It’s not uncommon to walk past someone on the street and become bewitched by the scent of their aftershave or perfume. After all, these scents have been specifically manufactured to elicit certain responses in our psyche, whether that is pleasure, attraction or other positive emotions. But have you ever wondered how scent really influences our minds?

You may already know that certain fragrances can affect your mood, behaviour and even work performance, but the reason for this may be very different from what you would expect…[i]

The power of association

According to professionals at Brown University, scents excite certain responses only after people have formed an associated memory with them.[ii]That’s not to say that a person can’t smell something new and decide whether it is pleasant or unpleasant, but rather that until a scent has a memory or association attached to it, it is unlikely to have a further effect.

What’s particularly interesting is that this all important association has been found to change people’s perceptions of whether a smell is pleasant or not. In one article written for Psychology Today, the writer insists that the smell of manure is enjoyable to them, and this is purely because of the positive associations it held relating to their childhood.[iii]

So what types of behaviours can scent influence? By learning more about this connection, dental professionals can start to use scents effectively in their practice.

Memories and motivation

Perhaps one of the strongest links between scent and human behaviour is fuelled by an aroma’s ability to recall a certain memory. This phenomenon is often referred to as the ‘Proustian memory effect’ – derived from a scene in one of Proust’s novels where his protagonist vividly recalls details of his past after dipping a biscuit into a cup of tea. This recalled memory effect has been proven to have a noticeable effect on the choices that people make.

For example, a study that compared different fragranced body lotions found that people with memories connected to a perfume present in one of more of the lotions rated them as better products, even going as far to say that they were better quality.[iv]This suggests that certain scents are more likely to feature in pleasant memories than others. Although every individual will have a unique bank of memories, it is probable that many will have shared experiences surrounding certain scents, especially those we are preconditioned to associate with specific occurrences.

An example of this would be that floral scents, for many, are deemed pleasurable. This could stem from memories of playing in the garden as a child or receiving flowers for special occasions. Furthermore, as flowers are predominantly seen as a good thing and linked to beauty and happiness, they can quickly form a positive psychological association. On the other hand, a specific floral scent such as lilies could form the complete opposite reaction, if their scent were, for instance, subconsciously linked to an upsetting event such as a funeral.

Another interesting aspect of scents is that our perceptions could change depending on how much we are subjected to them. It’s not uncommon to become “nose blind” when trapped in a room with an unpleasant smell, but studies have also found that our tolerance of strong smells may be linked to how often we smell them, and our exposure to them from a young age – even in utero. Research that tested the reaction to strong smelling substances such as garlic, cigarette smoke and alcohol revealed that infants whose mothers had consumed/used these products during pregnancy found these scents significantly more appealing than those whose mothers had not.[v]

A change in mood

Once memories have been established and linked to scents, it is likely that this will, in turn, begin to influence people’s moods. People may feel a surge of happiness if they smell a fragrance that takes them back to a happy memory, just as they may experience a burst of anger or sadness if a particular smell connects to events that inspired these emotions as well.

So how does this connect back to dentistry? The truth is, scents in professional healthcare environments are incredibly important. Although a portion of patients may find clean and clinical scents appealing, the typical smell of a hospital or dental practice has been found to be a key trigger for those suffering from dental anxiety.[vi]

As such, it’s a good idea to scent your practice with fragrances that are likely to help patients feel relaxed, at home, and happy. The Premium Scenting Cube from Initial Medical makes this easy. This portable scenting device fragrances spaces of up to 10,000 ft³and has a selection of scents such as lavender, fresh cotton and chocolate chip cookie to incite positive emotional responses from patients. Lavender, in particular, has been proven to calm nerves, making it the ideal choice.[vii]

Scents matter

There is no way to guarantee that any scent will please everyone. However, by choosing a scenting device with aromas that are more likely to evoke a positive emotional response from patients, you can help the majority of them feel relaxed and happier, even if they are anxious about their visit.

For further information please visit www.initial.co.uk/medicalor Tel: 0870 850 4045

Referecnes

[i]The Scientific American. Do Scents Affect People’s Moods or Work Performance? Link:

https://www.scientificamerican.com/article/do-scents-affect-peoples/[Last accessed March 19].

[ii]The Scientific American. Do Scents Affect People’s Moods or Work Performance? Link:

https://www.scientificamerican.com/article/do-scents-affect-peoples/[Last accessed March 19].

[iii]Psychology Today. How Does Scent Drive Human Behavior? Link: https://www.psychologytoday.com/gb/blog/the-athletes-way/201506/how-does-scent-drive-human-behavior[Last accessed March 19].

[iv]Sugiyama, H., Oshida, A., Thueneman, P., Littell, S., Katayama, A., Kashiwagi, M., Hikichi, S. Proustian Products are Preferred: The Relationship Between Odor-Evoked Memory and Product Evaluation. Chemosensory Perception. 2015; 8 (1): 1-10.

[v]The Scientific American. Do Scents Affect People’s Moods or Work Performance? Link:

https://www.scientificamerican.com/article/do-scents-affect-peoples/[Last accessed March 19].

[vi]NHS Worcestershire Health and Care. Community Dental Services – What is Anxiety? Link: https://www.hacw.nhs.uk/our-services/dental-services/dental-services/im-anxious-about-seeing-the-dentist/ [Last accessed March 19].

[vii]Koulivand, P., Ghadiri, M., Gorji, A. Lavender and the Nervous System. Evid Based Complement Alternat Med. 2013; 2013: 681304.

The British Dental Conference and Dentistry Show 2019 provided the perfect platform for dental nurses to get up-to-date on the latest concepts and career development pathways. The Dental Nurses’ Forum, supported by the British Association of Dental Nurses (BADN), presented a programme brimming with ideas designed to inspire delegates.

Highlights included Jacqui Elsden’s Friday session, titled “Dental Nursing: What Lies ahead?”. Jacqui, who is president-elect of the BADN, started with a look back at her own career, considering how the past has shaped the future. She discussed pre-registration and showed a photo taken during her training at King’s College Hospital Dental School in the Eighties with the dental nurses wearing paper hats!

Moving on to mandatory registration in 2008, she showed that with recognition and regulation came more responsibility. Jacqui then discussed her role with Health Education England (HEE), in particular her involvement with the HEE’s Advancing Dental Care (ADC) Education & Training Review, which was commissioned to develop an education and training infrastructure that supplies a dental workforce with the skills to respond to changing needs.

What could the future look like? Well, it could mean multiple pathways and entry points, to create a multi-skilled workforce, she said. Dental nurses should be able to move more easily into dental hygienist and dental therapist roles, should they wish. The possibility of a district dental nurse role was also discussed, as were non-clinical dental nurse opportunities such as mentoring and research. The main message Jacqui wanted delegates to leave with was to “get involved!”

Jaqcui’s presentation certainly struck a chord with Laura Hempleman, DCP Manager for NHS Lothian. She said:

“It was a fantastic talk, with an inspirational speaker who sparked my enthusiasm for the future. I was sitting next to a colleague who was considering leaving the profession, this session may have changed all that.”

Kicking Saturday morning off was Peter Whiteford, who discussed “Sepsis In The Dental Setting”, supported by SBDN. With more research needed – it is still unknown why, in cases of sepsis, the body’s immune system attacks the organs and tissues – and high-profile cases in the media, no wonder it was standing room only.

Peter played a hard-hitting video – which one delegate described as “totally devastating” – showing how sepsis can change a life. Although he reassured the audience that the risk of sepsis from a dental bacterial infection is low, he outlined the importance of everyone in a practice knowing how to spot it – crucially, symptoms can present differently in adults and children. He then went through a scenario, to show a possible dental team approach to sepsis. What is key, he said is that “we are all on the same page”.

Following Peter was Maxwell O’Neill, who discussed the challenges of dealing with difficult people, sponsored by Waterpik. Maxwell gave the audience tips about how to cope with people who irritate you and told them, “self-control is your best superpower.” He also told delegates how the fear of being wrong and not knowing your own worth can hold you back in your career; one of the most common mistakes is thinking that, “if I work hard, I will be noticed and I will be rewarded” – be your own cheerleader. Being mindful of your body language, mood and how you communicate is important and also to stop making assumptions – try to look at things from a different angle. A positive attitude is “contagious” Maxwell said, but “don’t wait to catch it from others, be a carrier”.

Following the session, one dental nurse commented:

“It has been fantastic. The knowledge shared was brilliant, clear and concise. I can’t believe what an impact it can have on you and your practice by making such simple mindful changes. Wow! I’ll definitely be back to the show next year!”

Other areas covered were bullying, dealing with gossip and how to ask for a raise. The main message he wanted to leave delegates with is than an unpleasant experience does not have to destroy you, you come back stronger. In fact, it can even help you realise your own potential.

Other sessions covered everything from a dental nurse’s role in dental implantology to improving patient safety. Also, aside from the hours of enhanced CPD, the trade floor had a real buzz. Dental nurses were able to browse the latest products and equipment, with on-stand learning adding to the experience. In addition, the show was the ideal place to socialise and network with friends old and new. What’s more, the Dental Awards were enjoyed by several lucky teams who managed to get tickets – many congratulations to the Dental Nurse of the Year – Siana Garstang!

About the event, delegate Melissa Mickewicz, dental nurse from Shrewsbury & Telford NHS Trust said:

“The show has provided good lectures with plenty of exhibitors and great freebies.”

Melissa Chase, dental nurse from Sherwood House Dental Practice, added:

“Extremely helpful staff all-round. The services and information given from the stands and lectures have helped me with understanding things in different perspectives and taught me new things. I can’t wait to learn more next year!”

The British Dental Conference and Dentistry Show, co-located with DTS.

For all the latest information on the next event, visit www.thedentistryshow.co.uk, call 020 7348 5270 or email dentistry@closerstillmedia.com

For a dental implant to be successful, firm osseointegration must be achieved. Osseointegration is the process by which bone knits to the surface of the implant – without it, the implant can become loose. Implant stability is regarded as one of the most critical elements for implant treatment success.[i]

There are numerous factors that can affect osseointegration in both the long and short-term. Early failures are caused by interference or impairment of the healing process during the initial months following implantation.

Early failures can arise for a number of reasons. Surgical errors of technique can of course result in failure, as can contamination of the surgical site. Implants vary in design and how forces are distributed – while some designs can be more prone to failure, there are reports that others achieve better primary stability.[ii]^,[iii]

Attaining primary implant stability is essential for osseointegration and this depends largely on the contact between the bone surface and the implant. Mechanical and biological factors such as the quantity of bone and the fit of the implant can also influence the success of osseointegration.[iv]Where bone quality is poor, osseointegration may not occur to the degree required.[v]Careful planning and case selection is required to achieve the best functional and aesthetic outcome for patients.

Later failures are typically due to host factors, such as the presence of systemic health problems, smoking, bruxism, radiation through radiotherapy, etc.[vi]Even if osseointegration has been successful, failure of treatment can occur as a result of peri-implantitis.

Peri-implantitis

Peri-implant complications run the gamut from soft tissue inflammation, all the way to progressive and irreversible bone loss. The former is characteristic of peri-implant mucositis (which is analogous to gingivitis), while the more severe

peri-implantitis is a destructive condition that can result in pocket formation and the loss of hard and soft tissues.[vii]The main clinical characteristic of peri-implant mucositis is bleeding upon gentle probing and due to inflammation, probing depth is often – but not always – increased. Erythema (redness), swelling or suppuration may also be found.[viii]Peri-implant mucositis precedes peri-implantitis. These complications are now believed to be alarmingly prevalent, with nearly half of dental implant patients developing peri-implant mucositis, and over a fifth of that group going on to develop peri-implantitis.[ix] 

Where the infection is only present in the soft tissues, as in peri-implant mucositis, minimally invasive treatment is possible by treating contributing factors – namely restoring plaque/biofilm control. Following this, symptoms can take in excess of three weeks to subside. However, if the infection reaches the bone tissue, surgical intervention is typically required, though in some cases antibiotic therapy in conjunction with non-surgical periodontal therapy may be feasible.[x]^,[xi]The progression of peri-implantitis and the rate of bone loss can vary considerably between patients, but typically proceeds faster than in cases of periodontitis. In the absence of treatment, progression accelerates over time, so early detection and intervention is highly preferred.[xii]

Research indicates that peri-implant soft tissues are more vulnerable than the gingiva, with greater inflammatory responses observed in reaction to plaque accumulation.[xiii]

Treating peri-implantitis is challenging and subsequent osseointegration will likely be impeded, resulting in less stability following successful treatment than prior to the onset of the disease.[xiv]Peri-implant complications are caused by failure to maintain adequate oral hygiene. Making sure patients understand the critical importance of looking after their oral health is the best preventative step that can be taken. Some patients are still under the misapprehension that because implants are artificial, they are in some way indestructible and do not necessarily appreciate the vulnerability of the bone-implant interface.

Retrograde peri-implantitis (RPI) is a rare surgical complication, where infection occurs at or shortly after implant placement. This has been attributed to a wide range of causes, including drilling too far, contamination during insertion, overheating the bone, micro-fracturing, pre-existing inflammation/infection, and so on. Unlike the aforementioned peri-diseases, RPI is not detectable through probing and in some cases may be asymptomatic. When successfully treated, healing following RPI is usually more complete than in cases of peri-implantitis.[xv]Consequently, very few implant failures due to RPI have been reported.[xvi]

Peri-implant mucositis (and subsequent peri-implantitis) has been clearly demonstrated to be caused by plaque accumulation around implants. Smoking has also been established as a risk factor. Some research has linked diabetes, genetics, and the surface characteristics of an implant as additional risk factors.[xvii]

Implant stability is an important diagnostic measure for gauging the success of implant procedures in both the short and long term. Designed to complement the No Implantology without Periodontology (NIWOP) workflow concept exclusive to W&H, the Osstell Beacon^TMis the byword for reliable, non-invasive implant stability measurement, providing an easy and accurate way of taking primary and secondary stability readings. The Osstell Beacon^TMfrom W&H provides easy-to-understand IDX and ISQ values, which can help with diagnosis and predicting implant success or failure.[xviii]ISQ values have also proven useful in diagnosing progressive bone loss due to peri-implantitis.[xix]

Careful planning and execution of treatment can make a significant difference to the success of highly stable dental implants. However, this work can be undone by patients failing to look after their oral health. Patient education and sufficient monitoring of treatment are important to ensure that successful outcomes stay successful.

To find out more about the full range from W&H, visit www.wh.com/en_uk, call 01727 874990 or email office.uk@wh.com

REFERENCES  

[i]Miri R., Shirzadeh A., Kermani H., Khajavi A. Relationship and changes of primary and secondary stability in dental implants: a review. International Journal of Contemporary Dental and Medical Reviews. 2017; 2017. https://doi.org/10.15713/ins.ijcdmr.112March 7, 2019.

[ii]Kate M., Palaskar S., Kapoor P. Implant failure: a dentist’s nightmare.Journal of Dental Implants. 2016; 6(2): 51-56. http://www.jdionline.org/text.asp?2016/6/2/51/202154March 7, 2019.

[iii]Karl M., Irastorza-Landa A. Does implant design affect primary stability in extraction sites? Quintessence International.2017; 48(3): 219-224. https://www.ncbi.nlm.nih.gov/pubmed/28168242March 7, 2019.

[iv]Baftijari D., Benedetti A., Kirkov A., Iliev A., Stamatoski A., Baftijari F., Deliverska E., Gjorgievska E. Assessment of primary and secondary implant stability by resonance frequency analysis in anterior and posterior segments of maxillary edentulous ridges. Journal of IMAB. 2018; 24(2): 2058-2064.https://doi.org/10.5272/jimab.2018242.2058March 7, 2019.

[v]Li J., Yin X., Huang L., Mouraret S., Brunski J., Cordova L., Salmon B., Helms J. Relationships among bone quality, implant osseointegration, and Wnt signaling. Journal of Dental Research.2017; 96(7): 822-831. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5480808/March 7, 2019.

[vi]Kate M., Palaskar S., Kapoor P. Implant failure: a dentist’s nightmare.Journal of Dental Implants. 2016; 6(2): 51-56. http://www.jdionline.org/text.asp?2016/6/2/51/202154March 7, 2019.

[vii]Wang W., Lagoudis M., Yeh C., Paranhos K. Management of peri-implantitis – a contemporary synopsis. Singapore Dental Journal.  2017; 38: 8-16. https://www.sciencedirect.com/science/article/pii/S0377529116301195March 7, 2019.

[viii]Berglundh T., Armitage G., Araujo M., Avila-Ortiz G., Blanco J., Camargo P., Chen S., Cochran D., Derks J., Figuero E., Hämmerle C., Heitz-Mayfield L., Huynh-Ba G., Iacono V., Koo K., Lambert F., McCauley L., Quirynen M., Renvert S., Salvi G., Schwarz F., Tarnow D., Tomasi C., Wang H., Zitzmann N. Peri-implant diseases and conditions: consensus report of workgroup 4 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions. Journal of Clinical Periodontology. 2018; 45(Suppl. 20): S286-S291. https://onlinelibrary.wiley.com/doi/full/10.1111/jcpe.12957March 7, 2019.

[ix]Holland C. Combating peri-implant disease. British Dental Journal. 2016; 220(2): 48-49. https://www.nature.com/articles/sj.bdj.2016.46.pdfMarch 7, 2019.

[x]Wang W., Lagoudis M., Yeh C., Paranhos K. Management of peri-implantitis – a contemporary synopsis. Singapore Dental Journal.  2017; 38: 8-16. https://www.sciencedirect.com/science/article/pii/S0377529116301195March 7, 2019.

[xi]Pierce J., Gurenlain J. Risk assessment for peri-implantitis. Decisions in Dentistry. 2017; 3(5): 28-31.http://decisionsindentistry.com/article/risk-assessment-peri-implantitis/March 7, 2019.

[xii]Berglundh T., Armitage G., Araujo M., Avila-Ortiz G., Blanco J., Camargo P., Chen S., Cochran D., Derks J., Figuero E., Hämmerle C., Heitz-Mayfield L., Huynh-Ba G., Iacono V., Koo K., Lambert F., McCauley L., Quirynen M., Renvert S., Salvi G., Schwarz F., Tarnow D., Tomasi C., Wang H., Zitzmann N. Peri-implant diseases and conditions: consensus report of workgroup 4 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions. Journal of Clinical Periodontology. 2018; 45(Suppl. 20): S286-S291. https://onlinelibrary.wiley.com/doi/full/10.1111/jcpe.12957March 7, 2019.

[xiii]Salvi G., Aglietta M., Eick S., Sculean A., Lang N., Ramseier C. Reversiblity of experimental peri-implant mucositis compared with gingivitis in humans.  Clinical Oral Implants Research.2012; 23(2): 182-290. https://www.ncbi.nlm.nih.gov/pubmed/21806683March 7, 2019.

[xiv]Javed F., Hussain H., Romanos G. Re-stability of dental implants following treatment of peri-implantitis. Interventional Medicine & Applied Science. 2013; 5(3): 116-121. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3831812/March 7, 2019.

[xv]Shah R., Thomas R., Kumar A., Mehta D. A radiographic classification for retrograde peri-implantitis. The Journal of Contemporary Dental Practice.2016; 17(4): 313-321. https://www.researchgate.net/publication/305480802_A_Radiographic_Classification_for_Retrograde_Peri-implantitisMarch 7, 2019.

[xvi]Kate M., Palaskar S., Kapoor P. Implant failure: a dentist’s nightmare.Journal of Dental Implants. 2016; 6(2): 51-56. http://www.jdionline.org/text.asp?2016/6/2/51/202154March 7, 2019.

[xvii]Renvert S., Polyzois I. Risk factors for peri-implant mucositis: a systematic literature review. 2014; 42(Suppl. 16): S172-186. https://onlinelibrary.wiley.com/doi/full/10.1111/jcpe.12346March 7, 2019.

[xviii]Baftijari D., Benedetti A., Kirkov A., Iliev A., Stamatoski A., Baftijari F., Deliverska E., Gjorgievska E. Assessment of primary and secondary implant stability by resonance frequency analysis in anterior and posterior segments of maxillary edentulous ridges. Journal of IMAB. 2018; 24(2): 2058-2064.https://doi.org/10.5272/jimab.2018242.2058March 7, 2019.

[xix]Monje A., Insua A., Monje F., Munoz F., Salvi G., Buser D., Chappuis V. Diagnostic accuracy of the implant stability quotient in monitoring progressive peri-implant bone loss: an experimental study in dogs. Clinical Oral Implants Research. 2018; 29(Suppl. 11): 1016-1024. https://www.researchgate.net/publication/327957292March 7, 2019.

Overflowing landfills and polluted waterways remain stark evidence of the way in which we as a society see many things as disposable, replaceable or temporary. It is this attitude that has given rise to throwaway culture, which refers to the excessive production and over consumption of short-lived, single-use items. Throwaway culture has become such a global crisis that many leading figures have spoken out against the issue. It is not only contributing to the depletion of our planet’s precious, finite resources, but also threatens to permanently damage the environment – particularly as it is having a substantial impact on the way we deal with waste.

The UK prides itself on being a world leader in ethical and responsible waste disposal, but even our developed infrastructure is straining under the weight of the waste we produce annually – over 200 million tonnes of it, in fact.[i]Recycling rates have risen steadily over the past few years, but not quickly enough for Britain to meet the EU target to recycle 50% of household waste by 2020.[ii]^,[iii]The UK had previously relied on shipping much of its waste overseas to be recycled in countries such as China and Malaysia, who now reject these imports as their own recycling plants have become overwhelmed.

All of our waste has to go somewhere, and some experts predict that this will lead to more waste being dumped in landfill or incinerated, thereby contributing to increased pollution and environmental destruction. Manufacturers are now being criticised for failing to play a greater role in reducing waste at the point of source in order to prevent single-use and non-recyclable materials becoming an issue in the first place. Instead, many firms produce and supply cheap goods that are disposable as opposed to durable, which encourages people to consume them quickly before throwing them away in favour of newer items. 

Like many other industries, the clothing and textiles sector is currently fuelling this throwaway culture through so-called “fast fashion”, whereby items are being sold so cheap that they are regarded as single-use purchases. A survey of 2,000 respondents aged 18 to 35 found that 61% of buyers have no interest in well-made, long-lasting clothing, with many preferring cheap trend-based items that could be thrown away the following season.[iv]This is alarming considering the production of clothes makes the industry one of the world’s most significant polluters. The disposal of any unwanted clothing also causes additional harm to the environment, as a lot of it is thrown away rather than reused or recycled. It is estimated that £140 million worth of clothing ends up in landfill each year, but much of this may be incinerated in the near future in order to manage the sheer quantity of textile waste being produced.[v]

It seems the food industry is no better when it comes to throwaway culture. Plastic food packaging, in particular, has revolutionised the way we store and consume food, enabling people to foster a lunch-on-the-go habit that generates 10.7 billion items of packaging waste each year. Research on over 1,200 UK workers has revealed that an average lunch purchase includes four packaged items, with 76% of shoppers picking up a main item such as a boxed sandwich, 70% a packet of snacks, and 65% a napkin.[vi]This creates huge levels of waste that often cannot be recycled as it is produced from mixed materials or contaminated by food residue. Drink bottles are the most popular form of single-use, plastic packaging that can be recycled, but just over half of the 38.5 million plastic bottles used in the UK every day are recycled. The rest are disposed of in landfill, burned or eventually find their way into our oceans, causing further damage to the environment.[vii]

Within the health and dental care industries, disposable single-use items offer several advantages over reusable products, including to help reduce the potential for spreading infection. However, this is also contributing to the global waste crisis, putting greater pressure on dental manufacturers to consider environmentally-friendly solutions for single-use goods. Many companies are already supplying oral healthcare products that can be reused or recycled. Curaprox, for instance, is combatting throwaway culture by offering patients CPS interdental brushes that are innovatively designed with a reusable handle and a replaceable brush head. This makes CPS interdental brushes last up to five times longer than traditional alternatives available on the market, thus helping patients reduce, reuse and recycle as much of their waste as possible.

With mounting concerns over worldwide waste management, the need to act has never been more pressing. We can no longer afford to use the countryside or the oceans as dumping grounds for our throwaway culture, or else we risk irreparably damaging the environment. This ultimately has the potential to detrimentally affect us as a society. Conscientious consumption of natural resources is key to leaving the planet in a better state than when we inherited it. As such, it is important that we all take steps to follow a more responsible, environmentally-friendly lifestyle.

For more information please call 01480 862084, emailinfo@curaprox.co.ukor visit www.curaprox.co.uk

References 

[i]Whittaker, L. and Ashton, P. (2019) Digital Revolution: transforming waste management in the UK. Gov.uk. Link: https://environmentagency.blog.gov.uk/2019/01/31/digital-revolution-transforming-waste-management-in-the-uk/. [Last accessed: 25.07.19].

[ii]Department for Environment Food & Rural Affairs. (2019) UK Statistics on Waste. Link: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/784263/UK_Statistics_on_Waste_statistical_notice_March_2019_rev_FINAL.pdf. [Last accessed: 25.07.19].

[iii]Department for Environment Food & Rural Affairs. (2019) Impact Assessment: Consistent municipal recycling collections in England. Link: https://consult.defra.gov.uk/environmental-quality/consultation-on-consistency-in-household-and-busin/supporting_documents/recycleconsistencyconsultia.pdf. [Last accessed: 25.07.19].

[iv]Wolstenholme, H. (2018) More than 80 per cent of shoppers are buying clothes they never wear, study shows. Evening Standard. Link: https://www.standard.co.uk/news/uk/more-than-80-per-cent-of-shoppers-are-buying-clothes-they-never-wear-study-shows-a4004996.html. [Last accessed: 25.07.19].

[v]WRAP. (2019) Clothing. Link: http://www.wrap.org.uk/content/clothing-waste-prevention. [Last accessed: 25.07.19].

[vi]Hubbub. (2019) Hubbub’s new #FoodSavvy Lunch Club campaign encourages a rethink of ‘lunch on the go’ routines to reduce good and packaging waste. Link: https://www.hubbub.org.uk/FAQs/hubbubs-new-foodsavvy-lunch-club-campaign-encourages-a-rethink-of-lunch-on-the-go-routines-to-reduce-food-and-packaging-waste. [Last accessed: 25.07.19].

[vii]Recycle Now. (2019) What to do with plastic bottles. Link: https://www.recyclenow.com/what-to-do-with/plastic-bottles-0. [Last accessed: 25.07.19].

Clark Dental is proud to supply the new Primescan intraoral scanner manufactured by Dentsply Sirona, which has been innovatively designed to ensure digital impression-taking is fast, easy and accurate. It offers seamless, validated and open data transfer options that provide the facility to export STL and exocad files to your preferred laboratory.

Suitable as a standalone digital impression-taking solution, Primescan can also be combined with the latest CEREC systems to support the provision of restorations chairside. This makes Primescan ideal for single-visit dentistry, whether for dental implants, orthodontics, or other treatments. 

Call Clark Dental today to find out more about Primescan’s unique features.   

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

For the majority of people, there is no place like home. The familiar surroundings, memories, family and friends along with the ability to stay independent and live happily and healthily to an old age is what most people hope for.[i]However, for frail or elderly people or those that have a chronic or disabling condition a residential or nursing home provides a safe environment with constant access to professional care and support.

Over 400,00 people live in care homes in the UK. Around 30,000 are younger people with learning disabilities, but approximately 70 per cent are older adults with some form of dementia or memory problems.[ii]The demand for residential living is expected to grow[iii]and providers strive hard to offer residents compassionate, dignified care in a homelike environment where residents are able to maintain their identity, a certain level of independence and have meaningful experiences.  Indeed, the Care Quality Commision (CQC) and other regulators check the standards of care providers across the UK to ensure that residents are safe and treated with dignity and respect. Care service inspections also ensure that care, treatment and support is effective and that good outcomes are achieved to maintain quality of life.[iv]

As anyone in the dental profession knows, poor oral health can impact a person’s well-being both physically and psychologically. It can influence how they look, speak, eat, socialise and enjoy life.[v]Plus, there is a growing body of evidence to indicate that periodontitis is a risk factor for certain systemic diseases and that impaired oral health can have a highly negative effect on quality of life.[vi]Nevertheless, it appears that helping older adults living in care homes to maintain good oral health, is still not a priority. Three years ago, the National Institute for Health and Care Excellence (NICE) published “Oral health for adults in care homes” as a guideline. Recommendations were included to ensure that care homes had plans and policies in place to properly assess individual oral health care needs; manage daily mouth care; report any oral health concerns and provide support to access both general and emergency dental services.[vii]

However, according to “Smiles Matter”, the latest CQC review, it appears that many elderly people living in care homes in England are not being supported adequately.

After visiting 100 care homes in England and reviewing 291 care plans, the CQC revealed that:

• 39 per cent of home care managers were not aware of the NICE guidelines, and only 28 per cent had heard of it and read it.
• Most homes had no policy to promote and protect people’s oral health (52 per cent).
• Nearly half were not training staff to support daily oral healthcare (47 per cent).
• Of the care plans reviewed, 73 per cent only partly covered or did not cover oral health care at all.
• Although 37 per cent of care homes said residents could always or nearly always access NHS dental care, the review found that 10 per cent had no way of accessing emergency treatment.[viii]

Poor oral health could be leaving these, our most vulnerable members of society, in pain or discomfort, embarrassed, lacking in confidence or even unable to speak or eat properly. Yet dental practices can help by forming links with local care homes to help promote the maintenance and improvement of oral health in their residents. They can support staff with educational material and training, as well as the capacity to offer appointments for routine dental care and emergency appointments when needed.

Dental professionals can also offer advice on the delivery of daily oral health care plans and recommend the most suitable, clinically-proven oral health products for each resident. The Waterpik^®Sonic Fusion flossing toothbrush for example, combines the proven effectiveness of the Waterpik^® Water Flosser with an advanced sonic toothbrush, which is up to twice as effective as regular brushing and flossing.[ix]This device can be used independently or with the help of a trained carer to both brush and floss the teeth easily but also effectively, to remove oral bacteria and actively help to prevent disease and decay and improve oral health.

The alarming CQC review highlights the deficiencies in the oral care provision afforded to older adults presently living in residential care homes. Certainly, the current situation could have a major impact on the quality of life of these people. Yet considerable improvements are possible if the importance of oral health is elevated within residential care and better connections are made with local dental practices and professionals. Indeed, by taking active steps to improve oral health and mouth care, there is the potential for older adults, including those with advanced care needs, to lead healthier, happier, more enjoyable lives.

For more information on Waterpik® products please visit www.waterpik.co.uk. Waterpik® products are available from Amazon, Asda, Costco UK, Superdrug online and in stores across the UK and Ireland. The Cordless Plus White WP-450, Cordless Plus Black WP-462 and JT450 Classic Jet Tips are also available in store at Boots as well as online at Boots.com

References

[i]Office for National Statistics. Statistical bulletin National Bereavement Survey (VOICES) 2011. https://webarchive.nationalarchives.gov.uk/20160107054622/http://www.ons.gov.uk/ons/rel/subnational-health1/national-bereavement-survey–voices-/2011/stb-statistical-bulletin.html

{Accessed 24^thJune 2019}

[ii]Alzheimer’s Society. Facts for the media. https://www.alzheimers.org.uk/about-us/news-and-media/facts-media[Accessed 24th June 2019]

[iii]Laing and Buisson 2017. Care Homes for Older People market analysis and projections. https://www.laingbuissonevents.com/wp-content/uploads/2017/05/William-COP.pdf[Accesed 24th June 2019]

[iv]Which? Quality and regulation of care providers. https://www.which.co.uk/later-life-care/home-care/organising-home-care/quality-and-regulation-of-care-providers-ax0f96v8pl85[Accessed 24th June 2019]

[v]World Health Organisation (WHO) Aubrey Sheiham. Bulletin of the World Health Organisation. Oral health, general health and quality of life. https://www.who.int/bulletin/volumes/83/9/editorial30905html/en/

[vi]Gil-Montoya J.A. et al. Oral health in the elderly patient and its impact on general well-being: a nonsystematic review. Clin Interv Aging. 2015; 10: 461–467. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334280/[Accessed 24^thJune 2019]

[vii]National Institute for Health and Care Excellence (NICE). NICE Pathways. Older adults in care homes overview. https://pathways.nice.org.uk/pathways/oral-health-for-adults-in-care-homes#content=view-node%3Anodes-care-home-policies

[viii]Care Quality Commission. Smiling Matters. Oral health care in care homes. Summary of our review. June 2019. https://www.cqc.org.uk/sites/default/files/20190624_smiling_matters_summary.pdf[Accessed 24th June 2019]

[ix]Goyal CR, Qaqish JG, Schuller R, Lyle DM. Comparison of a novel sonic toothbrush to a traditional sonic toothbrush and manual brushing and flossing on plaque, gingival bleeding and inflammation: a randomized controlled clinical trial. Compend Contin Edu Dent, June 2018; 39(2)(Special Iss. 1). https://www.aegisdentalnetwork.com/cced/special-issues/2018/06/comparison-of-a-novel-sonic-toothbrush-to-a-traditional-sonic-toothbrush-and-manual-brushing-and-flossing-on-plaque-ginigval-bleeding-and-inflammation[Accessed 24th June 2019]

Cone Beam Computed Tomography (CBCT), is useful across many areas of dentistry – including when diagnosing certain oral and maxillofacial pathologies and planning surgeries. Assessing bone quality and identifying vital structures such as the mandibular canal, blood vessels and maxillary sinus floor are important to reduce the risk of life threatening and life changing complications. CBCT imaging can be an invaluable tool when assessing and planning oral surgical procedures and dental implant surgery.[1]

However, even the best imaging technologies and treatment planning software available still require the human component to be safe and effective. Training and experience is essential to usefully interpret CBCT images. Full reporting of CBCT by a qualified clinician is mandatory. For the treating surgeon, training and experience is essential to usefully interpret CBCT images in order to carry out the surgery with precision and accuracy. Referring clinicians must also have sufficient training to ensure that the operator who takes the scan has all the necessary information. This requires including precise instructions such as the justification criteria and intended purpose, as well as the ROI and FOV when referring for CBCT to maximise the benefits whilst minimising the risks.

A recent study concluded that placing implants without first performing adequate radiological assessment is the leading cause of iatrogenic damage to the trigeminal nerve. The authors assert that this is a preventable complication; by using CBCT in concert with specific training into proper interpretation of the scans, better treatment planning can be achieved thus minimising the risk of serious injury to the blood vessels and nerves particularly when operating in the posterior mandible.[2]Ucer et al have published an evidence based protocol of risk management to avoid such complications and highlighted the importance of accurate diagnosis, imaging and interpretation.[3] 

Currently, CBCT is not mandatory for dental implant surgery, but it is becoming an increasingly indispensable aid to diagnosis and treatment. However, the clinician must follow the guidelines and justification criteria when subjecting patients to such invasive investigations, using well-established ALARA principle and considering dose reduction options by reducing FOV.

For those looking to develop their confidence in the field, the comprehensive Postgraduate Certificate (PG Cert) programme (EduQual level 7) offered by Ucer Education will bring your knowledge and skills to the next level. This 12-month course is led by the eminent Professor Cemal Ucer and delivered in state-of-the-art facilities, enabling you to gain experience with cutting-edge equipment while you advance towards a formal qualification in implant dentistry. From interpreting CBCT scans to advanced surgical and prosthodontically-guided 3D implant planning and placement, this course covers a wide breadth of topics in detail.

Dental implants are an excellent treatment modality for many partially and fully edentulous patients. However, the safe provision of implants requires careful assessment, diagnosis and treatment planning, as well as meticulous attention to detail in every aspect of patient care. The best results can only be reliably achieved by marrying knowledge and surgical skill with accurately interpreted diagnostic imaging.

For more information on the PG Cert in Implant Dentistry, please visit

www.ucer.education or call 0161 237 1842

Professor Cemal Ucer (BDS, MSc, PhD, Oral Surgeon, ITI Fellow)

References

[1]Fokas G., Vaughn V., Scarfe W., Bornstein M. Accuracy of linear measurements on CBCT images related to presurgical implant treatment planning: a systematic review. Clinical Oral Implants Research. 2018; 29(Suppl. 16): 393-415. https://doi.org/10.1111/clr.13142May 3, 2019.

[2]Yilmaz Z., Ucer C., Scher E., Suzuki J., Renton T. A survey of the opinion and experience of UK dentists: part 1: the incidence and cause of iatrogenic trigeminal nerve injuries related to dental implant surgery. Implant Dentistry.2016; 25(5): 638-645. https://doi.org/10.1097/ID.0000000000000472May 3, 2019.

[3]Yilmaz Z., Ucer C., Scher E., Suzuki J., Renton T. A survey of the opinion and experience of UK dentists: Part 3: An Evidence Based Protocol of Surgical Risk ManagementStrategies in the Mandible. Implant Dentistry.2016; 25(5): 638-645.https://doi.org/10.1097/ID.0000000000000472May 3, 2019.

The British Dental Conference and Dentistry Show is delivered by the BDA and CloserStill Media to ensure a diverse, relevant and high quality educational programme.

Following its success in previous years, the 2020 event is set to offer even more enhanced CPD in a wide range of topics. Leading speakers from across the profession will once again offer insight into the latest clinical and business concepts, helping all members of the dental team enhance their patient care and practice protocols.

Don’t miss the BDA Theatre and many other learning opportunities at the British Dental Conference and Dentistry Show 2020.

The British Dental Conference and Dentistry Show 2020 – 15^thand 16^thMay –Birmingham NEC, co-located with DTS.

Visit www.thedentistryshow.co.uk, call 020 7348 5270 or email dentistry@closerstillmedia.com