Don’t miss out on the chance to join an insightful BACD Recommended Meeting held in Yorkshire this February. Renowned clinicians, Dr Julian Caplan and Dr Rahul Doshi, are delighted to be presenting lectures on “CAD/CAM technology in restorative dentistry” and “Treatment planning for functional aesthetics”. 

Delegates will have the opportunity to explore various aspects of indirect restorative dentistry, examining standard analogue techniques and comparing these to the latest CAD/CAM procedures. Practitioners will also be able to find out how they can ensure predictable and successful aesthetic outcomes – including when treatment planning for full-mouth rehabilitations.

Be sure to visit the BACD website today to secure your place.

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

As is true for every healthcare professional, dental practitioners cannot treat what they can’t see. Good visualisation of the problem presented by each patient and precise information on the existing anatomy are both essential for successful treatment, regardless of the type of dentistry required.

For dental implant therapy, diagnostic imaging has become especially important as accurate planning is vital for successful long-term outcomes. Associated technologies have therefore evolved considerably over the past decade or so, with an array of imaging systems now available that deliver the minute details needed to ensure safe, effective and predictable care for a wide range of patients.

Types of imaging

As you will know, there is a range of imaging solutions widely available on the dental market today, including panoramic, cephalometric, CT and CBCT. Every modality offers different advantages and disadvantages, with each being suitable for different cases and ideal for use at various stages during the treatment process. The decision to use one over the other, or even a combination of techniques, depends on several factors such as cost, availability, amount of and need for radiation exposure, as well as the patient’s anatomy, with the clinician always looking to minimise potential risks for the patient.[1]Assessment of each individual case and selection of the most appropriate imaging modality is therefore important for the best results.[2]

Confirming appropriate treatment

The objective of imaging – regardless of the problem suspected or type of imaging used – is to determine the most effective treatment for the patient. With regards to dental implantology, the images generated help to establish whether the patient can tolerate treatment in the first place. These images provide the information needed to select the best location for the implant(s), avoiding vital anatomical structures like nerves and the maxillary sinus. They also same images enable practitioners to identify the most appropriate implant position, angle, length and width.

Prosthetically-driven planning

Effective imaging also helps to ensure the correct position of the abutment and prosthesis, while playing a role in the monitoring of post-operative healing and on-going maintenance.[3]In fact, there has been a move towards prosthetically-driven implant treatment planning of late, whereby clinicians consider the final prosthesis position and shape first, before planning implant placement accordingly. This ensures sufficient support for the desired prosthesis and allows clinicians to deliver the ideal function and aesthetics for the patient.

CBCT

In response to the increased demands placed on dental imaging solutions, CBCT machines continue to grow in popularity. Their high accuracy and relatively low radiation dose compared to other imaging methods are believed to have contributed to their rising favour,[4]giving practitioners all the information they need to diagnose and plan implant treatment safely and predictably.

CBCT imaging makes flapless implant surgery more viable, enabling clinicians to utilise less invasive intervention with the potential benefits of shorter treatment time, improved patient comfort and preserved soft tissue profiles.[5]CBCT images are also exported as DICOM (Digital Imaging and Communication in Medicine) files, which facilitate patient identification and can be reliably reported on aid compliance with GDPR (General Data Protection Regulations).

Equipment selection

Finding the right equipment for your practice is crucial in order to ensure you have the tools you need to deliver effective implant treatment for your patients. A balance between sophisticated technology and simple user interactions will help enhance diagnostics and treatment planning while still facilitating a simple workflow for the dental team. In turn, treatment and surgery times can be optimised, patient chair time minimised and satisfaction of both patient and practitioner improved. With the latest technologies on the market, all this can be achieved without compromising the quality of imaging produced or the standard of treatment delivered.

Versatility of the equipment should also be considered according to the practice’s most common applications. For example, if you offer a variety of treatments, having the ability to easily switch between panoramic and 3D imaging could be useful.

The CS 8100 3D and CS 8100SC 3D imaging units from Carestream Dental offer this benefit. With panoramic and 3D capabilities as standard and the option of adding a cephalometric imaging module, these systems provide highly accurate scanning from all angles, with an adaptable design to suit standing and sitting patients and a compact casing to fit in any practice.

It’s clear that digital imaging has become essential for safe and predictable diagnostics and treatment planning, particularly in dental implantology. Making use of the many benefits available by investing in the right system for your practice is the first step in delivering outstanding quality of care to all your patients.

For more information please contact Carestream Dental on

0800 169 9692 or visit www.carestreamdental.co.uk

For all the latest news and updates, follow us on Twitter @CarestreamDentl and Facebook

REFERENCES 

[1]Jayadevappa BS, Kodhandarama GS, Santosh SV, Rashid WT. Imaging of dental implants. J Oral Health Res. 2010;1:50–61.

[2]Nagarajan A, Perumalsamy R, Thyagarajan R, Namasivayam A. Diagnostic Imaging for Dental Implant Therapy. Journal of Clinical Imaging Science. 2014;4(Suppl 2):4. doi:10.4103/2156-7514.143440.

[3]Gupta S, Patil N, Solanki J, Singh R, Laller S. Oral Implant Imaging: A Review. The Malaysian Journal of Medical Sciences : MJMS. 2015;22(3):7-17.

[4]Gupta J, Ali SP. Cone beam computed tomography in oral implants. National Journal of Maxillofacial Surgery. 2013;4(1):2-6. doi:10.4103/0975-5950.117811.

[5]Ravindran DM, Sudhakar U, Ramakrishnan T, Ambalavanan N. The efficacy of flapless implant surgery on soft-tissue profile comparing immediate loading implants to delayed loading implants: A comparative clinical study. Journal of Indian Society of Periodontology. 2010;14(4):245-251. doi:10.4103/0972-124X.76930.

Reporting on radiographs precisely is necessary in order to provide the best patient care. However, if there’s one significant downside to this diagnostic process it’s that it can take time and extensive training to be able to do properly – something that is often difficult to commit to for busy professionals.

Although time consuming, it’s important that professionals adhere to guidelines, as otherwise this could open them up to litigation. But have you considered referring your radiograph reports to specialist radiologists? Doing so can have a number of benefits…

 Guidelines within the EU

The standards for radiograph reporting are different throughout the world. Because of this it can be confusing for professionals to know exactly what needs to be reported on in order to protect themselves from legal liability as well as ensure that the patient receives care that is truly tailored to their needs. According to the European Society of Radiology (ESR) there is no universally accepted definition of what constitutes a good radiology report,[i]and both radiologists and those that receive the reports will often think differently about what the optimal content of a report may be.

However, one thing that is universally agreed is that a report must be accurate, cover all findingsand portray information that is pertinent to developing the best possible care plan for the patient.

The speedy route

As previously mentioned, reporting on radiographs can take considerable time. Whilst this may not be a problem for professionals who only take one or two radiographs on a regular basis, for those who take a high volume of images the associated diagnostic administration can often require time that could be spent doing other things such as helping more patients.

Referring radiography reporting removes this pressure, as often radiology specialists will be able to return reports to you in a matter of days, freeing up the time you would otherwise have spent creating the report.

Protect yourself from legal action

In recent years, the way that professionals and patients think about the law has changed considerably. Lawsuits and complaints against GPs and dental professionals have risen sharply, with numbers rising by almost ten per cent from 82,559 in 2015/16 to 90,579 in 2016/17 alone.[ii]Due to this increase it’s little surprise that professionals are afraid of legal action being taken against them. Some reports even state that 90% of dentists now fear being sued, and that 94% of dentists feel like it’s now much easier to bring on a claim of clinical negligence than ever before.[iii]

This has further effects on dental professionals as 81% of respondents claimed that knowing these facts affects the way they provide care. This makes sense considering that 42% of respondents had had a legal claim filed against them and a further 66% of them knew a colleague who had been involved in legal action too.[iv]

Therefore, it makes sense to take any steps necessary to protect yourself from possible legal action. Referring radiographic reporting to a specialist helps to abate the chances of lawsuits as you will have received an expert opinion and are therefore more likely to be able to identify any abnormalities or problems that a patient should know about.

This provides a safety net, so that if the question of legal action does arise, you will have evidence to support that you did everything in your power to provide the best level of care. At the same time you have also applied an identical and recognised workflow that is in place for the general medical fraternity.

 A streamlined solution

Referring to a specialist dental radiologist can have a number of benefits, however, finding a specialist can be easier said than done. Some reports state that there are as few as 27 fully certified specialist radiologists in the UK,[v]and therefore referring to these professionals may not be an option if you require fast turnarounds.

Created to help dentists refer radiographic reporting with ease, PROPACS from Pro Diagnostics UK is a unique online cloud image storage system that also allows professionals to send radiographs to specialist dental radiologists for reporting. These reports take only 24 hours to turnaround and provide professionals with all of the information necessary to create the best possible care plan for the patient.

Ease the pressure

Taking radiographs is a necessary part of the diagnostic process, but that doesn’t mean that reporting on them needs to slow you down. By referring your radiographic reporting to a specialist you can save time, help safeguard yourself from legal action and receive highly detailed reports that will facilitate the creation of an effective care plan for the patient.

For more information, please visit www.prodentalradiology.com or email sales@prodiagnostics.co.uk

References

[i]European Society of Radiology. Good Practice for Radiological Reporting. Guidelines from the European Society of Radiology (ESR). Insights Imaging. 2011 Apr; 2(2): 93–96.

[ii]NHS Digital. Data on Written Complaints in the NHS, 2016-2017. Link: https://digital.nhs.uk/data-and-information/publications/statistical/data-on-written-complaints-in-the-nhs/data-on-written-complaints-in-the-nhs-2016-17[Last accessed July 18].

[iii]  ALLMEDPRO. 90% of Dentists Now Fear Being Sued. Are you Sufficiently Protected? Link: https://www.allmedpro.co.uk/90-of-dentists-now-fear-being-sued-are-you-sufficiently-protected/ [Last accessed July 18].

[iv]Dental Protection. 91% of dentists believe they are more likely to be sued now than five years ago. Link: https://www.dentalprotection.org/uk/about/media-centre/press-releases-display/2015/03/13/91-of-dentists-believe-they-are-more-likely-to-be-sued-now-than-five-years-ago[Last accessed July 18].

[v]Bamgbose, B., Suwaid, M., Kaura, M., Asaumi, J., Sugianto, I., Hisatomi, M. Current Status of Oral and Maxillofacial Radiology in West Africa. Oral radiology 2017. Link: https://www.researchgate.net/publication/316339587_Current_status_of_oral_and_maxillofacial_radiology_in_West_Africa[Last accessed July 18].

In spite of efforts to the contrary, periodontal disease is thought to affect around half the world’s adult population.[i]The severe form afflicts 11% of adults, making it the sixth most prevalent disease worldwide.[ii]

Traditional efforts have been directed towards arresting the disease and repairing damage, however, by taking a more proactive preventative approach to dentistry, the incidence rate could be decreased.

The key to preventing periodontal disease is plaque control. This aids in microbial balance, which when disrupted (dysbiosis) provides the opportunity for pathogenic bacteria to reproduce in greater numbers. The consequences of this are direct damage to the periodontal pocket, and indirect damage due to an escalation of inflammation.

While there is common understanding of the cause, the consistently high incidence of periodontal disease calls for greater understanding of current preventative measures. Toothbrushing remains the first line of defence, but is limited in what areas can be reached. For interdental cleaning and the proximal surfaces of the teeth and gingivae, other devices are required. The following information comes from systematic reviews of available studies, providing an overview of existing treatments based on the evidence as currently understood.

String Floss

String floss has long been recommended but in recent years its effectiveness has been called into question. In the absence of fluoride and when carried out by professionals, dental floss can demonstrably reduce caries.[iii]However, string floss seems to be supported by little scientific research that demonstrates its effectiveness in reducing plaque and gingival inflammation.[iv]A Cochrane review supported this by finding only weak and unreliable evidence for the benefits of string floss on gingivitis.[v]

Interdental Brushes

Evidence suggests that interdental brushes, when used in addition to toothbrushing, remove more dental plaque than brushing alone. In this capacity, they appear to be superior to string floss and woodsticks (see below). However, there is insufficient evidence to conclude that they reduce gingival inflammation or bleeding. The reduction of pocket depth is more pronounced than with floss. There has been a proliferation of new designs in recent years, but as yet it has not been established if these represent a genuine improvement.[vi]It has been reported that interdental brushes with metal cores may cause dentine hypersensitivity and iatrogencic tooth damage.[vii]It is important to note that interdental brushes require that patients have sufficient interproximal spaces to accommodate them without causing trauma, and that studies have been conducted with those parameters in mind. Because of this, interdental brushes are not a universally effective treatment.

Woodsticks 

Three studies reported an improvement in gingival inflammation due to reduced bleeding scores when compared to brushing alone. However, a systematic review found woodsticks did not have an additional effect on visible interdental plaque or gingival index beyond toothbrushing alone.[viii]

Water Flosser

Water flossers see a significant reduction in gingival bleeding when compared to string floss.[ix]When used in conjunction with brushing, oral irrigation demonstrably improves gingival health over brushing alone.[x]Oral irrigators are particularly recommended for patients with orthodontic appliances or dexterity issues, due to ease of use they offer.

A Proven Model

The Waterpik^®Water Flosser, when used alongside brushing, has been proven to be significantly more effective at removing plaque than brushing and string floss.[xi]Among the models available the Waterpik^®Water Flosser has been rigorously researched, with at least 70 published articles attesting to the safety and effectiveness of the device.

Conclusions

Though traditional methods of interdental cleaning may not be as effective as could be hoped, this does not make the concept any less important. By practising effective preventative dentistry fewer patients will require costly and drastic interventions later on. While dental floss has been widely recommended and used, the majority of patients lack the technical ability required for it to be of genuine benefit. A Water Flosser provides an excellent way forward, being easy and quick to use while enjoying substantial scientific proof of its effectiveness. Furthermore, they are able to irrigate spaces that are inaccessible to methods such as woodsticks and interdental brushes. For these reasons, you can be confident in recommending a water flosser as part of your patients’ oral health regimen.

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

References

[i]Nazir M. Prevalence of periodontal disease, its association with systemic diseases and prevention. International Journal of Health Sciences. 2017; 11(2): 72-80. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5426403/Accessed June 28, 2018.

[ii]Chapple I., Van der Weijden F., Doerfer C., Herrera D., Shapira L., Polak D., Madianos P., Louropoulou A., Machtei E., Donos N., Greenwell H., Van Winkelhoff A., Eren Kuru B., Arweiler N., Teughels W., Aimetti M., Molina A., Montero E., Graziani F. Primary prevention of periodontitis: managing gingivitis.  Journal of Clinical Periodontology. 2015; 42(Suppl. 16): 71-76. Available at https://onlinelibrary.wiley.com/doi/pdf/10.1111/jcpe.12366Accessed June 28, 2018.

[iii]Hujoel P., Cunha-Cruz J., Banting D., Loesche W. Dental flossing and interproximal caries: a systematic review.  Critical Reviews in Oral Biology & Medicine. 2006; 85(4): 298-305. Available at https://www.researchgate.net/publication/7210859_Dental_Flossing_and_Interproximal_Caries_a_Systematic_ReviewAccessed June 28, 2018.

[iv]Berchier CE, Slot DE, Haps S, Van der Weijden GA. The efficacy of dental floss in addition to a toothbrush on plaque and parameters of gingival inflammation: a systemic review. Int J Dent Hyg. 2008 Nov;6(4):265-79. doi: 10.1111/j.1601-5037.2008.00336.x.

[v]Sambunjak D, Nickerson JW, Poklepovic T, Johnson TM, Imai P, Tugwell P, Worthington HV. Flossing for the management of periodontal diseases and dental caries in adults. Cochrane Database Syst Rev. 2011 Dec 7;(12):CD008829. doi: 10.1002/14651858.CD008829.pub2.

[vi]Slot D., Dörfer C., Van der Weijden G. The efficacy of interdental brushes on plaque and parameters of periodontal inflammation: a systematic review. International Journal of Dental Hygiene. 2008; 6(4): 253-264. Available at https://onlinelibrary.wiley.com/doi/full/10.1111/j.1601-5037.2008.00330.xAccessed June 28, 2018.

[vii]Ay Z. Interdental hygiene devices for periodontal health. JSM Dentistry. 2016; 4(4): 1071. Available at https://www.jscimedcentral.com/Dentistry/dentistry-4-1071.pdfAccessed June 28, 2018.

[viii]Hoenderdos N., Slot D., Paraskevas S., Van der Weijden G. The efficacy of woodsticks on plaque and gingival inflammation: a systematic review. The International Journal of Dental Hygiene. 2008; 6(4): 280-289. Available at https://www.ncbi.nlm.nih.gov/pubmed/19138179Accessed June 28, 2018.

[ix]Nanning A., Rosema M., Hennequin-Hoenderdos N., Berchier C., Slot D., Lyle D., Van der Weijden, G. The effects of different interdental cleaning devices on gingival bleeding. Journal of the International Academy of Periodontology.2011; 13(1): 2-10. Available at https://www.ncbi.nlm.nih.gov/pubmed/21387981Accessed June 28, 2018.

[x]Salzer S., Slot D., Van der Weijden F., Dorfer C. Efficacy of inter-dental – mechanical plaque control in managing gingivitis – a meta-review. Journal of Clinical Periodontology. 2015; 42(Suppl. 16): S92–S105. Available at https://onlinelibrary.wiley.com/doi/pdf/10.1111/jcpe.12363Accessed June 28, 2018.

[xi]Goyal C., Lyle D., Qaqish J., Schuller R. Evaluation of the plaque removal efficacy of a water flosser compared to string floss in adults after a single use. Journal of Clinical Dentistry. 2013; 24(2): 37-42. Available at https://www.ncbi.nlm.nih.gov/pubmed/24282867Accessed June 28, 2018.

Tooth loss is often associated with advanced age, but as most dentists know, elderly patients are not the only ones to suffer. The condition can affect anyone of any age, as George Washington proved when he began losing teeth in his early 20s as a result of illness, an unhealthy diet, and poor dental hygiene. Unsurprisingly, he was embarrassed by the state of his teeth, so much so that he kept it a closely guarded secret and entrusted a French dentist to help restore oral function through the use of dentures.[i]Washington’s troubles with tooth loss are not too dissimilar to the challenges that some young edentate patients face today, who may have lost teeth – not necessarily through neglect – but as a result of other reasons such as birth defects or dental trauma.

For many of these patients, partial or complete removable dentures remain the most accessible solution to restoring missing teeth. People are able to eat, speak, and smile normally, and advances in treatment have meant that it is nearly impossible to tell if someone is wearing dentures. However, despite these advantages, there is still a social stigma surrounding their use – especially in younger patients, who may remember their grandparents having to take dentures out of their mouth to adjust them, or put them in a glass of water overnight. Understandably, these are not the images that most young patients want to be associated with and for some, having to adjust to wearing dentures is a difficult and humiliating process that can exacerbate their insecurities.

Ill-fitting solutions often add to frustrations, as they can be uncomfortable to wear and can fall out while talking or chewing. If the denture consistently rubs against the patient’s gums, it can cause sore spots which could become infected if left untreated.[ii]Similarly to natural teeth, dentures must be cleaned regularly to remove trapped food and prevent the build up of bacterial plaque, which increases the risk of periodontal disease.[iii]Although well-made appliances are very durable and meticulous care can extend their life, dentures will need to be replaced every few years, particularly if they become loose and show signs of significant wear.

Besides these issues, some denture wearers have to contend with more serious complications. Patients with partial dentures, for example, risk the adjacent natural teeth gradually weakening in an effort to support the appliance. Bone resorption is also a major concern that immediately occurs in the jawbone following tooth extraction, as dentures are unable to stimulate the bone in the same way a natural tooth would. Within just a few months of wearing a denture, a patient’s jawbone structure will have drastically deteriorated.[iv]Over time, patients will begin to notice that their denture does not fit or function as well as it did when it was first fitted. Bone loss can eventually become so severe that some patients are unable to retain a denture and many of their facial features can sink, making them appear older.

This can detrimentally impact an individual’s self-confidence and overall quality of life, especially as many young patients place great importance on their appearance. Thankfully, modern dental implants can offer an effective solution to tooth loss victims, reducing the risk of problems traditionally associated with denture appliances. For instance, bone resorption can be minimised, as implants are designed to imitate the function of a natural tooth, stimulating the jawbone to ensure long-term stability of the implant component and prosthesis. In the event of successful osseointegration, implants have the potential to last a lifetime, so long as patients follow a consistent maintenance programme. This includes good at-home oral care and regular visits to the dentist for examinations and professional cleanings.

Although dental implants can be more costly and require surgery to be placed, they can offer visually superior results to dentures. In fact, the most effective implant systems deliver excellent function and are indistinguishable from the adjacent natural teeth. TBR’s Z1 implant system, for example, can be placed in both posterior and anterior regions. It combines the biocompatible properties of titanium and zirconia in one seamless component, which is clinically proven to radically reduce bacterial colonisation. This protects both the crestal bone and the gingiva from the risk of iatrogenic inflammation or infection, thereby encouraging the tissue to heal around the implant in a way that mimics natural gingival growth.[v]Consequently, patients are able to achieve a highly aesthetic and functional outcome that surpasses that of conventional dentures.

Although they will continue to be an essential part of clinical practice, dentures may not always deliver the most desirable results to partially or completely edentulous patients looking for a more comfortable and permanent solution. Dental implants could be the answer in this case, but it is important for practitioners to utilise tried-and-tested products that will ensure patients are able to smile with confidence for many years to come.

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

[i]Mount Vernon. (2018) The Trouble with Teeth. Link: https://www.mountvernon.org/george-washington/the-man-the-myth/the-trouble-with-teeth/. [Last accessed: 11.09.18].

[ii]Ellakwa, A. (2012) Damage Caused by Removable Partial Dentures: Reality? Dentistry 1: e107. doi: 10.4172/2161-1122.1000e107.

[iii]Dula, L. J., Shala, K. S., Pustina-Krasniqi, T., Bicaj, T. and Ahmedi, E. F. (2015) The influence of removable partial dentures on the periodontal health of abutment and non-abutment teeth. European Journal of Dentistry. 9(3): 382-386. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4569990/. [Last accessed: 11.09.18].

[iv]Knezović-Zlatarić, D., Čelebić, A. and Lazić, B. (2002) Resorptive Changes of Maxillary and Mandibular Bone Structures in Removable Denture Wearers. Acta Stomat Croat. 261-265. Link: https://hrcak.srce.hr/file/6144. [Last accessed: 11.09.18].

[v]Bianchi, A. E., Bosetti, M., Dolci, G. Jr., Sberna, M. T., Sanfilippo, S. and Cannas, M. (2004) In vitro and in vivo follow-up of titanium transmucosal implants with a zirconia collar. Journal of Applied Biomaterials and Functional Materials. 2(3): 143-150. Link: https://www.ncbi.nlm.nih.gov/pubmed/20803431. [Last accessed: 11.09.18].

Innovation, evolution and revolution… whatever your specialty, dentistry is an exciting place to be. Trailblazing technology, ingenious techniques and groundbreaking new materials have helped us find successful, stable solutions to problems that would have seemed impossible in the not-so-distant past. The future looks bright too, as research, product development and quality education is set to continue, taking the profession from strength to strength.

As practitioners, you will be constantly inspired by the sheer scope of possibility in dentistry today. There’s always more that can be done. But it is essential that you never stop looking from the outside in and from the unique perspectives of your patients. With their sleek interiors and extensive menus of treatment options to improve oral health, function and aesthetics, many modern practices have an almost spa-like appearance. But the fact remains that few people actually enjoy going to the dentist.

Dental anxiety is a constant challenge and something that most practitioners will encounter every day. Its impact must never be overlooked. The last Adult Dental Health Survey included statistics on dental anxiety for the first time (it was not assessed in previous versions of the Survey). The Modified Dental Anxiety Scale (MDAS) was the tool used to ascertain levels of anxiety. The MDAS asked people to report on fears associated with anaesthesia, as well as anticipated anxiety in four common scenarios; going to the dentist tomorrow, sitting in a dentist’s waiting room, having a tooth drilled and having a scale and polish.[i]It found that 36 per cent of the adults questioned had a MDAS score between 10 and 18, indicating moderate anxiety, and a further 12 per cent scored 19 or over, indicating extreme dental anxiety.

So, a third of adults reported moderate anxiety; this is an important point and underlines the complexity of the issue. There are different triggers and levels of fear; someone who does not normally get afraid may suddenly feel their bravado vanish if they are told they need endodontic treatment or restorative work. Many patients will have past experiences that instinctively come to the fore if they find themselves facing a process that they believe will be invasive and/or painful. The sound of the drill, the uncomfortable chair and being leaned over by a masked dentist in unsettlingly close proximity – modern spa-like practices don’t stand a chance against powerful memories.

Moderate dental anxiety is a reason to delay or cancel an appointment, or leave the practice without committing to treatment. It’s never going away, either, which is why the profession must endeavourto understand it and look for ways to make every patient’s experience as comfortable and positive as possible.

Where to start? Good communication is essential. This should begin from the minute a patient walks into (or calls up) the practice; every individual should be treated with respect and empathy. All staff must be able to talk with authority and listen carefully, and if they are unable to answer a question, they should refer the patient promptly to someone who can.

It’s about reassuring someone that if they say “yes”, nothing bad is going to happen. In fact, the treatment that you are recommending is the gateway to better oral and general health, and often mental wellbeing too. Being able to restore the integrity of a tooth that is damaged or missing will not only improve mechanical function, but also revive self-esteem. As practitioners, you can allay anxiety by helping patients fully understand the procedure, assure them of your competence and address any concerns so they feel informed, involved and empowered. You can also reassure them that you are committed to using the very best materials designed to allow you to perform these treatments effectively, efficiently and ethically. For example, resin composites have allowed clinicians to place aesthetically pleasing and conservative restorations. COLTENE provides restorative materials that are easy to use and provide a quick, stable treatment process for the anxious patient. The range includes the BRILLIANT EverGlow^® for anterior and posterior restorations, and Fill-Up!^™dual curing bulk fill composite for Class I and Class II cavities.Practitioners need full confidence in their materials giving them a high-quality result; satisfied patients are a practice’s most powerful marketing tool.   

Despite the fantastic developments in dentistry, it’s important to remember that the more things change, the more they stay the same. Many patients will be fearful or anxious, which means that they may say “no” to treatment that could change their life for the better. The profession won’t ever cure dental anxiety, but it can put together the right elements to encourage patients to accept recommendations and give them a positive experience. Exceptional dentistry is based on a foundation of communication, with every patient trusting you to use your skills and experience alongside the very best products for consistently high-quality, long-lasting results.

To find out more visit www.coltene.com, email info.uk@coltene.comor call  01444 235486

[i]Adult Dental Health Survey 2009. The Health and Social Care Information Centre, 2011. Theme 8, Barriers and Access to Care. Link: https://files.digital.nhs.uk/publicationimport/pub01xxx/pub01086/adul-dent-heal-surv-summ-them-the8-2009-re10.pdf(accessed July 2018).

It goes without saying that the cost of running a dental practice has rocketed in recent years, to the point where many are now starting to feel the pinch. Inflation is partly to blame for rising prices, of course, with practices generally experiencing higher expenditure than ever before from utility bills like water and electricity to the cost of everyday materials and consumables.

The falling value of the pound due to present economic circumstances and ongoing Brexit negotiations has had a profound effect on practice owners’ pockets too. Together with a poor exchange rate and the fact that as much as 50% of the products used in the UK are currently manufactured and imported from Europe and America, practices are finding it more difficult to turn a profit.

The pressure is likely worse felt by NHS practices that are unable to increase their prices to make up for the rising costs, but ultimately everyone is in the same boat. The question is what can be done about it? As far as staffing and utility costs are concerned, there’s unfortunately not a lot that you can do to change your monthly bill, but if you’re savvy there are a few savings you could make elsewhere. Even if your finances haven’t been affected by the current climate, it doesn’t hurt to revisit your budgeting every now and again. After all, the more you save, the more you have in the kitty!

If you’re guilty of over ordering and over stocking the store cupboard, then the first place you can roll back the pounds is your dental supplies order. Excess stock is essentially money sat on a shelf doing nothing when it could be in the bank or being put to better use. By being shrewder with your ordering and cutting back on what you have lying around you could save yourself a small fortune – not to mention that you free up some storage for when you come across a bargain! The other thing is to shop around. There are so many deals and discounts available from various distributors on consumables, sundries, materials, small equipment and tools, that it makes sense to search for the best possible deal rather than pay full whack.

There is also a chance that you might be able to save a few pounds on your marketing budget, as there are now a number of ways to reach out without spending a fortune. Social media platforms such as Facebook, Twitter and Instagram where you can post videos, links, images and interesting copy, for instance, can be hugely effective at helping you to grab patients’ attention and provide regular updates. Plus, they’re all completely free to sign up to and use, so you’ve got nothing to lose! You could also make use of E-shots and E-newsletters to notify patients about treatment offers and new services available, which could, in turn, help fill your appointment book and boost your profits.

On top of that, take care to get the best prices on your internet, phone package and IT system so that you’re not overpaying. Costs might be rising, but there are still good deals to be had! That being said, sometimes you have to spend money to make money, so also be prepared to put your hand in your pocket. Gaining a new qualification or taking on a specialist, for example, will cost you initially, but if you are able to use that investment to entice patients to the practice then in the long run it will make you money.

The same goes for your equipment. Unless you purchase quality made, reliable equipment that will stand the test of time, you will end up having to replace every couple of years. This will cost you far more in the long run than if you had just spent that little bit extra initially, so if you can it’s always best to dig that little bit deeper. For sturdy, durable dental cabinetry with a reputation for performance, functionality and aesthetics, RPA Dental recommends Tavom. There are a number of cabinets available within the line, including the Alnair, Caryn, Quasar and Skyline compositions; all of which have been built to withstand the pressures of the dental practice and provide dentists with a long-lasting solution that they can trust.

Running a dental practice is an expensive business, now more so than ever, but with savvy spending and smart investments that will save you money in the long-term, you can make every penny count.

RPA Dental Equipment Ltd.

Visit us at www.rpadental.net

London and Manchester Sales and Service Centres call 08000 933 975

“Our practice was keen to work with W&H based on its reputation for quality products and the availability of the team’s support,” says Dr Greig McLean. 

“We invested in the Elcomed, the Implantmed and the Piezomed surgical units – all of which are reliable and easy for dental nursing staff to maintain. Not only are they also comfortable to operate and perform consistently well, they are also straightforward to move between surgeries and complement the unique aesthetic of our practice.

“I have no regrets in investing in W&H products and I’m delighted to have the team’s years of expertise behind me when operating on patients.”

To find out more visit www.wh.com/en_uk, call 01727 874990 or email office.uk@wh.com

“Since introducing Pastelli uniforms in the practice last year, we’ve had a huge response from patients,” says Fabio Bevilacqua. “It’s made a huge difference to our image and patients’ perception of the quality of service we provide.”

Fabio is Director and Clinical Dental Technician of ItalDent Dental Centre in Basingstoke.

“I knew Pastelli from before when I still lived in Italy so when I discovered that RPA Dental were UK distributors I was over the moon. I love the quality and luxurious feel of the material and contemporary, sophisticated nature of the garment. Plus, as an Italian I feel that it helps add to the identity of the practice.

“Now, the whole team has tunics from the Beirut collection with a mandarin collar design in either white or blue and grey or white trousers complete with the practice’s logo, which I designed myself. They look outstanding!

“I would definitely recommend to other practices.”

To see how RPA Dental can transform your dental practice, please call

0800 0933 975, visit the website www.dental-equipment.co.uk or

email jo@rpadental.net

Dr Emma-Louise Colvin shares her insight on the BACD Recommended Meeting she attended in Edinburgh recently:

“I was motivated to join this session based on my interest in developing current skills within composite placement and minimally invasive dentistry.

“Both the speakers at the meeting demonstrated how to apply specific techniques in a clear and direct way, which was supported by clinical evidence. The speakers were supportive, engaging and their enthusiasm was particularly inspiring. It was evident that they worked very well together and they have completely changed the way I will provide anterior and posterior composites in the future.

“I have always adopted the ‘less is more’ approach with anterior work which was fully supported in this meeting. I now have the evidence-based skills to produce beautiful aesthetics that are durable and are a tooth protective alternative to crowns. The techniques showcased by the speakers at the BACD Recommended Meeting have motivated me to adopt them within my own practice because they enable me to deliver the best results for my patients. I’m genuinely excited to do this, which is such a joy 20 years into the profession.

“I have already advised other colleagues to take part in BACD Recommended Meetings. They are a no brainer for busy dentists and a brilliant way to learn new skills so as to advance within your career. I had an excellent day at the session in Edinburgh.”

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