Month: September 2018

BSDHT- All bases covered at OHC 2018

The Oral Health Conference and Exhibition (OHC) 2018 is set to be another exciting event for all dental hygienists and dental therapists to enjoy. The two-day educational programme will be presented by an array of leading speakers in the field and will cover a wide spectrum of topics that cater to every professional’s learning needs, interests and experience levels.

Clinical coverage

Among those discussing clinical topics will be Phil Ower. Phil has an enormous amount of experience in different dental settings, including having worked in the RAF, lectured at the Eastman Dental Institute, worked within various specialist practices, been an examiner for the Royal College of Surgeons of England and Past President of the British Society of Periodontology.

He will be presenting “Perio classifications and diagnosis” on Saturday 24 November 9.15am

“I will be discussing all aspects of periodontal diagnosis, from the need to do a full and detailed assessment of the patient to the use of the new classification system for periodontal and peri-implant diseases that was released during Europerio 9 in Amsterdam, June 2018.

“All clinicians need to be aware of the importance of periodontal diagnosis. This not only ensures that patients can get the most appropriate treatment for their condition, but it also helps to avoid litigation since poor diagnostics is currently one of the main reasons for litigation.

“Right now the biggest challenge is getting used to the new periodontal classification system, which is radically different from what we have been used to for the last 20 years. Clinicians in general practice are probably going to find this difficult to implement so I want to try and make the new system workable for those in general practice. If delegates only take one thing away from my session, I hope it will be an appreciation of the need for thorough and accurate diagnosis, before any treatment planning is considered.”

Phil has been involved with the BSDHT since he was running the RAF School of Dental Hygiene in the early 1990s. About the conference, he says:

“The OHC is one of the most important dates in the postgraduate calendar, concentrating as it does on high quality science and state-of-the-art thinking in oral health. It is always a great way to network and catch up with old friends so I’m looking forward to it, especially as retirement looms!”

Communication Skills

In addition to clinical topics such as Phil’s, the OHC 2018 will cover other skills that professionals need to improve their daily lives. Janet Tarasofsky’s session entitled “Conversations for progress” on Saturday 24 November 12.05pm will be focusing on communication – but not the type that you might think.

“I will discuss why it is essential for us to know how to navigate interpersonal challenges in the workplace, especially when you are self-employed,” Janet comments. “I will share insights into the fuel behind our tendency to avoid difficult dialogue, and I will share my DARE strategy which has been designed to help prepare professionals for their next challenging conversation.

“This includes the following areas:

• Diagnose the real issues behind a challenging conversation.
• Acknowledge the ‘Personal Response’ technique, which delves into individual style.
• Respond quickly to a challenging discussion in a confident and respectful manner.
• Engage in more productive conversations which lead to progress, not arguments.
“In an ideal world, someone would have taught us how to face difficult conversations in school, but most didn’t have this experience. Too many people avoid these conversations as a result, leading to high stress levels and feelings of being undervalued at work, misunderstood or not heard. Being able to talk about it is important.”

In her own quest to find new ways of talking about difficult subjects, Janet herself has recently embarked on a new feminist rap career and she uses her extensive entrepreneurial and personal life experience to help others overcome their own challenging situations.

“We need to overcome our fear of fear,” she says. “This includes fear of making things worse when we speak out, of getting fired, becoming known as the ‘confrontational-one’, or of making a colleague cry.

“I hope delegates leave my session with the confidence to have more challenging conversations. I believe that it is absolutely essential to have more uncomfortable conversations than we are having right now – I know this to be true because the world is not a comfortable place! We can’t change that, but we can learn how to deal with it.”

Aside from the exciting lecture programme and hours of enhanced CPD, OHC 2018 will also host a trade floor with companies demonstrating their latest innovations, an exhibition of the Poster Competition Finalists and the evening dinner and dance with the Dr Leatherman Award presentation.

With every base covered, book your place for the OHC 2018 online today!

OHC “The future is yours” – 23-24 November 2018
Telford International Centre

For more information, please visit www.bsdht.org.uk/OHC2018,
call 01788 575050 or email enquiries@bsdht.org.uk

A novel solution for overcoming dental fear – Amit Patel

The patient was a 45-year-old female with mobile upper anterior incisors. She had a class II division 2 occlusion with a bite occluding on the upper palate and lower buccal gingival tissues. Her general oral health was OK, although limited bone volume was identified. No other abnormalities were identified during the full clinical assessment.

Treatment options were fairly limited as the upper anterior teeth had a hopeless prognosis and therefore extraction was indicated. The patient then had a choice between a removable partial denture and an implant-retained denture. She preferred the latter as it would provide a fixed solution.

The four anterior incisors were extracted during a subsequent appointment and a resin-bonded bridge was constructed using the Dahl Concept. This aims to place the prosthesis in supra-occlusion so that the final implant bridge could be fabricated without causing trauma to the gingival tissues in the upper or lower jaws. The resin-bonded bridge was left in situ for three months to allow for healing and enable the patient to become accustomed to the restoration.

A major barrier that needed to be overcome in this case was the patient’s fairly serious dental fear. She was very distressed during the initial consultation and almost distraught in the second appointment, despite the fact that she brought several members of her family along for support. This was of concern as the dental implant placement would require a more complex and lengthy procedure that she may have struggled to cope with.

I see a lot of anxious patients, especially as I perform various complex treatments such as block grafts and bilateral sinus lifts. I always prefer to avoid using sedation where possible. I find that patients often handle procedures very well without it as long as they feel like they’re in control and they are able to relax. In fact, in my 20 years working in practice, I have only used sedation a handful of times for those patients who really couldn’t proceed without it. I had thought about installing a TV on the ceiling of my surgery to help provide distraction for anxious patients and make them more comfortable, but then I came across another solution – HappyMed video glasses.

The glasses are unlike any other product on the market as they feature a slim design that is easy to wear and they include sound to better distract patients from the clinical procedure. The glasses are easy to use and offer a good selection of movies for patients to watch, making them ideal for use during longer treatments.

We decided to trial the video glasses with this patient in an attempt to help her relax during treatment. Amazing, she went from being extremely anxious to quite calm and more concerned about what she could watch than the actual surgery. As such, we were able to successfully place two dental implants in the lateral sites with simultaneous guided bone regeneration. The patient remained responsive throughout as the volume was set so that she could still hear me and I could update her as the procedure progressed. The resin-bonded bridge was then fixed in place and left for a further three months to allow the surgical site to heal.

The patient was very happy with the result achieved. Her occlusion was improved with over eruption of the posterior teeth, which allowed the final anterior screw retained implant bridge to be restored in an ideal position.

She also found treatment much easier to cope with when distracted by the HappyMed video glasses, which proved their value in the treatment of anxious patients. As such, her experience was greatly improved and we were able to deliver the results she desired in a stress-free way.

This is an important benefit of the HappyMed video glasses – being able to complete treatment on anxious patients without the need for sedation. Calmer patients also mean happier patients, whose satisfaction with the practice can only be a positive thing for business in terms of recommendations. Visiting the dentist is scary for many patients, anything we can do to enhance their experience will also improve the likelihood of them returning. Not only is the product quite affordable, it pays for itself very quickly in this way as well.

For more information on HappyMed, visit happymed.org/en

Author bio:

Dr Amit Patel is a Specialist Periodontist. Alongside running his own private practice in Birmingham, Amit is also an Honorary Clinical Lecturer at the University of Birmingham Dental School. His particular interests are dental implants, regenerative and aesthetic procedures.

25 years of Curaprox with Dr Paul Renton-Harper

Since the formation of Renton-Harper Periodontics in Bristol in 1993, Dr Paul Renton-Harper and his team have been using and recommending Curaprox oral healthcare solutions to patients in order to assist with treatment pathways and help improve oral health.

They now stock a large variety of Curaprox products, including the new Be You line of whitening toothpastes available in six unique flavours and colours, as well as products such as the Black is White range and CS manual toothbrushes.

“I always recommend CS toothbrushes to patients that have undergone surgery, as they’re ultra soft and available in various bristle formations,” says Dr Renton-Harper. “As for accompanying adjuncts, our recommendations are very much based on the individual’s needs. Indeed, we spend a lot of time putting together a tailored plan for our patients and providing in-depth oral and dietary advice.”

Predominantly, though, Dr Renton-Harper and his team of specialists will recommend the CPS prime and CPS perio ranges of interdental brushes. He continues: “After assessing and measuring our patients to calculate the most suitable size, we provide Curaprox interdental brushes as part of a complimentary oral health kit.”

CPS interdental brushes are made using CURAL® ultra-thin and extra strong surgical wire, meaning they can fit into the smallest of interdental spaces offering ultimate coverage, ensuring a safe, gentle and atraumatic clean every use. They also last up to five times longer than other interdental brushes on the market making them much more cost effective in the long-run. It is for these reasons and more that Dr Renton-Harper rates CPS interdental brushes above any others. “But it’s not just me that loves them,” he says. “We’ve found that between 65% and 70% of our patients continue to use Curaprox after the trial period, which speaks for itself really.

“Considering most of our patients when we first meet them are already using interdental brushes from another manufacturer, the fact that so many are willing to change is a testament to the sheer quality and efficaciousness of Curaprox’s products. There’s no pressure for them to swap to CPS, because the way we see it, as long as they’re practising a quality oral care regimen we’re satisfied. But if they’re happy to, we fully encourage patients to use Curaprox due to their flexibility and the umbrella effect of the bristles. Plus, because they’re available in a variety of sizes, we can rest assured that patients are using an interdental brush that is suited to their individual periodontal needs.”

As for the support from Curaprox, Dr Renton-Harper is thrilled with the help he has received over the years, and the team’s decision to award them A* Accreditation – an accolade that was created to reward practices’ commitment to the Curaprox brand. “The UK team has always been very accommodating to me and my practice, providing a consistently high level of customer service and advice that has proven invaluable. We were therefore thrilled to be named an A* Accredited practice and receive extra support with product selection and marketing. We’ve even had the pleasure of liaising with Ueli Breitschmid, the owner of Curaprox, about the availability of new products and how they could help to improve the oral health of our patients. How many other companies can boast that kind of service?

“For all of these reasons, my practice will continue to use and recommend Curaprox products to patients moving forward into 2019 and beyond, and I look forward to our ongoing partnership with the oral healthcare specialists.”

If you’re interested in offering Curaprox solutions to your patients or want to find out more about how to become an A* Accredited practice, contact the team today for more information.

For more information please call 01480 862084, email info@curaprox.co.uk or visit www.curaprox.co.uk

FGDP(UK) publishes revised Standards in Dentistry

The Faculty of General Dental Practice (FGDP(UK)) has published the second edition of Standards in Dentistry, its flagship publication for general dental practitioners and their teams which acts as a guide to personal or practice-based quality assessment.

A comprehensive compendium of guidance and standards relevant to primary dental care, it sets out specific standards covering consultation and diagnosis, paediatric dentistry, orthodontics, management of acute pain, periodontics, endodontics, removable partial dentures, complete dentures, minor oral surgery, implant dentistry, management of dental trauma, direct, coronal and root surface restorations and indirect coronal restorations.

It also summarises almost 70 standards and guidelines publications by the Faculty and 30 other organisations, encompassing emergency dental care, examination and record-keeping, infection prevention and control, medical emergencies, medications management, oral health, pathology, patient information, practice management, prevention, radiography, restorative dentistry, risk management and communication, sedation, special care dentistry and staff training.

The development of the second edition was carried out by Professor David Moles and his colleagues at Peninsula Dental School, Ewen McColl, Christopher Tredwin, Robert Witton and Lorna Burns, and its publication follows consultation with a wide range of national dental bodies. Professor Moles and his team have fully revised and updated Standards in Dentistry to reflect the contemporary clinical, organisational and dento-legal contexts in which dentistry is practised, as well as changes in the evidence base since the first edition was published in 2006.

The standards in the new edition are focussed on practitioner processes rather than treatment outcomes, descriptions of the ‘unacceptable’ have been dispensed with, and the book adopts the Faculty’s ‘ABC’ (Aspirational, Basic, Conditional) notation for the grading of recommendations. Standards for making and receiving referrals, and for oral medicine, are also included for the first time, and the book includes a section on keeping up-to-date with changing guidelines and standards over time.

Celebrating the publication of the new edition, Ian Mills, Dean of FGDP(UK), said:
“The Faculty’s core function is to raise the standards of care delivered to patients, and the provision of guidance and standards by dentists, for dentists, is central to this. On behalf of the FGDP(UK), I would like to thank David Moles and his colleagues for their tireless dedication in compiling the second edition of Standards in Dentistry. It is an indispensable reference guide which will assist the whole dental team in identifying appropriate standards for the delivery of high quality care.”

Professor David Moles FFGDP(UK), Editor of Standards in Dentistry, added:

“The team at Peninsula Dental School are honoured to have been offered the opportunity by the FGDP to undertake a comprehensive update of the standards. We would like to thank all the individuals and organisations that have generously given their time and expertise to comment on the drafts of the second edition. In some cases we have had to resolve strongly-held but contradictory views held by peer-reviewers. This is an indication of the extent to which members of our profession care passionately about the standards of care we all endeavour to provide, and it also illustrates the subjective nature of clinical practice. Whilst the evidence base for primary care dentistry is constantly improving, it is clear that much remains almost as much an art as a science.”

To mark the publication of Standards in Dentistry, the Faculty is distributing copies to all its members, and new members who join this year will be sent a copy with their welcome pack. Non-members can buy it for £44.99 at www.fgdp.org.uk/shop, and until the end of 2018 FGDP is also offering a 25% discount on its complete set of five guidance publications, which also includes Selection Criteria for Dental Radiography, Clinical Examination and Record-Keeping, Antimicrobial Prescribing for General Dental Practitioners and Dementia-Friendly Dentistry.

Does the NHS fining system need to be cleaned up? – Charlotte Gentry

Around a week ago I read an interesting article about patient fines. It discussed how dentists believe these fines are deterring the poorer patients within our community from attending the dentist. Working as a receptionist in my spare time, I’ve witnessed patients receiving these fines first-hand. It is often very stressful and upsetting for patients, particularly when they are exempt; they will struggle to pay the fine they’ve been given.

Around 370,000 fines were given out according to the latest annual figures and the BDA says the fining system is creating a ‘hostile environment’ for those most vulnerable patients. Those that are entitled to free treatment are often the most vulnerable, with complex needs that need addressing swiftly. However, with the worry of a fine lingering over them, they are often deterred from visiting at all.

So where is the system going wrong? In my opinion, the forms that exempt patients have to fill out can be very confusing. Although the free treatment benefits are listed clearly, there are often many different types of the individual benefit and not all entitle patients to free treatment. In the past year, I have noticed the FP17 forms have been changed slightly, with the aim of making entitlements clearer; yet this seems to have had little effect, the bold lettering clearly still isn’t helping in reducing the number of patients still getting fined.

The pressure is also on receptionists. Often patients come in and say ‘does this entitle me’ or come in after being fined saying ‘you told me I was exempt’. However, I feel receptionists are also put in a very difficult position. When explaining to a patient (not entitled) that their benefit doesn’t cover them, we often get the brunt of it. Patients often feel angry with reception teams when they are told they will have to pay. So in many ways, we can’t win. Although patients have to provide proof, entitlement letters are often very confusing and determining whether it is say, ‘income related’ or not, can be often be challenging. Although, it is made clear that filling in the form and claiming an exemption is entirely the patient’s responsibility, I feel as though receptionists are often made to feel responsible for the forms being filled out correctly.

In my opinion, there must be an easier way to determine the exempt from those that aren’t. It is very well arguing over whether or not dental practices or patients are to blame for the fine, however, in most cases, neither are. The FP17 form is not the clearest or easiest form to fill in. Lots of words and boxes often mislead the patient and they end up signing the boxes on the back, not ticking an exemption box and getting fined. The whole system needs to be cleared up.

I feel the way forward to reduce these fines and prevent deterring our most vulnerable patients, is to introduce a dental exemption card, similar to the medical exemption for prescriptions. If every patient who received a qualifying benefit received a card, it would be very easy to determine who is and is not exempt and the number of wrongly issued fines would dramatically increase. With so many fines being overturned after appeal now anyway, it is likely the fines aren’t doing the job they set out to do in the first place. By introducing a universal card, fraudulent activity would be easier to stop and patients would feel far more at ease coming to the dentist.

Align Technology announces November 2018 Invisalign Forum for General Practitioners

Align Technology, Inc. ((NASDAQ: ALGN) today announced it will host an Invisalign Forum for General Dentist Practitioners (GDPs) on November 3 in London, United Kingdom. The event will give a platform to leading dentists and dental experts across the UK to present insights into Align Technology’s latest portfolio innovations. The plenary sessions have been curated to enable general dentists treating patients with the Invisalign Comprehensive portfolio of clear aligners to learn how they can harness the latest Invisalign treatment advances to improve their clinical effectiveness, and will present concepts that could help ignite practice growth.

This much-anticipated annual event is designed to bring Invisalign trained dentists together with leading dental experts from across the UK, as well as renowned thought leaders including Dr Christopher Orr and Dr Monik Vasant. The speakers will share their insights and experiences about the progression of comprehensive dentistry and future trends for GDPs. Delegates will learn how to become more skilled in aesthetic dentistry and designing digital treatments. In addition, there will be an opportunity to explore simple steps to improve their practice workflow using Align’s iTero Element digital intraoral scanner.

Expert-led sessions in advanced aesthetic dentistry and Invisalign treatment will provide further guidance around the applicability of the world’s most advanced clear aligner therapy system. The sessions will offer opportunities to learn about:
o Future trends in comprehensive dentistry from a holistic approach
o Clinical excellence with the Invisalign system
o Benefits of digitising the dental practice and optimising workflow
o Understanding millennial consumers and how to engage with them as potential patients
o Case studies and best practice examples from some of the top Invisalign trained doctors

The event will include a series of small group sessions so that delegates can interact directly with speakers who will share their practical experiences of harnessing the Invisalign system to fuel practice growth. In addition to main plenary sessions, there will be two practical breakout sessions featuring Dr Rhona Eskander and Dr Teki Sowdani about engagement with millennial patients, whilst Dr Kunal Patel will showcase how the iTero Element has been integral to the development of his business.

The event`s fee for the full day’s meeting also includes welcome coffee, morning and afternoon refreshments and lunch. To register for the Forum and see more details, Invisalign trained doctors who offer Invisalign Comprehensive Portfolio should contact their local territory manager.

Dental and medical leaders issue call for reform of pay review body

The British Dental Association (BDA) and British Medical Association (BMA) have issued a joint call for fundamental reform of the Review Body on Doctors’ and Dentists’ Remuneration (DDRB).

Dental and medical leaders have stated the DDRB’s role to guarantee the independence of pay awards has been eroded over time, and the current process is no longer acceptable to their professions. GDPs in England still do not have clarity on whether the anticipated 2% uplift will be delivered from 1 October.

In a joint statement both associations have set out key principles that need to underpin the reform process, and raised these issues directly to government in open letters to Health Secretary Matt Hancock MP.

BDA and BMA joint statement on reform of the DDRB

The Review Body on Doctors’ and Dentists’ Remuneration (DDRB) advises governments in Westminster, Cardiff, Belfast and Edinburgh on rates of pay for doctors and dentists.

The British Dental Association (BDA) is the trade union and professional association for dentists. The British Medical Association (BMA) is the trade union and professional association for doctors.

The DDRB was established following the recommendation of the Royal Commission on Doctors’ and Dentists’ Remuneration in 1960. The Commission stated that such a body was necessary in order to give the medical and dental professions “some assurance that their standards of living will not be depressed by arbitrary Government action”, as well as achieving “the settlement of remuneration without public dispute”. The view expressed by the Royal Commission was that this “procedure will in fact, therefore, give the professions a valuable safeguard. Their remuneration will be determined, in practice, by a group of independent persons of standing and authority not committed to the Government’s point of view.”

Each year both the BDA and BMA provide evidence to the DDRB as part of the process for determining the annual pay uplift for dentists and doctors.

However, the view of the BMA and BDA is that the DDRB process has been modified beyond recognition from its original purpose. This has been developing over a number of years, but is now clearly no longer acceptable to the medical and dental professions. The BMA and BDA believe it is now time for fundamental reform of the pay review process for doctors and dentists, on the basis of the following principles:

Restitution of the DDRB’s independence and return to its original purpose.
Revision of its terms of reference to narrow the DDRB’s focus purely on pay uplifts rather than making recommendations on wider contractual matters.
Clear timetables for submission of evidence and publications of the report, and an undertaking that government(s) must not fetter the parameters of the DDRB’s recommendations.
Re-establishment of the undertaking that government(s) will respect and implement the DDRB’s recommendations.

The Postcode Lottery of care: 90 miles treks for dentist as £20m lost from NHS services

Welsh Assembly Members looking at the future of NHS dental care will hear today (Thursday 27 September) that £20 million has been pulled out of local NHS dental services, as patients travel further or wait longer for care.

The British Dental Association Wales will tell the Health, Social Care and Sport Committee that patients across Wales are now facing a ‘postcode lottery’ of care –fresh analysis of data from the official NHS Direct service shows that new patients are facing wholly unacceptable journeys to see an NHS dentist, with residents in Aberystwyth facing a 90-mile round trip. New patients in Newtown face 80-mile journeys, while even those in the Welsh capital Cardiff face a nearly 30 miles trek.[1]

BDA analysis from last year showed that only 15% of NHS practices are taking new adult NHS patients, with just 28% accepting new child patients.

Dentist leaders have said the perverse NHS dental contract system has fuelled access problems. Freedom of information requests reveal that £20 million has been lost from local NHS dental services in the last three years, where practitioners are unable to meet the tough targets set by government in their contracts. This money, known as ‘clawback’, is not reinvested to meet demand for NHS dental services.[2]

While BDA Wales has praised initiatives like Designed to Smile, which has narrowed deep health inequalities among young children, it has criticised the Welsh Government for failing to apply these effective preventive principles to wider strategy and reform of the failed NHS system.

Ministers are advocating modest ‘tweaks’ to the current target-driven NHS contract – which effectively caps patient numbers – rather than root and branch reform. The model has fed recruitment and retention problems across Wales, with recent official data revealing morale in the profession has fallen to its lowest levels since 2000 and more than half of dentists are considering leaving the profession.

Tom Bysouth, Chair of the BDA’s Welsh General Dental Practice Committee, said:

“The Welsh Government talks about prevention, inequalities and sustainability. But we require deeds not words to guarantee the future of this service and end the postcode lottery of care.

“It’s utterly perverse that £20 million has been lost from local services, while some patients are travelling 90 miles to see a dentist under the NHS. Sadly, it’s the inevitable result of a failed system, where officials bank on dentists missing their targets just so they can plug holes in other budgets.

“Wales has secured major breakthroughs investing in prevention among children, with health inequalities narrowed and a chance to shave millions off treatment costs. What’s missing is the willingness to apply that logic to fixing the rotten system at the heart of this service.

“Any progress hinges on the Welsh Government honouring its pledges and delivering real reform. We need a model that puts patient care ahead of tick boxes and targets, that can guarantee access for all who need it.”

The Impact of orthodontic treatment on oral health – Deborah Lyle

 

Orthodontic treatment is already common and demand is increasing markedly. Each year over 200,000 children and teenagers receive orthodontic treatment on the NHS.[i]Meanwhile demand among adults, while still a niche, continues to grow. Consciousness of, and aspiration to, higher aesthetic standards is almost certainly the key driver in adults seeking orthodontic treatment, leading to this demographic becoming the fastest growing segment in orthodontics.[ii]  Consequently, greater awareness of the oral health impact of these procedures is valuable to orthodontists and dental practitioners in general.

The key benefits of orthodontics are well established at this point: proper alignment of teeth, better mastication, improved quality of speech, and aesthetic concerns.  While there is some debate over the value of orthodontics in significantly improving oral health,[iii]post-treatment quality of life enhancements in regards to patient confidence and self-esteem are readily observable.[iv]

Gingival swelling and further periodontal complications, are reputedly the most common adverse effect of orthodontic treatment on oral health.vThough with adequate plaque control even teeth with reduced periodontal support can undergo successful tooth movement without adversely effecting their periodontal situation.[v]However, patients generally find that fixed appliances make cleaning their teeth more difficult.[vi]This is due to the additional surfaces and spaces that the appliance presents, which can trap food and lead to the accumulation of microorganisms and plaque on both the teeth and gingival tissue, as well as the brace itself. Additionally, the patient is required to clean from unfamiliar angles with greater thoroughness than they are used to, which presents something of a learning curve as well as being potentially uncomfortable. As a result of these factors, patients may engage in a suboptimal oral hygiene regime during orthodontic treatment.[vii]This can of course lead to the accumulation of plaque, a leading cause of gingivitis, which in turn can lead to periodontitis. Plaque coverage levels in orthodontic patients have been observed to be two to three times higher than in high plaque-forming adults without fixed appliances.[viii]Younger patients may be particularly at risk owing to a less conscientious approach to their oral hygiene,[ix]so it may prove wise to impress upon them and their caregivers the importance of due diligence.

Root resorption is another common negative consequence of orthodontic treatment. While not the cause, orthodontic treatment can trigger severe external apical root resorption (ARR), which can result in permanent loss of tooth structure from the root apex.[x]Key risk factors for root resorption are the length of treatment, impacted canines, thin and dilacerated roots, or a history of anterior tooth trauma. Habitual behaviours such as occlusal trauma, thumb sucking and chronic bruxism are further risk factors, and so should be checked for prior to treatment.[xi]Evidence suggests that light forces are preferable to heavy in reducing the incidence and severity of root resorption.[xii]

Adult orthodontic patients present additional challenges uncommon in younger patients. These include: uneven gingival margins, missing papillae and periodontal bone loss.iiWhen present, these can and should be treated in advance or alongside as required, in order to ensure the best possible long-term outcomes from orthodontic procedures.

Further possible problems are tissue damage, enamel demineralisation, allergic reactions to nickel and the potential for the treatment to fail resulting in a relapse. The benefits of orthodontic treatments are generally regarded as outweighing the risks and by taking proper precautions and timely interventions on the part of the dental professional these negative outcomes can be safely avoided.[xiii]

However, a key factor is the patient’s own oral health regimen, which even after receiving advice from their dentist may lapse due to the increased difficulty and hassle orthodontic treatment can cause during routine brushing and flossing. This is particularly important for patients fitted with fixed retainers, as they typically have slightly higher levels of plaque and dental calculus than those with removable retainers.[xiv]However, gingival inflammation presents equally in patients with fixed and removable retainers.[xv]

A product that you may wish to recommend that can greatly aid the patient in maintaining their oral hygiene is the Waterpik®Water Flosser. The patient will find this more comfortable and effective than traditional methods and it has been clinically proven to be more than three times as effective as dental floss for removing plaque around orthodontic appliances with the Orthodontic Tip.[xvi]

While earlier research has indicated that orthodontic treatment can improve periodontal health in general, there is some controversy regarding the factual accuracy of this assessment, as more recent reports do not necessarily support this conclusion.v

Though the rate of publications has increased drastically in the last decade, further research is still required in this area, however, improved understanding and cooperation between practitioners and patients will certainly improve treatment outcomes.

 

For more information on Waterpik® please visit www.waterpik.co.uk. Waterpik®products are available from Amazon, Costco UK, Boots.com and Superdrug stores across the UK and Ireland.

 

 References

 

[i]Kelly, B. NHS contractual obligations and communicating with the NHSBSA. NHS Business Services Authority.Available at https://www.bos.org.uk/Portals/0/Public/docs/Events/Brian%20Kelly%20NHSBSA%20TGG%202018.pdfAccessed March 8, 2018.

[ii]Khurana, P., Soni, V.P. Orthodontic intervention to resolve periodontal defects: An interdisciplinary approach. Journal of Indian Society of Periodontology. 2010;14(4):287–289. Available from: http://www.jisponline.com/text.asp?2010/14/4/287/76922Accessed March 8, 2018.

[iii]Elmahgoub F.A., Abuaffan A.H. The impact of orthodontic treatment needs related to dental health on the oral health-related quality of life of dental students.Clinical Research Trials 1. Open Access Text. 2015.

Available at http://www.oatext.com/The-impact-of-orthodontic-treatment-needs-related-to-dental-health-on-the-oral-health-related-quality-of-life-of-dental-students.php#ArticleAccessed March 8, 2018.

[iv]Johal A., Alyaqoobi I., Patel R., Cox S. The impact of orthodontic treatment on quality of life and self-esteem in adult patients. European Journal of Orthodontics. 2015;37(3):233–237. Available from: https://academic.oup.com/ejo/article/37/3/233/2756151Accessed March 8, 2018.

[v]Dannan A. An update on periodontic-orthodontic interrelationships. Journal of Indian Society of Periodontology. 2010;14(1):66-71. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933533/Accessed March 8, 2018.

[vi]Gastel J., Quirynen M., Teughels W., Coucke W., Carels C. Longitudinal changes in microbiology and clinical periodontal variables after placement of fixed orthodontic appliances. Journal of Periodontology. 2008;79(11):2078-2086. Available at http://www.joponline.org/doi/abs/10.1902/jop.2008.080153Accessed March 15, 2018.

[vii]Pandey V., Chandra S., Dilip Kumar H.P., Gupta A. Bhandari P.P., Rathod P. Impact of dental neglect score on oral health among patients receiving fixed orthodontic treatment: A cross-sectional study. Journal of International Society of Preventative & Community Dentistry. 2016;6(2):120-124. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4820570/

Accessed March 8, 2018.

[viii]Klukowska M., Bader A., Erbe C., Bellamy P., White D.J., Anastasia M.K., Wehrbein H. Plaque levels of patients with fixed orthodontic appliances measured by digital plaque image analysis. American Journal of Orthodontics and Dentofacial Orthopedics. 2011;139(5):463-470. Available athttps://www.sciencedirect.com/science/article/pii/S088954061100120XAccessed March 15, 2018.

[ix] Cantekin K., Celikoglu M., Karadas M., Yildirim H., Erdem A. Effects of orthodontic treatment with fixed appliances on oral health status: A comprehensive study. Journal of Dental Sciences. 2011;6(4):235-238. Available at https://www.sciencedirect.com/science/article/pii/S1991790211000845Accessed March 8, 2018.

[x]Topkara, A., Karaman, A. I., & Kau, C. H. Apical root resorption caused by orthodontic forces: A brief review and a long-term observation. European Journal of Dentistry. 2012;6(4):445–453. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474562/Accessed March 8, 2018.

[xi]Nabeel F. T. Adverse effects of orthodontic treatment: A clinical perspective. The Saudi Dental Journal. 2011;23(2): 55-59. Available at http://www.sciencedirect.com/science/article/pii/S1013905211000046Accessed March 8, 2018.

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OHF: Is the possibility of ‘re-growing’ our own teeth about to become a reality?

One of the biggest worries we have when it comes to our oral health is the possibility of losing our teeth, either naturally or because of an accident. But what if we could grow them back?

Two new pieces of pioneering research have given hope that this could one day be a reality.

The first of these has seen scientists in America create tooth buds which can grow and look like natural teeth.1

The second shows how tooth stem cells can be used to partially repair teeth that have been damaged.2

Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation believes that, while this may be a long way from becoming a reality, the prospect of re-growing our own teeth is highly exciting.

Dr Carter says: “Millions of people across the world lose teeth for many different reasons.

“Tooth loss can happen because of an unfortunate accident, poor oral health or another illness. But no matter how we lose them, missing teeth can mean problems in our everyday life. Missing teeth can affect how we eat, smile and speak. It can even have an impact on our confidence and mental wellbeing.

“Our current options to replace missing teeth include bridges, dentures and implants. These are great ways to replace lost teeth and give us back the confidence we need to smile.

“Given the choice however, we would always choose to have our own natural teeth.”

Scientific breakthroughs in similar fields have already led to developments in many other areas of healthcare, such as prosthetics and tissue regeneration.

These have helped millions of people gain a better quality of life and this cutting-edge research has the potential to do the same in the future.

“As exciting as the prospect may be, the ability to grow our own teeth remains quite a long way off. It may take decades for it to reach a point when it becomes routine within dentistry,” concluded Dr Carter.

If you would like advice about looking after your teeth, contact the Oral Health Foundation’s free and impartial Dental Helpline on 01788 539 780 or visit www.dentalhealth.org for more information.