Dr MJ Rowland-Warmann, Principal of Smileworks Liverpool, shares her inspirational story of practice development, highlighting the latest state-of-the-art upgrades and equipment projects.

I graduated in 2009 from the University of Manchester.  After working in mixed and private practice, I took an MSc in Aesthetic Medicine followed by an MSc in Orthodontics.  I set up a practice with my husband, Ed, six years ago.  Our vision was simple: we wanted to create an inspirational working environment for support staff and dentists alike, somewhere they could produce the very best in terms of care.  We also wanted to deliver exceptional services within an environment that made every patient feel cared for.  

In 2019, our team has grown from two to 35 and we have doubled in size twice, achieving maximum growth of six dental surgeries and two aesthetic treatment rooms.  The practice is airline-themed, reflecting a luxury travel vibe.  We have unique titanium-alloy jet-desks at reception, crafted from parts of a Tornado Fighter jet, airline drinks carts, branded upholstery on our original airline seats in the waiting room and porthole style picture frames.  Our team even wear hats and have rank stripes in their sleeves – we don’t do anything in half-measures and this provides a fantastic talking point for patients!  We still have the same vision as when we started, which we work on every day. Patients appreciate the amount of detail and time we spend on things.  This is evident in everything we do, especially our clinical standards.

The latest expansion project involved adding a third business unit, as per our original vision when we first moved in.  Everyone who visits from customers to business associates compliments us on our wonderful, thriving practice with excellent staff and beautiful things everywhere.  So when the opportunity for expansion came along we became extremely excited.  We have an enormous sense of achievement in managing to pull off what we said we would from the outset, and we’re so proud!

The challenges of expanding a dental practice

Having doubled in size in the past, this project was fairly seamless.  Like many start-ups, we made mistakes in the beginning and had worked with dreadful builders and faced enormous problems.  This time, we hired more trustworthy builders and they did a great job.  Practice refurbishments are like pancakes in that respect – the first might not be quite right but you learn from your mistakes!

Our greatest fear for this expansion was having a new, ginormous practice and not being able to fill it with people. However, that fear was soon cast aside! We were busting at the seams in our existing practice, with associates asking for more days and an average of ten new private patients per day. This was all thanks to the amazing marketing efforts of my husband Ed, who is a world-class digital marketer.

In terms of finances, the project was funded by Barclays.  It’s always a struggle to secure this type of funding for private practices, but the bank has the necessary insight to evaluate a good proposal when one comes their way.  Our broker for the financial aspects was Rob Griffin of Aspired Finance. He is, and will always be, our ‘fixer’.  He has worked with us from the very beginning and has helped us get to where we are today.  He took the stress out of the whole expansion by sorting all related financial matters, which meant I could carry on practising dentistry and running the business.

How to build a dental practice

Our builders are the heart and soul of all our projects. Thomas McVey of STL Shopfitting is a (very tolerant) genius who took each crazy idea out of my head and turned it into reality.  The project was so successful I hired him to renovate my home!

We are in a shopping centre complex, which is great in terms of location and visibility. However, dealing with a large and often unwieldy management company regarding the lease was the slowest part of the process.  Whilst I managed the project, Ed monitored business performance to ensure no surprises and a smooth transition.  

The best dental technology for your practice

At Smileworks we are early adopters and use a state of the art practice management software called MacPractice.  Of the companies that offered compatible imaging technologies, Planmeca came out on top in terms of compatibility.  Their solutions integrate seamlessly with MacPractice via an imaging bridge, which means we run only one software system.

We had previously found that Planmeca was great for the sensors and CBCT equipment and as we already had a relationship with them, we considered their chairs for our expansion.  We were impressed with the quality – the latest developments are not only user-friendly and technologically advanced, but also really comfortable for patients whilst being extremely cost effective.

We are therefore now an all-Planmeca practice. We were the first practice in the UK to have the new Planmeca Compact™ i5 dental units installed and we love them. Their small footprint and upright entry make for much better patient interaction.  Consultations, discussions with patients, impressions, photographs – it’s all so much easier with the knee-break type of chair.

In addition, James – our Planmeca sales representative – has been nothing short of fantastic. He is reliable, knowledgable and efficient.  From our first point of contact, we’ve always had great support and still have catch-ups to make sure everything is working as it should and discuss aftercare.  The delivery of the chairs was timely and accommodating of our expansion, and after some initial teething problems – which are to be expected in brand new bits of kit – everything has been working great.  Overall, we’re really pleased with the service received from Planmeca and I wouldn’t have any reservations in recommending the supplier for both imaging equipment and treatment centres – they’ve got it all covered.

Delivering patient happiness

Working in the new Smileworks is simply wonderful.  It’s a breath-taking space that our patients and staff love.  I wouldn’t say the project is ever complete – I’m forever looking for finishing touches and keeping it looking fresh.  I spend my free time scouring the internet for new things to put into the space that we have.  I am also currently in talks about a new art work for the second waiting room. Our patients deserve only the very best, and we firmly believe that the way you do anything is the way you do everything.  

Our ethos for patient care hasn’t changed over time – we still strive to deliver the best. I think it’s probably become a lot easier to do that with the practice we now have. We’ve filled it with cutting-edge equipment, allowing our clinicians to deliver the kind of dentistry that they have always dreamed of doing.

How to create your perfect dental practice

My advice for others approaching a similar project is to always research your suppliers!  A quick check of references can save you lots of hassle.  It’s also much safer to use trusted suppliers that are recommended by colleagues or friends.  Renovating or building practices can involve a significant investment and failing to do due diligence can result in not only heartache, but also financial distress.

Financial clarity is just as important.  Being an agile business means having a comprehensive oversight of all your finances, from the amount you spend on your dental chair to your toilet paper.  Don’t scrimp (especially not on the latter), but also don’t be wasteful.  You’re much less likely to be taken advantage of during your business development if you know precisely what your performance statistics are and sign off individually on each cost item.

Finally, it’s hugely beneficial to develop lasting relationships with suppliers.  Some of ours have been with us since day dot and I wouldn’t change them for the world.  It’s important to have trusted stakeholders who understand your business and work with you to deliver your vision.  As a practice, we don’t trade with companies that we believe aren’t doing right by their customers, who are greedy or treat us with indifference – it’s our way of playing fair.

A proud moment

We’re all incredibly proud of what the practice has become today.  Whilst expanding the practice not once, but twice, we’ve also managed to create an exceptionally well performing team.  Along the way, I’ve continued my development in both aesthetics and orthodontics.  Ed and I got married in that time too – we celebrated in style with our team in Vegas on an unforgettable trip.  Often it is said that you can’t have everything, but I think through hard work and dedication, we really have it all!  

For more information, please visit www.planmeca.com or call 0800 5200 330

Looking to perfect your dental implant skills?

Learn the latest about dental implantology surrounded by the majestic peaks of the Austrian mountains by heading to the 10^th Annual High Altitude Comprehensive Implant Symposium (HACIS), hosted by Meisinger.

Featuring a blend of informative lectures and limited space hands-on workshops, this premier event presents insights from some of the leading lights in the field, all of whom will impart wisdom and share their unique experiences.

Those attending HACIS will be able to benefit from sumptuous accommodation, plenty of chances to network with likeminded individuals and fun events throughout such as a ski race and an elegant dinner and awards ceremony.

HACIS 2020 takes place on 28 January – 2 February 2020.

Register your place today to ensure you don’t miss out: https://en.meisinger.de/events/registration/

To find out more, visit www.myplant-dental.com, email order@myplant-dental.com or call 0049 21311 259465

Are you fed up of having to stop mid-treatment to clean and reposition your dental mirror? Nuview can save you from this headache with the Yirro-plus^® self-cleaning dental mirror system. It combines innovative air flow technology with an ultra-reflective coating to keep the mirror free from grease and other contaminants.

No matter whether you are drilling or performing prophylaxis treatment, Yirro-plus^® ensures clear vision without the need to interrupt your workflow. This enables you to work more efficiently in order to save valuable time in practice.

To order your own Yirro-plus^® COMFORT or PREMIUM start set, get in touch with Nuview today.

For more information please call Nuview on 01453 872266, email info@nuview-ltd.com, visit www.nuview.co or ‘like’ Nuview on Facebook.

Ucer Education is a dedicated provider of first-class training and education within the field of dental implantology, catering to different needs and experience levels.

Led by renowned Specialist Oral Surgeon Professor Cemal Ucer, the PG Cert in Implant Dentistry provides a solid foundation in the field. The 12-month multi-system course provides a formal (EduQual level 7) award and includes both theoretical and practical sessions for comprehensive skill development.

For more experienced clinicians, there is a 3-day intensive Sinus and Bone Grafting course with hands-on cadaver surgery.

Advance your dental implantology with first-training from Ucer Education.

For more information on the implant training available from Ucer Education, please visit www.ucer.education or call 0161 237 1842

There are myriad factors that can impact the success of dental implant placement. Even the smallest design detail of an implant can make a difference, whether this is the choice of material, the shape or even the level it is placed within the bone.

One thing that is generally agreed however, is that achieving primary stability is one of the most important aspects of placement.[i] As such, clinicians should be aware of why this aspect of implant placement is so important and be able to identify implant features that help this process take place.

Why primary stability matters

Primary stability is the interaction between the dental implant and its mechanical engagement with the cortical bone. Primary stability is often cited as vital as it is said to encourage the process of osseointegration, and therefore allows the dental implant to form a proper foundation in the bone.

Without primary stability being achieved, it is likely that the formation of fibrous encapsulation could compromise the dental implant. Rather than integrating with the bone, this means that thick layers of healing matter will grow around the implant, possibly impeding its function.[ii]

The most important part of achieving primary stability is that it increases the predictability of implant function, and some sources even argue that without this foundation being achieved that implant survival is impossible in the long-term.[iii] Therefore, without primary stability it is likely that implants may fail, and in a world where successful outcomes are imperative and where litigation is at an all-time high, it’s necessary for practitioners to explore ways to achieve primary stability predictably.

The shape of you

Both implant surface and implant shape have been theorised as having a substantial impact on whether an implant can achieve primary stability and osseointegration.

In regards to shape, research has suggested that the most important factor is thread geometry and how this applies force once inserted into the bone. Both straight and tapered implants are effective, but the thread design is what dictates stress distribution, which in turn can impact primary stability.[iv] Therefore, progressive thread designs are the most effective for achieving a solid anchor, as the way they disperse forces ensures that they form a tight fit in the surrounding bone.

Dental implants are now available in a wide array of materials. Historically implants were crafted from a diverse selection of materials, including substances such as precious metals and ivory. However, with leaps forward in dental implant research, it is now clear that certain materials are capable of achieving better and more predictable results due to their biological interaction with natural human tissue.[v]

For example, in order to encourage osseointegration it’s widely accepted that titanium is one of the best choices. As the metal has a high level of biocompatibility, it promotes the formation of bone and doesn’t cause any adverse reactions such as allergies.[vi]

Implant surface topography is also essential to consider when attempting to achieve optimal primary stability. Implant surfaces that have a rough finish are typically better at achieving osseointegration than smooth materials. This is because the bone can penetrate porous surfaces readily, quickly forming a biological anchor that encourages faster bone regeneration and good stability.[vii]

Innovation and opportunity

As well as taking these physical details into account, it’s important to consider the lifetime of the implant after placement and what sort of prosthesis it will be supporting. It’s also vital to factor in the area of the dental implant and the available space when making your decision, especially as some implants are unable to perform well in more challenging space restrictions.

In this case it’s a good idea to find dental implants that have a conical connection and platform switching capabilities. Platform switching can help prevent crestal bone loss, again supporting better osseointegration and reliably assisting long-term success.[viii]

A result of decades of research and mastering a clinically proven approach, the new myplant two implants from myplant, the UK subsidiary of Meisinger, are an excellent choice for professionals who value predictable primary stability. Made from titanium with a conical abutment connection and a special expansion thread in order to promote osseointegration, these revolutionary implants are also ideally suited to a wide array of cases due to their platform switching capabilities and subcrestal placement.

Let the case decide

In the end, it’s important to explore the complexities of every case with an individual approach, especially when performing complex surgery such as dental implant placement. Regardless, primary stability is a gold standard, so aiming to achieve this should always be a chief concern.

By choosing dental implants that promote primary stability, you are not only giving the dental implant the best chance at success, but also making it clear to patients that you are helping them achieve a long-term solution to tooth loss.

 To find out more, visit www.myplant-dental.com, email order@myplant-dental.com or call 0049 21311 259465

References

[i] Javed, F., Ahmed, H., Crespi, R., Romanos, G. Role of Primary Stability For Successful Osseointegration of Dental Implants: Factors of Influence and Evaluation. Interv Med Appl Sci. 2013 Dec; 5(4): 162–167.

[ii] ResearchGate. During Implant Placement, If the Primary Stability is Not Achieved, Is the Implant a Success or a Failure? Link: https://www.researchgate.net/post/During_implant_placement_if_the_primary_stability_is_not_achieved_is_the_implant_a_success_or_a_failure[Last accessed August 19].

[iii] Patil, R., Bharadwaj, D. Is Primary Stability a Predictable Parameter for Loading Implant? Journal of ICDRO. 2016; 8(1): 84-88.

[iv] Ryu, H., Namgung, C., Lee, J., Lim, Y.  The Influence of Thread Geometry on Implant Osseointegration Under Immediate Loading: A Literature Review. J Adv Prosthodont. 2014 Dec; 6(6): 547–554.

[v] Saini, M., Singh, Y., Arora, P., Arora, V., Jain, K. Implant Biomaterials: A Comprehensive Review. World J Clin Cases. 2015 Jan 16; 3(1): 52–57.

[vi] Oh, J. Biocompatibility of Advanced Manufactured Titanium Implants—A Review. Materials (Basel). 2014 Dec; 7(12): 8168–8188.

[vii] Smeets, R., Stadlinger, B., Schwarz, F., Beck-Broichsitter, B., Jung, O., Precht, C., Kloss, F., Grobe, A., Heiland, M., Ebker, T. Impact of Dental Implant Surface Modifications on Osseointegration. Biomed Res Int. 2016; 2016: 6285620.

[viii] Prasad, KD., Shetty, M., Bansal, N., Hegde, C. Platform Switching: An Answer to Crestal Bone Loss. J Dent Implants. 2011;1:13-7. DOI: 10.4103/0974-6781.76426.

Some patients can injure their teeth and gums from brushing them too rigorously. Why not recommend a toothbrush that facilitates gentle but effective removal of plaque? Curaprox offers the CS 5460 manual toothbrush in a wide range of eye-catching colours to encourage high patient compliance.

The CS 5460 features ultra-soft CUREN^® filaments that are densely packed onto a compact brush head, ensuring easy access to hard-to-reach areas of the oral cavity. With its octagonal handle, the CS 5460 enables patients to position it at the ideal angle for atraumatic cleaning of the teeth and gums.  

Explore the colourful CS 5460 toothbrush range by visiting the Curaprox website today.

For more information please call 01480 862084, email info@curaprox.co.uk or visit www.curaprox.co.uk

Dr Nikhil Sethi from Square Mile Dental Centre in London comments on his experience of the Bioclear Method, which utilises restorative materials from 3M Oral Care.

“The standard of dentistry in this country still varies so much from one clinician to the next,” he says.

“The Bioclear matrix system, in particular the posterior system, has made a tricky procedure into a really predictable method using an injection moulding concept. Since using the posterior bands in 2016, I have found the technique to be repeatable and produces excellent form every time.”

The Bioclear Method is taught using the Filtek Supreme flowable and body XTE composite for anterior restorations, as well as 3M Filtek Flowable bulk fill and Filtek One bulk fill composite for posterior restorations. Find out more today.

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

 END

3M and Filtek are trademarks of the 3M Company

“The ABB course is going to revolutionise my dentistry – I learnt so much, thank you Tif!”

Dr Chetan Sharma from Dental Sense is one of many highly satisfied dentists to have completed the Align, Bleach and Bond (ABB) training course with IAS Academy. He continues:

“I wanted to increase my knowledge of the ABB protocol, but I took away so much more.

“Having taken many courses on similar topics, this was by far the most informative. I think it should be mandatory for every single GDP as it is an eye-opener! I would certainly recommend it to help dental colleagues spot things in patients’ mouths that you may not have thought about before.

“In addition, the IAS Academy ethos with tooth preservation at its core, is second-to-none and a must for ethical dentists.”

For more information, please visit www.iasortho.com or call 01932 336 470 and press 1.

 Britons spend a huge amount of time and money maintaining, decorating and filling their homes with possessions. People are spending more time at home, and consequently spending more on household possessions and upkeep, resulting in the homes and gardens sector becoming the fastest growing area of consumer spending last year (rising 12%).[i] According to the government’s wealth and assets survey, the median household in the UK now contains over £36,000 worth of possessions (the average being £47,700).[ii]Despite this, around 16 million British adults don’t have contents insurance at all, and many more have underestimated their requirements.[iii]

It’s unpleasant to contemplate losing possessions to fire, flood, theft or other calamities. There are always going to be sentimental items that are for all intents and purposes irreplaceable. However, having solid insurance policies and helpful records can enable people get back on their feet much quicker (while protecting reserve savings).

Documenting possessions

Should you need to make a claim it is important that you can prove what you lost, in line with the policy provider’s expectations. Failure to do this could make the claim appear potentially fraudulent and the provider can refuse to pay out.

Documenting purchases is very helpful. By going through your house room by room with a camera, you can easily produce photographic and/or video evidence of what you possess. Ideally, you should create an inventory as well. This will be helpful not only in making a claim, but also aiding your memory of what you actually own.

The rise of online shopping has increased the paper trail associated with purchases, which can be very helpful for claims. Purchases from online stores are typically permanently logged in your account, there is almost always a separate email confirmation (often easily searchable), and the record of the amount in your debit or credit account. Try to make sure that you are able to log into your important accounts no matter what happens. If your credentials are stored on a computer and it is destroyed, you may not be able to access important information, or in the event of theft a criminal may take control of your accounts.

The easy availability of cloud storage makes maintaining documentation far more resilient than in the past, providing you use it. Proof of purchase receipts aren’t much help if they are destroyed along with the item, and over time they may fade or get lost long before they are actually needed. It is well-worth photographing or scanning receipts to ensure a legible record survives.

As the world becomes more digitised, remember that online accounts may have substantial value attached to them (digital music and movie storefronts for example). Some policies may cover digital goods, but this is a relatively new area and can have numerous caveats.

Know your limits

Besides being underinsured, the other key aspect that can diminish your payout should the worst happen, are policy limits.

Some insurers impose a maximum limit that they will pay out. Others may not set a strict numerical limit, using terms like “unlimited sum insured”. Terms like this can be a little misleading, you should check for other restrictions that effectively do limit the coverage. For example, insurers may set a limit on the size of the property, such as covering houses with no more than 5 bedrooms.

The single item limit dictates the upper payment an insurer will give you for any item, regardless of how valuable it was. So, for example, if you lost an engagement ring worth £4,000, but the single item limit on the policy was £2,500, you would only receive the latter sum. This even applies if the total claim is less than the maximum limit. Nearly half of contents insurance policies impose a single item limit between £1,500 and £1,999, with only a fifth offer limits of £7,500.[iv] If you have one or more particularly valuable items, it may be worth taking out a separate policy specifically for them (valuable item coverage) on top of your contents insurance. This does not have to be from the same provider, allowing you to shop around.

Different policies can vary considerably in what they will pay out for individual items. Some offer amounts equivalent to purchasing the product again new, while others will only provide what they consider to be the current value of your possessions – which can be drastically less than the initial purchase price.

When considering contents insurance or other financial matters, it’s helpful to consult those with expertise, money4dentists are Independent Financial Advisors exclusively catering to dentists. Dentists can have relatively complex and interrelated financial needs, money4dentists understands this and provides expert financial advice for dentists across all aspects of their lives, not just in their professional career.

The last thing you want should a traumatic event like fire or theft occur is to find that you either have no coverage, or that your coverage is inadequate or defective. By consulting with an Independent Financial Advisor, you can help ensure your insurance works for you when you need it most and get the best out of your investments for years to come.

For more information please call 0845 345 5060 or 0754DENTIST.

Email info@money4dentists.com or visit www.money4dentists.com

[i] ITV News. Britons increase spending on underwear as more work from home – mintel. ITV News. 2019. https://www.itv.com/news/2019-07-11/britons-increase-spending-on-underwear-as-more-work-from-home-mintel/ September 12, 2019.

[ii] ONS. Physical wealth: wealth in Great Britain. Office for National Statistics. 2019. https://www.ons.gov.uk/peoplepopulationandcommunity/personalandhouseholdfinances/incomeandwealth/datasets/physicalwealthwealthingreatbritainSeptember 12, 2019.

[iii] Financial Inclusion Commission. Financial inclusion: improving the financial health of the nation. Financial Inclusion Commission. 2017. https://www.financialinclusioncommission.org.uk/pdfs/improving_access_to_household_insurance.pdf  September 12, 2019.

[iv] GoCompare. Cover collectibles, jewellery and other valuables. GoCompare. https://www.gocompare.com/home-insurance/jewellery-and-valuables/ September 12, 2019.