Month: September 2020

#SaveLabs

The DLA’s campaign to Save Labs, Buy British has so far been a huge success, having brought key issues to light and encouraged many dental practices to support their local labs.

As we tentatively move back to routine dentistry, it’s crucial that British laboratories continue to receive the support they need from their practice colleagues. The #SaveLabs slogan isn’t just about saving businesses right now, but also about securing their futures.

The Dental Technology Showcase (DTS) remains the DLA’s flagship event and there will be plenty of opportunities to find out more about this and other campaigns designed to support our lab community at the next event in May 2021. In the meantime, you can find out more on social media and on our website.

 

The next DTS will be held on Friday 21st and Saturday 22nd May 2021– Hall 5, Birmingham NEC, co-located with the British Dental Conference and Dentistry Show.

For the latest information, please visit www.the-dts.co.uk, call 020 7348 5270 or email dts@closerstillmedia.com

Virtual communication in the post-pandemic era

Millions of people worldwide are still trying to adjust to a new pace of life. Given the current health climate and the invasive nature of dentistry, some patients are understandably concerned about seeking treatment. Therefore, reaching out is more important than ever in order to rebuild trust and increase patients’ confidence about returning to the practice. What many dental professionals have come to realise since lockdown is just how beneficial virtual communication tools can be.

Website and email

As dental professionals, we need to be sensitive to the emerging concerns of patients if we are to nurture positive relationships with them in the post-pandemic era. We can help patients feel more comfortable about visiting the practice by advising them on what to expect. This should begin with your practice website and email communications, which you can use to continue reassuring patients about the additional infection control protocols that you have put in place to ensure their health and safety.   

A live online chat platform – where you can engage with patients in real-time – is another method of virtual communication you could take advantage of via your practice website. Providing such a service, makes it extremely convenient for existing and prospective patients to make enquiries or even schedule future appointments between, for instance, working hours or looking after children at home. The practice team can then respond quickly and easily amidst calls or when engaging with other patients directly in practice.

Live chat could even be supported by a dedicated patient portal that is built into the practice website. This provides a convenient and secure platform for patients to communicate with the dental team, where they can submit information prior to any appointments. As a result, patients are likely to feel more connected to your practice even when it is closed. Furthermore, a patient portal could help streamline check-ins or appointment rescheduling when patients can eventually return to the practice for treatment. An online billing service through the patient portal can further ensure convenience by making it easier for patients to pay for treatment, thereby eliminating the stress of doing so in practice on the day.

Social media

Through social media, dental professionals can take patient engagement a step further by providing a glimpse into the practice’s daily operations. In addition to informing patients about your health and safety protocols via your practice website and email channels, you can utilise engaging photos and videos across your social media networks to emphasise the preparedness of your practice team. For instance, you could post short videos of cleaning processes before and after each appointment so that patients can see exactly what measures you are taking to protect them. You could also film a walk-through to demonstrate to patients what steps they need to follow during their visit to the practice.

Furthermore, you could ask existing patients to provide testimonials on their treatment experience with you, which could then be uploaded to social media to promote your services. Facebook, Twitter and Instagram also offer the ideal platform for you and your team to offer oral health advice to the wider community, including how to minimise the burden of infection through an effective oral care regime. At the same time, you can seize this chance to remind patients of the importance of visiting the practice regularly so that you can assess the condition of their teeth and gums, and provide professional cleaning and/or treatment if necessary. 

Video conferencing

Teledentistry – especially video conferencing – can help patients and dental professionals stay connected from anywhere. Virtual consultations, in particular, enable dentists to engage with patients without them having to actually be in the practice, thus putting patients at ease with regard to non-urgent matters and offering a more convenient mode of communication. This has been particularly advantageous during the global COVID-19 pandemic, but video conferencing can offer benefits in the course of normal, everyday life too. For patients who have physical limitations, for instance, video conferencing enables them to conveniently seek initial treatment advice from the comfort of their own home. 

Beyond this, video conferencing can enhance the treatment journey – virtual consultations provide patients the space and time to digest the information their dentist has provided about their oral health, and identify the problems that they are most concerned about solving. As a result, the patient can feel more in control of the overall process, thereby helping to improve treatment acceptance rates. Even if you lack the facilities to offer more complex or specialist treatment, you can extend your virtual services by referring your patients to a trusted and like-minded partnering clinic. As a referral partner of Ten Dental+Facial, for example, your patients can attend a virtual consultation for the advanced treatment they need before benefiting from the best possible clinical care.

It is important for dental professionals to remain understanding of patients’ concerns during this extended period of uncertainty. Now is the time to assess how you can better utilise virtual communication tools going forward in order to encourage patients to seek treatment, whilst reassuring them that you are able to provide exceptional care within a safe environment.

 

For more information visit www.tendental.com or call on 020 33932623

Good for dentists, good for patients

When The Dental Advisor tested Cavex Cream Alginate, it provided a 5-star rating.

Dentists who have tried it talk about “easy mixing” and “good tear resistance”. It also offers “excellent” detail and a short working time for the benefit of clinicians and patients alike. Less need for remakes means faster, more efficient treatment.

Cavex Cream Alginate is suitable for multiple castings and its high-detail replication enables digital impressions as well, making it a value product as well as a high-performance one.

Cavex Cream Alginate is distributed by J&S Davis, as fast or normal set. Order direct or through your preferred dealer to see why it’s the first choice for so many dentists.

 

For more information on the industry-leading products available from J&S Davis,
visit www.js-davis.co.uk, call 01438 747 344 or email jsdsales@js-davis.co.uk

Expanding your horizons

In dentistry, keeping ahead of the curve is essential. Technology is constantly advancing and scientific research is always discovering new breakthroughs that can be used to provide better treatment. It’s vital to keep on your toes in order to branch out, embrace new opportunities and do all in your power to provide patients with the very best care.

Of course, this is easier said than done, and it’s not as simple as just forging ahead without thinking how to best explore possibilities and embrace them in a way that will benefit your practice and patients alike.

The benefits of branching out

It almost goes without saying that the biggest benefit of offering new treatments is the more versatile style of care you can give your patients. With new solutions and technology available to make treatments easier and more predictable, it’s paramount to see if these are feasible and something that your patients will directly benefit from.

However, it’s also a good idea to look at this from the perspective of potential as well. By adopting new technologies or starting to offer new treatments, you can easily bring in a whole new patient demographic. This will inevitably aid your business financially and boost your reputation, leading to more new patients.

It’s also necessary to think about the challenges that embracing new opportunities can bring. Branching out into new treatments or purchasing new technology will mean that training is necessary, but this is a good way to remain motivated and excited by what you do – variety is definitely the spice of life.

Find the niche

 Like all businesses, one easy way to ensure your practice is successful is to offer people something unique in your area. Every patient will have different needs and requirements, but that doesn’t mean that certain treatments won’t be more appealing to your general patient demographic. This is something that all professionals should look to identify and capitalise on.

For example, you may already offer exceptional orthodontics, especially if your practice is situated in an area with a high volume of schools, but what about offering services such as mouth guards and other useful items that the same patients could hugely benefit from? By looking at the typical enquiries you receive and utilising the opportunities these present, you are giving yourself the best chance of diversifying and delivering even greater value to your patients.

Another good example is to think even more outside of the box. Are you interested in aesthetic dentistry? Have you considered botulinum toxin injections or other aesthetic treatments that could complement the overall results you achieve? Grasping openings like this is a great way to stand out and boost your profitability while also keeping patients satisfied and inspired by your services.

Supporting the idea

Arguably the most important thing to prioritise when you’re looking at embracing new possibilities within practice is how to achieve these in a way that is beneficial to everyone. Technology is likely going to be a huge consideration, especially if you’re looking to move into a new field of dentistry and/or offer more complex treatments.

This can fast become an expensive undertaking, especially if you are looking at systems that are exclusively aimed towards one type of treatment alone. However, there are many new innovations that are versatile and easy to use, so branching out into new areas and embracing possibilities could be made simpler.

One example is the new CS 8200 3D CBCT system from Carestream Dental. Compact and straightforward, this ground-breaking new solution offers multiple imaging modalities and crisp, accurate images to suit a wide array of indications. Furthermore, its extended field of view means that professionals can use the system to easily expand their treatment capabilities, at their own pace and without having to invest in multiple pieces of technology.

The best for your practice and your patients

As dentistry continues to evolve, practices need to have solutions on hand to continue to provide an exciting range and variety of treatments. This is not just about providing exceptional quality care, but also offering opportunity for patients to get more out of their visits. This in turn will also benefit your practice and the professionals who work there.

 

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

 

 

Author: 

Nimisha

Nimisha Nariapara is the Trade Marketing Manager at Carestream Dental covering the UK, Middle East, Nordics, South Africa, Russia and CIS regions. She has worked at Carestream Dental for the past 7 years, where she has developed her marketing skills and industry knowledge to bring the core values and philosophy of the company to the market. 

FGDP(UK) & CGDent to update Covid-19 guidance following SDCEP AGP review

The Faculty of General Dental Practice UK and College of General Dentistry have welcomed the Scottish Dental Clinical Effectiveness Programme’s review of the mitigation of aerosol-generating procedures, and will be issuing updated COVID-19 guidance shortly in view of its recommendations.

The SDCEP document, published today, represents the agreed positions of a working group comprising dental professionals from across primary care, secondary care, academia and public health, in addition to expert opinion from subject specialists in particle physics, aerobiology and clinical virology. The consensus report was compiled following a review of the currently-available evidence on the generation and mitigation of aerosols in dental practice, and the associated risk of coronavirus transmission.

Among the key positions, and in contrast to those adopted to date in official protocols, the report divides dental procedures into three categories of aerosol generation potential according to the instruments used, with fallow periods recommended only for the highest risk procedures, and suggests the determination of fallow time using a multifactorial approach with a ‘benchmark’ of 15-30 minutes.

The FGDP-CGDent guidance, published in June, also set out a more nuanced approach to considering the generation of aerosols in dental practice, and while allowing for potential adjustment of fallow time, accepted a 60 minute period following procedures carrying a higher risk of exposure to potentially-infective aerosols.

Ian Mills, Dean of FGDP(UK), Trustee of CGDent and a member of the SDCEP’s review group, said: “SDCEP’s review of dental AGPs has been extremely thorough, and followed a rigorous and methodical approach. Its publication is potentially a very significant moment in the recovery of dental practices in the midst of the coronavirus pandemic and I commend the SDCEP Team for the hard work and dedication they have shown in producing this report.

“We welcome in particular the more refined stratification of the transmission risk inherent in types of dental procedure; the allowance for fallow time to be calculated from the cessation of the procedure; and the sophisticated approach to calculating fallow time, which considers both procedural and environmental mitigation factors such as high-volume suction, the use of rubber dam and provision of adequate air ventilation.

“These approaches align exceptionally well with our own guidance and we feel it is important that current standard operating procedures are reviewed in light of SDCEP’s recommendations. Adoption of these measures will enable the increased delivery of patient care to tackle the backlog of unmet need, and avoid further deterioration in dental access and oral health inequality. A reduction in fallow time will also support the viability of practices, while the maintenance of universal precautions will continue to keep both patients and members of the dental team safe.

“We aim to update our guidance as soon as possible, and are currently working with partners to develop an online Fallow Time Calculation Tool to support its implementation.”

SDCEP’s Mitigation of Aerosol Generating Procedures in Dentistry – A Rapid Review is available at https://www.sdcep.org.uk/published-guidance/covid-19-practice-recovery/rapid-review-of-agps.

The current FGDP-CGDent guidance, Implications of COVID-19 for the safe management of general dental practice – a practical guide, is available at https://www.fgdp.org.uk/implications-covid-19-safe-management-general-dental-practice-practical-guide and https://cgdent.uk/standards-guidance.

Using clear aligners and a fixed appliance for dual-arch treatment

A case study by Dr Ivan Yanchev

 

A 62-year-old female patient (my dental nurse) presented with concerns about the alignment of her lower anterior teeth. The position of the teeth had become worse over time and she sought a solution.

Assessment                                                                       

During the initial consultation, the patient revealed that she had undergone orthodontic treatment as an adolescent. She had also received some functional appliances in an attempt to correct the UR2/LR2 crossbite. No previous treatment had been performed on the lower teeth.

The patient was a healthy individual with a clear medical history, though she was an occasional smoker. As a dental nurse, she attended regular dental check-ups and demonstrated good oral hygiene – as would be expected. The comprehensive intraoral examination (Table 1) revealed healthy mucosa, no or minor caries activity and no gum disease. The amount of tooth wear present seemed to be normal for someone in her age group. The patient did advise of some clenching and grinding at night, but her TMD appeared to be stable.

Table 1:

Skeletal Class I
FMPA Average
Lower Face Height Average
Facial Asymmetry None
Soft tissues Low lip line
Overjet 1mm
Overbite 30% overlap of the incisors
Crossbite 12/43
Displacement on closure None
Incisor Relationship Class I
Molar relationship Right: Class I Left: Class I
Canine Relationship Right: Class III ¾ unit Left: Class I
Teeth Present 765321 123567
  765321 123567
Centrelines Lower deviated 1.5mm to the right

 

Treatment planning

Full clinical photographs were taken, while the Spacewize™+ space calculation tool was used to estimate the crowding present and confirm suitability for treatment. It suggested that 0.8mm of crowding was present in the upper arch and 2.1mm in the lower arch. The images, a bitewing and Spacewise™+ results were uploaded to the IAS forum to seek guidance from the instructors.

I was made aware that this would be a tricky case due to the moderate crowding – standard protocols may need to be supplemented with extraction. In the end, we decided that ClearSmile Aligners would be suitable for the upper arch and a ClearSmile Brace could be the best treatment option for the lower arch. A follow-up Archwise™ analysis showed that the case was possible to treat in this way and I discussed the treatment proposal with the patient. We covered all the possible complications, advantages and disadvantages of treatment and she provided consent to proceed (Table 2). The treatment plan was to use ClearSmile Aligners to slightly rotate the UL4 and UL5 buccaly, and to rotate the UL3 palatally. A ClearSmile Brace would simultaneously be fitted to align the lower arch.

Table 2:

Problem List
Overbite

Crossbite of the 12/43

Class III canine relationship on the right-hand side

Anterior crowding in the upper and lower arch

 
 Ideal Treatment – Aims:
Correct Class III canine relationship on the right

Correct the midline displacement

Correct the crossbite UR2/UL2
Improve the anterior crowding

 
Compromised Treatment 1 – Aims:
Accept the Class III canine relationship

Accept midline displacement

Focus on improving anterior crowding

Correct the crossbite at UR2/UL2

 

 

Impressions were taken and the appliances were ordered from the IAS Laboratory. The patient decided to begin treatment immediately after the summer holidays.

Treatment

Alignment of the upper arch with ClearSmile Aligners went as planned, with the patient using 10 aligners over 8 eight weeks. Impressions were then taken and a fixed retainer was fitted.

The ClearSmile Brace was bonded-up at the same time as the first clear aligner was provided. During treatment, there was some interference from the anterior teeth and premolars in the upper jaw on the lower brackets – mostly concerning the LR1, LL1, LL2 and LL3. Composite bumpers were placed on the brackets, but after continual debonding, composite was placed on the lower 7s instead.

Once the desired alignment had been achieved, the brackets were debonded and impressions were taken and sent to the lab for a lower Essix retainer and for three finishing aligners. Around six weeks after these were fitted, final impressions were taken for the whitening trays and a bonded retainer was fitted.

The patient used an at-home Opalescense 16% tooth whitening solution (Ultredent, USA) for 2 hours each night over 2 weeks. Following the ABB (Align, Bleach and Bond) concept, composite edge bonding was later provided to build up the upper and lower 3-3. This was performed freehand using Enamel puss composite (HFO).

During review appointments, the composite build-ups on the lower 7s were reduced to create a more sable occlusion. Strong contact points were established on the canines and shallower contact on the incisors. Over eruption of premolars due to the Dahl effect had caused fine occlusion in the premolars.

Once the occlusion was stable, a bonded retainer was placed on the lower teeth. The patient was delighted with the outcome.

Case appraisal

This case was slightly challenging due to the crossbite and heavy crowding in the lower jaw. From the case records, you may see that the lower crowding was on the boundary of what can safely be treated using IAS Academy protocols. We treated the upper jaw first in order to release the crossbite and allow us to work with the lower teeth freely. Some of the interferences during the initial part of treatment caused debonding, several times, but the composite anchors helped.

Images

For more information on upcoming IAS Academy training courses, including those for the Inman Aligner and Aligner system, please visit www.iasortho.com or call 01932 336470 (Press 1)

 

Author bio:

Dr Ivan Yanchev is a dentist practising in Norway. He graduated from the Medical University of Sofia, Bulgaria in 1997 and gained his Masters in Dentistry in 2005. He has also completed various postgraduate education in implant prosthetics, as well as several resto-orthodontic courses presented by IAS Academy.

Dentsply Sirona announces Let’s Talk Digital events

As dentistry goes through the pandemic, many dental professionals find themselves wondering what the future is going to look like; and crucially what they should be doing to adapt.

The Covid-19 pandemic has ushered in a new era of digital possibilities. Contactless, widely accessible and constantly evolving to meet every challenge, it has been video calling, online shopping and on-demand entertainment services that have kept us connected, sustained and entertained.

Dentsply Sirona recognises this and are more convinced than ever that digital is also the answer for dentistry. The company has long championed the innovation in digital dentistry and knows that digital workflows can help both dental practices and laboratories run profitable and future proofed businesses.

Now the Dentsply Sirona team has joined forces with a number of leading dental professionals, who have experienced the transformational effects of digital dentistry first-hand, to bring you a series of five, ‘Let’s Talk Digital’ online events.

The free-of-charge online evenings (7 to 8.30pm) will run during October and November 2020, starting with dentist Nik Sisodia and laboratory owner Steve Campbell, who will talk candidly about their own digital transformation. Find out more and register in the links below.

To find out more about Dentsply Sirona’s extensive range of digital solutions please visit www.dentsplysirona.com. 

You can visit the online Dentsply Sirona Academy for a wide range of education resources, video tutorials, courses and CPD webinars at dentsplysirona.com/ukeducation.

Waterpik® Launches 2 NEW Models

Renowned around the world for industry-leading oral health solutions, Waterpik® is delighted to bring you two brand-new models.

The Waterpik® Ultra Plus Water Flosser features 10 pressure settings, a high-volume reservoir for 90+ seconds of use and in-lid storage to keep the 6 tips it comes with clean and tidy.

For patients who need a more compact and cordless design, the Waterpik® Cordless Select Water Flosser features a 4-hour rapid charge, 2 pressure settings, 45-second water capacity and 4 tips.

To help your patients enhance their homecare oral health routines, discover the clinically proven solutions from Waterpik®. Lunch & Learn sessions with our Professional Educators are available virtually or in-person (wherever permitted and safe to do so). To learn more about the new Water Flosser models, visit the website to schedule a Lunch & Learn session.

 

For more information on Waterpik® products please visit www.waterpik.co.uk. The WaterpikÒ Ultra Plus Water Flosser and Waterpik® Cordless Select Water Flosser are available online from Superdrug across the UK and Ireland.  

To find out more, book a free Waterpik® Professional Lunch and Learn at
www.waterpik.co.uk/professional/lunch-learn/

Government announces Job Support Scheme to replace furlough from 1 November

The government’s furlough scheme, brought in at the start of lockdown, has been a lifeline to many businesses and saved the livelihoods of millions. The furlough scheme comes to an end on 31 October and the Chancellor, Rishi Sunak, has revealed that the new Job Support Scheme will replace it.

The Job Support Scheme will initially run for six months from 1 November until 1 May 2021. It is designed to top up the salaries of staff that businesses are unable to bring back into full-time work. Employees must work at least one-third of their regular contracted hours to be eligible. The government and employer will each pay one-third of the remaining wages to the staff member, meaning the employee takes home at least 77% of their pay. While at the height of the furlough scheme, the government paid 80% of workers’ wages, under the new scheme it will pay a maximum of 22%.

The Job Support Scheme is available to small and medium-sized businesses (often defined as organisations with 250 employees or fewer). Large businesses are also eligible so long as they can prove their revenue has fallen as a result of the pandemic.

Employees must have been on the firm’s payroll since 23 September and they can be moved on and off the scheme, or work different hours. Each working arrangement must cover at least seven days.
Workers cannot be made redundant or put on notice while a Jobs Support Scheme grant is being claimed on their behalf and, as with the furlough scheme, employers will be reimbursed by the government after the work has been done.

In addition, to further minimise unemployment, the UK government will also give firms:

  • £1,000 for every furloughed employee kept on until at least the end of January
  • £1,500 for every unemployed 16-24 year-old given a ”high quality” six-month work placement
  • £2,000 for each under-25 apprentice taken on until the end of January, or £1,500 for over-25s

Michael Copeland, senior area manager at Practice Plan parent company Wesleyan, the specialist financial mutual for dentists, commented on what the new scheme might mean for dental practices: “The Chancellor’s new measures will be welcome news for dental practitioners, many of whom are struggling to recover from impact of  lockdown. The Job Support Scheme announced today could help practices avoid redundancies and protect vital patient care services. It could also provide a further incentive for practices to bring back furloughed staff– supporting the profession’s efforts to resume a wider range of services.

“Extensions to the repayment terms of Bounce Back Loans and Coronavirus Business Interruption Loans will also help practices as they can keep essential cash in their business for longer. Together, steps like these will support the sector’s ongoing recovery – so essential to the wider wellbeing of the nation.”

One inch in twenty-three miles

Former CDO, Barry Cockroft, looks at current provisions within dentistry.

This summer saw the 75th anniversary of the establishment of the first artificial community water fluoridation scheme in Grand Rapids, Michigan in 1945. The American dental health community celebrated this through July with a series of four webinars hosted by the American Dental Association and the American Academy of Paediatric Dentistry. There was a wide range of speakers and it was a really fascinating programme. In the US about 70% of the population lives in areas where the water is fluoridated so their main issue is not initiating more new schemes but defending those that already exist.

It was really interesting to see that the challenges they face when attempts are made to challenge existing schemes are very similar to those we see in this country when new schemes are proposed.

Since I first became interested in the subject as an undergraduate in Birmingham every single disease or malady known to man has been blamed on fluoridation by its opponents and subsequently it has been proved that there is no link.

If, as I hope, we start to see movement on initiating new schemes in the next couple of years I am sure another obscure study will be quoted as a reason not to proceed despite the great wealth of evidence that it is both safe and effective.

Fluoride is the thirteenth most common ion in the earth’s crust and tea contains more fluoride that almost any other foodstuff, but I have not heard of tea being blamed in a similar way!

It is often said by opponents of water fluoridation that fluoride is a poison. This is not correct, but anything can be poisonous in the wrong dose. Six litres of water taken at one time can be fatal, oxygen given under pressure can cause blindness in premature babies, and did so on many occasions when incubators were first invented and used.

A speaker from the Royal Society of Chemistry confirmed this at the seminar in Hull organised as part of Hulls celebration of being that year’s city of culture in 2017. Understanding the meaning of dosage can be really difficult. Someone speaking during the US webinars, when making the point about dosage, said that if you put it into context and compare with distance, the recommended level in the US, of 0.7 parts per million is equivalent to one inch every 23 miles!

I believe everybody has the right to an opinion, but nobody has a right to their own facts, and this is what some people often confuse.

Like the UK, the US has inequalities, though some of the inequalities in America make ours look small by comparison. The key benefit of water fluoridation is that it requires no compliance to be effective so those most deprived or less knowledgeable benefit the most, therefore reducing the impact of inequality.

Fluoridation is not a “silver bullet” that totally prevents dental caries but hundreds of studies since 1945 have shown that it reduces the prevalence of dental caries and especially so in the more deprived parts of society.

Reducing the prevalence of dental caries requires a combination of national, community based and individual actions. When we first published Delivering Better Oral Health in 2007, we focussed on what clinicians could do for their patients in the primary care environment, but we did also recognise and advise on the wider determinants of oral health. It is always easier to criticise public health initiatives and difficult, sometimes, to explain the benefits when statements made without supporting evidence get just as much media coverage as unsubstantiated personal views.

Governments can really influence by supporting evidence based proposals. I was surprised and impressed to hear of the way Ronald Reagan put pressure on individual states to do the right things around controlling alcohol consumption and tackling obesity and drug abuse, over which he had no control as president, by making federal funding for other projects conditional on doing the correct thing on these health issues. I am not sure the current incumbent would do the same unless such policies had a positive impact at the ballot box.

Public Health England has come in for a lot of criticism during the current pandemic but a lot of the work it does, both locally and nationally, will have a significant positive impact on health in the years to come. The green paper on prevention published last year must have involved months of work behind the scenes and is a hugely positive document for the future, including the overt support for the development of new targeted water fluoridation schemes.

I hope the direction of travel indicated in that document does not get lost in the inevitable fallout from the pandemic and the potential descent into looking for scapegoats.