In recent years, the UK has undergone a number of challenges that have had a direct impact on nationwide standards of oral health. One consequence of this has been more patients becoming deemed as high-risk, meaning that they are more likely to experience tooth decay and other avoidable oral health conditions.

As dentists, it’s important to understand why patients may be considered high-risk and have solutions at hand to help protect them as much as possible.

The Covid-19 effect

Despite beginning in 2020, the full impact of the Covid-19 pandemic is still being felt in the dental industry. Oral health inequalities were created and exacerbated during this time, and a report from the GDC found that disabled individuals as well as those from poor socio-economic and ethnic minority backgrounds were affected most.[i]

With practices forced to close and a lack of access to dental services, it’s little surprise that the nation’s oral health suffered. However, this was also aggravated by the stress people experienced during this time, and the bad habits that many formed as coping mechanisms. Indeed, research suggests that the average person gained at least half a stone in weight during lockdown. This weight gain has primarily been linked to stress-eating behaviours, which typically involve individuals eating comfort foods high in fat and sugar in order to reduce feelings of anxiety.[ii] This weight gain has also been linked to an uptick in UK individuals developing type 2 diabetes, which as you are probably aware, also puts people at higher risk of oral health complications.[iii] 

Current challenges

Unfortunately, even though restrictions from the pandemic era are coming to an end and normal life has resumed for the majority, there are still issues affecting oral health in the UK.

One of the most prominent of these is the cost-of-living crisis. Rising rates of inflation, wage stagnation and increasing interest rates have meant that on average, people’s money has a lot less purchasing power than before. When someone is already struggling to afford necessities, it is possible that they will forego dental check-ups. When they do come to your practice it’s likely to be because they are experiencing a problem that needs resolution.

There is also the access crisis to consider. With a lack of NHS practices accepting new patients and waiting lists becoming years long in some areas,[iv] the impact this will have on oral health will likely echo that of the pandemic.

With all this considered, it’s perhaps not a huge surprise that estimates suggest 81% of UK adults are considered at high-risk of developing tooth decay.[v]

Who’s most at risk?

Despite so many people being considered high-risk, there are certain demographics who have been disproportionately affected by these challenges. The rising tide of childhood tooth decay, for instance, indicates that many children are not receiving the dental care they need.[vi] Disabled individuals also remain at high-risk, with Public Health England finding that people who fall under this umbrella have higher levels of untreated tooth decay, increased oral plaque levels and greater unmet oral health needs compared to those without disabilities.[vii]

Elderly individuals also fall into the high-risk bracket, with research suggesting that over half of people living in care homes have tooth decay.[viii] That’s not to mention those who are living with conditions that can also increase their risk of tooth decay and other oral health complications, such as diabetics, HIV/AIDS sufferers and people with osteoporosis.[ix]

Providing solutions for those in need

Industry-wide, a more preventive approach to dental care is fast becoming the norm. This means that solutions such as fluoride varnishes may be a good answer. However, as many high-risk patients will present when decay has already occurred, it is also a smart idea to consider products that can help safeguard them against further decay.

Diamond Carve hand-mixed glass ionomer cement from Kemdent is an excellent option that can be used in a wide variety of indications. Able to be chemically cured without dimensional change, it can be used to provide simple, one place restorations even in deciduous teeth. Plus, it steadily releases fluoride after placement, helping to safeguard against further decay – ideal for high-risk patients.

Catering to the modern patient population

Unfortunately, while oral health in the UK is generally improving,[x] current circumstances and ripples from the pandemic continue to negatively impact individuals across the nation.

For dentists to help these patients as much as possible, a preventive approach and solutions that enable better protection from future tooth decay are recommended.

For more information about the leading solutions available from Kemdent, please visit www.kemdent.co.uk or call 01793 770 256

[i] GDC. The impacts of COVID-19 on oral health and dentistry in 2020. Link: https://www.gdc-uk.org/standards-guidance/covid-19/the-impacts-of-covid-19#:~:text=Oral%20health%20inequalities%20are%20being,living%20in%20more%20deprived%20areas. [Last accessed November 22].

[ii] BBC. Lockdown weight gain averaging half a stone – survey. Link: https://www.bbc.co.uk/news/health-57968651 [Last accessed November 22].

[iii] University of East Anglia. We Drank more, Exercised Less, In Lockdown – Study Shows. Link: https://www.uea.ac.uk/news/-/article/we-drank-more-exercised-less-in-lockdown-study-shows#:~:text=Lockdown%20saw%20people%20in%20the,the%20University%20of%20East%20Anglia. [Last accessed November 22].

[iv] BDA. NHS dentistry at a tipping point, as BBC reveal true extent of access crisis. Link: https://bda.org/news-centre/press-releases/Pages/nhs-dentistry-at-a-tipping-point.aspx [Last accessed November 22].

[v] Dentistry Today. 84% of UK Adults at High Risk of Tooth Decay. Link: https://www.dentistrytoday.com/84-of-uk-adults-at-high-risk-of-tooth-decay/ [Last accessed November 22].

[vi] Dental Nursing. New research shows untreated tooth decay is still prevalent in young children. Link: https://www.dental-nursing.co.uk/news/new-research-shows-untreated-tooth-decay-is-still-prevalent-in-young-children [Last accessed November 22].

[vii] Public Health England. Health Inequalities: Oral Health. Link: https://www.gov.uk/government/publications/inequalities-in-oral-health-in-england [Last accessed November 22].

[viii] NICE. Improving oral health for adults in care homes. Link: https://www.nice.org.uk/about/nice-communities/social-care/quick-guides/improving-oral-health-for-adults-in-care-homes [Last accessed November 22].

[ix] Mayo Clinic. Oral Health: A Window Into Your Overall Health. Link: https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/dental/art-20047475 [Last accessed November 22].

[x] GOV.UK. Child Oral Health: Applying All Our Health. Link: https://www.gov.uk/government/publications/child-oral-health-applying-all-our-health/child-oral-health-applying-all-our-health#:~:text=Although%20oral%20health%20is%20improving,3%20to%204%20teeth%20affected. [Last accessed November 22].

Maintaining your air compressor can be a time-consuming task.

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Air to the Chair includes next-day delivery and installation of a new, ultra-quiet air compressor. It also provides all necessary certification to prove compliance and 24-hour breakdown coverage, meaning that instead of stressing about your air supply you can concentrate on what really matters – providing exceptional patient care.

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You can revolutionise dental implant surgery with the cutting-edge Implantmed from W&H.

This system offers dental implantologists and oral surgeons a host of benefits that can elevate treatment with ease.

Including five programmes for each implantation step, the system also has an integrated pump, multifunctional foot control and a motor and cable that can be sterilised for absolute ease of use and safety.

Plus, the drive unit offers automatic torq control, an automatic thread-cutter feature and the opportunity to measure implant stability with the optional Osstell ISQ module, making gold-standard oral surgery achievable in every case.

Contact the team at W&H to find out more.

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

Support patients suffering from temporomandibular disorders (TMDs) with the OraStretch Press, which can be easily incorporated into management plans.

Distributed by Total TMJ, this device is a true innovation, which people can use at home to maximise their range of motion – typically, they will gain 1-2mm per week – and help the jaw muscle get stronger.

Available in 5 different sizes, the OraStretch Press also assists rehabilitation by helping to reduce joint pain, when it is used continuously.

The discomfort from TMD can affect quality of life, including oral-health related quality of life as well as emotional wellbeing.

Even people with mild to moderate TMD can experience difficulties sleeping, talking and eating.

Help them return to health and comfort, by recommending the OraStretch Press.

For more details about Total TMJ and the products available, please email phil@totaltmj.co.uk or karen@totaltmj.co.uk

Dental implants are now offered by more practices to meet demand. But despite these treatments’ growing popularity, they are still complex, requiring meticulous planning at every stage. For the clinical journey to be a success for everyone involved, teamwork is crucial.

Although there are many reasons why modern patients would prefer to replace a tooth with a dental implant rather than a removable prosthesis, they will still have concerns. The internet gives access to information that may not be scientific or evidence-based, and could even be inaccurate or misleading, but people will read, and be influenced by what they read, nonetheless. Implant teams are seeing people who are experiencing a range of emotions. In many cases, individuals are feeling somewhere between sure they’re making the right decision and apprehensive and intimidated about the long-term commitment, expense, risk of failure.

To get that person from A to B, by delivering a treatment that restores health, function and looks beautiful, the implant team will need to work as one. They will have to seamlessly integrate all their different skills and knowledge, so that every patient feels well looked after, comfortable and informed from the start.

In every dental team, the lynchpin is often the dental nurse. A great dental nurse is organised and an excellent communicator, with the ability to stay calm under pressure. They are informative and compassionate, so if a patient is suddenly nervous, or has extra questions before treatment begins, they know they can talk to the dental nurse, who will give honest answers and support without judgement.  

On the implant team, the dental nurse is part of the process whereby the patient fully understands the procedure they’re having, all the risks for failure, and what they can do to reduce them. Having been present since the start of the treatment journey, the dental nurse will be familiar with their unique dental, medical and social history and have the ‘full picture’ necessary for the delivery of tailored, individualised care. They are crucial during the planning and treatment delivery stage, also post-operatively. When the patient is in the recovery and maintenance phase, the dental nurse will have been fully briefed on the care plan. If an individual is experiencing an unexpected level of pain or swelling, for example, they may feel more comfortable with contacting the nurse first, who will be able to reassure or recommend they return to the practice. Going forward, although the dental hygienist or dental therapist will often be the one who performs the professional cleaning of the implant, the dental nurse will be able to demonstrate how to do this too, and offer advice on areas like diet and other behaviours that can keep the smile looking and feeling good.

The dental nurse is crucial to the ‘human’ side of dentistry, whatever the application, but every dentist knows they are utterly fundamental in a practical sense, for enabling smooth and efficient workflows. In the implant team, they assist with surgical asepsis by maintaining strict protocols when preparing the surgery, including all instruments, equipment and materials, also when checking products sent in from the lab. They will be familiar with the various products that the implant dentist may use, depending on the case. During surgery, they help maintain the safe and sterile environment, as well as being a calming presence, who can anticipate what the clinician needs. Post-operatively, there will be more practical tasks, like ensuring there is a full case report and logging batch numbers of kits used.

In all areas of dentistry, education is the key to professional growth, also for developing the confidence to help more patients comprehensively. Although they already have a wide range of skills, when dental nurses assess quality implant training, they can take their careers to the next level. The One to One Implant Education is launching a new diploma for dental nurses in 2023, developed by the same Harley Street team that has helped thousands of dentists start their implant journey. Being taught by professionals and educators at the top of their game will inspire a passion for lifelong learning, as well as enable dental nurses to do more than simply ‘assist’ the implant process. With a combination of hands-on and theoretical learning, the programme will also help them expand their network, as well as boost their prospects in an increasingly competitive industry, so there will be personal rewards too!

Great implant dentistry is all about teamwork and, to my mind, working as part of an implant team is the opportunity of a lifetime for dental nurses. When they access quality training, they will be part of every successful patient journey, one that restores smiles as well as quality of life, and returns people to health and wellbeing, for many years to come.

To reserve your place or to find out more, please visit
https://121implanteducation.co.uk or call 020 7486 0000.

Dr Fazeela Khan-Osborne
Principal Implant and Restorative Surgeon
MSc.BDS (Lon) BSc(Hons) LDS.RCS (Eng) DRDP Dip. Imp. Dent.(RCS.Eng)Advanced Certificate, FCOI

The Curasept ADS Specialist range of oral care solutions, available from J&S Davis, offers targeted treatment to reduce the impact of gingivitis, periodontitis and peri-implantitis. Oral diseases affect many people – causing pain, inflammation, and tooth/implant loss if allowed to progress. The range of oral care solutions from Curasept aims to prevent and treat these issues, with formulae that target the main symptoms, treat the infection, and prevent further development.

As well as chlorhexidine, the gold standard mouth antiseptic in the field, hyaluronic acid is a key aspect of the range. It has water absorbing properties which help to maintain wound moisture and boost bio-cellular activity at the damaged site. This accelerates the healing process by facilitating the migration and proliferation of fibroblasts. To combat the potential negative side-effects of chlorhexidine, the range also features the patented Curasept Anti Discolouration System (ADS) system for dramatically reduced tooth discolouration and taste disruption.

Prolonged care for your perio patients

Available in a 500 ml bottle for a complete 4-week treatment plan, the Curasept ADS Perio Pro Oral Rinse offers specialist treatment for patients with periodontal issues. It’s designed for the effective care of red, inflamed and bleeding gingiva; making it an ideal solution for your patients with gingivitis, periodontitis, and peri-implantitis, as well as any who have undergone periodontal surgery. With 0.12% chlorhexidine, it provides a strong anti-bacterial and anti-plaque action. Its formula also includes hyaluronic acid and sodium DNA to reduce inflammation, soothe any irritations, and boost the healing process.

Patients should use morning and night; gently swishing around the mouth for 60 seconds over a period of 30 days. For the best results, this oral rinse should be used in conjunction with Curasept ADS 712 Perio Toothpaste.

Effective protection for your implant patients

The Curasept ADS Implant Pro Oral Rinse offers specialist protection for patients pre/post implant surgery, bone grafting and extractions. With 0.20% chlorhexidine, it provides an intense anti-bacterial and anti-plaque action. Its formula also contains hyaluronic acid and sodium DNA to reduce inflammation as well as soothe, heal and boost the regeneration of the oral mucosa.

Patients should use morning and night; gently swishing around the mouth over a period of up to 14 days. For best results, this oral rinse should be used in conjunction with Curasept ADS 720 Toothpaste and Curasept ADS Regenerating Gel.

Targeted care where it’s needed most

The Curasept ADS Regenerating Gel with 0.50% CHX, PVP-VA and hyaluronic acid is a topical gel which provides targeted and intense anti-bacterial and anti-plaque action due to the high concentration of chlorohexidine on gingival areas of concern. It is formulated with PVP-VA which means the gel has a sticky consistency, allowing it to stay in place for the active and prolonged treatment of the area. This also provides a protective layer which covers the wound to minimise irritation, assist pain relief and allow the wound to heal. The Curasept ADS Regenerating Gel contains hyaluronic acid which increases the speed that the wound will heal by regulating inflammation levels and by signalling to the body to build more blood vessels in the damaged area.

For best results, this gel should be used twice a day on the affected area over a period of up to 10 days. It is suitable for use before and after implant surgery, bone grafting/regeneration procedures, extractions, and those undergoing periodontal treatment or with deep pockets.

Curasept solutions in collaboration

Curasept ADS Perio Pro Oral Rinse and Curasept ADS Implant Pro Oral Rinse have been designed to work in synergy with all of the other products within the Curasept ADS range of oral care solutions. No matter whether your patients are using medicated mouthwash, toothpaste, or gel as part of their oral hygiene routine; you can be confident in the knowledge that all of the Curasept ADS products are SLS free, and none of them will therefore counteract the effectiveness of chlorhexidine. This also means that, with Curasept ADS products, your patients will be able to enjoy all of the clinical benefits of chlorhexidine without its potential side effects of tooth staining and taste disruption.

For a range of oral care solutions that will maximise your patient compliance and treatment outcomes; start recommending, using and selling Curasept ADS in your practice today.

For more product information and samples,

visit www.js-davis.co.uk, call 01438 747 344

or email jsdsales@js-davis.co.uk.

One big question on everyone’s lips at the moment is how the NHS contract reform will impact dental therapists and hygienists. At this point in time, where the details of the reform are still not solidified, it can be difficult to know what to expect and how to proceed.

In response to this uncertainty, the British Association of Dental Therapists (BADT) has issued a statement to members to help guide them through this unfamiliar territory:

Caution in the face of change

BADT President, Debbie Hemington, and Chair, Fiona Sandom  have urged caution to their members over the NHS contract reforms in England until the full details are clarified. Whilst being fully supportive of skill mix within the dental team, especially in regards to delivering NHS services, members must make sure they are not exposing themselves to unnecessary risk.

A major concern among BADT members right now is whether they can deliver the NHS appointments being booked for them where patients have not fist been seen by a dentist. Members have raised concerns about NHS check-ups being booked with them, often without any consultation. Currently, the BADT is seeking to clarify the details of the reforms in order to assist members on these and other matters. As such, current advice is for dental therapists and hygienists to not change their working patterns until the full details of the reforms are clear.

The widespread message of “misunderstandings” around the wording of the current contract has been disputed by the BADT, who were told explicitly in 2013 that opening an NHS course of treatment was against the regulations. As such, the BADT is working with National Health Service England (NHSE) to ensure that it is in fact now possible for dental therapists and hygienists to open an NHS course of treatment.

Administration and supply of prescription-only medications is also a hurdle, and the BADT continues to work together with the British Society of Dental Hygiene and Therapy (BSDHT) on the exemptions framework. This project has some considerable way to go and the BADT has impressed on NHSE that their input to facilitate a speedy resolution would be most welcome.

Dental therapists and dental hygienists also need to be aware that at present there is no provision to give a performer number to them, so any extra responsibilities will not contribute to an NHS pension or any other benefits for them. Indemnity costs may well rise with this change too, meaning that people in these roles will have to seek alternative cover. Plus, with dental therapists and hygienists likely to be performing more of their scope of practice, they may have to update their policies to ensure that their current indemnity will fully protect them.

The BADT is here for you

The BADT regularly updates members on any developments and continues to ensure that the best interests of all individuals within the Association are represented. With contract reforms causing confusion and raising a number of questions, being part of a like-minded community of dental therapists and hygienists is a huge benefit.

The BADT ensures that every member can have their voice heard, and offers individuals a variety of excellent perks that have been designed to help professionals to excel and grow in their careers. Membership includes access to a selection of high-quality educational resources, including members-only webinars, quarterly Dental Therapy Update Journals and discounted CPD courses.

Another priceless benefit of joining the BADT is the reassurance and guidance you receive. As an Association run by working dental therapists, the BADT has unmatched industry experience which is shared among members. Plus, members can also take advantage of access to legal and accountancy advice, making sure they have the resources they need no matter what challenges arise.

The BADT also offers members the opportunity to take advantage of unique indemnity offers in partnership with Dental Protection – a helpful resource should contract reform result in dental therapists and hygienists needing to change their indemnity to provide more detailed cover.

Keep calm and carry on

As with any big changes in dentistry, it can be easy for individuals to feel unsure of the future – especially with so much uncertainty surrounding the adjustments to the NHS contracts. By joining an Association that is here to offer support, guidance, and up-to-date information in the current situation, dental therapists and hygienists will have the peace of mind that they will know how to proceed once the solid facts of the NHS contract reforms come to light.

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

Debbie Hemington- Chair of the BADT

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.