Pursuing a thoroughly digitised workflow is a smart business decision that cuts down on waste, speeds up turnaround times and generally makes laboratories more attractive to potential clients. Many of the benefits speak for themselves, but one should also consider that there is also a generational shift occurring. Older clinicians used to working with traditional methods are gradually retiring, replaced with younger counterparts who have been raised with smart phones and tablets. For many young professionals if a digital alternative exists, and offers similar or better results, then switching to that is the obvious choice.

Intraoral scanners

Optical impressions, taken with modern intraoral scanners offer excellent levels of accuracy alongside numerous improvements over traditional methods. This is an area where dental practices and laboratories alike can switch to a digital approach and reap the considerable benefits.

Ease of use. Intraoral scanners simplify taking impressions. Rather than taking physical impressions and having to cast them, a simple scan can be taken. Taking physical impressions can be messy and time consuming, and in complex cases it can be difficult to capture the necessary details. When working in physical media it is easy to make a mistake, and that can be time consuming to correct. With an optical impression, the learning curve to take excellent impressions is much reduced; the process is clean and quick, and where a mistake is made an instant do over is possible. The data captured can be directly imported into CAD/CAM software, eliminating the possibility of information being lost. It is also possible to digitise a plaster impression, but considering the benefits of moving to an all-digital workflow many will want to avoid such half-measures where possible.

More environmentally sound. Using physical impressions creates dental waste.[1] Eliminating waste wherever possible is both environmentally friendly and good business; it reduces direct material costs, as well as employee time spent on disposal.

Furthermore, simply sending physical impressions to a laboratory, necessitates burning fuel and the resulting pollution – and an excess of vehicles on the road results in more congestion, slower traffic and more emissions. Safely moving the impression requires packing materials, and in instances where the impression is damaged, the whole process must be repeated. Any given delivery has a small impact, but the cumulative result of countless physical impressions being sent does inevitably add up. With public concern rising over climate change, and legislation sure to follow – any business seeking to future proof themselves must endeavour to minimise their environmental impact as soon as possible.

More efficient. Cutting out physical impression taking and transportation saves considerable time. Digital impressions can be effortlessly sent to a laboratory in an instant. In a competitive and ever-changing market, businesses are under pressure to make themselves as lean and efficient as possible. Removing physical steps – with all the potential for errors and delays that the real-world poses, enables businesses to make considerable efficiency savings. Not only does this enable a much quicker turn around, it facilitates easy communication between dental practice and lab. It is now possible for a clinician to send a digital impression to a lab, where a dental technician can assess the impression and immediately let the clinician know if it is for any reason unsatisfactory. Where before another appointment would have had to be made, it is now possible to get this feedback before the patient has even left the practice.[2]

Compatibility

One of the few drawbacks of going digital is compatibility. Market fragmentation and proprietary software and hardware can create walled gardens where some things work seamlessly with each other while others do not. Systems where the digital file is in a proprietary format are referred to as closed systems, limiting you to that provider and perhaps a few partners. Thankfully, there are open standards and widely compatible formats available that are much less restricted in what they will work with. Making sure that what you opt for is broadly compatible helps keep your options open in the future, rather than being tied into a single provider. It also helps minimise hassle and avoid unnecessary costs when sharing files with other parties. When a practitioner and their chosen lab do not have compatible equipment, it can be an expensive proposition to share files.

The CS 3600 intraoral scanner from Carestream Dental offers superior full HD 3D scans that are quicker and clearer than ever before. The CS 3600 also boasts outstanding precision, and thanks to its open system architecture it is compatible with any CAD software that uses STL files.

Digitising your workflow can have a transformative effect on your laboratory, and its working relationships. Being able to offer greater efficiency, less waste and quicker turn around are great selling points, that can help differentiate your lab from less modern competitors. For clients that are still working with traditional methods, it can be well worth informing them of just how much a digital process can help.

For more information, contact Carestream Dental on 0800 169 9692 or

visit www.carestreamdental.co.uk

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

and Facebook

[1] Haralur S., Al-Qahtani A., Al-Qarni M., Al-Homrany R., Aboalkhair A., Madalakote S. The dental solid waste management in different categories of dental laboratories in Abha city, Saudi Arabia. The Open Dentistry Journal. 2015; 9: 449-454. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4768654/ May 21, 2019.

[2] Managano F., Gandolfi A., Luongo G., Logozzo S. Intraoral scanners in dentistry: a review of the current literature. BMC Oral Health. 2017; 17: 149. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5727697/ May 21, 2019.

For dentists in the early part of their careers, progression of skills and experience is essential. However, with so many different areas to move into, choosing the right one for you can be challenging. This a topic that Shalin Mehra – Chief Executive Officer of Rodericks Dental – is passionate about. Having been heavily involved in professional training and education for several years, Shalin answers some common questions to help newly qualified dentists follow the right path for them…

I recently completed Foundation Dentist (FD) training and will be working as an associate in practice – what could my career pathway look like?

The initial two-three years after FD training are about consolidating and enhancing the skills learnt in dental school and during your FD year. You need to become more efficient in order to see the higher number of patients you will treat as an associate. The aim is to move through the four stages of competence regarding general dentistry and reach ‘unconscious competence’. At this point, you will likely be ready to consider your options. So, what do you want to do? It might be orthodontics, dental implants, cosmetic, paediatric or restorative dentistry, among others.

Once you’ve identified the area of dentistry you enjoy most, you’ll need to undertake further education to develop these targeted skills. This progression is underpinned by your Professional Development Plan (PDP) as required for enhanced CPD. Within this, you should record the CPD and training you plan to undertake, and how it is relevant to your current or intended field. So, if you want to move into dental implants, your PDP should detail courses related to implant restoration and placement, along with the anticipated outcomes of each. If you’re not sure what you want to focus on in the future or can’t identify areas you want to improve in, use the PDP the other way around. Identify areas you feel less confident in and plan how you can improve your experience in these fields.

I want to pursue a specialist interest but can’t choose between aesthetics, implant or minor oral surgery – how do I decide what to do?

If you really don’t know which areas to develop skills in, it is necessary to expose yourself to as many disciplines as possible. Make contact with those dentists you currently refer treatment to – speak to them about what they do and what career pathways they followed. There will often be various postgraduate training opportunities available from day courses to short courses, diplomas and MSc’s, so you need to do your research to see what might suit you best.

Where possible, observe the more experienced dentists treating your patients and work with them. Dentists are always willing to help and pass on knowledge, and you can upskill while learning more about a new field. You will quickly see if you enjoy the work and if you’d be interested in specialising yourself.

I work in a mixed practice doing NHS and private dentistry, but would like to do more private. How do I do this where I am?

For every patient, you need to provide all possible options as required in the GDC standards – this includes private options. It is, of course, entirely up to patients which they choose and care should be taken not to mislead them in any way. However, in my experience, many patients will choose alternative treatment to NHS options when they understand their choices, especially when it comes to cosmetic crowns, fillings or dentures. 

It is essential to understand the NHS rules and regulations on what you can and can’t provide. As some treatments are not available under the NHS, you may need training in these areas before you can offer them yourself instead of referring out. These might include tooth whitening, facial aesthetics, implants and short-term orthodontics. Once you have the skills, you can provide services that aren’t available to patients on the NHS, helping you do more private dentistry. Once again, it starts with training and skills development.  

I really enjoy teaching, how do to get into FD training?

It’s worth making contact with a local practice that offers FD training in the first instance. Ask to meet with the FD dentist and/or Educational Supervisor/Trainer to get more information. This will help you decide if this is what you really want to do.

 If it is, then you need to have been qualified for 4 years or more and you’ll need to service an NHS contract in the region of 1,000 UDAs. Evidence of your teaching and/or education skills will also be extremely valuable for the interview process. A certificate in dental/medical education may be useful as this will help develop your skills as an educator. At Rodericks, we routinely encourage dentists to undertake a dental/medical education certificate when considering a pathway towards FD training. The process then involves a practice visit and an interview, with some Deaneries offering an induction course for new FD trainers as well.

For details about Rodericks Dental,

please visit www.rodericksdental.co.uk or call 01604 602491

#wearerodericks

Modern dentistry has made good time management an indispensable skill. So why not make things universally simpler for yourself by choosing a restorative that helps save time in a number of ways?

Filtek Universal Restorative from 3M Oral Care helps make restoration selection simpler through a streamlined shade selection (eight shades cover the whole VITA classic spectrum).

Among these there is also an innovative Filtek Universal Restorative Pink Opaquer shade from 3M that has been designed to mask metallic defects and stained dentition to facilitate optimal aesthetics.[i]

Simplify your day by contacting 3M Oral Care.

For more information, call 0800 626 578 or visit www.3M.co.uk/Dental 

END

3M and Filtek are trademarks of the 3M Company.

[i] 3M Oral Care Internal Data. Masking with Pink Opaquer. Claim 7393.

The Association of Dental Implantology (ADI) is the go-to organisation for all dental professionals interested in or involved with dental implants. With more than 2,400 active members, it has become a thriving community of like-minded individuals who all share the same passion for excellent dentistry.

As such, there are many advantages to membership with the ADI. Not least of these are both learning and networking opportunities available throughout the year – both of which are essential for a long and successful career in dental implantology.

Events

ADI Members’ National Forum

The ADI Members’ National Forum is free for all ADI members to attend. It will present an array of sessions by professionals who wish to share their experience, research findings and insights into the latest trends, materials and technologies in the field. For all the details or to register, please visit the ADI website. The event is free for members, so why not join to make the most of this fantastic event?

ADI Study Clubs

Held throughout the year and at different locations across the country, the ADI Study Clubs offer a more intimate learning experience for dental professionals to hear from experts in their relevant fields. Upcoming sessions will offer a wealth of information and advice on how to maintain dental implants in the long-term, as well as digital smile design and its benefits in improving treatment acceptance, planning and surgical placement. Delegates will also find out more about the progression of the field over the past 10 years and discover how to optimise the business aspects of offering dental implant therapy. All ADI Study Clubs are held in evenings and offer verifiable CPD. The full list is available on the ADI website.

ADI Team Congress

This highly anticipated biennial event offers a comprehensive educational programme for all members of the dental team, including dentists, dental nurses, dental hygienists and therapists, practice manager and dental technicians. It presents an array of leading speakers from the UK and abroad, providing information and inspiration from globally renowned professionals. There is also a trade exhibition hosting manufacturers and suppliers of dental implant-related products and technologies for delegates to browse. The next event will be held in 2021, so be sure to look out for information when it is announced!

All these educational events also have a social aspect to ensure you have time to catch up with friends and meet new people.

Learning resources

Another invaluable resource for ADI Clinician and First Five Years members is free premium membership to Dentinal Tubules.

This platform offers more than 45,000 minutes of learning, with almost 1,500 videos covering a spectrum of subjects to suit all interests and experience levels. The intelligent Personal Development Plan (iPDP) also facilitates smart CPD planning and fulfilment.

While the benefits of face-to-face interaction are many, the ADI understands the time pressures dentists and their teams face in the modern industry. As such, it has made webinars available on key topics that can be watched between events to keep you up-to-date in an easy and convenient way. Seven webinars are currently available to members to access at any time, so you can fit your learning around your busy schedule with ease.

In addition to all this, the ADI also provides members with access to prestigious research journals that feature an array of the latest studies and concepts in the dental implant arena. The Clinical Oral Implants Research (COIR) Journal and EDI Journal are both highly respected publications that will help dental professionals remain at the cutting-edge of implant dentistry.

Network of support

Perhaps one of the biggest benefits of joining the ADI community is the support that becomes available to you. As part of a group of like-minded professionals, you will be able to share ideas, gain inspiration and seek advice on everything from specific cases to postgraduate qualifications. The ADI Members-only Facebook Group is perfect for this, enabling individuals to post queries and see how others have overcome similar challenges. This is a great place to find possible mentors or to pass on your own knowledge and expertise, helping colleagues grow and raising standards across the board.

Ultimately, knowing you’re not alone and having colleagues to turn to for support can make a huge difference to the quality of your implant dentistry and your job satisfaction. Regardless of whether you are just getting into dental implantology or have been offering treatment for many years, you will certainly gain from joining the ADI.

For more information or to join the ADI, please visit www.adi.org.uk

It sounds more like a poor Christmas joke you’d find inside a cracker than an actual medical condition, but for many people during the festive period, Christmas tree syndrome is no laughing matter.

But what is this festive condition and why does it occur? It basically all leads back to the introduction of Christmas trees into our homes. Many people forget that much like flowers and long grasses, trees create pollen too. Inhaling this pollen can lead to nasty allergic responses that mimic the symptoms of hay fever.

It’s not just the pollen that causes this allergic response, though, and the main culprit is often thought to be the mould that grows on Christmas trees when left in a warm environment, such as inside our homes. The spores of this mould can trigger the usual snuffly symptoms alongside asthma attacks and other potentially life-threatening responses.

According to some sources, almost a third of British people may suffer from Christmas tree syndrome, including children and young babies.[i] This means that as many as 22 million people could be suffering unnecessarily every year!

We also need to consider the potential effects that this allergic reaction can have on oral health. Much like hay fever, dry mouth caused by allergic responses can quickly encourage increased levels of tooth decay. Furthermore, pressure that builds up due to inflamed sinuses can also cause teeth to hurt, leading to consistent discomfort – something not particularly conducive to the festive spirit!

As such, it’s worth asking patients who are feeling flu-like throughout the lead up to Christmas whether Christmas tree syndrome could be the culprit.

One good alternative may be to suggest an artificial tree, though even these can gather dust and set off allergies. Therefore, the best option is likely to be to tell patients about Christmas Tree Syndrome and perhaps discuss with them some possible further alternatives such as keeping their tree outside in the garden where it won’t impact their allergies as much!

In the end, the lead up to Christmas should be fun and festive and not made miserable by mould. By telling patients about this little-known condition you can help them avoid allergic responses and the possible effects on oral health these may bring.

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

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

[i] The Independent. Christmas Tree Syndrome: How Your Festive Fir Could Be Making You Ill. Link: https://www.independent.co.uk/life-style/christmas-tree-syndrome-asthma-uk-allergy-coughing-sneezing-symptoms-a8089306.html [Last accessed August 19].

Whilst digital scanners are becoming more popular and ever more accurate, the reality stands that the majority of GDPs are still using VPS/Polyether for their impressions. A contemporary understanding of the materials available is therefore necessary to assist our clinical outcomes. Prior to impression taking, the salient features of preparation include removing sharp edges, ensuring finish lines are clear (where intended), and making sure that abutments are completely dry, as well as free of saliva, blood and debris. Vinylpolysiloxone is inherently hydrophobic, and whilst manufacturers have increasingly developed different formulations to improve hydrophilicity of products, the drawback remains that washed out margins and air bubbles are more likely to occur. Polyether, on the other hand, absorbs moisture and is resilient to contamination.

The ideal conditions are the same as with vinylpolysiloxone, however, polyether has become a mainstay in dentistry for its accuracy in capturing the details of multiple abutments and its rigidity involving fixture level implant impressions. 

Preparation design is a topic of much debate and, though this is not the focus of this article, the surface texture of a prepared abutment has a modest influence on the quality of the impression. In the event of sharp angles, this encourages the low viscosity material to potentially tear and distort upon removal from the mouth. But how do we know when to stop finishing/smoothing a preparation? In the author’s experience, use of rotary abrasive discs (Sof-Lex Diamond polishing system from 3M or Supersnap from Shofu) adequately finish a preparation. The grit size of an orange Sof-Lex XT system or purple Supersnap is ideal for this purpose. Further still, speed-increasing hand pieces are an excellent addition to the clinician’s armamentarium, and the reduced micro-vibration in the bur tip allows for optimal control at the outset (Figures 1-3). W&H and NSK are two reputable providers of such equipment.

Figure: 1

Figure: 2

Figure: 3

The following is a summary of impression materials, as recommended by the author: 

1) Imprint 4 VPS impression material from 3M Oral Care, auto-mixer only (3M Pentamix 3 or Pentamix Lite machine). Excellent margin definition and handling. Unforgiving in the presence of moisture and/or unfinished preparations. Figure 4.

Figure: 4

2) Honigum from DMG, VPS Auto-mixer (DMG Mixstar) or hand-mix. Excellent margin definition and handling. Highest number of accurate repeated castings. Figure 5.

Figure: 5

3) Doric Definition from Schottlander, VPS hand-mix only. Excellent margin definition and handling. Slowest setting hand-mix available. Consistent and economical. Figure 6.

Figure: 6

4) Impregum Super Quick polyether impression material from 3M, auto-mixer only (3M Pentamix 3 or Pentamix Lite). Excellent margin definition and versatility with combination cases and implant impressions. As a ‘super-quick’, this material sets relatively slowly compared to equivalent VPS systems. Forgiving in cases of subgingival margins and contamination. Can be challenging to remove once set. Figures 7-9

Figure 7

Figure 8

.

Figure 9

5) Hydrorise from Zhermack, VPS, hand-mix only. Very good margin definition and handling. Unforgiving in presence of moisture. Figure 10.

Figure: 10

For more information about products from 3M Oral Care, call 0800 626 578 or visit www.3M.co.uk/Dental

Author bio:

Sahil qualified from the University of Bristol Dental Hospital. He maintains an active affiliation with the British Academy of Aesthetic Dentistry, and British Academy of Cosmetic Dentistry. He believes in positivity, stickability and applying a progressive approach as often as possible.