Where temporary fillings are needed for inlay/only preparations and endodontic applications, a reliable material is essential to protecting against the infiltration of bacteria and ensuring the patient continues to have full oral function.

For double protection try COLTENE’s DuoTEMP^® temporary filling material with high marginal seal and dual-curing properties – it takes just 40 seconds to light cure DuoTEMP^® before it begins to self-cure on its own with saliva.

Once it’s been applied, your patients will hardly know it’s there thanks to the DuoTEMP’s^® high surface hardness and natural tooth-like feeling, ensuring ultimate comfort until the material is replaced with a permanent solution.

The temporary restoration is very easy to apply and remove as well, which helps to reduce the time the patient needs to spend chair side and maximises the patient experience. 

Contact COLTENE now to order your DuoTEMP^® temporary filling material.

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

The BACD is a vibrant community of dentists, students, and dental technicians.

A world-leading authority on ethical cosmetic dentistry, the BACD has always been forward thinking when it comes to making every patient feel comfortable and informed. It has comprehensive protocols for treatment planning, indispensable for the challenges ahead.

Patients can feel safe with BACD dentists. Members also have access to unparalleled learning opportunities, including a recently launched online learning portal, to ensure
they are up-to-date on the latest research and best practice.

To be part of the BACD, and to find out about all its benefits, visit the website today.

For further enquiries about the British Academy of Cosmetic Dentistry visit www.bacd.com

For your dental practice, as with many small-to-medium sized enterprises (SMEs),
cash-flow might be an eternal headache. Although your business will have a pragmatic budget in place, there is always something that pops out of nowhere, or an issue that’ve you’ve been vaguely aware of, but now can avoid no longer and have to a find a way to fund it.

Your most valuable resource

Staff-related expenses are often the biggest costs. Once salaries have been accounted for, as a forward-thinking practice owner, you’ll need to think about investing in training. The alternative is to increase numbers – either adding to the payroll, or by engaging the services of a contractor. But investing in your team can enrich your practice by enhancing patient services. In other words, it can make great business sense as part of a long-term plan for growth.

Among the clinical team, your practitioners may be looking to up-skill, so they can deliver specialist services. With patient-driven demand for treatments like whitening increasing, upskilling is a way for your practice to offer more, as well as give individuals the opportunity for professional and personal development. Or you may have a dental nurse desperate to move into practice management, or a treatment co-ordinator role.

Good-quality training costs money and you also may have to temporarily fill roles when people are away. While training generally encourages retention, people do move on and the recruitment process can be costly. Again, you might need to engage a contractor before someone new is in post, or your favoured candidate might want to negotiate their renumeration. If they are the right person for the job, you should be willing to do this.  

Where’s my money tree?

What other things that might require a cash injection? New equipment, technology and changes to your premise which could be anything from a spruce up, to building works. So, where to go for money? Well, a report from the end of 2019 indicated a funding gap in the SME sector worldwide, and you might not be successful in securing a loan from a high-street lender.[i] According to past data, UK high street lenders convert only a small percentage of loan applications from SMEs, which goes some way to explain the funding gap of tens of millions, according to one source.[ii] Reasons for this can include: “regulation… banks having huge cost structures (and) SMEs not having standardised data”.

Investing in your dental practice – whether it’s in people, products or premises – can enhance your service, increase numbers of happy patients and boost profits. Look for alternative finance, away from the high street. I have previously reported on a government-backed referral scheme that helps small businesses who failed to access finance from the major banks. Launched in 2016, the large banks will refer SMEs who they turned down for a loan to four alterative platforms.  

SMEs are the backbone of the UK economy. At the beginning of 2019, they accounted for 99.9% of the business population, employing over 16 million people.[iii] Investment in their success is essential. After you’ve discussed your plans with a specialist dental accountant – like the experts at Lansdell & Rose – and it’s agreed that they’re viable, don’t take no for an answer when seeking the funding you need to grow!

To find out more, call Lansdell & Rose on 020 7376 9333,

Or visit http://lansdellrose.co.uk

[i] Large funding gap forms in SME lending sector as UK banks fund just 8% of small business loans. CISION, 11 December 2019. Link: http://www.prweb.com/releases/large_funding_gap_forms_in_sme_lending_sector_as_uk_banks_fund_just_8_of_small_business_loans/prweb16773997.htm (accessed December 2019).

[ii] High street bank converts just 8% of SME loan applications. SME Guidance for Business Growth,
20 September 2018. Link: http://www.smeweb.com/2018/09/20/high-street-bank-converts-just-8-sme-loan-applications/ (accessed December 2019).

[iii] FSB figures, UK Small Business Statistics. Link: https://www.fsb.org.uk/media-centre/small-business-statistics (accessed December 2019).

As a dental professional, you’re probably familiar with clinical waste. However, unlike some other waste streams that are rather more straightforward to identify and dispose of correctly, the rules surrounding clinical waste can be a bit confusing.

So, why not have a refresher on clinical waste? This is especially relevant right now as any waste generated during the treatment of patients throughout the Coronavirus pandemic has to be deemed as clinical waste, and therefore knowing how to dispose of this safely and correctly is vital.

What is clinical waste?

The main confusion surrounding clinical waste stems from the fact that under the Department of Health’s colour code guidelines for best practice waste disposal, there are two different colours associated with clinical waste.

The first of these waste streams is infectious clinical waste. Items in this waste stream are categorised as orange waste in the colour code, and include everything from gloves to aprons, bibs, masks, or anything else that has come into contact with fluids that could potentially hold infectious diseases, such as blood. In dentistry, this means anything that comes into contact with the aerosol created when drilling is classed as clinical infectious waste as well and should be treated as such. This waste will either be destroyed by treatment or incineration. 

The other waste stream is highly infectious clinical waste. This is represented by yellow in the colour code, and contains many of the same items. The big difference is that items are deemed as highly infectious clinical waste if it is confirmed or heavily suspected that the patient has a disease that can be spread through contact with bodily fluids. This means anything disposed of after treating individuals with conditions such as hepatitis and HIV should treated as highly infectious clinical waste. This waste must be incinerated.

Of course, that means that the judgement in some cases will fall to you as a professional as to whether something should be categorised as yellow or orange waste.

Disposal is important

So why does clinical waste need to be segregated from other items? The core reason is that these waste items are likely to spread infection if they are improperly disposed of. Some infections can live in droplets of dried blood for days or even weeks, and this means that they could be spread unknowingly if they come into contact with people who aren’t wearing protective equipment.

For example, if something like a contaminated pair of gloves ended up in landfill, these could accidentally come into contact with people or wildlife, and this could potentially result in any diseases present on that contaminated item being passed on. 

Therefore, it’s essential for the safety of others to dispose of these items correctly.

Another thing to bear in mind is the reputation of your practice and any legal fallout that could occur due to improper waste disposal. Infection control is a massive priority for all healthcare operators, and if someone should accidentally be exposed to infection due to improper disposal of waste they would have every right to take legal action against your practice. This will inevitably have both a financial and social impact that could be difficult to recover from. 

Coronavirus and clinical waste

Under the Government guidance “COVID-19: Guidance for infection prevention and control in healthcare settings”, any waste generated from a possible or a confirmed case of Coronavirus must be disposed of as Category B clinical waste. This is in effort to help delay the transmission of the virus, and should be always be adhered to.

The problem with Coronavirus is that it is easily spread from any respiratory droplets expelled by coughing. This means that saliva is a perfect way for this disease to transmit, meaning that extra caution must be practised when treating any patient. Even if you think an item has not come into contact with any body fluids from a patient, it should still be treated as if it has, just to be on the safe side.

Keep clinical waste clear

As a dental professional you and your staff need to be on the same page when it comes to all types of clinical waste. As such, it’s a really good idea to host a refresher on this topic when the team is back together once more.

Another great option is to display some of Initial Medical’s Colour Code Character posters around the practice. These fun designs assign a character to each of the colours in the Department of Health’s colour code for best practice waste disposal, including extra visual clues that can encourage staff to remember what waste belongs in which category at a glance.

Safe now and in the future

Clinical waste is always going to be one of the most common waste streams in your practice. By ensuring that you and your staff are aware of what clinical waste is, where and how it should be disposed of and the dangers that these waste streams can carry, you can help guarantee that your practice remains a safe space for all, even during these unique and challenging times.

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

Author: Rebecca Waters, Category Manager, Initial Medical

Rebecca has worked in the Healthcare sector for the past 17years and was a Research Chemist with Bayer Cropscience prior to joining Rentokil Initial in 2003.  She keeps up to date on all developments within the clinical waste management industry and is an active member of the CIWM, SMDSA and BDIA.  

-Ends-

About Initial Medical

Initial Medical is an expert in healthcare waste management, providing a complete collection, disposal and recycling service for hazardous and non-hazardous waste and offensive waste produced by healthcare providers, and other businesses and organisations within the UK.

The safe management of healthcare waste is vital to ensure your activities are not a risk to human health.  Initial Medical’s healthcare waste services ensure that all of your waste is stringently handled in compliance with legislation and in accordance with Safe Management of Healthcare Waste best practice guidelines, providing you with the peace of mind that you are adhering to current legislation.

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

Media enquiries:

For more information, please contact:

erica@ekcommunications.net

01227 265700

Understanding that every patient is different, Straumann® offers an all-inclusive range of biomaterials to help you overcome the daily challenges you face. The complete portfolio includes solutions to improve efficiency and effectiveness of bone grafting procedures, soft tissue grafts and periodontal surgery.

For example, Straumann® Emodogain FL is designed to make periodontal regeneration less invasive. It can be used within flapless periodontal debridement procedures to efficiently[i] and effectively[ii] reduce pockets, while optimising patient comfort[iii] [iv] at the same time.

Aside from its clinical benefits, Emodogain FL is a powerful tool in improving professional workflows and patient experiences.

Find out more about this and the many other innovative solutions within the Straumann® biomaterials portfolio today.

For more information on the complete range of biomaterials, please visit www.straumann-uk.co/biomaterials

[i] Straumann Sponsored Study (data on file, study ongoing). 

[ii] Aimetti M, Ferrarotti F, Mariani GM, Romano F. A novel flapless approach versus minimally invasive surgery in periodontal regeneration with enamel matrix de­rivative proteins: a 24-month randomized controlled clinical trial. Clin Oral Investig. 2017 Jan;21(1):327-337. 

[iii] Wennström JL, Lindhe J. Some effects of enamel matrix proteins on wound healing in the dento-gingival region. J Clin Periodontol. 2002 Jan;29(1):9-14.

[iv] Gennai S, Petrini M, Tonelli M, Marianelli A, Nisi M, Graziani F. Acute phase response following non-surgical periodontal therapy with enamel matrix derivative. A randomized clinical trial. Poster presented at Europerio 9 in June 2018 (PD065).

Designed to help practices achieve first class disinfection safely, effectively and simply, the ThermoKlenz thermo washer disinfector dryer should be the first choice for any practice aiming for quality results.

Distributed by leading decontamination experts W&H, the ThermoKlenz offers both effective cleaning through the automatic regulation of water temperature and detergent quantity, and drying through forced hot air that reduces residual moisture internally and externally. This ensures that instruments are 100% ready for sterilization.

The ThermoKlenz is available with a KlenzSecure data logger, so that practices are able to keep electronic records of cleaning cycles – much more efficient than a paper trail.

To find out more, contact W&H today.

To find out more visit www.wh.com/en_uk, call 01727 874990 or email office.uk@wh.com

Shahram Mirtorabi is the principal dentist at Hindley Dental Practice, Wigan. Following his graduation from the University of Manchester Dental Hospital, he worked
in a number of practices before establishing Hindley in 2002. Shaz is passionate about all aspects of dentistry and is a member of the British Academy of Cosmetic Dentistry (BACD). He is also experienced in and lectures on implantology. Here, he presents a restorative case where a patient wanted to improve the aesthetics of a single tooth.

Case presentation

My patient was a 36-year-old female who attended the practice complaining of the appearance of her UL1. She was medically fit and well and explained that she had sustained trauma to her front tooth as a teenager and had repeatedly received direct restorations. She subsequently had a porcelain veneer fitted a few years ago, but had never been satisfied with the appearance of it and was now seeking a better aesthetic (see Figures 1 and 2).

On examination it was noted that her general dental health was good with healthy periodontal tissues, although there was hint of some recession around the labial aspect of the UL1, as shown in Figure 3. On radiographic examination, the UL1 had a sound orthograde root filling with no associated pathology.

Fig.1

Fig. 2

Fig. 3 

Treatment options 

The aim of the treatment was to achieve a symmetrical harmony of the central incisors by balancing the soft and hard tissues. This could be ideally achieved with tooth alignment, using short term orthodontics, but the patient was not willing to undergo any form of orthodontics. The alternative option was to recontour the gingivae around the UL1 to achieve a symmetrical zenith, and accept that it will be slightly wider. Furthermore, we discussed the possible whitening of her upper and lower teeth prior to the restorative stage involving an indirect restoration such as a veneer or crown to the UL1.

Discussing the possible treatment options and related costs with patients is often onerous, but it’s essential to obtain valid consent from them. This important step helps to avoid any confusion, misunderstandings and possible complaints at a later stage. In this particular case, the patient agreed to phase the treatment, dealing with the soft tissues by firstly contouring the gingivae and then address the restorative phase later.

The asymmetry of gingival zenith was rectified by using COLTENE’s PerFect^™ TCS ll, as it is effective and precise with no bleeding and fast healing, as shown in Figure 4. Once we were both happy with the symmetry of the gingivae, the defect was restored with COLTENE’s BRILLIANT EverGlow^™ shade A2 (see Figure 5, also Figure 6 to see the balancing pink and white and Figure 7 for the patient’s smile following the first stage of treatment).

After a few weeks, soft tissue stability was achieved and the restorative options were discussed and offered to the patient. Firstly, we had to decide whether to proceed to replace the veneer, or opt for a crown. Once we had decided to go ahead with the full coverage crown, we considered different materials and finally decided on an all-ceramic e.max crown. The crown was cemented using COLTENE DuoCem™, as it is my preferred and trusted cement due to its versatility with excellent technical properties and easy handling (see Figure 8). DuoCem™ is a dual curing resin cement in 5ml automix syringes, available in Dentin Trans and White Opaque, allowing me to determine the final shade of the restoration. In this case, I used shade Dentine Trans (see Figure 9). The final smile can be seen in Figure 10.

Fig. 4

Fig.5

Fig. 6

Fig. 7

Fig. 8

Fig. 9

Fig. 10

Discussion

This case demonstrates the importance of communication between clinician and patient and highlights the need to involve both parties in the decision-making and treatment planning processes. To obtain the patients’ valid consent is the duty of the clinician, who must also inform and advise the patient of the possibilities and consequences of their decisions. As clinicians we need, therefore, to have access to a variety of equipment and materials which enable us to deliver the best dentistry and address our patients’ needs. In my daily practice, the trusted COLTENE products I use provide me with the platform to consistently achieve these goals and thus give my patients the very best treatment possible.

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

As a dental hygienist or dental therapist, it’s likely that you are no stranger to spending the majority of the working day sitting down. Indeed, conditions caused by prolonged sitting are often discussed in articles for those working in offices and other similarly stationary environments. But what are these problems and what can we do to stop them?

According to data, sitting down for extended periods of time on a regular basis can exacerbate a number of conditions, as well as putting people at higher risk of developing new ones.[i] The core idea behind this is that when you are sitting down you are burning fewer calories, and this can quickly take its toll on your personal health.

As such, people working in sedentary professions are at risk of increased levels of obesity alongside a higher risk of cardiovascular disease and certain cancers. Furthermore, there’s the strain on the body to consider, and sitting down for too long can quickly lead to back problems if someone has bad posture,[ii] as well as reduced circulation to the legs and feet resulting in swelling and soreness.[iii]

So, as you can see, this is something which dental hygienists and dental therapists need to be aware of. But what can professionals do to help avoid these conditions?

One simple measure is to try and find chances to be active during the day when at work. Of course, with a busy schedule this is easier said than done, but if you do have a lunch break or a spare ten minutes here and there, try to do something active like heading out for a walk – even if this is just to go out and get some food or a quick stroll around the local area. Another easily incorporated way to help prevent these conditions is to make sure that you stand up at least once every 30 minutes. Even a small change in activitiy levels is bound to have positive effects.

What about parking farther away from work or getting off the bus a stop earlier? It’s tricks like these that can easily introduce more active time into your life without disrupting your schedule.

Another good tip is to work on your posture. Poor posture where the head stoops forward when sitting shifts the body’s centre of gravity forwards, putting unnecessary strain on your back as well as the supporting muscles on the lower half of your body if you sit in any strange positions. By concentrating on holding yourself erect when seated, you can help avoid this excess strain and take a lot of the pressure off, reducing the risk of swollen ankles and poor circulation.[iv] Wearing dental loupes can also help maintain a good working position and posture. Another tip is to do seated leg exercises throughout the day such as stretching your legs out and rotating the ankles to ensure that your circulation isn’t impacted by remaining in the same position too long.

In the end, we need to remember that looking after our own health is just as important as looking after that of our patients. Take the chance to have walks and be up on your feet, try to incorporate more activity into your days – the risks of staying seated are substantial, but they don’t have to be a probem if you take extra care.

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

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

[i] Mayo Clinic. What Are The Risks Of Sitting Too Much? Link: https://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/sitting/faq-20058005 [Lastaccessed January 2020].

[ii] Healthline. Why Does My Lower Back Hurt When I Sit and How Can I Relieve the Pain? Link: https://www.healthline.com/health/lower-back-pain-when-sitting [Last accessed January 2020].

[iii] PBE. Is Working at a Dek Hurting Your Feet? Link: https://www.pbergo.com/oh-my-aching-feet/ [Last accessed January 2020].

[iv] NEA. 4 Ways to Reduce Pain from Standing All Day. Link: https://www.neamb.com/family-and-wellness/4-ways-to-reduce-pain-from-standing-all-day [Last accessed January 2020].