Searching for a new job can be a full time job in itself! With the presence of the internet, there are now multiple channels that can be utilised in the hunt, giving greater choice and exciting opportunities. Whether the move in position is to gain a promotion, for a change in patient demographics or for one of many other reasons, time and effort needs to be put into the search to find that perfect job. Having a plan and strategy in mind can make the process more efficient and productive, and end with a successful result.

Objective: clarity Having a clear and defined objective in mind can make the job search much more straightforward. Further still, when it comes to making any decisions along the process, the objective is always there to refer back to, to help base the decision upon. The career path in dentistry can be as diverse as one wants it to be, which is often part of what attracts individuals to the profession. From general private or NHS high street practices to working out in the community or in an institution, such as a hospital, there are options galore. There is also the option to move away from clinical practice and into a public health role. Further still, there are multiple specialties to choose from as well.

Employer type

The type of employer and establishment can make all the difference to satisfaction in the workplace. It is more than just a job when it comes to any position within the healthcare sector. Due to the long hours, hard work and commitment, the full package on offer needs to be considered. It should include training, continual professional development support, career progression, mentoring, and so much more. From a technology perspective, most dentists enjoy the benefits that it can provide for improved patient care, therefore, the type of equipment used by a practice can be an important factor for many. Are they at the forefront of technology, using the latest in x-ray machines, rotary endodontics and practice management software?

Search channels

Within this digital era, there are now many ways to search for new positions. A person’s current position and their objective will often dictate which methods are most relevant and would therefore lead to success. A young dentists just starting out may have more limited contacts in the industry at that point and so could rely more heavily on recruitment agencies or online searches, whereas a dentist already well established in the industry might only need to use their network to find that next opportunity. However, in most instances, a combination of online and more traditional methods can be used to optimise the chance of finding the perfect next move.

Onwards and online

There is now an abundance of dental specific job websites. With the use of search fields, the specification can be refined so that only the most relevant and applicable positions are shown. This is a very efficient and proactive method of searching for a new job. Most sites offer an ‘email alert’ system to notify candidates when a position that fits their criteria has come online. Further still, these websites enable job seekers to upload their curriculum vitae so that employers can look for candidates that fit with their requirements.

Personal networking

Networking can now be carried out offline in person, or online over the internet. With the introduction of professional networking sites, such as LinkedIn and more dental specific networks like Dental Circle, the way in which the profession networks has evolved. More traditional, but still very relevant methods, include catching up with acquaintances and peers at events, meeting liked-minded people at educational courses, by word-of-mouth and through professional associations (which enable a more targeted approach).

An independent or group practice?

This is a relevant question when looking at the dental practice landscape of today. There are, of course, advantages to both, and it is usually down to personal preference and the positions and opportunities available at the time. Rodericks Dental, for example, offers modern practice facilities, career advancement, a mentoring scheme and clinical support from a dedicated team. Rodericks put excellent patient care at the very heart of everything they do, while always striving to create the best possible working environments and progression opportunities for professionals.

Making the decision to start hunting for the next step in your career is exciting, but it can also be time and energy consuming. Working to a plan and using a breadth of relevant job search channels can find that perfect position.

For more information please visit http://www.rodericksdentalcareers.co.uk/, please contact Christina Regan at recruitment@rodericksdental.co.uk or on 01604 970988

#wearerodericks

Prior to the introduction of the National Health Service (NHS), dental hygiene had been in a parlous state and for many, treatment options were limited. Dentistry itself had been very primitive – before it was established as a recognised profession, dental procedures were carried out by barbers or blacksmiths. Due to lack of training, sterile environments and equipment, thousands of people died as a result of infections, botched surgery or other complications arising from a trip to ‘the dentist’.

There had been no official control of dentistry until the introduction of the Dental Act in 1921, which made education compulsory for individuals who wanted to practise. Lack of fresh food and an increase in sugar as part of the British diet had led to a serious decline in dental health between the nineteenth and mid-twentieth century. It was not until the NHS was introduced that attitudes towards dental care began to change.    

NHS dentistry was founded in 1948 with the establishment of the General Dental Service (GDS), which provided patients with dental care via general dental practitioners (GDPs) who mainly worked as independent contractors from high street and local surgeries. Dentists and orthodontists who chose to work under a contract with the GDS did so as independent practitioners, with the ability to choose where they established their practice and which services they provided to patients.[i]

NHS dental charges were implemented in 1951 for adult patients, with exemptions for those in receipt of income support and those who were pregnant or nursing mothers. Charges were made according to an itemised list of treatments, ranging from simple check-ups to more complex procedures, and these were paid for by the patients on a fee-per-item basis.

Evidently, there were radical improvements in the overall state of the nation’s dental health. During the immediate post-war period, large numbers of the adult population were edentate and in 1968, it was estimated that 22 percent of adults aged between 35 and 44 had no natural teeth – but by 1998, the figure had fallen to 1 percent.[ii] Besides the advances in dentistry and technology, this progression was the result of much broader factors which comprised of changes in diet, fluoridation of toothpaste from 1959 and greater emphasis on the importance of maintaining good oral hygiene – which included attending the dentist.

By 2005, there were more than 400 items on the list of dental treatments that could be charged under the GDS contract, which led to reformation of the payment system in 2006. This simplified the process of charges through a three-tier payment structure which covered treatments ranging from routine examinations and fillings, to more extensive and complex work such as crowns and dentures.

The purpose of the reformed GDS contract was to improve patient experience, clinical quality, NHS commissioning capacity and capability, as well as the general working lives of dentists. While these aims remain to be wholly fulfilled, the GDS contract has made a significant impact on the dental industry by dictating the way in which NHS practices are run, including how they are bought and sold.

Dental practices with GDS contracts offer stability to practice owners because there is guaranteed income through the patient base, hence why the goodwill values for NHS practices has always remained strong. Year on year, doubters have been saying that the bubble will burst and goodwill values will start to decrease rapidly. However, results of the most recent Practice Goodwill survey show that the sales market for dental practices remains buoyant, with NHS practices still commanding high values despite the fact that private and mixed practices may have seen a small fall back in deals done.[iii]

Dentistry, and indeed dental health, has changed substantially over the last century. While the NHS continues to be a topic of debate within the dental community, there can be no denying that quality, affordable and accessible treatment has been fundamental to ensuring that Britons retain healthy smiles for many years to come.

Any prospective buyer looking to purchase a dental practice must identify what NHS contracts are in place and satisfy themselves that turnover is assured for the future. Failing to do so can leave buyers burdened with a practice in which most of its income goes towards servicing loans and reinvestment. Goodman Grant has the specialist dentolegal expertise to help buyers avoid any pitfalls in this regard. By carrying out comprehensive due diligence checks and preparing the appropriate paperwork, Goodman Grant helps to ensure that buyers receive value for what they pay in the purchase of an NHS practice.

Paul Harris of Goodman Grant Solicitors – contact on ph@goodmangrant.co.uk

For more information visit www.goodmangrant.co.uk or contact your nearest office:

London: 0203 114 3133

Leeds: 0113 834 3705

Liverpool: 0151 707 0090

[i] Parliament. (2008) 2 General Dental Services 1948-2006. Link: https://publications.parliament.uk/pa/cm200708/cmselect/cmhealth/289/28905.htm#note28. [Last accessed: 14.02.18].

[ii] Treated.com. (Unknown) UK Oral Heath 1968-2016: Are We Getting Better At Caring For Our Teeth? Link: https://www.treated.com/blog/uk-oral-health-1968-2016-are-we-getting-better-at-caring-for-our-teeth. [Last accessed: 14.02.18].

[iii] NASDAL. (2018) Practice Goodwill Survey – NHS practice values remain high. Link: http://www.nasdal.org.uk/assets/press-releases/Practice%20Goodwill%20Values%20-%20NHS%20practice%20values%20remain%20high%2017-01-18.pdf. [Last accessed: 14.02.18].

It’s no secret that the design, availability and success of modern dental implants have developed exponentially since their inception in the 1950s. But it has been quite a journey… one that Dr Will Carter has been on himself for the last decade or so.

He considers the key changes he has seen with regards to dental implantology throughout his career so far:

“The improvements in manufacturing processes using CAD/CAM systems have created better fitting, stronger and more predictable restorations. Alongside these have been the advent and development of innovations such as the All-on-4^® treatment concept, which enables a patient’s damaged teeth to be removed and a new set of teeth to be fitted onto implants on the same day.”

A Partner at Queensway Dental Clinic in Teesside and Tyne and Wear, Dr Carter works as part of an extensive and highly successful team of fellow implant dentists and support staff. Dr Carter recently celebrated placing more than 1,000 dental implants and he did this while enjoying exceptional success rates that are well above both the national and global estimated averages.

“I have now placed 1,017 implants with a cumulative success rate of 99.8%,” says Dr Carter. “In total, only 11 of these implants failed, of which two were replaced with bridges and nine were replaced with new implants free of charge.

“Over a six-year period these results are amazing because they include more complex surgeries where bone grafting was performed, as well as those cases where patients were smokers or had diabetes.”

When asked what he feels has led to this success, Dr Carter believes that the improved patient outcomes are multifactorial, but that advanced professional training and education have a great deal to do with it.

Dr Carter’s list of credentials speaks volumes. After qualifying from Newcastle Dental School, he completed further training at the Royal Victoria Infirmary Dental Hospital before completing a three-year Masters degree in Implantology and another Masters degree in Cosmetic Restorative Dentistry. Dr Carter also holds a sedation diploma, graduated from the Kois Center in Seattle, USA, and has completed surgical bone grafting courses in Berne, Switzerland, Edinburgh, Glasgow and Lisbon, Portugal. In 2016, Dr Carter received National recognition for his skills when he won ‘Young Dentist of the Year’. 

Dr Carter explores some of the other factors he believes have contributed to his success:

“Treatment planning for implants is key. At Queensway Dental, we take time to plan and assess patients accurately using CBCT scanning to determine volume and quality of bone. We also stabilise patients’ mouths to ensure they are free from underlying infection or pathology before proceeding with advanced cosmetic treatment. Our ethos is that we listen and talk to patients about their oral health in a professional and honest way so that a comprehensive assessment can lead to bespoke, high quality prevention and treatment. We don’t cut corners and we don’t rush.

“Maintenance is also very important and we have an experienced team of dental hygienists and therapists who provide effective cleaning around dental implants and help improve patients’ home care routines. It is this element of after care that probably has the most impact on longevity of implant restorations. 

“Finally, we only use the very best, most reliable implant system – from Nobel Biocare – and fit the highest quality of laboratory-made restorations. I have always chosen products from Nobel Biocare because it is a well-established, trusted brand that has remained at the forefront of implant technology since its inception. We know its systems are always going to be available for patients, so their implants and restorations are ‘future-proof’ to some extent. We hear stories of other manufacturers having problems with implants and withdrawing components or tools from the market and it means patients may suffer if they have one of those cheaper systems placed. This is not the case for those with Nobel Biocare implants.

“To complement this, the on-site laboratory means we have a better system of in-house quality control, so we know that only the best materials and processes are used from start to finish. Our patients visit the laboratory directly for advanced photography and shade matching to ensure the best aesthetic result can be achieved. Same-day alterations and additions can also be carried out on any restorations.”

In addition to caring for his own patients, Dr Carter is happy to accept referrals for dental implants from colleagues. He is also a mentor involved with the SmileTube.tv Ultimate Year Implant Course – which is supported by Nobel Biocare – whereby he shares his extensive experience to help other clinicians place and restore implants. Combining this with lecturing at various events, Dr Carter has had every opportunity to near perfect his implantology techniques and obtain outstanding success rates. From the team at Nobel Biocare, we would like to congratulate Dr Carter on his success so far!

For further details about Queensway Dental Clinic or to refer a patient, please visit www.queensway.co.uk or call 01642 554667

For more information, contact Nobel Biocare on 0208 756 3300, or visit www.nobelbiocare.com

Dr Mark Willings, Director of the Horbury Dental Implant Clinic and Honorary Clinical Teaching Fellow at Manchester University Dental Hospital, was among the esteemed speakers at the ADI Members’ National Forum 2017. Entitled, “Implant Failure – What Can We Learn”, Dr Willings’ lecture shed some light on what is still a relatively untouched subject:

“While research is available on dental implant failure and the reasons behind it,[i]^,[ii] the profession is still very uncomfortable talking about the issues that can present,” he explained when asked about his recent session.

“I think this is because many consider failure to be a weakness. On the contrary, I believe there is much to be learnt from analysing our problems, and as responsible reflective professionals, we have a duty to share this with our colleagues so that we can all develop and improve treatment outcomes.”

Dr Willings focused away from early failure and failure to integrate as there is much of this in the literature. He said: “We know that lack of primary stability, smoking, complex medical history and extensive bone grafting can all impact on osseointegration. For the purposes of this presentation I wished to concentrate on cases where osseointegration had occurred.”

Dr Willings classified failures into the following groups:

1. Dentist failure because of:

• Inappropriate prescription
• Inadequate planning
• Poor surgical execution
• Poor prosthetic management
• Inadequate maintenance

2. Patient failure

• Poor compliance with instructions
• Poor compliance with maintenance / home care
• Poor compliance with recall attendance for professional support
• Non disclosure of medical and dental history

3. Laboratory / technical failure

• Failure to follow material protocol
• Failure to execute processes with accuracy and precision
• Poor execution of lab processes
• Improper design for CAD/CAM restorations

4. Component / material failure

• Fracture of screws
• Fracture of abutments
• Fracture of dental implants
• Fracture of superstructure (including beams, acrylic and porcelain)
• General wear and tear

5. Biological failure

• Peri-implant mucositis
• Peri-implantitis

The areas of failure that are most avoidable, he said in his lecture, are those directly within the dentist’s control. Dr Willings recommends three simple steps to help reduce the frequency of failure from malpositioned / unrestorable dental implants and maximise the chances of success.

“My first tip is to always take a CT scan. While there is evidence to suggest that CT scanning doesn’t prevent all problems,[iii] when used correctly they can provide very useful information to aid planning. It can also reveal pathology that is not visible on a traditional radiograph, which can help the clinician to visualise the proposed site with much greater clarity.

“I would also suggest making a diagnostic wax-up. Look at the proposed result you are trying to achieve, and work backwards. Ideally, superimpose this using appropriate software onto your CT scan so that the proposed tooth position can be related to underlying bone and then make a guide to assist correct placement. Lastly, speak to your technician. To prevent failure, close collaboration is absolutely essential before placing any dental implant.

“Failure can largely be avoided, but it is important to recognise that sometimes it is beyond our control,” Dr Willings concludes. “Let us share our failed cases so we can simultaneously help others, whilst enhancing our own understanding of implant dentistry. Setting patient expectations is also critical. As we know, dental implants are not a bionic replacement for teeth, but an option to consider when faced with losing a natural tooth/teeth. Neither are they necessarily better than other treatment pathways, as much depends on individual circumstances and the clinical situation. We must remind patients that dental implants can – and do – fail, and that they are not a miracle cure. Nevertheless, we know from our successfully treated patients that dental implants can change some patients’ lives, so let’s work together to make a difference.”

Contact the ADI today for more information about the educational opportunities available and how to become a member.

For more information about the ADI, or to join, please visit www.adi.org.uk

[i] Nallaswamy DV, Ramalingham K, Bhat V. Impant Dentistry In: Textbook of Prosthosdontics 1st Ed. New Delhi: Jaypee Brothers Medical Publications; 2003 p.736 – 38.

[ii] Prashanti E, Sajjan S, Reddy JM. Failure implants. Indian J Dent Res. 2011; 22 (3): 446-53. Accessed online January 2018 at doi: 10.4103/0970-9290.87069.

[iii] Shelley AM, Ferrero A, Goodwin M, Horner K. The impact of CBCT imaging when placing dental implants in the anterior edentulous mandible: a before–after study. Dentomaxillofac Radiol. 2015; 44 (4): 20140316. Accessed online January 2018 at doi: 10.1259/dmfr.20140316.

In recent years we have seen some extraordinary scientific and technological breakthroughs, which are likely to influence and improve health care for many years to come. With advanced research, drug developments and ground-breaking innovations, thousands of lives have been saved. These exciting new discoveries are also enabling professionals to make better clinical decisions, offer more effective treatment pathways and improve patient quality of life. Here are just a few examples of the amazing findings and quantum leaps that have recently been witnessed:

Technology has evolved to such an extent that the elderly may soon be able to reach super strengths, and disabled people may achieve real freedom of movement, far beyond the limitations of a wheelchair. Leading manufacturers have developed, and engineered, wearable, motorised exoskeletons, with self-driving mechanisms that can give paraplegic individuals the power to stand, walk, and even climb stairs. As well as assisting disabled people, it has been suggested that augmenting the body, and enhancing its abilities with robotics, is the way forward so that hard manual labour, lifting heavy objects, or holding large tools, may become child’s play.

The collaboration of some of the top surgeons and scientists in the world has now made it possible for some very sophisticated transplants to be placed. In dentistry alone great strides in research and technology, has transformed areas such as dental implant surgery to enable clinicians to perform highly accurate and successful procedures whilst ensuring increased safety, and comfort to their patients. Similarly, huge improvements have been made in organ transplants and successful retrieval transportation and implant, procedures have become considerably safer and easier. For example, a new process called warm perfusion, is able to keep donated organs such as hearts, and lungs functional, allowing them to last longer and maintain their vitality. As well as internal organs there have also been penis, face and hand replacements, and in the last year hands have been successfully attached so that nerves connect, and operate to make them usable.

Another interesting arena is the potential integration of 3D bio-printed tissues. With the integration of technologies, from the fields of biomaterial science, cell biology, physics, engineering, and medicine, these constructions are continuously progressing, and increasing in their complexity. From tissues such as skin, cartilage and blood vessels, to solid printed organs such as a liver or kidney, several examples have been successfully created on a human scale that are approaching the functionality required for transplantation.[1] Eventually, it is hoped that this technology may be applied to a range of possibilities such as the acceleration of tissue healing, the removal and replacement of tissues during same surgery, further scientific analysis and drug testing.

It is always tremendously exciting when we hear of new ways to treat diseases. The newspaper headlines of recent months that have highlighted several breakthroughs, and the drug trials of Ionis-HTTRx to treat Huntington’s disease are particularly promising. This new drug is part of a new class of therapy, which aims to ‘silence’ certain genes to prevent the production of toxic proteins that damage nerve cells in the brain and cause this devastating disease.[2] It has also been reported that the fight against cardiac disease has entered an important new era: studies on a drug called Canakinumab, which works by lowering inflammation in the body could soon be used to prevent thousands of heart attacks every year. Findings from a four-year drug trial of Canakinumab showed another surprising result when the apparent reduction of tumour growth was also revealed.[3] Similarly, there is a lot of talk about nanoparticles that can be chemically programmed to seek out certain tissues in the body. This could potentially pave a brand new way for locating and marking diseased cells.

Certainly, we have seen a new wave of innovation for detecting disease. For example, tiny pill sized cameras that can take detailed microscopic images and transmit video are now available to help healthcare professionals to spot problems or make treatment-planning decisions. Digital breast tomosynthesis (DBT) or 3D mammography is another new imaging modality that is dramatically improving lesion visibility and early cancer detection.

Gaining traction after its launch into the dental market too, is the innovative CALCIVIS imaging system, which fascinatingly, uses a luminescent (light emitting) photoprotein to identify free calcium ions on actively demineralising tooth surfaces. This non-surgical, early detection device allows dental practitioners and their patients to access live visualisation of active tooth demineralisation and, at its earliest, most reversible stage.

Effective, new ways of identifying some of the world’s most prolific diseases are beginning to revolutionise health care provision. Furthermore, the shift from treating diseases and conditions, to preventing them is sure to benefit a great number of patients. Over the last few years more focus has been placed on healthy living, nutrition and physical fitness and the market for wearable digital devices and smart-phone apps to meet the trend of self-monitoring has grown significantly.

Any strategies that encourage patients to take responsibility for their own health are huge steps forward, and as we are well aware, prevention is always better than cure – so long may it continue.

For more information visit www.CALCIVIS.com

or call 0131 658 5152

[1] Murphy S. et al. 3D Bioprinting of Tissues and Organs. Nature Biotechnology August 2014. 32 (8). https://www.researchgate.net/profile/Sean_Murphy20/publication/264500820_3D_Bioprinting_of_Tissues_and_Organs/links/54ca3f450cf2c70ce521a333.pdf [Accessed 13th December 2017]

[2] University London. Science News. Drug lowers deadly Huntington’s disease protein. Science Daily, 11 December 2017. https://www.sciencedaily.com/releases/2017/12/171211100313.htm [Accessed 13th December 2017.

[3] Milmo C. Scientists say anti-inflammatory drug could prevent thousands of heart attacks each year. The Essential Daily Briefing, News 27^th August 2017. https://inews.co.uk/news/uk/scientists-say-anti-inflammatory-drug-prevent-thousands-heart-attacks-year/ [Accessed 13^th December 2017]

Eschmann exploring infection control in different countries

Dr Praveen Chandra L.P details a day in the life as a senior dentist and associate in Maidan Clinic – Sharq branch, Kuwait, where he’s been for 15 years. Dr Praveen graduated in 1992 with a BDS degree from the University of Mysore, India before gaining his Master’s degree from Kuvempu University, India in 1996. He has been an opinion leader many times for Dentsply Endodontics, and has trained with people like Dr Gary Carr and Dr John Stropko in micro-endodontics. His mentor was Dr William Ben Johnson, the inventor of Thermafil and pioneer of rotary endodontics. Previously, Praveen was an associate professor in endodontics and conservative dentistry.

When Maidan Clinic – Sharq branch opened in 1987 in the central business district, it was the first private dental practice in Kuwait. The aim was to provide a first class dental experience to patients by meeting the highest standards and using the latest technology and innovations. Now, there are six other centres that belong to the Maidan group, though Sharq remains the biggest, both in team and physical size (the centre is spread over roughly 10,000 square feet). Maidan Clinic – Sharq branch is very popular with VIP patients.

Including me there are 10 dentists in the Sharq branch, 16 dental assistants, 5 infection control specialists, 4 hygienists and 4 receptionists that work across 12 surgeries in shifts between 0900 and 2030. Together, we are able to provide a comprehensive list of treatments from general dentistry to implants, orthodontics, sedation dentistry and more thanks to the broad skill set of the team and variety of qualifications. I specialise in conservative dentistry and endodontics, but my scope of practice also includes placing implants and minimally invasive anterior alignment using the Invisalign appliance (though only in select cases). I was instrumental in arranging the first certification programme for Invisalign in Kuwait, an honour that was observed by the then United States Ambassador to Kuwait, Matthew H. Tueller.

Each dentist – myself included – will see approximately 10 patients each day, though of course this can vary depending on the types of treatment required. The practice is open Saturday to Thursday, which is a half-day, and we have Friday off as this is considered our weekend in Kuwait.

As part of our service, we also offer a state of the art mobile dental clinic designed especially for corporations, private senior management consultations, schools and to treat patients with additional needs that are unable to attend the practice for treatment. This service is usually offered around twice a month, but at peak times of the year it can be as many as four.

Altogether, our patients receive a high standard of care across all aspects of dentistry, not only with treatments but infection prevention and control too, which is regulated by the Ministry of Health. As well as our personal benchmark that we set, there are specifications that we’re required to meet in line with ‘Infection Control Guidelines in Dental Practice’. The instructions include information on all aspects of infection control from hand hygiene to the use of personal protective equipment, surface disinfection and equipment asepsis, waste disposal, and instrument decontamination. On top of that we follow both OSHA standards (Occupational Safety and Health Administration) and Universal Precautions, which along with our state-of-the-art infection control department ensures complete compliance and patient safety.

We have two rooms – one for the dirty, used instruments and cleaning and disinfection, and one for sterilisation, packing and storage, which are interconnected by a hatch to minimise recontamination. Equipment wise we use an ultrasonic cleaner before the instruments are packed, sealed and sterilised using either dry heat sterilisation or steam under pressure (autoclave). For best results all loads have either dry-heat or steam indicator tape to distinguish between processed and unprocessed, biological monitoring indicators to confirm the eradication of spores, and with the vacuum sterilisers, Bowie-Dick test packs to verify steam penetration.

Ultimately, it is the expert team of infection control specialists that are responsible for ensuring all protocols are followed to the letter, but I am very passionate about the infection prevention and control within our practice, as it ensures we are able to provide a quality level of care. Not only is it a legal requirement, but our patients trust us to provide an excellent service, and it’s what they deserve to receive.

To ensure I stay up to date with all the latest regulations, techniques, equipment and so on I regularly attend conferences and workshops all over the world such as the Midwinter Meeting in Chicago, the IDS Cologne and AACD (American Academy of Cosmetic Dentistry) event. Any new changes or innovations that I come across I always take back to my practice, and where possible we always try to incorporate to make our service that little bit better.

For more information on the highly effective and affordable range of decontamination equipment and products from EschmannDirect, please visit www.eschmann.co.uk or call 01903 753322

IMI Leeds Team

It has become recognised that periodontal disease is closely connected to several systemic diseases, including osteoporosis, cardiovascular disease, diabetes and the risk of premature birth.[1] Dr Francesco Martelli has made the study of the effects of periodontal disease on general health his life work, and he now leads a network of clinics conducting customised, non-surgical periodontal treatment.

Dr Martelli originally trained as a general practitioner in the 1980s before re-qualifying as a periodontologist and implantologist. In Florence, Italy, he became an expert at treating aggressive periodontitis with surgical procedures. However, after around 15 years of performing first-class treatment, Dr Martelli found himself intrigued by patients who did not respond or became worse after surgery. He recognised that he was able to stabilise the teeth of many patients but despite his best efforts, for others there was only littlie or no improvement in their periodontal situation. In order to understand the challenge of periodontal disease more comprehensively, Dr Martelli decided to return to education and enhance his knowledge of microbiology, molecular cell biology, biochemistry, genetics and immunology.

“At the end of this updating process I had more knowledge in terms of microbiology, immunology and genetics and could now understand the reasons why some patients did not get any benefit from surgical periodontal treatment,” Dr Martelli said from his IMI Clinic in Leeds.

Around the year 2000, new chair side microbiological testing became available on the market, making it possible for Dr Martelli to both identify and quantify periodontal pathogens. This type of testing provided him with clear information about the oral environment, the composition of the microbes that colonise in periodontal pockets and a better understanding of the molecular biology and ecological system of each individual patient. Dr Martelli was able to precisely customise treatment according to the patient’s genetic and microbiological predisposition.

This new insight allowed Dr Martelli and his team to develop ground breaking strategies to manage and challenge periodontal disease. Gradually, he and his clinical teams were able to significantly reduce the number of surgical procedures they performed. By carefully tailoring treatment according to the patient’s microbiological, genetic and enzymatic assessments a customised treatment plan, adapted according to the diagnostics of each individual patient, can be delivered to a large number of patients, both consistently and effectively.

In order to have his treatment methods recognised, Dr Martelli and his associates conducted double-blinded randomised studies on 2,683 dental patients at a number of different dental centres. This allowed them to evaluate the efficacy of the new protocol and revealed that periodontal treatment using laser irradiation, guided by accurate microbiological patient characterisation, and was consistently effective in modifying oral microbiome and eradicating periodontal pathogens, thereby restoring long-term periodontal health.[2]

Describing the bio laser assisted therapy, Dr Martelli stated: “Operating microscopes are used to guide the laser light. This allows us to penetrate periodontal tissue and deliver selective and precise action to break down cell membranes and destroy periodontal pathogens. By using laser treatment, we do not damage any healthy tissue and we are able to root plane the teeth, eradicate pathogens and bio-modulate inflammation without detaching the gum or causing bleeding. Through this approach, we have achieved an up to 100% success rate and patients receive a solution that is non-invasive so there is less pain, sensitivity and swelling.

“Even the assessments that we carry out are painless. The microbiological test for example, is carried out by inserting a small cone of absorbent paper into the periodontal pocket. The periodontal disease risk or genetic test is simple; a swab taken from the mucosa inside the cheek.”

The process is carefully monitored, he added.

“After each session we check the status of the microflora ecosystem once again to ensure that we have either reached our final goal or if we need to supplement the treatment. This does not mean that we never do periodontal surgery but we have been able to reduce it right down to around 2-5% of patients, and only after we have tried the personalised, laser assisted PerioBlast^™ protocol first.”

Dr Martelli’s passion for this revolutionary treatment is fuelled by the fact that as well as killing off periodontal pathogens, the PerioBlast^™ protocol also triggers the immune system into action and bio-stimulates the bone marrow stem cells surrounding the teeth. Apart from genetic, microbiological and biomechanical assessments, Dr Martelli and his clinicians also make bone metabolism assessments to measure bone density. This gives them insight into the health of the maxilla and mandible, indicates where the patient presents in terms of osteopenia or osteoporosis and monitors osseous-regeneration of the periodontal bone and, ultimately, the stability of the teeth.

Dr Martelli believes that this customised approach to treatment has the potential to restore the long-term periodontal health and prevent relapse. In just three words, he summed up the key points of the PerioBlast^™protocol: “Decontamination, bio-modulation and bio-stimulation.” This method modifies the bacterial communities of periodontal pockets, restores the oral ecosystem to health and offers enduring stability. He also claims that it has the potential to keep the teeth in function for the rest of a patient’s life, providing they are fully compliant following the procedure.

When asked about healing time, Dr Martelli explained that there are two facets to healing: “In terms of the infection and the microbiology of the situation, I can usually reach a solution within a few weeks. By eradicating the infection we can then help the periodontal tissues to heal, stimulate bone growth and improve bone density that will have benefits for many for years to come.

Dr Martelli concluded that periodontal therapy guided by the microbiological characteristics of the patient not only prevents pathogenic bacteria from thriving and destroying periodontal tissues, but also has the potential to prevent those pathogens from entering the bloodstream and causing or exacerbating other systemic diseases.

For further information about the PerioBlast™ protocol and IMI Clinics visit www.perioblast.com 

[1] Kim J & Amar S. Periodontal disease and systemic conditions: a bidirectional relationship. Odontology. 2006 Sep; 94(1): 10–21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2443711/ [Accessed 18^th July 2017]

[2] Martelli FS et al. Long-term efficacy of microbiology-driven periodontal laser-assisted therapy. European Journal of Clinical Microbiology & Infectious Diseases March 2016. Vol. 35(3)423-431. https://link.springer.com/article/10.1007/s10096-015-2555-y [Accessed 18th July 2017].