Dental implant treatment has become increasingly popular, as it can offer a reliable solution to partially or fully edentulous patients. Although implants have high success rates in the majority of cases, they can fail and often this is a result of poor treatment planning. As such, it is essential for practitioners to employ a rigorous and systematic approach to initial assessments in order to determine if a patient is suitable for dental implants. Not only will this ensure that treatment is successful, but also that the patient’s expectations are well met or managed.

Health status

Most practitioners understand that any future complications can be avoided by identifying potential risk factors for implant failure. Prior to treatment, the patient’s current medical and dental status should be evaluated – including systemic conditions, medications, behavioural habits (e.g. smoking), and the patient’s periodontal condition.

Systemic diseases, such as poorly-controlled diabetes or osteoporosis, are risk factors that will need to be discussed with the patient, as these conditions can severely compromise healing post-implant placement.[i]Similarly, the occurrence and severity of infections such as periodontal disease or other pathologies of the oral cavity will need to be analysed, to determine if the patient is an appropriate candidate for dental implants. Patients with a history of untreated periodontitis are at risk of implant failure and as such, any periodontal diseases must be properly controlled and maintained prior to surgery.[ii] 

Behavioural conditions that may interfere with treatment and follow-up care include tobacco use, substance abuse, and parafunctional habits (e.g. bruxing and clenching). Tooth grinding could place unnecessary strain on the implant thereby causing components to fracture, while excessive smoking could impair healing, as the nicotine typically found in tobacco products reduces blood flow, thus increasing the incidence of peri-implantitis.[iii]As such, smoking cessation may be advisable, particularly for patients suffering from immunodeficiency conditions.

Demands, expectations and compliance

Practitioners cannot underestimate the importance of discussing the demands and expectations of the patient, as this will influence the patient’s overall satisfaction of implant treatment following its completion. Their demands should be balanced with the objective evaluation of their condition and the proposed treatment outcomes. If the patient’s expectations are unrealistic, then they will deem treatment a failure – regardless of whether you believe it is, in fact, clinically successful. Therefore, communicating effectively is essential to ensuring that the proposed treatment plan is fully understood by the patient.

As part of initial assessments, practitioners should look at the patient’s compliance with past and current preventive care in order to determine whether the patient is likely to be compliant towards advice and guidance provided. As it has already been established, effective healing is crucial for the success of an implant, so patients must be made aware of their responsibilities to maintain good oral hygiene, which is key to avoiding the build up of plaque and preventing the development of complications such as peri-implantitis.[iv]^,[v]

Intraoral and extraoral examinations

The patient’s mouth opening should be assessed during consultations, as clinicians will need sufficient access to the surgical site during implant placement. Various characteristics such as the patient’s smile line, lip line, and facial midline should also be evaluated, particularly in cases where implants are placed in the aesthetic zone – an area in which visual outcomes tend to be the patient’s overriding concern.

One of the primary factors determining the long-term success of an implant is the bone in which it is placed, so examinations should confirm that there is sufficient bone quantity and quality in the area for implant placement.[vi]This will involve evaluating the shape of the bone, as well as the bone width and height. The patient’s bone density will also need to be examined from radiographs and CT scans. Some patients may require more advanced procedures such as bone grafting, which can ensure they have adequate bone quality and quantity.

Based on these extraoral and intraoral examinations, practitioners can then select the most appropriate implant solution for the patient. The key here is to choose an implant system that is proven to deliver long-lasting aesthetics and function. TBR’s Z1 implant system, for instance, combines the biocompatibility of titanium and zirconia in one seamless component, which is available in different lengths and diameters to enable practitioners to place the implant in both anterior and posterior regions.

Although there are various elements to consider, planning appropriately and following proper case selection protocols is crucial to ensuring patients are deemed suitable for implant treatment. By doing this, practitioners can avoid the risk of failure and achieve highly satisfactory results that meet, or even exceed patients’ expectations.  

For more information on the Z1 implant, visit z1implants.co.uk and to learn about the full range of implants from TBR, visit tbr.dental, email support@denkauk.comor call 0800 707 6212

 REFERENCES

[i]Chen, H., Liu, N., Xu, X., Qu, X., & Lu, E. (2013) Smoking, Radiotherapy, Diabetes and Osteoporosis as Risk Factors for Dental Implant Failure: A Meta-Analysis. PLoS ONE. 8(8): e71955. Link: http://doi.org/10.1371/journal.pone.0071955. [Last accessed: 20.06.18].

[ii]Stacchi, C., Berton, F., Perinetti, G., Frassetto, A., Lombardi, T., Khoury, A., … Di Lenarda, R. (2016) Risk Factors for Peri-Implantitis: Effect of History of Periodontal Disease and Smoking Habits. A Systematic Review and Meta-Analysis. Journal of Oral & Maxillofacial Research. 7(3): e3. Link: http://doi.org/10.5037/jomr.2016.7303. [Last accessed: 20.06.18].

[iii]Malhotra, R., Kapoor, A., Grover, V. and Kaushal, S. (2010) Nicotine and periodontal tissues. Journal of Indian Society of Periodontology. 14(1): 72-79. Link: http://doi.org/10.4103/0972-124X.65442. [Last accessed: 20.06.18].

[iv]Elias, C. N. (2011) Factors Affecting the Success of Dental Implants, Implant Dentistry – A Rapidly Evolving Practice. Link: http://cdn.intechweb.org/pdfs/18426.pdf. [Last accessed: 20.06.18].

[v]Ramanauskaite, A., & Tervonen, T. (2016) The Efficacy of Supportive Peri-Implant Therapies in Preventing Peri-Implantitis and Implant Loss: A Systematic Review of the Literature. Journal of Oral & Maxillofacial Research. 7(3), e12. Link: http://doi.org/10.5037/jomr.2016.7312. [Last accessed: 20.06.18].

[vi]Gulsahi, A. (2011) Bone Quality Assessment for Dental Implants, Implant Dentistry – The Most Promising Discipline of Dentistry. Link: http://cdn.intechopen.com/pdfs/21562/InTech-Bone_quality_assessment_for_dental_implants.pdf. [Last accessed: 20.06.18].

Author:

Mr Luc Trevisan is a biomedical engineer. He has been the TBR  Development Director since 2007

We are a nation that loves our homes so it comes as no surprise that many Britons obsess over home improvements. Unlike other countries, we in the UK tend to preserve houses rather than demolish them and as such, have retained one of the oldest stock of residences in the world. According to the latest English Housing Survey, approximately three quarters of homes are over 50 years old.[i]Zoopla has also revealed that Britons are moving house less frequently than they were several decades ago, which may be as a result of the current economic climate.[ii]

In areas where house prices are rising quickly, finding and buying the ideal home in the same local neighbourhood is proving difficult for many. If the rise in the value of a home is greater than the cost of improving it, then it makes sense that people are holding ownership of properties for longer periods of time, with the prospect of improving it being rather more appealing.

As you would expect, renovating your home can prove costly so there is an inevitable link between average earnings and the level of home improvements carried out in some areas across the UK. According to the Office for National Statistics (ONS), the top 20% of households on the income scale have spent approximately 14 times the amount on home improvements over the last 5 years, in comparison to the bottom 20%.[iii]Equally, in places where planning permission to build a new home is more difficult to obtain, homeowners are choosing to improve their residences rather than invest in an expensive, new property. 

Britain’s love affair with renovating homes can be largely credited to the fact that we are heavily influenced by home repair, maintenance and improvement programmes on TV – as well as our easy access to supplies via online marketplaces.[iv]While some people would prefer to employ an expert to carry out any improvements in their home, others choose to adopt the do-it-yourself approach to cut costs on large-scale work. This ambitious attitude can prove beneficial to some, but to many DIY enthusiasts, there is a heavy price to pay if something goes wrong.

Close to £3,000 has been touted as the average amount spent on hiring an expert to fix mistakes, emphasising the importance of seeking out a professional who has the expertise and skillset to effectively carry out home improvement work that is right first time.[v]This not only applies to homeowners but also to dental practice owners who may be interested in upgrading their surgeries.

The stress of redeveloping a dental practice can be overbearing if it is not planned well and there are various elements that need to be considered if the project is to be completed successfully. Equipment and supplies need to be sourced, budgets must be outlined and reliable contract workers should be sought out to finish work within the proposed timeframe. Indeed, practice owners must also ensure that any renovations made adhere to stringent CQC and HTM 01-05 regulations. If these considerations are not well met, then the project could be compromised and additional costs may well be incurred as a result – which adds more stress to an already demanding endeavour.

It may be far wiser to employ the services of a professional design company who has experience with large-scale dental practice refurbishments. This will give you greater peace of mind that there is somebody else you can rely on to complete the project to the highest standards. You will likely want your practice to reflect the personality and quality of your business as a brand, so perhaps look to hire a company that can understand the vision you have of the practice. They will then be able to translate this through the overall design of the surgery, helping to effectively distinguish you from competitors.

Only the best companies will be committed to working closely with you in order to ensure that the final result resembles what you originally envisioned the practice to look like. This begins with creating a detailed plan using computer-aided design (CAD) technology with 2D and 3D capabilities. You would then be able to walk through a guided virtual reality (VR) ‘tour’ of the design, helping to provide a real sense of the finished renovation. At these initial stages of planning, you can make any alterations you wish so when contractors come to start work, they will have an accurate blueprint to follow. With over 40 years’ experience in the dental industry, Clark Dental is a prime example of a company that works tirelessly to provide a superior surgery design service.

Similarly to how a home reflects an individual’s style, your dental practice is an extension of your professional persona. By working with a dependable team of designers, practitioners can rest assured knowing they can attain a sophisticated surgery that is fit to meet the demands of modern dentistry.

For more information call Clark Dental on 01268 733 146, email info@clarkdental.co.ukor visit www.clarkdental.co.uk

[i]Gov.uk. (2018) English Housing Survey 2016 to 2017: headline report. Link: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/675942/2016-17_EHS_Headline_Report.pdf. [Last accessed: 22.03.18].

[ii]White, D. (2017) How often do we move house in Britain? Link: https://www.zoopla.co.uk/discover/property-news/how-often-do-we-move-house-in-britain/#vWKOkuWkP1v0SYAf.97. [Last accessed: 22.03.18].

[iii]Office for National Statistics. (2015) Chapter 2: Housing expenditure. Link: https://www.ons.gov.uk/peoplepopulationandcommunity/personalandhouseholdfinances/incomeandwealth/compendium/familyspending/2015/chapter2housingexpenditure#housing-expenditure-by-socio-demographic-characteristics. [Last accessed: 22.03.18].

[iv]GS1 UK. (2017) Home improvement businesses take advantage of positive trading conditions. Link: https://www.gs1uk.org/our-industries/news/2017/09/06/home-improvement-businesses-take-advantage-of-positive-trading-conditions. [Last accessed: 22.03.18].

[v]Towergate Insurance. (Unknown) Brits spend £3,000 hiring professionals to fix DIY mistakes. Link: https://www.towergateinsurance.co.uk/home-property/brits-spend-hiring-professionals-diy-disasters. [Last accessed: 22.03.18].

I’m sure many of you would agree that this year seems to have flown by – we are already well into the autumn months and the Oral Health Conference and Exhibition (OHC) 2018 is almost upon us!

We are very excited to present another outstanding speaker line-up this year, which will feature some of the leading lights in dentistry, including:

• Irfan Abas
• Jan Baxendale
• Kara Gray-Burrows
• Christina Chatfield
• Bhupinder Dawett
• Faye Donald
• StJohn Crean
• Peter Galut
• Marina Harris
• Sara Hurley
• Tim Ives
• Hayley Lawrence
• Claire McCarthy
• John Milne
• Amit Patel
• Debbie Reed
• Mish Sachdev
• Fiona Sandom
• Nik Sethi
• Harry Singh
• Janet Tarasofsky
• Charlotte Thompson
• Jenny Owen
• Phil Ower
• Barry Oulton
• Karren Walker
• Angus Walls

Speaker Nik Sethi commented:

“I think the BSDHT is an absolutely fantastic organisation that provides an incredible platform for dental hygienists and dental therapists to learn, socialise and develop excellent relationships with the trade.”

With expertise in a wide range of areas, the speakers will be covering a huge spectrum of relevant and interesting topics. Whether you are looking to develop your skills in periodontal therapy, improve your injection technique, move into the field of facial aesthetics or update your knowledge with regards to detecting oral cancer, there will be something for you. In addition, any dental hygienists or dental therapists looking for non-clinical advice and guidance will not be left disappointed. You will have a chance to discover the benefits and challenges of setting up your own practice, to enhance your communication skills, ensure CQC compliance and find new postgraduate training courses to suit you.

The trade floor will complement the education on offer with further information and live demonstrations of the very latest products, technologies and materials. A variety of manufacturers and suppliers from across the dental profession will attend, providing further insight into the innovations discussed in lectures, and launching brand new solutions.

But that won’t be all the OHC 2018 offers. It will also be the perfect place to network with like-minded professionals who share a passion for excellent patient care. Catch up with old friends and colleagues and meet new people to renew your enthusiasm and gain inspiration to be the very best you can be. You might even find a mentor or be able to help guide a colleague through the next stage in their career.

Other opportunities to build on your reputation within the profession will be available through the Annual Poster Competition, sponsored by Waterpik. Successful applicants will have their entries judged by a specialist panel and the winners celebrated for their hard work and commitment to dentistry. The Student of the Year Award will also be announced and the evening dinner and dance will be the ideal place to relax and have fun with friends.

Feedback from delegates at the 2017 event included:

“Just a fantastic event. Amazing passionate speakers. Informative, excellent trade stands, I cannot fault anything. Thoroughly enjoyed the event and learn something new every time.”

“Fantastic opportunity for networking and the programme is superb. It is ideally tailored to our needs as dental hygienists and dental therapists and the CPD is of an exceptionally high standard, with fascinating lectures. It has a fantastic buzz.”

“The OHC has always offered a positive experience, both on an educational and social basis. It’s a fabulous weekend.”

“Being a dental hygienist can sometimes be a bit isolating, but the OHC is a great place to meet people – everyone is very friendly! There is also a wide range of subjects covered for brilliant CPD.”

Both BSDHT members and non-members are more than welcome, and booking is still available online for discounted prices (tickets will be available onsite too). To make sure you don’t miss out, book your place today!

Phil Ower concludes:

“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!”

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

Cardiovascular diseases (CVDs) are still the leading cause of death around the globe. They account for approximately 31 per cent of deaths worldwide – that’s around 17.7 million people every year.[1]

The saddest part of this is that many CVDs are preventable with some simple lifestyle changes. The main risk factors are unhealthy diet, lack of physical activity, tobacco use and alcohol abuse, as well as the effects of behavioural factors that cause raised blood pressure, raised blood glucose and obesity.[2] Here’s a snapshot of some of the evidence in the area..

Diet

A review paper[3]has suggested that the ideal diet to reduce risk of CVDs should focus on whole grains, fruits and vegetables, legumes, nuts, fish and poultry, with moderate dairy intake and a low amount of refined grains, added sugars and trans-fat, as well as red and processed meat. Traditional Mediterranean diets seem to be the best for heart health.

Exercise

The association between exercise and CVD risk has been established for some time. The literature supports a dose-response relationship between physical activity and CVD morbidity and mortality – more exercise, lower CVD risk – although it is unknown whether a threshold exists at which activity levels convey greater risk.[4]Regular exercise can have a major effect on several other risk factors for CVD as well – it helps to reduce body weight, blood pressure and bad cholesterol, while also increasing insulin sensitivity.[5]

Tobacco

Cigarette smoking has been established as a cause of various CVDs, including coronary heart disease, cerebrovascular disease (stroke), peripheral artery disease and abdominal aortic aneurysm. Smokers are also at double the risk of heart failure compared to non-smokers, plus, smoking tobacco can both induce and worsen serious cardiac arrhythmias.[6]Worryingly, even second-hand smoke can increase a person’s risk of CVDs,[7]although the risk is rapidly reversible.

Alcohol

A J-shaped relationship has been identified between alcohol consumption and CVDs, with an 86.3 per cent lower risk of CVDs observed in moderate drinkers thought to be due to alcohol’s effect on lipids, glucose, metabolism, inflammatory factors and blood pressure.[8]The term ‘moderate drinking’ still requires some clarification, though, as a 2017 study found those who drank less than 14 units a week actually had a lower risk of some – but not all – heart conditions.[9]While good news for those who enjoy the occasional glass of wine or beer, caution should certainly be taken as the risks of alcohol consumption still far outweigh the possible benefits.

Dental and heart health

As dental professionals, we are aware of the associations between dental and heart health. The link between periodontal disease and CVDs, in particular, has been the focus of research.There is some evidence to suggest that C-reactive protein is an inflammatory marker that can help to predict the risk of CVDs, but more studies are needed to confirm a casual relationship.[10]^,[11]In addition, a high dental calculus score has been associated with a higher incidence of angina,[12]so it seems that good oral hygiene remains crucial, regardless of the mechanisms by which CVDs and dental health are related.

Prevention

Prevention is always better than cure, so ensuring that patients are aware of the dangers and encouraging them to reduce potential risk factors is important. One study supported the idea that risk factors for CVDs can develop during childhood due to both genetic and environmental factors.[13]This further emphasises the need to educate people from a very early age for lower risks later on in life.

All members of the dental team can and should be involved with oral health education and making patients aware of the links between dental and systemic health. In fact, a joint effort is the only way to really get the message across effectively.

At the end of this month we celebrate World Heart Day – an event designed by the Wold Heart Federation to raise awareness of and help educate people on maintaining heart health. The campaign is asking everyone to make a promise to eat better and be healthier, and to do what we can to reduce the risk of heart conditions. Can you and your team make a promise to speak to more of your patients about the possible risk factors of CVDs? There are various useful resources available from the World Heart Foundation website including posters, social media posts, banners and leaflets, so why not make the most of them and remind your patients to look after their hearts this September?

For more information about the BSDHT, please visit www.bsdht.org.uk,

call 01788 575050 or email enquiries@bsdht.org.uk

[1]World Health Organization. Cardiovascular disease. Pub 2017. http://www.who.int/cardiovascular_diseases/en/[Accessed August 2018]

[2]World Health Organization. Cardiovascular disease. Key Facts. What are the risk factors for cardiovascular disease? http://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) [Accessed August 2018]

^[3]Anand SS, Hawkes C, de Souza RJ, et al. Food Consumption and its impact on Cardiovascular Disease: Importance of Solutions focused on the globalized food system: A Report from the Workshop convened by the World Heart Federation. Journal of the American College of Cardiology. 2015;66(14):1590-1614. doi:10.1016/j.jacc.2015.07.050

[4]Carnethon MR. Physical Activity and Cardiovascular Disease: How Much is Enough? American journal of lifestyle medicine. 2009;3(1 Suppl):44S-49S. doi:10.1177/1559827609332737

[5]Myers J. Exercise and Cardiovascular Health. Circulation. January 2003;107:e2-e5. DOI 10.161/01.CIR.0000048890.59383.8D

[6]Nancy A. Rigotti, Carole Clair; Managing tobacco use: the neglected cardiovascular disease risk factor, European Heart Journal. November 2013:(34)42; 3259–3267

[7]He J, Vupputuri S, Allen K, Prerost MR, Hughes J, Whelton PK. Passive smoking and the risk of coronary heart disease–a meta-analysis of epidemiologic studies, N Engl J Med. 1999: (340); 920-926

[8]Djoussé L, Lee I-M, Buring JE, Gaziano JM. Alcohol Consumption and Risk of Cardiovascular Disease and Mortality in Women: Potential Mediating Mechanisms. Circulation. 2009;120(3):237-244. doi:10.1161/CIRCULATIONAHA.108.832360

[9]Bell S, Daskalopoulou M, Rapsomaniki E, George J, Britton A, Bobak M, Casa JP, Dale, CE, Denaxas S, Shah AD, Hemingway H. Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records. BMJ. March 2017;356:j909https://doi.org/10.1136/bmj.j909[Accessed August 2018]

[10]Danesh J, Wheeler JG, Hirschfield GM, et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. The New England Journal of Medicine. 2004;350(14):1387–1397

[11]Mathews MJ, Mathews EH, Mathews GE. Oral health and coronary heart disease. BMC Oral HealthBMC series. 2016 (16)122https://doi.org/10.1186/s12903-016-0316-7[Accessed August 2018]

[12]Soder, B., Meurman, J. H., & Soder, P. Dental calculus links statistically to angina pectoris: a 26 year observational study. 2016. PloS ONE, 11(6): 1-8

^[13]Daniels SR, Pratt CA, Hayman LL. Reduction of Risk for Cardiovascular Disease in Children and Adolescents. Circulation. 2011;124(15):1673-1686. doi:10.1161/CIRCULATIONAHA.110.016170

As a world-renowned expert in CAD/CAM dentistry, Dr Julian Caplan utilises this technology in all aspects of day-to-day dentistry he provides for his patients. He is excited to be joining Dr Oliver Harman on stage at this year’s British Academy of Cosmetic Dentistry (BACD) Annual Conference, where they will provide professional insight on the benefits of becoming BACD Accredited.

“There are many reasons as to why it is worth going through the process of BACD Accreditation,” says Dr Caplan. “As practitioners know, the General Dental Council (GDC) is very keen on reflection following a learning programme. Reflection is one of the key aspects of BACD Accreditation, as the process involves presenting five specific cases to examiners, prompting candidates to focus their attention on a number of different treatment elements.

“These range from research-led treatment planning options and recognised treatment techniques, to organisational challenges and the practical collation of all the information into the format required by examiners. This may seem too large a hurdle to jump, but during our session at the BACD Annual Conference, Dr Harman and I will look at a range of cases and provide delegates with easy-to-follow guidelines on how to be successful.”

As a leading authority in the dental community, Dr Caplan is one of a handful of dentists in Britain who remain a member of the American Academy of Cosmetic Dentistry. He has travelled the world to attend several dental courses, learning from grandmasters of cosmetic dentistry in the USA and across Europe. Having lectured at the World Aesthetic Conference and across the globe on the benefits of CEREC dentistry, he is keen to share his knowledge on how to use revolutionary CAD/CAM technology in order to fabricate crowns and veneers in a single patient visit.

Dr Caplan lectures internationally and mentors other practitioners throughout the UK – helping them refine their skills in smile design and cosmetic dentistry. Being one of few dentists to achieve BACD Accreditation, Dr Caplan is ideally placed to offer delegates professional advice and guidance on the subject.

Speaking about his upcoming session at the BACD Annual Conference, he adds: “Delegates will gain up-to-date information on the protocols involved with Accreditation and the essential skills required in order to complete certain cases successfully. Dr Harman and I will look at how candidates should analyse faults in their work and how to complete reports correctly, especially in regards to referencing. We will also explore a range of photographic techniques that will enable examiners to accurately assess the quality of work presented.

“The key to this is to have a standard photographic protocol to help in recording initial presentation, treatment planning, presenting the proposed treatment plans to patients, communicating with dental technicians, and recording results achieved at the end of treatment. This photographic skill will have a positive effect on achieving greater patient acceptance, providing a bank of beautiful before-and-after photographs that can be used to demonstrate what is possible. Hopefully, this will motivate patients and lead to a substantial improvement in business profits.

“Motivated practitioners all aspire to reach ‘the next level’ within their careers and as part of everyday practice. BACD Accreditation is a wonderful programme that enables dentists to do this and to improve their confidence so that they are able to reach the heights of clinical excellence.”

Speaking about the BACD and its celebrated Annual Conference, Dr Caplan says: “I have been involved with the BACD for fifteen years and in that time, my peers and I have made substantial progress within clinical practice. We have also come on leaps and bounds from a business position and a management point of view – thanks to the support of the BACD community. Discussing issues we have at social events should not be underestimated as one of the most useful aspects of BACD membership. As an organisation, the Academy is very inclusive and everyone is welcome, whether they are an experienced practitioner, professor, dental student, or someone in between.

“As there are so many dental conferences held throughout the year, it can be difficult to choose which ones to attend. However, the BACD Annual Conference provides an astounding educational programme that is practical and research based, offering dentists the tools to improve patient care and extend the services that they are able to offer patients. If you want to reignite your passion for dentistry, the BACD Annual Conference helps foster a positive mental attitude for the challenges that may follow in the year ahead.”

Get involved with an exciting programme of hands-on workshops, engaging lectures, an exclusive Gala Dinner, and the chance to explore a diverse tradeshow. Visit the BACD website today to book your ticket to one of the dental calendar’s most anticipated events – you won’t want to miss out.

The BACD Fifteenth Annual Conference 2018
‘The Functional Smile: Start With Why…’
8th – 10th November 2018
Millennium Gloucester Hotel
Kensington, London

For further enquiries about the British Academy of Cosmetic Dentistry, visit www.bacd.com