Despite everything this past year has thrown at us, clinical excellence has remained a priority for dental providers across the UK. To ensure that you continue to utilise the latest, evidence-based materials, techniques and technologies, don’t miss the British Dental Conference and Dentistry Show 2021.

Lectures will be tailored to each member of the dental team, with a wide array of topics covered by leading lights in their respective fields. Hours of enhanced CPD, as well as hands-on workshops and live demonstrations will be available for all to enjoy.

There will also be a dynamic trade show with various dental manufacturers, suppliers, training providers and charities on hand to inform and inspire the team.

Make sure you and your team don’t miss out to maintain clinical standards in your practice!

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

For more information, visit www.thedentistryshow.co.uk, call 020 7348 5270 or email dentistry@closerstillmedia.com

The past year has been a particularly hard time for patients, and no less hard on their teeth. While vaccination efforts are well under way, and the end is hopefully in sight, the scars of the pandemic will be felt for years to come.

One key area of concern is mental health. Stigma around mental health concerns has improved in recent years, leading more people to seek the help they need. However, even before the pandemic began, accessing already overstretched mental health resources and services was far from ideal for many. The pandemic has been a double blow, increasing the environmental stresses people are under (loneliness, economic hardship, bereavement, etc.) while simultaneously putting more pressure on services directly with minimised contact and reduced staff availability.[1]

At present, research suggests that around two-thirds of patients diagnosed with mental illness have to wait more than a month from their initial assessment to get a second appointment. For a quarter of patients that wait extends to more than three months, and one-in-nine are left waiting for more than half a year. Delays in treating mental health are dangerous and damaging to patients, and can lead to dire consequences – with one-in-nine patients left waiting for mental health treatment ending up in A&E. Right now, there are patients with eating disorders, PTSD, depression, bipolar disorder, anxiety and gender identity disorders who have been left waiting for multiple years without treatment.[2] This is after patients take the steps to seek treatment, which itself can be a personal battle.

Mental health issues have systemic effects on other aspects of a patient’s life and health, which can easily tip into a vicious circle. Deteriorating mental health can lead to problems keeping or seeking work, which can lead to financial problems, and so on – all of which reduce quality of life and create additional psychological stress. The longer mental health issues go untreated, the greater the chances of further harm, and worsening circumstances for the patient.[3]

It is anticipated that some of the hardest hit by this pandemic will be fellow healthcare providers. For those in frontline care, which is already a demanding profession, the preceding year has created breaking point conditions with little to no reprieve. According to research conducted by King’s College London, around 40% of intensive care unit staff in England have PTSD symptoms, while 6.3% may have severe depression, and 11.3% show signs of severe anxiety. This research was conducted between June and July 2020, before the winter wave hit. Elsewhere, the British Medical Association reports that 60% of doctors in England and Wales are suffering with anxiety or depression.[4] While those in frontline healthcare may be among the hardest hit, evidence suggests that many more people from all walks of life have been deeply affected.[5]

Psychological distress can adversely affect patients’ oral health in a multitude of ways. Regurgitation, which can be a recurrent symptom of eating and anxiety disorders, can rapidly damage dental enamel. Even where vomiting is infrequent or not present, these and other mental health disorders are associated with higher levels of dental erosion, and worse periodontal health than in patients without these conditions.[6]^,[7],[8],[9]

Bruxism has a complex aetiology that is still not fully understood, but it has been associated with stress, sleep pattern disturbances and mental illness.[10] Bruxism varies dramatically between patients: duration, frequency and force can all be quite different, so some patients see little damage while others experience major problems, with severe cases causing occlusal load to be anywhere from 2-10 times higher than in non-bruxers.[11] Bruxism can be highly damaging to teeth, cause dental implants to fail, and is associated with temporomandibular disorders.[12]^,[13] Bruxism is also linked to gastro-oesophageal reflux disease (GORD) and when present together, the conditions can aggravate each other leading to severe tooth wear and erosion.[14] Other sources of acid (for instance dietary), can soften the enamel increasing the risk of damage from bruxism and other processes.[15]

These are difficult challenges to resolve, but to give teeth a fighting chance, patients should be encouraged to brush twice a day with a fluoride toothpaste such as Arm & Hammer™ Enamel Repair™. Featuring Liquid Calcium™ technology, this toothpaste has been specially engineered to help restore surface enamel by filling in micro cracks and crevices. Help your patients remineralise and strengthen their teeth by recommending a quality toothpaste.

Mental health problems are not quickly or easily resolved, and the pandemic has created a perfect storm of circumstances that have made things very challenging for countless patients. During this time, it is important to support patients in maintaining the rest of their systemic health, including helping mitigate and repair damage done to their teeth.

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 in-store and online at Boots, Superdrug, Sainsbury’s, Tesco, Asda and Morrisons throughout the UK.

Author

Maxwell O’Neill, professional educator for Waterpik

[1] Johnson S., Dalton-Locke C., Juan N., Foye U., Oram S., Papamichail A., Landau S., Olive R., Jeynes T., Shah P., Rains L., Lloyd-Evans B., Carr S., Killaspy H., Gillard S., Simpson A. & The COVID-19 Mental Health Policy Research Unit Group. Impact on mental health care and on mental service users of the COVID-19 pandemic: a mixed methods survey of UK mental health care staff. Social Psychiatry and Psychiatric Epidemiology. 2021; 56: 25-37. https://doi.org/10.1007/s00127-020-01927-4 April 12, 2021.

[2] Royal College of Psychiatrists. Two-fifths of patients waiting for mental health treatment forced to resort to emergency or crisis services. Royal College of Psychiatrists. 2020. https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2020/10/06/two-fifths-of-patients-waiting-for-mental-health-treatment-forced-to-resort-to-emergency-or-crisis-services April 12, 2021.

[3] Reichert A., Jacobs R. The impact of waiting time on patient outcomes: evidence from early intervention in psychosis services in England. Health Economics. 2018; 27(11): 1772-1787. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221005/ April 12, 2021.

[4] Mahase E. Covid-19: many ICU staff in England report symptoms of PTSD, severe depression, or anxiety study reports. BMJ. 2021; 372: 108. https://doi.org/10.1136/bmj.n108 April 13, 2021.

[5] Royal College of Psychiatrists. Country in the grip of a mental health crisis with children worst affects, new analysis finds. Royal College of Psychiatrists. 2021. https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2021/04/08/country-in-the-grip-of-a-mental-health-crisis-with-children-worst-affected-new-analysis-finds April 13, 2021.

[6] Dynesen A., Gehrt C., Klinker S., Christensen L. Eating disorders: experiences of and attitudes toward oral health and oral health behavior. European Journal of Oral Sciences. 2018; 126(6): 500-506. https://doi.org/10.1111/eos.12578 April 12, 2021,

[7] Pallier A., Karimova A., Boillot A., Colon P., Ringuenet D., Bouchard P., Rangé H. Dental and periodontal health in adults with eating disorders: a case-control study. Journal of Dentistry. 2019; 84: 55-59. https://doi.org/10.1016/j.jdent.2019.03.005 April 12, 2021.

[8] Radeef A., Faisal G. Assessment of depression, anxiety and stress symptoms among patients with periodontal disease. Journal of International Dental and Medical Research. 2017; 10(2): 260-264. http://www.jidmr.com/journal/wp-content/uploads/2017/05/12_D17_376_Ghassak_Ghazi_Faisal.pdf April 12, 2021.

[9] Zheng D., Kang X., Wang Y., Huang Y., Pang C., Chen Y., Kuang Z., Peng Y. Periodontal disease and emotional disorders: a meta-analysis. 2021; 48(2): 180-204. https://doi.org/10.1111/jcpe.13395 April 12, 2021.

[10] Saczuk K., Lapinska B., Wilmont P., Pawlak L., Lukomska-Szymanska M. Relationship between sleep bruxism, perceived stress, and coping strategies. International Journal of Environmental Research and Public Health. 2019; 16(17): 3193. https://doi.org/10.3390/ijerph16173193 April 12, 2021.

[11] Wu Y., Arsecularatne J., Hoffman M. Attrition-corrosion of human dental enamel: a review. Biosurface and Biotribology. 2017; 3(4): 196-210. https://doi.org/10.1016/j.bsbt.2017.12.001 April 12, 2021.

[12] Bucci C., Amato M., Zingone F., Caggiano M., Iovino P., Ciacci C. Prevalence of sleep bruxism in IBD patients and its correlation to other dental disorders and quality of life. Gastroenterology Research and Practice. 2018; 7274318. https://doi.org/10.1155/2018/7274318 April 12, 2021.

[13] Zhou Y., Gao J., Luo L., Wang Y. Does bruxism contribute to dental implant failure? A systematic review and meta-analysis. Clinical Implant Dentistry and Related Research. 2016; 18(2): 410-420. https://doi.org/10.1111/cid.12300 April 13, 2021.

[14] Li Y., Yu F., Niu L., Hu W., Long Y., Tay F., Chen J. Associations among bruxism, gastroesophageal reflux disease, and tooth wear. Journal of Clinical Medicine. 2018; 7(11): 417. https://doi.org/10.3390/jcm7110417 April 12, 2021.

[15] Wu Y., Arsecularatne J., Hoffman M. Attrition-corrosion of human dental enamel: a review. Biosurface and Biotribology. 2017; 3(4): 196-210. https://doi.org/10.1016/j.bsbt.2017.12.001 April 12, 2021.

Dr Adnan Rehman reflects on his recent practice sell, which he completed with the support of Dental Elite:

“I decided to sell my practice due to existing personal and professional commitments. I was looking for a buyer that could look after the practice and protect all the good work that we had put into it over the years. It was important to me that the buyer would continue providing high-quality care for patients and looking after the staff. 

“I needed an agent to help me find a dentist that would be caring enough to fulfil these ambitions and who shared my philosophy when it comes to dentistry. 

“I’d had dealings with Dental Elite in the past and had been quite happy with them, so I decided to approach them again. I worked very closely with Julie Randle, who was very warm and had a fantastic personality. At no point did she come across as ‘salesy’ and there was no pressure on me.

“During the process, Julie always kept me up-to-date with any situation. I can’t commend her enough for how she kept me motivated during the sale. I felt like she understood the process, as well as how the seller feels and she became a real friend during the transaction.

“The biggest challenge for my practice sale was trying to work around the restrictions and other challenges caused by COVID-19. This, combined with all the uncertainty in the industry and further afield, made the process difficult at times.

“However, we got there in the end! I would highly recommend Dental Elite again – particularly Julie Randle – to any dentists wanting to sell their practice to someone who is going to look after it post-completion. Thank you to Julie and Dental Elite.”

For more information on Dental Elite visit www.dentalelite.co.uk, email info@dentalelite.co.uk or call 01788 545 900

The BSP Conference 2021 is all about “Hard & Soft Tissue Regeneration”. The Straumann Group offers an array of materials and products designed specifically to support bone and soft tissue regeneration with regards to implant surgery, all of which will be in display at the event.

Among the comprehensive range of biomaterials are xenograft, allograft and synthetic graft materials, as well as resorbable and non-resorbable barrier membranes. This also includes Straumann^® Emdogain^®, which has now been on the market for over 25 years thanks to its innovative properties that regenerate lost tissue in a minimally invasive way.^{[i] [ii]} Other popular solutions are the Straumann^® Xenograft, Xenoflex and maxgraft^®, the Jason^® membrane and cerabone^®.

Aside from the extensive biomaterial portfolio, delegates can also find information on the implant solutions designed to optimise healing and treatment outcomes.

To upgrade your hard and soft tissue management with regards to implantology, don’t miss the Straumann Group team at the BSP Conference this November.

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

^[i] Shujaa Addin A, Akizuki T, Mat- suura T, Hoshi S, Ikawa T, Maruyama K, Ono W, Fukuba S, Izumi Y. Histological healing after nonsurgical periodontal treatment with enamel matrix derivatives in canine experimental periodontitis. Odontology. 2018 Jul;106(3):289-296

^[ii] Mellonig JT, Valderrama P, Gregory HJ, Cochran DL. Clinical and histologic evaluation of non-surgical periodontal therapy with enamel matrix derivative: a report of four cases. J Periodontol. 2009 Sep;80(9):1534-40

As we are living through such unpredictable times, it makes sense that professionals may be looking at ways to access some of the funds they had previously invested, for example, their NHS pension.

However, while this money is available through the right method, professionals need to think wisely about how to approach this or they may be in danger of losing their NHS contract. So, where do you begin?

Retire, claim, resume

One option is to take a short, non-permanent retirement for a period of 24 hours. As your NHS pension will be tied directly your NHS contract number and your active performer number, this means that if you are the sole provider, your NHS contract will come to an end when you ‘retire’. Despite this, it’s worth remembering that a break of at least 24 hours is required in order to access any funds.

As a sole provider, one option to protect your NHS contract is to enter into a temporary partnership for the duration of this short retirement period, usually to be dissolved as soon as this window has come to an end. This maintains the contract because you will be issued with a new “partnership number” so that even when you are retired for 24 hours, there is still someone in place to maintain and hold the contract.

From the perspective of the CQC, even during your 24-hour retirement period you will continue to be responsible for regulated activity in your practice and remain accountable. This is actually a bonus, as it means that you won’t necessarily need to register the partnership with the CQC, especially as once the partnership has been dissolved, regulated activity will continue to be undertaken under your sole trader registration.

Regardless, this whole process is not always straightforward, and there are a number of considerations to bear in mind.

The first of these is that if your Local Area Team is insisting on documenting a partnership despite the CQC not necessarily requiring partner registration, this process can take up to five months. This, inevitably throws a spanner in the works, meaning that you wouldn’t be able to access the funds in your NHS pension until this stage is complete. If this is the case, it’s worth making it very clear that the CQC does not require partnership registrations in the event of a 24-hour retirement.

Another consideration is who you are to form the partnership with for this period. Although GDS regulations state that a partnership can occur between GDPs and DCPs, a DCP cannot hold a GDS contract by themselves even for a 24-hour period, so they are not a viable choice in this instance. As such, you’ll need to find another GDP who is happy to partner with you during this time.

Expert advice

Of course, whenever something significant is undertaken such as a new partnership, even for such a short time period, you need to ensure that the process is completed by a legal professional with experience in the dental field, such as the award-winning team at money4dentists. This way, you can make sure that you have all of the terms of the partnership in black and white and that these are tailored to your individual circumstances. This also guarantees that both parties involved are fully aware of what is going on, and that neither can break the agreed terms of the contract.

You need to supply your solicitor with all of the signed NHS partnership documents (signed by both you and your chosen partner in advance) so that you can be added back onto the contract once the partnership has dissolved. This adds extra protection as it prevents any opportunity for your partner to not sign the contract back over to you or alternatively, not sign to dissolve the partnership once it has been made.

It’s worth reiterating that, due to the complexity of this arrangement and the numerous parties involved, it’s essential to choose a solicitor with substantial experience in the dental industry. By doing so, you can effectively navigate any of the potential pitfalls that may arise during this situation and be certain that you are receiving advice that is fully bespoke and reflective of the unique circumstances on every level.

A viable option

In the end, accessing your NHS pension fund is an effective way to free up some capital if necessary. By enlisting the help of a dental solicitor and by partnering with a trusted professional, you can reap the rewards of your saved funds without compromising your all-important NHS contract.

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

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

Richard T Lishman

Managing Director of the 4dentists Group of companies

The answer is: nothing!

One to One Dental Education offers world-class programmes in placing implants.

You will be taught by experts, in a custom-built facility in London, with training overseen by clinician and lecturer Dr Fazeela Khan-Osborne, known for her experience in this area.

When you embark on a course with One to One Dental Education, you gain mentors that will continue to guide and inspire you, long after the final day has ended.

This is limitless learning that will guide you on a journey to implant excellence!

Want to know more? Get in touch today.

To reserve your place or to find out more, please visit https://www.implantcourse.co.uk/our-courses/project-one-7kpfx

or call 020 7486 0000

Dr Dipesh Parmar will be a headline speaker at the BACD Annual Conference this November, presenting a full-day lecture and hands-on session entitled “An Introduction to Mini Smile Makeover”. He says:

“By attending my lecture, delegates will gain a deeper understanding and appreciation of the different techniques that can be used for the execution of composite veneers, including freehand, index-guided and indirect methods. They will come away with knowledge on how to deliver composite veneers that, importantly, are both aesthetically pleasing and long-lasting for their patients.

“The BACD Annual Conference is a fantastic event both from an educational and social perspective. I’m definitely looking forward to catching up with everyone that I haven’t seen in what will be two years!”

If you haven’t already, register soon your place for the BACD Seventeenth Annual Conference!

The BACD Seventeenth Annual Conference

‘Seeing Is Believing’

12^th – 14^th November 2020

The EICC

Edinburgh, Scotland

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