Sterilization: Back to basics

Dental practices today face the challenges of maintaining and improving productivity, whilst ensuring that patient and staff safety remains a top priority. At times, this can feel unachievable. However, industry advances have empowered practices to develop safer processes and ensure greater workflow efficiency, thus improving the standard of care provided. Areas of clinical practice where this can be easily demonstrated include decontamination and, in particular, sterilization of dental instruments. Of course, establishing a streamlined sterilization process requires consideration of several factors.


There are multiple steps involved with processing instruments, which include the use of specialised equipment. Every dental practice should have policies and procedures in place for containing, transporting, and handling dental instruments that may be contaminated with blood or other bodily fluids. Dental handpieces and their associated attachments – including low-speed motors and reusable prophylaxis angles – should always be heat sterilized between patients, as opposed to high-level or surface disinfected. In this regard, it is important to take heed of manufacturer’s guidelines on how best to sterilize such tools.  

Dental instruments are divided into three categories: critical, semi-critical and non-critical items. Those that are used to penetrate soft tissues or bone are critical items, and must be sterilized before and after use. Semi-critical items are typically instruments that come into contact with mucous membranes, but are not used for penetrating soft tissues or bone. These instruments should be sterilized in the same way as critical items. As non-critical instruments are used on intact skin only, an intermediate level of disinfection should be applied to these products after use, even if there are no visible signs that they have been contaminated with blood or other potentially infectious materials. Single-use items or instruments that cannot be satisfactorily sterilized must be disposed of after use.


According to HTM 01-05 guidelines, dental practices should have a nominated lead member of staff responsible for infection prevention and decontamination.[i] This individual should be in charge of developing a standardised, written protocol for decontamination, according to evidence-based regulations and standards. By implementing such a strategy, the dental team is more likely to achieve a reproducible system for consistently cleaning and sterilizing instruments, which can ultimately help improve the efficiency of decontamination procedures for greater productivity. Infection prevention and control policies should be tailored to the unique needs and preferences of the practice, and reassessed regularly to ensure their efficacy.

Although it is right that there is a lead co-ordinator, it is important that the entire dental team – including new members of staff – are educated on decontamination, particularly in terms of how to use the relevant equipment and maintain it on a day-to-day basis. This ensures team members benefit from the flexibility of being able to assume the role of cleaning and sterilizing instruments in case a problem arises – for instance, if the practice is operating under a reduced number of staff.

Staff training

It is the responsibility of the practice owner to ensure that there are systems in place to support the on-going education of the dental team in terms of decontamination. In fact, HTM 01-05 guidelines recommend that as part of verifiable ECPD, dental professionals should receive no less than five hours’ training in this area over a period of five years.i There are plenty of online ECPD courses that cover decontamination, but clinicians can also take advantage of training in-practice, which will enable them to update their skills and knowledge through a combination of theoretical and hands-on exercises. ECPD training is even available from some handpiece manufacturers.

In terms of sterilization, staff should know what kind of sterilizer is in the practice and what types of cycles the sterilizer supports. Additionally, the dental team should be familiar with how to prepare the wide range of instruments used in the practice for sterilization, paying attention to new instruments, loading configuration, lubrication, inspection, wrapping and labelling. Furthermore, staff should be educated on how to store the instruments after they have been sterilized. Having a comprehensive understanding of record management is also essential.

The sterilizer you choose for processing dental instruments will make a significant difference to the efficacy of your decontamination protocol. The preferred method of sterilizing instruments is delivering saturated steam under pressure at the highest temperature and longest holding time compatible with the instrument. For this reason, type B vacuum sterilizers are recommended, as they can also be used to sterilize hollow instruments and porous loads.

Leading manufacturer, W&H, offers a full range of top-quality autoclaves, including the Lara type B vacuum sterilizer with Eco Dry technology, which can process a typical 2kg load cycle in 38 minutes. The next generation Lisa type B vacuum sterilizer from W&H also offers intuitive connectivity and comprehensive traceability down to the individual instrument or kit via the EliTrace system. The Lisa sterilizer’s Eco Dry+ technology also reduces the cycle time – with an S class cycle time of 13 minutes, and B class cycles from 28 minutes – thus optimising energy consumption for cost-effective sterilization with each load.

Dental professionals are responsible for ensuring the safety of each other within the practice, but also the health and wellbeing of their patients. As such, it is vital that individuals maintain detailed knowledge of the key factors relating to sterilization of dental instruments.


To find out more about the products and training that W&H can offer visit, call 01727 874990 or email



[i] Department of Health. (2013) Health Technical Memorandum 01-05: Decontamination in primary care dental practices. Link: [Last accessed: 25.06.20].

LM-PerioKit available from J&S Davis

The LM-PerioKit is a carefully designed selection of periodontal instruments curated by Style Italiano and distributed by J&S Davis.

The products offer high wear resistance and a hard blade to promote efficiency, durability and comfort for the patient.

The LM-ErgoSense handle – an ergonomic, silicone design with a non-slip and natural grip – also improves the user experience and ensures good tactile sensitivity for accurate and highly effective clinical outcomes. In fact, the LM-ErgoSense handle has been rated the highest for ergonomics in studies by the Finnish Institute of Occupational Health.

The full range encompasses 8 different instruments to cater for a wide array of indications. Find out more about the LM-PerioKit from J&S Davis and optimise your periodontal therapies today.


For more information on the industry-leading products available from J&S Davis, visit, call 01438 747 344 or email

A lab-driven, minimally-invasive technique that delivered a highly aesthetic result


Jonathan Fitzpatrick is a dentist at Millersneuk Dental Practice, Glasgow with a keen interest in minimally invasive cosmetic dentistry. Here, he describes a case where restorative treatment was the culmination of an ethical and efficient plan to improve a patient’s smile.




The patient was a regular attender in his early 30s, with some abrasion, attrition and erosion on his upper anterior teeth (see Figures 1, 2). Examinations and radiographs had revealed that all was fine and in order, and that he was in good dental and oral health. 

Figure 1

Figure 2

One of the main reasons for the wear was the position of his teeth, so orthodontic treatment was provided to improve the crowding on the upper centrals, which had to be de-rotated. This had been provided using Invisalign clear aligners for around four months. Aligning the teeth also allowed me to deliver composite restorations in a minimally-invasive way. Prior to commencing the restorative portion of the treatment plan, the patient also had tooth whitening using at-home trays from Boutique Whitening.

Treatment pathway and technique


After the orthodontic and whitening treatments were complete, a full set of photos were taken and a digital scan using the TRIOS scanner. These were sent to Matrix Dental Laboratory, my preferred lab with whom I have a great relationship. The technician printed me a pre-op model (see Figures 3, 4), then a digital wax-up of what the final result would look like (see Figures 5, 6). This is fantastic from a predictability point of view and also key as a sales tool to get patient approval before going ahead.

Figure 3

Figure 4

Figure 5

Figure 6

The lab also made a clear stent which would be the template for the bonding procedure (see Figures 7,8). With the trial smile approved and the patient happy, I could then start the bonding itself using a minimally-invasive and time-efficient technique.

Figure 7

Figure 8

First, I covered every second tooth that was getting bonded with PTFE tape. Etch and bond were then applied to the alternate, uncovered teeth. The custom-made stent was filled with heated composite – I use BRILLIANT EverGlow™ universal composite from COLTENE – then cured.

When the stent was taken out, this left half the teeth treated with composite, with a bit of gross excess, which would need to be tidied up (see Figure 9). The PTFE tape was removed, put over those that already had composite on to ensure that they didn’t stick together, then the process was repeated.

Figure 9

The tidy up was completed using burs and discs. As part of my polishing protocol, I always use the blue disc from the DIATECH ShapeGuard kit (from COLTENE) last, as this gives me the highest shine.


My patient was delighted with the result (see Figure 10). I’d used a lab-driven minimally-invasive technique to deliver the composite in just one appointment – no local anaesthetic, no tooth preparation and no pain. He returned for a final polish two weeks later as I find that this gives a true high-gloss finish. 

Figure 10

My patients are always pleased with the long-term aesthetics of their restorations with BRILLIANT EverGlow™. The material has the ability to blend in and mirror the optical properties of a natural tooth extremely well, it handles fantastically, is efficiently manipulated, and also holds its shape.


To find out more visit,
email or call 01444 235486.

The obesity message: is this the trigger your patients needed?

In July, the government launched another bid to tackle the obesity problem; this wasn’t the first government-backed plan to help people lose weight and it won’t be the last. Over the last decade, across the UK, rates of obesity have been on the rise – data now classes two-thirds of adults in England as overweight and one quarter as obese, with Wales, Scotland and Northern Ireland having “nearly identical” levels.[i] This compares poorly with most other countries in Europe and it’s not just the grown-ups; a strategy to reduce levels of childhood obesity was set out in 2016.[ii] 

Of course, the reason that obesity is back in the spotlight is due to the evidence that links being overweight with serious complications, or death, from COVID-19.[iii] The UK’s weight problem has repeatedly been called a timebomb, and a threat to public health by practitioners from all disciplines. This latest drive, in the middle of a pandemic that has touched all our lives, now has a greater sense of urgency.

It’s a complex issue that is linked with social deprivation. Children and adults from deprived backgrounds are more likely to be overweight and in poorer areas there are more hospital admissions related to obesity.[iv] But wherever you live in the UK, you will see how our relationship with food has changed. Snacking, rather than stopping for three meals a day, is ingrained in modern food culture. All of us can relate to quickly grabbing something delicious and made from pastry in a break, rather than sitting down to a more balanced lunch. Time is a precious commodity when it comes to exercise too and good intentions to walk to work are scuppered if we’re running late and forced to take the car instead.

The government’s latest drive, named Better Health, isn’t just about educating people to make informed choices by displaying calorie counts on menus. It also wants to end ‘buy-one-get-one-free’ deals on unhealthy foods and ban TV/online ads for the same, before 9pm (presumably so they’re out of sight, out of mind for younger viewers). But how will this work, with the season for eating, drinking and making merry on the horizon? We’re all crossing everything for a peaceful festive period – a happy Christmas is the least 2020 owes us – while acknowledging that preparations for a worst-case winter scenario have been underway since the summer. Prevention and mitigation are essential to the challenges ahead and Better Health is a key component of the government’s forward planning.[v]

Previous attempts tell us that there are always problems with implementing a plan like Better Health. This goes back to the complexity of the obesity issue. Low-cost supermarkets are full of fresh fruit, veg, fish and lean meat but you can also pick up high-fat, high-sugar options, plus fizzy drinks and alcohol very cheaply too. You can’t turn a corner in most towns without encountering a fast-food outlet – for one of the biggest chains, its TV campaign to announce its restaurants were reopening featured relieved customers tucking in. Will the lack of pre-watershed advertising really put anyone off?

It’s a careful line to tread. For dental practitioners, we know the ongoing controversy around the Sugar Tax, including whether or not it has actually changed behaviours. Will your patients who need to lose weight respond positively if they feel that they are being lectured at, yet again? Doubtful. Will they respond if they are given pragmatic, sensible advice which, if they act on it, will help them feel better about themselves? Hopefully, yes. Staying in good health can reduce the risk of developing many serious, life-limiting diseases and everyone has long known this. Coronavirus could be the trigger for patients to now want to lose weight (the Prime Minister said it was for him), but for new habits to stick, they have to be achievable. For example, a healthy eating plan can often mean eating more, which is a message that you might feel is easier to deliver. If they never eat breakfast, challenge them to a week of eating something quick, yet nutritious in the morning, like peanut butter on wholemeal toast. It’ll fill them up and prevent mid-morning snacking. Small changes, big impact. Ask them to move a bit more, have a few less “treats” (or swap treats for a non-edible one, like a long bath) and to enjoy taking good care of themselves. This includes effective daily tooth brushing with quality tools, such as the TANDEX range – the feeling of a really clean mouth can be a revelation.

This has been a tough year, and self-care and kindness will be essential to get us through the next chapter, whatever it may be. Being in better health is the best preventive strategy there is. Support your patients to make whatever changes they need to, so they really want to improve their quality of life. 

For more information on Tandex’s range of products,
visit or visit the Facebook page


Author Kimberley Lloyd- Rees on behalf of Tandex

Kimberley graduated from the University of Sheffield in 2010, where she now works as a clinical tutor in Dental Hygiene and Therapy as well as working in practice. She has spent her career working across a variety of specialist private and mixed dental practices, for the MOD and volunteering her time to a dental charity in Nepal.


[i] How bad is our obesity problem? BBC, 25 July 2020. Link: (accessed July 2020).

[ii] Childhood obesity: a plan for action., published 18 August 2016. Link: (accessed July 2020).

[iii] New obesity strategy unveiled as country urged to lose weight to beat coronavirus (COVID-19) and protect the NHS. Press release from, published 27 July 2020. Link: (accessed July 2020)

[iv] BBC, 25 July 2020.

[v] Preparing for a challenging winter 2020/21. The Academy of Medical Sciences, 14 July 2020. Link to report: (accessed July 2020).

Convenient for all

Image acquisition needs to be swift, accurate and convenient.

Don’t settle for less than the CS 8100 3D Evo Edition CBCT system from Carestream Dental.

Its innovative Tomosharp technology and advanced image processing capabilities ensure exceptional image sharpness, whilst the open, face-to-face design helps encourage increased patient comfort.

Couple these features with ultra-fast scanning times (7 seconds) and the unit’s compact size and ergonomic functionality, and you can see why the CS 8100 3D Evo Edition is a convenient choice for practitioners and patients alike.

Find out more today.


For more information, contact Carestream Dental on 0800 169 9692 or


For the latest news and updates, follow us on Twitter @CarestreamDentl

and Facebook

Long-term temporary solutions you can trust

3M Oral Care offers an array of clinically proven products you can rely on for quality, durability and stability. These include the Cavit Temporary Filling Materials from 3M.

Cavit Temporary Filling Materials from 3M provide solutions for various temporary situations. The delivery mechanisms have been adapted to make application faster and more efficient in different clinical indications, so both bottles and tubes are now available.

Cavit Temporary Filling Materials from 3M are easy to place with filling instruments and designed to create void-free curing in a moist environment.

For confidence in the longevity of your restorations, even in temporary situations, work with solutions from 3M Oral Care.


For more information, call 08705 360 036 or visit




3M and Cavit are trademarks of the 3M Company

Supporting breast cancer patients

Breast cancer is the most common cancer in the UK and primarily affects women. Of the 55,000 women diagnosed with this disease every year, one out of 10 are aged 50 and over. Although breast cancer survival rates continue to improve and have doubled in the past 40 years, many women still die from the disease annually.[i] For those who survive it, the long-lasting physical and mental effects of breast cancer can, understandably, be overwhelming.

Despite these risks, a large proportion of women in the UK fail to check their breasts regularly for signs and symptoms of cancer. This method of identifying the disease is vital considering around two thirds of breast cancer cases are found by women noticing unusual changes in their breasts and checking it with their doctor. Research led by Breast Cancer Now in 2018 found that just 48% of British women surveyed were frequently checking their breasts for cancer, while almost one in 10 had never checked at all.[ii]

The earlier the disease is detected, the quicker treatment can be provided and is more likely to be successful. For this reason, dental professionals should take steps where possible to educate patients on the importance of regularly checking their breasts for any abnormalities. This is particularly important given the detrimental consequences of breast cancer on general and oral health, especially for patients undergoing treatment for this debilitating illness.

The oral health impact

Breast cancer treatments such as chemotherapy and radiotherapy can result in adverse oral side effects. These include pain, oral/pharyngeal mucosistis, xerostomia, and dental caries. Patients who are being treated for breast cancer can also develop opportunistic bacterial, fungal and viral infections as a result of chemotherapy-induced immune suppression. Furthermore, these patients are at increased risk of complications such as gingivitis and periodontitis, which can result in tooth loss.[iii] 

Having a comprehensive understanding of how breast cancer therapies can impact oral health is essential. Often, dental hygienists and dental therapists will become a key dental care provider for a breast cancer patient, perhaps seeing the patient more regularly than their dentist. Of course, the entire dental team will need to co-ordinate with allied healthcare professionals in order to help manage the effects of breast cancer and its associated therapies on the patient’s oral condition.

Ideally, patients should be examined and their teeth and gums thoroughly cleaned prior to treatment for breast cancer. A detailed dental treatment plan should then be drawn up that includes oral hygiene strategies that may change throughout the stages of breast cancer therapy. Dental professionals play an important role in educating the patient about appropriate nutritional intake, early detection of any potential complications (e.g. oral lesions), and following effective at-home oral care.[iv]

Fighting back

In light of Breast Cancer Awareness Month, we are reminded that we have a duty of care to help patients fight back against potentially life-threatening illnesses. Thankfully, advances in patient care and treatment of breast cancer, combined with earlier detection and faster diagnosis, means the chances of patients beating the disease continues to improve. As a result, almost nine in 10 women survive following a breast cancer diagnosis for five years or more.i Being able to make a difference in a cancer patient’s life is ultimately worth every bit of support that we can provide.


For more information about the BSDHT, please visit, call 01788 575050 or email



[i] Breast Cancer Now. (2020) Facts and statistics 2020. Link: [Last accessed: 30.06.20].

[ii] Breast Cancer Now. (2018) Just 48% of British women regularly check their breasts for signs of cancer, despite rising incidence. Link: [Last accessed: 30.06.20].

[iii] Taichman, L. S., Gomez, G. and Inglehart, M. R. (2014) Oral health-related complications of breast cancer treatment: assessing dental hygienists’ knowledge and professional practice. Journal of Dental Hygiene. 88(2): 100-113. Link:,women%20undergoing%20breast%20cancer%20therapy.&text=As%20prevention%20specialists%2C%20dental%20hygienists,undergoing%20therapy%20for%20breast%20cancer. [Last accessed: 30.06.20].

[iv] Taichman, S. (2016) Oral Health Maintenance for Patients With Breast Cancer. Decisions in Dentistry. Link: [Last accessed: 30.06.20].

Keep up-to-date

Staying abreast of the current trends in cosmetic dentistry is essential if practitioners are to continue delivering on patient demands and expectations.

The BACD encourages clinicians to build on their knowledge and skills through a wide range of educational programmes. These enable you to keep up-to-date with the latest techniques, concepts and technologies.

With a commitment to facilitating professional development among its members, the Academy also offers the opportunity to join its prestigious Accreditation Programme. If completed, BACD Accreditation serves as a unique accolade, demonstrating that successful candidates can deliver consistently high quality cosmetic dental treatment.

Visit the BACD website to find out how you can become a member today.


For further enquiries about the British Academy of Cosmetic Dentistry, visit

No better time to make a financial forecast for your practice

Before the pandemic struck, you may have had big plans for your practice’s growth and development, but you shouldn’t think that these will automatically need to be put on hold. That’s where financial forecasting comes in.

A question of data

Good forecasting is a question of data – gathering as much financial data as possible about your practice(s), as well as local and national market conditions, so you can make predictions that allow you to plan and give you space to make swift decisions should circumstances, either external or internal, change again.

When you have information, this means peace of mind, a benchmark to aim for and a solid basis for analysis. You can pinpoint past trends – was X treatment more profitable than Y? – and act on them, if necessary. Your practice might even outperform existing financial predictions. Perhaps you were too conservative in your estimation of how many patients would come back or commence a certain kind of treatment. If there is more demand than you expect, you will need to ensure you can cover all the related costs – materials, lab fees, clinician’s fees, etc.

Focus on your unique circumstances

Financial forecasting allows you to stay in control. Doing a financial forecast now means you can be better prepared should the unthinkable happen again. The suspension of routine services left some practices more vulnerable than others, which is why it’s important to not only be guided by the wider context, but also consider the individual, unique circumstances of your business. Focus on you, where you are now and where you would like to be, using the data available.

At Lansdell & Rose we can support you in setting realistic financial goals and help you to achieve them. We review how your finances are organised and possibly suggest how to improve cashflow – could you make changes to make your business more tax efficient, for example? Tailored advice is crucial here – not least because the media is fond of making blanket headlines that a) do not tell the whole story and b) do not apply to everyone. As a team of specialist dental accountants with years of experience and insight, any advice we give you will be specific to you, so you can pick up where you left off and continue to thrive.


For more information please visit
or call Lansdell & Rose on 020 7376 9333.

Return to practice with confidence

Like many dentists, Dr Daniel Caga regularly wears loupes as part of everyday practice. He explains how he was able to continue using dental loupes during the COVID-19 pandemic with the aid of the Nuview Headband Visor System:  

“I started wearing loupes during the third year of my BDS qualification, so I’ve been using them for most of my practising life. When I qualified as a dentist and moved to my current practice, I wanted a pair of loupes with a higher magnification. After several discussions with friends and having researched and trialled various loupe brands, I purchased a pair of 4.3x magnification Carl Zeiss EyeMag Pro headband loupes from Nuview.

“Naturally, I had become accustomed to using these loupes prior to the pandemic and I wanted to continue using them following my return to work. However, with the increased need for PPE, I became quite concerned that I would not find a visor that would fit with my headband loupes. This would mean that I would either need to work without loupes – something I avoid wherever possible ­– or I would have to buy a new pair of loupes, which I wasn’t keen on doing either.

“I contacted John Woods at Nuview, who reassured me that they were working on a new visor set-up for loupes. This was a great relief because I knew the team would create a very useful, carefully designed product that would be fit for purpose.

“As with the EyeMag Pro, I am very impressed with the Nuview Headband Visor System. Simple to install and use, it protects the clinician from splatter very well. It also effectively accommodates the positioning and ergonomics of the loupes and the light, whilst enabling easy adjustment. I’ve had no issues with this set up so far. The price of this visor system has been very well considered, which reassures me that I am working with an excellent company – one that is not simply focused on profit. I didn’t feel taken advantage of just because I needed this product.

“Moreover, I am extremely impressed with the clarity of the loupes through the visor. In my opinion, the EyeMag Pro still provides the best optics on the market compared to other brands. The headband makes the EyeMag Pro very stable without feeling heavy on the neck.”

The Nuview Headband Visor System enables Dr Caga to continue providing dental treatment to the best of his abilities, as he comments:

“I feel confident in treating patients even with all the extra PPE I have on, simply because I still have a fantastic view of the operative site. Having known me for some time at the practice, my patients are fully aware that I use EyeMag Pro loupes. Therefore, seeing me still wearing the loupes reassures them that I have invested in the appropriate PPE to protect myself and my patients, thus maintaining the same high clinical standards.”

Reflecting on the service he received from Nuview, Dr Caga adds: “As always, the service – including the aftersales support – provided by John and the Nuview team has been outstanding. They are always easy to contact, replying quickly to text messages and emails. I placed my order on the same day that I received an email notifying me that the Nuview Headband Visor System was released. I then received the equipment the following day. You cannot beat that kind of service. As such, I will continue doing business with Nuview throughout my career.

“I discuss the use of magnification equipment with all my colleagues and there are many posts on social media about dental loupes. I always promote Nuview and the loupes the team supply, so I will naturally endorse the Nuview Headband Visor System.

“Given the quality of Carl Zeiss loupes – especially in terms of optics and field of view – as well as the fantastic aftersales support provided by Nuview, I feel there is simply nowhere else to go for your loupes and headband visor. I would like to thank the team at Nuview for delivering a very useful product that is simple but very effective to use. The Nuview Headband Visor System has made my return to clinical dentistry during the pandemic more relaxed and enjoyable.”

Experience the benefits of this unique solution for yourself – contact Nuview to order your Starter Kit now.  


For more information please call Nuview on 01453 872266, email, visit or ‘like’ Nuview on Facebook.