BSP UK Clinical Practice Guidelines for the Treatment of Periodontitis

The European Federation of Periodontology (EFP) engaged a group of International experts to systematically reviewed evidence from clinical studies to create clinical guidelines for the treatment of periodontitis (gum disease).

The British Society of Periodontology and Implant Dentistry (BSP) has moved rapidly to take the European document and develop a British version of the guidelines, making sure they were suitable for the UK healthcare system. The paper is published today in the Journal of Dentistry: https://authors.elsevier.com/sd/article/S0300-5712(20)30310-9

This is an incredibly important project. Poor gum health can lead to tooth loss and affect other systemic health issues, such as diabetes, cardiovascular disease and dementia. It was wonderful that European experts came together to look at the 4 main phases of periodontal disease management with a view to creating clear guidelines for all.

The BSP has been kindly supported by GSK to record several educational videos and produce flowchart resources to help dental care professionals to implement the guidelines in clinical practice. By creating a series of short video clips, to be shared via social media and our website, we can help to spread the important educational message to the wider dental profession, patients and the public. We aim to distribute our clinical guideline flowchart to all dental practices in the UK to accompany their classification flow chart.

A lay version of the guidelines for the public and patients is also being produced. It was extremely important to the BSP to involve patients, who could present their important viewpoints in the workshops. They have also been involved in the process of creating a lay version of the guidelines.

This lay version will allow patients to empower themselves with evidence-based information to both take responsibility for aspects of their disease management and know that they are being offered appropriate, contemporary, evidence-based treatment.

In addition, the BSP has created a lay flowchart, which conveys the importance of gum health in a simplified, informative way. Our aim in creating resources for patients and the public include:

  • Help the public understand what gum disease is
  • Raise awareness of how you can look after your gums and maintain good oral health
  • Reduce the stigma associated with gum disease (as highlighted in “The Sound of Periodontitis” video) by identifying the many causes including smoking, diabetes etc.
  • Highlight that more can be done to aid gum health in addition to brushing your teeth
  • Encourage the patient to take ownership of their disease and highlight the ways they can do this

Project leads:

Professor Moritz Kebschull

Professor Nicola West

About the BSP

The British Society of Periodontology and Implant Dentistry was founded in 1949 to promote public and professional awareness of periodontology and implant dentistry to achieve our vision of “Periodontal Health for a Better Life”.

We enjoy research, debate and actively getting involved in issues that affect members and our work. We are keen promoters of periodontology and dental implantology and are working hard, through various initiatives, to significantly raise awareness to the public, patients, dental and medical professionals. One of our strategic aims is to work with key stakeholders and influence national and international policy makers to promote periodontal health.

To reflect our commitment to progression and innovation, the BSP awards prizes for research into periodontology – both for undergraduate and postgraduate students – on an annual basis. https://www.bsperio.org.uk/professionals/awards

The BSP hosts one key Conference every year. These are popular, content-rich, excellent networking events with high profile speakers covering a huge range of topics. We also have an educational webinar programme covering a range of topics for members and non-members. https://www.bsperio.org.uk/events/bsp-event-calendar

We have Undergraduate Representatives in all UK dental and hygiene/therapy school. In addition, we have a dedicated Early Careers Group, which is an energetic part of the BSP, helping to support young periodontists at the start of their specialist career. https://www.bsperio.org.uk/early-career-group

GSK Health Partner showcases how UK dentistry is rising to the challenge

A new campaign by GSK aims to showcase how dental practices and professionals across the UK have risen to the challenges of effective patient care during the Covid-19 pandemic.

In the video series, GSK showcases the resilience, passion and adaptability of the dental profession as it responds to new guidelines as a result of the Covid-19 pandemic. The videos are delivered by practitioners who have made small but imaginative changes to help patients to improve their dental health. Five voices, three videos, one goal: to share learnings and inspire better oral health. These videos can be viewed on: https://www.gskhealthpartner.com/en-gb/dentistry-innovation-rising-challenge/.

The series includes advice from Stuart Garton, a Practice Owner from Liverpool on seizing opportunities to embrace innovation, rethink practice and transform the patient experience. Additional content includes help with behaviour change and how the profession is coming together to evolve dental care including the role of new guidelines as a catalyst for innovation, inspiration and collaboration.

Andrei Gutierrez, Senior Expert Marketing Manager at GSK comments: “We hope that this series of videos can help to raise the profile of the continued dedication and commitment of the dental team during this challenging time and provide inspiration to other dental care professionals about how guidelines have become a catalyst for innovation, inspiration and collaboration. As Covid-19 restrictions continue across the world, the message of prevention of oral disease is more important than ever”.

Leading oral health organisations team up with GSK to provide toothpaste to the vulnerable of Manchester

The Oral Health Foundation and the British Society of Dental Hygiene and Therapy have teamed up with GSK to provide over 100,000 tubes of Sensodyne toothpaste to the vulnerable and those in need in Greater Manchester.

This mammoth community effort, facilitated by Manchester based charity Community 4X4, will see toothpaste distributed to places all over Greater Manchester. Those that will be receiving the toothpastes include homeless people, residents in care homes, people who use foodbanks and those who don’t have easy access to dental products or whom may have limited financial resources.

Talking about the impact that this donation will have, Emma Hall-Scullin, consultant dental public health, Public Health England North West, said: “Greater Manchester has some of the highest levels of tooth decay in the country and this is one of the many initiatives being undertaken to address this. Twice- daily toothbrushing is extremely important to maintain oral health and prevent tooth decay.”

Dr Ben Atkins, President of the Oral Health Foundation, hopes this donation will go far in boosting the oral health of those in Manchester who otherwise might be struggling during this difficult time: “It’s vital that oral health is maintained, not just for health of the mouth but also for mental health as well. We hope that this donation of Sensodyne toothpaste will allow those that receive them to get all the benefits that come with healthy teeth and gums and put a smile on their face.”

President of the BDSHT, Diane Rochford, added: “On behalf of the BSDHT I’d like to thank GSK for their generous donation. These toothpaste samples will make a huge difference to those in need and reinforce the fact that these items are a necessity, not just a luxury for those more fortunate.”

Of course, the donation would not have been possible if it weren’t for GSK, a spokesperson for the organisation said: “We are really pleased to help support the communities of Greater Manchester with this toothpaste donation, in a year where there have been significant limitations to dental service delivery.”

The Oral Health Foundation would also like to extend a special thanks to Singletons Transport who kindly offered their services for free to help deliver the toothpastes.

As commented on earlier, this year has indeed provided a number of challenges for the dental profession and the public alike. The Oral Health Foundation is committed to supporting the public with their oral health during this difficult time which is why we continue to run our Dental Helpline. The Helpline has helped hundreds of thousands of callers with their oral health problems and queries. It is open Monday to Friday from 9am to 5pm and can be reached on 01788 539780.

For more information about the Dental Helpline as well as the Oral Health Foundation’s wider activities head to www.dentalhealth.org.

Campaign launched by leading dental bodies to drive ETW screenings as part of routine oral exams

Leaders of the Erosive Tooth Wear Foundation, Faculty of General Dental Practice (UK), British Society of Dental Hygienists and Therapists, Dental Protection Society, and King’s College London have announced the launch of a joint campaign in partnership with GSK, the makers of Pronamel, to drive awareness of erosive tooth wear (ETW). 

Despite being the third most commonly observed oral condition, affecting up to 30% of European adults, and not requiring a drill to fix, UK research shows that ETW is currently not routinely screened or monitored as part of the standard dental examination. 

These leading experts are calling on the dental profession to use the basic erosive wear examination (BEWE) alongside the basic periodontal examination (BPE) as part of every oral assessment to prompt early identification and prevention. As it follows the same sextant approach as the BPE, BEWE can be conducted at the same time, therefore requiring little additional clinical time. 

Although the condition may have a slow rate of progression, the impact on aesthetics and function, as well as the financial implication of restoration, can be significant. According to a study by O’Toole et al., costs could be up to £31,000 for private treatment and the average treatment took 21 months. 

Reports show that the rise in snacking culture and the popularity of fresh fruit and fruit juices has significantly increased the risk of developing ETW, especially when they are consumed outside of meals. Odds ratios for example increase nearly 12-fold when acidic drinks are consumed on two occasions outside of meals, highlighting how modern diets and lifestyles have a substantial role to play. 

Dr Soha Dattani, Director of Scientific Affairs at GSK, commented: “Our modern snacking culture, coupled with an ageing population who retain their teeth for longer, means that ETW is a rapidly increasing risk. As ETW may have considerable aesthetic, functional and financial implications, there is a need to protect the patient and the professional through early identification and patient counselling for prevention. 

“To tackle the issue head on, we’ve gathered the UK’s leading dental bodies to jointly highlight the effects of ETW and the need to change the way we as a profession approach it. As a healthcare company committed to helping patients to do more and live better, GSK is proud to support and be involved with this important initiative and to lead the way on tackling ETW for current and future patients.” 

Reiterating just how common ETW is, Professor David Bartlett, Head of Prosthodontics and Graduate Training at King’s College London’s Faculty of Dentistry, Oral and Craniofacial Sciences, added that its prevalence is increasing. “The BEWE was designed specifically for use in general practice, it is a simple tool, which can be used alongside the BPE, to help screen for signs of the condition and prompt preventative discussions with patient,” he explained. 

“The BEWE is a quick, simple and effective way to assess tooth wear and could undoubtedly benefit both patients and practitioners,” noted Ian Mills, Dean of the Faculty of General Dental Practice (UK). “Our profession is committed to delivering excellence in patient care. Modern lifestyles and eating habits present a range of challenges including the potential rise in ETW. Just as we do with caries and gum disease, we need to ensure that ETW is routinely monitored and patients are informed.” 

Nairn Wilson, Emeritus Professor of Dentistry, King’s College London and Chair, Board of the College of General Dentistry, explained how it is important that all practitioners are up to date on the condition and are assessing patients for signs and risk factors. “For more established practitioners this may mean a need to change well-established examination routines and update knowledge to prevent any future risk of claims of supervised neglect.” 

Dr Saoirse O’Toole, Clinical Lecturer in Prosthodontics at King’s College London’s Faculty of Dentistry, Oral and Craniofacial Sciences, meanwhile highlighted how Patients are often referred to the hospital for treatment “It is because early signs may not have been identified and changes to behaviour have not been discussed with patients. Simple advice, such as limiting the number of acidic drinks you have and switching when you have them to mealtimes may make a real difference in reducing patient risk.” 

Diane Rochford, President Elect of the British Society of Dental Hygienists and Therapists, agreed: “As a profession, dental hygienists and dental therapists are traditionally identifying patients with adequate plaque control as an indicator of optimal oral health. We need to raise awareness that this is an exception, ETW generally occurs in patients who maintain optimal plaque control on a daily basis. Routine use of the BEWE alongside the BPE can efficiently and effectively identify patients at risk.” 

“It is important to record signs of tooth wear as part of the hard tissues examination and to monitor the rate of progression,” argued Dr Raj Rattan, Dental Director at Dental Protection. “From a dento-legal point of view, the records should also indicate the preventative advice offered and the patient’s compliance with that advice. The value of comprehensive clinical records in defending dental claims cannot be overstated.’ 

ETW becomes even more critical as many of us retain our natural teeth later in life, according to Nigel Pitts, Professor of Dental Health and Academic Lead for Impact at King’s College London’s Faculty of Dentistry, Oral & Craniofacial Sciences. ““With more people retaining their natural teeth later in life it is critical that prevention and control of potentially destructive conditions such as ETW is prioritised.” 

Comprehensive educational resources for both the clinician and patient to support this campaign are available via the Erosive Tooth Wear Foundation website https://www.erosivetoothwear.com and www.gskhealthpartner.com. 

Toothbrushes and toothpaste to help families in need

Thousands of toothbrushes and toothpaste are being given to children and adults, thanks to Kent Community Health NHS Foundation Trust and pharmaceutical company GlaxoSmithKline (GSK).

The trust, which provides community services in Kent, London and East Sussex, normally gives out around 800 of its brush for life kits a month, which include a toothbrush, a toothpaste and a leaflet about oral health.

However, at the beginning of the UK lockdown its supplies of toothpaste dried up –  and at the same time demand for the packs went up hugely, with families losing incomes or having to get by, with less.

But thanks to the collaboration, Kent Community Health NHS Foundation Trust (KCHFT) has now been able to hand out 5,045 packs since May, working closely with food banks and the Salvation Army on the distribution, so the packs get to those who need a little extra help, now.

KCHFT puts the packs together and buys the toothbrushes. The toothpaste is being donated by GSK.

Surjeet Jhheent, Senior Project Co-ordinator with KCHFT’s Dental Outreach Team in London, said: “Previously, I had worked with GSK on a clinical trial, so I approached my contact there and discovered it was happy to help. This was a great weight off my mind, as we were unable to get the toothpaste from our usual supplier. So far, the company has given us 8,000 tubes of toothpaste, some for adults and some for children and they are continuing to help, which is fantastic. We took delivery of the first round last week. When families are struggling with money, obviously food is a necessity, but so is oral health. Unfortunately, when times are hard this often gets pushed down the list of priorities. With these supplies we can help to make sure this is something people think about.

“As most of our dental services were suspended at the beginning of the lockdown, our Outreach Team has been busy putting the packs together, ready to send out, practising social distancing and with masks, gloves and hand sanitiser to hand. We’re very grateful for this help from GSK.”

Pictured is the outreach team’s head driver Graham Peek making a delivery to Hackney Food Bank.