Lodge Dental is a family-run business with three large, award-winning dental practices located in Abergavenny and New Inn, South Wales. The business is currently expanding and will offer brand-new training and referral facilities for colleagues around the UK to utilise. We spoke to group owner, Chris Lodge, about what they are trying to achieve…

Let’s set the scene, how did Lodge Dental come about and what is the vision for the business?

We originally took over an established practice in Monmouthshire, South Wales and almost immediately created a 5-year strategic plan. Our vision was to create a centre of excellence in dentistry at the heart of Wales. We were keen to stay away from being a stereotypical practice in everything other than the quality of dentistry we provided, which meant making the surgeries sophisticated and efficient environments with the latest technology and systems. We introduced brand-new equipment – including a comprehensive suite of digital solutions – chairs, monitors, computer system and more as part of stage one. This has enabled us to build a reputation for cutting-edge, digital dentistry, adding exceptional value to our specialist referral services.

Stage two was about broadcasting our services to ensure that local people knew about what we offered and expanding our team. As anyone in dentistry knows, to create a successful business, you need a great team of dentists and dental hygienists, but you also need superb dental nurses, admin and support staff. They are vital to ensure a positive patient experience from the moment they enter the building procedure.

The third and final stage of our 5-year plan is offering something unique for colleagues and the wider profession. We bought an adjacent building – a stunning, Edwardian property built in the late 1800s – which we thought would make a great addition to what we’d already created in the form of a specialist referral practice and brand-new training facility.

We have completely renovated the building from the new Welsh Slate roof to the under-floor heating system to create exactly what we need. Everything has been thought of from on-site parking to wheelchair access, staff shower facilities, electric car chargers – we aim to create the best possible experience for everyone who visits us.

What do you hope to offer through your new training facility and how will it differ to the many other opportunities on the market?

There will be training suitable for specialists and highly experienced dentists, junior dentists, dental hygienists and therapists, dental nurses and practice managers/treatment coordinators, with programmes delivered to small delegate groups on a range of topics.

Every possible avenue has been explored to deliver a world-class learning experience for all who come to the new facility. We have an excellent AV set-up, state-of-the-art equipment and a team of leading specialists and experts to share their knowledge and skill. The goal was to create a truly realistic environment in which to undergo practical training that can be immediately translated once delegates return to their own practices. We are unique in that we have the training facility and the ability for delegates to watch live procedures from the on-site practice. Our practice already operates all the cutting-edge digital technology we are teaching, so delegates can see them in action. We will do more than talk about dentistry and show it, so delegates can really immerse themselves in what they are learning.

In fact, we wanted to optimise the entire experience. We will offer a package that includes training, accommodation and food, so delegates needn’t book everything separately. All they have to do is get to us. We have teamed up with The Angel Hotel, which is an excellent local business that enables us to provide a social element for delegates in the form of a course dinner and drinks. I think this is important as it not only enables individuals to network, but it also ensures a great all-round experience. We have formed various partnerships with local businesses to deliver the best possible experience for dentists who join us for training – but also for patients who are referred to us. We’re lucky to be in a really beautiful part of the countryside, so there’s plenty for everyone to do while people are visiting too. By offering all this as a package, we save delegates time and money because we get fantastic deals from the businesses we partner with.

It’s also worth mentioning that we have the ability to offer one-to-one case mentoring following these courses too, ensuring dentists receive the on-going support they need.

Why did you decide to provide training for the whole team? How do you feel this will enhance what you’re offering?

It’s a fact that with any dental treatment, especially the more advanced, the experience and training of the dental nurse is vital. We will encourage dentists to bring their dental nurse on several of our courses, with a package that makes it worthwhile for them. We have some exceptional dental nurses at Lodge Dental, who are only too happy to share their experience with delegates on everything from learning digital scanning to consulting with the lab.

For other members of the team like dental hygienists and therapists, they have an essential role to play in supporting patients undergoing treatment or maintaining results achieved through surgery. They need an equally practical approach to training, which we feel we will be able to offer.

The new centre will also provide first-class referral services. What do you feel has stood Lodge Dental in such good stead among the profession?

We have always been strategic in expanding the business, so becoming a leading specialist referral centre was always part of our vision. Our commitment to state-of-the-art digital solutions has certainly helped to position us as a state-of-the-art referral centre. We offer an end-to-end digital treatment experience for patients we treat, ensuring a high-quality and seamless treatment journey for all.

We’re also proud to have such a well-respected, trustworthy and ethical team, who provide a personal touch by spending time with local dentists and getting to know them. Having a dedicated Referral Manger further distinguishes our services. From a customer service background, Jo [Morgan] is fantastic at speaking to dentists or practice managers of our referring practices, as well as liaising with referred patients, providing the support and information they need too.

In addition, we have always sought to provide minimal waiting times for referred patients – no one wants to wait 6+ months to start a new course of treatment once they’ve decided to proceed! We have committed sufficient surgery time to each of our clinicians to ensure they can deliver quality care efficiently.

To complement our referral and training services, we are launching monthly Lodge Study Clubs and inviting local dentists to enhance their skills alongside our expert team. For any local dentists interested details can be found on the website. Like everything else, this has come from a place of passion and vision to offer quality. I believe this shows in all that we do.

For further information, please contact Jo on 01873 854711 or referrals@lodgedental.co.uk, or visit lodgedental.co.uk/referrals

Browse all current courses, discover more about our training facility and contact the team for further information from the new Lodge Training website at www.lodgetraining.co.uk.

The effects of the rising cost of living are being felt across the country. With household energy bills having increased by 50% in April, and again by October, many of you may be anxious about how your household will cope.[i] As the world emerged from lockdown, the demand for oil and gas had already increased. The Russian invasion of Ukraine caused a further jump in oil and gas prices, due to concerns about the disruption to supply. Food produce also saw an increase in price; meat has gone up in price, such as lamb (16.9%), beef (8.6%) and poultry (7.3%). Oils and fats have seen a rise of 18.1%.[ii]

The government has implemented strategies to help families with these growing costs, in the form of a rise in the National Insurance thresholds, doubled Household Support Fund and a cut to fuel duty.[iii] However, the effects of these measures may not be felt by everyone, having already felt the squeeze of mounting energy and food costs.

In terms of employment, how will these societal shifts affect members of the dental team?

Sifting through the team

Due to increased living costs, many employers may feel pressured to raise wages. It had been suggested by the Bank of England governor that employees should not ask for a significant pay rise, in order to help control inflation. However, for many employees, a pay rise may help them to keep their head above water. Additionally, for employers, raising wages could help to retain staff members, although it could put a strain on their business, especially for larger practices with a bigger team. To balance these interests, employers may have to be more selective about who receives a pay rise/bonus.

However, with a recruitment crisis already in full swing in the UK, team members who are dissatisfied with their pay may simply look elsewhere to improve their situation. It is no secret that many dental nurses in particular are frustrated with their treatment in the profession, as well as their pay. However, with the National Minimum Wage (NMW) rising by 6.6%, many dental nurses will appreciate a boost in their wage slip. Numbers taken from our recent Benchmarking & Goodwill survey show that a dental nurse working a 40-hour week on NMW would see an increase in their wage of almost £1,228. This is certainly a step in the right direction to encourage more individuals to stay in the profession.

What this means for different professionals

As NHS revenues remain stationary, the NHS ratio of a ‘typical’ practice may reduce from the current 39.1%.[iv] This may prompt practices to hand back UDAs and focus more on private treatments. For the self-employed who concentrate more on NHS work, they may be losing out. However, for others, this change may provide greater flexibility, in addition to a greater salary. For instance, the average private hourly charge for a dental hygienist appointment is around £20 more expensive between predominately NHS and private practices.^iv For the employer, a dental hygienist can be an important addition to the practice; on an hourly rate of £31.94, the practice looks to make an average GP margin of 74%, which is at least 50% greater than a typical associate.^iv  

Given the increasing costs of employment, by next year’s survey there may be big changes regarding staff costs. There are some significant variances on practice compositions, with predominately NHS practices sitting at 20.5% of revenue. This may not match with the average hourly rate of £9.13 being paid to NHS dental nurses (which is lower than both mixed and private practices); however, NHS practices do tend to be lower grossing per dental chair and have larger patient footfalls. This, of course, will require a greater number of staff, therefore increasing the cost of employment. £9.13 now sits below the NMW; though this average does include rates paid to apprentices and trainee members of the team, so the number may surge by as much as 10% in the next year. This wage inflation could offer the added income that individuals need to at least partly combat the rising costs of living.

Things to consider

Individuals across the country are grappling with unprecedented societal changes, with wages struggling to keep up with the soaring costs. Dentistry has certainly taken its fair share of hits in the past couple of years, following the pandemic and now the surge in living costs, inciting professionals to throw the towel in. However, there may be rising competition as a result of this, with employers having to take steps in order to gain and retain their most valuable staff members.

If you’re thinking about making a change in your career, or you’re concerned about how these changes may affect you, the team at Dental Elite are experts in finding roles that suit professional’s individual needs and requirements. They also possess comprehensive knowledge regarding the dental market, and are happy to give advice and guidance to those who need it.

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

Author: Lisa McCusker, Recruitment Team Leader & Locum Specialist

Lisa joined Dental Elite in September 2015 and now leads the Dental Recruitment team after working as a Recruitment Consultant and Senior Recruitment consultant. She also heads up the Locum desk and works with practices nationwide to find solutions for their locum requirements.

[i] Stewart, I. and Bolton, P. (2022). Domestic energy prices. [online] House of Commons Library. Available at: https://commonslibrary.parliament.uk/research-briefings/cbp-9491/ [Accessed 3 May 2022].

[ii] Sandercock, H. (2022). UK cost of living crisis: this is how much food prices have risen amid ‘big squeeze’. [online] www.nationalworld.com. Available at: https://www.nationalworld.com/lifestyle/food-and-drink/inflation-uk-how-much-have-food-prices-gone-up-amid-2022-cost-of-living-crisis-will-they-continue-to-rise-3536980  [Accessed 3 May 2022].

[iii] GOV.UK. (2022b). Spring Statement 2022 (HTML). [online] Available at: https://www.gov.uk/government/publications/spring-statement-2022-documents/spring-statement-2022-html [Accessed 3 May 2022].

[iv] Dental Elite Goodwill & Benchmarking report

Figures published by GOV.UK[i] show “positive signs” that diets are becoming healthier, with sugar consumption in a steady decline since 2008.

However, despite this decline, sugar consumption in children and adults is still too high.

Among all dental professionals, a strong collaborative effort is imperative to ensure that patients are well-equipped to make positive changes in their diet. Hopefully, as a result, these trends in sugar consumption will continue to fall.

The importance of a dental nurse  

When a patient visits the clinic, there are plenty of opportunities for the dental team to interact with them and offer guidance on diet and general oral health. But no-one is in a better position to do this than dental nurses.

After acquiring additional skills in oral health education and promotion, dental nurses can provide important oral hygiene advice for patients. Not only are they in regular face-to-face contact with patients, but they become a familiar and friendly presence during patient appointments and/or treatment.  

Prevention is considered the best way to ensure good oral health in patients, and dental nurses are fully-equipped with the skills needed to educate and remind them about the importance of regular check-ups, proper brushing techniques and, of course, a balanced diet, to name but a few preventative methods.

Despite their vital position, dental nurses have, and continue to, voice their dissatisfaction regarding their roles and many have left the profession as a result.

Why?

 Does dissatisfaction around pay, lack of enjoyment/fulfilment and low recognition sound familiar?

These are just some of the reasons why dental nurses are quitting dentistry.[ii] Dental nurses are invaluable to the dental team and to patients, so why aren’t they always treated as such?

Here at Colosseum Dental UK, we recognise how integral dental nurses are within the dental practice. With your increasing responsibilities and continued passion for excellent patient care, we want to thoroughly reward you for your hard work and dedication.

So, what does a career with Colosseum Dental UK look like?

Join the team!

By joining the Colosseum Dental UK team, you’ll be in full control of your career, with some additional benefits added in!

First and foremost, we offer a competitive salary package as well as flexible working options. This not only demonstrates our recognition of your importance, but also helps you balance professional and personal commitments.

To ensure that you work in outstanding facilities, we have invested millions into revamping our clinics and kitting them out with modern equipment and technologies. As a result, our teams are better able to deliver outstanding care, as well as feeling proud to come to work.

The ethos among our team is one of productivity, positivity and proactiveness – we encourage our dental nurses to speak up if they think there’s something we could be doing better. Real change is only possible with your help!

The chance to go further  

Being a dental nurse means you have so many additional skills and areas you can delve into, to progress your career and improve your confidence when at work.

As such, we offer the chance to work across different dental specialisms as well as opportunities for continuous professional development. If you’re looking to explore a new specialism, or move up into management, we are here to make this a reality.

Imagine where you could go with Colosseum Dental UK

For some dental nurses, simply being recognised for their hard work would be a reward enough. But at Colosseum Dental UK, you’re worth far more than that.

Get in touch today to find out where you could go with us.

For more information, please visit https://www.colosseumdental.co.uk/careers/job-opportunities/dental-nurses

#WeCareMore

[i] Tedstone, A. (2020). New data reveals how our diets are changing over time – UK Health Security Agency. [online] ukhsa.blog.gov.uk. Available at: https://ukhsa.blog.gov.uk/2020/12/21/new-data-reveals-how-our-diets-are-changing-over-time/ [Accessed 31 May 2022].

[ii] Silver, R. (2021). Where have all the dental nurses gone? BDJ Team, [online] 8(10), pp.8–13. Available at: https://www.nature.com/articles/s41407-021-0765-y [Accessed 31 May 2022].

The BACD is delighted to have relaunched its Accreditation programme, making it easier than ever before for members to develop their skills, confidence and potential in cosmetic dentistry.

Why is BACD Accreditation so important?

The BACD Accreditation process requires professionals to demonstrate their ability to diagnose, plan and execute a range of high-quality cosmetic dental treatments, safely, ethically and competently. It covers a broad spectrum of topics to ensure that individuals develop their knowledge and skills in all areas related to modern cosmetic dentistry and become well-rounded clinicians and dental technicians.

What’s changed?

The BACD Accreditation programme has undergone various changes to make the application process simpler and more accessible to more professionals. Significantly fewer before and after photographs must now be submitted for short case types, saving time and streamlining the experience for candidates. The new points system offers a total of 100, which can be earned through a combination of case presentations (minimum 80 points) and other activities such as postgraduate education, lecturing and published articles (maximum 20 points).

The five original case types required for submission have been expanded with three new categories for dentists, now including: smile makeover, indirect shade matching, tooth replacement with natural gingival architecture, posterior aesthetics, complex direct composite bonding, periodontal plastic surgery, minimally invasive techniques and complex whitening. The categories for dental technicians focus on indirect shade matching, tooth replacement with natural gingival architecture and posterior aesthetics.

Is BACD Accreditation for me?

BACD Accreditation is an accolade to share with colleagues and patients alike. It recognises your dedication to self-improvement, shows the high standards that you are able to achieve and offers another reason for others to trust in your skills for their care or their patient’s care.

Dr Arun Darbar – the Chair of Credentialling, a BACD board member and an Accredited member himself – commented:

“BACD Accredited status sets members apart and rewards them with a marketable achievement that can be demonstrated to their own patients, and used in practice promotions across various media.

“For me, Accreditation has been a journey that has set me up with a systematic approach, for example using a photographic set that allows me to constantly review, critique, plan and improve on my clinical outcomes. It allows me to engage fully with my patients. This patient participation is really the best clinical management tool for constant improvement and avoiding medicolegal issues.

“The big question has always been: ‘why should I do BACD Accreditation?’, but it is now a question of ‘why not?’ It is now possible for any BACD full member to showcase their skills and get the recognition they deserve from their peers.”

Find out more and consider starting your own journey to BACD Accreditation today!

There are many reasons for dentists to enhance, expand and refine their clinical skills over time. Not only is continued education and training essential to remain abreast of the latest techniques, materials and technologies in the profession, but it is also integral to career progression and quality of patient care. While every dentist will have their own motivations and goals for training, we all share the same desire to provide the best possible care to our patients.

Confidence is key

In all jobs and industries, being confident in your role is important for performance and job satisfaction. This is just as, if not more true in healthcare professions. Research has shown that self-confidence can impact clinical decision-making and behaviour by healthcare professionals.[i] Indeed, patients seems to agree, with a study finding that patient perspectives also placed high importance on a professional’s confidence when assessing their competence.[ii]

When it comes to implant dentistry, it is particularly important for a clinician to have confidence in their knowledge and abilities. The advanced nature of the modality means a wealth of skills is required to deliver successful treatment. The practitioner must also be able to discuss potential treatment with patients to optimise case acceptance, which further requires a robust working knowledge to convey the right messages in the right way.

The fight against litigation

Enhanced skills and the ability to provided dental implant treatment assertively are also crucial when it comes to protecting one’s self in an increasingly litigious society. It is no secret that complaints have been rising across dentistry in recent years, with a huge number of dentists concerned that a legal case may be brought against them.[iii]

While simply being confident in your clinical skills may not prevent a patient complaint, knowing that you are delivering the best, evidence-based dentistry will offer peace of mind. Combined with meticulous record keeping and an opportunity for patients to raise issues locally, this ensures you have everything in place to minimise the risk of a complaint straight to the GDC.

Boosting clinical confidence

Aside from where the Dunning-Kruger effect is at play (a cognitive bias where people with low ability perceive themselves as experts), most people will be less confident the less they understand about a subject. This highlights the importance of continued learning and education to boost both competence and confidence.

Throughout the medical field it is widely recognised that on-going training and education can improve clinician confidence.[iv] It the method by which individuals improve their competency, broaden their experience and develop trust in the products or techniques they are using. The same has been suggested within dentistry, with one study linking the completion of an MSc programme to increased confidence, as well as improved communications skills and greater job satisfaction.[v]

So, how do you go about finding an implant-related course or training provider you trust to install the knowledge and competence you need to approach case in practice with confidence?

Among the many criteria to consider, here are some vital aspects to think about:

Who is the course designed for?

It is important that training is delivered at the right level for you – too easy and you will learn little, too advanced and you’ll leave with more questions that you started with!

What experience do the instructors/lecturers have?

Learning from those at the top of their game, who have all the appropriate qualifications and experience themselves is essential.

What format does the course take?

When learning or developing skills in almost any area of dental implantology, both theoretical and practical training will be critical, so you’ll need a programme that offers a sufficient amount of each.

What will be the outcome of the training?

Consider whether the course is designed as part of a pathway or to enable you to put what you’ve learnt into practice immediately, safely and confidently.

How large is the group?

If focusing on a surgical technique, for example, a small group size will enable one-to-one mentorship and an improved learning experience. That said, a larger group size brings together more individuals to network with, share ideas with and learn from also, so look for a balance of both.

For anyone looking to develop competency in soft tissue management around dental implants, BPI Dental Education & Training offers various courses that share a wealth of knowledge and provide hands-on experience. The Soft Tissue Around Dental Implants course covers everything from different soft grafting techniques, to microsurgical concepts, CBCT interpretation, donor site management, reduction of common complications and so much more. Cohorts fill up fast so be sure to secure your place soon for the next available dates in October 2022!

Fulfil your potential

Boosting your clinical confidence is central to becoming a successful dental practitioner and fulfilling your true potential in the implant field. If you can deliver treatment you trust to deliver functional, aesthetic and long-lasting, you will not only enjoy what you do more, but will also likely achieve more doing it as well.

 For more details of upcoming courses with Dr Boota Singh Ubhi and BPI Dental Education & Training, please visit www.bpieducation.co.uk

[i] Fry M, MacGregor C. Confidence and impact on clinical decision-making and behaviour in the emergency department. Australas Emerg Nurs J. 2014 Aug;17(3):91-7. doi: 10.1016/j.aenj.2014.03.003. Epub 2014 Jul 4. PMID: 25113311.

[ii] Bendapudi NM, Berry LL, Frey KA, Parish JT, Rayburn WL. Patients’ perspectives on ideal physician behaviour. Mayo Clinic Proceedings. March 2006. 81(3);338-344 https://doi.org/10.4065/81.3.338

[iii] Dental Protection. Dental Protection survey 8 March 2019 – 25 March 2018. Press release Dental Protection survey reveals 9 in 10 dentists fear being sued by patients. October 2018. https://www.dentalprotection.org/uk/articles/dental-protection-survey-reveals-9-in-10-dentists-fear-being-sued-by-patients [Accessed May 2022]

[iv] Fine P, Leung A, Bentall C, Louca C. The impact of confidence on clinical dental practice. Eur J Dent Educ. 2019 May;23(2):159-167. doi: 10.1111/eje.12415. Epub 2019 Jan 28. PMID: 30585682.

[v] Fine P, Leung A, Bentall C, Louca C. The impact of confidence on clinical dental practice. European Journal of Dental Education. December 2018. 23 (1). DOI:10.1111/eje.12415

Change your whole life and triple your income

All dentists have different backgrounds and interests outside dentistry. What is obvious to you, from your perspective, might not be to others. We view the world in our own unique way and each of us have something to offer.

Dr James Martin qualified as a dentist in 2016 and was quite content in his role treating patients. However, a small desire at the back of his mind to start his own side business became much more than that when he changed his mindset.

“I grew up interested in finance, reading lots of books on the subject, and I later became interested in cryptocurrency. I kept up-to-date with it and regularly traded, but it didn’t occur to me that the fundamentals of how it all worked weren’t general knowledge. It wasn’t until I looked at the fairly simple questions being asked by very intelligent people that I realised the gap in the market. The majority of dentists simply hadn’t been exposed to this information and the finance industry was not being as forthcoming in its education as it could be.

“Most clinicians don’t realise the many ways they could be missing out until they understand money and how to make it work for them. If you don’t think about it now, it can come back to haunt you – and often just implementing the smallest change will make a massive difference to your future.”

While every good business starts with a good idea, it is not as simple as that. A measured approach is important for a new venture, as is the confidence to get started. James found what he needed in The RE-IGNITE Academy.

“I had always thought about creating my own finance-related business but I didn’t know the first thing about where to start. I came across Dr Mahmood Mawjee at The RE-IGNITE Academy in a webinar, who was talking about how to be stronger mentally to tackle new ventures. He was convinced that everyone watching had the knowledge and opportunity to build something else alongside their dentistry – I wanted to know more.”

James embarked on a programme with The RE-IGNITE Academy and quickly realised what value he could offer others. He continues:

“Mahmood really made me put myself out there in everything that I did, including on social media to make use of the powerful networking opportunities it offers. I was able to identify and really target the right audience so I could proactively establish and build a success business that would change my life. I learnt that you should get attention first and create a product second – not the other way around. Mahmood’s course gave me the ability to speak confidently in public too, which is a skill that impacts every part of your life. With Mahmood’s mentorship and guidance, it was a revelation to discover just how achievable my own business would be.

“More than this, my income is now three times what it was before I embarked on this life-changing journey. I always worked hard, but now I spend my time and efforts more wisely, channelling them into more productive activities that deliver a significantly higher monetary return. Plus, I love what I do now!”

James goes on to share some of the challenges that come with striking out on your own:

“I first had to better understand how the internet works and how one actually generates money from having something online. I needed to consider how to create content and how much work this actually requires. If you don’t know what you’re doing and you’re on your own in this, it’s impossible to do it well. This makes guidance and validation crucial, as well as support and encouragement. To ensure you don’t get disheartened and lose interest when things don’t go to plan, you need someone to push you. For me, Mahmood and his team, as well as my family and friends kept me going.

“The more you do and the more you live in this world, the lonelier it becomes. The 9-5 people will find it strange and ask why you’re trying to do something different, which can make you second guess yourself. But ultimately, you have to do what you feel is right for you. How you do financially is about who you are and how willing you are to succeed. You need the right head space and The RE-IGNITE Academy helped me with this enormously. The new mindset I created with their help, changed my entire life.”

James now successfully leads a growing community, “Dentists Who Invest”, from his website and Facebook page, showing dentists how to generate their own financial freedom through programmes such as “Access to Bitcoin” and “Total Finance For Dentists”. Reflecting on his journey to date, he would encourage others to ensure they are living life to the full, adding:

“If you are not loving your job and your life, then it’s important to start exploring additional avenues. Every second lived that is not a 10/10 is a second wasted. If there’s room for improvement, find what you’re passionate about, change your mindset and surround yourself with people who can offer inspiration. It’s up to you to use your expertise and your experiences to create something unique that will serve others and bring you the joy and satisfaction you want from life.

“I would genuinely be gutted if I realised just how much I had been missing out on, if I discovered this way of living in 10 years’ time. I’m more excited for and optimistic about the future than I ever have been. Surely it’s worth a conversation with someone who could introduce you to a new way of thinking if this is what it can do for you too?”

To open the door to new opportunities and change your mindset, see what James has to say at events throughout 2022, including the DCP Study Day in July and BOC in September. Dr Mahmood Mawjee and The RE-IGNITE Academy will also be attending events so keep an eye out for them too!

For more information about The RE-IGNITE Academy, please follow @thereigniteacademy or @mahmoodmawjee on Instagram or visit www.thereigniteacademy.com

It was commonplace in previous centuries to simply remove the tooth from a patient’s mouth, with little regard to the complications that could occur. Nowadays, saving the tooth is the clinician’s first priority. Patients who have significant decay may be surprised to discover that the tooth does not always have to be removed. However, there are still situations where an extraction is deemed clinically necessary.

The most common indications for tooth extraction are caries and periodontitis.[i] While the procedure is relatively straightforward, there are issues that can occur that put the patient and the success of their treatment at risk. There are instances where a tooth cannot be removed in an upright position, which requires the clinician to individualise their approach to gain the most optimum clinical outcomes.

Complications

Wisdom teeth are generally considered to be the most common teeth extracted.[ii] Many individuals live life with minimal discomfort from their wisdom teeth. However, if they become impacted due to a lack of space in the mouth, patients often experience intense pain, with their neighbouring teeth at a higher risk of further complications. Wisdom teeth that are only partially erupted present as complex cases for clinicians, often requiring surgery to the soft and/or hard tissues surrounding the site. Similarly, teeth with larger and/or longer roots can require additional force during extraction. As you well know, this increases the risk of a tooth fracture and iatrogenic fracture of the mandibular.[iii] While rare, mandibular fractures can occur both intra-operatively and postoperatively, with a higher incidence in older age groups.[iv]

Dry socket has been shown to occur in around 5-10% of all tooth extractions,[v] potentially resulting in a throbbing pain, halitosis and trismus.[vi] Interestingly, the risks factors associated with dry socket include oral contraceptives (due to the presence of oestrogen),[vii] smoking, poor oral health and trauma from difficult extractions.[viii] [ix]

During and post-surgery

Even for the most experienced of clinicians, reducing the risk of complications both during and after the procedure can be a challenge.

Once treatment has taken place, patients are advised to follow a strict regime to ensure optimal healing of the site, such as implementing a soft diet, no smoking or consumption of alcohol, warm saline mouth rinses and avoidance of strenuous activity.[x] Patient compliance is a vital aspect of any dental treatment. Failure to comply can result in worsening oral health and a higher risk of encountering post-operative complications.[xi] For instance, a study demonstrated that patients who smoked reported more pain post-extraction than those who did not smoke.[xii] The incidence of dry socket was similarly more prevalent in smokers than non-smokers.[xiii]

However, as is customary pre-surgery, ensuring the patient fully understands what is involved, as well as their role in the aftermath, will ensure they recognise the importance of their compliance. Despite the relatively short healing period, some patients may struggle having to limit themselves in their day-to-day life, or adhering to strict post-operative recommendations. Reiterating their role during and after the procedure, whether via a telephone call or an email,[xiv] could help prompt them to stay on track.

Choose your tools wisely

As the oral cavity is a confined and restricted environment, and the tools needed for operating are quite powerful, trauma can be sustained to the surrounding soft and hard tissues. For instance, trauma can occur when the bur on the instrument overheats,^x or if it fractures during the procedure.[xv] 

As such, clinicians should be strategic when choosing their instruments, in addition to maintaining them with care, as this could influence the outcome of the extraction,[xvi] especially in more complex cases. It was noted in one study, where a patient was treated for an osteoma associated with an impacted inferior third molar, that careful operating and adequate instruments could limit the occurrence of complications.[xvii]

Invest in innovation

For a minimally invasive performance during oral surgery, the Piezomed from W&H is the perfect choice. It utilises cutting-edge ultrasound technology for a smoother procedure. Furthermore, with an efficient cooling feature, an LED handpiece and automatic instrument detection, this ergonomic unit allows clinicians to work with high precision. This helps to ensure that the surrounding soft tissues remain undamaged, providing relief for the patient in addition to a swifter healing period. Consider the Piezomed from W&H to streamline your procedures and maximise your outcomes.

In all areas of dentistry, complications can have varying origins, but through the implementation of modern technologies and equipment, clinicians can reduce these occurrences and gain optimal results for your patients.

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

[i] Lodi, G., Figini, L., Sardella, A., Carrassi, A., Del Fabbro, M. and Furness, S. (2012). Antibiotics to prevent complications following tooth extractions. Cochrane Database of Systematic Reviews. [online] Available at: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003811.pub3/full [Accessed 29 Apr. 2022].

[ii] Jafarian, M. and Etebarian, A. (2013). Reasons for Extraction of Permanent Teeth in General Dental Practices in Tehran, Iran. Medical Principles and Practice, [online] 22(3), pp.239–244. Available at: https://www.karger.com/Article/Pdf/345979 [Accessed 29 Apr. 2022].

[iii] Guillaumet-Claure, M.-A., Juiz-Camps, A.-M. and Gay-Escoda, C. (2022). Prevalence of intraoperative and postoperative iatrogenic mandibular fractures after lower third molar extraction: A systematic review. Journal of Clinical and Experimental Dentistry, [online] 14(1), pp.e85–e94. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8760961/  [Accessed 29 Apr. 2022].

[iv] Ethunandan, M., Shanahan, D. and Patel, M. (2012). Iatrogenic mandibular fractures following removal of impacted third molars: an analysis of 130 cases. British Dental Journal, [online] 212(4), pp.179–184. Available at: https://www.nature.com/articles/sj.bdj.2012.135#:~:text=Mandibular%20fracture%20is%20rare%2C%20but,of%200.0033%25%20to%200.0049%25.&text=These%20fractures%20could%20occur%20in,(Figs%201%2C2). [Accessed 29 Apr. 2022].

[v] www.healthcentre.org.uk. (n.d.). Osteitis (dry socket) Dentists Dry Socket Dentist. [online] Available at: https://www.healthcentre.org.uk/dentistry/osteitis.html#:~:text=Osteitis%20%28Dry%20Socket%29%20Find%20UK%20Dentists%20%C2%BB%20This [Accessed 29 Apr. 2022].

[vi] Ansari, A., Joshi, S., Garad, A., Mhatre, B., Bagade, S. and Jain, R. (2019). A study to evaluate the efficacy of honey in the management of dry socket. Contemporary Clinical Dentistry, [online] 10(1), p.52. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6974995/ [Accessed 29 Apr. 2022].

[vii] scholar.googleusercontent.com. (2019). Effect of oral contraceptives in the incidence of dry socket after mandibular 3rd molar extraction: A prospective clinical study. [online] Available at: http://scholar.googleusercontent.com/scholar?q=cache:2XAz8tlwiKYJ:scholar.google.com/+oral+contraception+dry+socket&hl=en&as_sdt=0 [Accessed 29 Apr. 2022].

[viii] Mamoun, J. (2018). Dry Socket Etiology, Diagnosis, and Clinical Treatment Techniques. Journal of the Korean Association of Oral and Maxillofacial Surgeons, [online] 44(2), p.52. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932271/pdf/jkaoms-44-52.pdf  [Accessed 29 Apr. 2022].

[ix] Mudali, V. and Mahomed, O. (2016). Incidence and predisposing factors for dry socket following extraction of permanent teeth at a regional hospital in Kwa-Zulu Natal. South African Dental Journal, [online] 71(4), pp.166–169. Available at: http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162016000400006#:~:text=The%20aetiology%20of%20dry%20socket [Accessed 29 Apr. 2022].

[x] Goswami, A., Ghorui, T., Bandyopadhyay, R., Sarkar, A. and Ray, A. (2020). A General Overview of Post Extraction Complications-Prevention, Management and Importance of Post Extraction Advices. Fortune Journal of Health Sciences, [online] 3(3), pp.135–147. Available at: https://fortuneonline.org/articles/a-general-overview-of-post-extraction-complicationsprevention-management-and-importance-of-post-extraction-advices.html?url=a-general-overview-of-post-extraction-complicationsprevention-management-and-importance-of-post-extraction-advices [Accessed 29 Apr. 2022].

[xi] Faheem, S. (2017). Patients Compliance and Follow-Up Rate after Tooth Extraction. [online] mpra.ub.uni-muenchen.de. Available at: https://mpra.ub.uni-muenchen.de/79401/  [Accessed 29 Apr. 2022].

[xii] Sanari, A.A., Alsolami, B.A., Abdel-Alim, H.M., Al-Ghamdi, M.Y. and Meisha, D.E. (2020). Effect of smoking on patient-reported postoperative complications following minor oral surgical procedures. The Saudi Dental Journal, [online] 32(7), pp.357–363. Available at: https://www.sciencedirect.com/science/article/pii/S1013905219306339#:~:text=Immediately%20after%20tooth%20extraction%2C%20the,almost%20all%20routine%20dental%20procedures. [Accessed 29 Apr. 2022].

[xiii] Mohammed H, A.Y. (2011). Dry Socket: Frequency, Clinical Picture, and Risk Factors in a Palestinian Dental Teaching Center. The Open Dentistry Journal, [online] 5(1), pp.7–12. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3089956/#:~:text=The%20incidence%20of%20dry%20socket%20was%20significantly%20higher%20in%20smokers,socket%20(P%20%3C%200.002). [Accessed 29 Apr. 2022].

[xiv] Aloy-Prósper, A., Pellicer-Chover, H., Balaguer-Martínez, J., Llamas-Monteagudo, O. and Peñarrocha-Diago, M. (2020). Patient compliance to postoperative instructions after third molar surgery comparing traditional verbally and written form versus the effect of a postoperative phone call follow-up a: A randomized clinical study. Journal of Clinical and Experimental Dentistry, [online] pp.e909–e915. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600202/ [Accessed 29 Apr. 2022].

[xv] Balaji, S. (2013). Buried broken extraction instrument fragment. Annals of Maxillofacial Surgery, [online] 3(1), p.93. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3645621/ [Accessed 29 Apr. 2022].

[xvi] Rajan, S.R., Hussain, K.A., Tarakji, B., Azzeghaibi, S.N. and Sirajuddin, S. (2015). Iatrogenic Damage to the Periodontium Caused by Exodontic Treatment Procedures: An Overview. The Open Dentistry Journal, [online] 9(1), pp.197–199. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541312/ [Accessed 29 Apr. 2022].

[xvii] D’Amato, S., Sgaramella, N., Vanore, L., Piombino, P., Orabona, G.D. and Santagata, M. (2014). Piezoelectric bone surgery in the treatment of an osteoma associated with an impacted inferior third molar: a case report. Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases, [online] 11(1), pp.73–6. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4064445/ [Accessed 29 Apr. 2022].

Temporomandibular joint disorders (TMDs) are significant issues that are surprisingly common among the UK population. In fact, it’s estimated that as many as one in ten people suffer from a TMD, meaning that millions of people are living their lives impacted by jaw issues that could potentially be rectified.[i]

But what causes TMDs and how can professionals help? 

A complex issue

Part of what makes TMDs so complex is that there are myriad causes and symptoms that can come into play with each individual case. The temporomandibular joint in itself is a multifaceted part of the human anatomy comprised of multiple muscles and ligaments that may cause issues if they are not operating properly. As such, there is no blanket solution for treating these disorders, and unique, individualised care is paramount in order to reach a solution.

Common causes 

Behaviours, accidents and medical conditions have been linked to the development of TMDs. A heavy impact from an accident, for example, may result in someone injuring the temporomandibular joint and suffering from on-going problems. On the other hand, a TMD may form gradually over time as the result of arthritis or a connective tissue disease. Bruxism or long-term teeth clenching due to stress or genetic factors like an uneven bite may also lead to a TMD, especially as these behaviours and features put excess pressure on this joint that can damage it in both the short and long-term.[ii]

TMDs occur when any of these causes lead to damage to the joint and prohibit normal function. When operating normally, the joint combines hinge action with sliding motion. The bones of the jaw are covered in cartilage that is separated by a small, shock-absorbing disk to keep movement smooth. If this disk erodes or is misplaced, or if the cartilage is damaged, then people start to suffer.[iii]

What symptoms will patients present with?

Much like the diversity of causes behind TMDs, symptoms of these disorders can be varied and vastly depend on how serious the injury to the joint is.

Patients may present complaining of pain around their jaw, temples or ears, or say that they are experiencing popping or clicking sounds when operating their jaw. They may also complain of pain when eating or speaking or experience lockjaw and other difficult to manage side effects.[iv]

These symptoms can range from mildly annoying to life-changing, making it clear that treating these issues should be a top priority for professionals.

The tools you need to succeed

The first part of providing tailored care is to fully understand the extent of the problem and any causes that may have led to the disorder in the first place. Talk to patients and find out more about their lifestyle and habits as well as performing an in-depth examination – there may be clues such as tooth wear and other visible indicators that point to the culprit.

Of course, diagnosing TMDs is made all the more simple if you utilise cutting-edge technology such as the CS 9600 CBCT system from Carestream Dental. As the scanner allows for multi-function imaging, professionals can utilise its exceptional power to combine 3D facial scans, 3D model scanning and more to help achieve an in-depth diagnosis.

Treatment options

Depending on the cause, the severity and the progression of a TMD, different treatment and relief options may be best suited. To help minimise discomfort, patients should be encouraged to avoid putting excess strain on their jaw where possible. For instance, hard foods should be replaced where possible with soft, easy to eat alternatives like pasta and omelettes. Patients can also massage the joint to achieve relief or use heat or ice packs to help reduce any pain.

If a cause such as bruxism is to blame, considerable improvement can be made by supplying the patient with a mouth guard or splint. This will help prevent the condition from progressing, and may even allow for the joint to heal itself over time. An uneven bite can be rectified with bridgework or tooth removal depending on the individual case, again correcting the problem by removing the pressure on the joint.

There are also therapies available to patients such as ultrasound treatment and botulinum toxin injections to help relieve symptoms should they persist. If serious damage has occurred, there may be a need to refer the patient to receive surgical intervention.

Make a difference

Ultimately, temporomandibular joint disorders can have a big impact on people’s lives. As dental professionals are well placed to understand these issues, you can make a real difference by utilising high quality technology, exploring causes and guiding patients towards much needed relief.

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 Facebook and Instagram @carestreamdental.uk

Author:

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. 

[i] Bupa. TMJ Dysfunction. Link: https://www.bupa.co.uk/dental/dental-care/symptoms/tmj-dysfunction#:~:text=Around%20one%20in%2010%20people,conditions%20more%20often%20than%20men. [Last accessed April 22].

[ii] Mayo Clinic. TMJ Disorders. Link: https://www.mayoclinic.org/diseases-conditions/tmj/symptoms-causes/syc-20350941 [Last accessed April 22].

[iii] Mayo Clinic. TMJ Disorders. Link: https://www.mayoclinic.org/diseases-conditions/tmj/symptoms-causes/syc-20350941 [Last accessed April 22].

[iv] NHS. Temporomandibular Disorder (TMD). Link: https://www.nhs.uk/conditions/temporomandibular-disorder-tmd/ [Last accessed April 22].

The Dentinal Tubules Congress is the perfect opportunity for professionals to come together to learn and network. Over three days, delegates can partake in plenty of hands-on workshops and lectures, taking full advantage of the educational resources on offer.

The Straumann Group will be there showcasing their range of products, including the ClearCorrect^® premier aligner. This remarkable system features a flat trimline above the gingival margin, in addition to robust ClearQuartz^™ tri-layer material. The result? A long-lasting solution that is comfortable, stain-resistant and customisable to suit your patients’ needs.

Plus, the Straumann Group will display their range of intraoral scanners (IOS), Neodent^® systems, biomaterials and plenty more!

Mark your calendar for 5^th, 6^th and 7^th of October and we’ll see you there!

For more information, visit https://www.straumann.com/gb/en/dental-professionals.html

Throughout our careers as dental therapists and dental hygienists we are faced with a number of exciting possibilities. This is particularly true as our roles continue to progress and develop, broadening our potential scopes of practice and opening new avenues to explore.

But how can we ensure that we’re adequately protected?

Despite being a legal requirement, finding an indemnity policy that is suited to our roles is not always straightforward – however, this doesn’t need to be the case!

Litigation in society

Society is changing and people are now more aware than ever before of the options available to them should they receive treatment or care that they deem unacceptable. There are many potential reasons for this – widespread use of the internet and targeted marketing from firms encouraging unhappy patients to take action are certainly part of it, but there has also been a general culture shift.

In fact, a report released by the UK government in 2016 suggested that we are now living in a far more litigious society than in the early 2000s.[i] This certainly has had an impact on dentistry, with figures from 2019 suggesting that clinical negligence claims have risen by 30% since 2018.[ii] Unfortunately, due to the pandemic and the cessation and limitation of dental services during this time, there are concerns that there may be a rising tide of dental negligence claims on the horizon.[iii]

What claims are being made against dental therapists and dental hygienists?

The foundation of dental negligence claims and other legal action isn’t always the same. For example, there have been cases that have arisen from failure to update a patient’s medical history, whereas as others may be based on an injury incurred during treatment.

Some of the most common claims, however, are related to the lack of detection of oral pathologies or periodontal disease. As a thorough examination of the oral cavity is part of the services we provide, missing anything in this vein can leave us open to legal action and have dire consequences, especially should either of these problems progress.

There could also be claims made based on us stepping outside of our scope of practice, not protecting patient privacy or breaching infection control standards. There are many pitfalls in any healthcare profession, and while claims based on these are incredibly rare, it’s still absolutely vital to have adequate protection.

Safeguarding yourself and your career

Ultimately, finding an indemnity policy that suits your circumstances is more important than ever before, especially as society continues to become more litigious. Although the risks of legal action being taken against individuals in our profession are low, finding comprehensive cover that is affordable and comprehensive offers excellent peace of mind and helps guarantee that you are safeguarded as much as possible.

Protection in a modern profession

As part of our commitment to support dental therapists and dental hygienists, the British Association of Dental Therapists (BADT) has teamed up with Dental Protection to offer members a 15% discount on their subscription. This is apt, given that Dental Protection, as part of the Medical Protection Society, were the first organisation to offer dental therapists indemnity. individuals will also gain access to other support services offered by Dental Protection including counselling for those suffering from work-related stress or any issues that they believe is impacting their work.

This perk joins a host of other benefits that ensures joining the BADT is an excellent option for dental therapists, dental hygienists and students of the profession.

A policy tailored to you

For many years, dental therapists and dental hygienists have been faced with limited options when it comes to finding indemnity policies that are truly tailored to reflect the risks of our profession. Many individuals in our roles take out indemnity policies that are designed for dentists. While comprehensive, these policies tend to be an expensive option, especially as they provide cover for circumstances that are beyond our scope of practice – meaning we’re effectively paying more for no added benefit.

As such, it pays to explore the market when looking for your indemnity policy and to really research what makes a policy good for you. As dental therapists and dental hygienists become more recognised as essential parts of the dental team, it’s likely that our duties will continue to expand – this is something to bear in mind when weighing up the options, especially if you want to ensure that you are adequately protected against every eventuality.

For more details, please visit www.badt.org.uk

Debbie Hemington- Chair. Debbie qualified from New Cross in 1983, the year it closed, and is actually the last New Cross Therapist to graduate. She qualified as a Hygienist at Kings in 1987 and has worked continuously during this time in a variety of settings. In 2003 she joined The Eastman as a tutor and combines that role with working in a mixed general practice where she has worked for 38 years! Debbie has also worked the for the former London Deanery as part of the DCP tutor team commissioning post graduate education, and was the educational lead on “Wild Smile” project with Heart your Smile. In 2012 she took part in a 2 year part time pilot scheme at Kings for Enhanced Skills in Periodontology. She has been a BADT member for most of her career and was elected Chair in 2018 and is now President of the Association.

[i] Gov.UK. Common Sense, Common Safety. Link: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/60905/402906_CommonSense_acc.pdf [Last accessed April 22].

[ii] Business Matters. Clinical Negligence Claims To Dentists Are On The Rise – Why is This The Case?  Link: https://bmmagazine.co.uk/business/clinical-negligence-claims-to-dentists-on-the-rise-why-is-this-the-case/ [Last accessed April 22].

[iii] The Dentist. A Knock-on Covid Wave? Link: https://www.the-dentist.co.uk/content/news/a-knock-on-covid-wave [Last accessed April 22].