Month: January 2020

Expanding in-house technologies and services – Elgin Park Dental Practice

Dr Ceri Owen-Roberts is the Principal of Elgin Park Dental Practice in Redland, Bristol. He graduated from the University of Bristol in 2007, and since qualification has worked across the South West with positions in Bristol, Cardiff and Stroud. He has a particular interest in restorative dentistry and dental implants. Ceri is a member of the International Team of Implantologists and a study club director for the Bristol region. He completed his MClinDent in Restorative and Cosmetic Dentistry with the BPP City of London Dental School. Ceri is an approved clinical mentor for the Straumann implant company and teaches with the Delta Dental Academy, among other private mentoring and other teaching/lecturing roles. 

With a focus on dental implants and oral surgery, I used to frequently refer my patients out to colleagues for CBCT scans. These are necessary for accurate diagnostics and treatment planning and offer greater visualisation than plain film. However, as my implant business grew, it was clear from the number of referrals being made that we would benefit from being able to perform CBCT scanning in-house. The benefits wouldn’t only be financial either. In some cases, the ability to take a CBCT and get the results immediately, without sending the patient elsewhere first, can be a huge advantage. I therefore decided to introduce the technology into the practice.

Elgin Park is based in an old Victorian building within a conservation area in Bristol. While it is a joy to work in such a beautiful establishment, it does come with its drawbacks. Not least of these is the inflexibility of the building to accommodate a new internal design. We work in very grand surgery rooms, but we only had an extremely small amount of additional space available when looking to add a CBCT imaging area.

What had been the old butler’s pantry remained a largely unused room and so I wanted to convert it into our new imaging facility. This involved repositioning the fuse board, extending the room, adding temporary walls and lead-lining the walls as per the regulations. In the end, the limited space available was the biggest challenge we had to overcome.

Preparation

In preparation for the project, I did a lot of research into the technologies on the market. I was particularly interested in the radiation dosage of each piece of equipment and the quality of images produced. I also focused very much on the software that came with each CBCT machine. I often use guided implant surgical techniques so I was aware of the importance of finding software that would be intuitive to my needs. I already had experience using several different software systems and often found this to be the limiting factor on the efficiency and quality of dentistry I could deliver, even more so than the imaging technology itself.

Having assessed the number of referrals I had been making and doing the appropriate financial calculations, I knew the business could afford to invest in a CBCT. I liaised with a finance company and arranged to pay the cost of the equipment in monthly instalments in order to make it as easily manageable as possible. 

The work begins

We worked with DecaDent to design, organise and complete the refurbishment. Our preferred local building company were responsible for the construction work. During this phase of the project, the main challenges faced were not unexpected. The nature of the old building meant that the walls were thick, solid stone, making them difficult to cut into. While the internal parts of the building didn’t require any planning permissions, even the smallest of changes to such an old building are always very involved!

It was a combination of DecaDent’s recommendation and my own market research that led me to select a CBCT machine from Planmeca. The Planmeca ProMaxÒ3D Max was one of the few scanners that was compact enough to fit into the small space we had available. I was also impressed with the quality and abilities of the software, which seemed to meet my needs and enable me to deliver the highest standard of treatment. Crucially, this CBCT achieved high image quality with the Planmeca Ultra Low Dose™ technology, encouraging a safe yet effective imaging procedure. In addition, the offer of excellent technical support bolstered my final decision.

DecaDent installed the CBCT while liaising with Planmeca very efficiently to ensure everything went smoothly. Planmeca then conducted comprehensive staff training and has since provided brilliant support. The team are easy to contact with any queries we might have and have been a pleasure to work with.

The outcome – 8 months later

Having eliminated the need to refer patients out for CBCT scans, we can now perform imaging during consultations and discuss the results with patients straight away. This has led to a quicker and more efficient service, while also having a positive influence on the profitability of the practice.

As far as patients are concerned, the new CBCT is an extension of the services we already offered, providing them with more in-house. We have also marketed our CBCT scanning facilities as a new service available by referral and we receive referrals from several local practices.

Upon reflection 8 months later, I wouldn’t do anything differently. I am most proud of the fact that we can take such high quality scans with a low radiation dose. Making the decision to invest in a CBCT is made all the easier with the assurance that you can see all the relevant anatomical structures at a fraction of the radiation 

dose of a traditional CT. For my work with dental implants and oral surgery, this has been invaluable.

For any other practitioners looking to invest in an in-house CBCT, I would strongly recommend researching radiation doses for equipment they’re considering. I would also advise looking at independent research rather than the manufacturer’s publications to get an unbiased and more accurate picture. Finally, I would recommend having a contingency budget when looking to renovate an old building in a conservation area, as there are always unexpected costs!

 

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

IAS Laboratory launches new website

IAS Academy is delighted to announce the launch of its brand new website for the full-service orthodontic and dental IAS Laboratory.

IASlab.co.uk features the full range of services currently available from the lab, making it easier than ever before to gain information and make an enquiry. Details of everything from appliance production to digital planning, whitening tray fabrication, study model scanning and sport guard production are now available at the click of a button.

Discover the many benefits of working with the only IAS Academy approved laboratory – visit the new website today!

 

For more information about IAS Laboratory products, please visit www.IASlab.co.uk, email enquiries@iasortho.com or call 01932 336470 (Press 6)

Same old, same old? For NHS contract reform yes. But…

Former Chief Dental Officer, Barry Cockcroft, looks at current provisions within dentistry.

The response from Paul Bachelor to my article in the October 2019 edition really made me realise that in relation to NHS contract reform, nothing has changed much for years – but also made me think of how in almost every other area of our profession everything has changed.

Paul referred to the Bloomfield report. Published in 1992, he could quite easily have referred to the Tattersall report, published in 1964 which said almost the same thing, but did not lead to any change. I worked for over 25 years in the system that led to the production of the 1992 report and became involved in PDS piloting from 1997 as a result, but 20 years on there is no significant change in sight for the vast majority.

Dentists have always been unhappy with their contract and probably even more so now as since 2006 they do not have the control of the availability of services that they had before. It is worth remembering that it was when dentists had control of access that difficulties of access were at their worst and this led to the introduction of local commissioning.

Something else that has not changed is the willingness of those who left the NHS under the old item of service system (“because it was a treadmill”) to use unhappiness with the contractual arrangements to criticise the quality of NHS care.

Looking beyond contracts almost everything has changed; the burden of beaurocracy is massive, just as it is with other professions, dental schools now teach far more out in the community, something which they resisted to any significant degree until the new schools showed it could be done and improved the quality of the clinical experience for undergraduates.

The demography of the population is vastly different to what it was when the NHS was introduced, and techniques are now far more developed and technical. As fewer people suffer the ravages of dental caries and retain their teeth for life the periodontal needs of the population have grown, as has the need to manage tooth wear in an older population.

Possibly the greatest change is the perception of the importance of good dental health and appearance within the majority of the population, something which is really important for the future of our profession given that traditional caries related treatments will reduce.

One would hope that there will be a change in the ongoing educational opportunities for GDPs, for too long the education establishment has been fixated with specialty training but there is a desperate need for more dentists to be able to use their skills to the full in the primary care setting. In my last talk as CDO at an LDC conference, I discussed the opportunities offered by engaging in the provision of tier two services in primary care. At the time the BDA delegate who spoke against the concept was dismissive but I get the feeling that the BDA may now have realised the career opportunities this offers.

All the professions face challenges at the moment; one of my best friends is a pharmacist and community pharmacy is under huge pressure, pharmacists have seen their earnings stay flat for over 10 years, in essence, an ongoing earnings drop due to the massive overproduction of pharmacy graduates and the changes in the retail markets that used to subsidise their incomes. The latest financial settlement for pharmacists involves a five year period of no increase in earnings for the provision of traditional community pharmacy services.

The other thing which has never changed is the politicisation of the NHS at election time. How many of us really believe all the promises about increased funding which were bandied about during election time? All of these increases will be swallowed up by population changes – and trying to make the status quo in terms of service structure fit the future is futile. I suspect that everybody would like to see the politics taken out of a place of influence with the NHS, why not introduce a truly cross party political approach to the service and establish an Executive which can just get on doing the right thing for the population without having to respond to knee jerk political pressure all the time?

In a system with a constrained budget and growing demand there are always going to be difficult decisions to be made and these should be independent of political pressure.

Politicians seem to be fixated by hospitals but the system is only viable in the long term if we focus on keeping people out of hospital and invest more in primary and social care.

Parliament as a whole should agree the budget it is prepared to give the NHS on behalf of the electorate – and then stay out of it!

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Boosting bone management – Mark Croft myplant

We all know that a patient’s bone quality can dictate the type of treatment they can receive. Indeed, poor quality bone or evidence of significant bone loss is likely to restrict patients’ options when it comes to dental implant placement.

As such, looking at methods to increase the available bone volume and improve the quality of bone has fast become a necessity for implant dentists, especially those who are confident that they can help patients who have been turned away elsewhere. With correct bone management materials, implant placement is still a viable option for many patients – including those who present with more challenging bone quality.

A material choice

The first thing to consider when it comes to bone grafting is what sort of bone graft material to use. In recent years, the available array of materials has expanded exponentially, so it can be difficult to decide what type of product is likely to result in the most beneficial outcome.

The initial choice you need to make is whether to use particulate or a block – both have certain benefits and shortcomings. For example, there is some evidence to suggest that block graft material suffers less from resorption after placement, though there seems to be only a minor difference when compared to particulate.[i]Furthermore, it has been speculated that this advantage has a sting in its tail. The sheer size of a block graft can cause issues with the material properly integrating at the site, and this means that it is a less predictable procedure than when particulate is used.[ii]

There’s also the origin of the bone used to consider and how this can affect the procedure. It’s generally assumed that autogenous bone (derived from the patient) is the best option. This, of course, makes perfect sense as the body is likely to react best to the patient’s own biomechanisms and therefore not reject the graft as a foreign material in the body. There’s also some research to support the suggestion that autogenous bone, due to its better abilities to osseointegrate, minimises the threat of infection, bone breakdown and dislodgement.[iii]

However, the same research does discuss the possible downsides to autogenous bone grafts. These include the fact that taking a bone graft from the patient will require greater operative time, the bone site graft may experience morbidity and fail, and moulding challenges may occur as the bone is likely to be less malleable than premade particulates. Furthermore, there is always the issue that harvesting autogenous bone may not be an option due to limited availability.

Particulates these days are generally made from equine, porcine or bovine sources and can bring their own set of benefits. As these products are pre-prepared, they are often easier to sculpt and manoeuvre, and are all effective osteoconductive materials which support the formation of new bone. Regardless, the downsides of these materials are that typically they have shown higher levels of resorption, and some bovine products, in particular, have been documented to result in immune reactions and possible diseases such as spongiform encephalopathy.[iv]There are vegetable-derived alternatives made from algae for vegetarian or vegan patients – these seem to preform similarly to animal-derived products.

Beyond the bone

Of course, bone grafting and bone management involves so much more than simply the choice of bone grafting material used. It’s necessary to think about how to hold these materials in place, and here is where your choice of collagen membrane comes in.

Much like grafting materials, there are a huge array of collagen membranes available, so it’s important for professionals to know what traits to look for. One of the core traits to find is how easy to place and mould a collagen membrane is. Bone grafting requires precision, so finding a membrane that is malleable to your needs and which can be placed easily but still has rigidity enough to prevent defects is essential. It’s also a good idea to look into the tensile strength of all potential options. This will determine how easy it is to keep a membrane in place using sutures, pins, or whatever your preferred method is. A weak tensile strength means that these products may rip. Lastly, you must consider how long you want the membrane to last. Bone graft procedures can take a long time to heal, so it’s necessary that membranes can keep particulate/block grafts in place for the duration of this time to ensure proper osseointegration.

Cytoplast RTM collagen membranes from myplant are the ideal option for professionals looking to boost their bone management skills. Tensile without being too flimsy and able to last as long as you need them, they are a trusted choice for predictable bone management.

 

 

 

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

 

 

 

 

 

References

 

[i]Dasmah, A., Thor, A., Ekestubbe, A., Sennerby, L., Rasmusson, L. Particulate vs. block bone grafts: three-dimensional changes in graft volume after reconstruction of the atrophic maxilla, a 2-year radiographic follow-up. J Craniomaxillofac Surg. 2012 Dec;40(8):654-9. doi: 10.1016/j.jcms.2011.10.032. Epub 2011 Dec 3.

[ii]Gultekin, B., Bedeloglu, E., Kose, T., Mijiritsky, E. Comparison of Bone Resorption Rates after Intraoral Block Bone and Guided Bone Regeneration Augmentation for the Reconstruction of Horizontally Deficient Maxillary Alveolar Ridges. Biomed Res Int. 2016; 2016: 4987437.

[iii]Rogers, G., Greene, A. Autogenous bone graft: basic science and clinical implications. J Craniofac Surg. 2012 Jan;23(1):323-7. doi: 10.1097/SCS.0b013e318241dcba.

[iv]Titsinides, S., Agrogiannis, G., Karatzas, T. Bone Grafting Materials in Dentoalveolar Reconstruction: A Comprehensive Review. Japanese Dental Science Review. 2019; 55 (1): 26 – 32.

Composite material like no other

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The business of facial aesthetics

Dr Harry Singh will present in the Facial Aesthetics Theatre at the British Dental Conference and Dentistry Show 2020. He says:

“I will consider the business of facial aesthetics and discuss how dentists and dental hygienists/therapists can turbo boost their profits from facial aesthetics. I’ll cover the three key pillars in an aesthetics business – attracting new patients, converting more patients and retaining existing patients.

“Many dental professionals are unhappy with attracting new facial aesthetic patients. They have invested money and time in getting training in this area, but don’t see the return on investment. They lose confidence and ultimately give up.

“I want to inspire delegates to implement strategies and tactics that will make a dramatic difference to their businesses and increase their revenue from facial aesthetics.”

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

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

The impact of tooth extraction – Mark Allen Coltene

A patient who has kept a good standard of oral health for years may still face the prospect of losing a tooth. A failed or failing restoration, a tooth that has been damaged as the result of a trauma or infection – it isn’t just decay and poor dental hygiene that can lead to extraction.

To be told that extraction is necessary, or is an option following assessment, can be a significant psychological blow. People have an emotional attachment to their teeth, yet perhaps they didn’t realise how strong this attachment was until they faced the prospect of losing one.  

A qualitative study from Guy’s, King’s and St Thomas’ Dental Institute in London that looked at the emotional effects of tooth loss, concluded that “the impact that tooth loss can have on people and their lives should not be underestimated”.[i] The study found that, for the 45 per cent of participants who had difficulty accepting the loss of a tooth following extraction, they were “more likely to feel less confident about themselves; more likely to feel inhibited in carrying out everyday activities; and less able to accept the inevitable change in facial shape which occurs following the loss of teeth”.[ii]

Another piece of research concurred with these findings. When asked how they felt when undergoing a tooth extraction, adult patients reported feelings of “sadness” and “depression”, as well as the “feeling of losing a body part” and of “ageing”.[iii] The authors also believed their study indicated that “the effect of tooth loss on self-esteem and self-image is not short lived, as it has been assumed”.

More than vanity

Teeth give support and balance to the face as well as carrying out essential roles. They are central to someone’s physical identity. The impact of losing a tooth can be social, aesthetic and functional. Feeling too inhibited to open your mouth to smile or talk, will affect social engagement and all kinds of relationships. The media may bombard us with images of beautiful smiles, but this isn’t solely about vanity. Anything that changes the way someone looks can affect their self-confidence. Happiness and level of self-worth can also be impacted which, again, may lead to social withdrawal and an unwillingness to participate in all kinds of activities, including work situations.

If someone has lost a tooth, or faces the prospect of extraction, they may become less willing to smile. Smiling is a simple, yet powerful action – both giving (and receiving) a smile establishes a positive bond between individuals. Smiling is contagious; when someone smiles at you, you often reciprocate without even thinking about it, leading to a feeling of wellbeing. A spontaneous, genuine Duchenne smile, where the corners of the mouth raise, makes everyone look more attractive. The rush of endorphins you experience when you smile is a natural stress-buster, too and, it has been claimed, can elevate a pain threshold.[iv]

More dentulous adults

In the past, losing a tooth was to be expected, as part of the normal ageing process. But as per the last published Adult Dental Health Survey, more than half of people over 85 have retained some of their natural teeth, compared to 37 per cent of the population 50 years ago.[v] If a younger patient facing extraction thinks that they won’t be able to chew food properly, or eat the food they want, this can also be a source of considerable distress.

So why, when the offered alternative to extraction is root canal therapy, do some patients still hesitate? If an infection has led to a recommendation for an endodontic procedure, because it is threatening the life of a tooth, this should always be the preferred option. Modern endodontic therapy is quick, ethical and stable. Success rates are extremely high and, even better, a patient will be able to save their tooth rather than needing to replace the extracted one with an implant or prosthesis.[vi] Thanks to modern techniques, a patient will also get their healthy-looking smile restored efficiently – with some tools and materials, the entire treatment can be wrapped in one appointment. Along with technique, material selection is fundamental for successful endodontics; COLTENE’s HyFlex™ file system means that even narrow files can be prepared efficiently. Clinicians may find they can complete the entire preparation sequence with just one or two files and the new HyFlex™EDM Glidepath file 15/.03 was recently introduced to help dentists successfully face the challenge of complex cases.

The psychological impact of extraction is significant and possibly underestimated. For dentists, the aim is to help patients stay dentulous for as long as possible and, should the situation arise, recommend that they choose to save and retain the natural tooth. Having a tooth extracted can affect many areas of a patient’s life, including their mental wellbeing and ability to engage with others. When the reason for a tooth failing is an infection, the best course of action for long term success is always root canal therapy.

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

 

[i] Davis DM, Fiske J, Scott B, Radford DR. Prosthetics: the emotional effects of tooth loss: a preliminary quantitative study. British Dental Journal. 2000 May;188 (9): 503.

[ii] Davis DM, Fiske J, Scott B, Radford DR.

[iii] Okoje VN, Dosumu OO, Alonge TO, Onyeaso C. Tooth loss: are the patients prepared? Nigerian Journal of Clinical Practice. 2012;15 (2): 172-5.

[iv] Dunbar, Robin IM, et al. “Social laughter is correlated with an elevated pain threshold.” Proceedings of the Royal Society of London B: Biological Sciences (2011): rspb20111373.

[v] Adult Dental Health Survey Executive Summary. The Health and Social Care Information Centre, 2011. Link: https://files.digital.nhs.uk/publicationimport/pub01xxx/pub01086/adul-dent-heal-surv-summ-them-exec-2009-rep2.pdf (accessed September 2019).

[vi] Pulp fact – looking inside endodontic claims. DDU Journal. Link: https://ddujournal.theddu.com/issue-archive/issue-3/pulp-fact—looking-inside-endodontic-claims (accessed September 2019).

 

 

The Dental Awards 2020: Raise a toast to those who help make it happen

The Dental Awards continue to receive support from some of the industry’s most highly esteemed innovators, with Colosseum Dental the latest to embrace what for years has been described as ‘the ceremony of the year’.

Rows and rows of dental professionals joined by their family and friends sit talking and laughing as they eagerly await the evening’s entertainment. The cocktail reception has already been attended, and as the most refined cuisine makes its way onto tables and sumptuous wine teases the palate, a DJ waits patiently for the Dental Awards ceremony to come to a close and the dancing to begin…

As those who have attended the Dental Awards in previous years will tell you, every event is unique for its quality entertainment, yet steadfast in its ability to deliver an exciting and unforgettable evening every time. Part of what allows the Awards to deliver on its promise of luxury is owing to the generosity and heartfelt commitment of its sponsors, who share our belief that dental professionals across the country deserve to be recognised for their dedication to patient care.

The team at The Probe would therefore like to thank our newest sponsor, Colosseum Dental, for helping us on our mission to create a night to remember.

One of the UK’s major providers of dentistry, as well as Europe’s most rapidly-growing dental company, Colosseum Dental cares for more than 750,000 NHS and private patients with over 70 UK clinics.

Colosseum Dental practices engage with their local communities and have a strong connection to charity. The Jacobs Foundation is the sole economic beneficiary of Colosseum Dental Group, which means all dividends go towards educational programmes around the globe. Colosseum Dental is just as dedicated to providing excellent patient care, as well as the training and support staff need to begin, develop and succeed in their dental careers.

It is a privilege to announce Colosseum Dental a Dental Awards sponsor!

Also supporting The Dental Awards 2020 are: Colgate, COLTENE, Dental Elite, Geistlich Biomaterials, Simplyhealth Professionals and Waterpik.

Building on 140 years of oral care expertise, Colgate’s commitment to oral health extends beyond its quality products. Colgate provides enhanced continuing professional development for dental professionals, ongoing health education for consumers, and actively partners in supporting dental associations and societies.

COLTENE is the name behind some of the most innovative dental products and materials on the market. Its mission is ‘Upgrade Dentistry’ – that it is always possible to find ways to do things better, quicker and easier, for reliable outcomes every time. COLTENE listens to what forward-thinking dentists want and this is just one of the reasons why it is committed to ongoing research and development.

As one of the two busiest dental agents in the UK and Ireland, Dental Elite aims for extraordinary results, specialising in dental practice valuations and brokerage services, dental recruitment and dental practice finance services. The team set their service ahead of the competition, guiding all their clients through the next step in their careers – be that job-hunting, buying or selling.

Over 1,000 pre-clinical and clinical studies prove the success in practice of Geistlich Biomaterials’ Geistlich Bio-Oss and Geistlich Bio-Gide. The excellent results of guided bone regeneration with Geistlich Bio-Oss and Geistlich Bio-Gide, are largely due to their unsurpassed biofunctionality.

Providing exceptional support to dentists, Simplyhealth Professionals is the UK’s leading dental payment plan specialist with more than 6,500 member dentists nationwide caring for approximately 1.7 million patients registered to a Denplan product.

Backed by over 70 published studies supporting safety and efficacy, the Waterpik brand provides a full range of innovative oral hygiene solutions to help patients to maintain optimal, long-term oral health. Waterpik is also dedicated to the dental team and offers professional Lunch and Learns, as well as online support and free CPD self-study courses on current, cutting edge topics.

To all of our sponsors, thank you for helping us to go the extra mile! 

The Dental Awards takes place on Friday 15th May 2020 at The Hilton Metropole N.E.C. Birmingham. Visit: www.the-probe.co.uk/awards/the-dental-awards-2020/

The restorative balance – Marjan Davasaz Managing Director Fairfax Dental

Dentistry has come a long way in 40 years. The procedures offered and the environments they are provided within are totally unrecognisable from those of the 1970s – which can only be a good thing! The latest generation of dentistry very much focuses on preventive protocols and the adoption of minimally invasive procedures wherever possible. It is also about finding the right balance between aesthetics and longevity of results. Only when both are achieved to a satisfactory standard will patients be happy with the outcome.

Continued demand for restorative dentistry

According to 2017/18 NHS data,[i] permanent fillings and sealant restorations were among the most common treatments delivered to dental patients in England. This was true for both adults and children. In fact, approximately 80% of the UK population has at least one filling.[ii]

The good news is that the numbers appear to be improving. Fewer courses of NHS restorative treatments were required by UK patients during this time frame compared to 2016-17, suggesting an improvement in oral health. Some caution is necessary though, as these figures do not demonstrate trends in treatment sought on a private basis.

An increased appetite for aesthetic dentistry

This is relevant because private dentistry can cater to certain patient demands that NHS services often cannot, fuelling growth in the sector. For example, the desire for highly aesthetic outcomes has become a priority for many patients. As such, the amalgam filling material that has historically been offered through the NHS is unlikely to be many people’s first choice. Instead, these patients prefer to opt for more natural-looking composite restorative materials and are happy to pay for the pleasure. Similarly, many people will seek bridges that blend seamlessly with their natural dentition and these solutions are not always available via NHS services. Alternative arrangements therefore need to be found.

So, why the increased appetite for aesthetic dental outcomes? There are several potential driving forces behind peoples’ need to achieve a certain appearance. Social media and its accompanying ‘selfie culture’ is commonly cited as a culprit, with pressure put on users of these online platforms to meet specific aesthetic standards. The national media may also be partly to blame, by promoting particular looks, body types and features as more beautiful than others among models, celebrities and other influential people.

As a result, one of the assets many people now crave is a good smile. Channelling this in a positive way is key. The health of their teeth and gums should come first, but it is also possible for dental treatment to have a massive impact on an individual’s self-confidence and quality of life. This is very much to be encouraged. However, managing patent expectations to avoid unrealistic goals, and discouraging invasive dentistry where alternative solutions are available, are both important for the dental team.

No compromise

Now, patients might be focused on the aesthetic outcome of dental treatment, but that’s not to say they are willing to compromise anywhere else. For instance, those who undergo restorative work – either to achieve the smile of their dreams or to treat the result of trauma or an accident – will expect their investment to last. Regardless of how good the restoration looks, no patient will continue to be delighted with the result if they require re-treatment within a couple of months.

Consequently, delivering a restoration that you and your patients can rely on to last is crucial. Of course, most restorative dentistry will require care and maintenance over the years – which patients should be made aware of early on. However, seeking to prolong the longevity of restorations is well within the ability of all dental professionals today.

Optimising strength and longevity

There are several options available to clinicians to improve the longevity of restorations delivered to patients. Many modern materials have been developed specifically to maximise on both aesthetics and strength. For instance, many bulk fill composites offer these properties as well as a streamlined workflow for quick and efficient procedures.

Furthermore, the use of additional tools can further improve results. Dentine pins have been shown to increase retention of restorations compared to use of bonding agents alone.[iii],[iv] This is especially true when restoring teeth with significant coronal structure missing. Stabilok Dentine Pins from Fairfax Dental have been used for such situations for more than 40 years to great effect.

Restorative success

Meeting the ever-rising expectations of modern dental patients can present a challenge for dental professionals. By managing their expectations and employing materials and products designed to boost both aesthetics and longevity of results, treatment can be highly successful.

For more information, please call 020 8947 6464

 

[i] NHS Digital. NHS Dental Statistics for England – 2017-18. Annual Report [PAS] 20 August 2018. Annex 1. Tables 5a, 5b ,5c and 5d. https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics/2017-18-annual-report#resources [Accessed October 2019]

[ii] National Smile Month. The impact of National Smile Month. https://www.dentalhealth.org/impact-nsm[Accessed October 2019]

[iii] ­Widjiastuti I. Pin-retain for restoration of widely tooth damaged. Dental Journal: Majalah Kedokteran Gigi. 2007. 40. 10.20473/j.djmkg.v40.i2.p98-100.

[iv] ImberyT, Burgess J, Batzer R. Comparing the resistance of dentin bonding agents and pins in amalgam restorations. JADA. 1995; 126(6):753-9.