People with periodontitis have a greater likelihood of high blood pressure (hypertension), according to a recent study published by scientists at UCL Eastman Dental Institute
The study was published in Cardiovascular Research, a journal of the European Society of Cardiology (ESC).
Senior author Professor Francesco D’Aiuto of UCL Eastman Dental Institute, UK, said: ‘We observed a linear association – the more severe periodontitis is, the higher the probability of hypertension.
‘The findings suggest that patients with gum disease should be informed of their risk and given advice on lifestyle changes to prevent high blood pressure such as exercise and a healthy diet.’
High blood pressure affects 30–45% of adults and is the leading global cause of premature death, while periodontitis affects more than 50% of the world’s population.
The driver of the heart attack
Hypertension is the main preventable cause of cardiovascular disease, and periodontitis has been linked with increased risk of heart attack and stroke.
Professor D’Aiuto added: ‘Hypertension could be the driver of heart attack and stroke in patients with periodontitis.
‘Previous research suggests a connection between periodontitis and hypertension and that dental treatment might improve blood pressure, but to date the findings are inconclusive.’
A total of 81 studies from 26 countries were included in the meta-analysis and moderate-to-severe periodontitis was associated with a 22% raised risk for hypertension, while severe periodontitis was linked with 49% higher odds of hypertension.
Lead author Dr Eva Munoz Aguilera of UCL Eastman Dental Institute said: ‘We observed a positive linear relationship, with the hazard of high blood pressure rising as gum disease became more severe.’
Average arterial blood pressure was higher in patients with periodontitis compared to those without.
This amounted to 4.5 mmHg higher systolic and 2 mmHg higher diastolic blood pressures.
Professor D’Aiuto said: ‘There seems to be a continuum between oral health and blood pressure which exists in healthy and diseased states.
The evidence suggesting periodontal therapy could reduce blood pressure remains inconclusive.
In nearly all intervention studies, blood pressure was not the primary outcome.
Randomised trials are needed to determine the impact of periodontal therapy on blood pressure.’
Regarding potential reasons for the connection between the conditions, gum disease and the associated oral bacteria lead to inflammation throughout the body, which affects blood vessel function.
Common genetic susceptibility could also play a role, along with shared risk factors such as smoking and obesity.
Professor D’Aiuto said: ‘Further research is needed to examine whether patients with high blood pressure have a raised likelihood of gum disease.
‘It seems prudent to provide oral health advice to those with hypertension.’
Aguilera EM, Suvan J, Buti J, et al. Periodontitis is associated with hypertension. A systematic review and meta-analysis. Cardiovasc Res. 2019.
2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39:3021–3104. doi:10.1093/eurheartj/ehy339.
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Snowbird Finance Ltd are pleased to announce the appointment of Kevin Green as business development director.
Kevin brings with him a wealth of knowledge and experience from the finance world and has held various senior roles within several global brands such as Dell, Netapp, Apple and Grenke Leasing.
In these roles, Kevin was instrumental in developing bespoke finance schemes and sales plans as well as training sales teams to effectively offer finance solutions to their clients.
A strategic part of Kevin’s role will be to offer equipment manufacturers and dealers with structured, flexible finance solutions enabling them to meet their business goals whilst satisfying customer needs.
These solutions enable clients to acquire the latest technologies within budget, improve productivity, help future proof their investment (ROI) and minimise the risk of technology obsolescence.
Kevin, commenting on the appointment, said: ‘I am delighted to have joined the team at Snowbird Finance to lead the business development programme.
‘This is an exciting time with so many product initiatives and new technological innovations, we want to develop the way finance is delivered to suppliers, partners and customers across all vertical sectors.’
Managing director, Simon Freeman, commented: ‘We are extremely excited to have Kevin join the senior management team as business development director.
‘With his extensive, experience in developing finance schemes for suppliers this knowledge will enhance our overall offerings and capabilities.
‘We are confident Kevin will embrace the strategic vision of the business and will effectively develop and deliver successful finance solutions.’
If you would like more information please contact Srini Srinivasan, marketing director on [email protected] or call 01932 874674.
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Sophie Kwiatkowski provides a snapshot of some of the updates announced for the 2019/20 tax year.
Although you may be in the process of having your 2018/19 tax return completed for the 31 January 2020 deadline, we are currently in the 2019/20 tax year. This runs from 6 April 2019 to 5 April 2020.
So, what is new for the 2019/20 tax year?
The personal allowance is £12,500. The budget announced that the personal allowance will be frozen at £12,500 for 2020/21. The basic rate band limit has been increased to £37,500, with tax rates staying the same (basic rate is 20%, higher rate is 40% and additional rate is 45%). The lifetime allowance for pensions was increased to £1,055,000.
These points will be of interest if you have employees with benefits.
From 6 April 2019, the figure used as the basis for calculating the benefit for employees who receive free private fuel from the employer for company cars is increased to £24,100.
From 2020/21, there will be a new range of low-emission percentages when calculating car benefits. There is also the introduction of an ‘electric range’, which is the number of miles that is essentially the maximum distance for which the car can be driven in electric mode without recharging the battery.
There were new salary sacrifice rules that impose a cost on the taxable benefits based on the value of the amount of salary given up if this is greater than the charge that would otherwise be due.
The rate of writing down allowance on the special rate pool is reduced from 8% to 6%.
There has also been a temporary increase in the annual investment allowance (AIA). For expenditure on or after 1 January 2019, the maximum AIA is increased to £1 million (previously £200,000). This means you can gain tax relief on assets purchased for your practice to a much higher value than before. This is only for a two-year period, so make the most of it.
This is just a snapshot of some of the tax updates announced, so if you want to know more on any of the points raised, speak to your accountant.
For more information visit pfmdental.co.uk.
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Sugar levels in drinks covered by the sugar tax have dropped 10 times faster than foods outside the levy.
Public Health England is challenging the food industry to reduce sugar in the rest of its products by 20% by 2020.
It hopes this drop in sugar will help to improve the level of obesity and tooth decay seen in children.
‘The report shows a mixed picture,’ Dr Alison Tedstone, chief nutritionist at PHE, said.
‘Encouragingly, some businesses have made good progress in reducing sugar.
‘But some businesses and categories have made very little or none.
‘We know the public wants the food industry to make food healthier.
‘It is clear this can be done.
‘But we urge the whole of the food and drink industry to keep up the momentum to help families make healthier choices.’
‘Delivering the goods’
The British Dental Association (BDA) argues this ‘voluntary challenge’ to the food industry doesn’t go far enough.
Voluntary measures saw only a 2.9% reduction in the sugar content of foods outside the sugar levy since 2015.
Only cereals and yoghurts are on track to reach a 20% reduction before 2020.
‘The sugar levy is delivering the goods,’ BDA chair, Mick Armstrong, said.
‘It shows hard and fast policy beats volunteerism when it comes to making the food industry change its ways.
‘Ideology must never trump evidence when it comes to public health.
‘Sugar is fuelling both tooth decay and obesity.
‘It is not “nanny statism” to follow tried and tested policies that can help reduce that burden.’
Carrot or stick
Sugar content in drinks covered by the sugar tax has dropped by 28.8% on average between 2015 and 2018.
Despite this, the total tonnes of sugar sold in foods included in the reformulation programme has increased by 2.6%.
‘We all try to get the balance right between the “carrot” and “stick” approach,’ Professor Michael Escudier, dean of the Faculty of Dental Surgery at the Royal College of Surgeons, said.
‘But we see today it’s the sticks that are working.
‘The soft drinks industry levy has been successful, with sugar content in fizzy drinks reduced by an average of 28.8%.
‘Meanwhile progress has been limited for the products covered by the voluntary sugar reduction programme.
‘We call for the government to consider extending the soft drinks levy to cover sugary dairy drinks.
‘Reducing children’s sugar intake is vital to tackling child tooth decay.
‘Statistics published yesterday show tooth decay remains the leading cause of hospital admissions for five to nine-year-olds, despite being almost entirely preventable.’
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Mark Topley talks to Ben Wilkes about how businesses can get the most out of working with charities.
For more information on the work of Children on the Edge visit www.childrenontheedge.org.
To hear more from Mark Topley visit marktopley.co.uk.
The post Business and charity tips appeared first on Dentistry.co.uk.
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Young dentist, Laura Beresford Pratt, explains why once she’d tried Palodent V3, she couldn’t go back to using any other sectional matrix system.
Class II restorations are something I perform every day as part of my private practice in Hailsham, East Sussex. Therefore, the materials that I use need to enable me to deliver long-lasting aesthetic restorations to my patients. Key to that is finding a sectional matrix that can give me reliable contact points even for deep cavities.
I was introduced to Dentsply Sirona’s Palodent V3 system in 2015 during my foundation year and it immediately impressed me. In particular the accurate contact points I could achieve with it, especially in comparison to the circumferential matrices I had used before.
Keeping in contact
The design and methodology of the Palodent V3 Sectional Matrix System makes creating predictable, tight contact points and a natural tooth shape much more achievable. The matrix band is shaped to fit snugly around the tooth and is thin so that contact is easier to achieve. It is then held firmly in place by the wedges and the ring.
I found that without the Palodent V3 matrix, I would often achieve a weak contact point where the teeth might not be touching at all or the contact point would be very narrow. The sectional matrix provides a longer contact, which helps minimise the risk of fracture, caries and periodontal disease.
When using the system I am able to perform composite restorations in really deep cavities. Instead of relying on the amalgam to push the matrix band out, the Palodent V3 matrix band is already in a good position for an effective composite restoration. I now use it for all my class II restorations that require a matrix band.
When I joined my current practice, I requested that we start using the Palodent V3 System and was delighted when my request was granted. It was at this time that I was introduced to the rest of Dentsply Sirona’s Class II Solution; universal adhesive Prime&bond active, bulk fill SDR Flow+ and capping composite Ceram.x Spectra ST (formerly Ceram.x Universal), all of which which I now use and give me an extra edge as they were designed to work together.
Success linked to quality of materials
My restorative failure rate is low, which I believe is partly due to the quality of the materials I am using, in particular the matrix band, which is the foundation of a long-lasting restoration. Repeat treatments and the consequent loss of valuable chair time can be a significant drain on practice budgets. My low failure rate and the added efficiency that Palodent V3 and the rest of the Dentsply Sirona Class II family has made possible means that I can fit in more treatments, which is a win for both me and my practice.
To find out more about the Dentsply Sirona extensive range of restorative solutions please visit www.dentsplysirona.com/classII or call 01932 838 338.
You can visit the online Dentsply Sirona Academy for a wide range of education resources, video tutorials, courses and CPD webinars at dentsplysirona.com/ukeducation.
Earn Dentsply Sirona Rewards on all your restorative solution purchases at dentsplysirona.com, all the solutions you need under one roof.
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Designed to Smile, the Welsh oral health scheme aimed at improving children’s oral health, is celebrating its 10th birthday.
Since its launch in 2009, tooth decay in five-year-old Welsh children has dropped by more than 10%.
There has also been a 35% reduction in the number of children undergoing dental procedures under general anaesthesia.
‘There is no doubt that prevention works, and results in less children suffering and having to take time off school due to tooth decay,’ Minister for Health and Social Care, Vaughan Gething, said.
‘Studies show children with decay in baby teeth are three times more likely to have decay in their adult teeth.
‘We need to make every effort to keep children decay free by five.
‘The last 10 years have shown what can be achieved through preventative measures.
‘A scheme that was criticised by some when first introduced has brought about great changes and had a significant impact on children’s dental health.
‘Whilst we celebrate this milestone, we must strive to eradicate tooth decay completely.’
The British Dental Association (BDA) Wales is using the opportunity to urge the government not to rest on its laurels.
It highlights concerns that Designed to Smile is taking budget away from treating older children.
Several health boards have stopped offering fluoride varnish applications to six to seven-year-olds, BDA Wales claims.
‘Designed to Smile has made significant inroads, but the Welsh government cannot rest on its laurels,’ Lauren Harrhy, deputy chair of the BDA’s Welsh General Dental Practice Committee, said.
‘Tooth decay remains the number one reason for hospital admissions among our children.
‘Yes we’re playing catch-up, but we still lag behind England in terms of oral health.
‘This scheme shows prevention works.
‘So we need real investment from Ministers not penny pinching.
‘And we need a willingness to act on a crisis that’s left barely a quarter of NHS practices taking on new child patients.’
Lack of NHS availability
BDA research shows only 27% of Welsh dental practices are taking on new child NHS patients.
Almost half (41%) of dental practices in Wales say they are taking daily enquiries from new patients seeking appointments.
One practice in Cardiff and Vale reported receiving more than 60 calls a day from would-be patients.
‘These figures confirm that the current NHS contract arrangements for dentists simply aren’t working,’ Plaid Cymru AM, Dr Dai Lloyd, said.
‘The low number of practices taking on new NHS patients and the variation between different parts of Wales is a significant concern.
‘People are not receiving the services that they need.
‘Recently, the Health, Social Care and Sport Committee undertook a review of dentistry in Wales.
‘We were clear that changes need to be made by the Welsh government in order to improve matters.
‘The current contract arrangements need to change if we are to see improvements.’
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Ivoclar Vivadent introduces its Bluephase Power Cure, which can cure in three seconds.
For more information visit www.ivoclarvivadent.co.uk/en-uk/specials/bluephase-powercure-appt.
The post The three-second Power Cure appeared first on Dentistry.co.uk.
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Damian Panchal lists some of the things to consider to avoid litigation when undertaking endodontic treatment.
Involving your patient
With a growing fear of litigation among young dentists, it is important that you take all the necessary steps to avoid a complaint in this increasingly litigious society.
During your undergraduate training, if the clinical situation dictated, root canal treatment was often the procedure of choice. There was little conversation about the risks and complications that can arise, as quite often specialists were on hand to provide assistance. However, the answer is not always root canal treatment.
When your head says, ‘taking the nerve out will solve the problem’, you need to stop, sit down and have a lengthy discussion with your patient about what they would like to do next. You will be surprised at how many people are not prepared to undergo multiple lengthy appointments for a procedure that does not have a 100% guarantee of success.
Whilst you may be thinking, why would you rather have the tooth out when we can at least try and save it, ultimately it is not your decision to make. You are there to advise in your patient’s best interests, however it is their tooth and therefore their choice.
Risks and complications
Root canal treatment comes with its own extensive list of risks and complications. A written consent form can be a useful aid to gaining informed consent.
Sometimes a patient’s only knowledge of root canal treatment is ‘I have heard it hurts’. It is your job to alleviate their concerns whilst ensuring they understand what the procedure involves. To ensure their consent is valid, it needs to be voluntary, informed and the person must have capacity to make that decision. Capacity is assessed by an individual’s ability to understand and retain the information, use or weigh up that information and communicate their decision back to you.
Your consent form should highlight who will be undertaking the procedure and on what tooth it will be completed on. You should always offer the option of a referral to a specialist endodontist for an improved prognosis. This is part of offering all of the treatment options, whilst ensuring you are covering yourself medico legally if anything unfortunately does go wrong.
There are at least seven risks that should be explained to each patient for all root treatment procedures. These need to be explained in terminology they can understand and can be supplemented with visual aids and radiographs where appropriate.
- Failure of canal location and negotiation
- Failure to remove existing root filling material
- Blockage of the root canal
- Fracture of an endodontic file within the root canal
- Tooth fracture
- Root perforation
- Hypochlorite accident.
Using your professional experience and judgement you should then highlight which of these risks are particularly relevant for their tooth. Ensure a thorough assessment has been completed and consideration paid to factors that complicate the procedure. The AAE Endodontic Case Difficulty Assessment Form and Guidelines (www.aae.org, 2010) can be a useful document to aid your discussion with the patient and give a realistic expectation of the prognosis.
Whilst many patients will sign where they are told without reading the risks, all material risks and complications should be explained to the patient to ensure you are gaining informed consent. A signature on a consent form is not evidence that consent has been gained and is of secondary importance to the quality of your communication and information you have provided.
The best means of avoiding litigation is to involve your patients, give them time to think and ask questions, and provide treatment that is within your experience and comfort. Complications do happen, it’s the nature of root canal treatment, but your patient needs to understand these risks before it happens, not once it has happened.
www.aae.org/specialty/wp-content/uploads/sites/2/2017/10/2006casedifficultyassessmentformb_edited2010.pdf (2010) accessed 21 April 2019
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The BOS is announcing a partnership between itself and the Oral Health Foundation today at the British Orthodontic Conference (BOC).
The BOS and Oral Health Foundation announced a national campaign to warn patients about risks from ‘direct to consumer’ orthodontics.
This joint campaign will advise patients to visit a trained clinician, thus ensuring they are fully informed.
‘We are teaming up with the OHF as we are concerned about the potential harm of DIY orthodontics on patients,’ president of the BOS, Jonathan Sandler, said.
‘As the demand for adult orthodontics increases, so do the options for patients,’ Dr Nigel Carter, chief executive of the Oral Health Foundation, said.
‘We are seeing a growth in online companies offering orthodontic treatments at significantly reduced prices.
‘Orthodontics should always involve face to face contact with a trained clinical professional.
‘This is to ensure safety and effective treatment.’
The American Association of Orthodontics’ views mirrors the position of the BOS and OHF.
Speaker Dr Jay Bowman from the American Association of Orthodontics said: ‘I share many of the same concerns about direct to consumer treatments.’
The BOS and the OHF have jointly developed a website for anyone seeking information about orthodontic treatment.
This will be launched in December 2019.
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