The Probe

New research finds link between gum disease and erectile dysfunction

More time in the bathroom could lead to extra hours in the bedroom:

Don’t go soft on your oral health routine – that’s the message from the Oral Health Foundation after new research finds a link between gum disease and erectile dysfunction.

The study, published in the Journal of Periodontology, reveals that men with severe gum disease are more than twice as likely to suffer from impotence compared to those with healthy teeth and gums.1

The first study of its kind that involved a European population examined more than 150 men, and researchers were able to determine that three in four (74 per cent) with erectile dysfunction also had poor oral health.

In response to the findings, the Oral Health Foundation wants to emphasise the links between advancing gum disease and issues in other parts of the body and believes the benefits of taking better care of your gums can go far beyond a healthy mouth.

Dr Nigel Carter OBE, CEO of the Oral Health Foundation, said: “As startling as these findings may be, it may turn out to be a wake-up call for men to start paying greater attention to their oral health, particularly their gums.

“In recent years, gum disease has been linked with conditions like diabetes, stroke and heart disease but an increased risk of coming up short in the bedroom may be the final straw for men who might have been reluctant to spend a little extra time looking after their gums.”

Gum disease happens when the tissues supporting the teeth swell and become sore or infected. If you fail to treat it in it’s early stages, the disease will continue to worsen, and can result in tooth loss.

Finding blood on your toothbrush or in the toothpaste you spit out after brushing is a common symptom of the condition. Your gums may also bleed when you eat, leaving a bad taste in your mouth.

“Fortunately, gum disease is an entirely preventable and treatable disease but avoiding it and lowering the risk of poor performance in the bedroom requires an effective and consistent oral health routine,” Dr Carter added.

“Brushing twice a day with a fluoride toothpaste, cleaning in between your teeth once a day using interdental brushes and maintaining regular visits to the dentist are the best way to avoid or treat gum disease.

“It takes a relatively small amount of time to give your teeth and gums the care they need and falling short of that can really leave you in a difficult position later in the day.”

The research also says that treating gum disease by reducing inflammation of the gums can result in improved erectile function.

As well as being able to treat any signs of gum disease before it develops into a more serious issue, regular dental visits can also remove plaque and tartar from your teeth, as well as give your mouth a fresh bill of health.

For more info or advice visit www.dentalhealth.org.

  1. Martin A, Bravo M, Arrabal M et al. (2018) Chronic periodontitis is associated with erectile dysfunction. A case-control study in European population. Wiley: Journal of Clinical Periodontology. 2018;45:791-798.

Special feature: Stress and oral health

Dentist and bacteriologist Dr Harold Katz looks into the relationship between stress and oral health…

April 2018 marked the launch of Stress Awareness Month and the Mental Health Foundation states “research has shown that around 12 million adults in the UK see their GP with mental health problems each year. Most of these suffer from anxiety and depression and much of this is stress-related”.

Dentist, bacteriologist, and founder of The Californian Breath Clinics and The Breath Company, Dr Harold Katz, answers questions about how stress can impact your oral health.

What oral hygiene problems can be attributed to stress?

Dr Katz says: “It is well documented that stress can have a huge impact on our general health and can cause a plethora of physical conditions such as heart disease and obesity as well as serious mental health disorders such as anxiety and depression. Specifically, when taking our oral health in to account, stress can really take its toll and be attributed to various oral health issues including bad breath, gum disease and mouth ulcers to name a few.”

How does stress cause halitosis?

It is estimated that 50 per cent of the population has bad breath. When individuals find themselves in high-stress circumstances, their bodies react by using the sympathetic nervous system as a form of protection. This system essentially triggers the fight-or-flight response mechanism, providing you with a boost of energy so you can react quickly to the situation. In cases of chronic stress, your body is kept in “fight or flight” mode and conserves energy by turning off certain digestive functions such as the production of saliva. The mouth then produces a lower level of saliva – saliva is mandatory for moistening food for easier digestion, but the body deems it unnecessary in critical situations.

Saliva evaporates and the mouth becomes dry, leading to bad breath. This happens because the odorous gases created by bacteria in the mouth, which are generally suppressed by spit and swallowed away, are free to be released into the air. Additionally, bacteria are much more likely to stick to the surfaces of a dry mouth, which can further enhance the sour smell. Drinking plenty of water, chewing sugar-free gum and rinsing with a non-alcohol mouthwash can help to minimise the effects of stress related halitosis.

How can stress cause gum disease?

A small amount of blood in the sink when you clean your teeth might not seem like a big deal, but consistently bleeding gums should not be ignored. Bleeding gums are a visual symptom of gum disease, which can be caused by stress. There are a few factors that link stress to bleeding gums and the onset of gum disease. Firstly, when the body is under stress it produces elevated amounts of the hormone cortisol, which acts as an anti-inflammatory agent. When cortisol is produced peripherally in the gums, it stimulates mast cells to produce more proteins, simultaneously increasing inflammation and the progression of gum disease. In addition, individuals with high stress levels tend to adopt bad oral hygiene and lifestyle habits, and this in turn can have a negative impact on their oral health. If gum disease isn’t in advanced stages then good oral hygiene habits can reverse it so it’s essential to adopt a robust oral hygiene regimen coupled with regular trips to your dentist who can offer sound advice on correct brushing and flossing techniques.

How can stress cause mouth ulcers?

Chronic stress suppresses the immune system and can leave you open to disease and infection. Mouth ulcers are one example of this and although are relatively harmless can make life unbearable when eating, drinking, speaking or swallowing. They occur on the inside of the mouth and are white or yellow surrounded by a dark red area. Minimising your exposure to stressful situations and adopting some simple lifestyle changes can reduce your chances of developing moth ulcers.

How can I minimise stress and its effects on my oral health?

Stress can often be an unavoidable part of modern day living, but that can really hinder your day-to-day life. You can help to minimise the impact that stress has on your oral health by adopting the following:

Start with some lifestyle changes. Stress can often lead us to make bad lifestyle choices that will impact our oral health. Limiting consumption of sugary foods and drinks, alcohol and quitting smoking will all contribute to healthier gums and mouth. Smoking in particular dries out the mouth and can lead to gum disease as a result of bacteria and toxins causing plaque to form in the mouth.

Exercise. Fitting exercise into your lifestyle will do wonders for your stress level. When you exercise, you’re using physical activity to shed the mind of stressful thoughts. Regularly practicing yoga for example, may be great for the body and mind. Similarly, deep breathing exercises can be very beneficial, and any form of exercise may boost endorphin production and help you better handle your emotions in high-tension situations.

Adopt a robust oral health regimen. Brush and floss regularly but avoid harsh soap in toothpaste. Brushing helps eradicate the plaque and bacteria on your teeth, however some toothpaste contain sodium lauryl sulphate (SLS), a soapy detergent that creates foam but has no cleaning benefit. The additive has recently been linked to serious side effects including canker sores. Flossing is an extra step, but it’s an important one, as it helps gets in between the teeth where toothbrushes sometimes miss. In addition, regular and specific application of alcohol-free mouth rinses such as The Breath Company Healthy Gums Oral Rinse will help calm the gum area and work to both eliminate germs associated with gum disease and reduce the formation of biofilm, which leads to plaque and tartar build-up. It’s important to steer clear of alcohol-based mouthwashes as these can cause dry mouth, and just mask odours rather than killing off bacteria.

Stay hydrated throughout the day. The fight-or-flight reaction to stress can make you dehydrated and this leads to dry mouth and bad breath bacteria forming which can both contribute to the onset of halitosis gum disease. If you keep your mouth and body well hydrated, you will minimise the chance of developing dry mouth that can lead to these problems.

Talk to your dentist and make regular check-ups. They are the very best source of advice and will be able to check for any signs of any stress-related gum disease and bad breath issues. In addition, they will be able to offer advice on how to prevent stress affecting your oral health and put in place a care plan that is bespoke to you.

Dr Harold Katz is a dentist with an advanced degree in bacteriology and a lifelong advocate of good oral health. He is the founder of The California Breath Clinics and the developer of the The Breath Company line of premium oral care products, and the internationally recognised expert in the fields of bad breath, taste disorders, tonsil stones and dry mouth. Known as the ‘Bad Breath Guru’ due to his numerous television appearances on US television shows, he has helped millions of people around the world eliminate their bad breath problems.

Dr Katz is a graduate of the UCLA School of Dentistry. In the 1970s he established a thriving dental practice in Beverly Hills, California and he has perfected his dental techniques while working with some of Hollywood’s biggest stars.

Dentists challenge Jeremy Hunt to prove his mettle by investing in prevention

The British Dental Association has challenged Jeremy Hunt to put prevention at the heart of government’s NHS ‘birthday funding’ pledge, as dentists warn that a rush to reduce political pressure on hospital targets will fail to tackle the pressures facing the wider service.

In an open letter to the Health Secretary the dentists’ union has demanded clarity on investment in primary care and public health services, which appear conspicuous by their absence, stating that any settlement geared purely around chasing targets for acute care stands entirely at odds with the preventive philosophy set out in the Five Year Forward View.

It has sought clarity on issues around the government’s successive manifesto commitments to reform dental primary care services, its increasing over-reliance on patient charges, threats to training budgets, and its unwillingness to engage meaningfully on public health programmes.

The BDA has stressed that a new prevention-focused NHS contract will only now be viable if ministerial contributions taken out of service since 2012 are restored, to boost quality, access and time spent with patients. Recent figures have shown spending per head has fallen £41 to £36 per person in just five years. Recent evaluation reports have demonstrated prototypes currently being tested are not financially sustainable.

Dentist leaders have also urged the government to engage with modelling from Public Health England on the huge returns of investment yielded by spending on prevention, and requested details on plans for public health budgets for cash strapped local authorities. £1 spent on early years prevention programmes of supervised brushing yield £3.06 in savings after just five years.

Tooth decay remains the number one reason for child hospital admissions in the UK, with a growing number of children facing more than six-month waiting lists. The BDA has documented the multi-million-pound costs hospitals are now facing for failure to tackle tooth decay, a wholly preventable disease, on GP services, emergency and secondary care.

BDA Chair, Mick Armstrong, said: “If Ministers fail to invest in prevention in primary care and public health services they will be on the wrong side of their own strategy for the health service.

“It is wrongheaded to focus on cure over prevention, treating the symptoms but not the causes of the pressure on our NHS. More and more children face six-month waits for tooth extractions in hospital, but the solution cannot be throwing cash at the surgical workforce.

“This is about targeted investment. Reform of the failed NHS contract has reached an impasse, and the government’s stated goals of improving both access and prevention simply cannot be delivered on a standstill budget. To make this work all we need is the cash Ministers have quietly siphoned out of the service since 2012.

“The government’s own figures show a pound spent on preventing decay can yield three back in savings. Reducing exposure on hospital and emergency targets is politically useful, but it isn’t a sustainable or cost-effective basis for a healthcare strategy.”

Don’t be frightened by KPIs

ADAM President Lisa Bainham talks to Practice Manager, Edd Jones, who is also Partner and Business Consultant at C&E Consult, about KPIs and how important and relevant they are to your dental practice…

I’m back once again with Edd Jones from C&E Consulting and today we are talking about KPIs. First of all, I think that the term can frighten some Practice Managers and it really doesn’t need to! Once you get into the habit of measuring them it really does become second nature.

EJ: Completely agree Lisa. Put simply, KPI’s are measures of your business’s performance in key areas, including productivity, financial measures and core non-financial measures, such as new patient conversions and plan patient numbers. I would recommend completing your KPIs at least monthly. I’m sure most readers have heard of KPIs, but what actually are ‘KPIs’ and how are they relevant to your dental practice?

LB: We have included a list below is a list of what Edd and I think are the absolutely key generic KPIs for your practice along with a brief description of the why’s and wherefores. This isn’t an exhaustive list or role/department specific and the KPIs will vary from practice to practice (dependent on size, NHS/private etc), but it’s good to have a starting point.

So, in no particular order…

  1. Clinician Productivity (Financial):

This is a great starting point and will help you measure whether your clinical team are measuring up. This also gives you an instant and daily guide as to whether your chairs are being fully utilised and have patients sat in them! What measure you use to actually get this information is open to discussion and can be tailored to meet your practice’s specific needs – this can be as simple as the chair time occupancy as a percentage e.g. this week we had 93 per cent chair time occupancy. However, this does not give you any idea of whether your pricing in relation to the occupancy is productive.

  1. Sundry Sales (Financial):

Sundries will never make rich, however they are a useful addition to your income. Pricing these correctly is essential, but that is an easy calculation – the cost price (Don’t forget VAT), plus 50 per cent of that cost price = retail price… right? Anyway, moving on… this should be a simple financial measure of how much your practice generates in pounds from selling sundries. It is important to have a target number in mind here; if you are a single dentist, hygiene led practice, with at least the same number of hygiene days as dentist days – start at a minimum of £500 per month as a target.

  1. Monies Owed or Bad Debt (Financial):

Your appointments software should have a specific report relating to this and it is essential that you keep a check on the level of money owed to the practice by your patients. There will almost always be a certain level of debt, where arrangements are already in place for payments with those patients. However, this is an area that is often politely ignored, as team members don’t like having the ‘money conversation’ with patients – keep on top of this area.

  1. Costs (Financial):

There are a lot of costs within your practice and there are two ways in which you should measure these. One is a straight amount and the second (and more important) measure is the cost as a percentage of your top line income. So look at measuring, as a minimum:

  • Laboratory work cost (remember not to panic completely when this number is high, it will relate directly to the amount of work you have completed in the month i.e. more orthodontic work = higher lab costs. This helps make it easier to measure whether you are charging enough for those treatments):
  • Materials spend
  • Salaries
  • Directors dividends
  • Clinical waste costs
  • Subcontractor costs
  • Marketing costs
  • Stationery spend

To work out the percentage spend (as mentioned above) simply complete this sum: Spend/income X 100. Then you need to decide what are acceptable levels for this percentage – as a guide, materials should be no more than six to 10 per cent and if they are, your fees almost certainly need to rise.

  1. Income (Financial):

Often referred to as ‘turnover,’ or, ‘top line,’ this is the money your practice takes, before any of the business costs are attributed to your profit and loss account. This all comes back to your fees and how you section out your appointment book for appointments, but get this measure in there – really important! This can be broken down further into income from specific types of treatment e.g. whitening, Ortho, Endo. This is recommended for practices which have a specialist or visiting specialist.

  1. Profit (Financial):

This is the ultimate measure for your business and its success – once all is said and done. No profit = no business, or one on a slippery slope anyway. This really does need to be measured against a specific target, and this target will vary depending on the type of practice you have, the amount of clinicians, location etc. Have a rolling target measure as well i.e. ‘profit over the last 6 months.’ This can be broken down further into profit from specific types of treatment also e.g. whitening, Ortho, Endo.

  1. New Patient Value (Financial):

A simple measure of how much money you have made from new patients, in a calendar month. Your appointments software system should give you this number at the click of a button. If you’ve had lots of new patients, yet this number is very low – something is very wrong!

  1. Enquiry Conversions (Non Financial & Financial):

This is NOT new patient conversions; it is simply how many enquiries were made to the practice from potential new patients versus how many actually booked a new patient appointment (ideally one that involves a fee. So, if you had 36 enquiries and 19 of them booked new patient appointments, your team have converted 53 per cent (rounded) of those enquires. You should aim high in this area – 60 per cent + target.

You should also be measuring where the enquiries came from e.g. internet advertising, social media, direct telephone call, and referral. These should be in direct relation to where/on what you spend your marketing budget.

You can also then subsequently measure how much each enquiry has cost that month e.g. marketing spend of £1,700 and 36 enquiries. Therefore, £1,700/36 = £47.22 per enquiry. This is a great number to help focus the attention of your front of house team, “Laura/Michael – did you know that every time you answered the phone to a new patient, or replied to one of their emails it cost £47.22?!” They will soon sit up and take notice and guess what… your conversion rates will improve (coupled with some half decent Front of house and sales training of course).

This is exactly the same for the conversions – Marketing/advertising spend of £1,700 and 19 conversions. Therefore, £1,700/19 = £89.47 per patient! This also gives you a good idea of what the starting point is for your new patient assessment fees…

  1. Conversions To Active Patients (Non Financial & Financial):

This is a measure of how many patients who had new patient assessments in a calendar month, are now ‘active patients.’ This means on plan or signed up to Ortho/a full restorative treatment plan. So again, if 11 of the 19 became active patients, your team converted 58 per cent (rounded) of those patients to ‘active patients.’

It’s absolutely vital to make the differentiation between points 8 and 9 here.

  1. Total Patients Seen (Non Financial & Financial):

Simply, how many patients you have seen during the month – your appointments software should be able to give you this information easily. Then divide this number into your income to give you an average spend per patient e.g. £65,000/578 = £112.47 per patient.

  1. Plan Patient Information (Non Financial/Financial):

This area is absolutely critical in the continued success of your practice. This gives you a core income each month and is a great reflection of whether your practice is truly health and prevention led. Some simple KPIs for each type of plan you offer:

  • Number of new joiners
  • Number of leavers
  • Current month’s plan numbers versus the previous month’s plan numbers
  • Current month’s plan numbers versus the same month the previous year
  • Income for the current month versus the previous month’s income
  • Income for the current month versus the same month the previous year.

     12. Associate:

If you have an associate – you need to measure whether having them is actually bringing you any benefit. There are three main areas to measure:

  • Associate productivity,
  • Associate’s profit contribution,

It is really important that the associate brings value – so move away from the traditional ‘we pay 50 per cent’ and get them on the right pay structure from the off – this takes time and effort to get right – but is very, very important.

    13. Treatment Coordination (TCO) Free Appointment Conversions:

If you have a TCO and offer free appointments – make sure you measure specifically how many of these freebies are converted by the TCO and how much £££ they make you.

Share this information with the TCO and make sure you set clear targets for them to attain – this is a sales role and making sure it pays its way is really important. I’m not saying we should be ‘hard selling,’ or the PM/BM to manage like a cold calling contact centre manager – just make sure the role brings real value to your Practice. Use some of the measures above, but specifically for the TCO.

LB: That’s a great list Edd and I think so important to making sure that your practice is running as well as it can do. Are there any things that you wouldn’t include in KPIs? Or perhaps anything else to avoid?

EJ: Very good question! Yes, a few. Patient Satisfaction scores is a specific issue and one that CQC will like to see stand alone evidence of. Also, although some people will tell you to measure absolutely everything – don’t. Focus on the important stuff, or the KPIs will just become a sea of numbers, which you go through the motions with each month just to get it done. Your P&L will soon throw up anything that you need to include, but be realistic and precise,

Don’t worry about what everyone else is doing and make sure that you seek qualified advice from your specialist dental accountant or business coach. Although social media and forums can be useful, don’t always rely on them for advice!

C&E Consult: www.ceconsult.co.uk

DDU warns that patients may want amalgam fillings replaced

Dental professionals are being advised by the Dental Defence Union (DDU) that they may be approached by patients wanting mercury amalgam fillings removed, following new rules which have just come into force to restrict the material’s use.

Under new EU regulations, from 1 July 2018 dental amalgam should not be used for the treatment of deciduous teeth, children under 15 years and pregnant or breastfeeding women, except when deemed strictly necessary by the dental practitioner based on the specific medical needs of the patient. There are also further restrictions on the disposal of mercury amalgam due to come into force next year.

David Lauder, DDU dento-legal adviser, said: “More than 80 per cent of the population has at least one filling so it’s likely that mercury amalgam will be present in the mouths of most people. The material has been used effectively for more than 150 years, and the new restrictions do not mean amalgam fillings need to be replaced.

“However, due to the publicity surrounding the new regulations, more patients may ask about the safety of existing amalgam fillings and request they are replaced as a precaution.

“Fortunately there are modern alternatives to dental amalgam readily available but dentists need to consider if replacing old fillings would be in the patient’s best interests. As the process of drilling out an old amalgam filling releases more mercury vapour than leaving the filling in situ, it may be difficult to argue that the benefits outweigh the risks, unless the filling is already compromised.

“In addition, it is possible that the treatment could itself cause trauma to the tooth and inflame the pulp, leading to pain and the possible need for further treatment or extraction. This in turn could lead to the patient making a complaint or claim for compensation.

“Dentists should try to reassure the patient about the long term safety of dental amalgam and the risks involved in replacing fillings, before making a detailed note of these discussions in the dental records. If necessary, recommend the patient seeks a second opinion.

“All treatment should be in the patient’s best interest and in line with current accepted practice and teaching as would be supported by a responsible body of dental opinion.”

Entries now open for the Dental Awards 2019!

Following the huge success of this year’s Dental Awards, the dates have now been announced for next year’s event… And entries are now also open for each category…

The Dental Awards, supported by the UK’s leading dental magazine publisher, Purple Media Solutions, consistently recognise the very best in UK dentistry. Winning or becoming a finalist is a tremendous accolade and provides a massive boost to the profile of your practice. After all, who wouldn’t want to be treated by the Dentist or Dental Practice Team of the Year?

The Dental Awards 2019 will take place on Friday 17 May with a sparkling gala dinner at the Hilton Birmingham Metropole, held alongside the British Dental Conference and Dentistry Show at the NEC.

This is always a great way to thank your team and celebrate all that is best in a profession that rarely gets the full credit it deserves. Presenting the Dental Awards alongside the British Dental Conference and Dentistry Show provides a brilliant opportunity to combine attending the awards with a visit to the show, the leading CPD-led exhibition in UK dentistry.

Entries now open

Entries are now open for next year’s prestigious event, so if you think that you, your colleagues or your whole team deserves the chance to be honoured at the Dental Awards simply download an entry form and put your case forward – and you could be picking up a trophy on stage at the Awards next May!

It is free to enter the Dental Awards only up until 7 September 2018; after this it will be £45 to enter.

Send your entries by the final deadline on 7 December 2018.

The finalists shortlist will then be announced in January next year.

Being a finalist or a winner can do wonders for you and your practice. So have you had a successful year, or do you have a particularly outstanding colleague or collective team? Perhaps you’ve recently refurbished your practice, you consider your online presence to be better than your competitors, or your National Smile Month campaign has been a tremendous success? Tell our judges! There are many categories at the Dental Awards that are perfect for recognising all the areas and all the roles that are essential in the efficient running of your dental practice. Previous winners have been amazed at the attention they have received from patients, the profession, local press and news programmes.

Start writing your entry now to try and wow the judges with how great you are!

New award category for 2019

The 2019 Dental Awards sees the introduction of a brand new category – Best Outreach or Charity Initiative in the UK. This award recognises the special work that dental professionals and practices do to help others, whether it is one mega event or continuous work in the community.

This category sits alongside other returning categories for 2019:

Best National Smile Month Event

Dental Receptionist of the Year

Dental Therapist of the Year

Dental Hygienist of the Year

Dental Nurse of the Year

Website & Digital Campaign of the Year

Young Dentist of the Year

Dental Practice Team of the Year

Practice Manager of the Year

Practice Design & Interiors

Dental Practice of the Year

Dentist of the Year

 

For information on how to enter and what the judges are looking for, visit:

www.the-probe.co.uk/awards Or, alternatively, call Linda Aitken on: 01732 371570 or e-mail: linda.aitken@purplems.com

You can send your entry by email – awards@purplems.com – or by post to –

Linda Aitken, The Old School House, St Stephens Street, Tonbridge, Kent, TN9 2AD.

Important – If you plan to enter more than one award category you must submit separate entries for each category. Do not combine entries for different categories. For example, if you plan to enter the Dentist of the Year and Team of the Year categories, you need to supply a complete entry for both.

How your favourite tipple could be changing the bacteria in your mouth… and it’s not good news

Just one alcoholic drink a day changes the balance of bacteria in the mouth and can lead to a range of diseases from tooth decay to cancer, a new study has revealed.

Researchers looking at the effects of alcohol on oral health discovered drinking habits influence the types of bacteria that reside in the mouth, with higher numbers of so-called ‘bad bacteria’ found in those who consume alcohol daily.

Scientists tested saliva samples from more than 1,000 adults and found that, compared to non-drinkers, those who had one or more alcoholic drinks per day saw a reduction of healthy bacteria in the mouth, with a significant increase of harmful bacteria also detected.

Such changes could contribute to alcohol-related diseases such as gum disease, tooth decay, head and neck cancer, and digestive tract cancers.

The Oral Health Foundation wants to raise awareness about the dangers of alcohol and the impact that regular consumption can have on the mouth and overall health.

Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation, said: “There are hundreds of different types of bacteria in the mouth and they all play a highly significant role in a person’s wellbeing. These bacteria are finely balanced and important for maintaining everything from the immune system and how the body deals with pollution in the environment, to protecting the teeth and gums and aiding with digestion after eating and drinking.

“The bacterial imbalance from drinking alcohol can cause serious problems in the mouth, such as gum disease, as well as increase the risk of head and neck cancer and heart disease.”

The study also found the type of alcohol consumed also affects the type bacteria in the mouth, with researchers testing wine, beers and spirits.

They found that wine drinkers produce more bacteria responsible for gum disease when compared to non-drinkers while those who consume beer produce an increase in bacteria that are linked to dental decay.

Researchers were able to show that alcohol consumption is associated with decreased abundance of Lactobacillales, a bacterium beneficial to oral health by reducing the risk of tooth decay. They also found that alcohol suppresses the growth of pathogens that can help reduce gum inflammation.

“A number of high profile studies have previously pointed to the dangers around drinking alcohol to excess but this research offers an additional cause for concern,” added Dr Carter.

“It is therefore important to be aware of the effects that even moderate alcohol consumption can have on oral and overall health, if drinking is sustained over a prolonged period of time.

“The best way for somebody to protect themselves from alcohol-related disease is to drink moderately, both in volume and frequency.

“It is also especially important that before bed, teeth are brushed correctly after drinking alcohol. Don’t allow the bad bacteria to build up overnight.

“By giving the mouth a good clean last thing at night, bacteria in the saliva can be neutralised and help prevent any unwanted oral health or general health problems.”

Oral Health Foundation: “Decision to finally offer boys a HPV vaccination is one which will save many lives”

The decision to offer boys a vaccination against the Human Papilloma Virus (HPV) by the Joint Committee on Vaccination and Immunisation (JCVI), announced yesterday by Health Secretary, Jeremy Hunt, has been hailed by the Oral Health Foundation as a decision that will save thousands of lives every year.

The charity believes the decision, which has been under consideration since 2013, will lead to many lives being saved due to the vaccination’s ability to prevent HPV related mouth cancer, as well as other life-threatening diseases.

Under the current programme almost 400,000 boys go unvaccinated every year, which has millions at risk of developing HPV related cancers later in life – cancers which are on the increase.

Dr Nigel Carter, CEO of the Oral Health Foundation, discussed this momentous ruling: “This decision has been an incredibly long time coming and one we firmly believe it will be a significant moment in the ongoing battle against many types of cancer in the UK.

“This decision brings to and end what has been a dangerously discriminatory and unfair HPV vaccination programme in Britain, which has left millions of boys and men unprotected from the biggest sexually transmitted infection in the world.

“HPV is one of the leading causes of mouth cancer; but now we hope that with the swift implementation of the vaccination programme we will see a significant reduction in these numbers.

“Since 2008, girls have been offered a HPV vaccination through a school based programme to protect against cervical cancer, but this has been proven to offer little protection for men from life-threatening diseases caused by HPV; including mouth, penile and anal cancers as well as genital warts.”

Every year more than 7,500 Brits are diagnosed with mouth cancer, with the disease claiming in excess of 2,000 lives – more than testicular and cervical cancer combined.

“There has also been overwhelming support for the vaccine from health professionals and public alike,” added Dr Carter.

“A recent poll from campaign group HPV Action discovered that 97 per cent of dentists and 94 per cent of GPs believe that the national HPV vaccination programme should cover both boys and girls, we have also seen roughly 84 per cent of the public support an extended vaccination programme.

“It has become very apparent that the only certain way to protect boys effectively from HPV is through a national vaccination programme and now this has finally come to fruition we will push for it to be implemented swiftly and effectively so we can ensure that it is most effective in saving lives in the future.”

BOS encourages patients to enter Against the Odds award 2018

The British Orthodontic Society’s Against The Odds award showcases the transformative power of braces by identifying the best account of orthodontic treatment told by a patient. Entries are now being encouraged for the deadline of 31 August 2018.

Patients who enter the award should describe in five hundred words their experience of treatment, explaining how the final outcome was achieved “against the odds” and how their specialist supported them through the treatment.

Sponsored by Ormco, the award is open to children and adults and is now in its 12th year. The most recent winner was 17-year-old Lubo Rnic. (www.bos.org.uk/Public-Patients/Against-the-Odds/Against-the-Odds-Lubos-Story)

Lubo’s orthodontic treatment was carried out by Bristol-based orthodontist Dr Peter Thomas after speech and language therapist Sarah Barnett suggested that orthodontics could help Lubo.

The first prize is £750 worth of travel vouchers for the patient while the orthodontist is awarded with a trophy. To download the entry form: www.bos.org.uk/Public-Patients/Against-the-Odds

Dental Protection: Good record keeping key in phase-down of dental amalgam

Dental Protection is reminding dentists in the UK to maintain good clinical records and obtain full consent if a decision is made to use amalgam as a restorative material, ahead of changes to EU Regulations on its use.

The EU Mercury Regulation is intended to protect the environment from the adverse effects of mercury pollution. It reflects the aims of the Minamata Treaty to reduce the use of dental amalgam in the medium to long term, and to eventually phase it out altogether.

From 1 July 2018 amalgam is not to be used in primary teeth, children under 15 years and during pregnancy/breastfeeding – except if deemed necessary on the ground of ‘specific medical needs’. This should be interpreted as including the specific dental needs of the patient.

By 1 July 2019 the UK and other EU member states will be required to have a national plan on the phasing down of the use of dental amalgam.

Dental Protection advises members to take extra care in obtaining consent and record keeping, to help in defending any future claims, complaints or regulatory investigations that may arise from the use of amalgam in the restricted groups.

Dr Raj Rattan, Dental Director at Dental Protection, said: “Complaints and claims may arise despite a dentist’s efforts to ensure that patients are satisfied with their treatment. Therefore, in situations such as these extra care needs to be taken.

“If a dentist deems it appropriate to use amalgam in a patient in one of the restricted groups, they must communicate the rationale to the patient, or the person who has parental responsibility for them, explain why the decision is in the patient’s best interest, and provide information about the material risks and benefits of amalgam in that particular situation. Valid consent must then be obtained ensuring they are aware of the restriction in specific patient groups.

“In order for the patient or their guardian‘s consent to be valid, they should be given the opportunity and time to ask questions about the proposed treatment to make an informed shared decision.

“Once the decision has been agreed, the justification for placing the amalgam should then be recorded in the patient’s clinical records, along with any discussions about the options, risks, benefits and costs as part of the consent process.

“Records should state clearly on what basis the decision to use amalgam in one of the restricted groups was taken, and that it was made with the patient or guardian’s full knowledge and understanding.”

The use of amalgam is so far not restricted in patients who do not fall into the identified groups. However, patients with knowledge of the restriction may express anxieties about the use of dental amalgam in their own mouths.

In these circumstances Dental Protection advises members to discuss the position of the EU Regulation with the patient, explain the risks and benefits, discuss any alternatives and ensure proper consent is obtained before proceeding with the treatment. Details of this discussion should be recorded in the patient’s records.

Dr Raj Rattan added: “Without proper consent and comprehensive, well-kept records, a dentist will be heavily disadvantaged in defending any allegations made down the line. Detailed records of treatment will influence whether a case can be defended or whether it will need to be settled. Dental Protection can provide members with further advice and guidance.”