A new study suggests that destroying microbes that live in the mouth and protect against obesity and diabetes is the result of swilling with anti-bacterial fluid.

While mouthwash is supposed to target the bacteria which cause plaque and bad breath, in fact, it is indiscriminate, washing away beneficial strains.

Reports Science Editor, Sarah Knapton in The Telegraph of 22 November, researchers at Harvard University found that people who used mouthwash twice a day were around 55 per cent more likely to develop diabetes or dangerous blood sugar spikes, within three years.
Although previous studies have found that poor oral hygiene can lead to health problems elsewhere in the body, it is the first research to show that seemingly positive practices can have unexpectedly negative consequences.
Kaumudi Joshipura, professor of epidemiology at Harvard School of Public Health, said: “Most of these antibacterial ingredients in mouthwash are not selective.
“In other words, they do not target specific oral bacteria-instead, these ingredients can act on a broad range of bacteria.”
The study looked at 1,206 overweight people aged between 40 and 65 who were deemed at risk of getting diabetes.
Over the study period around 17 per cent of people developed diabetes or pre-diabetes, but that rose to 20 per cent for those using mouthwash once a day, and 30 per cent for those who used it in the morning and evening.
Prof Joshipura said helpful bacteria in the mouth can protect against diabetes and obesity, including microbes which help the body produce nitric oxide, which regulates insulin levels.
Nitric oxide is also important for regulating the metabolism, balancing energy and keeping blood sugar levels in check.
According to The Telegraph, “a study published earlier this year in the Journal of Periodontal Research found that some mouth bacteria seem to protect against diabetes and obesity.
And another study from 2013 found just a week of mouthwash could decrease a person’s oral nitrite production by 90 per cent, lowering blood nitrite levels by a quarter. These shifts in production led to visible blood pressure spikes.
‘The indiscriminate routine use of antibacterial mouthwash products may cause more harm than good, in light of recent studies, and further supported by findings from this study,’ the new research concluded.
‘Mouthwash use may also have a detrimental impact on diabetes control and possible complications, as these share some common NO-mediated pathways with blood pressure and diabetes.’
The research was published in the journal Nitric Oxide.”

The revised format for Continuing Professional Development (CPD) which comes into force from January 2018 is welcomed by the British Orthodontic Society. From the start of January 2018, professional development will be known as Enhanced CPD (ECPD). All General Dental Council (GDC) registrants will be expected to maintain a Professional Development Plan (PDP), which keeps a record of their personal development and training.

The PDP will gradually include a log of completed activities, including date, number of hours and the learning outcomes covered. It will store the CPD certificate for each activity.

Professor Susan Cunningham, the BOS Trustee for Education, commented: “We welcome these changes to CPD because it encourages us all to be more focused on how we manage our own professional development.” She said that all members of BOS have already entitled to free access to online CPD thanks to an arrangement with ProdentalCPD. The new ECPD enhances the value of this member benefit. “Generally the aim is to promote high-quality CPD and to encourage us to spread our training more evenly across a five-year cycle.”

Sadaf Khan who is responsible for CPD arising out of all BOS meetings commented: “This is an excellent development and allows us all to maintain our CPD in a modern, streamlined way.”

During the five-year cycle, dentists will need to complete 100 hours of verifiable CPD, with 75 hours for hygienists, dental therapists, clinical dental technicians and orthodontic therapists and 50 hours for dental nurses and dental technicians. Nonverifiable CPD will no longer need to be declared.

In future, when paying the annual retention fee (ARF) dentists and dental care professionals must make a declaration of the CPD hours they have completed in that year. All dentists will move to the new scheme on 1 January 2018 and all dental care professionals on 1 August 2018.

Sue Power, a member of the BOS education committee and incoming BOS Trustee for Education, said she believed that improved quality assurance for all CPD activity was a positive step and something that her committee would embrace. “We are all looking forward to providing orthodontic courses for all sections of the dental workforce. Hopefully, we will be able to help our members satisfy the GDC requirement for professionals to plan CPD activity according to their individual field(s) of practice.”

The transitional arrangements are explained and a calculation tool is available on the GDC website: https://www.gdc-uk.org/professionals/cpd/enhanced-cpd and https://gdc.onlinesurveys.ac.uk/ecpdtool.

Chancellor Philip Hammond delivered the Autumn Budget on Wednesday 22 November. We have summarised the key points which will be of interest to dentists.

NHS

The Chancellor announced an extra £10billion will be invested over the course of this Parliament to support the NHS Sustainability and Transformation Plans.

There will be an additional commitment of resource funding of £2.8billion to the NHS in England.

Potentially the Government will relax the public sector pay cap from April 2018 for nurses, midwives or paramedics.

Education, science and research

From next April graduates will not have to pay back their student loans until they are earning £25,000 a year.

There will be £2.3 billion for investment in research and development.

Public health

Duty on beer, wine, spirits and most ciders will be frozen but high-strength alcohol will see an increase.

Tobacco will continue to rise by two per cent above Retail Price Index (RPI) inflation, while the minimum excise duty on cigarettes introduced in March will also rise. And hand-rolling tobacco will increase by additional one per cent.

Tax

From April the National Living Wage will increase from £7.50 an hour to £7.83. The amount you can earn before paying tax will rise to £11,850 from April 2018.

The higher rate of tax will increase to £46,350.

VAT threshold for small business will remain at £85,000 for two years.

Businesses with turnover above the VAT threshold will not be mandated to use Making Tax Digital until April 2019, and then only for VAT obligations.

The Government pledged not to widen the scope of Making Tax Digital until the system has been shown to work well, and not before April 2020 at the earliest.

Business

The Government pledged to provide a further £2.3billion of support to businesses to reduce the burden of business rates. Check with your local council for local schemes which may benefit you. Some businesses will be fully exempt.

Business rates will also switch to being increased by the Consumer Price Index (CPI) rather than by the typically higher Retail Price Index (RPI) from April 2018 – two years earlier than previously planned.

Business rates revaluations will start taking place every three years, rather than every five years, starting after the next revaluation, currently due in 2022.

The Government intends to introduce legislation shortly to retrospectively address the so-called “staircase tax”.

Affected businesses will be able to ask the Valuation Office Agency to recalculate valuations so that bills are based on previous practice backdated to April 2010 – including those who lost Small Business Rate Relief as a result of the recent Court judgement.

Brexit

As there will be a reduced access to the EU’s single market, the Government will be working towards an “outward looking, free-trading nation” after Brexit. There has been an investment of almost £700million so far.

There will be an additional £3billion set aside over the next two years to prepare the UK for every possible outcome as it leaves EU.

Off-payroll working in the private sector

The government reformed the off-payroll working rules (known as IR35) for engagements in the public sector in April 2017.

According to the government early indications are that public sector compliance is increasing as a result. They are therefore considering extending the reforms to the private sector, to ensure individuals who effectively work as employees are taxed as employees even if they choose to structure their work through a company. We will keep a watching brief on this issue and keep members informed of developments.

The government will consult on how to tackle non-compliance in the private sector, drawing on the experience of the public sector reforms, including through external research already commissioned by the government and due to be published in 2018.

What we do for dentists

We offer a range of advice and support for members on BDA dental activity reviews, companies and LLPs, financial management and tax, available from our advice section (member-login required).

Through our policy and campaigning work, we are able to ensure that the concerns of all sections of the profession are raised and that dentists’ voices are heard at a national level: join us.

You can also follow updates from the BDA on Twitter, Facebook or LinkedIn.

A 24-year-old dental student whose brother was an ISIS suicide bomber is accused of a UK terror plot after ‘he bought 500 ball bearings online then police found Jihadi manuals on creating a Western sleeper cell’, a court heard.

According to the Daily Mail, the police the jury they found Jihadist manuals on creating a Western sleeper cell and advice for making homemade bombs when they raided the home of undergraduate Mohammed Awan.

The 24-year-old from Huddersfield, Yorkshire, was arrested by anti-terror police days after purchasing hundreds of ball bearings, which extremist material he possessed advised could be used as shrapnel in home-made bombs, Sheffield Crown Court heard.

Awan, who was studying dentistry at Sheffield University, was found to possess a ‘significant volume’ of extremist material including advice on how to be a ‘sleeper cell’ in the West, it is alleged.

The defendant’s brother, Rizwan Awan and his partner, Sophie, had traveled from Manchester Airport to Istanbul, Turkey on May 17, 2015, and appears to have joined Isis, the court heard.

The brothers were then in contact with each other in August 2015, before reports emerged that Rizwan killed himself as a suicide bomber in Iraq in March 2016.

Meanwhile, in the UK, Awan’s internet searches and possession of extremist material was also ‘progressing’ from April 2015 onwards, Simon Davis, prosecuting told the jury.

BDJ Portfolio Associate Editor David Westgarth was awarded as Young Communicator of the Year by the British Dental Editors and Writers Forum (BDEWF), and Health Education England Clinical Fellow, Yasmin Allen, was honoured as runner-up.
This BDEWF Award is supported by the British Dental Industry Association (BDIA) and aims to recognise younger professionals who are contributing towards writing and editing in dentistry.
David was chosen for an article he wrote on stress and fitness to practise in dentistry, published in BDJ in Practice in March 2017. The article explored the relationship between the rising number of fitness to practise cases, the reasons for it, and resulting stress this is causing dentists.
Yasmin was awarded second place for writing, directing and producing a video in June 2017, which promoted the benefits of utilising digital technology and innovation within dental settings, using emergency dental care as an example.
The Awards were presented at the annual dinner of the BDWEF/BDIA, earlier this month, with guest speaker Sir Paul Beresford MP, Chair of the All Party Parliamentary Group for Dentistry and Oral Health.

Barry Cockcroft laments the emphasis on the negative when it comes to reporting on dentistry…

On the 11 and 12 October, the BDA and the Faculty of General Dental Practice both released press notices commenting on the CQC State of Care report (see page 6), which found dentistry to be safe, clinically effective, caring, responsive and well-led, a ringing endorsement of our profession. The BDA commented that “dental services in England have topped the league in providing high-quality care” and according to the FGDP the report, “highlighted the professionalism and dedication of dentists and dental teams across England”.
At a time when we all want as many people as possible to visit the dentist, especially the young and those from deprived backgrounds who tend to have the greatest needs, this would surely encourage them to attend.
However, on the 10 October, the BDA had apparently supported and contributed to a story in the Daily Mail that actually said NHS dentistry was unfit for purpose – completely contrary to its views expressed after the CQC report was published. Information around charges for dental treatment was also given, and I’d argue it was very misleading.
The article said that a basic exam costs £20.60 and a filling £56.30 with no explanation of the banding system. The intention here, it seems to me, was clearly to portray NHS dental care as being more expensive than it is. There was no mention of those entitled to free treatment and in one part of the article, an item of service charges in Scotland was directly compared with band charges in England with no attempt to explain the difference.
Later on in the article, the BDA is quoted as saying that rising charges are deterring people from seeking care at the dentist. I am sure that that situation can only be made worse by the media misleading the public about the true costs. So why did the BDA seem to support the Mail article? Obviously, the organisation is dissatisfied with the payment system for dentists in England, currently based on courses of treatment weighted by complexity (or the UDA system as it is usually referred to).
It seemed as if the BDA PEC member quoted in the article wanted a return to the item of the service system in place before 2006 (or “the item of service treadmill” as it was referred to for years!). Perhaps the BDA has forgotten that it made up 50% of the advisory working group that recommended weighted courses of treatment and was on the working group that devised the new patient charges arrangements in 2005.
Playing out complex arguments like this in the pages of the national press is never helpful, especially when it diverts attention away from other areas of concern and detracts from the positive image of dentistry that the CQC fleetingly offered.
I have said for many years that there is no good way to pay General Dental Practitioners but the three worst, in my opinion, are by an item or service, by capitation and the salaried option!
The current contract reform process has been trying (for nearly ten years now) to find a combination of all these to include improved outcomes for patients.
As the CQC report highlights, the dedication and professionalism of the dental teams across the country are ongoing and it’s a pity neither the media nor the BDA focuses on this more. The vast majority of dentists are just getting on doing what is right for their patients and don’t, as the piece in The Mail seemed to suggest, spend all their time looking at how much they will make from each patient.
Since the publication of Delivering Better Oral Health in 2007, the biggest single growth area in NHS dentistry has been the application of fluoride varnish as a preventive measure for children. This has occurred despite the fact that there is no direct financial reimbursement for doing this; a tribute to the profession.
Over the years I have made many visits, with dentists and their teams, to community schemes focused on getting preventive messages across and it is unusual for the clinicians to ask for payment. Why is the Daily Mail not reporting on this?
There were some important points in The Mail article but, sadly, these were hidden away. Patient charges are rising at a faster rate than contract values so the NHS is paying a smaller proportion of the cost, something that was specifically excluded when the new system was consulted on.
Probably more important now from the public perspective is the fact that where contracts are not being delivered, the money clawed back by the NHS is often not being reinvested in dental services. As I wrote last month, barriers are being placed in front of those providers wishing to recruit more clinicians to enable them to deliver their contracts, and the growth in DCP training that was part of the rationale for reducing dental student numbers in 2014 has still not happened.
I suppose as regards the slant of newspaper coverage of our profession is concerned we must resign ourselves to the reality of that old adage: bad news sells better than good. It’s a shame, though, given that there is so much ‘good’ out there.