Dental Health // Category

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15 Jun

British adults don’t have time to brush their teeth twice a day, a survey from the Oral Health Foundation shows.

One in five (22%) regularly miss brushing their teeth in the morning because they are running late.

And one in four (25%) skip brushing their teeth at night because they get home too late.

‘It would be easy to suggest these findings represent the demands of 21st century life,’ chief executive of the Oral Health Foundation, Dr Nigel Carter OBE, said.

‘But there really is no defence for overlooking your health.

‘The health of your teeth plays an extremely important role in your overall wellbeing.

‘Additionally, your teeth help you to chew and digest food.

‘A healthy smile can be a great asset; and because of this, it makes sense to give your teeth the best care possible.’

Top excuses

Running out of toothpaste (12%), watching television (7%) and pre-occupied by a mobile (7%) were the other top excuses.

The poll also shows men are less likely to brush their teeth than women.

Men are more than twice as likely to blame partners for distracting them, and more likely to blame work commitments.

‘The first key to improving your oral health is to visit the dentist,’ Dr Ben Atkins, dentist and trustee of the Oral Health Foundation, said.

‘By doing this regularly, you can give your mouth a clean bill of health, as well as help prevent wider issues such as heart disease and diabetes.

‘The second habit we would like everybody to adopt is brushing your teeth with an electric toothbrush.

‘The final habit is following a healthy diet.’

Brushing teeth ‘essential everyday activity’

Only 73% of people brush their teeth twice a day or more and 33% claim they never floss.

That’s according to the latest Simplyhealth Consumer Oral Health Survey launched recently at an event in London.

Women care for their oral health more than men, with 77% of women brushing twice a day, compared with 69% of men.

‘With busy lifestyles, it’s tempting to skip brushing or flossing, or delay visits to the dentist,’ Dr Catherine Rutland, head of professional support services at Simplyhealth Professionals, said.

‘A good oral health routine is an essential everyday activity that helps to protect against tooth decay and gum disease.

‘Moreover, studies are increasingly finding links between oral health and common conditions.

‘So further education for dental patients in this area is certainly needed.

‘It’s important for everyone to start thinking about how their oral health might impact on their general wellbeing.

‘This is especially significant if you’ve been diagnosed with a serious health condition, or if you’re at high risk of developing one.’


Related stories:

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15 Jun

With an environmental crisis on the horizon, is it time our regulators changed too, Neel Kothari asks.

The influential economist, John Maynard Keynes, was asked by a journalist why he had changed his mind over the years, to which he reportedly replied: ‘When the facts change, I change my mind, what do you do, sir?’

When the introduction of the CQC and HTM01-05 occurred almost 10 years ago, the world hadn’t yet woken up to the environmental crisis posed by plastic pollution.

The dental profession faced an uphill struggle with the guidance, which had the same appeal as reading software terms and conditions.

Whilst I could whinge on about the regulatory burden that was imposed upon us with much the same passion as the 48% who voted remain, let me focus on the impact of some of the changes that it brought about.

Suddenly dentistry had a new measure of quality, one that was linked not to patient outcomes, but rather to how well a practice complied with a strict set of rules that many felt lacked sound evidence.

These included the abandonment of many items that were disinfected or sterilised between patient use and their subsequent replacement with single-use plastic items.

‘Drop in the ocean’

For those feeling good about recycling the odd bit at home, this is simply a ‘drop in the ocean’ compared with the waste we generate during our working lives (pun intended).

Although clinical waste is incinerated, the environmental impact of single-use plastics extends far beyond its disposal, with all parts of the lifecycle, including production and distribution, carrying an environmental burden.

The question is, do the theoretical benefits of single-use plastics (often non-sterile at the point of use) outweigh the very real environmental crisis that we as an industry are contributing to?

Many forward-thinking practices are now asking what they can do to cut down their waste, whether it’s through a genuine passion for protecting the environment or simply as a way to communicate to their patients that they are environmentally conscious.

Whilst I don’t think banning single-use plastics is anywhere near a reality with today’s regulatory burdens, the momentum is certainly growing and dentistry in the UK really ought to be making itself heard about this issue and asking our regulators to show forward thinking and help the profession take the lead on this increasingly important issue.

This is certainly not a dig at the CQC, but a realisation that 10 years ago we simply didn’t know or didn’t care about how serious this issue would become.

It was all too easy for those deciding policy to suggest ‘improvements’ without considering the environmental costs incurred.

The facts have certainly changed and now it’s time for us to do the same.


Read more from Neel Kothari:

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15 Jun

Costech introduces its Monolith Adjustment & Polishing Kit, with a special offer on the first 50 kits sold.

Full zirconia restorations have all but revolutionised aesthetics in modern dentistry. Echoing the translucency and appearance of natural dentition, the material also offers good strength and biocompatibility, making it a favourable choice for patients and professionals alike. However, these same unique properties mean extra care needs to be taken when adjusting, polishing and cementing zirconia to ensure longevity of the restoration.

To aid our clients, we have developed the Monolith Adjustment & Polishing Kit, which will be available from the 21 June. The kits will go on sale at £149.95 but we are offering the first 50 kits at a discounted preorder rate of just £99.95 on a first come, first serve basis.

Adjusting monolith

The Monolith Adjustment & Polishing Kit comes with seven rotaries in an autoclavable storage case. There are two adjustment burs, two pre-polishers and two mirror-finish polishers. There is also a straight parallel bur to be used in the event a monolith restoration has to be removed.

Solid zirconia is easy to adjust and polish with the new kit so long as you follow these steps:

  • Use lots of water and air with the fine grit diamond burs to reduce the build-up of heat
  • Using the fine grit adjustment burs, use intermittent light pressure on and off the zirconia. This reduces the risk of microfractures, which could compromise the restoration
  • The football-shaped bur is ideal for adjusting occlusion and recontouring anatomy
  • Use the tapered bur for adjusting interproximal contacts.

Post adjustment polishing

After any adjustment takes place, the adjusted area must be polished. Unpolished zirconia is highly abrasive and will rapidly wear opposing natural dentition.

When polishing use light to medium pressure with no water and start with the brick red polishers as a pre-polish to remove any coarse bur marks left after adjustment, then use the green/yellow polishers to achieve a high lustre mirror finish.

Choose your cement

The chemical make-up of your dental cement can have a significant impact on how well it bonds to certain materials. Although the majority of cements are capable of bonding well with a vast array of restorative materials, professionals need to be wary of any cements that have phosphates or phosphoric acid as an ingredient when placing zirconia.

These phosphates are present in a wide selection of dental cement and adhesives, usually under the guise of 10-MDP (10-methacryloyloxydecyl dihydrogen phosphate). These can inhibit bond efficacy with zirconia restorations, potentially increasing the risk of the crowns to detach over time (Nagaoka et al, 2017). As such, we recommend you use a resin-modified glass ionomer cement, these products are typically free from phosphates and are able to achieve the desired bond.


We expect to start shipping the new Adjustment & Polishing Kits from 21 June with the first 50 being sold at the preorder price of £99.95. We’re taking orders now so call us on 01474 320 076 or email [email protected] to get your discount locked in.

For more information regarding monolith, sign up for a full monolith pack at www.costech.co.uk/Monolith.

References

Nagaoka N, Yoshihara K, Feitosa V, Irie M, Yoshida Y, Van Merbeek B and Hayakawa S (2017) Chemical interaction mechanism of 10-MDP with zirconia. Sci Rep 7: 1038/srep45563

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15 Jun

Missed out on this week’s dental news? No problem, here’s what happened over the past seven days…

Dental profession supports local authorities taking water fluoridation forward

The national conference of Local Dental Committees wis supporting community water fluoridation in areas of need.

At last week’s conference, a motion applauding those local authorities taking forward water fluoridation was approved unanimously.

The vote is an important milestone for the newly formed Community Water Fluoridation network.

Local Dental Committee members have provided the impetus for the network which is supported by a wide range of dental, medical, child and health-related organisations.

In 2016-17, more than 42,000 hospital admissions in England were for the extraction of decayed teeth, mostly in very young children, who cannot be treated in general practice, costing more than £50m.

Areas where water is not fluoridated have a disproportionately higher number of children suffering from dental decay.

A quarter of Brits share their toothbrushes

Despite it being bad news for their health, 26% of British people willingly share their toothbrush with others.

The research, which was commissioned by the Oral Health Foundation and Philips as part of National Smile Month, found that more than a quarter of the population admit they would share their toothbrush with a family member, friend, partner, neighbour or celebrity.

The poll found that men are significantly more likely to allow somebody else to borrow their toothbrush (32%) than women are (20%).

Younger adults are also nearly twice as willing to share their toothbrush (55%) compared to their parents (30%), and around four times more open to do so than their grandparents (13%).

Brits blame hectic schedules for being unable to brush their teeth

brushing

British adults don’t have time to brush their teeth twice a day, a survey from the Oral Health Foundation shows.

One in five (22%) regularly miss brushing their teeth in the morning because they are running late.

And one in four (25%) skip brushing their teeth at night because they get home too late.

Running out of toothpaste (12%), watching television (7%) and pre-occupied by a mobile (7%) were the other top excuses.

The poll also shows men are less likely to brush their teeth than women.

Men are more than twice as likely to blame partners for distracting them, and more likely to blame work commitments.

Should we ban single-use plastics in dentistry?

plastics

With an environmental crisis on the horizon, is it time our regulators changed too, Neel Kothari asks.

This is certainly not a dig at the CQC, but a realisation that 10 years ago we simply didn’t know or didn’t care about how serious this issue would become, Neel says.

It was all too easy for those deciding policy to suggest ‘improvements’ without considering the environmental costs incurred.

The facts have certainly changed and now it’s time for us to do the same.

Snowflakes could explain how tooth enamel is formed

Researchers have used the way that snowflakes form to explain how tooth enamel gets distributed over the crown during growth.

Physicists and mathematicians use the classical ‘Stefan problem’ to explain the principles of crystal formation, such as snowflakes.

The newly published work provides a theoretical basis for the developmental regulation of enamel formation, and helps to uncover why even closely-related species such as humans and have very different looking teeth.

Tooth enamel matrix is soft when freshly laid down but it starts to harden immediately and once mature.

Enamel is the most mineralised and hardest part of the mammalian body.

The researchers at the University of Helsinki and Aalto University propose that differences in enamel thickness are regulated by the nutrient diffusion rate – the rate that individual regions on a crown receive the required nutrients and substances needed to make the enamel.

Are a lack of funds stopping dental practice development?

Aileen Boyle sheds light on some of the dental sector’s thoughts on the future, which is based on research Braemar Finance commissioned in April.

She also explains more about Braemar’s products, which can be used to help business growth.

Eric Rooney says why you should come to the London Dentistry Show

Three quarters of health and social work firms are family businesses

Three quarters of businesses in the health and social work sector are family owned, a new report shows.

Making up a sizeable contribution to the UK economy, these family-owned businesses employ almost 900,000 people.

There are 272,000 family-owned businesses in the sector, making up 75% of all private sector firms.

Family businesses contributed £598 billion to UK GDP in 2017, making up 28% of the whole UK economy.

Across the UK, family firms have increased their employee headcount when compared to a year ago.

The report also shows family owned SMEs are more likely to have female leaders (81%), compared with non-family owned SMEs (58%).

Do you know what corporate social responsibility looks like in a dental practice?

CSR

Do you struggle to implement a manageable CSR plan in your practice, Mark Topley asks.

To help dentists to navigate the challenges of responding to the need to be more socially and environmentally responsible, Mark Topley is running a national survey across the profession to ascertain what practices are currently doing in the areas of CSR.

You can fill in the survey here: www.dentistry.co.uk/2019/06/12/know-corporate-social-responsibility-looks-like-dental-practice.

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14 Jun

Ensuring patients’ teeth and gums (90%) are healthy is the most important value when choosing a dentist, research shows.

The Consumer Oral Health Survey 2019 from Simplyhealth Professionals asked patients what they look for when choosing a dental practice.

Confidence the surgery is sterile and hygienic (90%) was joint first, with trust in my dentist (89%) just behind.

‘Our data trends show that confidence in surgery hygiene, ensuring the health of teeth and gums and trust in their dentist continue to be the most important factors to patients for a sixth year,’ Dr Catherine Rutland, head of professional support services at Simplyhealth Professionals, said.

‘Interestingly, the desire for cosmetic treatments has risen by 80% year on year.

‘These valuable insights are helpful to tailor services and patient communications.’

Rise in cosmetics

Offering cosmetic treatments (38%) is now listed as one of the top values patients look for when choosing their dentist.

Almost half of patients (42%) value awards and accreditations the practice has won.

The rest of the results show:

  • 90% – confidence that the surgery is sterile and hygienic
  • 90% – the dentist will ensure the health of my teeth and gums
  • 89% – trust in my dentist
  • 88% – treatments and procedures are explained clearly
  • 87% – good customer service
  • 87% – being seen quickly in an emergency
  • 84% – convenience of appointment times
  • 84% – being seen on time for appointments
  • 82% – convenience of practice location
  • 82% – steps to maintain oral health between appointments are clearly communicated
  • 81% – value for money
  • 79% – reputation/recommendation of practice
  • 50% – they offer a range of payment options
  • 42% – quality awards and accreditations
  • 38% – they offer cosmetic treatments
  • 34% – they offer cosmetic non-dental treatments.

‘As cosmetic dentistry is on the rise, it is important for dentists to continue to evolve with their patients,’ Dr Rutland continued.

Satisfied patients

The survey shows 85% of adults that visit the dentist regularly are satisfied with the dental care they receive.

This rises to 93% for those patients on a dental plan.

‘It is reassuring that a high percentage of patients are satisfied with the dental care they receive,’ Dr Rutland concluded.

‘Particularly, 87% of adults aged 55 and over were satisfied which was the highest of all age groups monitored.’


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14 Jun

Jayne Gibson asks to hear your views on the sustainability of goodwill values in dentistry.

With NHS goodwill values almost halving in the six months up to January 2019, many practice owners may be wondering whether contract reform will improve or deteriorate the situation.

In July 2018, NHS goodwill values were 224% of gross fees, but they dropped to 177% by October and 118% by January 2019, according to figures from NASDAL.

Private practices saw their average goodwill value bounce back to 127% in the quarter leading up to January 2019, while mixed practices stayed steady.

Alan Suggett, specialist dental accountant and partner in UNW LLP who compiles the goodwill survey, commented: ‘The fact that NHS practice values have now seen three consecutive quarters of reduction in value, does seem to suggest that it is now potentially a trend rather than a blip.

‘Perhaps in these particularly politically uncertain times, what once looked like a safe, long-term bet is less attractive?

‘Government backed promises are not what they were.

‘Valuations have stayed quite steady for the last year and it seems the market is less turbulent than it was a couple of years ago.’

Goodwill changes

With contract reform due to begin rollout within a matter of months, practice owners may well be wondering what kind of effect the changes may have on their goodwill value.

To gauge the feelings of the profession about the sustainability of goodwill value and in light of the contract reform proposals, Practice Plan is asking NHS and private dentists to complete its Dentistry Confidence Monitor survey.

Along with questions about the future, in terms of dentistry and their own careers, the survey also asks dentists about the GDC, mental health and other aspects of practising today.

Take the survey here.


Related stories:

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13 Jun

As non-surgical facial aesthetic treatments continue to rise in popularity, Harry Singh considers the possible risks and complications, and how to steer clear of them

As health professionals, dentists are committed to providing the highest level of care and work hard to keep their patients safe. Even then, there are potential risks and complications when it comes to administering facial aesthetic treatments, something we must be vigilant about.

As always, informed consent is key, and I suggest using the Montgomery consent process rather than Bolam, individualising your explanations to the patient and areas being treated. Share all the common side effects, such as swelling, bruising and lumps, and let the patient know that certain areas of face are more high risk, such as the temple and tear troughs.

Following treatment, clinicians should make themselves available and ensure the patient knows how to make contact, including out of hours. Normal advice can be given over phone, but, if you have any doubts whatsoever, see the patient as soon as possible. The good news is most side effects are temporary and short-lived.

Botulinum toxin

Botulinum toxin is one of the most popular non-surgical facial aesthetic treatments, with the BBC reporting around 100,000 injections are carried out each year. Meanwhile, Saveface, a professional standards authority, indicated in 2017-18 there were 224 complaints made by patients concerning their botulinum toxin treatment. Yes, this represents a relatively small percentage, but the truth is, that’s 224 complaints too many.

With botulinum toxin, the more common problems that can arise include:

  • Raised eyebrows – caused by under-treating the frontalis
  • Eyebrow ptosis – caused by over-treating the frontalis or under-treating the glabellar complex
  • Eyelid ptosis – caused by an unwanted spread of toxin downwards
  • Wonky smile – caused by over-treating laughter lines, especially too low down
  • Bruising – caused by injecting into a blood vessel.

When we know the possible pitfalls, we can, of course, take steps to avoid them. Taking each of the above in turn, it is simple to ensure we don’t fall into the trap many unregistered practitioners practically dive into.

Consider the following:

  • Raised eyebrows – treat the lateral aspects of the frontalis
  • Eyebrow ptosis – under-treat the frontalis and make sure all muscles are treated in the glabellar complex
  •  Eyelid ptosis – create a finger block on the orbital rim to prevent downward diffusion and tell the patient not to exercise for 24 hours
  • Wonky smile – do not inject too low down and baby-step your dosages in this area
  • Bruising – never inject into a blood vessel.

Dermal fillers

Alongside botulinum toxin, dermal fillers are the most popular non-surgical facial aesthetic treatments in the UK. Like botulinum toxin, in the right hands excellent results can be achieved, but there remains the possibility of complications:

  • Lumps – caused by injecting at too superficial a level and administering too much, too fast
  • Bruising – caused by injecting into blood vessel
  • Vascular occlusion – caused by injecting too much filler into or next to a blood vessel, resulting in compression of the blood vessel. This leads to a restricted blood supply to the skin and, in rare cases, tissue necrosis.

To avoid these problems, make sure you are at the right depth, using a suitable particle-sized product, inject small quantities, administer the filler slowly and, to avoid bruising, use cannulas.

As for vascular occlusion, it is essential you know how to reconstitute Hyalase and are able to administer it. Where vascular occlusion is suspected, treat with Hyalase and then refer to a specialist for follow-up care, if needed.

While on the subject of Hyalase, it is essential to have a ‘filler crash kit’. Treat it on a par with a medical emergency kit. Contents should include:

  • Hyalase
  • Saline
  • Needles
  • Antibacterial cream
  • LMX4 cream
  • Arnica cream
  • Corticosteroids
  • Antibiotics.

A practical approach

All the risks and complications associated with non-surgical facial aesthetics can be assessed and avoided by:

  • Understanding the anatomy
  • Baby-stepping – for example, under-dosing
  • Injecting slowly and in small quantities
  • Injecting at the right depth
  • Using cannulas.

Beyond the clinical aspects of treatment, keeping excellent notes is incredibly important should a patient decide to make a complaint. You want to detail everything said and done, the complication, your differential diagnosis, your treatment plan and follow-up care.

To secure the well-being of your patients and the reputation of your practice, make sure you have dotted the ‘i’s and crossed the ‘t’s, both clinically and administratively.


To find out more about how you can build more profit for your practice through facial aesthetics, visit www.botulinumtoxinclub.co.uk, email
[email protected] or call 0800 047 2038.

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13 Jun

Braemar Finance has been working with dentists for many years and in this column, Aileen Boyle sheds light on some of the dental sector’s thoughts on the future, which is based on research Braemar Finance commissioned in April. She also explains more about Braemar’s products, which can be used to help business growth.

Dentists in the UK are, in the main, positive about their business prospects over the coming 12 months but standing in the way of growth is a perceived lack of funds to develop the business in the way they want, according to new research from Braemar Finance.

Nearly three in every five (56%) dentists expect their business to perform as it did in the previous 12 months, with 25% hoping to expand their operations. The remaining 19% anticipate their practices will either contract or close entirely.

When asked the question ‘from a competitive point of view, what are your main business concerns?’, the lack of funds to develop the business in the way they would like was cited nearly twice as often as the next option, ‘corporate dominance’.

These findings are more or less in line with those of the professions sectors as a whole and while, on the face of it, the lack of access to funds could be interpreted as an unexpected finding, particularly since the dental market has been described as a ‘green light’ sector and is currently relatively buoyant.

However, many practices are reluctant to look at funding options to stimulate growth and rely instead on savings. For example, some dentists don’t want to consider refinancing their existing debt because they’re worried about being switched to a higher rate.

While these are understandable concerns, they don’t necessarily reflect the true state of the funding market, particularly since there are so many varied and affordable options available today.

Patient finance

Our online patient finance facility is an easy-to-use online solution that offers your patients manageable monthly payments to fund their treatment plans or the procedures they need.

The application can be completed online by your patient either in your practice or at home at a time that suits them, with a decision received within seconds.

Tax loans

Our unsecured tax loans permit you to spread the cost of your tax demand into more affordable monthly payments.

Business loans

Our unsecured business loans are available to assist when you need to borrow funds to invest in your business.

Consolidation and refinancing loans

If you have several existing agreements, a consolidation loan may be the way forward because it would combine your monthly payments over a term that suits you.

Personal loans

Personal loans are unsecured and can be used for virtually any purpose other than the purchase of property.

Hire purchase

Hire purchase allows outright ownership of the asset and enables you to spread the cost over a term that suits you.

Leasing

If you want to maximise the use of your equipment without the responsibility of owning it, leasing will give you the freedom and flexibility you need.

Finance approval subject to status.


For more information on how Braemar Finance can help grow your business visit www.braemarfinance.co.uk/dental or call a member of the team on 01563 897 545 who will be happy to help.

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