The field of facial aesthetics is showing no signs of slowing as society continues to place high value on appearance and the positive affect improvements can have on confidence and self-esteem. Dental professionals are ideally placed to provide such treatments in a safe environment and many are looking to capitalise on the opportunity to expand services from their practices.

Whether you are just starting out in the field, or you have found it challenging in the past, seeking expert advice and guidance from practitioners who have made it work can prove invaluable. This is why Dr Harry Singh – founder of the Botulinum Toxin Club, a facial aesthetics professional teaching academy – is keen to share his ideas and experience within the field of facial aesthetics at the British Dental Conference and Dentistry Show 2019. About his presentation “How to add an extra £120,000 annual income from facial aesthetics” in the Facial Aesthetics Theatre, he says:

“Many dental professionals undertake the necessary clinical training but struggle to get enough patients through the door to support their facial aesthetic offerings in the long-term. This lack of patient interest can lead to a loss of confidence for professionals and quickly put a stop to facial aesthetic services. This is a shame as there is definitely enough appetite out there to not only sustain a business, but allow it to truly thrive.

“I hope that my session at the British Dental Conference and Dentistry Show 2019 will unlock the potential of facial aesthetics in delegates’ dental practices. I will share the tried and tested strategies that I implemented in order to build my facial aesthetics business – ultimately, they enabled me to give up dentistry and focus solely on facial aesthetics, so I know they work.

“Delegates will discover that any business success relies on the three concepts of attraction, conversion and retention of patients. If you can master all three, you’ll be able to turbo boost your profits from facial aesthetics. The same concepts can be utilised in your dental business too.

“I believe that more and more of your dental patients will be requesting facial aesthetic services in 2019, especially if you market effectively. It all comes down to one important question: do you want their business or will your competition get them? My sessions will offer simple strategies to implement immediately and offer a massive return on your time spent at the show.”

The British Dental Conference and Dentistry Show 2019 will offer a wealth of information and advice on various other topics of relevance to modern dental professionals. Lecture programmes will be dedicated to orthodontics, periodontology and dental implants, with the main theatres tailored to each member of the dental team to ensure something for everyone. In addition, the trade floor will host more than 400 exhibitors, enabling delegates to discover the latest products and innovations while networking with friends and colleagues.

“The British Dental Conference and Dentistry Show 2018 was excellent and I’d expect 2019 to be no different,” adds Dr Singh. “There is no other conference that has such a wide and varied array of topics and world-class speakers. It is the one-stop experience for all dental professionals.” 

The British Dental Conference and Dentistry Show 2019 will be held on Friday 17^thand Saturday 18^thMay at the Birmingham NEC, co-located with DTS.

For further details visit www.thedentistryshow.co.uk, call 020 7348 5270

or email dentistry@closerstillmedia.com

Some patients are unsuitable for conventional implant treatment in the edentulous maxilla due to insufficient bone to provide sound anchorage. This can be due to factors such as advanced bone resorption, atrophy of the alveolar ridge, or extensive maxillary sinuses. While for many patients, bone grafts are employed in order to provide the necessary foundation into which implants can then be placed, this is not suited to everyone.

Although the number of patients suffering from a fully edentulous maxilla today may be lower than in the past, when the condition does manifest even experienced clinicians can face serious challenges in successfully rehabilitating the patient. Autogenous bone grafts are often seen as the current gold standard, but they are not without their drawbacks, including donor site morbidity, unpredictable resorption and the potential lack of available volume. Meanwhile, extraorally sourced bone grafts have been associated with increased risks of morbidity and complications.[1]

While bone graft procedures do generally afford a high rate of success, there now exists an alternative for patients who are contraindicated for, or wish to avoid, bone grafting – zygomatic implants.

What is a zygomatic implant?

Instead of attempting to rebuild the necessary bone structure, zygomatic implants bypass this need entirely. Zygomatic implants have been in use for around two decades now, with an impressive track record. A systematic review of over two dozen studies reported a 100% success rate, with an implant survival rate of 98% after three years.[2]Many implant failures are caused by weaknesses in this area, with a 5 year analysis reporting that 35% of all implant failures occurred in porous trabecular bone due to its thin cortex, likewise immature bone grafts have been found to increase failure rates.[3]Rather than using the comparatively delicate tissue found in the roof of the mouth, zygomatic implants utilise longer screws to access the zygom,a which provides a firm foundation (though typically four cortical portions are required due to the specific microarchitecture of the region rather than one or two as with conventional implants).[4]Because the procedure is graftless, only a single surgical procedure under local anaesthetic is required, which may be particularly desirable for certain patients.

Contraindications for sinus bone grafts

The main contraindications for sinus bone grafts are:

• Alcoholism
• Heavy smoking
• Acute or chronic maxillary sinusitis
• Recent radiotherapy in the maxilla
• An uncontrolled systemic disease such as diabetes mellitus
• Psychosis
• Oroantral fistula
• A tumour in the maxillary sinus.[5]

The presence of an antral pseudocyst was previously considered an absolute contraindication for a sinus lift procedure, with additional surgery recommended to remove the cyst prior to attempting a sinus lift. That said, more recent reports suggest that sinus lifts can still be preformed in the presence of pseudocysts, though larger lesions increase the risk of complications. A pseudocyst reduces the size of the maxillary antrum, which can lead to blockages and can provoke the development of sinusitis. It is also possible that a pseudocyst may leak into the grafted area, which can result in infection and cause the graft to fail.[6]

Previous failed bone grafts may also make subsequent attempts more difficult or indicate an underlying problem.

Which patients benefit most from zygomatic implants?

The main beneficiaries of zygomatic implants are patients with:

• Severe resorption of the maxilla
• Total edentulism, especially if coupled with reduced bone height
• Pneumatisation of the maxillary sinus.[7]

For edentate patients with extremely severe resorption of the anterior maxilla, it is possible to combine this technique with a bone graft. The dimensions of the graft in this case can be smaller than would be required with the more common approach.⁷

Due to the reduced treatment time and preoperative risk of zygomatic implant placement compared to traditional bone grafting methods, it may be an option for older patients and those with significant general health problems.⁷

Referring patients for the best outcomes

 Zygomatic implants have several advantages over conventional graft-based procedures and for some patients, they are the optimal or only realistic treatment modality. If you feel that your patient may benefit from this treatment but are unsure or unable to offer it yourself, referring them to a practice you can trust is highly desirable. BPI Dental has the expertise to work with you on challenging cases where the patient may otherwise be left without a stable or long-term solution. Dr Boota Ubhi brings a wealth of training and experience to his consultations on zygomatic implants and enjoys an outstanding success rate.

Quality dental referrals help ensure the very best outcomes for patients and reflect well on your own practice – with BPI Dental your patients will receive excellent care, no matter how challenging the case.

For more information on the referral service available from Birmingham Periodontal & Implant (BPI) Dental, visit www.bpidental.co.uk, call 0121 427 3210 or email info@bpidental.co.uk

REFERENCES

[1]Jensen A., Jensen S., Worsaae M. Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study. Oral and Maxillofacial Surgery.2016; 20(2): 115-122. DOI: 10.1007/s10006-016-0551-8. Available at https://www.ncbi.nlm.nih.gov/pubmed/26932593Accessed October 18, 2018.

[2]Goiato M., Pellizzer E., Moreno A., Gennari-Filho H., dos Santos D., Santiago J., dos Santos E. Implants in the zygomatic bone for maxillary prosthetic rehabilitation: a systematic review. International Journal of Oral Maxillofacial Surgery.2014; 43(6): 748-757. DOI: 10.1016/j.ijom.2014.01.004. Available at https://www.ncbi.nlm.nih.gov/pubmed/24530034Accessed October 18, 2018.

[3]Kate M., Palaskar S., Kapoor P. Implant failure: a dentist’s nightmare. Journal of Dental Implants.2016; 6(2): 51-56. Available at http://www.jdionline.org/text.asp?2016/6/2/51/202154Accessed October 18, 2018.

[4]Sharma A., Rahul G. Zygomatic implants/fixture: a systematic. Journal of Oral Implantology. 2013; 39(2): 215-224. Available at https://www.ncbi.nlm.nih.gov/pubmed/22248122Accessed October 18, 2018.

[5]Kumar A., Anand U. Maxillary sinus augmentation. Journal of the International Clinical Dental Research Organisation. 2015; 7(3): S81-93. Available at http://www.jicdro.org/text.asp?2015/7/3/81/172935Accessed October 18, 2018.

[6]Delilbasi C., Gurler G., Burgaz I. Sinus lifting in the presence of pseudocyst: case series. Oral Health and Dental Management. 2014; 13(4): 959-962. Available at https://www.researchgate.net/publication/273085964Accessed October 18, 2018.

[7]Sharma A., Rahul G. Zygomatic implants/fixture: a systematic. Journal of Oral Implantology. 2013; 39(2): 215-224. Available at https://www.ncbi.nlm.nih.gov/pubmed/22248122Accessed October 18, 2018.

In modern dentistry, professionalism is an essential skill that all dental care professionals must possess. To help undergraduate students get to grips with what it truly entails and encourage an active approach to professional practice, the Association of Dental Groups (ADG) has run the ‘Professionalism’ Bursary Award for four years now. Open to all undergraduate students, the Award is an opportunity for students to explore professionalism with regard to ethics, patients, self and clinical team and peers.

The winner for 2018 was fourth year BDS student at Barts and The London School of Medicine and Dentistry, Ali Nasser, who proudly adds this accolade to two others gained this year: the British Society of Prosthodontics’ (BSSPD) Kulzer Undergraduate Award 2018, and the British Association for the Study of Community Dentistry (BASCD) Keith Woods Essay Competition 2018. Here, Ali opens up about applying for the ADG Bursary Awards and what professionalism means to him.

“I found out about the ADG Bursary Awards from one of the more senior dental students at my university, who had entered and won the same Award previously. I was immediately immensely interested, as I knew it would be a great opportunity to gain some exposure in the dental community, earn national recognition and expand my knowledge – though of course the cash prize was a great motivator too!

“In terms of why I chose that particular category, professionalism is a topic that I have come to be very passionate about during my undergraduate education, due in part I think to my university’s extensive teachings during our ‘Professionalism, Teamwork and Social Responsibility’ sessions. Every year we focus on different aspects of professionalism, and the more time goes by the more I realise what a fascinating, diverse and pertinent subject it is.

“My time in clinic has certainly helped with this too. With each placement I have become increasingly more familiar and confident with the many different layers and complexities of professionalism, which has only strengthened my drive and determination to be as professional as possible at all times. I’ve also learnt that there are no hard and fast rules when it comes to professionalism. Rather, everyone has their own principles and views on the matter and different ways of working; none of them wrong per se, but I have come to recognise that certain ways of practising are better than others.

“Alongside this, I now appreciate that everyone has innate professionalism within themselves; without even thinking, dental professionals (for the most part) will act professionally. This has really struck a chord with me because it just goes to show that it’s there within us all, it just needs refining from time to time. On the flip side, if someone doesn’t act in a professional manner or to the expected standard, I now notice it more.

“It is for this reason that working on this application was such an eye-opener for me as a soon-to-be graduate entering the dental profession. The process made me think about all the various aspects together rather than separately, and by exploring the concept of professionalism in dentistry, expected standards from governing bodies and what the term means personally to me, I feel I am much better prepared for what lies ahead. I’m also confident that I will practice in a much more conscientious way now and will not take professionalism for granted. I think this could make a huge difference to my career moving forward, particularly as I aim to buy my own practice one day. I firmly believe that the more of a grasp I have on professionalism and the better I can champion best practice, the more my practice will prosper.”

As it has done with others before him, applying for and winning the undergraduate ‘Professionalism’ Bursary Award has provided a good foundation for Ali as he ebbs ever closer to becoming a dental graduate. It is clear that professionalism is integral to the provision of quality patient care and in creating a good working relationship with colleagues, and as such must remain a key element of a professional’s education – both at undergraduate level and beyond.

Other Awards that were available at the 2018 ADG Bursary Awards include the undergraduate ‘Innovation in Dental Care’ category, which was new this year, and the postgraduate Bursary. To find out more about the Awards and this year’s winners, get in touch with the ADG today.

For more information about the ADG visit www.dentalgroups.co.uk

With Christmas over and the New Year well and truly underway, many of your patients will be turning their attentions to the next celebration on the calendar – Valentine’s Day. Often celebrated with the gifting of flowers, chocolates and cuddly toys alongside a romantic meal, the 14^thFebruary is an opportunity for couples to express their feelings for their significant other. It’s also a good excuse for those who are new to a relationship or looking for love to test the field or signify their interest. But it’s not just the date itself that matters; for many the preparation in the run-up is equally as important – particularly in terms of personal grooming.

For new couples and those meeting for the first time especially, getting ready is all part of the dating process. There’s a lot riding on Valentine’s Day after all, and first impressions count for everything! It’s no surprise then, that 31 per cent of women and 30 per cent of men would be willing to splash out £40 to £80 on their date preparations, and that one in five men and 39 per cent of women typically spend between one and two hours getting ready. This is all according to a poll conducted by dating website Elite Singles, which surveyed more than 1900 singles.[i]

The survey also found that 85 per cent of men would trim their beard or have a wet shave in preparation for a date, while 27 per cent would go the extra mile and either have a professional facial or apply moisturiser. For women, make-up (85%), a manicure (50%) and a session at the hairdressers (41%) topped the grooming trends.ⁱOf course, fresh breath is also a key consideration when venturing out on a date; couples and singletons don’t just want to look good for their beau, but feel and smell good too – and for good reason. According to research carried out by the Oral Health Foundation unpleasant breath was judged to be the biggest turn-off by almost nine in every ten people (86%) when looking for a potential partner.[ii]That’s a lot of pressure for new couples and singletons who will no doubt be thinking about that Valentine’s Day kiss! It should come as little surprise then that malodorous breath tops the list of pre-date worries for Brits ahead of outfit selection, looking fat and body odour.[iii]

Luckily for many with plans this February 14^ththe fear of oral malodour will be little more than that – a fear; just pre-date nerves. But for one in four, halitosis has the potential to ruin all the hard work put in to make Valentine’s Day a success, if left unmanaged. Indeed, if it doesn’t put their date off – which research suggests it can – unpleasant breath could have such an impact on self-confidence and anxiety levels that it ruins the occasion anyway.

For those that are passed the ‘honeymoon period’ who are more comfortable in one another’s company or even married, halitosis might be less of a big deal. That being said, it is still highly embarrassing, and can have a huge impact on confidence and anxiety levels – especially if a loved one has passed comment on it before. So what can be done?

As a trusted dental professional there are a number of steps that you can recommend to your patients to tackle the issue and ensure they benefit from first class breath. Remind them that a good oral hygiene regimen that includes interdental cleaning in addition to efficient tooth brushing is essential to getting rid of food particles that can linger in the mouth and cause oral malodour. As you know this can also help to curtail the development of gingivitis and periodontitis, which are another leading cause of halitosis.[iv]On top of that, be sure to encourage your patients to keep hydrated. A reduced salivary rate can have negative effects on self-cleaning of the mouth as saliva functions help to keep bacteria at a manageable level,^ivso by drinking water patients have a better chance of keeping malodorous breath at bay.

Additionally, you could recommend a high-quality mouth rinse such as the CB12 mouthwash that has been clinically proven to both target and neutralise the volatile sulphur compounds that cause halitosis and inhibit the formation of biofilm. Made using an innovative, patented formula, CB12 could help your patients to increase their hygiene levels and prevent oral malodour, leaving them breath confident for up to 12 hours.

There’s a lot that goes into preparing for a date and for many patients making a good impression is vital. By reminding your patients of steps that can be taken to prevent the embarrassment of oral malodour, they can enjoy Valentine’s Day and any kisses, without any worries.

For more information about CB12 and how it could benefit your patients, please visit www.cb12.co.uk

[i]Elite Singles: The Highs and Lows of Getting Ready for a date survey results. Accessed online September 2018 at https://www.elitesingles.co.uk/em/from-single-to-couple/getting-ready-for-a-date

[ii]Oral Health Foundation: A ‘healthy smile’ and ‘fresh breath’ are the keys to finding love, according to new research. Published 13 June 2016. Accessed online September 2018 at https://www.dentalhealth.org/News/a-healthy-smile-and-fresh-breath-are-the-keys-to-finding-love-according-to-new-research

[iii]Research by CB12. Bad breath is Brits’ biggest pre-date worry. [Accessed online October 2018 at http://www.cb12.co.uk/blog-post/bad-breath-is-brits-biggest-pre-date-worry/

[iv]Bahadir Uğur Aylikci, Hakan Çolak. Halitosis: From diagnosis to management. J Nat Sci Biol Med. 2013 Jan-Jun; 4 (1): 14-23. Accessed online September 2018 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633265/