Just like fingerprints, the teeth are unique. Simply by looking at the teeth, it is possible to determine a person’s age, gender and ancestral background as well as what type of diet an individual maintains. The teeth can tell us whether a person smokes or not and even provide an insight into an individual’s personality. For instance, a person that grinds their teeth may be highly stressed, anxious, competitive or aggressive.

The health of the mouth can reflect the overall health of the body. Worn down teeth, dry mouth, inflamed gums, bad breath, ulcers and swelling can be a warning sign of systemic disorders such as diabetes, heart disease, respiratory disease and even cancer.[1] A dentist is likely to be the first clinician to notice the physical signs of an eating disorder such as bulimia or anorexia. Certainly, dental erosion is very common in these patients and regurgitating the acidic contents of the stomach can result in loss of tooth structure, as well as change in the colour, shape and length of the teeth.[2] Research suggests that tooth mobility and tooth loss may be linked to osteoporosis,[3] nutritional deficits and even cognitive decline.[4] As well as the effects of disease and aging, the teeth also record traumatic or environmental events. They can have a significant effect on a person’s appearance and also, the way in which they are perceived by others.

It has been said that the teeth are the human equivalent of a peacock’s tail – they serve as an ornament display providing information about developmental history, current disease, health and genetic quality to prospective partners and potential rivals.[5] A smile is a vital factor when it comes to human social interaction and as well as determining the attractiveness of the face, the colour of teeth is an important factor in social perception.[6] Research tells us that any deviation away from normal spacing or the presence of yellowed discolouration can negatively affect rates of attractiveness.⁵  Moreover, any abnormalities in the colour of the anterior teeth, in particular, can adversely affect how an individual is judged or perceived socially.

First impressions are made in milliseconds and humans search the face making judgements and high-speed decisions about other people. If a negative emotion is shown in the face, a negative impression is made – while a smiling face increases rates of attraction and is attributed to greater degrees of sincerity, sociability and competence.[7] Straight, white teeth are seen as a sign of good health, status and wellbeing, and offer positive psychological and social benefits.^6,[8] Discoloured teeth, however, are aligned with poorer ratings of social competence, intellectual ability, psychological adjustment and relationship status.⁶ Furthermore, if an individual is self-conscious about the condition of their teeth, it can cause considerable embarrassment, psychological distress and negative emotions – feelings that can significantly affect the ability of an individual to participate and interact fully in society.[9]

Tooth discolouration is a concern for a large number of patients and a study conducted in February 2020 revealed that quite a significant number of British adults have or would consider having their teeth whitened.[10] This is possibly why the global tooth whitening market is poised to grow by $840.38 million between 2020 and 2024.[11] The so called ‘Hollywood Smile’ is indeed a highly desirable status symbol and dental professionals are able to provide safe and effective whitening treatments. However, one should never underestimate the necessity or the efficacy of a good daily oral hygiene routine.

What a lot of patients do not realise is that the most common cause of tooth discolouration is not substances like red wine, tea or coffee, but inadequate cleaning.[12]  Therefore, working with patients to develop a consistently effective oral hygiene routine is the best way for them to achieve a bright white smile that they can maintain for the long term. Patients should be encouraged to floss the teeth daily and brush twice a day with a fluoride toothpaste such as Arm & Hammer ^TM Advance White^TM. This carefully formulated toothpaste is low-abrasive, contains baking soda for an exceptionally deep clean and is clinically proven to provide significantly greater plaque removal efficacy than non-baking soda toothpastes.[13] Arm & Hammer ^TM Advance White^TM with Micropolisher Technology^TM is the secret to long-lasting whiteness, as it leaves the teeth up to 3 shades whiter with twice daily brushing, whilst forming a protective shield on the surface of the teeth to prevent further staining.

A clinically proven whitening toothpaste used as part of the daily oral hygiene routine is convenient, effective and motivational. It can encourage patients to maintain good habits that have the potential to enhance both their oral and general health. In addition, helping patients to eliminate the inhibitions associated with discoloured teeth can provide a considerable boost to their quality of life and well-being.

For more information about the carefully formulated Arm & Hammer™ toothpaste range, please visit http://www.armandhammer.co.uk/
or email: ukenquiries@churchdwight.com

Arm & Hammer™ oral healthcare products are available at Boots, Superdrug, Sainsbury’s, Tesco, Asda and Morrisons throughout the UK.

Author: Maxwell O’Neill, professional educator for Waterpik

[1] FDI World Dental Federation. World Oral Health Day 2018. http://www.worldoralhealthday.org/sites/default/files/assets/2018_WOHD-brochure-EN.pdf [Accessed 11th August 2020]

[2] National Eating Disorders Association. NEDA Dental Complications of eating disorders. https://www.nationaleatingdisorders.org/dental-complications-eating-disorders [Accessed 11th August 2020]

[3] Oral health and bone disease. NIH Osteoporosis and Related Bone Diseases National Resource Center. https://www.bones.nih.gov/health-info/bone/bone-health/oral-health/oral-health-and-bone-disease [Accessed 11th August 2020]

[4] Kossioni A. E. The Association of Poor Oral Health Parameters with Malnutrition in Older Adults: A Review Considering the Potential Implications for Cognitive Impairment. Nutrients. 2018 Nov 8;10(11):1709. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266396/#:~:text=Several%20studies%20in%20older%20populations,intake%20of%20fibre%20and%20vitamins. [Accessed 11th August 2020]

[5] Hendrie C.A. et al. Evidence to Suggest That Teeth Act as Human Ornament Displays Signalling Mate Quality. PLoS ONE 2012; 7(7): e42178. https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0042178 [Accessed 11th August 2020]

^[6] Kershaw S. et al. The influence of tooth colour on the perceptions of personal characteristics among female dental patients: comparisons of unmodified, decayed and ‘whitened’ teeth. British Dental Journal. 2008. 204, E9 https://www.nature.com/bdj/journal/v204/n5/full/bdj.2008.134.html [Accessed 11th August 2020]

[7] Reis H et al. What is smiling is beautiful and good. European Journal of Social Psychology. Volume 20, Issue 3 1990 259–267 http://onlinelibrary.wiley.com/doi/10.1002/ejsp.2420200307/abstract [Accessed 11th August 2020]

[8] Whiter teeth can lead to greater success in work and love. P&G News 2007. http://news.pg.com/press-release/pg-corporate-announcements/new-study-shows-whiter-teeth-can-lead-greater-success-work- [Accessed 11th August 2020]

[9] Ibiyemi O. et al. Psychosical aspect of anterior tooth discolouration among adolescents in Igbo-Ora, South Western Nigeria. Ann Ib Postgrad Med. 2011 Dec. 9(2): 94–99. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4111029/ [Accessed 11th August 2020]

[10] Statistica. Health & Pharmaceuticals, State of Health. Attitudes towards teeth whitening in Great Britain in 2020, by age. Published by Conor Stewart, July 2020. https://www.statista.com/statistics/1132103/opinion-on-teeth-whitening-in-great-britain-by-age/#statisticContainer [Accessed 11th August 2020]

[11] Businesswire. News, March 13^th 2020. Technavio Research. Global Teeth Whitening Market 2020-2024. https://www.businesswire.com/news/home/20200313005100/en/Global-Teeth-Whitening-Market-2020-2024-Evolving-Opportunities [Accessed 11th August 2020]

[12] Kadam A. et al. Drug Induced Tooth Discolouration. The Internet Journal of Dental Science. 2008; 7 (2). ispub.com/IJDS/7/2/10979 [Accessed 11th August 2020]

[13] Putt M. et al. Enhancement of plaque removal efficacy by tooth brushing with baking soda dentifrices: results of five clinical studies. J Clin Dent. 2008;19(4):111-119. https://pubmed.ncbi.nlm.nih.gov/19278079/ [Accessed 11th August 2020]

The Dental Technology Showcase (DTS) 2021 is an all-inclusive event – so you and your entire team are invited!

The educational content is tailored for all members of the lab community, from dental technicians to clinical dental technicians, orthodontic technicians and lab owners. A combination of lectures and interactive sessions offer hours of enhanced CPD, as well as the chance for individuals to share their own experiences and seek guidance from the experts.

What’s more, DTS 2021 will present an ideal opportunity to finally catch up with friends and colleagues from across the industry.

Free to attend for all delegates, DTS 2021 is not an event to miss!

The next DTS will be held on Friday 21st and Saturday 22^nd 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

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Halloween heralds the beginning of the end of another year. Even if Autumn has been
mild, once Halloween is here it’s time to accept that winter is on its way. In recent years, Halloween seems to have become a bigger deal in the UK – a development that many of us have greeted with despair. If it has become more popular where you live and practise, trick or treating is a tradition to make any dental practitioner wince, particularly if your own children have been insistent on going out to collect buckets full of sweets.

On any “normal” year, Halloween for DCPs is a chance to remind our patients about the dangers associated with the over-consumption of sugar. Sugar has been the focus of several public health campaigns to help families find practical ways to reduce their everyday consumption. In 2018, a report from Public Health England (PHE) and the Food Standards Agency led to grim headlines, when its findings revealed that sugar made up 13.5% of 4 to 10-year-olds and 14.1% of 11 to 18-year-olds daily calorie intakes, which is way above the daily recommendations.[i] The Sugar Tax (really, a soft drinks levy) was also introduced in 2018; in 2019, another PHE report revealed that not as much progress had been made as had been hoped in terms of how the food and drinks industry was reformulating certain products to reduce their sugar content, especially the “hidden” sugars in things like breakfast cereals.[ii]

Fast-forward to Autumn 2020 and we’re all still reeling from the impact of a worldwide health crisis that has changed our lives forever. As for PHE, it spent most of this year otherwise engaged with COVID-19 and in late summer, it was announced that it is due to be replaced with a new body, the National Institute for Health Protection. The government launched its UK-wide “Better Health” plan in July, but the focus is broader and the message more urgent than it has ever been. Maintaining a healthy weight and lifestyle, of which eating a low-sugar diet is obviously key, has been linked with having a lower risk of becoming seriously ill with COVID-19, along with a host of other diseases.[iii]

But now Halloween has rolled around – many won’t miss the opportunity to point out how 2020 has been like one long horror movie that isn’t over yet – and whether you love it or hate it, there is a strong argument that it is the first time to party in a party season that will run until December 31^st. So, if we want to be heard, our oral health messages need to be put in context of the bigger picture.

At time of writing, how we will be able to celebrate the various feasts and festivals that we always look forward to, and that mark the end of the year, is unknown. The fun starts with Halloween, then comes Guy Fawkes’ night, also Diwali, Hanukkah, Christmas, New Year’s Eve… all occasions to get together with family and friends. Regular get-togethers that many of us always took for granted aren’t something we have been able to enjoy for much of 2020.

But doing things that make us feel good and happy have become essential for self-care and enduring the downs in a year of very few ups. So, as we head towards the season of (over)indulgence, oral health education must celebrate the positive. As a DCP, who sees the new challenges your patients now face, you will know that it will take more than a few catchy slogans to engage with them successfully.

As we all look forward to fun, festivals, and feasting, anything and everything that makes people feel “normal” and hopeful must be encouraged in moderation. Yes, the end of the year will look and feel a little different, but let’s work with what we have. These have always been occasions to have fun and appreciate how lucky we are. Now more than ever, we know that good health is a blessing to be appreciated, so we must tell our patients to treat themselves well! Your patients should enjoy the time to be together, to connect, reflect and celebrate, but also understand that good health – of which their oral health is a huge component – is a true privilege. They should eat, drink and be merry, make good choices and swaps when and if possible, but never compromise self-care in the form of everyday cleaning using high-quality tools such as TANDEX brushes.

At this time of year, DCPs are quite used to being the party poopers. Once Halloween is over, articles warning about overindulging in festive drinks – like the speciality coffees, full of sugar and fat – start to appear in the press. But now is a time to make your message balanced and realistic – a bit of this, a bit of that, to respect and look after mind, body, soul and mouth as we prepare to say a not-so-fond farewell to 2020.

For more information on Tandex’s range of products,
visit www.tandex.dk or visit the Facebook page

Author Kimberley Lloyd- Rees on behalf of Tandex

Kimberley graduated from the University of Sheffield in 2010, where she now works as a clinical tutor in Dental Hygiene and Therapy as well as working in practice. She has spent her career working across a variety of specialist private and mixed dental practices, for the MOD and volunteering her time to a dental charity in Nepal.

[i] Results of the National Diet and Nutrition Survey (NDNS) rolling programme for 2014 to 2015 and 2015 to 2016. Published 16 March 2018. Link: https://www.gov.uk/government/statistics/ndns-results-from-years-7-and-8-combined (accessed August 2020).

^[ii] Obesity increases risk of Covid-19 death by 48%, study finds. The Guardian, 26 August 2020. Link: https://www.theguardian.com/world/2020/aug/26/obesity-increases-risk-of-covid-19-death-by-48-study-finds (accessed August 2020).

^[iii] Sugar reduction: progress between 2015 and 2018. PHE, 20 September 2020. Link: https://www.gov.uk/government/publications/sugar-reduction-progress-between-2015-and-2018 (accessed August 2020).

Dr. Richard Brooks from the Tanshire Clinic in Farnham explains why he relies on Scotchbond™ Universal adhesive from 3M Oral Care.

“What I really like about Scotchbond™ Universal adhesive from 3M is that it’s all in one bottle. This makes it incredibly easy to use in all indications.”

“Having used it for many years I also appreciate the fact that Scotchbond™ Universal adhesive from 3M is supported by a long history of clinical data – it’s a 10/10 product and I would definitely recommend it to other dental professionals.”

For more information, call 08705 360 036 or visit www.3M.co.uk/Dental

3M representatives continue to be available via video calling technologies for your convenience.

END

3M and Scotchbond are trademarks of the 3M Company

Dr Grant McAree, Principal of The Whyte House Dental Group in Exeter, has changed the way he does dentistry over the years. He used the support and mentorship of colleagues at IAS Academy to improve his work-life balance while delivering advanced orthodontics to his patients. Here he reflects on how he got started and how he hopes to help others, as well as sharing a case he was proud to recently complete.

I remember the first IAS Academy course I went on with the amazing, energetic and much missed Anoop Maini, many years ago now. He said, “There will only be a small number of you who will take these skills away and use them” – three years later, I provided 100% orthodontics. I later attended the IAS Advanced Course with Professor Ross Hobson, my mentor today. The case presented was fully supported, with guidance provided by Professor Hobson every step of the way. I would therefore like to share the success and the outcome with him. His no-nonsense approach to orthodontics and extensive experience has changed the way I do dentistry. My work-life balance is also now a healthy one as a result. I have been able to step off the treadmill and provide orthodontics safely and under the watchful eye of someone who knows better. 

Anoop was one of the first people to ask me to speak to an IAS Academy group in London. I spoke about how to increase case numbers and shared the marketing and advertising tips and tricks. I utilise in the many squat practices I have built over the years. I now provide a mentoring service for dentists who want to find a better work-life balance by getting off the treadmill we often find ourselves on. Life as a dentist can be tough, it can be stressful. Support from a group like IAS Academy can ease the burden. Having someone watch over your shoulder to help stop things going south or provide support when it does, takes the pain and stress away. The following case is one I am particularly proud of, given the complexity of the treatment, as well as the support and encouragement I received throughout.

Case presentation

A female patient came to me complaining of post-orthodontic relapse after she had not worn her retainers following the course of treatment. She was mainly concerned about her top anterior teeth and her crowded lower arch. The upper left premolar was also a cosmetic issue. 

A comprehensive orthodontic assessment was conducted (Table 1). Mild crowding was identified in the upper arch, along with moderate lower labial crowding. A Talon Cusp was also present on the UL5, which the patient was particularly aware of.   

Table 1:

Treatment planning

All possible treatment options were discussed with the patent in detail. This included the removal of the first premolars or second as well as Invisalign, non-extraction alignment with fixed appliances and of course do nothing. Due to the amount of lower flaring required for alignment on a non-extraction approach could have led to a higher risk of gingival recession, which is less than ideal. As such, the decision was made to approach this case conventionally and with extractions. The upper left second premolar was an issue for the patient, so correction of this was incorporated early into the treatment planning discussions.

Clinical photographs and 3D scans were taken of the upper and lower arches, and the wire sequence planned for treatment.

Treatment provision

A UFA LFA lingual arch/nance appliance was used in this case. I followed the standard archwire sequence as set by IAS Academy and the patient returned to the practice at 6-week intervals for review. The wires were changed, IPR performed progressively and progress was documents with photographs. The patient’s compliance with oral hygiene remained excellent throughout and she didn’t miss any appointments. Alignment was completed over the course of approximately 18 months.

Case appraisal

While both the patient and I were pleased with the outcome in this case, it was not perfect. The lower incisors could have been more detailed and the spacing between the lower 4s and 6s could have been further improved. However, the patient was happy with the result achieved and was keen to remove the appliance. She was made aware of the compromise but was completely satisfied to finish treatment there.

To be part of a transformation like this is why I got into dentistry – it epitomises the joy you can get from doing a good job. When you achieve this type of outcome – with a minimal intervention – it may or may not be appreciated by the patient. To obtain a Class I molar/incisor and canine relationship is an achievement only a dentist can really appreciate and get excited about. Patients commonly only appreciate the smile aesthetics at the end of treatment. While the patient in this case was thrilled with the result, I remain particularly ecstatic. 

Case images

Figure 1 – pre treatment left lateral

Figure 2 – pre treatment right lateral

Figure 3 – pre treatment left retracted

Figure 4 – pre treatment right retracted

Figure 5 – pre treatment upper occlusal

Figure 6 – pre treatment lower occlusal

Figure 7 – lower alignment

Figure 8 – post treatment left lateral

Figure 9 – post treatment left retracted

Figure 10 – post treatment right retracted

Figure 11- post treatment upper occlusal

Figure 12 – post treatment lower occlusal

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) 

For details of the mentorship opportunities from Dr McAree, please visit www.dentalbusinessmentor.co.uk or call 07896877827

Author bio:

Dr Grant McAree graduated from dental school in 1997 and opened The Whyte House Dental Surgery in Plymouth in 2001. He has since complete various postgraduate education in removable and fixed orthodontics, the ABB (Align, Bleach and Bond) concept, endodontics, restorative dentistry, dental implants, trauma, hypnotherapy for nervous patients and advanced facial aesthetic procedures. His dentistry now consists of 100% orthodontics thanks to the IAS academy.