Making a big financial commitment to buy a practice or a dental laboratory can be daunting. There are several possible sources of finances you can consider: bank finance, financing from friends and family and equity finance.

Getting professional, impartial help is invaluable. For example, money borrowed from family while a useful alternative to borrowing from a bank or other commercial lender, can have tax implications. While private loans can be cheaper, more convenient and flexible than formal arranges, it is important to consider the consequences of such a loan.

Dental Elite has more than a decade of experience in the buying and selling of dental practices and also operates DE Finance which focuses on negotiating dental practice finance for buyers.

To find out how Dental Elite can assist with your business decisions, or to arrange a free dental practice finance consultation, contact the team today.

 For more information contact Dental Elite. Visit www.dentalelite.co.uk, email

info@dentalelite.co.uk or call 01788 545 900

The British Endodontic Society (BES) is looking forward to getting together for the Spring Scientific Meeting on 16 March.

Both members and non-members are welcome to attend the event, held at One Great George Street, London, for a day of networking, socialising, and learning. The enriching educational programme features sessions presented by two experts in the field, Dr Jose Aranguren and Dr Sergio Kuttler, covering a wide range of topics “Exploring Controversies in Endodontics”.

In addition, the BES welcomes its Early Career Group to convene for a drink’s reception at the end of the day.

Register now to secure your place at the event!

For more information about the BES, or to join, please visit the website

www.britishendodonticsociety.org.uk or call 01494 581542

With the backing of over 20 peer-reviewed studies and success rate of 96.5% over 10 years,[i] the implant systems from Neodent^®, a Straumann Group brand, offer a variety of implant designs for different applications.  

These include the Zi, Neodent’s^® Ceramic Implant System which combines the notions of flexibility, stability and aesthetics. This metal-free solution allows the immediate treatment of patients and features a modern, naturally tapered ceramic design.

The Neodent^® Grand Morse^® Implant System combines mechanical strength and versatile prosthetic, offering stability, simplicity, aesthetics and reliability. While the

Neodent^® Grand Morse^® Helix^® posterior implant solution is designed for immediate placement in challenging post extraction sockets with an advanced wide implant design.

The Neodent® Ø2.9mm Helix GM Narrow uses an optimised stable and strong screw-retained morse taper connection which facilitates aesthetic outcomes in small interdental spaces and the Neodent^® GM Zygoma-S provides an immediate solution as an alternative for bone grafting procedures

To find out how Neodent^® implant systems could transform your implantology treatments, visit the website today.

For more details, please visit www.neodent-uk.co/portal

[i] Straumann https://www.straumann.com/neodent/gb/en/professionals/education-and-events/clinical-evidence-research/literature.html

There is a widespread perception among the general public that endodontic treatment is painful. It is a procedure that often triggers concern and fear in patients, which makes our job as the professional performing root canal treatment all the more difficult. The actual incidence of pain is largely unknown, with estimates suggesting postoperative pain occurs in anything between 3% and 69% of patients.[i]

Several studies and research papers have looked into methods for reducing possible pain and discomfort, as well as generally enhancing the patient experience. It’s important to be aware of the techniques and technologies that can be implemented in practice to achieve this while generally improving the endodontic patient’s journey.

Changing perceptions

One study[ii] found that the severity of pain expected by the patient was much higher than the actual pain experienced. There was also a statistically significant correlation between the anticipated pain intensity and the level of anxiety felt. The paper concluded that dental professionals should look to reduce the patient’s concerns prior to endodontic treatment in order to improve their experience and lower the pain they expect to feel. This may be achieved by building patient rapport, encouraging their confidence in the treatment itself and providing clear information on what to expect. Though this may not have any impact on the actual amount of pain or discomfort a patient feels during or after endodontic treatment, it will go a long way to creating a more positive treatment journey.

Pain management

As is common with most root canal therapy in the UK, administrating appropriate analgesia before treatment has been shown to reduce postoperative pain. This might include non-steroidal, anti-inflammatory drugs (NSAIDs) that are designed to block pain signals. Peri-operative dexamethasone has also been shown to reduced intra- and post-operative pain. Effective local anaesthetic provided during treatment can also lower the impact of postoperative pain when providing non-surgical therapy.[iii]

Occlusal reduction

Occlusal reduction involves the removal of occlusal contacts so as to minimise the impact on the periodontal ligament and lessen the risk of mechanical allodynia. This is an evolving area of research, but there are initial studies[iv] to suggest that occlusal reduction following endodontic treatment could reduce postoperative pain in the days after the procedure. However, there is only some evidence in very specific cases of irreversible pulpitis and apical periodontitis so more research is needed in this area.

Treatment technique and tools

The clinical techniques employed during endodontic treatment warrant consideration in order to optimise predictability and quality of the outcome achieved, but also to positively affect the patient experience. For example, we should take steps to avoid excessive instrumentation and extrusion of root canal debris past the apical foramen, as this can cause iatrogenic periapical discomfort.[v] Mechanical and chemical damage to the tissue should also be actively prevented, reducing the inflammatory response.

Technological assistance

Linked to this is the use of cutting-edge technology. Rotary systems have been associated with lower postoperative endodontic pain.[vi] Research has shown similar success rates with rotary and manual instrumentation, though the former may be achievable in a shorter treatment time[vii] and with greater predictability – reducing chair time for patients for greater satisfaction.

Several other technologies have evolved and continue to be developed to support endodontic treatment and improve the patient’s perception of the procedure. These include radiographic and CBCT imaging units, 3D printers and digital impression scanners – with the added benefit of integration with artificial intelligence (AI) in some situations. All of these solutions promote accuracy and predictability for everything from diagnostics to treatment planning, surgical or non-surgical treatment or retreatment, and restoration, reducing the risk of complications and alleviating unnecessary postoperative pain. They also make it possible to minimise treatment time and enhance communication with the patient, further improving the patient journey.

Though this is a very promising field with several potential applications within endodontics, it is worth noting that not all technologies are 100% ready to be utilised in every situation. Some refinement is still needed, for example, in the accuracy of intraoral scanners, if we are to use them for precise occlusal management alongside endodontic therapy.

Putting the patient at the heart of endodontics

Colleagues who share my desire to achieve high-quality endodontic treatment outcomes will be familiar with many of the clinical challenges faced every day. In addition to managing and overcoming these, it is just as important that we consider the patient experience throughout treatment. The ultimate goal is to reduce postoperative pain, help them feel less anxious about the procedure and utilise the right techniques and technologies to minimise the risk of complication.

Author: Dr Alyn Morgan, President of the BES.

[i] AlRahabi MK. Predictors, prevention, and management of postoperative pain associated with nonsurgical root canal treatment: A systematic review. J Taibah Univ Med Sci. 2017 May 9;12(5):376-384. doi: 10.1016/j.jtumed.2017.03.004. PMID: 31435267; PMCID: PMC6695063.

[ii] Perković I, Romić MK, Perić M, Krmek SJ. The Level of Anxiety and Pain Perception of Endodontic Patients. Acta Stomatol Croat. 2014 Dec;48(4):258-67. doi: 10.15644/asc47/4/3. PMID: 27688374; PMCID: PMC4872819.

[iii] AlRahabi MK. Predictors, prevention, and management of postoperative pain associated with nonsurgical root canal treatment: A systematic review. J Taibah Univ Med Sci. 2017 May 9;12(5):376-384. doi: 10.1016/j.jtumed.2017.03.004. PMID: 31435267; PMCID: PMC6695063.

[iv] Nguyen D, Nagendrababu V, Pulikkotil SJ, Rossi-Fedele G. Effect of occlusal reduction on postendodontic pain: A systematic review and meta-analysis of randomised clinical trials. Aust Endod J. 2020 Aug;46(2):282-294. doi: 10.1111/aej.12380. Epub 2019 Oct 22. PMID: 31638301.

[v] Law A.S., Nixdorf D.R., Aguirre A.M., Reams G.J., Tortomasi A.J., Manne B.D., Harris D. Predicting severe pain after root canal therapy in the National Dental PBRN. J. Dent. Res. 2015;94:37–43. doi: 10.1177/0022034514555144

[vi] da Silveira MT, Batista SM, Mamede Veloso SR, de Oliveira NG, de Vasconcelos Carvalho M, de Melo Monteiro GQ. Effect of Reciprocating and Rotary Systems on Postoperative Pain: A Systematic Review and Meta-Analysis. Iran Endod J. 2021;16(1):1-16. doi: 10.22037/iej.v16i1.27944. PMID: 36704409; PMCID: PMC9709880.

[vii] Manchanda, S, Sardana, D, Yiu, CKY. A systematic review and meta-analysis of randomized clinical trials comparing rotary canal instrumentation techniques with manual instrumentation techniques in primary teeth. International Endodontic Journal, 53, 333–353, 2020.

Technological advancements are driving innovation in dentistry and helping clinicians to elevate standards across the profession. The advent and implementation of the 3D printer for fast, efficient and beautiful cosmetic and restorative dentistry is just one example of how the clinical workflow is changing.

Dr Robbie Hughes, CEO and Principal Dentist of Avant Garde Dentistry, is a leading clinician in the UK who has developed a keen interest in the utilisation of cutting-edge digital technology to optimise his patient care. He will be speaking at 13:15 on 23^rd March in the Clinical Theatre at BDIA Dental Showcase, where he will discuss “The Same Day Smile Sprint: No-Prep 3D Printed Veneers” in a session sponsored by SprintRay.

Robbie suggests what he feels would be the most important initial steps for a clinician looking to introduce 3D printing and injection moulding into their practice:

“When getting started, it is important to implement a structured workflow, following the proper training, to maximise efficiency and reproducibility. Chairside 3D printing has the potential to reduce chair time and internal costs – but only if planned and executed well. Individuals should be sure to gain true knowledge of the investment they’re making and how it will modify and benefit their working day.”

As is true when implementing any new technology, it’s necessary to be aware of the potential challenges of 3D printing in order to prepare for and overcome them. Robbie offers insight into the top three areas in which clinicians often come unstuck:

“Correct planning is the first element to consider. It is essential that the planning phase of any treatment is carefully executed to ensure the fit process runs seamlessly as intended. Case selection is the second step in which clinicians may fall down. Much like in any dental workflow, case selection plays a pivotal role in the success of same day 3D printed units. From single unit crowns and veneers, to full arch cases and injection mould stents, undergoing extensive training to avoid failures due to inappropriate case selection is essential.

“Finally, finishing and polishing methods should be reviewed. Unlike alternative indirect restorative methods widely used within the profession, chairside printing requires chairside finishing and polishing. Undergoing training to complete this task with ease is paramount to maximising all the benefits of chairside 3D printing. 

“When you get it right, the benefits of 3D printing and injection moulding are exponential. The key focuses are reduction of chair time, lab costs and patient costs, as well as maximising the conservation of natural tooth tissue.” 

Robbie will discuss all of this and more during his session at BDIA Dental Showcase in March. He adds:

“I will outline the entire Same Day Sprint workflow, encompassing the planning and execution of same day 3D printed no-prep veneers. I hope delegates will walk away with a new found interest and understanding of one of the most technologically advanced workflows at the forefront of digital dentistry. If implemented correctly, this will catapult their careers into the future of cosmetic dentistry.

“BDIA Dental Showcase is a fantastic opportunity to be at the pinnacle of upcoming techniques and be ahead of the curve – I hope to see you all there!”

BDIA Dental Showcase will host eight lecture theatres dedicated to various areas of the profession, each one presenting an array of industry-leading speakers and experts in their fields.

In addition, the trade exhibition held alongside the programme remains the largest and longest-running dental exhibition in the UK. It provides an opportunity to discover the latest and greatest technologies and materials on the market, with product experts on hand to provide live demonstrations and answer any questions you may have. For example, why not visit SprintRay on stand E31 after hearing from Robbie to see how their 3D printers could benefit your practice?

There’s not much time left to secure your place, so register for your free pass online today at https://dental-showcase-2024.reg.buzz/register-free-pr!

BDIA Dental Showcase 2024

22^nd-23^rd March

ExCeL London

dentalshowcase.com

For a natural solution that delivers extraordinary smiles to your patients, consider options from the 100% Natural Baking Soda Toothpaste range from Arm & Hammer™.

Clinically proven to whiten teeth in three days, this toothpaste features baking soda in order to rebalance oral pH with the aid of its alkaline properties. With a return to neutral, patients can avoid demineralisation of their enamel, and maintain an aesthetic and protected smile.

Stain removal is superior with the 100% Natural Baking Soda Toothpaste range when compared to other products that do not contain baking soda, gently lifting stains for a noticeable result.

Patients can choose from toothpastes that are tailored to whitening or gum protection, meaning they can find the solution that suits their needs the most.

To learn more about the toothpaste that can effortlessly reinvigorate your patients’ smiles, contact the team today.

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

 Arm & Hammer^™ oral healthcare products can now be purchased from Boots, Amazon, Superdrug, ASDA, Sainsbury’s, Tesco, Morrison’s, Waitrose & Partners and Ocado.

Is water fluoridation the panacea for tooth decay in young children?

Recent government statistics lay bare England’s dental crisis in young children: three in 10 children aged five have enamel or tooth decay.[i]

In this survey of 5-year-olds in England, the national prevalence of children with enamel and/or dentinal decay was 29.3%. Regionally, this ranged from 23.3% in the South West to 38.7% in the North West.

Children living in the most deprived areas of the country were almost three times as likely to have experience of dentinal decay (35.1%) as those living in the least deprived areas (13.5%). There were also disparities in the prevalence of experience of dentinal decay by ethnic group, which was significantly higher in the ‘other’ ethnic group (44.8%) and the Asian or Asian British ethnic group (37.7%).ⁱ

It’s no surprise then that some councils, such as Nottingham, are planning to add fluoride to the water supply.[ii]Figures from the government survey show that 34.2% of five-year-olds in the city had obvious signs of dental decay with the average number of teeth affected by decay in Nottingham’s five-year-olds being 1.3, while the England average is 0.8.

All water contains small amounts of naturally occurring fluoride, but at too low a level to provide any oral health benefits. Water fluoridation schemes raise it to 1mg per litre of water.[iii] 

Fluoride force

Fluoride works to control early dental caries in several ways.[iv] It strengthens the enamel of the teeth, making them more resistant to decay. The antibacterial action of fluoride is due to the acidification of the bacterial cytoplasm through the formation of the hydrogen ion and the fluoride ion from hydrogen fluoride and the disruption of the bacterial metabolism by inhibiting vital bacterial enzymes such as proton releasing adenosine triphosphatase and enolase.

The use of fluoride lowers the pH. Bacteria will thus use more energy to maintain a neutral pH. Therefore, they will have less energy to grow, reproduce and generate acid and polysaccharides.^iv

The World Health Organization recommends water fluoridation as an “effective and safe public health intervention”.[v] Indeed, fluoridated water is currently supplied to 10% of the population in England (including parts of Nottinghamshire).

However, while proponents argue that it is a safe and effective way to prevent tooth decay, there are also concerns about the potential health risks and ethical considerations.

Some studies have linked excessive fluoride exposure to various health problems.[vi] High fluoride levels can lead to dental fluorosis, a condition characterised by discolouration and pitting of tooth enamel. Opponents contend that water fluoridation may not be the most effective way to prevent tooth decay. They say that the benefits of fluoride can be obtained through other means, such as brushing with fluoride toothpaste. Moreover, some studies suggest that the decline in tooth decay rates observed in fluoridated communities may be due to improved oral hygiene practices and dietary changes rather than fluoridation itself.[vii]

Good habits

Indeed, what is undoubtedly key to the prevention of caries in children is the establishment of a good oral care regime from the get-go (hand in hand with limiting the consumption of sugary drinks and snacks).ⁱⁱⁱ Brushing should start as soon as the first deciduous tooth breaks through, using just a smear of fluoride toothpaste (with a fluoride level of at least 1,00ppm).[viii] Children aged 3 to 6 years can use a pea-sized amount of toothpaste (that contains 1,350ppm to 1500ppm) and always under the supervision of parents or carers.

From the age of 7 children should be able to brush their own teeth and new elements introduced into their oral care routine to keep dental plaque and resulting cavities at bay, such as interdental cleaning.

Flossing, using conventional string floss, is a technique-sensitive process and can prove challenging for children still developing their fine motor skills.[ix] That’s where a Water Flosser may help (with supervision, of course).

The Waterpik^® Water Flosser is backed extensively with clinical research, proven to remove up to 99.9% of plaque from treated areas.[x] The Waterpik^® Water Flosser is easy to use and is needed for only a minute a day for improved oral health. Studies support its efficacy over traditional methods of interdental cleaning: for instance, one study found that cleaning interproximal regions with a Water Flosser “achieved more effective removal of interproximal biofilm” compared to a sonic toothbrush.[xi]

While water fluoridation can go some way to improving the oral health of young children in a community,[xii]establishing good oral care practices within the home/care setting from milk teeth onwards, can serve to optimise its benefits. Good habits formed young can make all the difference.

For more information on Waterpik^® Water Flosser products visit www.waterpik.co.uk. Waterpik^® products are available from Amazon, Costco UK, Argos, Boots, Superdrug and Tesco online and in stores across the UK and Ireland. 

Join the 3,000+ dental teams who have already benefitted from a professional Waterpik^® Lunch & Learn. Book your free session for 1 hour of verifiable CPD and a free Waterpik^® Water Flosser – available either face to face or as a webinar – at http://www.waterpik.co.uk/professional/lunch-learn/

Andrea Hammond is a Dental Hygienist and Waterpik Professional Educator

. Andrea has worked in dentistry since 1996, first qualifying as a dental nurse in 1998 – the same year in which she secured a place on the very first dental therapy cohort at the Eastman Dental Hospital. Following this, she was awarded diplomas in both dental hygiene and dental therapy in the year 2000, and became an active member of the GDC fitness to practice panel since 2015. Today, she continues to share knowledge as a Professional Educator for Waterpik and be deeply involved in the industry as a Regional Group Representative for the British Society of Dental Hygiene and Therapy (BSDHT).

[i] Office for Health Improvement & Disparities. https://www.gov.uk/government/statistics/oral-health-survey-of-5-year-old-children-2022/national-dental-epidemiology-programme-ndep-for-england-oral-health-survey-of-5-year-old-children-2022 [Accessed October 2023]

[ii] ITV News 6 September 2023 https://www.itv.com/news/central/2023-09-06/fluoride-to-be-added-to-nottingham-water-to-cut-rising-tooth-decay-in-children

[iii] UK Parliament https://post.parliament.uk/water-fluoridation-and-dental-health/ [Accessed October 2023]

[iv] Aoun A, Darwiche F, Al Hayek S, Doumit J. The Fluoride Debate: The Pros and Cons of Fluoridation. Prev Nutr Food Sci. 2018 Sep;23(3):171-180. doi: 10.3746/pnf.2018.23.3.171. Epub 2018 Sep 30. PMID: 30386744; PMCID: PMC6195894. [Accessed October 2023]

[v] World Health Organization https://www.who.int/publications/i/item/9241563192 [Accessed October 2023]

[vi] Guth S, Hüser S, Roth A, Degen G, Diel P, Edlund K, Eisenbrand G, Engel KH, Epe B, Grune T, Heinz V, Henle T, Humpf HU, Jäger H, Joost HG, Kulling SE, Lampen A, Mally A, Marchan R, Marko D, Mühle E, Nitsche MA, Röhrdanz E, Stadler R, van Thriel C, Vieths S, Vogel RF, Wascher E, Watzl C, Nöthlings U, Hengstler JG. Toxicity of fluoride: critical evaluation of evidence for human developmental neurotoxicity in epidemiological studies, animal experiments and in vitro analyses. Arch Toxicol. 2020 May;94(5):1375-1415. doi: 10.1007/s00204-020-02725-2. Epub 2020 May 8. PMID: 32382957; PMCID: PMC7261729. [Accessed October 2023]

[vii] Fluoride Alert https://fluoridealert.org/studies/ifs/ [Accessed October 2023]

[viii] NHS England https://www.nhs.uk/live-well/healthy-teeth-and-gums/taking-care-of-childrens-teeth/

[ix] Lin J, Dinis M, Tseng CH, Agnello M, He X, Silva DR, Tran NC. Effectiveness of the GumChucks flossing system compared to string floss for interdental plaque removal in children: a randomized clinical trial. Sci Rep. 2020 Feb 20;10(1):3052. doi: 10.1038/s41598-020-59705-w. PMID: 32080218; PMCID: PMC7033121.[Accessed October 2023]

[x] Gorur A, Lyle DM, Schaudinn C, Costerton JW. Compend Contin Ed Dent 2009; 30 (Suppl 1):1 – 6.

[xi] Tawakoli, P.N., Sauer, B., Becker, K., Buchalla, W. and Attin, T. (2015). Interproximal biofilm removal by intervallic use of a sonic toothbrush compared to an oral irrigation system. BMC Oral Health, [online] 15(1). Available at: https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-015-0079-6 [Accessed October 2023].

[xii] Goodwin M, Emsley R, Kelly MP, Sutton M, Tickle M, Walsh T, et al. Evaluation of water fluoridation scheme in Cumbria: the CATFISH prospective longitudinal cohort study. Public Health Res 2022;10(11) [Accessed October 2023]

The Orthophos S is the all-round excellent solution for any dental practice, from Clark Dental.

The high-performance 2D/3D X-ray unit offers a comprehensive range of capabilities suitable for every practice. Even in anatomically difficult cases, the Orthophos S delivers sharp and autofocussed images thanks to the 2D Csl sensor with autofocus function. A Ceph arm can also be added or retrofitted at any time, on the right- or left-hand side, depending on your preference. Plus, motorised temple and forehead support, automatic temple width measurement, light localisers, and sturdy handles ensure safe and proven patient positioning.

For more information about how the Orthophos S can benefit your practice, please contact the team at Clark Dental.

If you’d like to find out more about Clark Dental’s solutions, call the team on 01268 733 146, email

info@clarkdental.co.uk or visit www.clarkdental.co.uk.