Month: October 2023

CGDent publishes Sustainability in Dentistry review

The College of General Dentistry (CGDent) has published Sustainability in dentistry: Leading for change, a scoping review to inform and engage the dental profession, industry, and wider oral health and dental care infrastructure on the environmental sustainability of practicing dentistry.

With the sub-title Environmentally sustainable dentistry to address the climate crisis, the review is organised thematically to provide an in-depth exploration of a wide range of factors such as legislation, health service emissions targets, prescribing, procurement, education and regulation, and makes recommendations for change that can be undertaken by each part of the system. It also presents case studies of exemplar efforts made to address the environmental impact of dental care and oral health services, and includes suggestions for further reading.

The review was written by a team of eight Clinical Fellows working at national dental organisations as part of the Chief Dental Officer for England’s Clinical Leadership Scheme, with input from expert contributors from academia, dental practice and government organisations.

Produced with the support of the Office of the Chief Dental Officer for England and the College of General Dentistry, it aims to inspire positive change by all those involved in the provision of oral healthcare related products, services and policy.

On behalf of the authors, Amarantha Fennell-Wells, Senior Clinical Policy Manager at the Office of the Chief Dental Officer England, said:

“Dental care creates a significant carbon footprint, and we owe it to current and future generations to contribute to emissions reduction by making our dental practice as environmentally sustainable as possible. Each practice and all staff can play their part in delivering sustainability in dentistry, and our review synthesises information which we hope will be educational and inspiring of collaboration to achieve a more sustainable future for the profession and dental patients.”

The document is freely available to download via a new College webpage which signposts a selection of free e-learning resources, guidelines and other tools which dental practitioners and practices can use to understand and reduce their environmental impact.

The new page can be found at https://cgdent.uk/sustainable-dentistry/

Epilepsy Society launches ‘FixIt4Free’ Campaign

The Epilepsy Society is calling on the NHS to provide free dental repairs for people with epilepsy whose teeth are damaged as a result of their seizures.

The UK charity has launched a campaign called FixIt4Free, after hearing from many people with epilepsy that they are struggling to afford treatment after breaking or knocking out teeth, sometimes on repeated occasions.

Data from a survey carried out by the charity shows that half of people who have suffered dental injuries during a seizure, have not had them repaired because they can’t afford the treatment. 69% had broken or chipped teeth, 61% had painful jaws and 31% had lost teeth.

The NHS offers a number of payment exemptions for dental treatment, such as free treatment for pregnant women, under 18s in England and under 26s in Scotland, but there are currently no medical exemptions. The NHS Low Income Scheme covers costs for some people, but 76 per cent of respondents to the Epilepsy Society survey said they were not eligible.

The charity has launched a petition that has attracted sixteen and a half  thousand signatures, and is urging supporters to write to their MP to raise awareness and ask for help with the campaign.  It is also asking people with epilepsy to share their experiences of NHS dentistry, as 80 per cent of survey respondents raised concerns about their dentist’s awareness of the condition and over half reported struggles with long waiting lists.

“If a person breaks their nose, or their arm or leg as a result of a seizure, the injury will be repaired for free on the NHS. But if they break their teeth – and many with epilepsy do – they are expected to foot the bill themselves or get by without their teeth”  said Clare Pelham, Chief Executive at the Epilepsy Society. “When someone is too scared to smile because half their teeth are missing, they instantly lose their self-confidence, stop going out, withdraw into themselves and become isolated.  Teeth are not an optional cosmetic accessory, they are an intrinsic part of who we are and how we communicate with one another.

“There are 200,000 people in the UK with uncontrolled seizures.  When they crash to the ground without warning, the NHS must be there to pick up the pieces, literally.  We all know the NHS is struggling, but the financial burden should not fall on people who are already coping with a debilitating disability.  We must all do what we can to support the NHS.  But it is not right to stand back and watch people with epilepsy shoulder the cost alone in broken teeth and shattered self-confidence.”

To find out more about the campaign and sign the petition, visit https://epilepsysociety.org.uk/FixIt4Free

Why do handpiece maintenance processes need automating?

Investing in your handpieces means that you can improve the quality of care that you provide. To protect your handpieces’ longevity, and ensure that they are working to maximum potential, so that your patients receive high-quality treatment, it’s important to employ the best methods of maintenance. 

The issue of handpiece maintenance and decontamination has become more and more important with the development of automated devices to ensure effective, consistent lubrication dosing to keep the instruments in full working order. These devices not only make handpiece care more effective but improve the efficiency of the team whilst making sure that your handpieces are maintained and ready for use.  Consistent high-quality maintenance extends their working life, whilst enhancing the efficiency of the practice team.

The importance of handpiece care

The maintenance process of a handpiece will depend on the manufacturer’s instructions,[i] but HTM 01-05 guidance recommends a detailed clean of the interior and exterior soon after use, followed by a lubrication of the interior framework, before undergoing sterilisation.[ii] Lubrication is an important step, contributing heavily to the longevity of the handpiece.[iii] By including it within the reprocessing workflow, the moving parts are protected when exposed to high temperatures, pressure, and any debris that could damage the tool.

Lubrication is required for the dental ball bearings to perform optimally, which are, in turn, a primary determinant of handpiece performance.[iv] As part of handpiece reprocessing, lubrication can be completed manually or by machine between patients, as well as at the end of the day, or beginning of the next, as recommended by the manufacturer. This process must be completed regardless of whether or not the handpiece has been used.[v]

Inconsistent maintenance

Lubrication is paramount to providing excellent care in the long-term, but the quality of the upkeep must be dependable. Automated systems can sustain handpieces consistently over time, negating the adverse risks of human error, i.e. over or under lubricating, influencing the maintenance process.

The amount of lubricant needed is usually small, with 2-3 drops of oil generally considered sufficient, though it is often administered in a mist or spray.[vi] In such a small quantity, it is important to apply enough oil to maintain the quality of the handpiece. HTM 01-05 states that if a dental professional applies an inadequate amount of lubricant, they risk damage to the internal mechanisms.[vii]

However, an excess amount of lubricant can also prove troublesome for sustaining longevity and ensuring optimal sterilisation is achieved. The oil should be expelled before sterilising, as its excess could prevent the infiltration of steam to the inner mechanisms and in turn, the effectiveness of the sterilisation treatment.[viii] It could also place further stress on the inner mechanisms, as they try to overcome the resistance it leaves. An automated maintenance device can apply the exact amount of oil required repeatedly over time, minimising the risk of over- or under-lubrication that is associated with human error.

An efficient option

Automating maintenance procedures can be both financially and time efficient. Firstly, the process requires time between patients and at the beginning/end of the working day to undertake the process: clearing the inner mechanics of multiple handpieces, ensuring each is cleared of debris and appropriately lubricated before being sterilised. Automated procedures allow members of the dental team to reduce the time they commit to the maintenance process, as automated systems can complete it quickly and consistently. The simplified processes may only require a handpiece to be inserted into the device, a button pressed, and then the removal of the handpiece.

Financially, the consistency of the lubrication minimises the risk of damage to handpieces, thereby reducing the need for repair or replacement. Investment in an automated handpiece maintenance device will improve processing efficiency and remove lubricant wastage, thereby amortising the cost of the unit in a short period.

Choosing the right automated maintenance device for your practice can help you save time and money, all whilst maximising the life-span and quality of your handpieces. With the Assistina Twin from W&H, you can experience unmatched innovation with an efficient duo-chamber system that lubricates instruments in just 10 seconds each. The second chamber allows a handpiece to be loaded for immediate reprocessing once the first has finished. Its dynamic design allows you to adjust the adapters to your needs, suiting the handpieces used within your practice. The integrated Quick Connect system also means handpieces can be smoothly removed and replaced with a single click. The Assistina ONE with its single chamber offers a smaller option for tight spaces. With both the Assistina Twin and ONE, all aerosols are removed from the process chambers through an integrated HEPA filter to ensure that the air released into the environment is clean.

The addition of a handpiece maintenance device not only improves the quality of care for your handpieces but ensures optimal efficiency and speed whilst making sure that consistent, superior maintenance and lubrication is guaranteed every time.

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

[i] Smith, L. (2019). Just how clean are you?. Dental Nursing, 15(10), 508-509.

[ii] Department of Health. (2021). (HTM 01-05) Decontamination in primary care dental practices. (Online) Available at: https://www.england.nhs.uk/publication/decontamination-in-primary-care-dental-practices-htm-01-05/ [Accessed on 04/07/23]

[iii] Wei, M., Dyson, J. E., & Darvell, B. W. (2012). Factors affecting dental air-turbine handpiece bearing failure. Operative Dentistry, 37(4), E1-E12.

[iv] Wei, M., Dyson, J. E., & Darvell, B. W. (2012). Factors affecting dental air-turbine handpiece bearing failure. Operative Dentistry, 37(4), E1-E12.1

[v] Sasaki, J. I., & Imazato, S. (2020). Autoclave sterilization of dental handpieces: A literature review. Journal of prosthodontic research, 64(3), 239-242.

[vi] Wei, M., Dyson, J. E., & Darvell, B. W. (2012). Factors affecting dental air-turbine handpiece bearing failure. Operative Dentistry, 37(4), E1-E12.1

[vii] Department of Health. (2021). (HTM 01-05) Decontamination in primary care dental practices. (Online) Available at: https://www.england.nhs.uk/publication/decontamination-in-primary-care-dental-practices-htm-01-05/ [Accessed on 04/07/23]

[viii] Sasaki, J. I., & Imazato, S. (2020). Autoclave sterilization of dental handpieces: A literature review. Journal of prosthodontic research, 64(3), 239-242.

A different type of customer, a different type of care

Dental professionals have a duty of care to provide dental services of the highest standard to patients. Alongside this, there are other considerations that go hand-in-hand with quality clinical care: providing an outstanding patient experience before and long after the treatment has commenced. Individuals who seek dental care are both ‘patients’ and ‘customers’: it is important to see the value in providing an exceptional non-clinical experience for your patients, which can contribute to an enhanced treatment journey overall. Not only can this foster a more positive atmosphere for the patient, but it can also be key in helping dental professionals improve the care they deliver.

The patient and the customer

Dental patients are not customers in the traditional sense: all dental professionals must legally deliver care that is safe, ethical and in the patient’s best interests. As dentistry is patient-centred, it follows that, much like consumers, patients have a list of criteria when choosing a dental service provider. For dental practices that wish to grow their patient base, there are many expectations that must be met and can influence whether a patient chooses your business. Nowadays, there is an increase in ‘shopping around’: choice is in abundance and individuals seeking dental care – whether that be a simple check-up, tooth whitening or more comprehensive treatment – have plenty of options at their disposal. Thus, focusing on ways to enhance the non-clinical aspects of your business is vital.

A 2022 Consumer Oral Health Survey demonstrates that various areas are important to patients when choosing a dentist and/or dental practice. These include: trust; good patient communication; convenient appointment times; value for money; and being seen on time.[i] Undergoing dental treatment can be an emotional experience for some, and these non-clinical aspects of dentistry may contribute to a healthier, more positive patient experience on the whole. Patient satisfaction is a vastly important aspect of delivering excellent dental care: it is also a useful tool for ascertaining what aspects of the business can be improved.[ii] So, alongside providing exceptional treatment, dental professionals must consider the ways that non-clinical care can be enhanced for a more holistic and positive experience overall.

Patients who feel listened to, involved and engaged throughout their time at a practice may be more likely to follow oral care advice and remain compliant with post-operative care.[iii] For children, the elderly or those with more complex needs, an empathetic dental team can facilitate an easier, more comfortable experience. Non-clinical care can range from the bedside manner of the team to the decor of the practice, the ease of appointment booking and the ability to obtain information about the practice (like costs, treatment times etc). In order to provide a service that goes above the call of duty, it is vital to consider these small, yet influential aspects of non-clinical care.

Bridging the gap

There are certain elements of clinical and non-clinical care that can often collide, such as the communication between professional and patient prior to treatment, and also the dental products and tools

employed in the surgery. It is imperative that high-quality products are utilised to ensure that the best treatment outcomes are achieved. For instance, in dental implant therapy, patients seek a smile that will look and feel natural, restoring confidence and function for as long as possible. Therefore, it is important to make the right investment in products that will help you achieve this outcome. Similarly, patients want to know that they are being treated with products that are of a high standard, for ultimate confidence and peace of mind. Leading dental products on the market can also provide an improved experience through intelligent and science-driven designs, which help to shorten treatment times and accelerate recovery without compromising on the quality of care.

For instance, the Neodent® NeoArch® Immediate Fixed Full-Arch solution, from the Straumann Group, is an optimised system for immediate fixed treatment protocols. Edentulous patients, even those with a severe atrophic maxilla, can have function and aesthetics restored immediately so they can enjoy an enhanced quality of life sooner. The tilted posterior implants minimise the need for grafting procedures, while the options of straight or angled abutments (with a broad gingival height range) allow you to cater to your patient’s needs. With shorter treatment times and immediate, beautiful aesthetics, you can deliver an outcome that will truly transform each patient’s confidence.

A balancing act

A positive patient journey depends on successful clinical and non-clinical experiences. Patients, in many ways, are customers and so it is imperative that they feel valued, in addition to being confident about their investment in the high-quality services you offer.

 For more information on the Neodent® Grand Morse® Implant System, visit

For more information on the Neodent® Grand Morse® Implant System, visit

www.neodent-uk.co/portal

 [i] Denplan: Consumer Oral Health Survey Results 2022. (2022) Available at: https://www.denplan.co.uk/content/dam/simplyhealth/documents/consumer-oral-health-survey-denplan-2022.pdf [Accessed 31 Jul. 2023].

[ii] Afrashtehfar, K.I., Assery, M.K.A. and Bryant, S.R. (2020). Patient Satisfaction in Medicine and Dentistry. International Journal of Dentistry, [online] 2020. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787801/ [Accessed 31 Jul. 2023].

[iii] Sbaraini, A., Carter, S.M., Evans, R.W. and Blinkhorn, A. (2012). Experiences of dental care: what do patients value? BMC Health Services Research, [online] 12(1). Available at: https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-12-177 [Accessed 31 Jul. 2023].

Achieve more with Neodent®

Optimised for superior treatment outcomes, the Neodent® NeoArch® Immediate Fixed Full-Arch Solution is ideal for edentulous patients, even those with severely atrophic maxilla.

With a singular connection promoting simplicity, you can still choose from a range of gingival heights, for both angled and straight abutment designs. Suitability to different dental implant techniques means you can reduce the need for grafting procedures, and the optimised implant design achieves high primary stability in all bone types.

Patients will appreciate the shorter treatment times and the immediate results, allowing them to enjoy enhanced aesthetics and function sooner, with less time spent in the dental chair.

Increase patient satisfaction and deliver results that are truly life-changing. For more information regarding the Neodent® NeoArch® Immediate Fixed Full-Arch Solution from the Straumann Group, visit the website today.

For more information on the Neodent® Grand Morse® Implant System, visit

www.neodent-uk.co/portal

Family dentist replaces family doctor for over half of Brits

  • Almost six in ten (59%) Brits say they see the same dentist more consistently than they see the same GP according to leading dental plan specialist Denplan’s Oral Health Report.
  • The survey, released 31st October 2023, also finds considerable loyalty to dentists, with a quarter of respondents that visit the dentist (25%) staying with the same dentist for over 10 years and nearly one in ten (7%) for their entire life.
  • The data indicates dentists are playing a wider role in healthcare – with three in 10 (28%) asking their dentist about other health problems and 15% of respondents being referred to another health practitioner following their dental appointment.
  • Despite this, access to dentistry remains in crisis across the country with people struggling to access appointments.

New figures reveal six in ten (59%) Brits say they see the same dentist more consistently than they see the same GP, showing the vital role dentists play in people’s health and lives. 

The findings have been released by the leading dental plan specialist Denplan, part of Simplyhealth, in its annual Oral Healthcare Report, one of the most comprehensive reports into attitudes and habits in UK dentistry, surveying over 5,000 consumers in the UK who used both NHS and private dentists. Denplan has over 6,500 member dentists nationwide, caring for over 1.4 million patients.

The survey shows that a quarter (25%) of Brits that visit the dentist have seen the same dentist for the last ten years, with two-thirds (66%) of people reporting consistency meant they felt comfortable with their dentist and 91% of people who attend the dentist at least every two years saying it’s important to trust your dentist. 

Over half (51%) of people say their entire family all sees the same dentist. Six in ten (60%) say they would not consider changing dental practices because they want to keep their current dentist. 

Despite dentists’ valued role in society, the UK faces a crisis with people struggling to access dental services, with both Conservative and Labour governments acknowledging that further reform is needed on the current NHS dental contract.

With dentists being one of the more regular points of contact for patients, their role in wider health is apparent. The survey reveals three in ten (28%) have spoken to their dentist about other health problems and 15% of respondents have had dentists refer them to another health practitioner during their appointment. Of those that were referred, 20% were diagnosed with skin condition, 15% with iron-deficiency (anaemia), 10% with diabetes and a further 10% with a viral condition (e.g. herpes).

Denplan dentist Shamir Chandarana, Principal Dentist at Dental House, Sunbury-on-Thames said: “As a dentist, you’re privileged to have the chance to truly get to know patients and their families. Many of us have supported patients far beyond just their dental needs – whether being able to advise on common health conditions, simply listen to their current concerns, or refer them to another healthcare professional.

“At a time when GP appointments are increasingly difficult to come by, my colleagues and I have definitely noticed an uptick in wider healthcare questions – a role that would have traditionally been played by the family doctor. We can help to identify other health conditions, but then need to refer patients on for any symptoms to be managed properly.” 

The survey also identified that almost a third (32%) of people worry about the cost of going to a dentist, with over a third (34%) of respondents saying they have previously postponed or cancelled a dentist appointment because they could not afford it. However, healthcare professionals advocate taking a preventative approach to oral health and seeing a dentist for examinations rather than waiting until problems get worse.  

Those with a private dental payment plan set up said they’d chosen this option because it gave them peace of mind (30%) or helped them to be more proactive about their oral health (26%).

Whereas putting off going to the dentists could see people end up paying more for emergency dental treatment, those with a private payment plan said it helped spread the cost of their treatments (42%) and budget for dental costs (36%). 

Catherine Rutland, dentist and Clinical Director at Denplan, said: “Our survey demonstrates the vital role of the dentist in public life, with over a quarter (28%) of adults saying they have asked their dentist about problems other than their oral health and a majority (59%) saying they actually see the same dentist more often than their doctor.

“However, dentists are already stretched and this growing shift of the wider healthcare burden is indicative of the mounting pressure on health services.

“Dental services often play second fiddle to primary healthcare in policy, but they’re servicing the same communities with the same needs and identifying problems. To keep communities healthy, there needs to be a joined-up approach to the way that dentistry is viewed within healthcare and government.

“When considering how best to improve access to dentistry, we must not consider the reform of the NHS contract in isolation. We must also recognise the role of mixed and private practices in communities, and wider initiatives such as making better use of the wider dental team to carry out a range of services.” 

Case studies

Why you should be seeing your dentist, even if you have no teeth – Andrew Farr, Principal Dentist, Broad Street Dental Surgery, Hereford

“People should see their dentist at least once a year, and ideally every six months, even if they have no teeth. One of the biggest misconceptions surrounding dental care is that it’s solely about teeth. As a dentist I examine the entire mouth, gums, tongue, and even areas of the head and neck. 

“I have made several referrals for patients with skin lesions and one patient was treated for skin cancer of the nose. I also refer patients to their GP for low iron levels, or a suspected weak immune system due to tell-tale symptoms or the appearance of their mouth.”

“Unfortunately, I also see many patients with complex dental issues that cannot be treated, as by the time they come to the dentist their conditions have progressed beyond repair. Many of these are people who stopped trying to find a dental appointment during the pandemic and left their conditions untreated for several years. I’ve recently treated an individual in their early 30s who had nine teeth taken out as they had not seen a dentist for several years.”

It’s not right that two fillings cost the same as ten – Niki Keyhani, Principal Dentist, Horsham Dental Studio, Horsham, West Sussex 

“Seeing the dentist isn’t just about your teeth, but broader systemic health too. Financial and time constraints mean patients frequently leave their conditions untreated, on top of which many are worried about having to see a dentist due to phobias as well as cost. 

“In recent years I have been increasingly forced to remove teeth due to lack of adequate dental care. One emergency patient even had to miss work due to severe pain from toothache. The patient came to me privately after spending days trying to find a NHS appointment. 

“It is clear that NHS dentistry has major flaws, for instance, two fillings cost the same as ten, while root canal surgery is more expensive to the patient than taking a tooth out. This doesn’t promote oral maintenance and regular care – but rather the opposite. Unless things change, not only will we see staff leaving, and practices ditching NHS contracts, but many people are going to go without care.”

About the 2023 Denplan Oral Health Survey 

Between 30 June and 10 July 2023, Deltapoll surveyed a representative sample of 5,101 adults in Great Britain. 

Please refer to the Oral Healthcare Report from Denplan and Simplyhealth to see the data outlined in this release.

About Simplyhealth and Denplan

Simplyhealth is a leading healthcare company, committed to providing affordable healthcare, to support everybody’s everyday healthcare needs. Through our health and dental plans, including the market leading Denplan, we look after over two million customers. We aim to support and protect the NHS through the provision of outpatient support to help people live their best lives.

We don’t have shareholders and since 1872 we’ve been led by our purpose of improving access to healthcare, for all in the UK. We are changing the game, investing £60 million in new businesses to accelerate the development of predictive and preventative healthcare services. 

We understand our health depends on the health of our communities and our planet. Each year we commit to giving £1million to a range of community causes, in March 2022 we achieved Carbon Neutral + status for the second year and in 2022 we became the first Health Insurer to be awarded B Corp status.

To find out more, visit www.denplan.co.uk and www.simplyhealth.co.uk

Dental complaints on the rise

Complaints about NHS dental practices have risen by two-thirds with access, treatment, and fees, common causes for concern, according to England’s Health Ombudsman.

The number of complaints to the Parliamentary and Health Service Ombudsman (PHSO) about dentists increased by 66% from 1,193 in 2017/18 to 1,982 in 2022/23.

The proportion of complaints being upheld or partly upheld after investigation by the Ombudsman has also gone up from 42% to 78% in the same time span. This is significantly more than the average uphold rate of 60% for all other NHS services.

The Ombudsman receives around 100 calls a week about issues relating to dental practices, such as people being removed from practices’ lists of NHS patients, lack of NHS dentists, and poor treatment.

Ombudsman Rob Behrens said, “Poor dental care leaves patients frustrated, in pain and out of pocket. They, and dental professionals, deserve a better system that leads to quality care. Many of us will have read recent headlines of people removing their own teeth and seen images of people queuing outside practices for an NHS dentist. This shows in access problems, such as appointment availability and lack of treatment being a common issue in complaints brought to us.”

Cases upheld by the Ombudsman in 2023 include:

  • a pregnant woman from Southampton who was forced to pay £1,045 for a private root canal treatment after her dentist failed to tell her that she was exempt from NHS fees so her treatment should have been free. After treatment, the dentist then failed to fit a crown within the 30 days as recommended by the private specialist, leaving the woman in pain and distress.
  • a woman was burned inside her lower lip during a root canal treatment at a practice in Birmingham. She was left in ‘excruciating’ pain for 13 days, couldn’t sleep and could only eat soft or liquid foods such as eggs and soup.
  • a practice in Stockport said the price for a five-tooth bridge was £330 total, rather than £330 per tooth. If the patient had understood the real cost, he would not have agreed to his front tooth being removed in preparation for the bridge and would have considered other treatment options. He was left with no front tooth and had to have further work carried out by another practice to fix the gap.

Earlier this year, the Ombudsman gave evidence to the Health and Social Care Select Committee inquiry into dentistry.

It was recommended that Integrated Care Boards (ICBs) should take the lead in removing barriers to accessing dental services. These barriers include poor information available via the NHS website and 111 about local NHS dental services and the imposing of unnecessary private costs for procedures that could have been completed on the NHS.  

The PHSO also said that to address inequalities in oral health, Government’s reform of the NHS dental contract should go further in improving information for patients. There should be a requirement for clear and current information on accessing a dentist in an emergency or out of normal service hours on the Directory of Services on the NHS website.

There also needs to be complete transparency over the costs of care. This includes more public information about NHS treatment bands, what does and does not meet the criteria for NHS treatment, and the options for private referral.

Mr Behrens added, “Like many other areas of the NHS, dentistry is suffering from low morale, underfunding, and a recruitment and retention problem. More needs to be done to tackle the serious issues in dentistry. Patients must be able to access quality care and be clear about what is and is not available to them on the NHS. Dental professionals need to feel supported and that leaders in the NHS and Government understand the problems they are facing and are working towards a meaningful solution.”

William Pett, Head of Policy, Public Affairs and Research at Healthwatch England, said, “NHS dentistry is the second most common problem the public tells Healthwatch about. Over the past three years, our local services have produced over 400 research reports exposing experiences of people suffering in pain, performing DIY dentistry and struggling to pay treatment costs. Improving information, including online, will be essential so that people have a clear picture of where and how they can access services, and the charges they will need to pay. We have therefore welcomed the Health and Social Care Select Committee’s call for a national information campaign to tackle misconceptions about ‘registration’ with dentists.

“Ultimately, however, only fundamental and fully resourced dental contract reform can tackle the deep-seated problems we see across England. We eagerly await the government’s long awaited dental recovery plan. Patients will continue to pay the price until action is taken.”

Greener Dentistry spotlighted at FDI World Dental Congress

Greener Dentistry, the international accreditation programme for dental practices wanting to reduce their environmental impact, was highlighted in a talk on sustainability at the FDI World Congress in Sydney. The package of resources that members of Greener Dentistry can access was referenced by Michael Fahey, Henry Schein’s Commercial Director, in his presentation on the main scientific programme.

Michael was demonstrating the measures that the dental profession and industry can implement to enhance their environmental sustainability.  He highlighted the Greener Dentistry toolbox – the web-based package of measures which practices can implement – and its certification scheme, which enables dental practices to raise awareness of their commitment to being socially and environmentally responsible.

Davinder Raju, the founder of Greener Dentistry, was among a group of pro-environmental individuals interviewed by Michael ahead of the Congress. The title of Michael’s talk was “Partnering with Industry to Support Sustainable Dentistry.”

The intention of his presentation, Michael said afterwards, was to provide very practical ways that dental practices can reduce their impact and environmental footprint.

Davinder commented: “It was a pleasure to discuss all things sustainable with Michael, and I am delighted that Greener Dentistry was namechecked at such a prestigious event at which more than 8,000 dental professionals from around the world were gathered – this is outstanding recognition. My aim is to make a difference, and the more people who join Greener Dentistry and start implementing our programme, the less environmental impact dentistry will have.”

For more information on Greener Dentistry:  https://greenerdentistry.global

Advancing your training means more focused care

The challenge with delivering modern implant therapies is that every patient will have their own, unique functional and aesthetic needs, as well as unique lifestyle factors. All of these aspects will need to be taken into account when treatment planning, for a successful outcome that lasts. At the same time, thanks to the internet, people are now able to access a vast amount of information. If they previously thought a removable prosthesis was the only option for them, many now realise that they may be suitable for a dental implant.

In order to help as many people as possible, and offer comprehensive high-quality care, practices must be patient-focused. The dental team should be willing and able to offer advice and education on a range of topics and treatments, in order to guide people towards making the right decisions to improve their health.

Forward-thinking dentists will therefore be knowledgeable and skilled in a number of treatment modalities. This means they are better equipped to find the optimal solution that meets every patient’s expectations and is clinically appropriate. If a patient with complex oral needs starts a conversation about dental implants, a dentist trained in several methodologies will be more confident in discussing the most appropriate options and even providing them.

Giving more implant patients, more choice

The quality and quantity of existing bone is key to suitability for dental implant therapy. Without enough healthy bone, there is a greater risk of complications and treatment failure.[i] Bone could be inadequate for a number of reasons, including disease, such as peri-implantitis, and injury. Individuals who have had an extraction or suffered tooth loss – and the tooth was not replaced – may also have atrophied bone with new hard tissue not yet formed.[ii]

Grafting can add bulk and stability to keep a dental implant in place. If a maxillary implant is required, a sinus lift may be indicated to add height too. Sinus pneumatisation, where the paranasal sinuses have increased in volume, often occurs following an extraction in the posterior region.[iii] Patients in research mode may have read that bone grating and sinus lifts are complex, and be daunted by the prospect. A patient-focused practice will ensure that, during the planning stage, they have answered all the patient’s questions. If they are anxious, the patient should know that the dentist is well trained, and experienced in performing augmentation procedures, safely and confidently.

Grafting procedures may not be the only option, though. Zygomatic implants, for example, sometimes provide an alternative treatment solution that bypasses the need for hard tissue augmentation. This means that even patients with severe atrophic maxilla can enjoy the life-changing benefits of implant therapies, without the need for extensive healing periods and bone grafting procedures.

Dentists with the knowledge and skills to place zygomatic implants can offer a treatment that requires fewer appointments, with a shorter healing time in appropriate situations. Patients can get on with their lives, enjoying their new smiles. This is very appealing to people who want to invest in quality and minimally invasive dentistry, that is delivered efficiently. The need for fewer appointments also enhances value and cost-effectiveness, and zygomatic implants have demonstrated high survival rates for added peace of mind.[iv]Zygomatic implants are well-suited to immediate loading protocols in many cases, thus boosting patient comfort and convenience even further.

Zygomatic implants do require greater skill on the part of the clinician, as well as knowledge of the different kinds of products and biomaterials available for facilitating gold-standard therapies. Progressive dentists, who want to offer patient-focused care, must access training specifically in zygomatic implants in order to offer the solution. Education in this field would also be suitable for clinicians who wish to further their knowledge of more conservative procedures. Eminent Specialist Oral Surgeon, Professor Cemal Ucer, has developed a range of courses to enable implant dentists to increase their scope of practice, including one for zygomatic and pterygoid implants. Taking place at the prestigious ICE Postgraduate Dental Institute and Hospital, Manchester, the programme will cover how to deliver graft-less zygomatic and pterygoid implant treatments in state-of-the-art facilities.

When you know a variety of implant techniques, you can better meet your patients’ expectations and needs. Boost their satisfaction and your reputation by giving people more treatment choices that provide predictable outcomes in a range of clinical scenarios. When you train in as many modalities as you can, you will learn how to deliver a range of gold-standard care that will improve levels of oral health.

Please contact Professor Ucer at ucer@icedental.institute or Mel Hay at mel@mdic.co

01612 371842

www.ucer-clinic.dental

Prof. Cemal Ucer, BDS, MSc, PhD, FDTFEd., ITI Fellow, Specialist Oral Surgeon

Cemal Ucer first established an implant referral centre in 1995. He was awarded an MSc in Implantology at Manchester Dental Hospital following his research into guided bone regeneration and osteopromotion. He later gained a PhD for his clinical and laboratory studies into the factors affecting the success of implant treatment in iliac grafts and the investigation of the effect of skeletal bone density on implant survival. He has personally trained and mentored more than 1,000 dentists in implant dentistry as one of the main providers of implant education in the UK.

Cemal’s current clinical research interests include immediate implant placement, reconstructive bone surgery, nerve damage and the effect of bone density on the success of implant treatment. Academically, he has gained European recognition for his work on the development of a new framework for teaching and assessment of clinical competence in implantology. He is a co-author of the consensus paper produced by the Association for Dental Education in Europe (ADEE) following the first pan-European collaboration between EU universities to establish common training and assessment standards in dental implantology. He is an invited member of the working group convened by the FGDP (UK) and the General Dental Council (GDC) to update the Training Standards in Implant Dentistry (TSID) guidelines in 2012 and 2016.

Cemal is a Fellow of the Dental Trainers Faculty of the Royal College of Surgeons of Edinburgh (RCSEd) and a Fellow of the International Team for Implantology (ITI) and a member of Megagen’s MINTEC UK & I Board for education and clinical research. He is a member of the editorial board of JOMR (Journal of Oral & Maxillofacial Research) and the chair of the editorial advisory board of Implant Dentistry Today. Cemal is Professor and Clinical Lead of the MSc programme in Dental Implantology  and a member of the Faculty of Examiners of the Royal College of Surgeons of Edinburgh’s Diploma in Implant Dentistry. He is a past president of The Association of Dental Implantology (ADI) (2011-2013).

Cemal has been appointed by FGDP (UK) to lead the working group to develop the “national standards in implant dentistry” which is due to be published later in 2018 following the completion of an external consultation process.

[i] Turkyilmaz, I., McGlumphy, E.A. Influence of bone density on implant stability parameters and implant success: a retrospective clinical study. BMC Oral Health 8, 32 (2008). https://doi.org/10.1186/1472-6831-8-32

[ii] Hansson S, Halldin A. Alveolar ridge resorption after tooth extraction: A consequence of a fundamental principle of bone physiology. J Dent Biomech. 2012;3:1758736012456543. doi: 10.1177/1758736012456543. Epub 2012 Aug 16. PMID: 22924065; PMCID: PMC3425398.

[iii] Alqahtani S, Alsheraimi A, Alshareef A, Alsaban R, Alqahtani A, Almgran M, Eldesouky M, Al-Omar A. Maxillary Sinus Pneumatization Following Extractions in Riyadh, Saudi Arabia: A Cross-sectional Study. Cureus. 2020 Jan 9;12(1):e6611. doi: 10.7759/cureus.6611. PMID: 31966939; PMCID: PMC6957056.

[iv] Fernando Duarte., et al. “Graft-Less Solution for Extreme Atrophic Maxilla: Zygomatic and Short Implants Combined – Case Series”. Scientific Archives of Dental Sciences 3.7 (2020): 20-25.

Dental Nurse Recruitment and Retention Survey report available

The Report of a recent Survey, undertaken by Dr Debbie Reed of the University of Kent and supported by the UK’s professional association for dental nurses, BADN, is now available for download via ResearchGate.

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“It has been a pleasure to work with the UK’s Registered Dental Nurses (RDNs) and BADN to produce the DN UK Retention Survey 2023 Report” said Dr Reed, a Registered Dental Nurse herself, former BADN Chairman, and Chair of the College of General Dentistry’s (CGDent) Dental Nursing and Orthodontic Therapy Faculty Board. “The document presents the findings from the survey carried out between January and March 2023. The survey is believed to be the first comprehensive survey solely focused on DN retention in the UK. The report has been made freely available for those who wish to draw upon the data. It is hoped the report will make a significant contribution to the discourse related to dental nurses (and other dental professional) workforce retention.”

Current BADN Chair Joan Hatchard said “As the professional association for dental nurses in the UK, BADN were delighted to work with Dr Debbie Reed on this survey. Finally, we have reliable data on this issue obtained through an ethically approved, methodologically sound research approach which can be used to inform decisions relevant to the dental nurse workforce.