As revealed in the Independent, modern MRI machines could end up poisoning people who have had a filling put in at the dentist, according to a new study.

New high-powered scanners can cause mercury to leak out of previously set fillings, and the study has shown that levels of the poisonous metal were much higher after they were exposed to the strong magnetic fields the new machines can generate, posing a risk to patents and hospital staff.

When dentists use amalgam for a filling, it is around 50 per cent mercury but the hardening of the liquid when bonded with the chemical structure of the teeth means that any mercury leakage is minimal until it is exposed to strong magnetic fields like that of an MRI.

Scientific adviser to the BDA Professor Damien Walmsley told The Independent: “This will be a decreasing problem in time but the development of new ultra-high-strength scanners, which were only approved by the US Food and Drug Administration last year, needs to be reviewed closely.”

A new study, published in the journal Community Dentistry and Oral Epidemiology, has found that too much exercise could cause tooth decay. By assessing more than 350 sportsmen and women from professional backgrounds, they found that half of them had untreated tooth decay while 77 per cent had inflamed gums that could progress into gum disease. Despite all these worrying figures, 97 per cent of those assessed reported brushing their teeth twice a day.

Professor Ian Needleman of the Eastman Dental Institute at UCL, said to the Telegraph: “Every sport examined revealed significant levels of oral ill-health with the overall risk of tooth decay being higher for an elite athlete than the general population.”

One theory for this correlation is a diet that is very heavy with carbohydrates, one that is common amongst sportspeople. Interestingly, carbs can linger in the mouth while they break down into sugars. Celebrity dentist Dr Richard Marques, explains the theory further to the Telegraph:

“Things like pasta, potatoes – crisps are probably the worst. They can get stuck in the fissures in your teeth, where they break down and can cause decay, Even bread particles can get stuck in the grooves. You shouldn’t brush immediately because your teeth are weakened after eating. Instead, chew sugar-free gum or mints.”

Another factor that could lead to sportspeople having bad oral health could be due to them taking part in sports that feature a heavy airflow, such as cycling or running. Heavy breathing is known to dry the mouth and the protection that saliva offers one’s teeth is no longer there, leaving the enamel exposed to decay.

As well as the above theories, the stress encountered by sportsmen and women may also have a lot to answer for. There have been reports that a lot of athletes vomit before an event, meaning that their teeth are exposed to corrosive stomach acids that wear down the enamel.

Despite the study, staying hydrated while practicing sports has been proven to keep up saliva production, therefore providing a barrier from decay!

NASDAL (The Association of Specialist Dental Accountants and Lawyers) is delighted to announce that it has created a new award, along with a £1000 prize, to recognise excellence in the provision of dentistry for children. The award seeks to recognise a practice that has successfully introduced the British Society of Paediatric Dentistry (BSPD) Dental Check by One into their practice and seen a real business improvement. (The aim of the campaign is to increase the number of children who access dental care aged 0-2 years.) 

Nick Ledingham, Chairman of NASDAL, commented, “NASDAL has always been keen to recognise business excellence in dentistry. We hope that this new award will illustrate that doing the right thing makes good business sense. We look forward to seeing the efforts that practices up and down the UK have put into DCby1.”

Claire Stevens, President of BSPD, welcomed the new award, saying: “We are delighted that NASDAL has got behind our Dental Check by One campaign. We have always believed that DCby1 would be a practice-builder and we hope this award will deliver the evidence, showing DCby1 to be a highly rewarding initiative for the practices that commit to it.”

Practices who are interested in entering the NASDAL DCby1 award, should visit https://www.nasdal.org.uk/award/index.php , where they will find all the relevant details. All entries must be submitted before 5pm, Friday 31^st August 2018.

The winner of the award will win £1000, a trophy, and the right to use the NASDAL Dental Check by One Practice of the Year 2018 title.

By Barry Cockcroft – former Chief Dental Officer, England and a non-executive director at Mydentist

I recently had the good fortune to attend the annual conference of the European Chief Dental Officers in Cardiff. I was a member of this group for many years and was also on the executive committee for a few years. The current chair is the Scottish CDO and receiving the invitation to attend the one-day seminar, which precedes the business meeting, was a pleasant surprise.

As with all conferences the opportunity to catch up with former colleagues, some of whom I had not seen for quite a while, made it a special couple of days.

The most interesting talk, among many high quality presentations, came from David Williams, former dean of the Southampton Medical School and now he’s back in dental research at the University of London.

As CDO you become aware of the value of good data (and we have some of the world’s best in the UK) but the most interesting slide in David’s presentation showed very graphically how headline figures can mask really significant issues.

He showed a slide relating to the outcomes of the treatment of prostate cancer in two European countries and a specialist prostate clinic in Hamburg. The first table focussed on five-year survival rates after treatment and showed an almost uncanny similarity across the board. So, all is well with respect to prostate cancer treatment in the two countries without the specialist centre?… Well, no!

David showed a second slide that showed up what the researchers had found when they delved a little deeper into patient outcomes, beyond simple survival data. The two most common post-treatment complications following the treatment of prostate cancer are erectile dysfunction and urinary incontinence, issues of no little significance to the patients. This showed that the level of postoperative complications was much higher in the two European countries than in the specialist clinic. This seemed to me to typify a trend in developing services to focus on length of life without any regard to the quality of that life.

These two slides demonstrated how just focusing on headline figures can lead to inaccurate conclusions being drawn and possibly, even worse, service design being poorly informed.

In many ways this granularity of data is also an issue in the dental world in the UK. We have been systematically collecting high quality data on oral health for years and the overall pattern of improvement is there for all to see, but those data hide significant parts of the population that are not benefiting from such improvement. The latest Child Dental Health Survey, which demonstrated a continuing significant overall improvement, showed that disease levels were actually increasing in some poorer areas and particularly in those areas with high numbers of Eastern European and ethnic Chinese populations.

Given that resources are finite, and always will be, should we not focus our oral health improvement programmes on areas where these groups are situated, as opposed to wider schemes focussed on the geography of the NHS?

Attendance at a dental practice is one of the three evidence-based pillars of improving oral health. Data on dental care gathered from the quarterly GP patient survey shows that approximately 97 per cent of those who seek NHS dental care are successful and this is used to rebut claims that there needs to be more investment in some areas.

However, the data needs closer inspection. The overall 97 per cent figure sounds reassuring but if you remove those who have already been attending on a regular basis this figure falls to 77 per cent per cent. This means that nearly a quarter of people who are trying to access NHS dental care, having not done so previously, simply aren’t able to; this is a worrying figure and far removed from complacent reference to the headline figure.

New analysis in ‘The state of care in urgent primary care services’ shows that the majority of walk-in and urgent care centres, NHS 111 and GP out-of-hours services in England are rated good (118) or outstanding (10). However, 16 services (around one in 10) remain rated as requires improvement, with 3 rated inadequate.

Today’s report also highlights that effective urgent primary care benefits not only patients but the wider healthcare system, by easing pressure on other services. This means the value of its impact is greater than the cost of service provision – but this is not always considered in complex commissioning decisions and as a result appropriate resource may not be made available to these types of services.

Other challenges faced by urgent primary care providers include pressures around staffing, compounded by the reality of unsocial working hours and high reliance on self-employed clinicians, and many providers experience difficulties in accessing people’s medical records.

While the majority of care is rated good or outstanding, voluntary sector groups also raised concerns that there is a lack of public information about which services to contact and when, and that people require guidance to overcome an historic reliance on accident and emergency.

Professor Steve Field, Chief Inspector of General Practice at the Care Quality Commission, said:

“Well-resourced and integrated urgent care not only provides safe, high quality care to people, but can also ease pressure on other areas of the NHS – particularly emergency departments during the winter period and other times of peak demand. These benefits should not be overlooked.

“It is encouraging that the majority of care is rated good or outstanding and important that commissioners and other services recognise the value that urgent care offers as part of integrated care for people in a local area. As CQC’s interim work reviewing local systems has shown, the relationship and interaction between services is vital to better patient experience and outcomes.

“The work already underway by NHS England is an important step in driving better care for people. However, there is more to be done to make sure complex commissioning arrangements and gaps in public information do not undermine care or undervalue these essential services.”