The government has today published a series of guidance documents outlining what will happen in the event of a no-deal Brexit in 2019. Included in this first batch of documents is the guidance relating to the regulation of medical devices and a separate letter from Health Secretary, Matt Hancock.

No deal Guidance
The headline for our industry is that, in line with the position the BDIA has maintained during the negotiations, the government has committed to ensuring regulatory parity with the MDR, noting, “The UK will comply with all key elements of the Medical Devices Regulation… which will apply in the EU from May 2020”.

Specifically, in the case of ‘no deal’, it is stated that, “The UK will recognise medical devices approved for the EU market and CE-marked” in order to accept products onto the UK market. However, it is suggested that this recognition would be for a “time limited” period. Subsequent arrangements would be subject to consultation and the BDIA will continue to engage with government and the MHRA throughout this process.  The formal UK presence at EU committees in respect of devices would cease. (At this stage there is no mention on the impact of UK devices exported to Europe, but the EU’s own ‘no deal’ documents refer to the future need for the use of an EU Notified Body, if required, and an EU based Authorised Representative).

UK-based Notified Bodies would, in a ‘no deal’ scenario, no longer be able to assess the conformity of medical devices for devices to receive the CE mark and enter the EU market. Therefore, the MHRA would no longer be able to oversee Notified Bodies in the way that it does now.

If there’s ‘no deal’, the MHRA would continue to perform national post-market surveillance of medical devices on the UK market, and be able to take a national decision over the marketing of a device in the UK, regardless of the position of the European regulatory network, or any decision of the CJEU.

The Department of Health and Social Care also sets out that the MHRA would maintain an online national portal for the submission of regulatory information for medical devices, but that a separate submission would be required for applications to the EU.

Letter from the Minister
You can read the letter from the Minister here.

I read a piece of research recently that investigated the oral health impact of the sugar content in leading breakfast cereals in the UK. Remarkably, the results showed that almost two thirds of the Britain’s bestselling breakfast cereals contain more than half the recommended daily sugar intake for four to six-year-olds.

The excessive amount of added sugar in our foods and drinks is a severe and on-going problem for oral health, but this is not the only issue at play here. The way in which these consumables are being sold is significantly worrying, too. Analysis from the study exposed how 13 top-selling cereals are displaying images of bowl servings three times the manufacturers’ recommended portion size.

Visiting my local supermarket, this practice seems alarming widespread and means the nutritional values presented on the back of many cereal boxes do not reflect the portion sizes represented by the imagery. I fear such misleading packaging could dangerously influence the dietary habits of young children and ultimately lead them to a lifetime of poor oral health. It is extremely easy for parents to ‘over-serve’ their child and it also becomes especially difficult for children to understand what safe and moderate portion sizes are.

In addition, the use of colourful packaging, cartoon characters and careful shelf positioning, all give manufactures the ability to target and appeal to children. These factors only serve to multiply the dreaded ‘pester power’ for parents’ buying choices.

The frequent consumption of sugary cereals is now a major cause for concern, as is the sheer amount of sugar children are consuming for breakfast. Both these factors are responsible for accelerating tooth decay in children, as well as other general health problems. So, what can be done?

A cereal sugar levy

Sugar is highly addictive and children who regularly have high-in-sugar breakfast cereals are likely to continue to have them in adulthood. This pattern is extremely similar to the consumption of sugary drinks. We have already seen the government introduce a sugar levy on soft drinks, which will undoubtedly have a positive effect on children’s oral health going forward. Logically, the next step could indeed be a levy on high sugar breakfast cereals; although it appears manufacturers are being given the chance to take responsibility for themselves first.

Last December, the UK’s largest cereal brand, Kellogg’s, announced it would be cutting the sugar content of its three most popular cereals by between 20 and 40 per cent. The sugar content in Coco Pops will be reduced by 40 per cent, in Rice Krispies by 20 per cent and in Rice Krispies Multi- Grain Shapes by 30 per cent.

It will extremely interesting to see how this develops. We hope Kellogg’s continue their commitment to reducing sugar in their products and that other manufacturers follow suit. However, if resistance is shown, much like we saw with soft drinks, a forced levy maybe the only alternative.

The steps taken by Kellogg’s to reduce the amount of sugar in breakfast cereals is obviously very welcome and a good start in addressing the child health problems caused by sugar. However, for it to have real and tangible effect, more needs to be done to stop misleading consumers.

We would certainly like to see portion sizes represented accurately by the images on the front of packaging, or the nutritional information corresponding to the advertised pictures. Above all this, we must see an improvement in education so that consumers can make their own informed decisions. As dental professionals, we advocate the importance of diet and a healthy lifestyle, but we need support.

It is time for manufacturers of sugary cereals to take a wider responsibility towards children’s health. These companies must invest more money into educational programmes for schools and families, working alongside dental professionals to develop a sustained and cohesive approach towards an improvement in childhood oral health.

At last, Tony the Tiger and the Tooth Fairy on the same team… Who would have thought!

The Faculty of General Dental Practice UK (FGDP(UK)) has endorsed new advice for dentists on the prophylactic use of antibiotics against infective endocarditis (IE).

Following the revision in 2016 of the National Institute for Health and Care Excellence’s Clinical Guideline 64 (NICE CG64), the Scottish Dental Clinical Effectiveness Programme (SDCEP) has published implementation advice, the crux of which is that:

“The vast majority of patients at increased risk of infective endocarditis should not be offered prophylaxis. However, for a very small number of patients [‘Patients Requiring Special Consideration’], it may be prudent to consider antibiotic prophylaxis in consultation with the patient and their cardiologist or cardiac surgeon”.

Earlier this year, the Faculty raised some concerns when the advice was in development. However, a number of improvements have been made as a result of feedback from FGDP(UK) and other organisations, and the Faculty now supports the finalised guidance – which has also been endorsed by NICE – and says dentists throughout the UK will find it useful.

NICE CG64 states that antibiotic prophylaxis is not recommended ‘routinely’ for invasive dental procedures, and the new SDCEP advice aims to clarify the non-routine circumstances in which antibiotic prophylaxis to prevent IE from such procedures might be justified. It is accompanied by a patient management flowchart, a discussion points document for use with patients, and a patient advice leaflet, and also includes a template letter for use when contacting a patient’s cardiology consultant or cardiac surgeon.

Dr Nick Palmer, Editor of the FGDP(UK)’s Antimicrobial Prescribing For General Dental Practitioners – which reflects NICE CG64 and provides evidence-based guidance for appropriate antimicrobial prescribing and stewardship – commented:

“For over ten years the recommendations in NICE CG64, which apply to all healthcare professionals including cardiologists, have remained the same. These are that patients at increased risk of IE should be advised of the risks and benefits of prophylaxis, and that antibiotic prophylaxis is not routinely required for invasive dental procedures. The patient should also be advised of the symptoms of IE, of the importance of maintaining good oral health to reduce their risk of IE, and when to seek expert advice. 

Simplyhealth Professionals is hosting a free NHS webinar and Q&A session on Friday afternoon (24 August), presented by Len D’Cruz, providing an overview of the current issues affecting NHS dentistry:

The complexity and constraints of NHS contracts continue to overshadow dentistry and remain clouded in uncertainty. This webinar will explain these difficulties to clarify the situation, and to help you plan for your future.

Members and non-members can join and earn 30 minutes of CPD for attending (live or on demand).

The details – Title: NHS Webinar with Len D’Cruz (1805849)

Date: Friday, 24 August 2018

Time: 2:30pm

The webinar will last for approximately 30 minutes, including the live Q&A session with Len D’Cruz. The webinar will then be available on demand from around 4.00pm on Friday.

For more information or to register, follow the link below.

Technical information: To ensure you get the best experience using this webinar, please ensure your web browser has enabled Flash player to work, as this will provide the best experience when playing the audio/visual element of the webinar presentation.

https://event.on24.com/wcc/r/1805849/7598A162D59B8B8E9D9AE046D2124C5F

The speaker: Len D’Cruz BDS LDS LLM MFGDP DipFOd PGCert Med Ed

Len qualified from the Royal London Hospital in 1989 and did his vocational training at Whipps Cross. After an associateship in Hertfordshire he bought into his practice in Woodford Green as an expense sharing partner a year later and eventually took over the practice with his wife Anne, who is also a dentist. He has done clinical assistantships in Restorative Dentistry and orthodontics.

Len has been a vocational trainer for the London Deanery for a number of years and the practice is Denplan accredited and is also a Gold BDA Good Practice Scheme member.

It is now a six surgery practice and the practice is also part of the NHS new contract pilots /prototypes since September 2011

Len was an Examiner for the Faculty of General Dental Practitioners for the MJDF exam and for the Overseas Registration Exam (ORE). He completed a Masters in Law at Cardiff in 2003 and the Certificate in Practice Appraisal from the FGDP in 2004. He completed a Postgraduate Certificate in Medical education from the University of Westminster in 2009 and has completed his FGDP Mentoring Certificate in 2012.

He currently splits his time between clinical general dental practice, work as a Dento-legal advisor for Dental Protection Ltd and as Visiting Lecturer at the University of Bedfordshire for the MA in Dental Law and Ethics. He is also a Dental Postgraduate tutor for Health Education East of England and a non-executive Director of the BDA.

Infection rates of high risk human papillomavirus (HR-HPV) oral infection in England are lower than expected, compared to previous US studies.  The research, conducted by the University of Sheffield, also strengthens evidence that smoking and sexual behaviour were shown to be risk factors for oral HPV infection, which can lead to oropharyngeal (throat) cancer.

This timely study published in the British Medical Journal Open today, led by Professor Hilary Powers, Dr Vanessa Hearnden and Dr Craig Murdoch and funded by the World Cancer Research Fund UK, coincides with the announcement of a new UK HPV vaccine programme for boys which will reduce the risk of HR-HPV related cancers.

Rates of oropharyngeal cancers are increasing worldwide, attributable to an increase in the rate of oral infection with HR-HPV.

This new study of 700 men and women in Sheffield, which is the largest of its kind in England, looked for HR-HPV infection and also asked participants lifestyle questions relating to their sexual history and tobacco use.

A total of 2.2 per cent of people were infected with oral HR-HPV infection with 0.7 per cent positive for HPV16 or HPV18. There are large variations in oral HR-HPV prevalence globally however this study showed lower rates compared to previous Scottish and US studies which both found 3.7 per cent of individuals positive for oral HR-HPV*.  

Former smokers were significantly more likely to be HR-HPV positive compared with those that had never smoked. The study also found that participants with a greater number of sexual or oral sexual partners were more likely to be HR-HPV positive.

Dr Vanessa Hearnden, from the Department of Materials Science and Engineering at the University of Sheffield, said: “Previous studies have been US-focused or in smaller UK studies in London or Scotland. This is the first study in the North of England and found lower rates of oral high-risk human papillomavirus infection.

“We fully support the newly announced HPV vaccination programme for boys which will reduce the risk of HPV related cancers including throat cancer in men and will also provide further prevention of cervical cancers through herd immunity.

“However, we found the majority of individuals testing positive for high risk strains of HPV were actually positive for strains other than those covered by the current vaccine (HPV 16 and HPV 18). This shows the need to consider newer vaccines which protect against more HPV strains in the future and for individuals to be aware of lifestyle risk factors such as number of sexual partners and tobacco use.”

Dr Craig Murdoch, from the University of Sheffield’s School of Clinical Dentistry, said: “Many people associate the HPV virus with cervical cancer but there is less recognition of the fact that HPV causes oropharyngeal cancer, and unfortunately, the prevalence of this cancer has increased dramatically in the past few years.

“The Sheffield Head and Neck Oncology Research Team are conducting research into HPV-related oral cancer in order to find better ways to treat this disease and improve quality of life.”

Dr Kate Allen, Executive Director of Science & Public Affairs for World Cancer Research Fund International, said: “This study confirms the importance of lifestyle risk factors in prevention of the disease and sheds new light on the rates of oral HR-HPV infection in England.”

Read the paper here: http://dx.doi.org/10.1136/bmjopen-2018-022497

Henry Schein, Inc. (Nasdaq: HSIC) announced today that it has been named to FORTUNE’s “Change the World” list, an annual ranking of companies that are doing well by doing good. Henry Schein was recognized for its efforts to improve the oral health and, by extension, overall health of underserved populations around the world.

“Since our earliest days, we at Henry Schein have worked to align our strengths as a business with the needs of society, so it is greatly rewarding to be named to FORTUNE’s ‘Change the World’ list,” said Stanley M. Bergman, Chairman of the Board and Chief Executive Officer of Henry Schein. “This recognition only serves to reinforce our commitment to improving the health of people in need, and we look forward to ‘helping health happen’ for years to come.”

Henry Schein was recognized for its efforts to improve the oral health of people in need through three initiatives the Company supports as part of Henry Schein Cares, its global corporate social responsibility program:

• The Alpha Omega-Henry Schein Cares Holocaust Survivors Oral Health Program – An initiative of Henry Schein and the Alpha Omega International Dental Fraternity to provide free oral health care to Holocaust survivors living in poverty across North America.
• Give Kids A Smile – Henry Schein helped the American Dental Association create this program in 2003, and since then it has provided free oral health care and education to more than 5.5 million children in need across the U.S. Henry Schein has served as the program’s official professional products sponsor since its inception.
• The Global Student Outreach Program – Through this initiative, Henry Schein partners with dental schools to improve the oral health in remote and underserved communities around the world while enhancing educational opportunities for the next generation of oral health practitioners.

The “Change the World” list recognizes companies that have had a positive social impact through activities that are part of their core business strategy. FORTUNE considers a company’s measureable social impact, the business results of a company’s socially impactful work, the degree of innovation related to that work, and how integral the initiative is to a company’s overall strategy.

To view the entire list, please visit http://fortune.com/change-the-world/

Following a record number of nominations from patients and peers, mydentist has announced its shortlisted superstars ahead of its coveted Excellence Awards 2018.

Due to celebrate the industry and reward those who go that extra mile for the five million patients the team at mydentist treats every year, the Excellence Awards and Gala Dinner will take place during its annual two-day Clinical Conference on 14^th and 15^th September held at The Vox in Birmingham.

mydentist Excellence Awards 2018 shortlisted nominees:

Area development manager / field team member of the Year

• Paul Mead
• Johnathan Lucke
• Paul Francis

Practice Team of the Year

• mydentist Queensferry (Gladstone Street)
• Love your Smile Orthodontic Centre in Leeds
• mydentist Salisbury (Endless Street)

Dental Nurse of the Year

• Phoebe Grace Underwood
• Brydie McAnaney
• Anna Miiller

Dentist / Orthodontist of the Year

• Mike Herescu
• Ella Dresener-Black
• Ruth Patefield

Hygienist / Therapist of the Year

• Amanda Evans
• Anita Harris
• Vicky Hobson-Hargreaves

Practice Manager of the Year

• Sami Hasan
• Kirstie Murray
• Sarah McLeod

Support Centre Team Member of the Year

• Asif Nazir
• Ashleigh Brett
• Jonathan Wassell

Young Dentist of the Year

• Domingos Mamede
• Meabh Brady
• Michael Hicks

Nyree Whitley, group clinical director of mydentist, adds: “This year marks our fourth Clinical Conference and it’s shaping up to be even bigger and better than before.

“More than 600 delegates plan to attend the conference, which this year has the theme of future building and how we can deliver excellence together, both as a group and an industry.

“We’ve had an unprecedented number of award nominations from our patients and colleagues and it’s been exceptionally tough narrowing it down to this shortlist.

“I wish every nominee the very best of luck.”

On 31 July 2018 almost 36,000 dental care professionals (DCPs) reached the end of their five-year CPD cycle, and each of them need to have submitted their CPD statement to the General Dental Council (GDC) no later than 28 August 2018. With just one week to go, the GDC has revealed there are still 2,187 DCPs yet to make their submission. The regulator is keen to highlight that this could lead to them being at risk of falling off the register and no longer able to practise.

If the initial submission deadline is missed, registrants then have a short window in which to provide the regulator with evidence of the full 150 hours of CPD undertaken over their five-year cycle and, should that not be forthcoming, non-compliant registrants will face removal.

GDC Executive Director, Registration and Corporate Resources, Gurvinder Soomal, said:

“With just one week to go to the deadline, and with such a large number of DCPs still to submit their CPD statement, the risk for them is now very real. It takes just a few minutes to complete the statement via the online portal at egdc-uk.org and I’d suggest that anyone who employs DCPs as part of their dental team might want to check that everyone’s made their submission.”

Further information is available at gdc-uk.org/professionals/cpd and the GDC can be contacted at cpd@gdc-uk.org or on 020 7167 6000 to answer questions.

In addition, from 1 August 2018 all DCPs moved onto the new system of Enhanced CPD from which, amongst other things, sees changes to the way CPD should be planned and recorded over the cycle, as well as to the amount of CPD to be undertaken. To find out everything you need to know about Enhanced CPD visit gdc-uk.org/professionals/cpd/enhanced-cpd.