T T April 2017 by Dental Technologists Association

volume 10 issue 2 april 2017

issn 1757-4625

the

technologist the official journal of the dental technologists association

In this issue: The digital world (part 2) Infection control for the dental laboratory A perspective on shade taking

HOURS OF VERIFIED CPD PLUS 1 HOUR OF UNVERIFIED CPD IN THIS ISSUE!

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technologist in this issue Editor: Vikki Harper t: 01949 851 723 m: 07932 402 561 e: vikki@goodasmyword.com Advertising: Sue Adams t: 01452 886 366 e: sueadams@dta-uk.org

DTA administration: Sue Adams Chief Executive F13a Kestrel Court Waterwells Drive Waterwells Business Park Gloucester GL2 2AQ t: 01452 886 366 e: sueadams@dta-uk.org DTA Council: James Green President Delroy Reeves Deputy President Tony Griffin Treasurer Andrea Johnson John Stacey Gerrard Starnes Marta Wisniewska

Editorial panel: James Green Tony Griffin Andrea Johnson

Design & production: Kavita Graphics t: 01843 583 084 e: dennis@kavitagraphics.co.uk

Published by: Stephen Hancocks w: www.stephenhancocks.com

news

dta column

hr facts: the perfect match

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getting the most out of your accountant

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introduction to CoDTEI and dental technology education

the digital dental world: part two 10

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infection control for the dental laboratory: part one

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shade taking using the 5th generation easyshade

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classifieds

dental technology showcase 2017 20 continuing professional development

The Technologist is published by the Dental Technologists Association and is provided to members as part of a comprehensive membership package. For details about how to join, please visit: www.dta-uk.org or call 01452 886 366 ISSN: 1757-4625

Find out the 11 reasons to join DTA by visiting:

www.dta-uk.org the

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Views and opinions expressed in the publication are not necessarily those of the Dental Technologists Association.

Cost effective professional indemnity insurance for dental technicians and laboratories

Tel: 01634 662 916

2 april 2017

news&information

■ DEDICATING A YEAR OF SUPPORT Crisis is the national charity for single homeless people and we are proud that DTA members voted to support it during 2017.

■ NATIONAL MINIMUM WAGE AND NATIONAL LIVING WAGE National Minimum Wage The National Minimum Wage (NMW) is the minimum pay per hour most workers are entitled to by law. The rate will depend on a worker’s age and if they are an apprentice. The National Living Wage The Government’s National Living Wage was introduced on 1 April 2016 for all working people aged 25 and over, and is currently set at £7.20 per hour. In April 2017 it will go up to £7.50. The current National Minimum Wage for those under the age of 25 still applies. Rates of pay It is important to note that these rates, which came into force 1 October 2016, apply to pay reference periods beginning on or after that date. The rates from 1 October 2016 are: ■ ■ ■ ■ ■

£7.20 per hour – 25 yrs old and over £6.95 per hour – 21-24 yrs old £5.55 per hour 18-20 yrs old £4 per hour – 16-17 yrs old £3.40 for apprentices under 19 or 19 or over who are in the first year of apprenticeship.

risis is dedicated to ending homelessness by delivering lifechanging services and campaigning for change. The charity explains that homelessness is about more than rooflessness. A home is not just a physical space; it also has a legal and social dimension. A home provides roots, identity, a sense of belonging and a place of emotional wellbeing. Homelessness is about the loss of all of those things. It is an isolating and destructive experience and homeless people are some of the most vulnerable and socially excluded in our society.

Crisis aims to: ■ do more for more homeless people in more places across the UK and help to change their lives for good ■ change the way society thinks and acts towards homeless people After years of declining trends, 2010 marked the turning point when all forms of homelessness began to rise. However it is likely that homelessness will increase yet further as the delayed effects of the economic downturn, cuts to housing benefits and other reforms all start to bite.

Much more than putting a roof over people’s heads People become and stay homeless for a whole range of complex and overlapping reasons and solving homelessness is

The rate will then change every April starting April 2017. The rates from 1 April 2017 will be: ■ ■ ■ ■ ■

£7.50 per hour – 25 yrs old and over £7.05 per hour – 21-24 yrs old £5.60 per hour – 18-20 yrs old £4.05 per hour – 16-17 yrs old £3.50 for apprentices under 19 or 19 or over who are in the first year of apprenticeship.

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about much more than putting a roof over people’s heads. The isolation and destructive nature of homelessness means that homeless people find it difficult to access the help they need. There is no national figure for how many people are homeless across the UK. This is because homelessness is recorded differently in each nation and because many homeless people do not show up in official statistics at all. Crisis’ work is split into key areas such as employment, education, housing and Crisis Skylight Centres – its award-winning and accredited education, training and employment centres.

Employment Lack of work is a major cause and consequence of homelessness. Crisis’ employment coaches help people find their own route towards a new job or career. Eighty per cent of homeless people say they want to get back into work.

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TO CRISIS – THANKS TO YOUR VOTES Education Lack of skills and qualifications can lead people to become and stay homeless, isolated from society, work and independence. Education is at the heart of Crisis – supporting people to build knowledge and skills, grow in confidence and feel more positive about the future.

Housing The Crisis housing service breaks down the barriers homeless people face when finding a rented home. Renting Ready training helps prospective tenants learn about budgeting and bills, finding flatmates or DIY. Crisis also works with landlords to ensure a supply of places to live – both directly and through projects supported across the UK.

Health and wellbeing Six out of ten homeless people suffer from loneliness. Coming to Crisis’ classes can be a chance to re-connect socially. Its health and wellbeing coaches help people identify specific challenges and rebuild the self-esteem shattered by homelessness.

Articulate e-journal Are you receiving Articulate by email? If not, let us know your current email address and we can add you to the mailing list. Alternatively, you can view each issue on the website in the publications section. Each issue contains at least 30 minutes of CPD.

family and home. Every Christmas Crisis provides companionship and support to tackle loneliness and isolation, and help people take their first steps out of homelessness.

Policy and research With more than 40 years of work, Crisis has built up a huge body of expertise and experience, directly influencing policy and practice in a number of areas. The charity also delivers and commissions research to better understand the causes and nature of homelessness.

Get involved You can support Crisis by volunteering your time, raising funds by joining an event or organising your own event or donating money – all help enormously.

letterstotheeditor

Christmas Christmas can be an incredibly difficult time of year for a person cut off from

■ For more information visit www.crisis.org.uk

Editorial Assistant The Dental Technologists Association wants to recruit an Editorial Assistant to support the editors of The Technologist and Articulate. You will be expected to support the editors by sourcing appropriate articles for publication, peer reviewing copy and setting CPD questions. As part of the role, you will be expected to attend DTS and Dental Showcase to develop networks, and an annual planning meeting. You must have an appropriate dental technology qualiﬁcation and ideally be registered with the GDC.

From: Diane Shannon CPD Questions: The use of removable appliances in place of fixed appliances Comments: Found this article interesting and very easy to follow. From: William J Waugh CPD Questions: The digital dental world Comments: Bioengineering, whatever next? From: John D Marsden CPD Questions: The digital dental world Comments: Excellent, keep up the good work. From: K Parmar CPD Questions: The use of removable appliances in place of fixed appliances Comments: Interesting and a good learning curve.

This is a part time, self-employed post. For further details please contact the DTA ofﬁce on 01452 886 366. the

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4 april 2017

thedtacolumn

■ THE DTA COLUMN

GDC consultation – Shifting the Balance: A Better, Fairer System of Dental Regulation On 26 January James Green and John Stacey attended the press launch of Shifting the Balance: A Better, Fairer System of Dental Regulation at the General Dental Council (GDC) offices in Wimpole Street, London, on behalf of DTA. The GDC believes there needs to be a fundamental rethink regarding the way dental professionals are regulated. The Shifting the Balance programme has been launched to ensure that dental regulation is fit for the future and builds on many of the themes set out in Patients, Professionals, Partners, Performance, the GDC corporate strategy for 2016–2019, which was launched last year. In recent years the GDC has made a significant investment in improving its

performance and this has required changing the way it functions, especially how its workload and related costs are managed. The GDC says its current business model has a limited shelf life – a signiﬁcant change is required and it wants to work with patients, the public and the profession to make this change.

The GDC needs help with this work and is working closely with stakeholders, including patients, professionals and partners, throughout this process. The GDC wants to know what registrants think about the proposals in Shifting the Balance and welcome responses to their plans. ■ Access the Shifting the Balance

A key driver of GDC costs are ﬁtness to practise investigations, which may not always be the best way to deal with the wide range of conduct and performancerelated issues that are raised; many could be resolved better by other organisations but there are limited processes available to reroute these issues to a more appropriate body. Part of the solution will be providing clearer information about where a complaint might be best dealt with.

discussion document here: http://www .gdc-uk.org/Newsand publications/ consultations/Documents/Shifting %20the%20Balance.pdf ■ Responses can be submitted via the

online survey here: https://gdc.online surveys.ac.uk/shifting-the-balance

Dentaid A big thank you to everyone who made a donation to Dentaid when paying their subscription. Just over £200 was donated and we will be presenting this to Dentaid at the DTS in May.

DTS 2017 If you are attending the show, come along to the DTA stand and say hello. We are keen to talk to as many members as possible and to find out how DTA can support you, your career needs and your business. You’ll find us on stand D20.

Congratulations to Edmund Proffitt, currently BDIA's Policy and Public Affairs Director, who has been appointed its new Chief Executive.

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Keep in touch with DTA on Facebook and Twitter:

@DentalTechnologistsAssociation

@The_DTA

april 2017 5

hrfacts

■ The Perfect Match Standards for the Dental Team: Standard 7.3 Update and develop your professional knowledge and skills ■ Educational aim: – to understand what employers and employees are respectively looking for to thrive and find success ■ CPD outcomes: – to understand the drivers of employee and employer job satisfaction and the criteria for each – to be informed and better able to engender a positive working relationship and environment

Are employers and employees looking for the same thing? Richard Mander looks at recent research from the CIPD (Chartered Institute of Personnel and Development) and identifies five areas where there may be a good match between what employees want from work and what employers need in order to be successful. Bearing these in mind during the recruitment process and beyond can help your business to thrive.

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1. Employability

op of the list of things that most people want from work is the ability to develop themselves – be the best they can be. Despite the importance of salary and the nature of the work, this factor comes out head and shoulders above all others in recent surveys to assess what people want from work. And the best employers have a key role to play in this by providing the right training and development opportunities for people to grow their careers. From an employer’s perspective, what’s not to like about increasing the skills of your workforce? Well, in fact it’s a fear of developing your staff to see them walk out of the door to a competitor that’s often cited as a major concern! The reality is that this risk is overstated and the benefits of that added horsepower could really make a difference to your business, whilst locking good people in for longer.

2. Fairness and equality The next fundamental expectation most employees have from their work is fair treatment. Although reinforced by employment legislation and discrimination law, it goes much deeper than that as a way in which employees gauge what ‘type’ of company they are working for and if the culture fits their ideal.

It’s easy for employers to sign up to the idea of equality at work but much harder to deliver on. Delivering fairness in the workplace can be messy as it relies upon managers and supervisors making good judgements, often about subjective matters. Differential treatment can stem from basic prejudice, poor policies or working practices but most often in my experience from weak management. Often it’s the more demanding, belligerent employees who get the best ‘deals’ at the expense of others when managers fail to confront issues.

The solution can often be found in developing a good equality and diversity policy, coupled with an investment in good supervisory and management training, to nip issues in the bud before they develop into problems.

3. Influence Most employees crave a level of influence over their work and the decisions that might affect them. The more enlightened employers understand this and consult widely on the big decisions that affect their employees when changes are necessary. Again, it can feel counterintuitive for an organisation to give away control over such important matters. Clearly there may be highly confidential situations where this is not always possible, but in the main, business decisions are more rounded and effective with the benefit of employee input. For smaller businesses this can mean making sure that you consult in advance of implementing change and where possible incorporate employee views into the final decision.

4. Reward Beyond fair pay for the job there are a number of ways in which a match can be found between employee and employer needs in the area of reward and recognition. Well-designed bonus schemes can help employees to focus on the areas that make the biggest difference to an employer’s success. There is also a growth in the number of employers offering a longer-term stake in the success of the business through ‘share’ and ‘partnership’ schemes. Overall, ‘team performance’ bonus schemes linked to company objectives are growing and are seen as more effective than traditional appraisal processes which struggle to truly differentiate at an individual level. the

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6 april 2017

hrfacts

businessaccounting

■ Getting the most out Standards for the Dental Team: Standard 7.3 Update and develop your professional knowledge and skills ■ Educational aim: – to have an awareness of how accountants can assist your business and what criteria to review before choosing one

5. Information Finally, does it go without saying that a well-informed workforce will operate more effectively than otherwise? You might think so, but in reality many organisations struggle with getting the balance right on this one. Little and often is the best approach here but it requires a significant amount of effort even in a small business to keep everyone on the same page. Delegate this task to the natural ‘bloggers’ within your organisation and take advantage of the latest technology to keep everyone up to date, bearing in mind that the most effective way of communicating information is still ‘face to face’. Additional information: Sample policies covering equality and diversity and training and development can be found in the membership area of the DTA website.

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■ CPD outcome: – to be aware of the different skill sets available, what they cost and how they can assist and influence your business

As a new or well-established business, your relationship with your accountant is an important one. Many people see their accountant as a necessary evil rather than an important part of your successful business. A good accountant can take away many of the headaches that can bog down a business owner and they can free up your time to do what you do best! Here, I look at the top ten things to consider when choosing or getting the most out of your accountant.

1. Who should I choose?

he term ‘accountant’ is not a protected name so beware who you choose to look after your accountancy needs. To help ensure the person you choose is appropriately qualified, and is adequately insured, I would strongly recommend you choose either:

Richard Mander Richard Mander is a freelance HR consultant with over 25 years’ experience. If you would like to ﬁnd out more about this topic or advice on other HR matters, you can contact him at www.manderhr.com 07715 326 568.

a) a chartered accountant or b) a chartered certified accountant These are the two primary recognised accountancy bodies in the UK, and their members must be qualified and insured, which should put your mind at rest! Chartered accountants are members of the Institute of Chartered Accountants in England and Wales (ICAEW) and chartered certified accountants are members of the Association of Chartered the

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Certified Accountants (ACCA). So look out for those details in any information relating to a prospective accountant.

2. What size firm should I choose? Accountancy firms come in many shapes and sizes from sole practitioners to large multi partner firms. But which is right for you? It really depends on whether you need specialist advice or whether your affairs are relatively straightforward. If your affairs are complicated, for any particular reason (maybe you trade in overseas markets with complicated VAT or tax consequences), then you might need the additional specialist knowledge a larger firm can offer. If your affairs are more straightforward, then a smaller one- or two-partner practice should be more than adequate for your needs.

3. What should I pay? If you need to use a larger firm with more specialist knowledge then obviously it will cost you more, so if you don’t need that advice then do use a smaller firm with smaller fees.

4. What can they do for my business? Most accountants will offer the traditional services of preparing your business accounts and preparing your tax return, but please remember that they can offer a whole lot more, including: a) preparing your VAT returns b) looking after your wages and PAYE records

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of your accountant! If you are a limited company, then I would suggest that you need to use an accountant to at least prepare the final statutory accounts that need to be filed with Companies House and HM Revenue and Customs. These accounts are much more complicated than those for a sole trader and need to comply with the latest Companies Act and accounting guidelines.

7. Other services c) dealing with Companies House if you are a limited company d) giving ongoing advice as required

5. What about a bookkeeper? When would using a bookkeeper be more appropriate? Bookkeepers can relieve you of the burden of keeping your day-to-day records. This would include keeping records of your sales and business costs but would not include the final accounts or tax services. Bookkeepers are not as well qualified as accountants but would normally be cheaper than an accountant if you do want someone to keep the day-to-day records for you. You would still need to use an accountant to prepare the final accounts and sort out the tax consequences.

6. Do I need an accountant at all? If you are a sole trader or traditional partnership then you may not need the services of an accountant! If you feel you are competent and your accountancy and taxation affairs are relatively straightforward then you may wish to forego the need to appoint an accountant. It would, however, be important to look at the amount of time it is taking you to deal with all these non-income earning activities to make sure that your time could not be more productive by focusing on what you do well and use an accountant to free up that time for you!

It is important to realise that your accountant can be much more than just the person who does your final accounts and tax return. They can be an important cog in the wheel of your business success. They have a vast amount of business experience and as an independent consultant could give you invaluable ongoing advice on your business. Many accountants offer business coaching and advice alongside the traditional accounts preparation services and getting an independent eye to look at your business could give you invaluable insights into how you could improve things and ultimately make more money!

8. When should I speak to them? Many new businesses leave it until their first year is over before appointing an accountant and likewise ongoing they just contact them each year after the year end is over. I would strongly urge you to speak to your accountant on a regular basis because once the year end is over, it is often too late to make any adjustments that may benefit you and your business when it comes to your tax liabilities. Important changes can be made prior to your year end, which may drastically improve your tax burden, so please take the time to have a chat with your

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accountant to see if there is ac anything you gett count ing ants could be doing the most at this time. If you are a limited company then your accountant should be reviewing the company affairs on a regular basis, normally quarterly, to see how things are going and advise you on any potential dividend that could be voted and the corporation tax charge that is accumulating in the business so you can be prepared in advance.

9. Aren’t they all the same really? All accountants are different and it is important that you find one whom you feel you can talk to and get along with! You need to feel comfortable with the person who is looking after your important monetary and business affairs, so do shop around and if you do not feel comfortable then keep looking until you find the right accountant for you.

10. Conclusion An accountant is often maligned, but finding the right one for you and using them and all their skills whilst freeing up your time to do what you do best can be an important step on the road to business success.

About Peter Blake Peter Blake is a chartered accountant, business coach and master practitioner of NLP. He has his own practice based in Wiltshire, lectures on ﬁnance and mentors new business start-ups for Gloucestershire Enterprise Ltd. For further details, contact Peter on 07912 343 265 or email peterblake@pbcoachingandtraining.com the

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april 2017 9

CoDTEI

■ Introduction to CoDTEI and Dental Technology Education By Chet Geisel Leadership). A simple browse through will hopefully highlight two things: 1: It’s not a simple task to develop and maintain a GDC recognised programme for dental technology: there are many constraints to address in practice and documentation.

Dental technology education is a bone of contention in our profession. Debate centres on several issues: levels and qualifications; broad practical competence and knowledge; and cost, length and mode of study across the various educational institutions. What I think we all agree on is the need for education in the profession.

ental technology has evolved tremendously in the recent past (and is still evolving), and professional education must go hand in hand with that, but underpinning it all must be consistency – that’s the goal. Educational differences exist because of the powers that be in government and the teaching institutions. The Conference of Dental Technology Educational Institutions (CoDTEI or ‘Cody’ for ease) is a group that comprises dental technology teaching staff and managers/directors in participating UK educational organisations. CoDTEI continues to evolve itself in order to maintain currency and improve its effectiveness, and it aims to achieve its purpose through the dissemination of information via regular articles in the trade press. Our articles focus on a raft of topics aimed at clarifying confusion and addressing unanswered questions

regarding dental technology education. Their main aim is to engender an understanding among practising technicians of the need for good quality education, and to give an insight into how it might be accessed and achieved through existing educational vehicles. The General Dental Council’s requirements of educational institutions across the dental professions can be found on its website, and you are encouraged to browse the ‘Preparing for Practice’ publication for dental team education. The final section is pertinent to dental technology, and as you are probably aware, all institutions are required to meet every condition in the four categories (Clinical, Communication, Professionalism, and Management and

2: Given the above, there are still aspects of the document that allow for flexibility and leeway, and as mentioned earlier, complications are exacerbated because of differences in levels and qualifications, broad practical competence and knowledge, cost of study, length and mode of study, etc., across the institutions. One of the reasons for the differences in dental technology educational institutions is the flexibility of the GDC – in simple terms, we are all different because we can be. The GDC is open to the above variations and as a result many of those iterations are visible across the board. It’s a simple case of being allowed to be different in all these aspects, while still being able to maintain accreditation from the GDC. The most significant difference would arguably be qualification (or ‘level’) at graduation. We currently have routes to graduation across the UK at level 3 through to level 7, with a minimum of level 3 being recognised by the GDC for registration. This highlights the existing massive disparity and is just a small example of why CoDTEI is actively working towards consistency and transparency. CoDTEI will continue to develop and maintain standards in the sector, and with your help, input and understanding, future dental technicians in the UK will benefit and thrive. the

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10 april 2017

dentaldigitalworld

■ The digital dental world: Part Two – Blue Light Scanning Technology In the second of its new series discussing the digital dental world, The Technologist turns its attention to the latest blue light scanner technology. Standards for the Dental Team: Standard 7.3 Update and develop your professional knowledge and skills ■ Educational aim: – to gain an understanding of blue light scanning technology ■ CPD outcomes: – to understand what blue light scanning technology is and how it can be used – to understand the benefits of using blue light scanning technology

Before a dental technician can use their CAD software to start designing a restoration, whether it be a crown, bridge, coping or veneer, they must first capture a virtual impression of the patient’s dentition.

f the dentist uses an intraoral scanner this becomes very simple. The dentist scans the patient’s mouth in the surgery and emails the resultant STL file directly to the lab. In some cases, clinician and technician can share information and discuss the case in real time via a shared computer link, without leaving their respective places of work, no matter how far apart they are. However many clinicians still prefer to take a traditional impression using alginate or silicon in a tray and send it to the lab. In traditional practice this will then be used to make a plaster model that can

3D design in the Aadva software

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Blue light scanning inside an impression

Blue light scanning needs no closed compartment

be scanned using white light or laser scanning technology. For some of these techniques, powder must be applied to the model to allow the scan to fix its data more precisely. It can prove a lengthy process, and by using the latest blue light scanners, it can be by-passed completely.

the other colours in the spectrum and environmental light sources – so time is not wasted opening and closing doors.

Using a blue light system, the impression itself can be scanned to create an exact virtual model that can be instantly uploaded into the CAD software. There’s no need for powdering the impression, and blue light is so coherent the scans can take place without locking the impression behind closed doors. The first such scanner was created in South Korea by (Dental) Medit Corp, and the most recent addition to its range – the patented Medit Identica Hybrid Scanner™ – remains amongst the most advanced in its class. Laurence Grice-Roberts, Regional Sales Director for EMEA and Russia (Dental) Medit Corp, explains how the technology works. He said, ‘The enhanced blue light scanning projector supplied with the Identica Hybrid unit has been around for a year now. Its more intense light penetrates further into deep and thin areas, meaning it can scan into quite compact hollow spaces. ‘The blue light wavelength has two principle benefits: it is both the smallest in the spectrum and the easiest for the computer to identify. This makes it unnecessary for the scan area to be closed off because the software can disregard all

‘Blue is also the least available colour in normal environmental light so there’s practically no opportunity for light pollution, and thanks to its smaller wavelength, blue helps to achieve a more accurate scan reading than the longer laser or white light wavelengths. It also has the advantage of penetrating less into surfaces that are slightly transparent, like impression materials. This ensures an even more precise scan of surface detail. This also has the added advantage that reflection is greatly reduced with blue light. ‘As you are aware, white light combines every other colour in the spectrum, a fact demonstrated when shining white light through a prism or when a rainbow appears during a rain shower on a sunny day. This means that because these other wave forms are present in white light they will interact, reflect, or be absorbed when they hit coloured surfaces, causing the phenomenon known as ‘scatter’, which interferes with optimum precision.

Teeth scanned by white light, centre, provide less information than blue light, right

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c range of veriﬁore ed indications and materials, and it will work as part m & e ateria of the digital quip ls men pathway t with other manufacturer’s software and milling units. This diagram demonstrates how white light is absorbed by the skin

Powders must be applied in an effort to reduce this effect. ‘Blue light is pure, and there is no scatter, which means that powders are not required to coat surfaces and the scanned outcome is the fastest and most precise available with today’s technology. Medit designed the first dental scanner in the world to utilise blue light and it has proved perfect for scanning translucent materials, such as skin and teeth. Scanning a dental impression is simplicity itself.’ Renishaw agrees. Its DS30 dental scanner is based on the Medit Identica Blue, and is designed to bring ‘flexibility, speed, and accuracy’ to the manufacturer’s scanner line-up. Renishaw says that the use of advanced ‘blue light’ technology allows quicker and more accurate data capture into narrow and deep areas than conventional dental scanners. The DS30’s intelligent multi-view system has been designed to allow the selection of the best possible angles to precisely acquire the required data. As with the Medit unit, impression scanning is fast

and accurate, allowing the digital manufacturing process to proceed without the need for a conventional model, and the Renishaw’s multi-die mode allows for the rapid creation of high volumes of shell copings. And the DS30 is fast: it is possible to scan and design eight shell copings with collars in less than eight minutes. Thanks to its blue light technology, Renishaw considers its DS30 blue light scanner to be perfect for scanning full bridges, impression and wax, abutment pins and antagonist scanning, with no need for powder coating. Another entry to the blue light arena is the GC Aadva lab scanner, a fully automated unit featuring some of the most recent projection and measurement technology. Thanks to its use of a highend dual camera system with blue LED structured light, in combination with GC’s implant scan technology, GC says users can be assured of ‘The highest accuracy and extremely fast scanning of objects’. As with the Medit and Renishaw technology, GC’s Aadva provides an open system (exchange of STL data) for a full

A GC spokesperson explained: ‘Implant supported restorations require the highest accuracy level from scanners and design creativity from CAD software, to ensure a perfect and passive fit of the implant when seated. This is recognised as a clinical prerequisite.’ He concluded: ‘The Aadva Lab Scanner delivers it all and delivers it very quickly. Thanks to the use of its unique GC Scanflags, it enables precise capture of implant position and orientation with the highest degree of accuracy in seconds. The result is a high-precision virtual model and the perfect base for Aadva CAD design, even for extremely complex geometries such as bars and implantsupported, screw-retained frameworks. Aadva has been designed to be flexible, intuitive and functional. It meets any clinical case from crowns to implantsupported frameworks.’ GC’s Aadva Lab Scanner

Information regarding translucent material such as a thumbnail is lost with a white light scanner, left, but captured with blue light

Blue light is the least absorbed light spectrum

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12 april 2017

infectioncontrol

■ Infection control for the dental laboratory – Part one

Fig.3: Chain of infection

By Andrea Johnson, BSc (Hons), LOTA, MDTA Standards for the Dental Team: Standard 7.3 Update and develop your professional knowledge and skills ■ Educational aim: – to be aware of the risks posed to you, colleagues and patients by a lack of awareness and rigour towards infection control in your dental laboratory ■ CPD outcomes: – to get a better understanding of what the infection control risks are – to understand how infection and cross contamination occur – to be aware of the process for maintaining high standards of infection control within your dental laboratory

Cleanliness within the dental laboratory environment can be challenging at times, as the very nature of lab work is messy; however, the example you see below is most definitely not the norm or deemed acceptable in any way.

he images below (Figs:1&2) were published in The Sun newspaper on 19 January 2012 and were particular to a specific dental technician’s ‘laboratory’. He was found guilty of illegally practising dentistry as he had apparently made appliances directly for patients that were not prescribed by a dentist and were not fit for purpose. The other issue that was not discussed was the potential for cross infection that this apparently filthy environment posed.

Infection control is a huge concern for all of us who work in the healthcare industry and we must all be aware of the potential for cross infection in all aspects of our work and personal lives. So, with that in mind, we will be looking at the main modes of infection transmission and cross infection, the chain of infection, laboratory infection control procedures and bacteria and viruses, with the aim of highlighting how these can affect us inside and outside of work. The objective is to raise awareness of our own infection control procedures to enable us to find ways to break the chain of infection.

Modes of infection transmission & cross contamination The two main methods for cross infection and infection transmission are: ■ Direct contact – with patients and other people in general. Touch – hand to hand, doors, equipment such as hand pieces, keyboards and inoculation injuries are all examples. ■ Indirect contact – contaminated objects – impressions, repairs, instruments, and inhalation via coughs, colds, sneezing and the use of equipment that can cause airborne infection through microbial-laden aerosols and spatter.

How does this translate into the chain of infection & what is the chain of infection? The definition of the chain of infection is:

Fig. 1: & Fig. 2: Images published in The Sun newspaper

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Infectious agent: bacteria, virus, fungi etc Susceptible host: immunocompromised – elderly, young, post op etc

Reservoir: where the pathogen lives eg patient, equipment etc

Portal of entry: stream, ingestion etc

Portal of exit: blood, saliva etc

Transmission: direct, indirect, airborne etc

‘A circle of links, each representing a component in the cycle. Each link must be present and in sequential order for an infection to occur.’3 As you can clearly see, (Fig. 3) the chain of infection is composed of six separate yet linked sections: infectious agent, reservoir, portal of exit, transmission, portal of entry and susceptible host. Each one of these links must be present and in the correct order to form the chain. If we manage to break even just one link anywhere at all in this chain, the chain of infection will be broken and the cycle of infection cannot continue.

So how do we break the chain? We could go completely overboard with our PPE! After all, we don’t want to catch anything, do we? But is this really sensible and practical? We would have to do this for every case that came into the clinic and/or lab, so it isn’t very practical. We really don’t know which patient Fig.4: Welder in PPE

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infectioncontrol Microorganisms on a dental impression may be transferred to dental casts and remain in set gypsum for up to seven days.

has a transmissible infectious agent and who hasn’t, so why go overboard? Standard precautions are our best option: these include sensible defences, which can be used for every case that we come into contact with. We treat every single case in a standard format as if they all have something that may be transmissible and we will not miss anything. One of the single most important things that we can do to break the chain of infection is to carry out effective hand washing on a very regular basis.

Fig. 5: Booking work into the lab in a clean environment

Did you know that: ■ eighty per cent of all infections get transmitted by the hands ■ damp hands spread 1,000 times more germs than dry hands ■ the number of germs on your fingertips doubles after you use the toilet ■ up to half of all men and a quarter of women fail to wash their hands after they use the toilet ■ right-handed people tend to wash their left hand more thoroughly than their right, and vice versa ■ millions of germs hide under watches and bracelets, and there could be as many germs under your ring as there are people in Europe ■ germs can stay alive on hands for up to three hours

Laboratory infection control procedures Separate receiving area for incoming work The receiving area should be used for all items entering the laboratory and have running water and hand-washing facilities. Countertops in this area should be cleaned and disinfected on a regular basis. The technician must wear appropriate personal protective equipment (PPE) when receiving and disinfecting laboratory cases. After the items have been cleaned and disinfected, they can then be safely transferred to the production area, and because items in this area have already been disinfected, they no longer require special handling.

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It is widely known that if you repeatedly disinfect some impression materials, it can cause the impression to become damaged and/or distorted, but your safety, the safety of your team and your patients must always come first, so if in doubt, disinfect again!

Impression disinfection Alginate A number of studies have evaluated the effects of disinfection on irreversible hydrocolloid (alginate) impressions. Results have varied greatly depending on the techniques and materials evaluated.

Fig. 6: Some areas but not be disinfected effectively due to imperfections in the impression material and/or technique

We all know that ‘The responsibility for ensuring impressions and appliances have been cleaned and disinfected prior to dispatch to the laboratory lies solely with the dentist.’1 However, despite the best efforts of the dental nurses who are normally charged with the cleaning and disinfecting of these items, there is always a chance that a viable microorganism can survive the disinfection procedure by becoming trapped in a reservoir within the impression material, such as an air blow or tear, etc.

Generally, however, distortion has been found to be minimal and not clinically significant. Based on these findings, disinfection via immersion in dilute hypochlorite or iodophor is usually recommended. Elastomeric impressions Rubber-base silicone impressions can be disinfected adequately by immersion in an iodophor, diluted hypochlorite solution, chlorine dioxide, glutaraldehyde, or complex phenol for the time required for tuberculocidal activity. However, the method of disinfection should be verified with the material manufacturer to prevent distortion of the impression or loosening of the adhesive bond between the impression tray and the impression material.

Separate production area

Fig. 7: Bacteria can live on cast models for up to seven days

It is important to have a separate production area within the laboratory and NO contaminated items should enter this area. Within this production area you should not bring in untreated appliances as this also establishes the potential for cross infection. the

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Fig. 8: Polishing lathe

The rotary action of wheels, stones and burs generates aerosols, spatter, and projectiles that could spread any potential contagion across the whole laboratory environment, which is why you must use a plexiglass shield, ensure good ventilation/extraction and use the appropriate PPE when using this equipment. When pumicing and polishing you should use fresh pumice and pan liners for each case or use a disinfecting agent in the pumice and change pumice daily. Use a separate lathe for potentially contaminated items and dispose of the pumice immediately after use or try to use disposable items as much as possible. Heat sterilise as many items as possible – including rag wheels, burs, knives, spatulas, bite forks, etc., but disinfect what cannot be sterilised as required. Pressure pots, water baths, articulators, case pans, etc., should be disinfected between cases.

Separate shipping/dispatch area This can be the same as the shipping area as long as the area has been cleaned and disinfected in between. HTM 01-05 states that impressions, prostheses and orthodontic appliances must be decontaminated prior to and after placing in a patient’s mouth. Again, this is the legal responsibility of the dentist or orthodontist, but I also believe the ethical duty of the dental laboratory staff too. An interesting paper has been written by DW Williams et al. titled ‘Microbial the

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contamination of removable prosthodontic appliances from laboratories and impact of clinical storage’, which can be found at http://www.nature.com/bdj/journal/v211 /n4/full/sj.bdj.2011.675.html. It brings up some key points that cannot be ignored. It states that ‘It is recognised that the responsibility for disinfection of dental appliances between the clinic and the laboratory lies with the dentist. Similarly on receipt of the appliance from the laboratory the dentist is also responsible for disinfection before insertion in the patient’, but that ‘Dental laboratory personnel are in a position to minimise contamination of appliances during stages of production and as such should give consideration to potential areas of improvement.’ It also claims that ‘Previous studies have revealed that dental laboratories are a source of contamination, with Wakefield (1980) finding that 90% of dentures received from dental laboratories were contaminated with potentially pathogenic microorganisms, possibly originating from other patients.’ And that ‘only half (49%) of the laboratories that completed the questionnaire had a crossinfection policy, the majority (61%) did not use a disinfectant in their pumice, and 93% did not disinfect their polishing instruments. A number of other studies have discovered that pumice used for finishing dental appliances can be heavily contaminated with microorganisms and therefore this substance should be considered a serious source for potential cross-infection.’ They have looked into the disinfection of dental prostheses and found that ‘a ten minute exposure to a 1% sodium hypochlorite solution (10,000 ppm available chlorine) was an effective process for the disinfection of dental prostheses.’ They conclude with ‘It is clearly the responsibility of all the members of the dental team, including laboratory personnel, to endeavour to ensure that all appliances are correctly disinfected before they reach patients.’ Which, to be fair, cannot be argued with.

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References 1. British Dental Association, 2003 2. http://www.mylot.com/w/image/2053101.aspx accessed on 26/2/2012 at 16.00 3. http://faculty.ccc.edu/tr-infectioncontrol/chain.htm accessed on 26/2/2012 at 17.28 4. http://1300apprectice.com.au/wp-content/uploads/ 2012/01/Welder-Final.jpg accessed on 22.10 at 19.46 5. http://www.uow.edu.au/content/groups/public/ @web/@health/documents/mm/uowo25316.jpg accessed on 26/2/12 at 19.35 6. http://www.cdeworld.com/courses/4530 accessed on 27/2/12 at 19.32 7. http://lista-dentallab.com/images/pictures/ dental-main.jpg accessed on 22/2/12 at 19.31 8. http://www.keysignsuk.co.uk/imahes/products/ images/products/SIMPSONS-PPE-SAFETY-POSTER.jpg accessed on 27/2/12 at 21.27 9. http://masteryworksinc.com/wp-content/uploads/2011/ 04/broken-shains51.jpg accessed on 27/2/12 at 21.27 10. http://thesun.co.uk/sol/homepage/news/4060914/ Fake-dentist-sold-DIY-false-teeth.html accessed on 19/1/2012 at 9.00 11. Pritchard,C. (2012,November17). Is the toilet seat really the dirtiest place in the home? Retrieved September 8, 2014. From BBC News Magazine: http:// www.bbc.co.uk/news/magazine-203234304 – Overview of bacterial infections image: Häggström, Mikael, Medical gallery of Mikael Häggström 2014, Wikiversity Journal of Medicine 1 (2), DOI10.15347wjm2014.008. ISSN 20018762 [Public domain], via Wikimedia Commons – Overview of viral infections image: Häggström, Mikael, ‘Medical gallery of Mikael Häggström 2014’, Wikiversity Journal of Medicine 1 (2), DOI:10.15347/wjm/2014.008. ISSN 20018762 – All used images are in the public domain. – Mainly Chapter 33 (Disease summaries), pp. 367–392 in Fisher, Bruce; Harvey, Richard P; Champe, Pamela C Lippincott’s Illustrated Reviews: Microbiology (Lippincott’s Illustrated Reviews Series), Hagerstwon, MD: Lippincott Williams & Wilkins, pp. 367–392, ISBN: 0-7817-8215-5. – For common cold: National Institute of Allergy and Infectious Diseases (NIAID) > Common Cold. Last Updated 10 December 2007. Retrieved on 4 April 2009. – For exclusion of CMV among the main viral STDs: Lucile Packard Children’s Hospital > Sexually Transmitted Diseases (STDs) Retrieved on 5 April 2009, Public Domain, https://commons.wikimedia.org/w/ index.php?curid=6416098.

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shade taking

■ Shade taking using the 5th generation Standards for the Dental Team: Standard 7.3 Update and develop your professional knowledge and skills ■ Educational aim: – to demonstrate how an electronic shade taking system can enhance communication between the dental laboratory and dental clinic to deliver improved patient aesthetic outcomes ■ CPD outcomes: – to gain a better understanding of the factors that impact on shade taking – to learn how an electronic system can achieve more consistent results

As the renowned French painter Paul Cézanne said in the 18th century: ‘I do not think when I paint, I see colours’. The ability to ‘see’ colours is also an art in dentistry; however, there are limits to what the human eye can achieve. This is why even the most experienced eye may find that external factors can distort their perception of colour, impacting negatively on the success of the shade reproduction process right from the start.

he transfer of shade values from the surgery to the laboratory does not always run smoothly either. However, while patients in the past were quite willing to accept finalised crowns or prostheses with slight differences in appearance compared to their natural dentition, expectations today are much higher, with patients demanding restorations that are virtually impossible to distinguish from the real thing with the naked eye. As a result, prosthetics has long since been transformed from a craft based on medical and technical expertise in the area of dentistry into a complex business service, where manual skills have been supplemented by digital knowhow combined with innovative highperformance materials. For shade taking, Professor Hassel uses modern digital measuring technology – in

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Professor Alexander Hassel from Mannheim, Germany, is a guest professor at the University of Heidelberg and a specialist in dental prosthetics (DGPro). the shape of VITA Easyshade. This device is not only easy to handle, it offers superior measurement accuracy based on spectrophotometric technology that enables precise shade determination in a matter of seconds, regardless of ambient lighting or shine. According to Professor Hassel, ‘Shade taking is vitally important to a successful restoration because shade adjustment is one of the few quality criteria that allow a patient to judge the technical ability of a practitioner, and is therefore hugely important in promoting patient loyalty to a dental practice’. ‘Correct shade taking isn’t easy’, says Professor Hassel, ‘because success not only depends on the experienced eye of the practitioner, but also on several contributory factors. These include, for example, the influence of colour in the immediate surroundings, a patient’s make-up or the colour of their clothing, the intensity of daylight, or the background provided by the walls.’ According to Professor Hassel, ‘This is compounded by the fact that a tooth is never comprised of just ONE shade, but

of numerous shade effects, varying levels of enamel, and discolorations. Variations in dentition, cracks, and fissures are particularly evident in older patients.’ As Professor Hassel says: ‘Digital shade taking has become an integral part of my practice routine. The fact that shade taking can now be performed under standardised conditions using standardised devices, repeated as often as required, and offers results that are more consistent than is the case with visual shade taking, is of considerable benefit. By standardising conditions, we can eliminate numerous potential errors and further optimise our quality management process.’

From the dental technician’s perspective André Bouillon, a master dental technician from St Wendel, Germany, describes the benefits of digital shade taking and shade communication from a laboratory perspective. ‘I have used the VITA 3D-MASTER system since the beginning, and wanted to show

Fig. 1: VITA Easyshade in action – this point measurement device determines the basic shade of the tooth by measuring the shade values of the dentin core

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shade taking

Easyshade Fig. 2: A perfect shade result: ceramic threequarter crowns on teeth 44 and 45 (before implantation in region 46)

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Fig. 4: VITA Easyshade

This is why the master dental technician André Bouillon always makes sure that he has VITA Easyshade with him when determining and verifying shades in the patient’s mouth in a dental practice.

Fig. 3: Successful composite restoration in quadrant III: fast and reliable shade determination using VITA Easyshade was also important in this case

dental surgeons just how easy it is to use digital measurement to determine the shade for the VITA 3D-MASTER shade guide, and then to compare the result with the VITA classical A1–D4 shade guide, as both shade values can be displayed.’ ‘Since then, our shade results have been far more accurate, irrespective of the material used in fabricating the restoration.’

Fig. 5: Initial situation guide

This easy-to-use, wireless device gives him maximum flexibility in this regard. ‘I use Easyshade mainly in order to determine the basic shade’, he explains. ‘This device is very helpful in this respect, as the ambient lighting generally varies in each practice, and could compromise manual shade determination. Measurements using VITA Easyshade are not affected by external limiting factors of this kind. Together with the practitioner and the patient, this allows us to quickly determine the appropriate shade hue. Using the digital measuring device as an aid thus allows us to effectively double the level of reliability when it comes to precisely determining the shade required for reproduction.’

In particularly difficult cases, the m master dental & e ateria quip ls technician also men t uses this innovative little device for performing 3point shade taking, as in the case of a 48-year-old patient who drinks large amounts of tea. The patient was to be fitted with three single-tooth crowns in the upper jaw from 12 to 22. However the deposits on the patient’s teeth, resulting from her consumption of tea over the years, made manual determination of the shade difficult.

According to Mr Bouillon, the initial situation was also particularly difficult because the teeth in position 1 differed in size, demonstrated significant external mesial rotation, and also overlapped each other. The master dental technician explains: ‘Before milling, the cervical areas of the teeth were quite dark, although the basic shade of the teeth was generally quite bright. As a result, we decided to perform 3-point measurement using VITA Easyshade in order to improve determination of the initial shade of the patient’s natural dentition. Shade measurement in the lower jaw indicated 2M3 in the cervical area, 3M1 at the dentin core and 3M1 again at the incisal edge, which was why we used ENL incisal

Fig. 6: Shade determination using the VITA 3D-MASTER shade guide

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material. We then verified the shade indicated by VITA Easyshade in daylight using the VITAPAN 3D-Master Colorguide (the red shade guide differs from the blue 3D-Master shade guide in that the teeth do not have a cervical area), and we were very happy with the match. All that remained in order to create the perfect restoration was some shade customisation.’ The benefits of VITA Easyshade can also be seen in other cases. For example, the digital measuring device can be used for any patient, even those who have had almost all their teeth crowned. ‘We recently had a case where a patient only had one natural tooth remaining in her lower jaw, tooth 33’, says Mr Bouillon, ‘as all her other teeth had been crowned almost 20 years previously by another laboratory. Obviously none of the crowns were in particularly good condition any more, which made it difficult to determine the exact shade. The patient was to be

fitted with a new bridge restoration with single-tooth crowns across parts of the lower anterior jaw from 32 to 43. With Easyshade there was no problem – we simply performed the measurement on the remaining tooth 3.3, which gave us the reading 2L1.5. This then served as the basic value for the restoration. The patient was very happy with the result.’ Using VITA Easyshade, or using a VITA shade guide, the VITA Assist software guarantees exact transfer and management of the tooth information required for reproduction, thus optimising communication between the laboratory and the dental surgeon. Dental technicians and dental surgeons can record, edit and manage patient data, dental diagnoses and digital photos, and forward them via email or as a printout. It

Figs 7 & 8: A perfect result thanks to digital shade determination

Figs 9 & 10: Precise shade measurement using VITA Easyshade

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also allows tooth shade determination and bleaching procedures to be documented, as well as the interactive simulation of full and partial prosthetics. There are a variety of modules provided for this purpose, for example, VITA ShadeAssist and the VITA Tooth Configurator. Vita Easyshade Advance referred to in this article has been superseded by Vita Easyshade V. ■ We thank the writers for allowing us to print an edited version of their original article. For further information, please contact Panadent: 01689 881 788.

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classifiedadverts Guyâ&#x20AC;&#x2122;s and St Thomasâ&#x20AC;&#x2122; NHS Foundation Trust

BAND 5 DENTAL TECHNICIAN An exciting opportunity has arisen to join the team in the Crown & Bridge Laboratory at Guy's Dental Hospital as a Band 5 Dental Technician. This is a permanent appointment. You will be expected to provide a broad range of work however the majority of work will be simple fixed restorative appliances for clinical staff and postgraduate students. Ideally you should have experience in single metal ceramic crowns and bridges including resin bonded bridges, post & cores, full gold crowns including inlays and onlays, Emax crowns, single implant restorations, radiographic stents and guides. Knowledge of CAD/CAM scanning would be an advantage but not necessary as full training would be given. You must have an appropriate dental technology qualification such as the National Diploma and ideally two years post qualification work experience and be registered with the GDC. For further details / informal visits contact: Geraldine Williams, Lead Technician, Crown & Bridge Laboratory. Tel: 0207 188 1749 Email: geraldine.williams@gstt.nhs.uk Web: http://jobs.gstt.nhs.uk/job/v650678.

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dentaltechnologyshowcase2017

■ DTS 2017 DTS 2017 DTS 2017... Dealing with vertical preps At DTS 2017 Stephen Lusty will be one of many renowned speakers at The Dental Technology Showcase (DTS) this May. He will be presenting a session in the DTS Lecture Theatre entitled ‘Dealing with vertical preparations – protocols for the laboratory’.

About his session, Stephen says: ‘Vertical preparations are being used more and more and there are very few resources available on how to deal with these cases from a lab perspective. What’s more, zirconia is a material that is becoming more trusted in the dental industry so it is important for technicians to educate themselves on correct procedures for dealing with this popular material.’

Stephen’s lecture is designed to outline a standardised protocol for dealing with the increased use of vertical preparations in the practice. Delegates will be shown how to best design restorations, covering the whole workflow from making of the models to delivery of the completed products. Stephen continues:

tephen qualified in Cape Town, South Africa in 1997 and moved to London after working there for two years. Having completed various further education courses, Stephen currently runs his own bespoke dental laboratory in Cornwall and works with some of the country’s top aesthetic dentists.

‘With the growing use of zirconia in dentistry, especially with widespread inhouse milling, I will take delegates through a logical and systematic approach to working with this material, particularly when it comes to zero margin cases. This approach will give dental technicians an insight into how to achieve consistent and highly aesthetic results.’ Like many of the speakers in this year’s DTS Lecture Theatre, Stephen is also a member of the Dental Technicians Guild (DTG). The DTG is a group of dental technicians and dentists, who come together to share ideas and knowledge for the improvement of industry standards. They believe in hand-made, aesthetic restorations and aim to raise awareness of just what technicians worldwide can do.

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‘I think it is fantastic that the DTG is becoming involved in meetings in the UK’, comments Stephen. ‘The organisation exists primarily to help technicians improve themselves, so it

seems a great fit to be present at a show like DTS.’ Chaired by Phil Reddington, Stephen will join an exceptional speaker line-up in the DTS Lecture Theatre, including Von Grow (founder of the DTG), Carl Fenwick, Chris Wibberely, Bill Marais, Ian Smith, Eugene Royzengurt and Simon Newbold. Further learning opportunities will be available in the Digital & Innovation Theatre and ADI Implant Theatre, as well as throughout the 100-strong, lab-dedicated trade exhibition. Demonstrating the latest and greatest products, technologies and materials on the UK market, the array of dental manufacturers and suppliers will be more than happy to provide information, live demonstrations and fantastic deals to suit every lab. What’s more, DTS is completely free to attend for the entire team! To find out more, or to register for your free place, go online today.

DTS and The Dentistry Show 2017 – Friday 12 & Saturday 13 May 2017 – NEC Birmingham. For more information, visit www.the-dts.co.uk, call +44 (0) 20 7348 5270 or email dts@closerstillmedia.com

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dentaltechnologyshowcase2017 One Step Back, Ten Steps Forward At DTS 2017 Dentistry today is ablaze with cutting-edge technologies, all designed to simplify the professional workflow while enhancing the clinical outcome and patient experience.

dvancements in this field have boomed in the past decade, propelling dentistry into the digital era. Indeed, many suppliers suggest that only with their latest innovations can dental teams achieve the very best results, accrediting state-of-the-art software and equipment with the progression of the profession as a whole.

Born in Johannesburg, South Africa, Bill moved to Cape Town at the start of his high school years and graduated as a registered dental technician from Cape Peninsula University of Technology in 1993. After working in a dental laboratory in South Africa for three years, Bill immigrated to the USA. In 1999 Bill opened his own lab (Disa Dental Studio is a one-man lab focusing on high-end, complex, combination cases) in Santa Monica, California, which relocated to Portland, Oregon, in January 2011. Bill is also a key opinion leader for GC America and he lectures and teaches internationally. Bill comments:

While the value of modern technologies in dentistry today cannot be disputed, the sheer volume of products available on the market creates a new problem. How do you know which to purchase? How do you choose between manufacturers? What should you look for with regard to equipment and customer service? Further still, how much of your business really depends on the technology you purchase? Is the opportunity to double your bottom line – as advertised by manufacturers – really afforded by the technology alone? Aren’t there other factors at play? Bill Marais believes there’s a lot to be gained by going back to basics.

‘The market for systems manufacturing dental restorations and prostheses today is tremendously overwhelming – for dental technicians and dentists alike. Extreme pressure from marketing propaganda dictates that in order to prevent “falling behind” in an advancing health field, one must follow a particular course: a path to advance you in the dental field. Purchase a particular system and you will advance your lab, your skills and your artistry. ‘Circumstances dictated my professional choices several years ago. Because of my situation, I was forced to resort to using the fundamentals of dental technology. Reverting to the basics of dental technology not only supported the survival of my business, but it took my restorative skills to a level I never imagined possible.’ Bill will be speaking at The Dental Technology Showcase (DTS) 2017, giving a lecture sponsored by GC entitled ‘One Step Back, Ten Steps Forward (Reverting to the Basics of Dental Technology)’ in the DTS Lecture Theatre. About his session he adds:

‘I will discuss how dental technicians can go back to basics to add individuality and their own “fingerprint” to each and every case that they do (applicable for both fixed and removable prosthetics). I hope this will help to give them a competitive edge in what is now a vastly outsourced and technology-driven industry. ‘In addition I will highlight the importance of removable prosthetics in every aspect of dentistry and offer my own top tips to help delegates improve their workflow. Finally, I hope to explore the importance of teamwork and communication between laboratory and practice as a means of ensuring the highest quality of prosthesis for every patient.’ The DTS Lecture Theatre 2017 has been programmed by the Dental Technicians Guild (DTG) and Bill will join an impressive speaker line-up, including Phil Reddington, Carl Fenwick, Chris Wibberley, Eugene Royzengurt, Ian Smith, Von Grow and Jason Smithson. Additional features, such as the Digital & Innovation Theatre, ADI Implant Theatre and Dental Business Theatre – delivered by Practice Plan – will offer even more insight and inspiration for delegates, with hours of vCPD available throughout. What’s more, the trade floor will host more than 100 lab-dedicated exhibitors, providing on-stand learning, demonstrations and fantastic deals for all. So whether you are looking to go back to basics and refine your skills, or to purchase new technology that will help you to raise standards, DTS 2017 is an event you don’t want to miss.

Bill Marais

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22 april 2017

continuingprofessionaldevelopment Continuing Professional Development (CPD) Programme The Technologist is pleased to include a continuing professional development (CPD) programme for DTA members in accordance with the UK General Dental Council’s regulations and the FDI World Dental Federation’s guidelines for CPD programmes worldwide. The UK General Dental Council regulations required that from 1 August 2008 all dental technicians must start documenting their CPD. They are required to complete and record a minimum of 150 hours of CPD every five-year cycle, a third of which should be verifiable CPD (50 hours). This should include verifiable CPD in the following core subjects: ■ medical emergencies (10 hours per cycle) ■ disinfection and decontamination (5 hours per cycle)

■ materials and equipment (5 hours per cycle) The questions in this issue of The Technologist will provide verifiable CPD for those entering the programme. Complete your answers for free online at www.dta-uk.org, or use the answer sheet overleaf (or a photocopy if this is preferred, so as not to remove the page). Return your answer sheet to the DTA Head Office address with your £5 payment (please note that your CPD won’t be processed without payment) before the 15 May 2017. Online and paper responses must be received by the deadline. Dental technicians completing the programme will receive a certificate for the prescribed number of hours of verifiable CPD, together with the answers to the questions either online or by post according to the above guidelines.

The Perfect Match (Other specific cpd – 30 minutes) Q1 – Research suggests that the top criteria that people look for in their work is: A – The nature of the work B – The basic salary C – The location D – The opportunity to develop themselves

Q2 – Fair treatment at work is rated highly by employees and research suggests is most heavily influenced by: A – Strict policies B – Supervisors and managers making good judgements C – The company appraisal scheme D – The company reward system

Q3 – The most effective way for employers to manage changes affecting their staff is to: A – Decide what to do and then quickly implement B – Involve managers only in developing ideas for change C – Consult all employees as early as possible and take their views and ideas into account where practical D – Make small changes on a regular basis

Q4 – The most effective bonus schemes are based on: A – Individual performance B – Paying everyone the same bonus every year C – Group or team performance linked to overall company performance D – Matching competitor bonus schemes

Q5 – Well-informed employees are better motivated and contribute significantly to business success with the most effective communication strategy being: A – Written updates B – Online updates C – A combination of face-to-face and written briefings delivered on a regular basis D – A quarterly newsletter the

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Aims and outcomes In accordance with the General Dental Council’s guidance on providing veriﬁable CPD: ■ The aim of The Technologist CPD Programme is to provide articles and material of relevance to dental technicians and to test their understanding of the contents. ■ The anticipated outcomes are that dental technicians will be better informed about recent advances in dental technology and associated subjects and that they might apply their learning to their practice and ultimately to the care of patients. Please use the space on the answer sheet or online to provide any feedback that you would like us to consider.

Getting the most from your accountant (Other specific cpd – 30 minutes) Q1 – One of the main recognised accountancy bodies is: A – IAWE B – ICAEW C – CAEWI D – AECWI

Q2 – Limited company accounts need to comply with: A – Health and safety regulations B – Disability Discrimination Act C – Companies Act D – Financial Services Regulations

Q3 – Normally a bookkeeper will not: A – Record your sales transactions B – Reconcile your bank C – Record your business costs D – Prepare your final statutory accounts

Q4 – An accountant should be seen: A – At regular times in the year B – After the end of the year C – Once in a blue moon D – As little as possible

Q5 – Why might a business need to use a larger accountancy firm? A – Safety in numbers B – Need for specialist advice C – Money is no object D – Can’t trust a smaller firm

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continuingprofessionaldevelopment The digital dental world: Part two (Materials & equipment CPD – one hour) Q1 – What kind of file is created by an intraoral scanner? A – PDF B – JPEG C – STL D – TIFF

Q2 – Does a blue light scanner require an object to be powder-coated? A – No B – Yes C – Only if the object is red D – Only if the object is yellow

Q3 – What is the name of the company that created the first blue light dental scanner? A – Renishaw B – GC UK Ltd C – Roland DG D – (Dental) Medit Corp

Q4 – (Dental) Medit Corp is based in which country? A – South Korea B – China C – Vietnam D – Japan

Q5 – Why is blue light better for precision scanning? A – The light is harder B – It contains every other colour in the spectrum C – It has a shorter wavelength D – It is easier to send by email

Q6 – What types of scanner is the blue light version compared to? A – Infrared and ultraviolet B – White light and laser C – Contact and pinpoint D – Ultrasound and dark light

Q7 – What is scatter? A – The powder used when scanning an object B – The common term for a scanner file C – The scanner light being absorbed, interacting with, or reflecting from the scanned object D – Chips of plaster knocked from a model

Q8 – What is white light made from? A – Every other colour in the spectrum B – The principal colours known as CMYK C – Refracted light from the sun D – A mix of red, green, yellow, and blue

Q9 – Which Renishaw scanner is derived from Medit technology? A – Renishaw DS15 B – Renishaw DS20 C – Renishaw DS30 D – Renishaw DS54

Q10 – What is the GC Aadva lab scanner’s unique feature called? A – Scanflags B – Scanpoints C – Scanbytes D – Scanwaves

Infection control for the dental laboratory (Disinfection & decontamination CPD – one hour) Q1 – How many main methods exist for the transmission of infection? A–1B–2C–3D–4

Q2 – Which of the following is NOT a method of indirect contact for cross infection? A – Contaminated objects B – Inhalation C – Inoculation injuries D – Microbial-laden aerosols

Q3 – Choose the correct definition of the ‘chain of infection’ A – A circle of links, each representing a component in the cycle and with each link being present and in sequential order B – A series of linked boxes, with each link present and in sequential order C – A circle of links, each representing a component in the cycle and with each link being present and not in sequential order D – A chain of circles representing the cycle

Q4 – What is the single most important thing you can do to break the chain of infection? A – Wear as much PPE as possible B – Undertake effective hand washing on a very regular basis C – Don’t touch anything without wearing gloves D – Have excellent ventilation

Q5 – What percentage of infections do the hands transmit? A – 50 B – 70 C – 90 D – 80

Q6 – Choose the correct characteristics of a receiving area for incoming work: A – Running water, hand-washing facilities, infected countertops B – Running water, hand-washing facilities, wearing appropriate PPE, disinfected countertops, production area C – Running water, hand-washing facilities, wearing appropriate PPE, disinfected countertops D – A basin of water, hand-washing facilities, wearing appropriate PPE, wiped countertops

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continuingprofessionaldevelopment Q7 – You can protect against rotary action that creates aerosols and splatter by... A – Plexiglass shield and c) only B – Good ventilation and all the answers C – Extraction systems D – PPE and a) only

C – Reliance is on an individual’s own shade perception D – Dentistry has become a complex business service and a) and b)

Q3 – Which of the following is NOT suggested as an advantage of the digital shade-taking device?

Q8 – Which of the following is NOT true: A – There should be a separate production area where no contaminated items should enter B – When pumicing and polishing you should use fresh pumice and pan liners for each case C – Disinfection via immersion in dilute hypochlorite or iodophor is usually recommended D – The rotary action of wheels, stones and burs does not pose any contamination problem

Q9 – Microorganisms on a dental impression may be transferred to dental casts and remain in set gypsum for up to how many days? A–5B–7C–9D–3

Q10– Which of the following items is it NOT recommended to heat sterilise? A – Rag wheels B – Burs and knives C – Spatulas and bite forks D – Rubber-base silicone impressions

A – Offering a wide range of digital hue determination B – Superior measurement accuracy based on spectrophotometric technology C – Precise shade determination in a matter of seconds D – The negligent impact of ambient lighting or shine

Q4 – The article suggests that because shade taking is one of the few quality criteria that allows a patient to judge the technical ability of a practitioner, it can … A – Reduce the number of remakes B – Promote patient loyalty to a dental practice C – Allow a range of chroma to be used D – Build team working

Q5 – What is NOT a factor indicated by Professor Hassel as affecting shade taking with a tab? A – The influence of colour in the immediate surroundings B – The colour of the patient’s clothing C – A patient’s skin tone D – The intensity of daylight

Q6 – Which tooth is having its dentine value assessed by the digital shade recording device?

Shade taking using the 5th generation Easyshade (Materials & equipment CPD – one hour) Q1 – With regard to dental shade taking, the writer considers that: A – Negative factors can affect shade taking and b) only B – There are limits to what the human eye can achieve C – It’s an art, and all answers D – External factors can distort colour perception

Q2 – The writer maintains that because patients demand restorations that are virtually impossible to distinguish: A – Digital know-how has supplemented manual skills B – There’s a necessity for treatments to use innovative highperformance materials

A – Upper left central B – 21 C – 11 D – 12

Q7 – Which two shade guide systems are mentioned in the article? A – Shade Light plus and b) B – Tetric and c) C – 3D-MASTER and d) D – VITA classical and a)

Q8 – According to master dental technician André Bouillon, the wireless digital device allows quick accurate determination of a tooth’s: A – Chroma B – Value C – Hue D – Spectrum

Q9 – With complex cases, André Bouillon indicated that there was an ‘X’ number of recordings taken for the shade determination: A–2B–3C–4D–5

Q10– The digital shade-taking device is supported by: A – Using digital photos and c) B – Links to denture prosthetic work C – Digital modules that assist the tooth configuration D – All the above

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Simply fill in the multiple choice answer sheet on the inside back cover and complete the form ...

april 2017

continuingprofessionaldevelopment

answer sheet the technologist april 2017 Please PRINT your details below: First Name*

Last Name*

GDC no.*

Title

DTA Member: Yes

DTA no.*

*Essential information. Certificates cannot be issued without all this information being complete.

Complete free online at <www.dta-uk.org>. First-time users will need to register; those already registered need only log in. Or, either remove this page, or send a photocopy to: Dental Technologists Association, F13a Kestrel Court, Waterwells Business Park, Gloucester GL2 2AT. A £5 payment must be included with your CPD answer sheet – please do not forget! Please note that you must achieve a score of 50% or more to receive a certificate.

Answer sheets must be returned before 15 May 2017 for CPD responses returned in the post and for online CPD users. Answer sheets received after this date will be discarded. Answers Please tick the answer for each question below The Perfect Match (Other specific cpd – 30 minutes) Question 1:

Question 2:

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Getting the most from your accountant (Other specific cpd – 30 minutes) Question 1:

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The digital dental world: Part two (Materials & equipment cpd – one hour) Question 1:

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Infection control for the dental team (Disinfection & decontamination cpd – one hour) Question 1:

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B B

Shade taking using the 5th generation Easyshade (Materials & equipment cpd – one hour) Question 1:

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B B

Feedback We wish to monitor the quality and value to readers of The Technologist CPD Programme so as to be able to continually improve it. Please use this space to provide any feedback that you would like us to consider.

An important note for non-DTA members Non-DTA members will incur a £25 fee for undertaking CPD provided through this publication. Cheques made out to DTA should accompany your answer sheet. the

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