he prescribed 500
mg Amoxicillin and Ibuprofen.

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On 5 January 2011, the patient visited my office for the
first time. The pain had diminished but not disappeared. Intra-oral examination showed a
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Fig 2

[15] =>

Endo Tribune 15

United Kingdom Edition April 9-15, 2012

tioning as abutments. Tooth
#37 showed an occlusal filling
in the crown. Palpation of the
buccal fold was not painful and
there was no mobility of teeth
#36 and 37. The pockets of #36
were within normal limits.
However, periodontal probing
distal of #37 provoked strong
pain and extreme bleeding.
The distal pocket measured
approximately 6mm.
As the previously taken radiographs were not available
and the OPT was considered
unsuitable for proper diagnosis, a peri-apical radiograph
(Fig. 3) was taken. The radiograph showed that tooth #37
had previously been treated

therapies (retreatment or extraction), we opted to rule out
the local marginal periodontitis first. Under local anaesthesia, the distal pocket was
thoroughly cleaned and the
patient was instructed to use
dental floss distal of tooth #37
on a daily basis.
On 31 January, three weeks
after initial treatment, the patient returned for evaluation
and appeared free of complaints. Therea was no bleed-

ing on probing and pain could
not be provoked.
It should be noted that by
selecting this strategy, neither
an AP nor a VRF was definitively excluded as a cause of
pain. It should be taken into
account that owing to the
patient being on antibiotics,
the symptoms of the AP may
have temporarily disappeared
and returned at a later stage.
Nevertheless, at that point we
treated the patient based on

history, a radiograph and patient complaints rather than
merely on the basis of the radiolucency evident on the radiograph.

sis… the picture may show a
lot of rarefaction, but to use it
as the sole means of diagnosis is unwise.” Thomas Philip
Hinman, 1921

In May 2011, the patient
returned to our office once
again. He was free of complaints, pockets were within
normal limits and there was
no bleeding on probing. DT

About the author

“The radiographic picture
is only one means of diagno-

Dr Sander Loos
Heuvelweg 21, 3761 XL Soest, Netherlands
s.loos@acta.nl

Treat small
spaces with

confidence

Fig 3
endodontically. The mesial
canals were filled with silver
cones rather too short of the
apex. There also appeared to
be some gutta-percha and a
large metal post in the distal
canal. Additionally, radiolucency was noticeable around
the apex of the mesial root.
According to the patient,
he had received endodontic
treatment about 15 years ago
owing to pain following bridge
cementation. The tooth had
been without symptoms since
then.
Considering the history
and my clinical and radiographic findings, my differential diagnosis was:

1
2

painful AP owing to reinfection or leakage

painful marginal periodontitis distal of tooth #37 owing to poor oral hygiene

Human histology shows the apical
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vertical
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As diagnosis 1 and 3 would
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1. Radiographic Analysis of Crestal Bone Levels on Laser-Lok Collar Dental Implants. CA Shapoff, B Lahey, PA Wasserlauf, DM Kim, IJPRD, Vol 30, No 2, 2010.
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Bio Horizons_treat small.indd 1

01/03/2011 16:33

[16] =>

16 Endo Tribune

United Kingdom Edition April 9-15, 2012

When flexibility and strength are key
Dr Philippe Sleiman discusses root canal treatments

R

oot-canal retreatment is
a very common procedure
that endodontists and
general practitioners are faced
with on almost a daily basis. The
biggest challenge here is to reestablish the initial pathway of
the canal and its original exit or
apex. During the past decade,

several techniques required that
gutta-percha be used to fill the
root canals. Sometimes and for
many reasons, such as leakage
or short preparation and/or obturation, the gutta-percha needs
to be removed and the canal renegotiated.

Generally, NiTi rotary files
were used in such cases in order to facilitate and expedite our
task. However, the files used to
accomplish this task faced additional challenges, that is, the
debris coming from the previous
obturation and the density of the
obturation material. The first dif-

ficulty is piercing the mass of the
obturation material. Here, our
choice of file should focus on a
strong tip that can take the pressure and engage the mass of the
gutta-percha, break it down and
push it back into the access cavity.
The second challenge is to select
an instrument that can enter the

root-canal structure and
engage the obturation
material, pushing it out
coronally, while offering enough flexibility to go around
curves and shape
Fig 1
the root-canal
surface safely.
Today, thanks to heat treatment that has changed the world
of rotary NiTi files, allowing us
to modify the crystalline structure of the metal, we have been
able to obtain several types of
the alloy to give us different files,
from the Twisted File to the latest modification of the K3 system, the K3XF (SybronEndo;
Fig. 1). The K3 system files are
known to be robust yet very safe.
The slight modification in
their structure gives these files
much-needed flexibility, while
preserving their very high safety
levels. The clinical applications
are very simple. My favourite
sequence of the K3 system is
the G-pack, which allows me
to do crown-down using the taper of the files and keeping the
tip stable at ISO 0.25. This sequence allows for a very nice
start, removing the obturation
material from the coronal third
with relatively short files, such
as orifice openers, and doing so
in a relatively short time. The
deeper we go, the more we need
to decrease the taper, especially
when curves are present inside
the canals and smaller taper files
are needed.
It is at this particular moment that the flexibility of the
heat-treated alloy gives the
files the ability to negotiate the
curves without any distortion of
the canal or macro-damage to
the file structure (as has been
demonstrated in research and
clinically).
Clinical cases
The first clinical case could be
described as a very bad day in a
dental office. Two files had been
trapped and separated in the mesial canals and the patient was
referred to the clinic but had to
drive for more than two hours to

Fig 2

Fig 3

[17] =>

United Kingdom Edition April 9-15, 2012

get to our clinic. When I first saw
the X-rays (Fig. 2), I remembered
a very similar case from several
years ago with practically the
same location of file separation.
The separated files in the mesial
canals were clearly visible. It was
also noticeable that the distal canal had not been treated to full
length. Ultrasonic tips and the
use of an operating microscope
allowed me to retrieve the separated files and it was then time
to reshape the canals and retreat
the distal canal (Fig. 3). Owing to
the combination of requirements
for the treatment of this case—
shaping and retreatment in one
tooth—my instruments of choice
were K3XF files. I started with
25.08, followed by 26.06 and concluded crown-down with 25.04.
This gave access to the apical part, which was enlarged to
35.04 in the mesial and distal
canals in order to prepare the
apical portion of the root-canal
system. The speed of the micromotor for the shaping procedure
was 500rpm and a sequence of
push-and-pull movements—four
to five strokes per canal—with
each file was used in order to
reach full working length. Figure
4 shows the obturation of the canals, which was performed with
RealSeal (SybronEndo) after
both separated files had been removed and the root-canal system
reshaped.
The second case came as
another referral. The patient
was suffering from pain in her
lower molar and was sent to
the office in order to check the
case and give the necessary
treatment. The preoperative
X-ray (Fig. 5) showed an apical lesion with an incomplete
root-canal treatment. Because
diagnostics found no sign of a
root-canal crack, retreatment
was my choice. However, we
had to overcome two obstacles:
the crown placed on the tooth
and the fibre post inside the distal canal. I decided to go through
the crown without removing it in
order not to place any tension on
the distal canal. When analysing
the anatomy, it appeared that the
roots were fused. In such cases,
avoiding any tension is recommended in order to avoid any
cracks.
Under the microscope and
through the crown, I managed

post was a great help in reshaping the root-canal system, which
appeared very convergent.

Fig 6
to remove the filling surrounding the post. With the use of the
ultrasonic WHAT, I managed to
remove the fibre post itself together with the previous filling
from the access cavity. Using the
K3XF after removal of the fibre

The files displayed no sign of
metal fatigue and the 25.06 was
taken deeper into the canal compared with the standard K3 files.
The extra flexibility and strength
of the K3XF allowed me to perform crowndown and final apical shaping. Obturation of the
rootcanal system was performed
with the Elements Obturation
Unit (SybronEndo) and RealSeal

Endo Tribune 17
material. The post-operative Xray (Fig. 6) shows that the merging canals had been cleaned,
shaped and filled; and the same
had been done for the fibre-post
space.
Conclusion
In the two clinical cases presented here – both rather a challenge
for root-canal retreatments – the
final results were an endodontic success. This lends support
to the fact that each challenge
needs to be treated separately

without fear or tremor from the
initial pre-operative X-rays. Our
fear shall control neither our
judgment nor our choices!
I would like to thank Yulia Vorobyeva, interpreter and translator, for her help with this article. DT

About the author
Dr Philippe Sleiman, Dubai Sky Clinic, Burjuman Business Tower, Level
21, Trade Center Street, Bur Dubai,
Dubai, UAE
phil2sleiman@hotmail.com

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[18] =>

18 Endo Tribune

United Kingdom Edition April 9-15, 2012

Rubber dam hazards?
Dr Kenneth Serota gives his opinion

he September issue of Oral
Health included an article
by Dr Ellis Neiburger entitled Rubber dam hazards. The
contextual inaccuracy, skewed
perspective and postulatory bias
of the author was disingenuous
at best and horrifying at its worst.

I’m not certain how it managed to
secret itself into our beloved centenarian journal, but it did. Before
I comment on the text, I’d like to
share a scientific article with you
published by Smith and Pell in the
British Medical Journal in 2003
(entitled Parachute use to prevent

death and major trauma related to
gravitational challenge: systematic
review of randomised controlled trials) to give my concern about this
article’s publication an element
of gravitas. The abstract reads:

er parachutes are effective in preventing major trauma related to
gravitational challenge.

Main outcome measure: Death
or major trauma, defined as an injury severity score > 15.

Design systematic: Review of
randomised controlled trials. Data
sources: Medline, Web of Science,
Embase, and the Cochrane Library databases; appropriate Internet sites and citation lists.

Results: We were unable to identify any randomised controlled trials of parachute intervention.

Study selection: Studies showing
the effects of using a parachute
during free fall.

Objectives: To determine wheth-

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and participated in a double blind,
randomised, placebo-controlled,
cross-over trial of the parachute.

As to the inaccuracies, rather
than repeating the text, I’ll answer the “factoids”: rubber dam
is routinely used in the vast majority of endodontic and restorative procedures by contemporary
dentists; sterilisation of the rubber
dam can be done readily; reuse is
the most scurrilous of the factoids
proposed; colour is not an issue,
in fact it can be used to enhance
photographic documentation; the
physical and chemical properties
of the dam enable it to be used
with most if not all dental materials and its strength cannot be in
dispute, as the average endodontic
procedure does not require multiple replacement; damage from
clamps occurs because of improper placement; the sheer enormity
of clamp sizes and design allows
for literally any clinical situation with tissue injury essentially
non-existent; there are a raft of
alternatives to clamp placement
(Fig 1); the issues pertaining to time
for placement, phobias, material
residue in pockets anon … even
providing a rebuttal to the text
gives it a undeserved credibility.

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Fig 1

Not wishing to misjudge nor
malign the author, I searched the
many publications attributed to
Dr Neiburger in the literature using Google Scholar. My personal
favourite was Similar mandibular
osseous lesions in Tyrannosaurus
Rex and man,1 followed closely by
Voodoo Barbie and the dental office,2 not to be outdone by Water
line biofilm dangers—A tempest in
a teapot.3 Of note, none of the references pertaining to the hazards
were dated beyond 1990.

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Conclusions: As with many interventions intended to prevent ill
health, the effectiveness of parachutes has not been subjected to
rigorous evaluation by using randomised controlled trials. Advocates of evidence-based medicine
have criticised the adoption of
interventions evaluated by using
only observational data. We think
that everyone might benefit if the
most radical protagonists of evidence-based medicine organised

16.02.12 14:38

[19] =>

Endo Tribune 19

United Kingdom Edition April 9-15, 2012

Dentistry is perched on a slippery slope. In North America
alone, it represents a silo of approximately $60 billion. Evidencebased science has been replaced
by eminence-based science and
the concept of “nonfiduciary advocacy” has been lost in the ether.
I wish I possessed Randy Lang’s
erudition and Will Rogers’ wit.
His recent editorial on a specific
orthodontic band of dubious value
beyond the strength of its marketing showcased the fact that even
amongst those whose focus is narrowed by a specialty, a segment
can be catalysed through market
forces to recognise something
as the holy grail, when another
faction sees the same product as
having the value of a Gwyneth
Paltrow
GOOP-substantiated
cleanse.
In my own area of interest, a
recent article by one of the better-known clinicians questioned
the value of the wealth of new
endodontic products coming to
market, especially the latest NiTi
iteration that reintroduced reciprocation. The essence of the article was, “if it ain’t broke, don’t fix
it”, which then included the takeaway message that the product
long associated with the reputation of the author had served the
discipline well and it too required
only a paucity of instruments to
achieve 100 per cent predictable
clinical success.
To bring this to a purposeful
conclusion, I would encourage
you to Google Bayes’ theorem. It
is in essence an equation and depending upon whether you are a
frequentist, a subjectivist or and
objectivist, the theorem suggests
that if we assign some a priori
probabilities and then compute
a posteriori probabilities, the
degree of confidence in some
hypotheses can be conditioned
by the new data that becomes
available. For example, the Venn
diagram (Fig. 2) relates to a popu-

lation, the number expected to
have a type of cancer, the number that are indeed positive for
the cancer and the number that
show a false positive by virtue
of a test for markers. Alter the
variable, consider the efficacy
of lasers by way of example, the
degree of penetration into the
dental profession, the advocacy
of those that use them and the
perception of the value inherent
based upon their need to see viable applications and substantiated results. It is a technology

that will inevitably prove to be
an invaluable tool, albeit currently in its infancy.
Read all publications with
extreme caution – think HealOzone. Dentistry is getting very
complicated as technology and
innovation alter its construct.
The one essential aspect that
must never be overlooked is the
need to sustain biological fundamentalism through assiduously conceived investigations
and authorship that follows the

Cochrane Collaborative principles. We are about to enter
a decade wherein it is manifestly conceivable that teeth
can be regenerated or replicated and achieve morphological
and functional integration into
the gnathostomatic apparatus.
While it may not impact on the
$4 billion a year whitening arena
of oral services, it will impact
on many others. The number of
rubber dam hazard articles may
well breach the levees and floodgates and overwhelm the profes-

sion, decimating the landscape
and relocating the populace. It
is Oral Health’s job to stand on
guard:
“Oh Canada, to stand on
guard for thee”. DT
References
1. Neiburger EJ. Similar mandibular osseous lesions in Tyrannosaurus rex and
man. J Mass Dent Soc. 2005 Fall;54(3):14–7.
2. Neiburger EJ. Voodoo Barbie and the
dental office. N Y State Dent J. 2001 JunJul;67(6):26–7. 3. Neiburger EJ. Water line
biofilm dangers a tempest in a teapot. J Mass
Dent Soc. 2001 Winter;49(4):20–1.

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W. Switzer Memorial
Key for Excellence in
Prosthodontics. He received his Certificate in Endodontics and Master
of Medical Sciences degree from the
Harvard-Forsyth Dental Center in
Boston. A recipient of the American
Association of Endodontics Memorial
Research Award for his work in nuclear medicine screening procedures
related to dental pathology, his passion is education, and most recently
e-learning, and rich media. Dr Serota
provided an interactive endodontic
programme for the Ontario Dental Association from 1983 to 1997 and was
awarded the ODA Award of Merit for
his efforts in the provision of continuing education. The author of more
than 60 publications, Dr Serota is
on the editorial board of Endodontic
Practice, Endo Tribune and Implant
Tribune. He founded ROOTS, an online educational forum for dentists
from around the world who wish to
learn cuttingedge endodontic therapy,
and recently launched IMPLANTS
(www.rximplants.com) and www.tdsonline.org in order to provide dentists with a clear understanding of
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[20] =>

Biodentine Probe.pdf

23/05/2011

10:04:42

United Kingdom Edition April 9-15, 2012

DENTINE CARE
INNOVATION

An in-vitro study
Biodentine

James Prichard discusses the effect of ultrasonic irrigation variables on the dimensions
of artificial root canals
Contemporary endodontics
falls into three distinct categories:

... is the first all-in-one,
biocompatible and bioactive
material to use wherever
dentine is damaged

1
2
3

Preparation
shaping)

(mechanical

Irrigation (syringe flushing
and adjunctive cleaning)

Obturation (sealing the root
canals in three dimensions)

Fig 1
Pulp exposure

Dentine caries

Biodentine

Pulpotomy

Perforation

Biodentine

Resorptions
Biodentine

Immature root
Biodentine

Apical surgery
Biodentine

For crown and root indications
CM

Helps the remineralisation of dentine

im: To investigate the effects of power setting, type
of irrigant and duration of
ultrasonic irrigant agitation with
IrrisafeTM on the mean percentage change in the cross-sectional area and diameter of artificial
root canals in an in-vitro model.
Methodology: Twenty-five
extracted anterior human teeth
were collected and split into
twohalves, each of which was

from the canal orifice at baseline
and after one, two and five minutes of ultrasonic agitation.
This study came about as
a result of a presentation that
Chris Stock, Godfrey Cutts and
I made to Prof Kish Gulabivala.
We showed him a protocol for
shaping and then cleaning root
canals using Irrisafe. He announced that all steel instruments and tips remove dentine

The existence of several morphologically different micro-organisms was shown to be associated with necrotic pulps as early
as 1984 by W.D. Millar. Bacteria
in the root canal system has been
shown to cause apical periodontitis in gnotobiotic rats (Kakehashi et al. 1965). Sundqvist
demonstrated that 18 out of 19
traumatised but intact teeth associated with periapical radiolucencies gave positive bacterial
cultures (Sundqvist 1975).
Schilder (1967) suggested
that the root canal be cleaned
and then shaped to allow for
three-dimensional obturation.
However, at least 38 per cent of
the root canal surface could remain uninstrumented during
root canal treatment (Peters et
al. 2001) and 70 per cent more
debris remained following instrumentation when compared
with instrumentation and irrigation (Baker et al. 1975)

Preserves pulp vitality and promotes pulp healing
Replaces natural dentine with the same mechanical properties

CMY

Fig 2
embedded in epoxy resin. The
external root surfaces were polished to produce flat, smooth
dentine surfaces. A pilot score
was used as a guide to prepare
an artificial canal using rotary
instruments to a size 30/.06.
The root canals were randomly
assigned to five groups. Group
1: irrigation with 2.5 per cent
NaOCl, ultrasonic agitation at
power setting 7 (n=5); Group 2:
irrigation with 17 per cent EDTA,
ultrasonic agitation at power setting 7 (n=5). Groups 3, 4, and 5
were irrigated with 2.5 per cent
NaOCl, 17 per cent EDTA, 2.5 per
cent NaOCl, with ultrasonic agitation at power setting 4 (n=5), 7
(n=5) and 10 (n=5) respectively.
Irrigant was delivered with a syringe and ultrasonically agitated
with a P5 Satelec® and IrrisafeTM
tips. Canal area and depth were
measured at 17, 16 and 9mm

and cut root canals, so I set out to
prove him wrong!
I would like to express my
thanks to Prof Gulabivala for
the idea behind this project and
the incredible opportunity he afforded me.

Fig 3

Furthermore the landmark
studies of Byström and Sundqvist
(1981, 1983) demonstrated a
100-1000 fold decrease in bacterial counts when 0.5 per cent
Soduim Hypochlorite (NaOCl)
was introduced instead of saline. Therefore it has generally
been accepted that a chemo-mechanical approach to root canal
debridement is required to significantly reduce the bacterial
load that may encourage more

[21] =>

Endo Tribune 21

United Kingdom Edition April 9-15, 2012

UK) is a stainless steel instrument that is non-cutting, parallel sided and available in two
lengths (21 and 25 mm) and two
tip sizes (ISO 20 and 25) and designed to be used after root canal
shaping is complete to agitate
freshly delivered irrigants.

predictable healing.
The role of root canal preparation has therefore undergone
a shift from one primarily fulfilling a debriding function to one
regarded more as establishing
radicular access to the complex
root canal system, for irrigation
and obturation (Gulabivala et al.
2005).
Root canal irrigants should be
biologically compatible, chemically able to remove both organic and inorganic substrates,
be antibacterial, demonstrate
good surface wetting , have no
adverse effects on remaining
tooth structure and be easy to
use and effective within clinical
parameters (Gulabivala et. al
2005).

It can be pre-bent in curved
canals and introduced to 1mm
short of the working length. It
should fit loosely within the prepared canal shape so that the
2012Fig.5
Tipped For Success A4 Ad_2012 Tipped For Success A4 Ad 06/01/2012 12:29
Page 1 of the irrigant around
movement

Penetration of irrigants in to
the root canal is a function of irrigating needle diameter in relation to preparation size (Ram
1977), and placement of the needle closer to the working length
increased the efficiency of irrigation (Abou-Rass & Piccinino
1982, Sedgeley et al. 2005).
Improvement of the efficiency of irrigation especially in
the apical third of the root canal
system has been attempted by
agitating the irrigant. The use
of hand-files, pumping of well
adapted GP cones (manual dynamic), continuous irrigation
during rotary instrumentation
and sonic and passive ultrasonic
devices have all been described
(Gu et al. 2009).

the tip is uninhibited and the tip
can vibrate freely. Once inserted, the power is activated and
the violent movement of the irrigant “scrubs” the walls of the
canal thereby implying the effective removal of dentine debris,
micro-organisms (biofilm and
planktonic bacteria) and organic
tissue from the root canal (van
der Sluis 2007).
The technique requires that
the NaOCl irrigant is delivered in
à DT page 22

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Extremely versatile ultrasonic and irrigation products
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Richman first described the
use of ultrasonics in endodontics in 1957. Endosonics was a
term first described by Martin
and Cunningham (1984) and

P5 Newtron Range

Fig 4
referred to the simultaneous
preparation and irrigation of
root canals. Passive ultrasonic irrigation (PUI) was first described
by Weller et al. (1980) and relates to the non-cutting action of
the ultrasonically activated file.
The free movement of the file
or wire allowed irrigant to penetrate more easily into the apical
part of the root canal (Krell et al.
1988)
However significant problems were encountered with
k-files as they produce irregular shapes and apical perforations (Stock 1991, Lumley et al.
1992), straightened canals (Chenail & Teplitsky 1985, 1988) and
ledged simulated root canals (Al
Jadaa et al. 2009).
IrrisafeTM

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[22] =>

Andalthisfromthestrilzerwith efaste rtueBcyleonthemarket!

22 Endo Tribune
Key features of IrriSafe
• Driven by the Newtron®
range of piezoelectric generators, IrriSafeTM generates micro-cavitation and
micro-currents that spread
through the canal system.
It is the best instrument
for the passive ultrasonic
irrigation currently available
• The irrigant effect is
amplified not only by the

United Kingdom Edition April 9-15, 2012

mechanical activation provided by the vibration, but
also by the heating effect
of the ultrasonics, that intensifies the sodium hypochlorite dissolution and
debridement properties
• Non-cutting edges to prevent any damage to the
root canal anatomy
• IrriSafe is more efficient
than smooth wires, because its loops generate
turbulences and optimize
the irrigant activation

• The blunt-end prevents
any perforation to the apex
or to the canal walls
• The special steel benefits from a specific surface
treatment that provides the
instrument with a better resistance and transmission
of the ultrasonic vibrations
and a complete compatibility with sodium hypochlorite, versus nickel-titanium
ultrasonic wires
Godfrey Cutts and I run

an annual two-day endodontic re-treatment course,
throughout which we also
use Acteon’s Endo Success
Kit. This ultrasonic tips
kit has been designed as a
solution for the problems
most often encountered
during non-surgical endodontic treatments. The
new titanium-niobium alloy allows optimum use of
ultrasound in the trickiest
situations.

The current trend in
surgical
techniques
is
to offer minimally – or
even non- invasive protocols. By using an operating microscope, together
with high-tech micro-instruments, it is now possible to treat the entire root
canal

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ß DT page 21

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3ml boli via a syringe fitted with
a side vented needle and then IrrisafeTM is inserted and activated
for 20 seconds. This is repeated
three times. In oval canals the tip
can be moved towards the walls
(avoiding contact dampening) to
encourage fluid movement into
these areas.
Ideally EDTA liquid is then
inserted and agitated for a further 20 seconds before a final
flush of NaOCl is performed.
The canal(s) can then be
dried and obturation carried out
according to preference.
n
The results of the study
The mean percentage change in
cross-sectional area and diameter in descending order were:
Group 2 - 52.7 per cent and 26.2
per cent; Group 5 - 42.6 per cent
and 25.8 per cent; Group 4 - 23.2
per cent and 9.4 per cent; Group
3 - 14.6 per cent and 5.1 per cent;
Group 1 - 6.5 per cent and 3.8
per cent. Linear regression analysis of the data from Groups 1, 2
and 4 revealed that canal dimensions were significantly affected
by irrigant regime (p=0.0001),
corono-apical level (p=0.009)
and duration of irrigant agitation
(p<0.0001). Analysis of the data
from Groups 3, 4 and 5 revealed
that both corono-apical level
(p=0.009) and duration of agitation of the irrigant (p<0.0001)
significantly affected the increase in canal dimensions.

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Conclusions: The test model
established that there is a clinically insignificant change in root
canal dimensions when manufacturer’s instructions were followed (Group 4). Irrigant choice
and combination, duration of
agitation and corono-apical level all had a significant effect on
the dimensions of the artificial
root canal. DT

About the author

ISO2008
9001:
9001:
20002000
ISO ISO
9001:
Certificate
No.36436
FS 36436
Certificate
FS
Certificate
No.No.
FS 36436

James W Prichard MSc, BDS, LDS
RCS, MFGDP; DRDP; FADFE

Registered
Registered
Member
Member

19/12/2011 16:36

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[24] =>

24 Money Matters

United Kingdom Edition

April 9-15, 2012

Safeguarding pensionable pay and the ARR
David Paul discusses the Annual Reconciliation Report for pensions
The total pensionable pay
allocated to the dentists working at the practice cannot exceed the pensionable pay ceiling identified in Step 1. If there
is working at the practice a
non-pensionable dentist identified in Step 2 then the declared pensionable pay on the
ARR will fall short of the ceiling by the amount earned by
the non-pensionable dentist. It
is unlawful for this shortfall to
be allocated to other pensionable dentists at the practice.

Failure to meet necessary requirements may result in a void dividend with unwelcome tax consequences

n early April, every practice in England and Wales
with a GDS contract or a
PDS agreement receives its
Annual Reconciliation Report
(ARR). It is a statutory duty of
the contract holder to submit
a completed ARR to the PCT/
LHB by 31 May.

The ARR is the cornerstone in the process of identifying the pensionable pay of
the dentists at the practice. It
is this pensionable pay that
will eventually determine the
amount of the NHS pension
for each dentist. It is therefore
essential that the ARR is accurate in apportioning the pensionable pay available at the
practice amongst its dentists
who are members of the NHS
Pension Scheme (NHSPS).
The ARR requirements
were introduced in 2006. The
new dental contract transferred the responsibility for
pensionable pay from the
Business Services at Eastbourne to the individual
practice. It is fair to say that
both the pension regulations
and the guidance given by
Business Services in relation
to the ARR were not fit for
purpose. As a result the dental profession endeavoured
to complete the ARR as best
it could. No unified approach
was adopted and many diverse, mainly incorrect, completions occurred.
The Pensions Agency, Business Services at Eastbourne,
the BDA and NASDAL (National Association of Specialist
Dental Accountants and Lawyers) became aware of the escalating problems arising with
the ARR. Over many months,
discussions have taken place

between the organisations,
which have resulted in clearer
Guidance Notes to accompany
the 2011/12 ARR.
The main issues and problem areas that were identified
related to
• The adoption of a common
procedure of ARR completion
• The correct allocation of the
practice’s pensionable pay
amongst the dentists at the
practice
• What constituted an associate’s pensionable pay
• In the case of a practice that
had incorporated what constituted the pensionable pay
of the director/shareholders,
particularly in a limited company with mixed (NHS and
private) income

practice who are not members
of the NHSPS such as
• Dentists already in receipt of
their NHS pension
• Dentists who have opted out
of the NHSPS
• Associates who are incorporated and who cannot pension
their income with effect from
7 November 2011
Step 3
Sole practitioner or partnership
The pensionable income
allocation to the dentists at the
practice is as follows:
• Following Step 1 calculate
43.9 per cent of the achieved
GDS/PDS contract value. This
is the pensionable earnings
ceiling

As a result of the discussions, the Guidance Notes to
the 2011/12 ARR now give
much more comprehensive
guidance as to the correct
completion of this year’s ARR.

• Declare the pensionable pay
of the associates. This is the
actual net amount paid for
GDS/PDS work undertaken in
the pension year ending at 31
March

The correct procedure for
completing the ARR and the
allocation of pensionable pay
is now as follows

• The declared pensionable
pay of the associates is deducted from the pensionable
pay ceiling. If the practice has
any dentists identified in Step
2 their earnings are also deducted from the ceiling

Step 1
Calculate 43.9 per cent of
the achieved GDS/PDS contract value. This identifies the
maximum pensionable pay
available to the practice and
is a ceiling that cannot be exceeded when the pensionable
pay is distributed amongst the
dentists at the practice who
are members of the NHSPS.
Step 2
Identify any dentists at the

• In the case of a sole practitioner the balance remaining
represents the pensionable
pay of that sole practitioner
• In the case of a partnership
the balance remaining can
be allocated between the
partners in any proportions
provided by the partnership
agreement

If the practice employs a
dentist then the amount of
that dentist’s basic NHS salary
constitutes their NHS pensionable pay and must be deducted
from the pensionable earnings
ceiling to arrive at the balance
available to the sole practitioner or partners.
Limited company
Where a practice has incorporated and the limited company holds the GDS contract
or PDS agreement, the limited
company is required to com-

in a limited company that all
the company law and tax rules
are followed when a dividend is paid. Failure to meet
the necessary requirements
may result in a void dividend
with unwelcomed tax consequences. Where salary and
dividends paid to director/
shareholders falls short of the
pensionable pay ceiling the
unused balance cannot be carried forward to future pension
years and it is unlawful to allocate the shortfall to any other pensionable dentist at the
practice.
The Pension Agency had
identified that one of the main
problem areas with earlier
ARRs was the understatement
of the pensionable pay of some
3,000 associates. The Guidance Notes with the 2011/12
ARR now clarifies the position
in that any associate’s pensionable pay is the amount paid
to the associate for GDS/PDS
work undertaken. It therefore does not matter about the
terms of the individual associ-

‘It is fair to say that both the pension
regulations and the guidance given by
Business Services at Eastbourne in relation
to the ARR were not fit for purpose’

plete an ARR as the provider.
The process involved for the
company is exactly the same
as occurs for a sole practitioner or partnership up to the
point that the balance of the
pensionable earnings ceiling has been determined. At
this point the pensionable pay
of the director/shareholders
who are active NHSPS members is the amount of salary
and dividends paid to those
director/shareholders in the
year to 31 March, the NHS
pension year.
It is often the case that
where a practice has incorporated the limited company
receives mixed dental income
(ie NHS and private). In these
circumstances there is no need
to apportion salary/dividends
between NHS and private income for NHSPS purposes. All
salary/dividends paid to dentists who are active NHSPS
members, up to the ceiling,
are available for allocation as
NHS pensionable income.
It is important to ensure
that where dividends are paid

ate agreement. All that does
matter, for pensionable pay
purposes, is the amount that
is eventually paid under that
agreement to the associate for
GDS/PDS work.
In November 2011 new
legislation was enacted. As a
result of this legislation, it is
likely that there will be major changes in the 2012/13
ARR which will further safeguard the pensionable pay
position of associates. In the
meantime, the 2011/12 ARR
and its guidance notes are a
considerable
improvement
upon earlier versions and
should ensure a more accurate pensionable pay allocation to dentists involved. DT

About the author
David Paul is a Chartered Accountant and a member of the National
Association of Specialist Dental Accountants and Lawyers. He is on
NASDAL’s superannuation committee
and has played a key role in resolving
issues associated with the ARR. He
can be contacted on 01656 679800, or
d.paul@grahampaul.com. Or to find a
NASDAL member in your area, go to
www.nasdal.org.uk

[25] =>

United Kingdom Edition

Events 25

April 9-15, 2012

The Ninth Clinical Innovations
Conference 2012
Preparing your practice for the future

he Clinical Innovations
Conference has become
a major event in the dentistry calendar. Now in its ninth
year, this established event
gives participants a chance to
hear from world-class speakers
from around the globe who will
be presenting a host of lectures
and live workshops. The event
looks set to be inspirational and
motivating for all involved.
This year the conference
will be held in the Millennium
Gloucester, Kensington in London on Friday 18th and Saturday 19th of March 2012. With a
varied schedule throughout the
conference, participants will
have an opportunity to understand and learn how to apply the
latest aesthetic developments
through practical experience,
and to attain treatment tips that
can immediately be introduced
to everyday practice.

dental IT integration, and he
has recently created Endobiz, a
clinical software programme.

Professor Gambarini has lectured in universities all over the
world and is the author of or

has contributed to hundreds of
books and articles. He has been
the keynote speaker at major

Dental Web Design

Development

Professor Barghi is head of
the aesthetic dentistry division
in the Department of Restorative Dentistry at the University
of Texas, San Antonio. He has
presented over 650 educational
courses and empiric workshops
in more than 30 countries and
written over 250 articles. He is a
member of the American Academies of both Esthetic Dentistry
and Fixed Prosthodontics, and
the International Association
for Dental Research.

Dr Kahan is a Harley Street
specialist and the senior visiting lecturer on endodontology
at the Eastman Dental Institute.
A highly regarded lecturer nationwide, his other interest is

à DT page 26

MediMatch Media Solutions

The conference meets the
GDC’s educational criteria and
delegates who attend both days
will gain 14 hours of verifiable
CPD certified by Smile-On Ltd.
The event is not just an opportunity to gain priceless experience but a chance to encounter
experienced speakers.
Confirmed speakers for the conference are:

Dr Chan is a teeth whitening
specialist who has conducted
research which has led to the
granting of five UK patents. He
has developed protocols that
improve the safety, predictability and efficacy of teeth whitening procedures. A prolific
author on this subject, he is responsible for a chapter in the
new Quintessence manual “The
Art of Treatment Planning.”

national and international endodontic congresses, including

from

£50

/mo
nth

Dental Web Design

Bespoke Web Development

Search Engine Optimization

(+44) 08 444 993 888
MediMatch Dental Laboratory, Unit A, Orion Business Park, West Ealing, London, W13 9SJ, www.medimatch.co.uk
MediMatch Media Solutions

[26] =>

26 Events
ß DT page 25

those of the AAE, IFEA and ESE.
He is currently working with
manufacturers to develop new
technologies and clinical procedures for root canal treatment.

United Kingdom Edition

graduate level, and lectured both
in the UK and internationally.

the UK, Holland, Italy, Germany,
Australia and Dubai. Matt will be
discussing how implementing
guru within the practice can help
educate patients and increase
treatment plan acceptance.

Anthony Roberts qualified from
Birmingham Dental School having also completed an Intercalated Bachelor of Science Honours
Degree in Physiology. Anthony
Amit Patel is a Specialist in
Matt McColley, Group Corporate
worked in general practice as a
periodontics practicing at Grace
Business Manager for Software of
VDP and then in a variety of SHO
House Specialist Dental Centre in
Excellence, joined the company
positions. He completed his FelBirmingham. His special interests
in April 2010, taking guru from
lowship in Dental Surgery in 1999.
are dental implants, regenerative
virtually an unknown product to
Anthony’s main interest in restorand aesthetic periodontics. He has
the first choice for patient educa2012 Sopro Life Ad (Dental Tribune)_2012 Sopro Life Ad (Dental Tribune) 30/01/2012 17:15 Page 1
ative dentistry is periodontology.
taught at undergraduate and posttion software and making sales in

Dr John Moore is a private GDP
from Plymouth in Devon who
uses Cerec for all his cosmetic
smile makeovers. For eight years
John has developed Cerec techniques and taught other dentists
how to benefit from Digital dentistry. John became an ISCD Cerec
Trainer in Dubai in 2007 and with
his brother Dr Paul Moore in Galway, has had articles published.
Dr Ajay Kakar, Periodontist and
Implantologist, in private practice

Fraser McCord graduated from
Edinburgh and spent ten years in
a busy general dental practice. He
bagged DRD and Part 1 FDS while
in practice and then migrated to
be a Registrar in Restorative in
Edinburgh Dental Hospital for
two years when, after passing FDS
Part 2. Fraser retired in 2010 but
continues to lecture for fun.

DIAGNOSIS & TREATMENT

Mhari Coxon has 20 years’ experience in dentistry in the UK, in
a variety of practice and hospital
environments. At present, she
works as Senior Professional Relations Manager for Philips Oral
Healthcare and clinically as a
hygienist. Mhari is a keen writer
and is a sought after speaker who
has lectured extensively in the UK
and overseas.

SoproLife
L.I.F.E. Light Induced Fluorescence Evaluator,
for the diagnosis and treatment of tooth decay

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.
The AOG Clinical Innovations
Charity ball will be held on the
Friday evening for the third year
running. In 2011 more than 200
people attended and enjoyed
a festive occasion of wonderful food and entertainment.

For a limited time only, get the
USB Dock Station (shown right)
absolutely FREE when you
purchase the SoproLife.

The Clinical Innovations Conference is always well attended.
Now it is firmly established, it is
valuable for dentists seeking to
improve their own practice and
performance. Delegates can also
be kept well-informed on endodontic progress, enjoying and
varied and enlightening event.

For further information:

01480 477307
info@acteongroup.co.uk | sales@acteongroup.co.uk | www.acteongroup.com

in Mumbai is the current Secretary
of the IAACD and the Vice President of the International Academy
of Periodontology and a member of the Extended Board of the
European Academy of Cosmetic
Dentistry. He is also a Clinical
Assistant Professor at Stony Brook,
SUNY – USA. Lecturing extensively
around the globe satiates the urge to
teach, travel and taste. BITEIN and
the IDO, his creations created a
decade ago are the fore runners of
the internet and Indian dentistry.
Basil Mizrahi graduated from the
University of the Witwatersrand,
South Africa. After qualifying with
an MSc in Dentistry, he left South
Africa to specialise in prosthodontics and Implant dentistry at Louisiana State University, USA. Basil
is fully recognised by the General
Dental Council as a Specialist in
Prosthodontics and Restorative
dentistry. He operates a full time
referral private practice as well
as running hands-on “Advanced
Aesthetic and Restorative Dentistry” courses. Basil publishes and
lectures extensively both nationally and internationally.

SOPROLIFE
A patented new fluorescence
technology which allows you to
‘see the invisible’ – detection of
occlusal or interproximal decay,
even in its earliest stages, which
is often missed by X-rays. The
fluorescence images produced
in treatment mode show a
differentiation between healthy
and diseased tissue, while
images can be compared under
white light in daylight mode. All
images can be evaluated with
magnification of 30x to 100x
and work seamlessly with Sopro
Imaging software.

April 9-15, 2012

to create

For information and to book a
place call Smile-on 020 7400 8989
or visit www.clinicalinnovations.
co.uk. DT

[27] =>

United Kingdom Edition

Professional standards
Glenys Bridges provides a guide to work

pplying the qualities and
attributes of professionalism are an essential
requirement for all healthcare
professionals. In the dental profession standards of professionalism stem from regulations set
out in the Dentist Act and Health
and Social Care Act. I often meet
dental professionals who are
aware that they do not wholly
meet some aspects of these requirements. Such shortfalls can
stem from the practical pressures encountered in day-to-day
workplace situations, or from a
lack of knowledge and understanding, or from unassertive,
unproductive behaviour which
fails to focus on goals. This article provides a guide for DCPs
who want to become more assertive at work.

When communicating state the
facts, rather than relying on personal opinions alone. Describe
your thoughts and feelings about
the situation (for example, determined, confident), then go on
to clarify your needs (say what
you want the other person to

DCPs 27

April 9-15, 2012

do). Always close the conversation by summarising your main
points. Finally ensure your make
sure you maintain assertive nonverbally communications with
steady eye contact, a serious expression and a firm voice with a
moderate rate of speech.

Say what you want or what
action you want taken - having
set the scene you are now at the
point where you need to make
a clear request. This should be
based on the facts, regulations
or requirements of the situation.
Being assertive is no guarantee
that you will achieve the desired
outcome, but it dramatically increases the chances.
Recognising the need to develop assertiveness skills is just

the beginning. If assertiveness is
not naturally part of your character a first step is to model on
someone whose assertiveness
you admire. To do this think of
someone whose assertiveness
underpins high professional
standards, without unduly antagonising others. This person
would make an ideal coach or
mentor able to direct and support you by sharing their philosophy, strategies, techniques and
thinking patterns. DT

You can start from the
2nd session & make up the 1st session
next Year in Geneva

Most people are aware that
assertiveness is an attribute
which enables those who are shy
or lack confidence to become
more involved. Assertiveness
also helps the more extrovert
or volatile people to fine tune
their interactions with patients,
suppliers and colleagues. An
assertive person is a positive,
resourceful presence in dental
team. Therefore an important
aspect of professional and personal development should be to
avoid unproductive behaviour
patterns, in favour of focusing
on goals, solving problems and
feeling at ease at work.
So how can you start to develop more assertive behaviour
patterns? From the outset it is
essential to recognise that assertiveness is not about getting
your way at the expense of others. Professional assertiveness is
about feeling at ease when setting your standards and maintaining them, without violating
the rights of others. Here are
three basic and essential steps to
help you to achieve this.
Listen and show understanding - productive assertiveness is based on good communication skills. This means taking
enough time to understand all
points of view and vested interests. You may not agree with
other people’s views, but goals
are most easily met when information gathering clarifies
matters and leads to consensus.
Say what you mean, how
you feel or what you think this can be more difficult. Manage your state of mind so that it
supports you in being assertive.

Program Fee: 11.900€

Register & More Information at:
Contact in Athens:
Τel: +30 210 213 2084, +30 210 222 2637
E-mail: info@omnicongresses.gr
Web: www.omnicongresses.gr
Contact in the US:
Nena Puga
Tel.: +1 310 696 9025
E-mail: nena@gidedental.com
website: www.gidedental.com
Media Partner:

About the author
Glenys Bridges is an independent
dental team trainer. She can be contacted at glenys.bridges@gmail.com

SPONSORS:

Initial deposit payable upon registration EUR 1.000€
1st payment EUR 4.900€, before 5th Jan ‘12
2nd payment EUR 3.000€, before 5th May ‘12
3rd payment EUR 3.000€, before 25th Αug ‘12

[28] =>

28 Industry News
Ultrasonic Instrument cleaning

Alkazyme® enzymatic a combined cleansing and disinfecting agent for the
thorough cleaning-pre-disinfection of all reusable, immersible dental
instruments prior to autoclaving.

*Rapid cleaning action
When used in conjunction with a standard ultrasonic cleaner a maximum 5
minute immersion time is all that is required to render soiled instruments
thoroughly clean & shining bright.

Continual Disinfection
Alkazyme® continually disinfects the contaminated ‘wash water’ as created
within the ultrasonic cleaner

Economical
Just 5 grams of Alkazyme® with ordinary tap water makes 1 litre of enzymatic
cleaning/disinfecting solution
Choice of user format
Available from all dental sundry suppliers in both 750gm loose powder tub and
tubs of 100 easy dose water soluble sachets
For comprehensive product information visit www.alkazyme.com

Ultrasonic instrument cleaning
Alkazyme® enzymatic a combined
cleansing and disinfecting agent
for the thorough cleaning-predisinfection
of
all
reusable,
immersible dental instruments prior
to autoclaving.
Rapid cleaning action: When used
in conjunction with a standard
ultrasonic cleaner a maximum
5 minute immersion time is all
that is required to render soiled
instruments thoroughly clean &
shining bright.

Continual Disinfection: Alkazyme® continually disinfects the contaminated
‘wash water’ as created within the ultrasonic cleaner
Economical: Just five grams of Alkazyme® with ordinary tap water makes one
litre of enzymatic cleaning/disinfecting solution
Choice of user format: Available from all dental sundry suppliers in both 750gm
loose powder tub and tubs of 100 easy dose water soluble sachets

United Kingdom Edition

Take control with the Optima MX2 INT from
Bien-Air
Bien-Air has developed probably the most efficient
dental micromotor on the market with the Optima
MX2 INT. Thanks to Smart Logic technology, the
Optima MX2 INT control unit offers ultimate
regulation of the power required, linearly and
without vibration ensuring you are in perfect control of the speed, torque and
reversal at all times. With Easy-Nav philosophy the Optima MX2 INT is incredibly
intuitive and adapts to most dental chairs. Being particularly versatile the control
unit offers 10 pre-programmed modes for your main restorative work and 10
sequences for your endodontic work, all at the quick press of a button. This Swiss
made control unit has been developed with your endodontic work in mind. You
can perform your root treatments with complete peace of mind, as the Optima
MX2 INT has been designed to reduce the risk of NiTi instrument breakage to
an absolute minimum with the precise auto reverse function. A true all-in-one
system the Optima MX2 INT makes your life easier! In most cases 2 contra-angle
handpieces are sufficient to carry out the vast majority of dentistry, so go on take
control with the Optima MX2 INT from Bien-Air. Optima MX 2 INT drives the new
LED MX 2 Micromotor. MX 2 is shorter and lighter than its predecessor and with
its shortened nose accepts Bien-Air’s new Micro-Series contra-angles, as well as
standard contra-angles. The combination of both the MX 2 and Micro-series is a
reduction in the overall length of 30 per cent and a weight reduction of 23 per
cent! For further information please contact Bien-Air on 01293 550 200
or visit www.bienair.com

April 9-15, 2012

Get them brushing!
The Aquafresh Kid’s Motivation
Pack is a great way to help instil
good dental care habits in your
younger patients – habits which
could last them a lifetime. The
kits are bursting with colourful
materials, all aimed at making
brushing fun and visits to the
dentist less intimidating.
Inside you’ll find ‘well done’ stickers
to reward dental attendance,
‘Nurdle’ passports for parents to
record children’s dental visits,
brushing charts, and other activities for your young patients and their parents.
For your surgery there’s a poster and a display card – to let everyone know that
yours is a “child friendly practice”.
The free packs can be ordered at www.gsk-dentalprofessionals.co.uk

For comprehensive product information visit www.alkazyme.com

InstrumentSafe. An essential for
decontamination
This is an excellent time to try InstrumentSafe
disinfectant from Kemdent. It is available on a buy
2 get one free offer until the end of April.
InstrumentSafe is one product within the new,
high quality range of Kemdent Cross Infection
control products. It is available in a one litre
dispensing unit and five litre and 10 litre refills.
InstrumentSafe is a pre-sterilisation concentrate
which is aldehyde and phenol-free. It is an easy
to dispense concentrate that is suitable for both
thermo-labile and thermo-stable instruments.
Instrumentsafe is recommended for use in an
ultrasonic bath. It breaks down the enzymes
left by blood and saliva which would inhibit
sterilisation.
InstrumentSafe can be diluted to different concentrations depending on
the time available. 40 ml of Instrumentsafe makes a one litre, four per cent
concentration soak. This concentration kills harmful bacteria including HBV/
HIV/HCV/BVDV, vaccinia are Tubercolocidal and Hospitalism prophylaxis after
15 minutes of soaking. InstrumentSafe renders instruments safe from MRSA.
For further information or to order a sample call Helen or Jackie on 01793
770256 or visit our website www.kemdent.co.uk

Practice Plan makes a further climb
in the Sunday Times Top 100 best
Companies to Work For!
After the achievements of last year,
the team at Practice Plan were all
keen to find out where they would be
positioned in the Sunday Times Best
Companies to Work For 2012, and for
the second year running, a further
climb in the ranking was achieved!
The company attained 30th place in the Best Small Companies category after
facing tough competition from hundreds of selected organisations, all battling
to gain a high placing in the rankings. To support the company’s appearance
in the 100 Best Companies list, Practice Plan sent a team of ten employees
from across the business, including Managing Director Nick Dilworth, down
to London to enjoy the black tie awards ceremony at Battersea Evolution
and to collect the company’s award. Nick Dilworth gives his thoughts on the
company’s achievement: “Given the extra demands placed on staff caused by
our growth and acquisitions in the last 12 months, set against a backdrop of a
continuing difficult economic environment, this is a really pleasing result and a
true testament to the top draw team we have in the business!”

The route to successful endodontics
NSK understand that successful endodontic treatment
requires precision and attention to detail. NSKs range of
endodontic handpieces, micromotors, ultrasonic scalers
and apex locator, provide clinicians with a superior level
of technology, leading to more predictable treatment
outcomes. NSK’s ENDO-MATE DT endodontic micromotor is specifically designed
for use with Ni-Ti files from all major suppliers. This ultra-slim, lightweight
endodontic micromotor delivers complete versatility with an advanced memory
able to store up to nine speed and torque settings. NSK’s Endo-Mate TC2 cordless
handpiece has a large LCD screen incorporated in the lightweight cordless
handpiece, and a simple five-key operation ensuring it is easy to use even during
the most delicate endodontic procedures. The NSK Varios 970 Ultrasonic scaler
provides a patient-friendly and efficient way to meet the challenges of endo by
exchanging the tip, and with a choice of over 70 alternative tips, there is always one
to meet your needs. Each Varios 970 LUX is supplied, as standard, with a twin LED
handpiece, 3 tips, 3 tip wrenches and an autoclavable container. Those looking for
a more compact unit would benefit from either the Varios 570, or the Varios 370,
specifically designed as a portable control unit for easy installation into any dental
unit. In addition, the Varios 170 is available as a built-in unit, where all its functions
can be controlled via NSK’s new MultiPad. NSK’s apex locator iPex, which accurately
measures the length of any root canal, including dry, wet and bloody canals, helps
clinicians perform safer, more accurate root canal treatment.

Philips wins 18 red dot awards for
product design
Philips Electronics has won 18
awards from the 2012 prestigious
red dot product design competition.
Awards include a red dot ‘Best of the
Best’ award representing ‘highest
design quality’ for the Philips
Sonicare DiamondClean power
toothbrush. This is a welcome result
for a product designed to be the ultimate in form and function. An impressive
17 red dots recognising ‘high design quality’ have been awarded to products
across Philips Consumer Lifestyle, Lighting and Healthcare sectors, as well
as Brand Licensing and the Company’s ‘Philanthropy by Design’ programme.
Sonicare AirFloss was also a red dot award winner. The award recognised its
ergonomically designed handle and angled nozzle which encourages access
to all areas of the mouth. With more than 14,000 submissions from more than
70 countries, the International ‘red dot design award’ is one of the largest
and most renowned design competitions in the world. The red dot jury is
comprised of design experts of international repute, whose background
allows them to consciously assess the special intercultural aspects of design.
All award-winning products are presented an online exhibition and in the red
dot design museum in Germany.

Contact Jane White at NSK on 0800 634 1909 or your preferred dental supplier. Visit
us at Dentistry Live Stand 6. www.nsk-uk.com

For more information about Sonicare DiamondClean and AirFloss please
visit www.sonicare.co.uk/dp or call 0800 0567 222.

Sirona wins process of patent infringement Bensheim/Salzburg, 26 March
2012.
Sirona, the dental technology leader, has won a first instance patent infringement
lawsuit against Vatech’s ALSA technology. On March 9th, 2012, the regional court
of Mannheim granted an injunction against sales of Vatech´s products with
infringing ALSA technology and unspecified damages for the use of Sirona’s IP.
Sirona is a leading creator of intellectual property in the dental industry and it
will continue protecting its intellectual property rights globally.
Contact details for further information: Sirona Dental Systems 0845 071 5040
Info@sironadental.co.uk

And, as a further cause for celebration, Practice Plan was one of only 113
organisations out of 1082 entrants to successfully achieve Three Star Status in
the Best Companies accreditation.

TePe Select with you for life
TePe toothbrushes are high quality
toothbrushes with a user-friendly
handle. The tapered brush-head
improves access and the endrounded filaments provide a gentle
clean.
The TePe Select range of brushes
are available in:
• a range of stylish colours
• two head sizes – compact and
medium, which are suitable for both children and adults
• and three filament textures – medium, soft and extra-soft
Best of all they are great value and can be sold for as little as £1.25 each!
Win an Apple iPad!
During March and April, for every 24 TePe Select toothbrushes you order
through your wholesaler, you can enter our prize draw (eg, order 48 brushes
and double your chances of winning!) to win an Apple iPad 2, 16GB, Wifi Worth £399!*
Go to www.molarltd.co.uk/ipad to enter
*terms and conditions apply. Draw valid from 1.3.12, closing date 30.4.12.
For more information please contact your usual wholesaler.
Molar Ltd
01934 710022
www.molarltd.co.uk

New software update supports
the hands-free operation of the
SIROEndo endodontic treatment
system
As soon as the file reaches the apex
of the root canal the dentist can
reverse the direction of rotation via
the foot switch.
Version 5.2 of Sirona Dental Systems’ SIROEndo software is the passport to more
effective and convenient root canal treatment. As soon as the dentist reaches
the apex he can reverse the rotation of the file – either on the SIROEndo unit or
via the foot control. Just one brief touch is enough to change from clockwise
to counterclockwise rotation and vice versa.
Introduced six months ago, the new apex indicator keeps the user informed at
all times. The exponential progress bar now consists of 18 blocks as opposed to
six. It indicates the distance between the file tip and the apex. When the file tip
reaches the apex an “A” is displayed. The message “-1” is shown as soon as the
tip extends beyond the apex. This is accompanied by differentiated acoustic
signals. A series of short beeps can be heard as the file approaches the apex.
This changes to a continuous tone when the file tip goes beyond the apex.
“Since the launch of SIROEndo at IDS 2005 we have continuously developed
the software,” said Anja Weidemann, Product Manager in the Instruments
Division of Sirona Dental Systems.
For further information please contact: Sirona Dental Systems 0845 071 5040
info@sironadental.co.uk

A simple rotary system for
everyday endodontics!
Dental Sky’s CMA System was
designed to simplify endodontic
treatments by minimising the
number of instruments necessary
and providing one uncomplicated
sequence for both treatment and
retreatment.
CMA stands for Coronal, Median and Apical and provides a simple sequence
with only four core instruments in the range: Coronal C to flare out the coronal
portion of the canal, Median M to enlarge the middle part of the canal and Apical
Fine A1 and Apical A2 to enlarge the apical portion of the canal.
CMA provides safe, secure and reliable rotary instruments with several unique
design features including a shorter handle to improve ease of access to molars
and a helical shape to aid removal of debris from the canal. CMA instruments also
have a cross-section with three cutting angles for excellent cutting efficiency
and feature a non-cutting tip to ensure the instruments respect the trajectory
of the root canal.
CMA files are available in starter kits in 21mm, 25mm or 29mm and in refill packs
of six instruments.
To download the full CMA product brochure and view a demonstration video
please visit www.dentalsky.com or for further information please contact Dental
Sky on 0800 294 4700.

Quality Endodontic Distributors
Ltd QED’s Superendo B&L-beta
and alpha II QED’s Superendo
B&L-beta and alpha II cordless
obturation devices form the
perfect combination
The Superendo B&L-beta enables
fast and easy delivery of warm
obturation
material
for
the
endodontic backfill technique,
facilitating rapid obturation of even the most difficult root canals. Cordless,
compact and easy to handle, it features variable temperature settings; a
rechargeable lithium ion battery which supports hours of use from a single
charge; and a choice of 23g and 25g needle sizes with 3600 swivel for
improved access. Supplied with three tips, the Superendo B&L-alpha II is the
ultimate in cordless warm vertical compaction devices and supersedes oldfashioned cable machines. It features multiple temperature settings (150°C,
180°C, 200°C and 230°C) to accommodate both gutta percha and resilon, with
a quick heating tip that reaches temperature within 10 seconds. It incorporates
a rechargeable lithium-ion battery which facilitates multiple uses on a single
charge and allows the operator to complete many cases without the need to
recharge. Finally it comes complete with a tip, so it is immediately ready to use,
with a full range of optional tips available separately. For further information
telephone Quality Endodontic Distributors Ltd on 01733 404999, email sales@
qedendo.co.uk, fax 01733 361243 visit www.qedendo.co.uk or contact your
local QED Salesperson.

[29] =>

United Kingdom Edition

Quality Endodontic Distributors Ltd
RECIPROC® Files: The endo
revolution stops today!
RECIPROC, from Quality Endodontic
Distributors Ltd, is not just a new file,
but a new concept in canal preparation.
RECIPROC® is the first one file system
where no glide path is required (in most
cases). It works with a reciprocating
action which is driven through the VDW
Silver RECIPROC® motor, which can also
be used with conventional rotary file
systems.
RECIPROC® is made from M-wire™ NiTi which is stronger and more flexible
than standard NiTi. There are three files in the range which all have a regressive
taper, which means that the apical portion of the file has the greatest taper.
The RECIPROC® file sizes are R25 (08/25), R40 (06/40) and R50 (05/50). Each of
which is available in lengths 21, 25 and 31mm. The system also has matching
gutta-percha and paper points.
RECIPROC® is exclusive to Quality Endodontic Distributors Limited.
For further information telephone Quality Endodontic Distributors Ltd on
01733 404999, email sales@qedendo.co.uk, fax 01733 361243
visit www.qedendo.co.uk or contact your local QED Salesperson.

Curasept ADS – clinically proven to keep
staining to a minimum
The advanced technology used to create
Curasept ADS, developed by Swiss oral
health care specialists, Curaprox, means that
patients benefit from the effectiveness of a
chlorhexidine-based oral hygiene programme
without enduring the usual unpleasant sideeffects. Although highly effective at treating
gingivitis, oral infections and preventing plaque build-up, chlorhexidine (CHX)
is traditionally associated with several problems, including the discolouration
of the teeth and tongue, as well as interference with taste perception.
However, the unique patented Anti-Discolouration System (ADS) developed
by Curaprox, and used in every Curasept ADS product, helps to keep these
side-effects to a minimum without in any way hindering the efficacy of the
active ingredients – a fact that has been independently verified by three
clinical studies. In addition, Curasept ADS mouthwash is alcohol free, thus
reducing the incidences of burning and sensitivity experienced by some
patients, resulting in higher levels of compliance. Curasept ADS mouthrinse
comes in two strengths 0.2 per cent or 0.05 per cent, making it suitable for both
every day and post-operative use. Also available in the range is Curasept SLSfree toothpaste (0.05 per cent), and periodontal gel (0.5 per cent), providing
the full spectrum of protection against oral pathogens.
For free samples or for more information please call 01480 862084,
email info@curaprox.co.uk or visit www.curaprox.co.uk

Exceptional endodontic
treatments from EndoCare
Refer your patients to EndoCare
today for superior Endodontic
treatments and exceptional
patient care. The EndoCare
team firmly believes that first
impressions really matter, and
for this reason every referring
practice can expect to be dealt with in a pleasant and courteous manner by
a team members dedicated to offering the very best service to patients and
referring practices alike. To make the process even easier practices may also
refer patients through the EndoCare website if they should so wish. After
the initial referral comes treatment. During the procedure, the patient will
receive an excellent level of care in state-of-the-art facilities, from specialist
clinicians who are passionate about what they do. Throughout the course of
the treatment the referring practice is constantly kept up to date with details
of the procedure and any associated treatment plans. Thanks to exceptional
treatment, with an emphasis firmly on patient care, patients are returned to
their referring dentist calm and confident that the treatment they received was
to the highest standard possible.
To find out more about how Endodontic referrals can benefit your practice,
contact the EndoCare team today. For further information please call EndoCare
on 020 7224 0999 or visit www.endocare.co.uk

RPA Dental – we heart dentists
In the competitive world of dentistry,
some companies stand out on more
than just price alone.
At RPA Dental we understand that
practices are often looking for a
little bit more from their equipment
provider – something extra that makes
them stand out from the crowd. That’s
why we launched iheartdentists –
www.iheartdentists.com – a campaign that represents everything we stand
for; a campaign designed to show our clients just how much we care.
As a UK-based dedicated family business, we pride ourselves on knowing
each one of clients personally, knowing exactly what equipment they have,
and where they have it; knowing nurses on first name terms, and knowing
exactly who works where and when within the facility. It’s this level of care and
customer support that we feel makes us stand out head and shoulders above
other equipment providers as we really do heart dentists, and we think you’ll
heart us too!
To discuss your requirements or to arrange a cuddle, give us a call on 08000
933 975, or visit our equipment website, www.rpadental.net.

April 9-15, 2012

Discover the benefits of BKH at
Dentistry LIVE 2012
Newly launched dental corporate BKH
Healthcare is attending Dentistry LIVE
2012 to join forces with any dental
professionals who want to take control of
their careers.
Come and talk to the BKH team at
stand number 5. They will be on hand
throughout the event, which takes place at the QE2 Conference Centre in
London from 25th to 26th May 2012. “We want to hear from clinicians and team
members who are looking for careers with a corporate whose culture is clearly
stated,” says Dr Al Kwong Hing, CEO of BKH Group of Companies, “and we want
to work as joint venture partners in new or existing practices.”
BKH Healthcare promises a proven business structure, managerial guidance
and full educational support. Valuing people and profits in equal measure, BKH
Healthcare aims to develop enjoyable, stimulating working environments and
ensure that each member has a share in the rewards of success.
For more information about BKH please call 0161 820 5466 or email Al Kwong
Hing at al@bkh.co.uk, Chris Barrow 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

Save time and money with dbg
Since its earliest days when dbg was
known as the Dental Buying Group,
dbg has worked hard to expand
its portfolio to encompass a broad
range of fields in order to provide its members with the very best in value and
support.

Industry News 29
Superior digital imaging exclusively from
Carestream Dental
The Kodak RVG 6500 is one of the most talkedabout technological advances from Carestream
Dental.
Renowned for providing the dental profession
with the most advanced digital imaging
solutions, the Kodak RVG 6500 represents a
breakthrough in utilising wireless technology.
The Kodak RVG 6500 offers superior image
quality and the highest image resolution in the industry (true resolution
superior to 20 Ip/mm) whilst the sensor is extremely robust and waterproof,
thanks to its protective silicone layer. State-of-the-art WiFi technology allows
the user the freedom to operate without cables, giving greater
liberty of movement around the chair. With data uploaded within seconds,
the practitioner gets the data they need almost instantaneously, saving
treatment time.
That freedom of movement is also translated into image portability, with
direct transfer of data to iPod devices without the need for a computer and
the ability to review and edit images wherever and whenever the practitioner
wants.
For superior technological solutions, Carestream Dental provides.
For more information contact Carestream Dental on 0800 169 9692
or visit www.carestreamdental.co.uk

For more information on the benefits of dbg Membership, or to join, call 0845 00
66 112 or visit www.thedbg.co.uk

Ammanyo Ga Emirembe - Teeth
For Life
Sponsor a Ugandan dentist to give
oral health education and treatment
to a rural village.
Dentaid is working with a team of
Ugandan dentists, funding them
to travel to rural villages with the
following objectives:
• To carry out general oral health
education (OHE) • To sensitise communities on the dangers and prevention of
infant oral mutilation (IOM) • To screen children and establish their oral health
status • To provide a pain-relief service of emergency extraction and atraumatic
restorative treatment A sponsorship of £35 will go towards one day’s travel and
professional expenses.
£420 will help a dentist to provide this outreach for one day per month for
one year.
If you would like to help with this important health initiative, please contact
Barbara Koffman at barbara@dentaid.org or 07970 163 798 for further
information, or donate via http://www.justgiving.com/dentaid-barbarauganda giving your contact details so that Dentaid can send you feedback on
the dentist you have funded.

*CQC England only, dbg’s management programmes available to all Dental
Practices throughout the UK

For further information about Dentaid please visit www.dentaid.org,
email info@dentaid.org or tel. 01794 324249.

Kent Implant Studio – working together
for positive outcomes
Kent Implant Studio is now taking referrals
for all forms of dental implant treatment,
including the innovative All-on-4TM
technique.
Kent Implant Studio prides itself on working
in partnership with referring dentists to
provide implant rehabilitation ranging
from single tooth replacement, to implant
supported dentures and full arch with augmentation reconstruction. Depending
on what works best for you the team at Kent Implant Studio are happy to either
place and restore implants, or place and expose, returning the patient to their
home practice for the final restoration.

With affordable, quality implants the Kent Implant Studio offers outstanding
treatment for all patient referrals. Refer your patients to the Kent Implant Studio
today for quality restorative and aesthetic treatment options at a price that suits
every budget.

The LR appliance training course
The LR appliance was born out of the
understanding that many patients become
acutely conscious that their appearance
could be vastly improved if their front teeth
were straight. Provided that the other teeth
are sound it seemed illogical to undertake
the extensive healthy tooth destruction
necessary for crowns. Veneers, though far
less destructive, might well be avoided if
simple orthodontics can be successful. For
dentists who wish to experience and use the LR Ltd appliances, the one-day
hand-on course has been designed to teach attendees how and when to use
the appliance. Courses are for GDPs who wish to undertake some simple
orthodontics restricted to straightening anterior teeth in a short time with
a small discreet appliance, no extractions and some interdental stripping
where required. “It was a very knowledgeable presentation, in an informal
environment, with the emphasis on participation and questioning. It was
good to have the hands on aspect of the treatment, using the typodonts. The
course was great value and adds another treatment modality for this kind of
in demand treatment.” Dr Simon Thackeray from Thackeray Dental Care For
clinical information contact Dr Ross Hobson on 07710 243690 or email: ross@
oralign.co.uk

For more information, or to obtain a referral pack, call 01622 671 265 or visit
www.kentimplantstudio.com

For information on administration contact Dr Lester Ellman on 07973 875 503
or email: lester@oralign.co.uk Web: www.oralign.co.uk

Beautify your patients’ smiles with the
Inman Aligner
Straight Talk Seminars are the official trainers
for the Inman Aligner – an innovative
appliance that straightens anterior teeth
quickly and gently. Offering both online and
hands-on courses in the UK, USA, Europe,
the Middle East and Australia, practitioners
and patients worldwide are benefiting from
this non-invasive procedure. Jessica Harvey
is the current Miss North Carolina in the
USA, and commenced treatment with the Inman Aligner in January. Jessica’s
dentist Dr Ross Nash attended a Straight Talk Seminars course in Orlando, run by
UK-based experts Dr Tif Qureshi and Dr James Russell, who also helped form the
treatment plan to ensure the best results.

CPD - UCL Eastman Certificate in Advanced
Aesthetic Dentistry
Dr Anna Turo is an associate dentist at Pudsey
Dental Practice in Leeds and she recently
completed a Postgraduate Certificate in
Advanced Aesthetic Dentistry with the UCL
Eastman Dental Institute.
“I decided to do the course because I lacked the
confidence to take on more complex cases and
I didn’t have a clear understanding of how to
establish anterior aesthetics,” says Dr Turo.

dbg’s services now include service, management and compliance programmes
to help members stay up-to-date with the latest updates in CQC* and DH
legislation. Be it arranging equipment maintenance, or organising training to
meet the latest regulations, dbg has a solution to meet your practice’s needs.
But while it may have expanded its fields of expertise, dbg can still offer its
members substantial savings on the products and services that the business was
founded upon.
With over 7,000 members already, dbg strives to be practice managers’ first port
of call before making a purchase, and has developed a comprehensive portfolio
of services and products aimed at saving time and money.

In addition, thanks to its long-standing partnership with implant manufacturer
Nobel Biocare, Kent Implant Studio is able to transfer direct cost savings directly
to patients.

“The Inman Aligner was a huge part of my smile makeover,” says Jessica. “The
appliance was able to do in three months what would have taken traditional
braces at least a year or longer.
“What an amazing experience it has been to see the transformation happen so
quickly and so successfully! I would recommend the Inman Aligner to anyone
who is considering beautifying their smile – I have never felt better or more
confident about my smile than I do now!”
For more information on Straight Talk Seminars visit www.straight-talks.com or
phone 0854 366 5477

“I really enjoyed the course. I now have the confidence and knowledge to go
further with more complex cases. I’d like to move into private practice at some
point in the future, and I am sure this will help to make it a smooth transition.
“I have already noticed an increase in the amount of work with more significant
restorative cases I’m taking on. I’m working much more closely now with the
laboratory who have given me lots of positive feedback. The course has also
given me the skills to reduce risk of failure and so reduce risk of litigation.
“One of the best benefits is the network of colleagues I have gained from
relationships developed during the course.”
For further information, please contact Richard Banks, Programme
Administrator, on 020 7905 1281, email r.banks@ucl.ac.uk
or visit www.ucl.ac.uk/eastman/depts/cpd

[30] =>

United Kingdom Edition

April 9-15, 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

April 9-15, 2012

Classified 31

STAND OUT FROM THE CROWD

Choose a first class dental specialist
accountant, with unrivalled expertise
and over 30 years’ experience
dealing with:
• Tax savings – Chartered Tax Advisor
• Buying and selling a practice
• Incorporations
• NHS Superannuation
• HMRC Investigations

FREE
CONSULTATION
Book your free
initial meeting at
our Thame office.
WWW.DBS.ORG.UK
01844 260111

210x148.indd 1

29/03/2012 15:21

SPECIALIST DENTAL ACCOUNTANTS
- Assistance with Buying & Setting Up Practices
- NHS Contract Advice
- Tax Saving Advice for Associates and Principals
- National Coverage

Please contact:
Nick Ledingham BSc, FCA
Tel: 0151 348 8400
Email: mail@moco.co.uk
Website: www.moco.co.uk/dentists

- Incorporation Advice
- Particular Help for New Associates
- Help for Dentists from Overseas
- We act for more than 550 Dentists

Contact

To
advertise
call
Joe Ackah
on
0207
400 8964

[32] =>

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

Visual representation of dentine cross-section
and dynamic reparative layer

Specialist in dentine hypersensitivity management
References: 1. Burwell A et al. Journal of Clinical Dentistry 2010; 21 (Special Issue): 66–71. 2. LaTorre G & Greenspan DC. Journal of Clinical Dentistry 2010; 21 (Special Issue):
72-76. 3. Efflandt SE et al. Journal of Materials Science: Materials in Medicine 2002; 13(6): 557−565. 4. Clark AE et al. Journal of Dental Research 2002; 81 (Special Issue A): 2182.
5. Earl JS et al. Journal of Clinical Dentistry 2011; 22 (Special Issue): 62-67. 6. Du MQ et al. American Journal of Dentistry 2008; 21(4): 210−214. 7. Pradeep AR & Sharma A. Journal of
Periodontology 2010; 81(8): 1167−1173. 8. Salian S et al. Journal of Clinical Dentistry 2010; 21 (Special Issue): 82–87.
SENSODYNE, NOVAMIN and the rings device are registered trade marks of the GlaxoSmithKline group of companies.

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[cover] => DT UK No. 9, 2012

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